12-Week Clinical Evaluation of Menopausal Skin Function Using Protective and Reparative Skin Care

Abstract

Background: The skin is hormonally responsive, and declining estrogen levels during menopause are linked to measurable structural and functional changes. Estrogen, along with progesterone and androgens, affects receptors involved in collagen synthesis, antioxidant activity, immune response, and barrier integrity. Estrogen deficiency disrupts these pathways, reducing skin resilience, hydration, and immune defence, contributing to visible ageing. Purpose: To investigate the clinical effectiveness, safety and tolerability of a tailored topical skincare regimen to support skin resilience, function, and radiance throughout the menopause transition, in order to manage skin changes associated with hormonal decline. Participants: Twenty subjects used skincare (The Essential Six, RATIONALE, Victoria, Australia), comprising solar protection by day and repair night for 12 weeks. No other skincare or aesthetic treatments were used during the study. Measurements: Facial imaging was performed at baseline, and after 30, 60, and 90 days. Participants completed self-assessments at each time point. Ten participants also received tailored Professional Formulations at days 30 and 60 to evaluate whether targeted in-clinic intervention enhanced outcomes compared to the remaining participants. Results: This study was performed on twenty participants who were provided with a dedicated skincare regimen to be used over 90 days at home. Half of these subjects (10) were provided with additional in-clinic professional treatment. Fourteen of the full cohort (70%) showed improvements in oxidative stress, inflammation, wrinkle depth, and hydration. Of these fourteen, seven of them (35%) had received in-clinic professional treatments. Two participants (10%) experienced transient adverse responses during the study period. Both participants developed initial cutaneous reactivity, which resolved following temporary discontinuation of active ingredients and subsequent modification of their daily skincare regimen. Conclusion: This study confirms that a targeted solar protection and repair regimen supports skin health during menopause, particularly when delivered through a combined approach composed of a structured at-home application with adjunctive clinical treatments, it yielded superior outcomes. Among the 10 participants receiving the combined approach, 70% reported improved outcomes and expressed intent to continue adjunctive treatments.

Share and Cite:

Hampton, T. , Aganahi, A. , Tanaka, Y. and Parker, R. (2025) 12-Week Clinical Evaluation of Menopausal Skin Function Using Protective and Reparative Skin Care. Journal of Cosmetics, Dermatological Sciences and Applications, 15, 120-138. doi: 10.4236/jcdsa.2025.153008.

1. Introduction

The menopause transition is a natural endocrine milestone characterised by a progressive decline in circulating estrogen, progesterone, and testosterone [1] . Given the skin’s dense expression of hormone receptors, this hormonal attenuation exerts profound effects on cutaneous physiology -[7]. Historically underexplored, the dermatological consequences of menopause are now receiving increasing scientific attention. As the skin is a hormonally responsive organ, shifts in endocrine activity during perimenopause and menopause have measurable impacts on structural and functional skin parameters -[11]. Estrogen, progesterone and androgens act on cutaneous receptors to modulate collagen synthesis, antioxidant defences, immune surveillance, and lipid barrier maintenance - . Disruptions to these systems during menopause can precipitate a cascade of adverse cutaneous outcomes, diminishing skin health and aesthetic appearance - . Targeted dermatologic intervention during this period may therefore play a crucial role in restoring homeostasis and preserving skin vitality.

Given the growing recognition of menopause as a critical window for targeted dermatologic care, this research aims to address an underexplored clinical need: research-based, non-invasive interventions designed to mitigate the cutaneous impacts of hormonal decline. By intervening at the level of topical therapy, this study investigates whether structured, topical skincare can re-establish physiological equilibrium within the skin, thereby supporting health, vitality, and visual rejuvenation throughout the menopause transition.

2. Materials and Methods

2.1. Participants

In order to examine the physiological skin changes that occur in menopause and to determine the extent that a solar protective and solar repair skincare regime could play in alleviating undesirable dermatologic side effects, twenty female patients aged 37 to 63 years (mean age range: 47.95 years) with Fitzpatrick skin types I to V, comprising 65% perimenopausal and 35% postmenopausal subjects, were enrolled in this prospective, open-label study. None were prior users of RATIONALE formulations. None of the patients had a history of any type of skin disease or had undergone a cosmetic procedure that affected the treatment areas within 2 years of this study. Informed consent was obtained for exclusive use of the prescribed regimen over a 90-day period, with abstention from other topical products and professional treatments (unless allocated).

2.2. Inclusion Criteria and Exclusion Criteria

Participants were selected following an initial phone-based screening process, during which they were asked to provide information regarding their menopausal status and any associated cutaneous concerns or changes. Eligibility required participants to commit to monthly diagnostic facial imaging sessions using VISIA® Complexion Analysis at baseline (Day 0), Day 30, Day 60, and Day 90. Additionally, participants needed to be available for in-clinic professional treatments, if selected as part of the intervention subgroup, and to abide by specific inclusion and exclusion criteria (Table 1). Participants were required to exclusively use the prescribed RATIONALE topical formulations for the duration of the study, with no concurrent use of other skincare products. Individuals scheduled for upcoming surgical procedures or medical interventions during the study period were excluded to minimise potential confounding factors.

