Skin Care Questions
|What Skin Changes Occur In Menopause?
Most women (unless they are very lucky!) will notice changes to their skin in early perimenopause. Those changes range from dryness and tenderness to the appearance of fine lines and occasional outbreaks of adult acne. Some of this is linked directly to the aging process. The longer we live, the more exposed we are to the effects of gravity and its pull on our skin. Additionally, over time our skin is exposed to sun damage, illness and medications which all contribute to wear and tear. However some experts believe that declining levels of estrogen during menopause plays a significant role. The collagen and elastin fibers which keep the skin supple slowly begin to deteriorate as estrogen levels decline. This leaves room for wrinkles to develop. But medical experts are divided on how blame should be apportioned - which has the worst effect, gravity or declining levels of estrogen? Some scientists believe it is all part of the natural aging process, while others declare low levels of estrogen in the years leading up to menopause speed up the process. This is an important differentiation because it may be the deciding factor for some women on whether or not to start estrogen replacement therapy (ERT).
Don't Miss: Our extensive article on the effects of menopause on the body.
Signs Of Changes
As we age our skin tends to produce less oil. This causes it to send thirst signals to the brain in the form of dry patches and itching. Symptoms may worsen in the winter months. Ointment moisturizers such as Vaseline Petroleum Jelly and Aquaphor are effective and inexpensive all over body moisturizers for dry skin. They should be used in small amounts to prevent leaving too much grease and rubbed in well. Oil moisturizers are slightly less greasy and can be applied directly to the skin or added to bath water. In general it is better to apply all types of moisturizers after bathing onto damp skin. Cream moisturizers tend to be the most popular option and good brands include Vaseline Cream, Aquaphilic, Cetaphil Moisturizing Cream and Eucerin Cream. Also, Nivea, Nutraplus and Nutraderm. Lotions are less greasy and another popular choice for women. However as they contain alcohol they may be slightly more drying. Lubriderm, which is developed by dermatologists, is a good option. Generally speaking the greasier the moisturizer the better, as this will help trap moisture in the skin. See, what is dry skin? as well as what is the best treatment for dry skin?
Note: The US Food and Drug Administration does not have the authority to regulate what ingredients go into cosmetics. They can only interfere where they have received reports that the product is causing harm, or where completely false claims of effectiveness are claimed. If in doubt consult a dermatologist for advice.
Not sure if you are menopausal? See Menopause testing and signs of menopause. Additionally you may find our list of books on menopause provides some useful guides.
As skin ages it becomes thinner and more sensitive to irritants. As women enter menopause they may notice that their skin reacts to products which never bothered them in the past - certain cosmetics, soaps, perfumes or laundry detergents suddenly start causing rashes. The nipples and vulva skin can become dry and chapped and be particularly sensitive to chemicals. When you wash your underclothes, rinse them twice and never use dryer sheets because their antistatic agent can cause irritations. See, what is sensitive skin?
During perimenopause estrogen levels decline but the male hormones (androgens) remain relatively high. This creates a hormone imbalance which can lead to excess testosterone at the skin receptor, a common cause of adult acne. Androgen excess acne can remain a problem until postmenopause when the production of androgens finally falls. Women taking hormone replacement therapy which contains testosterone are more prone to outbreaks as well as other side effects such as hair loss in menopause (male-pattern baldness) and hirsutism (excess body hair). Other common causes of androgen excess acne include polycystic ovary syndrome, insulin resistance and ovarian and adrenal tumors. See also, what is acne?
As our skin loses its elasticity the pores on our face become bigger. If we do not maintain a good cleansing routine, a buildup of oil and cells can cause the pores to expand even further.
As we age the skin becomes drier and less elastic and so wrinkles start to occur. Creases appear in the skin where the muscles contract regularly, the so-called laughter lines. But with age these lines remain long after we have stopped laughing! Other fine lines (known as crow’s feet) appear on other parts of the weakened skin. Some researchers feel that these may however also be the result of estrogen levels and not just the aging process. See also, what is a wrinkle?.
Under 40 with menopausal signs? See: Premature menopause.
