Life expectancy doubled in the last century and women still continue to outlive men. It means that women in the developed world entering the post-menopausal generation can look forward on average to a third of their life ahead of them. The menopause is particularly challenging.
As female hormones deplete the skin’s aging process accelerates. Here we will look at how this occurs and what you can do to minimise its impact.
Menopause is clinically diagnosed as the day a woman has not had a menstrual flow for a full year. Before this happens, a woman will experience changes in her menstrual cycle, such as infrequent periods, heavier or lighter bleeds, hot flushes, night sweats, mood swings and vaginal dryness. This is what’s known as the peri-menopausal stage, which can either pass by symptomless for some or noted changes can last up to a few years. The natural transition into post-menopause is a journey which every woman will encounter at some point in the years that follow her 50th birthday. Some women will go through these changes earlier.
Oestrogen affects every organ system of the body, not just the skin. However, the most plentiful oestrogen receptors are in places such as the face, lower limbs and genitals. This is why most skin problems exacerbated by the menopause tend to occur in these areas.
As the ovaries produce low levels of oestrogen in menopausal women, skin ageing becomes more aggressive. This is because oestrogen is partly responsible for dermal thickness and hydration. Oestrogen also increases the skin’s hyaluronic acid levels, which is its number one hydrator. Hyaluronic acid loves water and can attract water molecules equal to a thousand times its own weight. This process contributes to what we commonly call a youthful, plump appearance in younger adults. When hyaluronic acid levels deplete, the skin becomes drier, and wrinkles are more likely to develop.
Oestrogen also helps to increase collagen synthesis within the dermis. Collagen is what supports the skin’s deeper layers, keeping them tightly packed together like a supportive mesh. As oestrogen levels decline, collagen quality and density diminish within the skin. Lack of collagen causes the dermis to become thinner and wrinkles to increase.
Oestrogens also have anti-inflammatory properties, so when these hormones drop in a woman’s body she can experience hot flushes and night sweats. If the patient suffers from any inflammatory conditions, such as Rosacea for example, it is not uncommon for these conditions to flare up before, during or after the menopause. Extra care and consideration should be given to all women with inflammatory conditions and who are going through the menopause.
Another skin issue exacerbated by the menopause is sun damage. Oestrogens regulate melanocyte activity (the colour forming cells); so again as these hormones decline the number of melanocytes in the skin reduce. As a result of lower melanin levels, menopausal women have less protection from ultra violet rays and their skin colour becomes paler. Hyperpigmentation (patches of increased colour) and age spots can also occur on the face, hands and upper torso if those areas are exposed to the sun. Again this is due to oestrogens not being present in order to regulate melanin production. It’s therefore very important to use high factor broad-spectrum sun protection every day, regardless of the weather forecast.
Female pattern alopecia, or baldness, can also occur during the menopause. As oestrogen levels decline, the oestrogen–androgen ratio becomes unbalanced resulting in relatively higher androgen levels, such as testosterone. Higher testosterone levels in the body can cause hair loss in women, increase sebum production so menopausal women are more prone to acne and facial hair can be more prominent.
The menopause can also cause increased mucosal dryness. Many women notice vaginal dryness and discomfort during intercourse. There are oestrogen creams which can improve this symptom, or simple KY jelly can help.
It’s important to be aware that not all women going through the menopause will face all of these symptoms, some may not have any symptoms at all. If signs of skin ageing are a concern, there are plenty of professional treatments which will boost collagen and elastic tissue production as well as increase glycosaminoglycans such as hyaluronic acid, in the skin. As with all anti-ageing treatments, the earlier you start treating the skin the better the result is likely to be.
If the skin has become dry, avoid using skin-drying soaps and shower gels. Anything that foams up is likely to dry your skin further. A moisturising wash which is soap free, such as Dermol 500, would be a better option.
To increase the collagen and elastic tissue production on the face, neck, upper torso and back of hands, Fraxel laser treatment can be a very effective anti-ageing solution. You should visit your dermatologist for a consultation and they will assess whether you are suitable for such a treatment. Significant results can be seen from the first session. The Fraxel laser works by creating microscopic puncture holes into the dermis which cause regenerating effects, improving aged skin as well as scar tissue.
Exfoliation is another key step in rejuvenating ageing skin. Professional treatments such as microdermabrasion help to speed up a slower cell turnover, and improve the texture of the skin’s surface, resulting in a more translucent complexion.
Retinoids, including Retinol, are part of the Vitamin A family. These increase cell proliferation and fibroblast activity such as the synthesis of new collagen and elastic proteins. Retinoids help prevent thinning of the skin as we age, reducing fine lines and wrinkle formation. For best results you should choose a 0.1% or 0.05% tretinoin cream and use once to twice a week nightly to start, with the aim of using every night once tolerance has improved. This is a prescription only medication so again you must visit a qualified doctor in order to ascertain your suitability.
In the daytime, a hyaluronic acid serum or cream applied to clean skin would improve hydration each morning. If you are experiencing hot flushes or have inflammation then try using a non-steroidal anti inflammatory cream which contains ingredients such as camomile, green tea or liquorice.
The antioxidant, Vitamin C, can also have ‘brightenthing’ effects on the skin; when used topically in high concentrations (10-20%) and has been shown to boost collagen production too.
The menopause can accelerate a range of symptoms, but there are treatments available to help ease the impact. Better understanding of the menopause will help women cope with the changes they are likely to encounter. It’s a challenging stage in any woman’s life but hopefully with the correct advice and support can be dealt with smoothly.
By Una Jefford