How to Care For Your Skin During and After Menopause
Time to read 9 min
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Time to read 9 min
Menopause is a process rather than an isolated event, and happens over several years. In each phase, you’ll see changes in the production of sex hormones like Estrogen derivatives, Progesterone, and other female hormones. Most of the effects on skin health are due to estrogen deficiency. The average age at which women experience menopause is 51.
Women's skin loses about 30 percent of its collagen in the first five years of menopause as well as significant reduction in skin elasticity. Collagen is one of the most significant factors in the appearance of laxity in your skin. So how can you create the perfect skin care routine for mature skin? That depends on the current condition of your skin and what your concerns are. Read on for tips for better skin as you experience changes to your skin in menopause.
Perimenopause refers to the period of decline in hormone production and function in the years preceding the cessation of menstruation. During this time, you will start to experience changes in the frequency of your menstrual period. This phase can last for 2-8 years.
Menopause is not a phase but more of a benchmark. This is marked by the end of your last menstrual period.
Once you have not had a menstrual period for at least 12 months, you will be considered to be post-menopausal.
Just as your body changes during menopause, your skin does too. There are changes in the surface of the skin, the epidermis. There are changes to the dermis as well,, the underlying “organ” of the skin where you’ll find vasculature, structural proteins, hair follicles, and more. These changes bring about side effects like thinning skin, dryness, impaired wound healing, atrophy of facial muscles, decreased subcutaneous facial fat, and deterioration of skin proteins like elastin and collagen.
One of the hallmarks of post-menopausal skin is deepening fine lines and wrinkles. This is due to the deterioration of structural proteins of the skin, like collagen and elastin, which give your skin the ability to move, stretch, and bounce back without any alterations to the skin’s outer surface. There is also a loss of facial fat, which decreases the volume of the support under your skin, owing to that “hollow” look. Another contributor to the “hollowing” of facial skin is loss of bone density. The loss of facial bone mass after menopause causes hollowing in the mid face, narrowing of the chin, jowling and loss of jaw line definition.
The dry skin that comes along with menopause is owed to several changes.
Glycosaminoglycans are an element found in the skin of animals, and it serves to protect the skin by drawing in water and giving skin a certain “cushioning” effect to protect it from compression injuries. Glycosaminoglycans decrease water loss and add the look of fullness to the skin. The decrease in estrogen that comes along with perimenopause significantly reduces the presence of these elements.
The dryness of aging skin is also attributed to a decrease in your skin’s oil production, called sebum. Sebum protects and seals your skin’s outer barrier, preventing environmental stressors from affecting the skin.
Redness of the face, Dermatitis, or Rosacea are common after menopause and often come with hot flashes. Skin irritation is more common in menopausal skin, without sufficient production of estrogen. Things to avoid to keep your skin from flaring up are alcohol, extreme temperature changes, stress, and spicy foods.
Age spots and sun spots are other common skin complaints as women move through hormonal changes with age. This is due to cumulative damage from the sun and dysfunction of melanocytes, which create pigmentation in the skin.
Due to decreased blood flow, reduced collagen and elastin content, and skin thinning, women are more likely to sustain a skin injury and experience delayed wound healing. This can give rise to dead skin cells on the skin's surface, acne spots that take longer to heal, and persistent redness after skin healing.
Sunscreen is a preventative measure to keep wrinkles from getting worse. Oxidative damage from UV rays can cause further deterioration of skin proteins as well as cause you to develop sunspots or discoloration. Using sunscreen will prevent new spots from forming and helps skin stay healthy. The risk of skin cancer increases with age, no matter your skin tone. Ensure you do skin self-exams or go to the dermatologist often enough to keep an eye out for skin cancer and pre-cancerous growths.
Retinol works to repair wrinkles and tighten skin by increasing the rate of skin cell turnover, essentially exfoliating the skin of dead skin cells. Retinol has several mechanisms for reducing the look of aging skin, like increased hydration, improved skin thickness, and collagen repair. Retinol tightens wrinkled and sagging skin. A dermatology journal researching the use of retinol states that:
“Significant induction of glycosaminoglycan, which is known to retain substantial water, and increased collagen production are most likely responsible for wrinkle effacement. With greater skin matrix synthesis, retinol-treated aged skin is more likely to withstand skin injury and ulcer formation along with improved appearance.”
Retinol is a powerhouse ingredient to combat skin aging and should be part of any anti-aging skincare routine.
Just as retinol does, Alpha Hydroxy Acids (AHA) and Beta Hydroxy Acids (BHA) resurface the skin, clearing out blockages, dead skin cells, and dirt. AHAs are best used for surface exfoliation, giving a supple texture, decreasing the look of scarring and age spots, faded wrinkles, and decreased blemishes. The most supported AHA for reducing signs of aging is glycolic acid. BHAs penetrate more deeply into the skin, decreasing inflammation and signs of sun damage. The most common BHA used is salicylic acid. Exfoliating regularly will make your skin look brighter and keep skin healthy.