Table 1. Inclusion and exclusion criteria.

Inclusion Criteria

Exclusion Criteria

Specific

Sex: female

Age: between 35 and 65 years old;

Phototype: no specification

Subjects with cutaneous concerns attributed to estrogen deficiency

General

Healthy subject;

Subject having given his/her free informed, written consent;

Subject willing to adhere to the protocol and study procedures.

Subject with make-up, fake tan or SPF on the day of diagnostic facial imagery;

Use of topical or systemic treatment during the previous weeks liable to interfere with the assessment of the cutaneous acceptability/efficacy of the study product:

non-invasive procedures within previous month on the studied zones,

invasive procedures:

deep chemical peeling, Microneedling, laser resurfacing within previous 3 months on the studied zones.

Subject enrolled in another clinical trial during the study period (concerns the studied zone).

2.3. Topical Formulations

Each participant underwent a comprehensive skin consultation and diagnostic evaluation using VISIA® diagnostic facial imaging to facilitate the accurate and individualised prescription of topical formulations. Prior to imaging, the skin was cleansed using RATIONALE #4 The PreCleanse Balm followed by #4 The Cleanser to ensure complete removal of makeup, sunscreen, and surface impurities. At-home treatment regimens were then tailored according to each participant’s specific cutaneous needs as identified during the assessment.

A minimum of one formulation from each of the RATIONALE Essential Six Collections (Table 2) was prescribed, with all participants required to incorporate #3 The Tinted Serum SPF 50+, #4 The PreCleanse Balm, and #4 The Cleanser as mandatory components of their daily regimen. Each Collection contains specificset of active ingredients (Appendix A), combinations of skin identical ingredients and boosting actives. Additionally, 50% of the cohort received two targeted in-clinic professional treatments during the study period. Follow-up imaging was performed at 30, 60, and 90 days to monitor and record clinical and subclinical cutaneous changes.

Table 2. Formulations per collection.

Solar Protection Formulations

Solar Repair Formulations

#1 Resilience

#2 Vitality

#3 Brilliance

#4 Integrity

#5 Clarity

#6 Renewal

Targets skin immunity, calming and soothing

Targets skin protection againstoxidation,revitalizing

Targets skin protection against environmental damage including photodamage

Targetsdeep skin hydration, nourishment and barrier repair

Targets skin texture enhancement, evening skin tone and rebalancing pH

Targets skincell renewal and rejuvenation

#1 The Serum

#2 The Serum

#3 The Tinted Serum SPF50+

#4 The Cleanser

#5 The Serum

#6 The Night Crème

#1 The Hydragel

#2 The Light Crème

#3 The Enriched Crème

#4 The Crème

#5 The MilkConcentrate

#6 The GelCrème

#1 The Mask

#2 The Mask

#4 The PreCleanse Balm

#5 The GelCrème

#1 The Crème

#2 The Hydragel

#4 The Balm

#5 The Mask

This paper evaluates the efficacy of selected formulations (highlighted in bold in Table 2) in addressing cutaneous concerns associated with estrogen-deficient skin.

2.4. In-Vivo Clinical Evaluation

An observational in-vivo study was conducted on a cohort of 20 subjects to evaluate the effects of daily application of RATIONALE’s Essential Six formulations over a 90-day period. Each participant followed an individually tailored regimen, applying the formulations consistently across the study duration.

To objectively assess cutaneous changes, facial imaging was performed using the VISIA® Complexion Analysis System (Canfield Scientific, NJ, USA). Standardised facial images were captured on clean, product-free skin at four key timepoints: baseline (prior to product initiation), Day 30, Day 60, and Day 90.

Quantitative data were collected across multiple VISIA-defined parameters. Spots were assessed to evaluate improvements in skin clarity and tone uniformity. Red Spots were analysed as indicators of subclinical inflammation and epidermal barrier impairment. Porphyrins were measured to observe shifts in bacterial colonisation and associated changes in skin pH. Brown Spots were evaluated to detect pigmentation changes resulting from oxidative stress and environmental exposure. Texture analysis was used to monitor variations in cutaneous topography, while Wrinkles provided insight into changes in wrinkle depth and skin hydration.

Following comprehensive consultations and in-depth dermatological analysis, 90% of study participants demonstrated signs of cutaneous sensitivity attributed to impaired epidermal barrier function. Clinical indicators included increased Trans-Epidermal Water Loss (TEWL), elevated skin pH, delayed wound healing, and reduced regenerative capacity.

In addition, 70% of the cohort exhibited rosacea-like symptoms, most notably centrofacial erythema localised to the nasal region. Of these, 25% reported a family history of rosacea and indicated that symptom recurrence coincided with hormonal fluctuations associated with perimenopause and menopause. Furthermore, 65% of participants presented with xerosis, characterised by visible dryness and epidermal thickening.

