Skin care During Menopause
Skin is the largest organ in the human body and is the important barrier that protects us from potential harm from our environment. Our skin defends our bodies from extreme heat and cold, fungal, bacterial, and viral infections as well as toxins and irritants - indeed anything that we come into contact with. Our skin has receptors that give information to our brains about changes in temperature, things we touch, tissue damage, and light. It is important for our overall health and as menopause can age our skin, it is important that we understand these changes so that we can protect it as it protects us.
Skin is structured into two main layers, the outer epidermis, and the inner dermis. The epidermis is thin and contains melanin, which gives skin its colour. The dermis is thicker, supporting our blood vessels, nerve endings, and fibres – mainly collagen and elastin. The dermis supports the epidermis and enables our skin to thrive.
Aging affects all of our cells as our systems slow down and our metabolism declines. Skin cells are additionally affected by exterior aggressors such as the sun, heat, cold, and a variety of other environmental factors. How our skin reacts to this combination of factors is entirely individual.
We know that hormones carry messages to the brain, influencing our nervous and circulatory systems, and they also promote healthy cell growth and repair. So, when hormones fluctuate in menopause those functions can go awry.
Hormone depletion in menopause - particularly estrogen - has visible and very physical effects. As our skin has a high volume of estrogen receptors, it is common for women to experience skin problems during menopause.
Estrogen plays a huge role in preserving our skin’s youthful quality. Studies have shown that the decline in estrogen is associated with various skin issues, such as:
Thinner and more easily damaged skin
Dryness, which can cause itching (pruritus) and tingling (formication)
Delayed Wound Healing
Let's consider each of these below:
Collagen is a protein that makes our skin cells firm and stretchy to retain a good structure. It accounts for the bulk of skin weight and is at its highest level in new-borns. As we age, collagen production starts to slow down, especially after menopause.
Glycosaminoglycans (GAGs) - Help to keep our skin plump and flexible. We lose GAGs due to declining estrogen levels, which leads to cell depletion and means that our skin is more likely to bruise or tear.
In the first 5 years of menopausal hormonal disruption, it is estimated that up to 30% of our skin collagen is lost. Along with the reduction in GAGs, the loss of collagen affects our skin elasticity and firmness and leads to wrinkles and sagging.
Not only does estrogen help with the formation of GAGs, but it also encourages oil (sebum) production, keeping our skin hydrated and maintaining the barrier function mentioned above. This helps to retain moisture in the skin to plump up cells and repels environmental hazards from getting into our pores too easily.
As Estrogen levels drop, there is less oil production, so our skin can become drier, and more prone to irritation and breakouts.
Extreme dryness can cause itching (pruritus) or a sensation of your skin having a moving tingle or tickle (like ants crawling), known as formication.
Delayed Wound Healing
In addition to being more likely to bruise or tear as a result of your falling estrogen levels, our skin cannot heal itself as effectively as it used to. So, as well as being more prone to skin damage in menopause, your repair system doesn’t work as well. This means we should be mindful of taking special care of any wounds and minimize infection.
You may experience more clumsiness in menopause because of temporary hormonal, cognitive impairment and be more inclined to have accidents. We do all need to take greater care as a result.
It's worth saying here that our skin can sometimes make those flashes visible by becoming red.
We flash because our tiny blood vessel endings rise to the surface in the parts of our body most exposed to the environment, such as our face, neck, and head. They do this to try to get the most out of external coolness in the air, to bring down our internal raised temperature.
You may feel more self-conscious because what’s going on inside our body becomes visible to others but try to take it in your stride as being anxious can make hot flashes worse.
Hot flashes can manifest more severely as Rosacea. As blood vessels rise to the surface of the skin on the face, small breakouts occur in both blood vessels and pores, causing a rash-like appearance.
Regardless of whether you had spots as a teenager or not, hormone fluctuations in menopause can cause imbalances in skin secretions that can cause acne.
This can be painful and embarrassing and because of our hormones, women are more likely than men to develop adult acne.
As well as female hormones, we also have naturally occurring androgens (male hormones such as testosterone) in our bodies. During menopause, our level of androgens becomes higher than usual relative to the levels of our female sex hormones. Androgens stimulate hair growth and oil production in the skin, so if these increase, pore activity, irritation, and spots may occur!
Adult acne is generally different from adolescent acne, in that teens tend to get pus-filled spots, black or whiteheads, whereas menopausal women usually get small, hard cysts on their jaw, chin, or neck.
What can I do?
Maintain a healthy diet
What we eat and drink effects how our bodies respond. Having a healthy, balanced diet with adequate hydration assists our cells in their everyday work. When our hormone levels fall, we need to make good choices about what we eat and drink to keep us well.
Avoid or moderate foods and drinks that will rob your body of vital nutrients or that make it work too hard to process – in particular, alcohol, sugar, processed foods, and foods containing additives.
Moisturise & Protect
While we can’t avoid menopause, we can help to minimize the effect it has on the appearance of our skin. Good skin moisturizers and rich emollient creams can help to protect our skin's barrier from moisture loss. Harsh cleansers, soaps, very hot bathing, and scrubbing will strip our skin of its natural oily barrier and make our skin more vulnerable to moisture loss.
Look for products that match the pH of the skin to help retain moisture balance. Don't forget sunscreen as it is vital to protect our skin from UV damage, burning, and dryness.
Products containing the following ingredients may be helpful:
Hyaluronic Acid is a GAG that has exceptional moisture-retaining properties, and so contributes to much of the skin's plumpness. Hyaluronic acid diminishes as we age but can be supplemented topically by using skin products that contain it.
Glycolic acid and Lactic acid are also available as topical skin products and can improve skin tone and texture.
Retinoids are derived from Vitamin A. They boost collagen production and can have an impact on wrinkles. They also open pores to help prevent blockages. Retinoids can dry and irritate the skin though, so are usually only available on prescription.
Skincare products that contain Vitamins C and E may also help to build collagen and give skin a firming boost. This will also improve the efficiency of your sunscreen.
Treatments that minimize Redness
The irritation and appearance of skin rashes and rosacea may be alleviated by using Dicarboxylic acids, Retinoids, or antibiotics if infection and or inflammation are present. They can also help to treat adult acne, whilst benzoyl peroxide offers anti-bacterial protection.
Treatments such as laser therapy or dermabrasion could improve the quality of damaged skin and blue light therapy can work as an anti-microbial aid and tackle oiliness. It is best to consult with your GP and a skin specialist for specific advice about your own skin.
HRT works to replace the hormones that our body loses in menopause and so can slow down the effect on our skin cells. The right formulation and dosing can
help to maintain collagen production, the fibres that keep our skin elastic and our cells firm. By helping our skin to do its normal job, we can retain its moisturizing and protective functions, and may look a little healthier too!
HRT isn't everyone's choice, and some women are unable to use it. Please consult your doctor to discuss whether HRT is right for you.
Adopt a Healthy Lifestyle
A healthy lifestyle can help delay the signs of aging. Maintain a good diet, exercise regularly, and avoid smoking. Take care of yourself and have ‘me’ time away from the everyday stresses