How does the menopause affect my skin?
When thinking about menopause, much of the conversation centres around symptoms such as hot flushes and vaginal and urinary symptoms. However it is also a time of significant change for our skin – and many women are understandably bothered by this. We invited Winchester GP’s friend and associate Sharron Gordon, prescribing consultant pharmacist and aesthetic expert, to share her wisdom. Below is an extract of her more extensive blog post which can be found here.
Why does skin change during the menopause?
The link between the skin and hormones is well acknowledged, so it makes sense that the dramatic changes in hormone levels experienced during the perimenopausal and menopausal years would impact on the skin. Women typically start feeling the effects of the hormonal changes between 4 and 8 years before they actually reach menopause.
During menopause, oestrogen levels reduce and cause a variety of side effects, including on the skin. This is because oestrogen plays a fundamental role in the production of collagen and elastin, the principal component of our skin which gives volume.
The epidermis also begins to thin as cellular turnover reduces and the capillary blood flow slows down. This leads to reduced barrier function, which means the skin often becomes quite dry. Reduced oestrogen levels are also thought to make it harder for the skin to retain water.
Finally, there is an increased risk of pigmentation during menopause. This is because your melanocytes (the cells that produce skin pigment or melanin) degenerate and produce less melanin, which is your natural protector against the sun. Melanin can also be overproduced in certain areas which have previously been exposed to a lot of sun. This is due to a lack of oestrogen, which would usually help regulate this process. As a result, the skin is more sensitive to the sun's damaging rays, and you may see an increase in pigmentated patches, brown spots or age spots on sun-exposed areas such as the face, chest and backs of the hands.
Tell me more about some of the key pillars of a menopausal skincare regime
The first step when embarking on any medical skincare regime is to have a consultation with a specialist. They can help guide you as to what your individual skin needs are, as every woman will experience something different during menopause.
Sun protection SPF is the cornerstone of any skin health regime. Every day, inside or outside, it will protect you from the sun's ageing rays (UVA), which account for 80% of skin ageing.
Hyaluronic acid is a powerfully hydrating ingredient because it has the ability to attract water. We naturally have hyaluronic acid in our skin, and levels deplete with age.
Retinoids are the overarching term for derivatives of vitamin A, which are converted in the body to retinoic acid, the active form of vitamin A. Retinol is a type of retinoid. Retinoids work at a gene level, reducing minimising pigment and helping to increase cell turnover to reduce pigmentation, also enhancing collagen and elastin production, smoothing skin and evening pigmentation. Starting it does need a little support so you get the most benefit and minimise any side effects, but once you have it built into your routine, this can be transformative for the skin.
Peptides are the building blocks of amino acids, which ultimately build proteins. When we apply them to the skin, they fool it into believing it is broken, and this increases the production of new cells with more collagen and elastin.
Collagen drinks can be very gimmicky when you look at the contents. However, supplying the gut with high levels of hydrolysed collagen in a form that can stimulate the production of both type I and type II collagen does seem to increase hydration and improves the thickness of the skin. At a time when depletion of collagen is so rapid and taken up by key joints etc some extra supplies can’t go amiss - however is is always better to improve the diet as much as possible. And save on supplements!
Will HRT help my skin through menopause?
There are many benefits to Hormone Replacement Therapy (HRT), both physical and cognitive. In terms of your skin, there have been numerous studies that suggest HRT can help in the management of skin-related symptoms associated with menopause. It is worth pointing out that it is not indicated for this.
Studies have shown HRT can help increase epidermal hydration and skin elasticity and thickness (Sator et al. 2001) as well as to boost dermal collagen levels (Brincat MP et al. Climacteric 2005; 8: 110-123)
In one observational study, more than 3,000 women found that compared to non-users, HRT use was associated with a statistically significant reduction in dry skin and wrinkling (Dunn LB et al. Arch Dermatol 1997; 133(3): 339-342)
For expert advice on all matters HRT, be sure to book a consultation with our expert Dr Jacqui Tuckey.
What other treatments might one try?
There is a wide range of treatments that stimulate skin health and support skin at any age, such as chemical peels, HIFU (stands for High-Frequency Ultrasound Energy), Skinboosters, microneedling and laser resurfacing. When considering these more potent treatments, it’s important to engage with a skincare expert who will discuss the options with you and make an overarching plan to ensure that your treatment is appropriate for your needs. We recommend looking for practitioners who are medically trained, registered with Save Face and members of industry groups such as Aesthetics Experts Complications Group
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