2.5. Participant Subjective Assessments

Subjective evaluations were conducted using structured questionnaire (Appendix B) with data being collected at Days 30, 60, and 90 following the commencement of treatment. Participants were asked to identify perceived changes in their skin based on a predefined list of outcome measures. These included: skin feels more nourished, skin feels less inflamed, reduced redness, fewer breakouts and blemishes, increased hydration, skin feels stronger, skin is more resilient, and skin has a brighter more radiant complexion. Participants also had the option to report no noticeable change or condition of skin worsened to ensure comprehensive and unbiased self-reporting.

3. Results

Reductions in skin sensitivity of 53%, 69% and 76.9% were self-reported by subjects (Figure 1) and confirmed by investigator analysis at 30, 60 and 90 days post treatment. Similarly, reductions in cutaneous erythema were reported and confirmed at 30, 60 and 90 days of 69.2%, 84.6% and 69.2% post treatment.

Skin dehydration is a common dermatologic consequence of menopause. Alleviation of this condition of 78.57% was self-reported (Figure 2) and confirmed by investigator analysis at 30, 60 and 90 days post treatment.

Figure 1. Sensitive skin self-assessment after using the specific at-home skincare regimen for 30, 60 and 90 days. Any improvement over 50% is considered a significant skin sensitivity reduction.

Figure 2. Dehydrated skin self-assessment after using the specific at-home skincare regimen for 30, 60 and 90 days. Any improvement over 50% is considered a significant increase in skin hydration.

Related to dehydration but manifesting as easily irritated and tight, flaky skin is commonly reported in menopause. Improvements in skin dryness of 76.9% and 84.6% were self-reported (Figure 3) and confirmed by investigator analysis at 30, 60 and 90 days post-treatment.

Loss of skin luminosity and an accompanying complexion dullness are commonly reported by perimenopausal, menopausal and post-menopausal women. Improvements in skin clarity and radiance of 36.3%, 63.6% and 90.9% were self-reported by subjects (Figure 4) and confirmed by investigator analysis at 30, 60 and 90 days.

Figure 3. Dry skin self-assessment after using the specific at-home skincare regimen for 30, 60 and 90 days. Any improvement over 50% is considered a significant skin dryness reduction.

Figure 4. Dullness skin self-assessment after using the specific at-home skincare regimen for 30, 60 and 90 days. Any improvement over 50% is considered a significant increase in skin radiance.

Red Areas (on the forehead and cheeks) were examined in this study to identify improvement in a variety of potential skin conditions that could be exacerbated by sun damage (inflammation, rosacea etc.). This patient experienced a 24% decrease in Red Spots (Figure 5).

Wrinkles are defined as folds or creases in the skin, which are known to be associated with a decline in skin elasticity and are often considered to be a result of excessive sun exposure over time. The baseline results for this patient were 13% and increased to 57% over a 12-week period (Figure 6).

Figure 5. Visible improvements in erythema after using RATIONALE Essential Six Regimen (#1 The Serum, #2 The HydraGel, #3 The Enriched Crème, #3 The Tinted Serum, #4 The Crème, #4 The Pre Cleanse Balm, #4 The Cleanser, #5 The Serum and #6 The Night Creme) for 12 weeks and two professional in-clinic treatments. Baseline (L) 90 Days (R).

Figure 6. Visible improvements in hydration and wrinkle depth after using RATIONALE Essential Six Regimen (#1 The Serum, #1 The HydraGel, #3 The Tinted Serum, #4 The Crème, #4 The Pre Cleanse Balm, #4 The Cleanser, #4 The Eye Crème and #5 The Milk Concentrate) for 12 weeks and two professional in-clinic treatments. Baseline (L) 90 Days (R).

Wrinkles are defined as folds or creases in the skin, which are known to be associated with a decline in skin elasticity and are often considered to be a result of excessive sun exposure over time. The baseline results for this patient were 9% and increased to 99% over a 12-week period (Figure 7).

Red Areas were examined in this study to identify improvement in a variety of potential skin conditions that could be exacerbated by sun damage (inflammation, rosacea etc.). This patient experienced a 32% decrease in Red Spots (Figure 7).

Figure 7. Visible improvements in wrinkle depth, erythema and skin hydration after using RATIONALE Essential Six Regimen (#1 The Serum, #2 The Light Crème, #3 The Tinted Serum, #4 The Pre Cleanse Balm, #4 The Cleanser, #5 The GelCreme and #6 The GelCreme) for 12 weeks and two professional in-clinic treatments. Baseline (L) 90 Days (R).

Tolerability and Adverse Events

Two participants (10%) experienced transient adverse responses:

Participant A exhibited mild cutaneous reactivity following four weeks of daily use of the prescribed skincare regimen. Clinical presentation included itching localised to the lower face and the emergence of small pustular lesions on the neck and décolletage. The adverse response was managed through the temporary cessation of active ingredients and simplification of the at-home regimen. Upon gradual reintroduction, both Niacinamide and Bakuchiol were successfully tolerated by Day 60.

Participant B experienced cutaneous sensitivity within two weeks of initiating the prescribed regimen. The subject presented with erythema, stinging sensations, and xerosis. These symptoms resolved following the temporary suspension of active ingredients and simplification of the at-home regimen. Successful reintroduction of Niacinamide was achieved by Day 60 in the form of #1 Crème, following an unsuccessful attempt with #1 The Serum, which resulted in a recurrence of sensitivity.

