Menopause is something that's not talked about enough - but we'd like to change that. This article will cover the SKIN changes that occur during and post menopause, and our part 2 article will be written by naturopath Katie Addison-Saipe, covering the internal changes brought about by menopause.
I’m lucky. I grew up in a very open household, and when my mother went through menopause, she told me all about it. Seeing her experience of menopause and having her talk about it so openly, I have a pretty good idea of what I can expect when I go through it too.
In many households and social settings though, menopause is a taboo subject. It's simply not talked about, despite the fact that every woman will go through it at some stage in our lives - and as a result, a lot of women are really not informed on the menopause process.
So what exactly is menopause?
Menopause is a hormonal shift that most commonly occurs when women are in their forties/fifties (the average age of menopause is around 51). There are some exceptions to this of course, but this is the most common timeframe.
Menopause is defined as the final menstrual period, and is confirmed when a woman has not had a period for 12 consecutive months.
The hormonal transition of menopause usually lasts around 7 years, during which time the body's production of estrogen and progesterone shifts. This leads to a host of changes in the body, which can affect sleep patterns, temperature regulation, moods, metabolism, bone density, and... the skin.
In this article, I'm going to zero in on the SKIN changes that occur during and post menopause - we'll cover the other effects of menopause in our part 2 post (coming soon!).
The skin side of things...
There are a LOT of changes in the skin during and post menopause. I'll give you the short/simplified version first (with diagram!), followed by an in-depth version below. If you want to skip the nitty gritty, just read the short version and scroll right past the in-depth version!
The short/simplified version:
Skin becomes thinner
Production of new skin cells (cell turnover) slows down
Production of oil in the skin slows down
Collagen and elastin levels reduce in the skin (from the age of 25, we lose an estimated 1-2% of our existing collagen density. During the first 5 years post-menopause, we lose 30% of our remaining collagen density.)
Skin becomes more prone to sensitivity
Skin becomes more prone to dehydration
Skins immune function can be impaired
Muscle tissue and facial fat pads atrophy, reducing facial volume
The long, in-depth version, for those who want it:
Thinning skin occurs due to a multitude of factors, including a decrease in number of fibroblast cells (which produce collagen and elastin), and a slowdown of collagen and elastin production by these cells. This all results in declining collagen and elastin density, which not only reduces the thickness of the skin, but also reduces elasticity, and tensile strength of the skin.
To compound the issue, collagen and elastin begin to arrange differently within the skin - no longer in an organised, basket weave pattern, instead the fibres curl and bundle, causing wrinkling of the skin tissue, and loss of elasticity.
Volume loss is partly due to thinning skin, but more to do with atrophy of the fat, muscle tissue, and bone underlying the skin.
The facial fat pads that provide our skin with cushioning and give volume to the face, reduce in size, which reduces the overall volume of the face.
Finally, muscle tissue underlying the skin also atrophies, again affecting overall facial volume.
Lastly, the decline in estrogen during and post menopause, results in bone resorption which causes a gradual decrease in bone density and to a degree, bone size. The visual effects of this loss of bone tissue can particularly be seen in the jaw area, where it exacerbates skin laxity ("sagging"), and the orbital (eye) area, where it exacerbates under-eye hollowing and dark circles.
Cell turnover slowing down means production of new skin cells in the epidermis is slower. This means cells remain in the epidermis for longer, and accumulate more damage. It also can lead to a thickening of the stratum corneum (outermost layer of epidermis), rougher skin texture, dull appearance, and poorer absorption of skincare products.
Decreased oil production can cause dryness and dehydration, as well as barrier impairment. The flow on effect is reduced water content of the skin, and increased sensitivity/reactivity. Visually, it enhances the appearance of lines/wrinkles, and creates a dull appearance of the skin.
The all-important dermo-epidermal junction is affected too. The rete ridges that anchor the dermis and epidermis together, flatten out - weakening the junction between the layers, and reducing the surface area available for nutrient transfer to the epidermis.
Decreased numbers of immune cells can result in reduced immune function of the skin, which combined with barrier impairment, increases risk of skin infections.
Hyaluronic acid and glucosaminoglycans are depleted, reducing the water-retaining abilities of the skin and contributing to dehydration.
So this all sounds pretty grim - but I promise there is GOOD news to follow.
Menopause results in pretty significant changes to the skin, but there is actually a lot you can do to minimise/slow these changes, and support your skin health. Lets go through them:
Sunscreen is the best thing you can do for your face. Period. I really can't stress this enough, so if you only take one thing away from reading this article - make it this paragraph! Just about every skin change brought on by menopause (and the skin ageing process) is worsened by UV damage. Protecting your skin from the sun will help to slow down and mitigate the changes happening in the skin. It will also help to prevent skin cancer so, there's that.
Topical nutrients literally alter the way your skin cells behave and are an effective tool that we should all be utilising to support the health of our skin. The key ingredients to focus on are: vitamin A (retinol, retinal, etc), vitamin B (niacinamide, panthenol, etc), vitamin c (THD ascorbate, ascorbic acid), hyaluronic acid, and peptides.
Topical lipids are incredibly supportive to your skin barrier, and can replenish the important oils that are produced less and less in menopausal/post-menopausal skin. Ceramides in particular (which are naturally produced by your skin) are extremely beneficial to post-menopausal skin.
Reduce your inflammatory load, and drink plenty of water. Sugar, alcohol, systemic dehydration, lack of sleep, smoking (or vaping), will all worsen skin health, at any age. I'll leave lifestyle factors in supporting menopausal skin (and the rest of the body) to the part 2 menopause article, but I just wanted to note that your internal health must be taken into consideration, when addressing skin concerns.
Finally, clinical treatments are the cherry on top when you've nailed your skincare routine, and are looking after your health. Skin peels and micro-needling (collagen induction therapy) are two transformative skin treatments that will boost skin health, and slow down/mitigate the aforementioned changes that happen during menopause. In many cases, cosmetic injectable treatments can be utilised too, to support a good skincare routine and clinical treatment program.
In conclusion...
The skin changes brought about by menopause are more than just lines/wrinkles - its a huge shift in the structure and health of your skin, and the way that it behaves.
But there is truly so much you can do to support the health of your skin, and slow down these changes.
We all want to look good, but it's important to focus on the health of the skin first and foremost. If the skin is healthy, and functioning properly, it will look better too!
My final piece of advice, is to enlist the help of experts if you have access to them. Skin therapists like me, yes - but also, women's health specialists, naturopaths, integrated medical doctors. The menopause process can be physically and psychologically difficult, but there are experts out there who can help to make your experience a smoother one.
Some experts I personally recommend to my clients are:
https://holisticmedicalcentre.co.nz/ for integrated medical doctors, with a holistic approach
https://www.claritywellness.co.nz/ Katie Addison-Saipe naturopath
http://www.drfrances.co.nz/index.html Dr. Francis Pitsilis, integrated medical doctor
If you are in need of guidance in caring for your skin, book a complimentary skin consultation with us - you can do this here: https://www.skinritual.co.nz/book