Caring for your skin in menopause

You can do something about the changes to your skin and hair that occur in menopause.

Menopause, which officially begins one year after your last period, can bring with it some noticeable changes to your skin and hair. As hormone levels plummet, your skin can become dry, slack, and thin. You may notice more hair on your face and less on your scalp.

With the right care, you can lessen these effects. Here’s what dermatologists recommend.

Age spots and other signs of sun-damaged skin

If you’ve spent ample time in the sun without sun protection, you’ll likely see the effects now. Age spots and larger areas of darker skin can appear on your face, hands, neck, arms, or chest.

Skin cancer and pre-cancerous skin growths also become more common.

What you can do: To protect your skin, you want to:

• Apply sunscreen every day before going outdoors. To give your skin the protection it needs, use a broad-spectrum sunscreen with SPF 30 or higher. Apply it to all skin that clothing won’t cover.
  
  This can help fade age spots, prevent new spots from forming, and reduce your risk of getting skin cancer.

• Make an appointment to see a dermatologist for a skin cancer screening: Your risk of getting skin cancer increases with age. As your risk rises, skin cancer screenings become so important. The earlier you find skin cancer and pre-cancerous growths, the more treatable they are.

• Start skin self-exams: During your dermatology appointment, ask your dermatologist how often you should examine your own skin. You'll find everything you need to know to examine your skin at:
  
  Detect skin cancer

• Ask your dermatologist to recommend treatment for age spots: Before you buy any treatment for age spots, see your dermatologist for a skin exam.
  
  Skin cancer sometimes looks like an age spot or other dark spot on your skin. If you use your age-spot treatment on a skin cancer, you may fade the spot and delay treatment. Delaying treatment for skin cancer gives the cancer time to possibly grow and spread. This can make the cancer more difficult to treat.
  
  After examining your skin, your dermatologist can recommend an age-spot treatment that’s suitable for your skin.

In menopause, your risk of skin cancer rises, making skin-self exams and dermatology check-ups even more important.

Bruise easily

As estrogen levels fall, skin becomes thinner. Thin skin bruises more easily.

What you can do: You may be able reduce thinning skin. Here’s how:

• Apply a broad-spectrum sunscreen with SPF 30 or higher every day. While this cannot thicken your skin, it can prevent further thinning. You want to apply sunscreen to your face, hands, neck, and any other area that clothing won’t cover. And you want to do this every day — even in winter.

• Consult with a dermatologist about treatment options. A dermatologist will be honest about what may work for you. For some women, a retinoid cream can help. Laser treatment may be another option.

Dry skin

In menopause, skin loses some ability to hold water, so skin can get quite dry. This can be especially noticeable when the air is dry.

What you can do: The following can help combat dry skin:

• Wash with a mild cleanser instead of soap. For mature skin, soap can be too drying. And you definitely want to skip the deodorant bars.

• Apply moisturizer after bathing and throughout the day when your skin feels dry. A moisturizer with hyaluronic acid or glycerin can be especially helpful.

• See your dermatologist if your skin still feels dry. Exfoliation or microdermabrasion may help, but you want to see your dermatologist before trying one of these. At menopause, skin becomes thinner and trying one of these at home may cause more harm than good.

Facial hair

As levels of female hormones fall, you can see unwanted hair under your chin and along your jawline or above your lip.

What you can do: Waxing may be an option. If your skin becomes too thin for waxing, your skin can tear and bleed. To remove unwanted hair, you’ll want to:

• See your dermatologist. A board-certified dermatologist can tell you what you can use to remove unwanted hair. Options include laser hair removal and a prescription hair-reduction cream.

• Have a board-certified dermatologist perform laser hair removal if that’s an option: In skilled hands, this treatment may seem easy. Your risk of side effects increases dramatically when the person performing your laser treatment lacks medical training and in-depth knowledge of the skin.
  
  Who should perform your cosmetic treatment?
  Laser hair removal

After examining your skin, a board-certified dermatologist can tell you what can help lessen the changes.

Hair loss on your head

At menopause, many women notice thinning hair on their head. The first sign may be a widening part. Some women find that their hairline starts to recede.

