How the menopause can change your skin

Consultant dermatologist Dr Michelle Thomson, a member of the Birmingham Skin Clinic based at the city’s BMI Priory Hospital in Edgbaston, looks at how skin changes as women age and at the effect that the menopause has on skin condition. Here she answers a selection of frequently asked questions.

Why does our skin change when we hit the menopause? Is it primarily down to declining oestrogen levels? Or are there other reasons too?

Ageing of the skin is due to a combination of intrinsic factors (changes that occur with the passage of time) and extrinsic factors (changes from environmental exposure). Intrinsic factors are advancing age, and oestrogen deficiency during menopause whereas extrinsic factors include sun exposure and smoking. Declining oestrogen levels due to the menopause result in loss of collagen that makes the skin look different.

What are the main skin changes we’re likely to see as a result of the menopause? Adult acne, lost elasticity, dryness for example?

Dry skin is the predominant complaint at this stage. Other changes are fines lines and wrinkles due to reduction in elasticity and increase in extensibility of the skin. Itchy skin is another common skin problem of the menopause.

How do these changes specifically differ from those associated with just ageing?

As mentioned before, skin ageing is due to a combination of factors. Intrinsically aged skin tends to be smooth with fine lines and wrinkles whereas extrinsically aged skin from sun exposure is coarse and leathery with deep wrinkles and irregular pigmentation.

Are most of these changes fairly gradual? As women enter the menopause, can they expect to see these changes alongside the typical menopause symptoms?

Yes, the skin changes are gradual as oestrogen levels decrease with advancing age. You can expect to see them alongside the typical menopausal symptoms.

What can women use to help combat these skin problems? For instance, a particular moisturiser to help deal with dry or itchy skin, and something to help with any acne?

Emollients – also known as moisturizers – are the most effective way to improve dryness. They do this mostly by preventing the evaporation of water from the skin surface. Emollients also help to reduce itching.

Sunscreens are also important to prevent sun damage that causes photageing. Broad-spectrum (UVA plus UVB) is optimal. UVA is represented by the five-star rating system and UVB protection by the sun protection factor (SPF). People in the UK are advised to wear a sunscreen of SPF 15 or higher, and high quality (preferably five-star) UVA protection. Increased protection may be required abroad or in fair skinned individuals.

As the skin thins, is it likely to become more sensitive, and is there any value in using a product that is designed for more mature, sensitive skin?

Numerous over-the-counter creams may improve the appearance of facial skin, perhaps by simple moisturisation and some may diminish shadows and wrinkles by altering the reflection of light. Products containing photoprotection will help to prevent wrinkles and pigmentation associated with sun damage. There is also some evidence that products containing retinoids (Retin A) help to repair photoaged skin. Other preparations may be effective but the evidence is less robust.

Does HRT have any positive effect on skin changes caused by the menopause?

Studies have shown that oestrogen supplements after the menopause increases collagen, skin thickness and elasticity so it improves the quality of the skin. However, more trials are necessary to help make informed recommendations about using HRT solely to reduce skin ageing as there are side effects of HRT to consider as well.
What about diet? Are there any specific foods that might help with skin changes caused by the menopause?

Healthy eating is important for healthy skin. A balanced diet will provide antioxidants such as vitamin C and E, minerals such as zinc and selenium and plant derivatives such as soya that help to keep the skin in good condition.

Is there any particular skin change that could indicate cause for concern, ie is there anything that might not be considered normal as a result of the menopause?

Everybody needs to check their skin regularly to identify anything new or different on their skin. Seek help if you notice any changes in size, shape or colour of your moles or patches that are not healing.

For more information, visit bmihealthcare.co.uk.