Menopause is a natural physiological change that usually occurs between the ages of 45 to 55. It occurs due to a change in hormone levels and signals an end to a woman’s menstrual cycles. This has a number of effects on a woman’s health, including skin changes. The term “menopause skin” is a collective name for the various skin changes that occur due to these hormonal shifts. In this article we are going to explore how menopause skin changes lead to problems like itching, dryness and acne, and how you can treat them.
What Happens to Your Hormones During Menopause?
Menopause occurs when a woman’s ovaries stop producing eggs. As a result, the levels of the hormones oestrogen and progesterone decline. These two hormones play a number of important roles in the body. There is also a change in FSH and LH, which are hormones that the pituitary gland produces. They stimulate the ovaries to produce eggs and release hormones. During menopause, FSH and LH levels increase as the ovaries become less responsive to them. This contributes to the typical menopause symptoms and risks that some people may experience.
Oestrogen is the primary female sex hormone. It is responsible for a number of bodily functions, including regulating the menstrual cycle, maintaining bone health and protecting the heart. Progesterone is a hormone that the ovaries produce. It works with oestrogen to regulate the menstrual cycle and prepare the uterus for pregnancy. That’s why at menopause, periods may become irregular or stop altogether. The decline in oestrogen and progesterone levels during menopause can cause well-known menopause symptoms like hot flushes, night sweats, sleep problems, vaginal dryness and mood swings. It can also increase the risk of osteoporosis, which puts you at risk of fractures and heart disease.
These symptoms can vary from woman to woman. As such, menopause effects may be more or less severe depending on the individual. This is important to consider when looking for the best treatments.
How Does Menopause Affect Your Skin?
Oestrogen is a key player in skin health and promotes the production of collagen and elastin. These two proteins are responsible for making your skin plump, firm and elastic. Oestrogen also regulates the skin’s moisture balance and barrier function. Progesterone, on the other hand, controls oil production, promotes new skin cell growth and blood vessel formation. It also has wound healing and anti-inflammatory properties. The reduction in these hormones gives rise to a variety of skin problems, including itching, dryness, skin ageing, acne and discolouration. These are together known as “menopause skin”.
Skin Itching, Dryness and Sensitivity
As oestrogen and progesterone levels go down, so do collagen, elastin and natural oils. As such, your skin may become dry, flaky and itchy. The decline in progesterone, which has anti-inflammatory effects, can make this worse. The reduced oestrogen levels also weaken the skin’s protective barrier. This leads to increased skin sensitivity, inflammation, redness and irritation.
Accelerated Skin Ageing
The reduced collagen and elastin production can speed up and worsen the appearance of fine lines and wrinkles as well as loss of face volume. Collagen gives the skin its strength and plumpness. When collagen levels decline, the skin becomes thinner and more prone to wrinkles. Elastin and collagen together maintain the skin’s elasticity. When these are reduced, the skin is less able to bounce back after being stretched, which can give the appearance of sagging.
Acne Breakouts
The hormonal imbalance during menopause can trigger sebum over-production, which leads to clogged pores and acne breakouts. Oestrogen and progesterone normally help to regulate the oil glands under the skin. When the levels of these drop, the body may produce more androgens in their place. Androgens are a type of male hormone that is normally present in women in smaller amounts. Excess androgens stimulate the oil glands in the skin, which leads to an increase in oil production. The increased oil or sebum can clog pores, which then become infected or inflamed and result in acne.
Additionally, other menopausal symptoms like stress, poor sleep and dietary changes can also lead to acne. Stress increases cortisol, which is another hormone that can cause the skin to produce more oil. Poor sleep and dietary changes can also cause changes in the skin’s physiology and exacerbate acne.
Facial Redness & Flushing
Hot flushes are a common menopause symptom. They are sudden and transient periods of intense warmth and flushing that spread over the body, particularly concentrated in the face, neck and chest. When hot flushes occur, they cause the blood vessels in the skin to dilate (vasodilation). This is your body’s attempt to cool down and results in temporary skin redness and flushing.
Frequent hot flushes can lead to persistent redness and broken capillaries. This redness looks similar to that seen in rosacea. Furthermore, when capillaries break they give rise to a network of tiny, red, web-like lines under the skin’s surface. These are called telangiectasia or ‘spider veins’ and can become a permanent feature on the skin.
Rosacea
Rosacea is a chronic skin condition that causes redness and visible blood vessels in the face. It may also give rise to small, red, pus-filled bumps that are better known as acne rosacea. The exact cause of rosacea is unknown, but it is thought to be due to a combination of hereditary and environmental factors. The connection between menopause and rosacea is not yet fully understood. Menopause is thought to exacerbate rosacea, though it is not thought to cause it.
During menopause, the levels of the hormones oestrogen and progesterone decrease significantly. This decline in hormones can lead to various physical changes, including hot flushes. This sudden increase in body temperature can cause dilation of the blood vessels in the face, which can trigger a rosacea flare-up.
Moreover, decreased levels of oestrogen can make the skin thinner and more sensitive, potentially exacerbating the symptoms of rosacea. Dry and thin skin can get irritated easily, and such irritation can trigger rosacea symptoms.
It’s also worth noting that stress is a well-known trigger for both hot flushes and rosacea. The changes and symptoms that occur during menopause can cause significant stress and anxiety, which could possibly lead to more frequent or severe rosacea flare-ups.
