How to Care for Your Skin as You Approach Menopause
You might be prepared for some symptoms as you go through menopause — like hot flashes, night sweats, insomnia, weight gain, and irritability — but your skin will also undergo changes. That’s because your dermis, or the thickest layer of your skin, is sensitive to the shifts in hormones that accompany menopause.
The average age of menopause — when a woman goes one year without a menstrual cycle — is 51, according to the American College of Obstetricians and Gynecologists. But that’s not when the transition begins. There’s a time period before menopause called perimenopause, which starts in a woman’s late 30s or 40s, says Leslie Meserve, MD, a board-certified internal medicine doctor, North American Menopause Society–certified practitioner, and chief medical officer and co-founder of CurieMD in Newport Beach, California. “It’s a time frame when women’s cycles and ovulation become less regular. A nice way to think about this is that ovaries go in and out of retirement,” she explains.
The cause of this is fluctuating hormones. During some cycles, estrogen will be high; during others, the hormone will be low. Levels of the hormone progesterone fluctuate as well. “There are a lot of ups and downs in the perimenopause years,” says Dr. Meserve. When you’ve gone through menopause, estrogen drops to close to zero. “In some cases, both estrogen and progesterone are undetectable,” she says.
As it turns out, these shifts also affect your skin. “Estrogen receptors in the skin play a role in sebum production, which keeps skin lubricated and promotes normal collagen production, the main building block that gives skin structure,” says Lauren Fine, MD, a board-certified dermatologist at Chicago Cosmetic Surgery and Dermatology. The fall in estrogen also leads to a decrease in skin thickness, so you may see more sagging and volume loss. And the hormone is vital to maintaining skin elastin. You may notice skin loses its bounce and begins to sag, she says.
During this time, there’s also a dip in testosterone, decreasing the activity of sebaceous (oil) glands, so you may notice less acne. That’s certainly fortunate, but with the one-two punch of the decline in estrogen and testosterone, the resulting dryness makes wrinkles appear more prominent, says Shilpi Khetarpal, MD, a dermatologist at the Cleveland Clinic. These changes to your complexion happen slowly over time, though there’s evidence that after menopause, skin and facial structure undergo more rapid changes, including thinner lips, deeper wrinkles, and a sagging jawline, according to a study published in August 2019 in the American Journal of Physical Anthropology.
How to Care for Aging Skin
This process can make it tough to know when — and how — to tweak your skin-care routine. Here are four steps for maintaining your skin health and appearance during this life stage.
Caring for Your Skin During Menopause Means Putting Hydration First
Because dry skin is one of the most common complaints at this time, you’ll want to switch to more moisturizing products. That means using a creamy cleanser (these will appear literally creamy out of the pump; avoid foam and gel or those with active ingredients like alpha hydroxy acids, which can be drying), says Dr. Fine.
Rather than applying a basic moisturizer before bed, look for a night cream. These are more occlusive than lightweight lotions, a term that simply means they effectively lock water into skin. When shopping for a night cream, one ingredient that traps moisture is ceramides, says Dr. Khetarpal; you can find them in CeraVe Skin Renewing Night Cream . Hyaluronic acid is another hydrator and is naturally found in your skin. This ingredient “pulls water in from the environment to hydrate skin, making it temporarily plump up like a grape,” she says. One option: Clarins Multi-Active Nuit .
Combat Wrinkles With Retinoids — But Still Stay Hydrated
Retinoids are another area that deserves your attention. These vitamin A derivatives, which you can get through a prescription from your dermatologist or over-the-counter promote cellular turnover (to reveal a fresh, brighter layer of skin) and increase skin thickness, says Fine. “We know that during menopause the actual thickness of skin is decreasing. Retinoids are the most targeted medication we have,” she says. The cruel reality is that retinoids are inherently drying, which only exacerbates problems with parchedness. You can combat this by using a single pea-sized amount on skin one or two times per week and increasing frequency as skin begins to build tolerance. (Each step up in frequency may take weeks to months.)
Also consider a retinol, a weaker form of retinoids, that’s available over-the-counter. Products like Sente Intensive Bio Complete Cream have been specifically formulated with sensitive skin in mind. If you find that retinoids and retinols are not compatible with your skin, look for products that contain peptides, which are proteins that promote collagen production, suggests Fine.
Recommit to Protecting Your Skin With a Sun-Safe Routine
Another surprising function of estrogen is that it protects skin from the damage caused by UV exposure. Without this built-in guard, you may notice more discoloration at this time, says Fine. Dermatologists might preach the importance of sunscreen for people of every age, but it’s even more critical now. In the morning, apply a broad-spectrum SPF 30 to exposed areas of skin before leaving your house.
Applying antioxidants topically are also important for combatting existing brown spots and preventing new ones from forming. Vitamin C is a tried-and-true antioxidant that dermatologists like Fine recommend applying before SPF in the morning. One of her recommendations is Avène A-Oxitive Antioxidant Water Cream ($42, Dermstore.com). She also likes SkinBetter Science Alto Defense Serum ($150, SkinBetter and through dermatologists), a combination of vitamins C and E, plus 17 additional antioxidants.
Talk to Your Ob-Gyn About Hormonal Therapy for Overall Symptom Relief (With Better Skin Being a Potential Extra Perk)
Estrogen is your skin’s best friend. A review published in June 2018 in the Journal of Cosmetic Dermatology suggests that higher levels of estrogen are associated with a more youthful appearance. That’s where hormone therapy (HT) may come in. HT refers to prescription drugs that treat certain symptoms in menopause, according to the North American Menopause Society.
Indeed, HT can help improve skin thickness, ramp up collagen production, and improve skin healing, says Meserve: “It’s an underreported but extremely valuable benefit of treatment.” HT is approved by the Food and Drug Administration for the treatment of vasomotor symptoms (hot flashes and night sweats) and vaginal dryness, she says. General skin health is not on that list, so it’s unlikely you’ll be using HT for skin benefits alone. That said, “most women going through menopause will have some degree of hot flashes and night sweats for a period of time. If they choose to use estrogen therapy, they’ll get the added benefit of improved skin health,” explains Meserve.
Several types of HT are appropriate if you’re seeking complexion benefits, and your ob-gyn can help determine whether this treatment is right for you. While there are estrogen suppositories for the vagina, these only target and improve vaginal health, so they’re not appropriate if you’re seeking skin perks, too. You’ll need systemic HT. “Systemic estrogen can be delivered through a pill, patch, gel, spray, and vaginal ring,” says Meserve. While these medications are safe, there are some concerns for certain groups of women (like those at risk for blood clots), so have an open conversation with your doctor to discuss what option is best for you.
