Skin changes are some of the most common and visible symptoms of perimenopause and menopause. For many people, the sudden shift in appearance can be a little challenging. And some issues – like slower wound healing – can have serious health ramifications.
The good news is that you can compensate for many of these changes using a combination of care practices, cosmetics, and medications. Here’s what you should know about caring for your skin during menopause.
Estrogen is a very important hormone in adult physiology. It plays a key role in reproductive health and almost every other body system. Your skin, of course, is no exception. During menopause, when levels of estrogen in your blood begin to fall, the complex biochemistry of your skin changes significantly. This causes a number of changes, including:
These changes are a natural part of menopause and affect almost everyone. But as we mentioned above, there are some simple steps you can take to maintain your skin health.
Sun damage is cumulative throughout your lifetime, which is why skin cancer risk increases as you age. This risk is augmented by menopause, as estrogen-deprived skin is less able to protect itself from sun damage. That’s why skin cancer vigilance – which is important at all ages – is extra significant during menopause.
The first and best thing you can do to safeguard your skin is to cover up. Wear UV-protective clothing and a broad-brimmed hat that covers your face and neck. You should also wear a high-SPF sunscreen (at least 30, preferably higher) all over your body. During activities with high sun exposure (e.g. hiking), consider a UV-rated parasol.
It may surprise you to learn that your car’s windows don’t fully block out harmful UV rays. That’s why many drivers tend to develop “sun spots” – small, dark blotches – on the left side of their face and on the hand which rests on top of the steering wheel. So be sure to wear sunscreen, even if you’re just out on a drive. Or consider UV-rated driving gloves (which notch you extra points for style).
The appearance of aging skin during menopause is actually due to several underlying factors, including wrinkles, loss of elasticity, and melasma (a type of dark spot that typically appears on your face, neck, arms, and back). For some of these issues, cosmetics can be very helpful. You may also want to speak with your dermatologist or primary care physician about a retinoid prescription.
“Retinoid creams are considered a safe and effective treatment for maturing skin,” says Dr. Millheiser. “Most patients will see significant improvement in fine lines as well as mild melasma.”
Retinoids are a class of drugs that protect your skin from the oxidative damage that undermines collagen. While some retinoid products (like retinol) are available over-the-counter, they tend to have weaker effects than prescription-strength retinoids, like tretinoin and tazarotene, which are more powerful.
Research has found that retinoid drugs can smooth out fine wrinkles after 3 months of use. They’ve also been shown to improve the tone of mottled and sallow skin, soften rough patches, and help reduce the appearance of melasma and other forms of photoaging.
The first thing to know about hair loss is that it’s very common during menopause, and you have many options to treat it. The second thing to know is that a sudden loss of large volumes of hair can be caused by underlying medical issues entirely unrelated to menopause, such as thyroid problems or autoimmune issues. So if you’re abruptly losing a lot of hair, talk to your doctor and get evaluated.
Hair and the follicles it grows from are very sensitive to estrogen and other hormones. When the ratio of these hormones shifts during menopause, hair follicles begin to miniaturize, which contributes to hair loss and the appearance of thinner hair. This results in something called “Female Pattern Hair Loss” (FPHL) which looks somewhat different from Male Pattern Hair Loss. In a recent study, about half of menopausal women were found to have FPHL.
If your hair loss is mild, you may be able to treat it with volumizing shampoo, spray, and similar cosmetic treatments. For many people, these style changes are enough. For more serious hair loss, there are both prescription and over-the-counter treatments available. Minoxidil, for instance (sold under brand names like Rogaine), has been in use since the 1970s and has proven safe and highly effective for FPHL.
As estrogen levels fall during menopause, your body creates less elastin, keratin, and collagen – three important proteins that help your skin retain moisture and give it structure. You also have less of the hormone progesterone, which stimulates oil production in your skin. With less of those healthy oils, water evaporates more quickly, leaving your skin even drier. Estrogen stimulates your skin’s natural oil production, which helps your epidermis retain moisture. When your estrogen level falls, you get less of these healthy oils – and that allows your skin’s water content to simply evaporate. Your body also produces less collagen, which can further reduce the moisture in your skin.
Fortunately, it’s fairly easy to restore and retain this moisture with some basic skin care practices. First, use a moisturizing cream or lotion – especially when you get out of the shower. This will trap the hydration in your skin, where it belongs. The American Academy of Dermatology recommends a moisturizer containing hyaluronic acid or glycerin. Eucerin can also be helpful, as can simple Vaseline.
And second, consider replacing your conventional soap with a more gentle skin cleanser. Look for something without fragrances, dyes, or Sodium Lauryl Sulfate. Plant-oil based cleansers tend to be ideal.
Your skin is just one of many organs affected by menopause. But it’s one you see every day, and it can have a powerful effect on your self-image. And while you can’t completely stop the natural effects of aging on your skin, you can steer them with smart self-care and a little help from your dermatologist.
Reviewed by Dr. Leah Millheiser, MD, FACOG, NCMP