Melasma
Melasma is a condition that causes dark coloured patches on the skin. It is usually found on the face. Although it can affect anyone, melasma is more common in women. It is particularly likely to occur during times of significant hormonal shifts such as pregnancy or menopause.
Oestrogen and progesterone have been linked to melanin production. Melanin is the pigment responsible for the colour of our skin, hair and eyes. It is produced by melanocytes, the pigment-producing cells in the skin, which are affected by oestrogen and progesterone. When these hormones decrease, as they do during menopause, the melanocytes may over-react and produce excess melanin in certain areas. This results in the dark patches characteristic of melasma. Furthermore, melasma is also often exacerbated by sun exposure, because UV light from the sun can also stimulate melanocytes. During menopause, as the skin thins and loses some of its natural sun protection, it can become more susceptible to the effects of UV light, which can further exacerbate melasma.
Treatments for Menopause Skin Changes
The good news is that menopause skin responds well to a layered approach. Most women see the best results by combining a targeted skincare routine with professional treatments where they want extra help, medical options such as hormone support, and the everyday habits that keep skin resilient. The sections below walk through each of these in turn.
Menopause Skincare
The most effective way to treat menopause skin changes is with a consistent and personalised skincare routine. Your menopause skincare routine should firstly address the accelerated skin ageing that occurs with menopause. It should also be designed to target specific menopause skin problems like itching, acne, redness, rosacea and melasma if you have them. The foundations of a good anti-ageing skincare routine will contain:
- Gentle hydrating cleansers to protect your skin’s natural oils and avoid irritation.
- A moisturiser containing humectants like hyaluronic acid or polyglutamic acid to hydrate, and ceramides to lock in moisture and support your skin’s natural barrier.
- A hydrating broad-spectrum sunscreen with at least SPF 30, since sun exposure can worsen menopause skin changes.
You will also need to consider active products to address skin concerns. Tretinoin and other retinoids treat wrinkles, build up collagen and elastin, and fade hyperpigmentation. They will also treat acne, smooth your skin and give a brighter complexion. Exfoliating acids and vitamin C can also help improve skin texture and radiance. Azelaic acid and tretinoin can also help with rosacea and facial redness.
Professional Skin Treatments
If you wish to augment your menopause skincare routine, professional skin treatments can potentially help. Chemical peels can help with skin ageing, acne and melasma. Laser therapy can help with wrinkles, texture and telangiectasia. Microneedling, RF microneedling and Profhilo can help improve collagen and elastin production to improve the appearance of crepey and sagging skin. Injectables like Botox anti-wrinkle injections and dermal fillers can improve the appearance of lines, wrinkles and loss of face volume.
Medicines for Menopause Skin
Topical oestrogen creams can combat moderate menopause skin changes. These creams deliver oestrogen directly to the skin. If you use them regularly, they can improve skin elasticity and increase moisture levels.
Hormone Replacement Therapy (HRT) or BHRT can help with severe skin changes due to menopause. HRT replaces oestrogen and sometimes progesterone throughout the body. This can help manage a wide range of menopause symptoms such as hot flushes, night sweats, mood changes and skin changes. By restoring hormone levels, HRT can help improve skin thickness, elasticity and hydration. It may also help with menopause-associated redness, rosacea exacerbation and melasma.
How Does Your Lifestyle Affect Menopause Skin?
Whatever treatments you choose, your everyday habits play a pivotal role in managing menopause skin. A healthy diet, regular exercise, good sleep and a few sensible swaps all support your skin from the inside:
- Eat for your skin: Antioxidant-rich foods like berries, spinach and bell peppers help combat the free radicals that accelerate skin ageing, whilst omega-3s in fish, walnuts, chia and flax seeds add hydration and calm inflammation. Lean proteins support collagen, and there is even a link between the gut microbiome and skin health, so fermented foods and probiotics can help too. Try to limit processed foods, sugar and alcohol, and drink plenty of water through the day.
- Move regularly: Exercise improves circulation, which delivers oxygen and nutrients to your skin. It also helps manage stress and maintains the bone and muscle that support your facial structure.
- Prioritise sleep: Your skin repairs itself overnight, so aim for 7 to 9 hours. Too little sleep raises stress hormones, which can inflame the skin and speed up ageing.
- Rethink smoking and alcohol: Smoking damages collagen and elastin and dulls your skin, whilst alcohol dehydrates it. Cutting back on both improves tone, texture and hydration over time.
You can manage menopause skin changes successfully with a little patience and consistency. It’s important to understand the hormonal and physiological changes your body is going through and how these are affecting your skin. This will allow you to take a personalised approach to treating menopause skin. An anti-ageing skincare routine targeted towards menopause changes is key to improving the look and feel of your skin. You should also incorporate healthy lifestyle habits, since these can go a long way to manage menopause skin changes and your overall well-being. Remember that each woman’s menopause journey is unique. The best treatment for you will depend on your specific symptoms, medical history and lifestyle, so consult with a healthcare professional for advice and treatment options tailored to you. This is especially important if you are considering medical options.
At City Skin Clinic, we are passionate about personalised skincare. Through our online skin clinic, our doctors offer prescription-strength treatments for skin ageing and other concerns like melasma, acne and hyperpigmentation. To begin, book a video consultation or fill in our online consultation form. The journey towards great skin and hair starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.