These outcomes underscore the necessity of individualised treatment planning for sensitive phenotypes.

4. Discussion

Estrogen, plays a pivotal role in maintaining skin homeostasis by binding to specific estrogen receptors expressed in key cutaneous cells, including keratinocytes, fibroblasts, sebaceous glands, hair follicles, and immune cells such as Langerhans and macrophages - [6] -[14]. Upon binding to these receptors, estrogen activates or suppresses specific genes, regulating essential skin functions such as collagen production, lipid synthesis, inflammatory control, and the maintenance of epidermal barrier integrity - [15]. Notably, estrogen enhances the skin’s antioxidant capacity by upregulating the expression of antioxidant enzymes such as Superoxide Dismutase (SOD) Glutathione Peroxidase (GPx), thereby contributing to the reduction of oxidative stress [16] [17].

During perimenopause and post-menopause, diminished estrogen levels disrupt these processes, manifesting as structural and functional alterations [2] [6]. Reduced fibroblast activity impairs collagen and elastin synthesis, causing dermal thinning, decreased elasticity, and wrinkle formation. . Attenuated sebaceous and lipid function compromises the epidermal barrier, promoting xerosis, rough texture, and increased transepidermal water loss . Dysregulated inflammatory signaling heightens cutaneous reactivity, while diminished antioxidant defenses exacerbate oxidative stress, leading to dullness and uneven tone . Concurrently, impaired estrogen-mediated modulation of Langerhans cells and macrophages compromises immune surveillance and reparative capacity [3] [13].

Though discussed less frequently, progesterone and testosterone also influence skin physiology during peri-menopause and post-menopause. The natural decline in progesterone levels affects the brain’s chemical signalling systems—most notably the GABA system—which plays a key role in maintaining calmness and balance, as well as supporting emotional stability, focus, and sleep [19]. These functions are indirectly linked to skin health through elevated cortisol levels. Elevated cortisol is associated with impaired wound healing, increased collagen and elastin degradation, and amplified inflammatory processes [20]. Furthermore, sleep disruption has been clinically correlated with impaired skin barrier function, increased transepidermal water loss (TEWL), delayed cellular repair processes, and contributes to a dull, lackluster complexion [21]. Progesterone plays a modulatory role in cutaneous homeostasis, contributing to the regulation of inflammatory responses within the skin and influencing sebaceous gland activity to support balanced sebum production [1] [2].

Testosterone, an androgen with known roles in collagen maintenance and structural support via musculoskeletal systems, influences cutaneous function by stimulating sebaceous gland activity [17] [22] [23]. During periods of hormonal fluctuation, the pro-inflammatory and pro-oxidative effects of androgens may become pronounced, often manifesting clinically as nodulocystic acne predominantly localised to the lower facial region [5] [24].

The integration of a structured daily at-home regimen, comprising targeted solar protection and reparative interventions, in conjunction with adjunctive clinical therapies, demonstrated significant efficacy in supporting cutaneous health in estrogen-deficient skin -[29]. Clinical treatment regimens that were individually tailored according to cutaneous presentation, incorporated customised topical pharmacologic agents in combination with LED light therapy [26] [27]. This dual-modality approach yielded superior clinical outcomes, substantiating the role of combined photoprotective and reparative strategies with in-clinic treatments in mitigating menopausal skin changes -[30]. Among participants receiving professional in-clinic treatments, 70% reported measurable improvement in skin quality, accompanied by enhanced self-perception, self-esteem, and confidence.

Further knowledge, based on the reported adverse responses, confirmed the need for targeted and personalised skincare regimen, especially for sensitive skins. While two participants initially reacted mildly to Niacinamide and Bakuchiol specifically, their skins showed better tolerability by day 60. This was made possible by simplifiying their skincare regimen to remove the incriminated ingredients for a few weeks all the while building up their skin resilience and finally reintroducing gradually the ingredients.

The potent agents, although designed for the less resilient skins, can occasionally trigger reactions depending on the concentration and whether the skin it is applied to has an impaired skin barrier.

The documented improvements reflect the potency of the RATIONALE Essential Six in modulating skin inflammation, oxidative stress, and barrier function during hormonal decline [27]-[29]. The synergistic inclusion of antioxidants, bio-lipids, anti-inflammatory actives, barrier-repair agents, and photoprotective compounds is consistent with current mechanistic understanding of menopausal skin physiology.

The authors acknowledge the limitations of the study. Due to resources restrictions, the study group counted only twenty participants who had never been exposed to the skincare products chosen so that can represent their own controls. The products were presented and used in an open-label manner and was performed by the sponsors staff members, which assisted in understanding how to best tailor the skincare regimen based on the skin types and needs but also could be viewed as biased. Future research will further elucidate ingredient-specific contributions in a close-label manner and via an external lab as well as explore expanded treatment algorithms incorporating in-clinic interventions.

5. Conclusion

The findings of this 12-week study affirm the efficacy of the RATIONALE Essential Six regimen in restoring cutaneous health during the menopause transition. The combination of structured at-home application with adjunctive clinical therapies yielded superior outcomes, substantiating a dual-modality approach to optimising menopausal skin care.

