Rarely will you hear women cheer about the onslaught of menopause. Yes, it signals the end of your monthly cycle, but menopause can also bring about other changes, such as hot flashes, hair dulling and, in most cases, skin issues — and these issues can last well beyond menopause. Why must we suffer through more adverse skin conditions later in life? The answer boils down to biology, but the good news is that lifestyle tweaks coupled with the right products can help your skin push through menopause practically unscathed. Here, we deep dive into the causes and symptoms of menopausal skin.
What causes menopause?
First things first: Thankfully, menopause doesn’t hang around forever. Most commonly symptoms stop within a year. However, for some women symptoms can last as long as three years or more. And, sadly, symptoms strike around 85% of women both before and after they actually hit menopause — a cruel part of female biology.
First, why does menopause happen?
A few internal changes factor into the “why.” Women are born with a finite number of eggs, and once their ovaries produce the last ones, their hormone levels (particularly estrogen and progesterone) decline drastically. Our ovaries are actually the source of estrogen and progesterone production, the two hormones responsible for menstruation and fertility. When the ovaries stop releasing eggs and menstruation halts, this is considered menopause. Because estrogen declines, testosterone (yes, the male hormone — women have it too) then becomes “unmasked,” which can wreak all kinds of havoc. When all of these changes are combined, it can cause the aforementioned hot flashes (intense bouts of heat and sweating) as well as deeper voices, new facial hair growth and, yes, changes in skin.
How do these hormonal changes affect skin?
Overall, lower levels of estrogens and progesterone coupled with an imbalance of testosterone levels adversely affect the skin. How? Let us count the ways …
The decline of estrogens reduces blood flow through the skin’s dermal capillaries, which means there are less nutrients and oxygen being distributed to the stratum basale layer of the epidermis. Over time, reduction of nutrients and oxygen contributes to the thinning of the skin and slowing of cell turnover.
Estrogens also help increase the amount of glycosaminoglycans (GAGs), such as hyaluronic acid (HA), which exist to keep our skin balanced and moisturized. If estrogens plummet, GAGs do as well. And there’s more: The skin’s barrier function also declines, which leads to dry, sometimes itchy skin.
Wrinkles and Sagging Skin
Again, estrogens’ decline is to blame. When estrogen levels are normal, fat deposits distribute somewhat evenly over the entire female body. Once these levels are in decline, these fat deposits can redistribute and collect in unfavorable areas (think: stomach and/or butt), leaving other areas devoid of the supportive fat that’s needed below the skin—particularly on your face (but also breasts, neck, hands and arms). Without this supportive fat, gravity can more easily have its way with skin, causing sagging and wrinkles.
This means there’s a degeneration of skin’s elastic tissue, and it can also be attributed to a decline in estrogen levels. Estrogens partially stimulate protein synthesis for collagen and elastin, and, guess what? Lower estrogen levels equal a decrease in production and repair of collagen and elastin. That means skin loses its plump appearance and taut resiliency.
Hyperpigmentation + Age Spots
Can we stop blaming estrogens’ decline? Nope. These little workhorses actually regulate melanin (pigment) production, too. However, during menopause, when estrogens decrease, and therefore their regulatory functions decrease in tandem, melanin synthesis can run amuck in areas that have been exposed to UV rays over the years (think: face, hands, chest). This can lead to age spot formation and hyperpigmentation.
Estrogens control melanocytes, the cells that produce melanin. When estrogen levels drop, melanocytes’ function drop as well, and less melanin is produced. Why does this matter? Melanin provides a protective layer against UV damage; without a healthy amount of melanin, skin is more prone to sun damage, appears lighter and will require even more diligence on your part when it comes to applying sunblock (which you should already be doing!).
Oily Skin and Adult Acne
The minute estrogen levels decline, the body’s estrogen-androgen balance goes out of whack, allowing testosterone to take a hold. When this happens, sebaceous glands can become stimulated and secrete thicker sebum. In turn, skin can present as excessively oily and, in some cases, adult acne can rear its ugly head.
Again, testosterone’s emergence is at fault. More pronounced facial hair—in particular, pesky chin hairs — can become an unattractive nuisance for some women.
This is a perimenopausal (the transition into menopause) symptom that can last into menopause and beyond. Increased tingling, warmth, sweating, rapid heartbeat and reddening/blotchiness of the skin are believed to occur due to a more active sympathetic nervous system.
Speaking of redness: Those all-important estrogens contain anti-inflammatory properties, too, so once they decline, conditions like rosacea could worsen.
That’s a lot to process! So, how do I treat menopausal skin?
With so many different skin conditions that can arise due to menopause, you may feel like throwing up your hands and letting nature take its course. Luckily, many over-the-counter topical creams and serums as well as in-office treatments for afflictions like hyperpigmentation, skin reddening, acne, dryness and wrinkles exist. Look for products with ingredients that boost collagen and elastin production, stimulate cell turnover, strengthen barrier function and even skin tone (think vitamins A and C, retinol and peptides).
Of course, drinking water for hydration and internal cooling as well as slathering on sunblock daily will only help benefit you further. Even avoiding certain triggers — like the sun, heat, spicy food and alcohol — can help quell some uncomfortable symptoms, like hot flashes.
Changes to your diet can also work to your benefit. Antioxidant-rich foods, like brightly colored vegetables and fruits, could help combat the effects of collagen depletion. Soy could also deter skin thinning thanks to isoflavones, plant-based compounds believed to mimic the effects of estrogen.
But the reality of menopausal skin issues is that hormonal changes are to blame, and your best bet for grappling with them is to seek the advice of your OGBYN and dermatologist. Your OBGYN can discuss with you a range of treatment options to address internal hormonal imbalances, like off-label use of antidepressants (which have been to help with hot flashes) or topical or oral hormone replacement therapy (HRT), though these treatments have been found to have adverse side effects that particularly affect skin. Whatever treatment path your healthcare professional puts you on, pay close attention to your skin needs so that once you’re beyond menopause, your complexion shows few signs of the struggle.