Changes in hormone levels impact most women’s skin in some way
- Dry, itchy skin is a common symptom during perimenopause and menopause
- Some women suffer from acne, increased signs of sun damage and loss of definition
- Learn how best to take care of your skin
Skin changes are very common during perimenopause and menopause. One survey shows that almost half of women (46%) attending a menopause clinic had skin issues arising from menopause [1]. Sometimes, skin conditions that you may have experienced years ago – such as eczema in your childhood – may flare up, or you may experience a new, and even unexpected skin issue.
In a Newson Health survey of perimenopausal and menopausal women, 64% reported experiencing dry skin, 56% experienced itching, 30% had developed spots or acne and 22% reported a crawling sensation known as formication.
As the largest organ in your body, your skin responds to the fluctuations and drop in hormone levels experienced in perimenopause and menopause. The majority of women in the Newson Health survey (60%) changed their facial skincare routine as a result of perimenopause and/or menopause, with almost half (48%) spending more on facial skincare products. Before you make changes, it is worth understanding these common skin concerns and the impact of hormones so you are best placed to take action.
RELATED: The impact of hormones on our skin, health and nails
Dry and itchy skin
The most common skin complaint among women around the time of menopause is dry skin. Oestrogen is required for your skin’s natural hydration mechanisms, as it helps skin produce four key substances: ceramides, natural hyaluronic acid, sebum and collagen. Without these substances, water evaporates very easily, causing your skin to become dry, scaly and itchy.
How to manage it
Soap can be very drying, and it is best to avoid products that lather, foam or bubble, as these will simply strip away grease from your skin. Use a gentle, non-foaming cleanser on your body instead of soap. If your skin is still dry, use a moisturising lotion as a soap substitute.
Try to get into the habit of moisturising your skin twice a day and immediately after a shower or bath. Moisturisers help your skin hold onto more water and can prevent it from drying out. Use a lighter moisturiser in the daytime and something heavier at night.
There are other causes of itching, aside from dry skin. Sometimes it can be related to release of histamine in the skin and irritation of skin nerves can give the sensation of insects creeping on your skin (known as ‘formication’). Other causes of itching are iron deficiency and thyroid disturbance. It may be worth reviewing these possible causes with a healthcare professional.
HRT will help to replace the lost oestrogen and you should start to see an improvement in the feel and texture of your skin within a few months.
RELATED: Do you really need a menopause moisturiser?
Redness and flushing
Flushing is a well-recognised symptom of menopause. It can also occur from rosacea, a condition in which the blood vessels in your skin become very reactive. Rosacea appears to be more common in women, especially during menopause.
How to manage it
Redness and flushing from rosacea can often improve with simple lifestyle changes, such as cutting down on your intake of alcohol and caffeine, avoiding spicy foods, and protecting your skin from the sun. Sometimes additional measures may be required, such as creams or laser treatments that help shrink tiny blood vessels in the skin.
RELATED: Rosacea and menopause: what's the link?
Spots and acne
Spots can be very distressing at any stage in life, but particularly when they occur around perimenopause and menopause. Many women, especially those who had acne as a teenager, have flare-ups around menopause but it is not clear why. It is possible that a drop in oestrogen means the ratio of male hormones is relatively higher, and this may trigger acne. For some, acne continues to be a problem, even following oestrogen replacement.
How to manage it
Take a good look through your make-up and sun protection products and check that they are all suitable for oily or combination skins, or described as non-comedogenic (this means they are not going to clog your pores and aggravate acne).
Use a mild cleanser that contains salicylic acid, as this will help to exfoliate your skin and unblock pores. Active ingredients such as retinol and niacinamide are useful to include in a skincare regime if you are prone to outbreaks. Remember, it can take a couple of months for skin products to work for acne, so be patient.
Sun damage
Signs of sun damage may become more prominent around perimenopause and menopause, especially for anyone who has spent a considerable amount of time in the sun over their lifetime. Sun damage can present as irregular skin tone, lacklustre skin and sun spots (also known as age spots, these are flat brown marks that show up on your face, décolleté and arms). Thread veins, lines or wrinkles may also develop.
Sun exposure can also contribute to melasma, an inflammatory skin condition – it doesn’t cause melasma but can aggravate it.
RELATED: Melasma and menopause: what you need to know
How to manage it
Avoid tanning and any skin burning by wearing a high factor SPF (e.g. Factor 50) and reapplying the SPF every 2 hours that you are in the sun. Also wear a hat with a wide brim and long sleeves, where possible. If you are worried about any dark sun spots or changing moles, see your doctor for a review of your skin.
RELATED: 7 common sun protection mistakes and how to avoid them
Bruising or delicate skin
Your skin can become thinner and more fragile as you get older, and a lack of oestrogen can exacerbate this process. This is because oestrogen is necessary for collagen production and if collagen production drops, your skin can become weaker [2].
Bruising is also caused by a reduction in collagen around the tiny blood vessels in your skin. With a lack of collagen, even the slightest knock can produce a bruise. Wounds also take longer to heal in women with low oestrogen levels.
RELATED: Can collagen help menopausal skin?
How to manage it
Consider replacing your lost oestrogen by taking HRT, sooner rather than later, as this can help to preserve your skin’s collagen levels.
Wrinkles and loss of definition
The change in facial appearance that occurs with menopause can be very distressing for many and can severely affect self-confidence and quality of life.
Research shows that during menopause, women lose bone density (bone strength) from their facial bones – as well as elsewhere in their body – and this may contribute to many of the facial changes they notice [3]. Bones can become smaller, as old bone tissue is lost faster than new bone tissue grows.
In the spine and limbs, this loss of bone tissue and strength makes women more prone to fractures. On your face, the loss in bone mass causes hollowing in the mid face, narrowing of the chin, jowls and loss of jawline definition.
The drop in collagen means skin can lose its tightness and become more prone to fine lines and wrinkles, which add to the signs of ageing. An estimated 30% of skin collagen may be lost in the first five years after menopause [4].
RELATED: Do you really need a menopause moisturiser?
How to manage it
The most important changes you can make are to cut out habits that cause skin collagen levels to decline, such as damaging sun exposure and smoking. Once these issues are addressed, serums that contain anti-ageing ingredients that can help preserve skin collagen levels (including topical retinoids and vitamin C) can be helpful.