Disclosure

The authors disclose that this study was entirely funded by RATIONALE Skincare Pty Ltd., Victoria, Australia.

Appendix A. Detailed Ingredients Complexes Per Collection

Solar Protection Formulations

Solar Repair Formulations

#1 Resilience

#2 Vitality

#3 Brilliance

#4 Integrity

#5 Clarity

#6 Renewal

Vitamins

NiacinamidePanthenolCyanocobalamin Pyridoxine Tocopherol

Retinol Ascorbyl Tetraisopalmitatesodium Ascorbyl Phosphate Ascorbyl GlucosideTocopherol Tocopheryl AcetateTocotrienols

NiacinamideTocopherol, Tocopheryl Acetate, Tocotrienols7-Dehydrocholesterol

PanthenolRetinyl Palmitate Tetrahexyldecyl AscorbateTocopherolTocotrienols7-Dehydrocholesterol

Retinal, RetinolBakuchiol (Vitamin A Analog)Nicotiana Benthamiana Hexapeptide-40Sh-Polypeptide-76 (Vitamin A Boosters)Xanthophylls (Vitamin A Boosters) Tocopherol

AHA &BHA

Lactic AcidGlycolic AcidCitric AcidMalic AcidTartaric AcidSalicylic Acid

Complex And Essential FattyAcids

PhytosphingosinesSphingosinesPhospholipidsCeramide Ap, Eop, Eos, Ng, Np, NsCholesterolGlycosphingolipids

PhytosphingosinesSphingosinesPhospholipidsCeramide Ap, Eop, Eos, Ng, Np, NsCholesterolGlycosphingolipids

PhytosphingosinesSphingosinesPhospholipidsCeramide Ap, Eop, Eos, Ng, Np, NsCholesterolGlycosphingolipids

Arachidyl PropionateEthyl Linolenate PhytosphingosinesSphingosinesPhospholipidsCeramide Ap, Eop, Eos, Ng, Np, NsCholesterol

PhytosphingosinesSphingosinesPhospholipidsCeramide Ap, Eop, Eos, Ng, Np, NsCholesterol

PhytosphingosinesSphingosinesPhospholipidsCeramide Ap, Eop, Eos, Ng, Np, NsCholesterolGlycosphingolipidsLinolenic AcidLinoleic Acid

AminoAcids

Zinc GluconateMagnesium AspartateCopper Gluconate Alanine LysineArginine TyrosinePhenylalanineProline ThreonineValine IsoleucineSodium BenzoateCitric Acid HistidineCollagen Amino Acids

GlycineSerineAspartic AcidLeucine

Zinc GluconateMagnesium AspartateCopper Gluconate Alanine LysineArginine TyrosinePhenylalanineProlineThreonineValineIsoleucineSodium BenzoateCitric AcidHistidine

Zinc GluconateMagnesium AspartateCopper Gluconate Alanine LysineArginine TyrosinePhenylalanineProlineThreonineValineIsoleucineSodium BenzoateCitric AcidHistidine

Zinc GluconateMagnesium AspartateCopper Gluconate Alanine LysineArginine TyrosinePhenylalanineProline ThreonineValine IsoleucineSodium BenzoateCitric AcidHistidine

Zinc GluconateMagnesium AspartateCopper Gluconate Alanine LysineArginine TyrosinePhenylalanineProlineThreonine ValineIsoleucineSodium BenzoateCitric Acid Histidine

Minerals

Zinc GluconateMagnesium AspartateCopper Gluconate

Zinc GluconateMagnesium AspartateCopper Gluconate

Zinc OxideZinc GluconateMagnesiumAspartateCopper Gluconate

Zinc GluconateMagnesium AspartateCopper Gluconate

Zinc GluconateMagnesium AspartateCopper Gluconate Zinc PCA

Zinc GluconateMagnesium AspartateCopper Gluconate

Peptides, Proteins & Enzymes

AcetylHexapeptide-37AcetylOctapeptide-3Hexapeptide-10Betaine

Superoxide DismutaseGlutathione Carnosine

KeratinAcetyl Tetrapeptide-22

Oligopeptide-1AcetylHexapeptide-37

AcetylHexapeptide-37Hexapeptide-10

AcetylHexapeptide-51 AmideTripeptide-10 CitrullineHexapeptide-10Tripeptide-9 Citrulline, Tripeptide-1, Acetyl Tetrapeptide-2

Continued

Ferments & Algae

Leuconostoc/Radish Root Ferment Filtrate

Yeast Extract

Bifida Ferment Lysate Pseudoalteromonas Ferment ExtractMicrococcus LysatePlankton Extract

