Hi Phia
No need to feel embarrassed - we all care about our health first and then how we look and they are intertwined as well! How we look - or perceive ourselves to look - contributes enormously to our well-being so it's important to feel good about yourself.
I think signs of ageing brought about by the menopause are always difficult to come to terms with. I always thought I looked young for my age (62 - almost 63) and colour my hair, keep my weight down, wear clothes that don't make me look like a fuddy duddy etc - but I've noticed just these last few months the skin on my face looking a bit old lady-ish ie more droopy and especially the skin on my upper arms since last year - the underside going a bit wrinkly when it hangs a little - yuk! So what I'm saying is any change that's new for you needs adjustment - and the first ageing signs are probably the worst - especially if they happen in your 40's.
Re the HRT - it will certainly help your skin as well as the other things you mention - but there are lots of other things you can do as well re lifestyle and diet. Plenty of fresh air and exercise for a start. Keep to healthy BMI. Drink lots of water. Make sure your diet is mainly cooked from fresh ingredients rather than processed foods and sauces with plenty of fruit, veg, nuts, pulses, as well as fairly low fat and cut down sugar and carbs. Reduce alcohol (very ageing) and stop smoking if you do so (also very ageing). Use some sun screen on your face - but make sure the rest of your body gets direct sunlight from April - October. Also if you have dry skin - use a good body cream/butter, and ditto good face cream products to keep skin hydrated.
Hair - what sort of style do you have? Mine is medium length and around my face which means my face (jowls and chin/neck) isn't seen as clearly as if I had really short hair. Use products to enhance it eg volume stuff etc
Make sure you wear clothes that you are happy in and make you look good.
Have you had your thyroid checked? Underactive thyroid affects skin.
Hopefully the Femoston will help - skin as well as other symptoms. If your periods are still fairly regular then it's best to start low because of fluctuations in your cycle - but maybe increase later on. Alternatively you could think about a birth control pill like Qlaira? Maybe post on All Things Meno board for specific HRT advice etc? Once you are feeling better from a good night's sleep and fewer flushes, then you will also hopefully feel better about yourself too and think about how to make the best of yourself so that you don't have to worry about this.
Hope this helps?
Hurdity x