Skin Changes During Menopause - what is really happening?

Our skin is exposed to many environmental damaging factors such as pollution, sunburns and chemicals, which, in the long term, can cause skin damage and premature aging. Another cause for gradual and permanent alterations to the general aspect of women's skin is menopause. In most women, this natural aging process occurs around 50 to 51 years of age. Menopause is defined as a permanent ceasing of the fertile period when the ovaries no longer secrete estrogen.

What does estrogen have to do with the skin?

Estrogen is vital for women's health and plays a series of essential roles in the development of female body characteristics and fertility. This hormone is also crucial for a strong immune system, balanced metabolism, protection of the heart function and blood vessels, sustaining bone density, mental health, fighting various illnesses, and also skin aspect. Estrogen is benefit for the skin as it:

• prevents dermal collagen decrease, which is essential in skin elasticity and firmness;

• maintains a healthy level of hyaluronic acid, which is responsible for retaining water, keeping tissues well hydrated and moist,  and preventing dryness; 

• sustains a healthy skin metabolism, it supports adequate blood circulation and tissue oxygenation;

• prevents and reduces dermal damage, post-injury inflammation and skin atrophy;

• boosts the immune response and promotes tissue repair after injury.

How do these changes happen?

Once the fertile period is over, estrogen is no longer required and the ovaries stop producing this hormone. The main menopausal changes, including those at skin level, are caused by a sharp decline in estrogen level or estrogen withdrawal and secondary impairment of the previously mentioned processes. Although other cells in the body still produce small amounts of estrogen, it is not sufficient to compensate for the secretory function of the ovaries, which are the primary sights of production.

In most women going into age-related menopause, skin alterations appear gradually. On the other hand, women undergoing surgical menopause, when for various reasons, the ovaries need to be removed, may experience more rapid changes. The skin aspect of each woman may also depend on the genetic background, associated skin issues, immune status, and even daily skincare routine. 

The sudden drop in estrogenic hormones that occurs with menopause will cause:

• a decrease in hyaluronic acid and collagen, a further appearance of fine wrinkles, especially around the eyes and accentuated permanent expression lines; 

• a reduction in the fat deposits under the skin which may emphasize the flaccid aspect, predominantly on cheekbones, jawline and neck;

• various degrees of skin dryness and even pruritus or itchiness in cases of severe or prolonged dehydration; 

• atrophy and significant loss of elasticity, also as a consequence of a decreased dermal collagen content;

• significant alterations in dermal cellular renewal and impaired skin metabolic processes;

• frailty and thus a higher predisposition for trauma, lacerations, bruising, and slow-healing processes.

Decreased collagen content: 

Estrogen deprivation is not the only reason why collagen synthesis is reduced and degradation is increased. Dermal collagen content is lowered even further due to a sudden rise in a series of small proteins called cytokines. In pre-menopausal women, these small proteins will help reproductive hormones communicate with specific cells. Their concentration is control by estrogens. After menopause, because estrogen can no longer maintain a healthy level of cytokines, these proteins will increase. A high level of cytokines is damaging to the skin as it contributes to elasticity loss, the appearance of fine wrinkles, thickening, inflammation, lowering of skin immunity and higher predisposition for infections.

Vascular changes in the skin:

In menopause, blood vessels of the entire body, including skin, are no longer protected by estrogens. The velocity of blood flow through the capillaries, or small blood vessels of the skin, is significantly diminished and they become dilated. This phenomenon may be aggravated with hot flashes and cause flushing or noticeable redness of face, neck and chest. Hot flashes appear as a result of a lower threshold in the heat-regulating center or body thermostat, which is located in an area at the base of the brain. During hot flashes, the brain misinterprets the body temperature as too high or too low.

Can we combat age-related skin dryness? 

Yes, absolutely! Skin aging, although natural, can affect the psychological state and well-being of all women. Although we cannot stop the passing of time, there are a few simple things that can help slow down the aging process and sustain a healthy aspect of our skin, overall health and state of mind:

• Eat a healthy diet rich in minerals, vitamins and antioxidants that protect the body from free radicals or harmful molecules and promote collagen synthesis. 

• Drink enough water to keep your entire body well hydrated and avoid too much coffee or alcoholic beverages as they can cause dehydration;

• Exercise regularly and get enough sleep to get relief from stress, boost your immune system and improve healing processes. An active lifestyle will also increase blood circulation and oxygen to the entire body, including the skin;

• Opt for natural products rich in antioxidants that are adequate and balanced to fit your skin type. Don`t use chemicals that might prevent your skin from healing and producing new healthy skin cells;

• Develop a daily skincare routine, use moisturizing cleansing solutions and avoid soap-based makeup removers that might worsen dryness. Always use adequate moisturizing creams or serums on your face, neck, chest and hands. During the day, use a 30+SPF moisturizer to protect your skin. Keep spots away with gentle exfoliating products, and always hydrate your skin. Facial massage can stimulate collagen production and help you regain your beautiful contours.

Summary:

Our body functions and metabolism modify with every year that passes, and menopause-related skin changes may seem inevitable. Yet, it is not mandatory to feel that at 50+ years of age, the skin on our face went almost overnight, from looking soft and hydrated, like a peach, to very dry and almost like crepe paper. A healthy lifestyle and skincare routine with natural products can help keep back those dreaded wrinkles and dryness. 

What can we do about skin dryness?

Go with pure and natural products! Dr. Elsa Jungman can help you prevent and treat skin dryness, with our microbiome products. 

References:

Borg, M., et al. “The Role of Cytokines in Skin Aging.” Climacteric, vol. 16, no. 5, 2013, pp. 514–521., DOI:10.3109/13697137.2013.802303.

Pfeilschifter, Johannes, et al. “Changes in Proinflammatory Cytokine Activity after Menopause.” Endocrine Reviews, vol. 23, no. 1, 2002, pp. 90–119., DOI:10.1210/edrv.23.1.0456.

Raine-Fenning, Nicholas J, et al. “Skin Aging and Menopause.” American Journal of Clinical Dermatology, vol. 4, no. 6, 2003, pp. 371–378., DOI:10.2165/00128071-200304060-00001.

Brzezinski, Amnon. “Menopausal Symptoms.” Menopause, vol. 26, no. 3, 2019, pp. 229–230., DOI:10.1097/gme.0000000000001290.

Tiidus, Peter M. “Estrogen and Menopause: Muscle Damage, Repair and Function in Females.” Sex Hormones, Exercise and Women, 2016, pp. 71–85., doi:10.1007/978-3-319-44558-8_5.

Birkhaeuser, Martin, and Andrea R. Genazzani. Pre-Menopause, Menopause and Beyond: Volume 5: Frontiers in Gynecological Endocrinology. Springer International Publishing, 2018.