How does menopause affect the skin?

It’s estimated that almost half of women experience skin changes during the menopause. As levels of estrogen decline, physical changes become increasingly noticeable. Dryness is the most frequently reported skin-related concern, but other changes are often apparent as skin becomes thinner and more fragile (1).

These changes are mainly caused by a decrease in both collagen and elastin, which can lead to a reduction in skin thickness, which in turn exacerbates skin ageing resulting in wrinkling and sagging. These effects tend to occur more rapidly at the start of the menopause transition; however, the rate usually slows with time.

Dryness and itching

The dry skin that many women experience during menopause is often accompanied by itching. Estrogen acts as a natural hydration booster by facilitating the production of hyaluronic acid as well as ceramides and sebum, both oily substances produced in the skin. As levels of estrogen decline, these substances also decrease, resulting in dryness, irritation and itching (2). The changes that occur during menopause also impact the skin barrier, again reducing sebum production and slowing wound healing.

It is important to recognise that itchy skin can also be a sign of other medical conditions, and for this reason, women are advised to see a healthcare professional for itching that doesn’t settle.

Thinner and more delicate skin

Reduced levels of estrogen can also cause the skin to become more fragile. Estrogen facilitates collagen production, a key protein that provides skin with its elasticity and firmness.  During the first 5 years following menopause, the skin loses approximately 30% of its collagen, followed by a more gradual decline in subsequent years.  This can cause the appearance of wrinkles, and the skin may be more vulnerable to bruising. Rosacea, a skin condition characterized by redness, flushing, and visible blood vessels, can be worsened or even triggered, by menopause.

Hot flushes and sweats (vasomotor symptoms)

Hot flushes are one of the most common symptoms of menopause and are experienced by a majority of women. During a flush, the skin may become redder or darker and may be sweaty and warm to the touch.

Excessive sweating over a prolonged period of time can soften and break down the skin, making it vulnerable to infections and irritation. It can also worsen existing skin conditions like eczema and psoriasis.

Scalp and hair

The scalp and hair may also suffer from the impacts of menopause, resulting in dryness of both and thinning hair. Some women may lose hair, too.

Does menopause have an effect on skin ageing?

Reducing the impact of skin ageing is a concern of many women during menopause, and the changes and alterations in function that occur during this time happen alongside the changes that naturally occur with ageing (3).

Preventative recommendations focus on reducing sun damage and preserving collagen, hyaluronic acid, and elastic tissue. A good sunscreen is crucial, and antioxidants and retinoids may also be considered to reduce the impact of ageing.

Other helpful approaches include lifestyle interventions such as stopping smoking and reducing alcohol intake, a balanced diet and adequate hydration.

Impact of hormone replacement therapy (HRT)

Research suggests that HRT may have a beneficial impact on skin ageing during and post the menopause transition (4,5,6). Studies of HRT in estrogen-deficient women suggest that moisture content, thickness, features of ageing and wound healing may improve (4,5,6).

References

1. https://pubmed.ncbi.nlm.nih.gov/21970508/
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC4264279/
3. https://pubmed.ncbi.nlm.nih.gov/16198774/
4. https://sciencedirect.com/science/article/abs/pii/S0190962204022200
5. https://sciencedirect.com/science/article/abs/pii/S0378512217306357
6. https://pubmed.ncbi.nlm.nih.gov/16096167/