Natural Moisturising Factor & Analogs

Sodium Hyaluronate

Sodium HyaluronateBetaine

Sodium LactateUreaSodium Hyaluronate

Zinc PcaSodium Hyaluronate

Sodium HyaluronateBetaine

Sugar

Diglucosyl Gallic Acid

FructoseMaltoseTrehaloseGlucoseInositol

Sorbitol

Saccharide Isomerate

Glucose

Others

Glycyrrhetinic AcidAllantoin

UbiquinoneMelanin BisabololLycopene

Melanin BisabololAllantoin

PiroctoneOlamine

Bisabolol Glycyrrhetinic AcidAllantoin Hydrolyzed RNA Hydrolyzed DNA

Australian Botanicals Extracts and Other Plant Extracts

Aloe Barbadensis (Aloe Vera) Leaf Juice Acacia Melanoxylon Leaf ExtractBanksia Serrata Flower ExtractBorago Officinalis Seed OilBrachychiton Acerifolius Flower Extract Davidsonia Pruriens Fruit ExtractHibbertia Scandens Leaf ExtractHibiscus Sabdariffa Flower ExtractHoney ExtractMelaleuca Alternifolia (Tea Tree) Leaf ExtractSantalum Spicatum (Sandalwood) Seed Oil Tasmannia Lanceolata Fruit Extract Telopea Speciosissima Flower/Leaf ExtractTerminalia FerdinandianaFruit Extract

Santalum Spicatum (Sandalwood) Seed OilBrachychiton Acerifolius Flower ExtractBanksia Serrata Flower Extract Telopea Speciosissima Flower/Leaf Extract Davidsonia Pruriens Fruit ExtractMelaleuca Alternifolia (Tea Tree) Leaf Extract Tasmannia Lanceolata Fruit Extract Terminalia Ferdinandiana Fruit Extract Hibiscus Sabdariffa Flower ExtractVaccinium Macrocarpon (Cranberry) Seed Oil, Durvillaea Potatorum Extract, Aloe Barbadensis (Aloe Vera) Leaf JuiceSolanum Lycopersicum (Tomato) Seed OilMyrtus Communis Leaf Extract Kunzea Pomifera Fruit Extract Jojoba Oil/Macadamia Seed Oil Esters Ligustrum Lucidum Seed Extract

Argania Spinosa Kernel Oil Voandzeia Subterranea Seed Extract Anigozanthos Flavidus Flower Extract Davidsonia Jerseyana Fruit Extract Syzygium Luehmannii Fruit Extract Aspalathus Linearis Leaf ExtractCamellia SinensisLeaf Extract

Acacia Decurrens Flower WaxBanksia Serrata Flower ExtractSantalum Spicatum (Sandalwood) Seed Oil Telopea Speciosissima Flower/Leaf Extract Tasmannia Lanceolata Fruit Extract Zea Mays (Corn) OilHibiscus Sabdariffa Flower ExtractAloe Barbadensis (Aloe Vera) Leaf JuiceMelaleuca Alternifolia (Tea Tree) Leaf ExtractTerminalia Ferdinandiana Fruit ExtractBrachychiton Acerifolius Flower Extract Davidsonia Pruriens Fruit Extract Barklya Syringifolia Flower/Leaf ExtractJojoba Esters

Vaccinium Myrtillus Fruit Extract Saccharum Officinarum (Sugar Cane) ExtractSantalum Spicatum (Sandalwood)Seed OilAcer Saccharum (Sugar Maple) Extract Brachychiton Acerifolius Flower Extract Banksia Serrata Flower Extract Tasmannia Lanceolata Fruit Extract Santalum AcuminatumFruit ExtractHibiscus Sabdariffa Flower Extract Telopea Speciosissima Flower/Leaf ExtractMelaleuca Alternifolia (Tea Tree) Leaf Extract Davidsonia Pruriens Fruit ExtractTerminalia Ferdinandiana Fruit ExtractPelargonium Graveolens OilMelaleuca Alternifolia (Tea Tree) LeafMentha Australis Leaf Extract

Banksia Serrata Flower ExtractSantalum Spicatum (Sandalwood) Seed OilSantalum Acuminatum Fruit Extract Acacia Victoriae Fruit ExtractArabidopsis Thaliana Extract

Appendix B. Questionnaire

Menopause and Skin Health Questionnaire

Please select the box that best describes your current stage.

□ Pre-menopause

No menopause-related symptoms; menstrual cycles are still regular.

□ Perimenopause

Transition phase with hormonal fluctuations, irregular periods, and symptoms such as hot flashes, mood changes, and sleep disturbances.

□ Menopause

No menstrual period for 12 consecutive months; marks the end of reproductive years.

□ Post-menopause

Hormone levels have stabilised following menopause.

□ Surgical- orInduced-Menopause

Menopause resulting from the removal of ovaries or medical treatments, causing an abrupt transition.

How would you categorise your skin before starting RATIONALE (Select all that apply)

□ Dry

□ Sensitive

□ Oily

□ Breakout-prone

□ Dehydrated

□ Unpredictable

□ Itchy

□ Dull

Skin Changes (30 Days) What improvements have you noticed?

□ Dehydrated

□ Unpredictable

□ Itchy

□ Dull

□ Dehydrated

□ Unpredictable

□ Itchy

□ Dull

□ No noticeable change

□ Condition of skin worsened

Skin Changes (60 Days) What improvements have you noticed?

