How to Care for Your Skin Around Menopause
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As you approach menopause, you might expect some typical symptoms — like hot flashes, night sweats, insomnia, weight gain, and irritability — but your skin will undergo changes too. That’s because your dermis, or the thickest layer of your skin, is sensitive to the shifts in hormone levels (such as estrogen and progesterone) that accompany menopause.
“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.
Studies show that a woman’s skin can lose about 30 percent of its collagen during the first five years of menopause and about 2 percent of its collagen every year after that for the next 20 years, says Keira Barr, MD, a dual board-certified dermatologist and menopause specialist and the creator of Somatic Skincare, a mind-body intervention that aims to help women feel comfortable and confident in their own skin.
“Without estrogen’s influence to help produce hyaluronic acid and collagen, fine lines, wrinkles, jowls and sagging skin become more prominent, wound healing is delayed, and bruising is more common,” says Dr. Barr.
The skin becomes dryer, more sensitive, and more susceptible to irritation, inflammation, and rashes, she notes, adding, “Women may also notice that their pores appear larger due to weaker collagen and elastic tissue.”
During this time, there’s also a dip in testosterone, decreasing the activity of sebaceous (oil) glands, so you may notice less acne. Unfortunately, less oil production in more mature skin can further exacerbate dryness and dullness, says Fine.
Testosterone also plays an important role in skin firmness and tightness, notes Fine. “It directly impacts skin thickness, and so as testosterone levels drop (in both men and women), it can also contribute to skin sagging, fine lines and wrinkles, and thinning hair.
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 the change of life.
Put Hydration First
Because dry skin is one of the most common complaints, 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 apply 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.
Skin-care products can get pricey; some products are worth splurging on (see more on that below), but when it comes to cleansers and moisturizers, Fine recommends sticking with tried-and-true drugstore brands.
“CeraVe and Cetaphil are my favorites, no matter what your age,” she says. For example, CeraVe Skin Renewing Night Cream (Ulta.com) contains moisture-trapping ceramides, molecules that create and support the skin’s barrier to help it stay hydrated. Cetaphil Moisturizing Cream is another option that’s recommended for very dry and sensitive skin.
“Fancy, high-priced cleansers and moisturizers don’t work any better at the job they’re made to do. If anything, there may be added ingredients in them that are unnecessary and even detrimental when used in combination with other products,” warns Fine.
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 (Sephora.com).
Combat Wrinkles With Retinoids — but Still Stay Hydrated
Retinoids are vitamin A derivatives, which you can get through a prescription from your dermatologist or over-the-counter (Differin gel, CVS.com). They promote cellular turnover to reveal a fresh, brighter layer of skin as well as increasing 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.
But retinoids are inherently drying, which only exacerbates problems with parchedness. You can combat this by using a single pea-size 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.)
For women who can tolerate it, Barr recommends nightly use of a topical retinoid, but for those who find them too drying and irritating, there are alternatives.
“Bakuchiol is a naturally derived plant extract found to offer similar benefits to topical retinoids without the photosensitivity and skin irritation,” she says.
Although it has no structural resemblance to retinoids, bakuchiol has been shown to function similarly to traditional retinols by targeting the same cellular pathways, which means it offers skin benefits including smoother texture, less hyperpigmentation, improved elasticity, and fewer wrinkles, says Barr. Backuchiol is available in serums, creams or facial peels.
Additionally, peptides and senolytics are being incorporated into more products to support skin cell rejuvenation and regeneration as well as expanding options for addressing skin thinning and wrinkles, she says.
Barr’s go-to products containing these ingredients include Defenage 8-in-1 BioSerum and One Skin OS-01 FACE.
Retinol, a weaker form of retinoid that’s available over-the-counter, is another option. Products like Sente Even Tone Retinol Cream have been specifically formulated with sensitive skin in mind, says Fine, adding, “OTC retinoids have come a long way.”
Protect Your Skin With a Sun-Safe Routine
Another 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.
In the morning, apply a broad-spectrum SPF 30 to exposed areas of skin before leaving your house, says Barr. SPF is only a measure of UVB protection, says Barr. “You also need UVA protection and visible light, which is why you want broad-spectrum in addition to SPF 30 or above,” she explains.
A big part of how much protection your sunscreen is offering is how often you reapply, says Barr. “When you are outdoors for more than two hours, have been sweating profusely or wiped your body down after swimming, reapply sunscreen,” she says.
And don’t be stingy, says Barr. “Most people apply a fraction of the recommended amount, which is one ounce of sunscreen on your entire body, enough to fill one shot glass (2 tablespoons). For your face, ears and neck, an additional nickel-size amount or equivalent to about ½ teaspoon is recommended,” she says.
Topical antioxidants are also important for combating 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.
“Never skimp on a vitamin C product, because there is huge variation in formulations available, and they are truly not all equal,” she says. Fine recommends C-RADICAL Defense Antioxidant Serum (Alastin Skincare) and Revision Skincare C+ Correcting Complex 30 percent (Revision Skincare).
Know what is in your skincare products to avoid redundancy, suggests Fine. “Using too many active ingredients usually leads to excessive irritation and dryness and can ultimately do more harm than good,” she cautions.
Talk to Your Ob-Gyn About Hormonal Therapy
Although hormone replacement therapy is only approved by the U.S. Food and Drug Administration for the treatment of vasomotor symptoms (hot flashes and night sweats) and vaginal dryness, it could help. if you’re battling skin dryness. Meaning: Systemic estrogen therapy will help with bothersome hot flashes and sleep while also providing a benefit for skin, says Grace Evins, MD, a gynecologist at Live Well in WNC in Asheville, North Carolina.
Systemic hormone therapy comes in the form of a pill, patch, gel, spray, and vaginal ring, according to the Mayo Clinic.
While these medications are considered 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.
Dr. Evins agrees that a full risk/benefit conversation with a doctor who knows your health history is a must. “If it’s decided that systemic HT is appropriate, most women will experience positive effects on their skin,” she says.
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