Whether or not estrogen therapy can slow the pace of aging is still not clear. Some experts believe it does while others are certain that changing balances of hormones have nothing to do with skin quality. If you do decide to try HRT, skin creams rather than an oral pill may be more effective. Creams, technically known as transdermal estradiol therapies are applied directly to affected area. Premarin is one brand which is derived from pregnant horses urine (!) and sold as an estrogen cream, patch and pill.
The best way to prevent wrinkles is to keep your face out of the sun. But assuming it’s too late for that, there may be some other options to reverse some of the effects. Facelifts, dermabrasion and chemical peels and all options for sagging skin and deepset lines. Botox injections can temporarily remove lines by paralyzing the affected muscles. After a few months the paralysis wears off and the lines return. On a more practical level, a few years ago researchers announced that they had discovered a wonder drug that would permanently remove wrinkles. It was called Retin-A (generic name tretinoin, a form of vitamin A acid). It certainly seems that products which contain tretinoin appear to plump the skin and smooth out fine lines. It can reverse sun damage by speeding up cell renewal and restoring the skin’s ability to produce collagen. However it usually takes months before any improvements are noted and when treatment stops, the lines return. To prevent skin irritation it needs to be started in small doses and the applied area needs to be covered with sun screen. Another option is fruit acids, otherwise known as alpha-hydroxy acids (AHAs). They help to remove surface dead skin cells, making the skin look and feel smoother. It can cause irritation but new products contain beta-hydroxy acids which incorporate a mild aspirin type chemical to reduce irritation.
Note: Be wary of creams which are advertised as a 'scientific' breakthrough for promoting collagen production. No cream or lotion can pass through the skin and make the body produce more collagen.
There is truth in the saying 'you are what you eat'. For this reason it is a good idea to include skin-friendly foods in your diet. These include yellow and orange colored foods, such as oranges, carrots and pumpkins which contain high levels of vitamin A. Include foods which contain omega 3 and omega 6 fatty acids, such as salmon and walnuts as they help the skin's membrane to retain moisture. Berries such as strawberries, blackberries and strawberries contain phytochemicals which protect the skin from free radicals. And, green tea contains an anti-inflammatory which is good for skin health.
What Skin-Care Regime Should I Have?
As we approach menopause our skin care regime should be gentle on the skin, it should protect it from harmful elements and feed it nutrients to prevent premature aging.
Clean the skin with a cleanser free of perfumes and colors. Medical cleansers such as Obagi and Biomedic are good choices because they contain active ingredients which cannot be purchased in the same strength over the counter. Also choose a cleanser with a pH lower than 5.5; a lotion is usually better than a bar.
If you apply lots of moisturizer but your skin still feels dry, chances are you need to exfoliate. The lotion is not permeating the skin because there are too many dead skin cells in the way. Exfoliating will give your face a brighter appearance and also reduce the amount of blackheads. Ideally choose an exfoliate which contains beta hydroxy acids because it is less harsh on the skin. Prescription options include Tazorac and Retin-a Micro.
Choose a moisturizer that protects from both UVA and UVB rays. UVA rays affect us all year round and can penetrate glass. These are the ones that do the long-term damage to skin. UVB rays cannot pass through glass but they can burn and tan the skin. One product which contains both is Anthelios which contains a very strong sunscreen called mexoryl. Women who have had skin cancer or suffered skin pigmentation problems such as the 'mask of pregnancy' should use a moisturizer with mexoryl.
How To Prevent Premature Skin Aging
If you would like to hold off the aging process as long as possible, the following a few important prevention tips:
Avoid Sun Exposure
90 percent of symptoms associated with premature skin aging are caused by the sun. See also cancer causes for more effects of the sun.
Drink lots of water as this will help keep the skin rehydrated and plump. Although it will not prevent wrinkles it will help reduce their appearance.
Skin Care Regime
Follow a good skin care regime as outlined above.
Do Not Smoke
Smokers on average have more wrinkles than non-smokers. A heavy smoker at 40 can have the same lines as a 60 year old non smoker.