□ Dehydrated

□ Unpredictable

Continued

□ Itchy

□ Dull

□ Dehydrated

□ Unpredictable

□ Itchy

□ Dull

□ No noticeable change

□ Condition of skin worsened

Skin Changes (90 Days) What improvements have you noticed?

□ Dehydrated

□ Unpredictable

□ Itchy

□ Dull

□ Dehydrated

□ Unpredictable

□ Itchy

□ Dull

□ No noticeable change

□ Condition of skin worsened

Product Suitability: Did you feel the products were suited to your skin?

□ Yes

□ No

Professional Treatments: Did you receive professional Treatments?

□ Yes

□ No

Professional Treatments: Will you continue to receive professional treatments?

□ Yes

□ No

Product Experience: What were you’re favourite products to use and why?

Product Experience: Which products do you feel provided the best results and why?

Product Experience: Have you learned anything new about you skin during this journey?

Product Experience: What information was most valuable to you?

Product Experience: How have your skin improvements made you feel?

Product Experience: Did you have any preconceived notions about RATIONALE or our products?

Continued

□ Yes

□ No

Product Experience: Will you continue using RATIONALE products?

□ Yes

□ No

Recommendation: How likely are you to recommend RATIONALE to someone going through their Menopause Journey?

□ Yes

□ No

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

References

[1] Bravo, B., Penedo, L., Carvalho, R., Dal Vesco, C., Calomeni, M., Gapanowicz, D., et al. (2024) Dermatological Changes during Menopause and HRT: What to Expect? Cosmetics, 11, Article 9. [Google Scholar] [CrossRef
[2] Gratton, R., Del Vecchio, C., Zupin, L. and Crovella, S. (2022) Unraveling the Role of Sex Hormones on Keratinocyte Functions in Human Inflammatory Skin Diseases. International Journal of Molecular Sciences, 23, Article 3132. [Google Scholar] [CrossRef] [PubMed]
[3] Belboul, A., Ashworth, J., Fadel, A., Mcloughlin, J., Mahmoud, A. and El Mohtadi, M. (2025) Estrogen Induces the Alternative Activation of Macrophages through Binding to Estrogen Receptor-Alpha. Experimental and Molecular Pathology, 143, Article 104971. [Google Scholar] [CrossRef] [PubMed]
[4] Lephart, E.D. and Naftolin, F. (2020) Menopause and the Skin: Old Favorites and New Innovations in Cosmeceuticals for Estrogen-Deficient Skin. Dermatology and Therapy, 11, 53-69. [Google Scholar] [CrossRef] [PubMed]
[5] Kamp, E., Ashraf, M., Musbahi, E. and DeGiovanni, C. (2022) Menopause, Skin and Common Dermatoses. Part 2: Skin Disorders. Clinical and Experimental Dermatology, 47, 2117-2122. [Google Scholar] [CrossRef] [PubMed]
[6] Rzepecki, A.K., Murase, J.E., Juran, R., Fabi, S.G. and McLellan, B.N. (2019) Estrogen-deficient Skin: The Role of Topical Therapy. International Journal of Womens Dermatology, 5, 85-90. [Google Scholar] [CrossRef] [PubMed]
[7] Nikoletić, Đ.C., Ivanov, D., Levakov, O., Bulajić, J., Lukač, S., Rakić, V.K., et al. (2025) Menopause, Menstrual Cycle, and Skin Barrier Function. Skin Research and Technology, 31, e70203. [Google Scholar] [CrossRef] [PubMed]
[8] Pagac, M.P., Stalder, M. and Campiche, R. (2024) Menopause and Facial Skin Microbiomes: A Pilot Study Revealing Novel Insights into Their Relationship. Frontiers in Aging, 5, Article 1353082. [Google Scholar] [CrossRef] [PubMed]
[9] Thornton, M.J. (2013) Estrogens and Aging Skin. Dermato-Endocrinology, 5, 264-270. [Google Scholar] [CrossRef] [PubMed]
[10] Merzel Šabović, E.K., Kocjan, T. and Zalaudek, I. (2024) Treatment of Menopausal Skin—A Narrative Review of Existing Treatments, Controversies, and Future Perspectives. Post Reproductive Health, 30, 85-94. [Google Scholar] [CrossRef] [PubMed]
[11] Brincat, M. and Pollacco, J. (2024) Menopause and the Effects of Hormone Replacement Therapy on Skin Aging: A Short Review. Gynecological and Reproductive Endocrinology & Metabolism, 5, 34-37.
[12] Wend, K., Wend, P. and Krum, S.A. (2012) Tissue-Specific Effects of Loss of Estrogen during Menopause and Aging. Frontiers in Endocrinology, 3, Article ID: 19. [Google Scholar] [CrossRef] [PubMed]
[13] Mao, A., Paharkova-Vatchkova, V., Hardy, J., Miller, M.M. and Kovats, S. (2005) Estrogen Selectively Promotes the Differentiation of Dendritic Cells with Characteristics of Langerhans Cells. The Journal of Immunology, 175, 5146-5151. [Google Scholar] [CrossRef] [PubMed]