What you can do: When it comes to hair loss, the earlier you start treating it the better your results. Because many things can cause hair loss, you’ll want to:

• See a board-certified dermatologist at the first sign of a problem. Treatment for hair loss depends on the cause. If your hair loss is due to menopause, your dermatologist may recommend minoxidil, laser treatment, or both.
  
  If you have already lost a considerable amount of hair, a hair transplant may be an option.
  
  Thinning hair and hair loss: Could it be female pattern hair loss?

Jowls, slack skin, and wrinkles

In menopause, skin quickly loses collagen. Studies show that women’s skin loses about 30% of its collagen during the first 5 years of menopause. After that, the decline is more gradual. Women lose about 2% of their collagen ever year for the next 20 years.

If you use only one anti-aging product, make it broad-spectrum sunscreen with SPF 30 or higher. Apply it daily.

As collagen diminishes, our skin loses it firmness and begins to sag. Jowls appear. Permanent lines run from the tip of the nose to the corners of the mouth. Wrinkles that used to appear only with a smile or frown become visible all the time.

Later, the tip of the nose dips. You may see pouches under your eyes.

Large pores also are due to lack of skin firmness.

What you can do: If sagging skin or wrinkles bother you:

• Protect your skin from the sun. This can reduce visible wrinkles and prevent new wrinkles.
  
  You’ll find other ways to treat wrinkles at:
  Wrinkle remedies

• Consider using a skin care product that contains retinol or peptides. These ingredients can increase collagen in your skin.

Pimples and other types of acne

As levels of female hormones drop before and during menopause, some women develop teenage-like acne.

What you can do: Because a woman’s skin is thinner and drier, treatments for teenage acne are often too harsh. Dermatologists recommend that you:

• Wash acne-prone skin with a cleanser that contains salicylic acid. This helps unclog pores.
• Avoid acne products that dry your skin. Drying your skin can worsen acne.
• Make a dermatology appointment if you cannot get acne under control. A hormonal treatment may be necessary.
  
  10 skin care habits that can worsen acne

Rashes and easily irritated skin

Around 50, the pH level of our skin changes. With this change, skin becomes more sensitive, and women are more likely to develop rashes and easily irritated skin.

If you have an existing skin condition, such as eczema or rosacea, this could worsen.

What you can do: If you notice any of these changes, you should:

• Use a fragrance-free moisturizer. This can reduce irritation.
• See a board-certified dermatologist if the rash lasts or a skin condition worsens. As skin becomes drier and more easily irritated, you may need a dermatologist’s help.

Wounds heal more slowly

Hormones play an important role in healing our skin. When hormones levels fall, skin takes longer to heal.

What you can do:

• Realize that your skin will heal. It may take longer now.
• See a board-certified dermatologist if an infection or other skin problem occurs. When skin takes longer to heal, you have a greater risk of getting an infection or other skin problem.

What changes will you make?

Now that you know what to expect, you also know there’s a lot you can do to diminish these changes. If all this seems overwhelming, a board-certified dermatologist can create an effective treatment plan that delivers noticeable results.

Find a dermatologist

Images: Getty Images

References
Hall G and Phillips TJ. “Estrogen and skin: The effects of estrogen, menopause, and hormone replacement therapy on the skin.” J Am Acad Dermatol 2005;53:555-68.

Kunin A. “Menopause and your skin: There is something you can do.” In: Kunin A. DERMAdoctor: Skinstruction manual. Simon & Schuster, United States of America, 2005:339-45.

Neder L and Sebastião Freitas de M. “Topical estradiol does not interfere with the expression of the metalloproteinase-1 enzyme in photo exposed skin cells.” An. Bras. Dermatol. 2012;87:70-5.

White GM and Cox NH “Disorders of hair.” In: White GM and Cox NH. Diseases of the skin: A color atlas and text (second edition) Mosby Elsevier, China, 2006:588-9.

Yaar M, Gilchrest BA. “Aging of skin.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008:967-8.

Zaulyanov-Scanlan L. “Hormones and aging skin.” In: Baumann, L. Cosmetic Dermatology. (second edition) McGraw Hill Medical, China, 2009:29-31.