Chemical exfoliation increases the skin's sensitivity to the sun, so be sure to apply sunscreen in conjunction with any exfoliation routine. Aging skin can be more sensitive to acids, so try a patch test or spread out the application of these products to once weekly, if your skin can tolerate it. Physical exfoliation is not recommended due to the thinness of the skin and compromised barrier function.
There is evidence for the topical application of peptides on the skin, but research on the permeability of these peptides and their ability to soak into the skin is limited. This is primarily size-dependent. Many smaller peptides show more promising use cases than others, with some support for improved wrinkle and elasticity scores.
Drier skin is one of the most common concerns post menopause, and nothing moisturizes like hyaluronic acid. This ingredient has the ability to actually attract water molecules as it soaks into the skin. Choosing a moisturizer or cleanser with hyaluronic acid will decrease moisture loss and the dull appearance associated with dryness. This works best if applied when your skin is still damp.
Topical estrogen aims to help the skin by increasing the prevalence of estrogen receptors in the skin and rebuilding the structure lost by the decrease in estrogen production associated with menopause. Using topical estrogen with glycolic acid for 3 months has been shown experimentally to decrease the appearance and depth of wrinkles by 38%.
Ceramides repair the skin’s protective barrier and help maintain hydration levels, which are both affected in people going through menopause. There is about a 30% decrease in the ceramide concentration in the skin’s barrier with age. The reduction in the production of sebum is a critical use case for ceramides as they help change the pH of the skin and build up its barrier in the absence of your skin’s own oil barrier. Ceramides help with the problems caused by the loss of glycosaminoglycans by helping retain and lock more moisture in the skin.
There are ways to support glowing skin from the inside out by using antioxidants, proteins, and vitamins. Read our comprehensive article on Vitamins in Skincare for more information. Try adding these products to your skin care regimen around menopause.
One of the most significant contributors to the appearance of fine lines and wrinkles is the degradation of collagen and elastin in the skin. Supplementing with a quality collagen supplement that is targeted to the skin can improve skin texture by rebuilding and maintaining integral matrix proteins, restoring and protecting the look of skin volume. Collagen tripeptides work the best for the skin as they are small enough to cross the blood-skin barrier to affect real change in the dermis layer.
Topical Vitamin A in the form of retinol has been discussed already, but you can also take a Vitamin A supplement for your skin. Combined with topical retinol, skin aging scores are improved to some degree, though it has not been quantified at this time.
Vitamin C is a potent antioxidant that works wonders for the body and skin alike. Oxidation of the skin by UV radiation is one of the leading causes of degradation of skin proteins, causing wrinkles, spots, and general laxity of the skin.
Vitamin E has some effects when taken on its own, but is most potent when taken in conjunction with Vitamin C, further decreasing the effects of oxidative damage.
Hormone Replacement Therapy after menopause is a popular choice as it mitigates the effects of aging on the skin and body. Estrogen replacement can help with everything from degeneration of bone mass and skin proteins to hot flashes. There are some contraindications for its use, such as if you have a clotting disorder, a predisposition to breast cancer, or have had a stroke. Talk to your doctor if you are interested in this option, as it must be prescribed.
A well-rounded skincare routine for post-menopausal skin should have elements to protect, repair, and care for your skin from the inside and the outside. This regime can change depending on your individual skin concerns and sensitivities. If you have sensitive skin or any other skin condition, contact your dermatologist before undertaking an active-ingredient-heavy skincare routine.
There is a lot that you can do to support your skin as you go through this transition, from the inside and the outside. Build your custom skincare routine based on your concerns and what works for you. Crafting a personalized skincare routine with the right skincare products can make a significant difference in how your skin looks and feels during this time. Consult a dermatologist if you want to receive prescription-level concentrations of active ingredients to help with your skin concerns, such as Tretinoin.
The best active ingredients for aging skin are retinol and ceramides, in conjunction with collagen tripeptides, vitamins, and a healthy diet.
Skincare ingredients that have an alcohol base should be avoided.
The most important is Collagen, but Vitamins C & E are helpful as well. Consult a doctor if you’re considering Hormone Replacement Therapy.
Madeleine is a Medical Copywriter who was born in Upstate New York. She graduated from Temple University with a Bachelor of Science in Human Biology in 2019. She is a digital nomad who travels full-time.
Felipe is a hardworking and self-motivated dermatologist with a great passion for skin diseases and therapeutics. He has experience in specialised clinical care, researching scientific literature, and writing scientific articles.