[14] Thornton, J. (2007) Effect of Estrogens on Skin Aging and the Potential Role of SERMs. Clinical Interventions in Aging, 2, 283-297. [Google Scholar] [CrossRef] [PubMed]
[15] Lephart, E.D. and Naftolin, F. (2022) Factors Influencing Skin Aging and the Important Role of Estrogens and Selective Estrogen Receptor Modulators (SERMs). Clinical, Cosmetic and Investigational Dermatology, 15, 1695-1709. [Google Scholar] [CrossRef] [PubMed]
[16] Strehlow, K., Rotter, S., Wassmann, S., Adam, O., Grohé, C., Laufs, K., et al. (2003) Modulation of Antioxidant Enzyme Expression and Function by Estrogen. Circulation Research, 93, 170-177. [Google Scholar] [CrossRef] [PubMed]
[17] Horstman, A.M., Dillon, E.L., Urban, R.J. and Sheffield-Moore, M. (2012) The Role of Androgens and Estrogens on Healthy Aging and Longevity. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 67, 1140-1152. [Google Scholar] [CrossRef] [PubMed]
[18] Fore, J. (2006) A Review of Skin and the Effects of Aging on Skin Structure and Function. Ostomy/Wound Management, 52, 24-37.
[19] Gilfarb, R.A. and Leuner, B. (2022) GABA System Modifications during Periods of Hormonal Flux across the Female Lifespan. Frontiers in Behavioral Neuroscience, 16, Article ID: 802530. [Google Scholar] [CrossRef] [PubMed]
[20] Khalid, K.A., Nawi, A.F.M., Zulkifli, N., Barkat, M.A. and Hadi, H. (2022) Aging and Wound Healing of the Skin: A Review of Clinical and Pathophysiological Hallmarks. Life, 12, Article 2142. [Google Scholar] [CrossRef] [PubMed]
[21] Kim, M.A., Kim, E.J., Kang, B.Y. and Lee, H.K. (2017) The Effects of Sleep Deprivation on the Biophysical Properties of Facial Skin. Journal of Cosmetics, Dermatological Sciences and Applications, 7, 27-38.
[22] Makrantonaki, E., Ganceviciene, R. and Zouboulis, C.C. (2011) An Update on the Role of the Sebaceous Gland in the Pathogenesis of Acne. Dermato-Endocrinology, 3, 41-49. [Google Scholar] [CrossRef] [PubMed]
[23] Chen, J., Lin, P., Tsai, Y., Yang, Y. and Kang, H. (2019) Androgens and Androgen Receptor Actions on Bone Health and Disease: From Androgen Deficiency to Androgen Therapy. Cells, 8, Article 1318. [Google Scholar] [CrossRef] [PubMed]
[24] Khunger, N. and Mehrotra, K. (2019) Menopausal Acne—Challenges and Solutions. International Journal of Womens Health, 11, 555-567. [Google Scholar] [CrossRef] [PubMed]
[25] Tanaka, Y., Parker, R., Aganahi, A. and Pedroso, A. (2023) Novel Low Viscosity Zinc Oxide, Iron Oxides and Erioglaucine Sunscreen Potential to Protect from Ultraviolet, Visible Light and Near-Infrared Radiation. Optics and Photonics Journal, 13, 217-226. [Google Scholar] [CrossRef
[26] Marsh, K., Coppa, B., Matten, K., Parker, R. and Tanaka, Y. (2023) A Non-Invasive Skin Treatment Combining LED with Pharmacologic and Ultrasonic Technologies for Facial Rejuvenation. Journal of Cosmetics, Dermatological Sciences and Applications, 13, 333-344. [Google Scholar] [CrossRef
[27] Aganahi, A., Parker, R. and Tanaka, Y. (2025) Skin Hydration Augmentation Following Solar Protective and Repair Skincare Regimen. Journal of Cosmetics, Dermatological Sciences and Applications, 15, 1-23. [Google Scholar] [CrossRef
[28] Tanaka, Y., Parker, R. and Aganahi, A. (2023) Up-regulated Expression of ICAM1, MT1A, PTGS2, LCE3D, PPARD, and GM-CSF2 Following Solar Skincare Protection and Repair Strategies in a 3-Dimensional Reconstructed Human Skin Model. Clinical, Cosmetic and Investigational Dermatology, 16, 2829-2839. [Google Scholar] [CrossRef] [PubMed]
[29] Aganahi, A., Parker, R. and Tanaka, Y. (2024) In Vivo Improvements in Facial Appearance and In Vitro Changes in Gene Expression Using a Topical Formulation Designed to Repair Environmentally Induced DNA Damage. Journal of Cosmetics, Dermatological Sciences and Applications, 14, 141-173. [Google Scholar] [CrossRef
[30] Flament, F., Jiang, R., Delaunay, C., Kerob, D., Leclerc‐Mercier, S., Kosmadaki, M., et al. (2023) Evaluation of Adapted Dermocosmetic Regimens for Perimenopausal and Menopausal Women Using an Artificial Intelligence‐Based Algorithm and Quality of Life Questionnaires: An Open Observational Study. Skin Research and Technology, 29, e13349. [Google Scholar] [CrossRef] [PubMed]

Copyright © 2025 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.