How does menopause affect our skin?
As part of our regular Lunch & Learn series we were joined by Consultant Dermatologist Dr Emma Wedgeworth, to find out more about how menopause affects our skin, and what we can do about it.
Menopause and your skin
Henpicked: This was one of our fastest-filling webinars, which goes to show the importance of this topic for women. Let’s start by asking: how does our skin change during menopause, and why?
Dr Emma Wedgeworth: Skin changes hugely during menopause. This is due to hormonal changes and declining oestrogen levels. Oestrogen has a significant effect on skin, especially on collagen, which is the main building block of your skin. We have a ‘scaffolding’ underneath our skin, which keeps it nice and plump, but during menopause this can become weaker, leading to lines, wrinkles and loss of volume.
We know also that natural hydration levels can be lost. Hormonal changes can also lead to breakouts in the skin – caused by oestrogen falling and other hormones becoming more active. We can see a lot of things like bumps, dryness and sensitivity around menopause
Henpicked: Is it inevitable that the skin will change? And will it help if you’re on HRT?
Dr Emma Wedgeworth: Yes it is pretty inevitable that there will be some sort of shift around menopause. But there’s plenty we can do. HRT can have significant effect on skin health, as it promotes collagen. However, not everyone wants to take HRT, and we don’t recommend people take it just for the sake of their skin.
There are other things we can do to protect your skin and help with dryness. These include skincare and products, lifestyle, diet, and keeping out of the sun. There will be changes, so we need to address and tackle them.
Henpicked: What are the main challenges?
Dr Emma Wedgeworth: One of the big ones is sensitivity. As our skin becomes more lined and loses some volume we often want to start using active creams and anti-ageing products, but skin is sensitive so can’t tolerate these too well. It can also be a bit of a cycle. You want to prevent dryness so use a product, but then this can cause breakouts.
Henpicked: We accept that hormonal changes that happen in puberty, and teenage acne is very much understood. Do more women need to appreciate that acne can be part of menopause?
Dr Emma Wedgeworth: It’s a real myth that you only get acne around teenage years. A significant number of women who are spot prone may be so throughout their lives, often around the time of their period. During perimenopause, your androgen levels become relatively higher and you may break out a lot more. These breakouts can make people feel miserable about their skin, but there are so many things we can do to treat and address these changes.
Henpicked: Is eczema related to sensitivity?
Dr Emma Wedgeworth: Definitely, as our oestrogen levels start to decline our skin barrier – which helps our skin hold moisture – will start to become weaker and make our skin dry out and make it more prone to eczema. Some women also notice rosacea, a red flushing condition that can produce spots.
Henpicked: When it comes to managing menopausal skin what would be your top tips?
Dr Emma Wedgeworth: Everybody’s skin will behave a little bit differently. So it’s worth sitting down and thinking what is it you don’t like about your skin. This may be blemishes and breakouts, redness, or concerns about lines and wrinkles. Find one or two issues to target.
Then look at these in terms of lifestyle, skincare and medical and active creams. The big big big thing for skin is UV and sun exposure. It can be so tempting to go out and lie in it, I know. Lots of people say to me ‘I spent a huge amount of time in teens frying myself so it doesn’t matter.’ It does matter.
Being careful in the sun is really important. Pigmentation can also often be seen around menopause. So cover up, use sun protection, and avoid the hottest part of the day.
Henpicked: What is the best SPF?
Dr Emma Wedgeworth: Go as high as possible. We know from studies that we don’t apply anywhere near enough sunscreen get to the number on the bottle. Nor do we apply it regularly enough, we should be doing this every 2-3 hours.
I’d advise going for SPF 50 or sometimes 30. But SPF isn’t the only important thing. It helps protect against UVB rays, which burns us. But other rays like UVA can cause ageing.
Look for a broad spectrum sunscreen which protects against different types of rays, like Heliocare.
Henpicked: Is there a suitable sunscreen if you’re spot-prone?
Dr Emma Wedgeworth: Some people are tempted to try to control their spots with sun exposure to dry them out, but I really don’t recommend this.
Some sunscreens can be irritating, look for non-comedogenic which won’t block pores. Also, there are two types of sunscreen, chemical and mineral – some people with spot-prone or sensitive skin find the mineral ones better.
Henpicked: What kind of skincare and active products would you recommend?
Dr Emma Wedgeworth: First, go for a cream-based, rather than foaming, cleanser. This will act as a nice base for actives. Then try a rich moisturiser – ingredients like shea butter, glycerine and niacinamide can help your skin hold in water.
Then you might want to think about other things. Falling oestrogen levels means skin doesn’t hold water in as well, so you can use products to reproduce the effects of oestrogen. Emepelle can be great for this and it has been proven to improve dryness, thinning of the skin (atrophy) and dullness.
Their products use a special technology called MEP which mimics the way oestrogen works on skin.
It’s important to say this is not an HRT but can help skin hold water in and stay hydrated. In fact, anyone who can’t take HRT might find this a useful way to mimic the effects of oestrogen on their skin.
Other active products include retinols and retanoids, which are Vitamin A based and can boost collagen and even out tone and texture. These can be a brilliant addition to your menopause skincare regime.
Vitamin C is a potent antioxidant, so these products are good to use in the mornings to boost the skin.
Henpicked: Talking of vitamins, can supplements help?
Dr Emma Wedgeworth: I’m not the biggest fan of supplements, as you can usually get these nutrients through diet. I would recommend vitamin D, as we don’t generally get enough of that through sunlight.
Really, the best thing you can do is add plenty of protein, biotin, zinc and antioxidants to your diet. Try to eat lots of different coloured fruits and vegetables like berries, apples, carrots and sweetcorn.
Henpicked: Do you have any advice for crêpey, saggy skin on the body?
Dr Emma Wedgeworth: If you think this is unusual speak to your GP or dermatologist to check it’s caused by ageing and not a skin condition.
Exercise can help to boost muscle tone. And again, lots of protein in your diet. Meat, fish and eggs are first-class proteins and if you’re on a plant-based diet add in lots of things like lentils and tofu.
Henpicked: How much is genetic?
Dr Emma Wedgeworth: This is fascinating, actually. In terms of face ageing, it really isn’t that much. Maybe 20-30% is genetic, the rest is all about what we do, like smoking or exposure to the sun. It’s wholly heartening, as there’s so much we can do to change our skin.
Henpicked: Are there any ways we can eradicate dermatitis and eczema on our face and neck?
Dr Emma Wedgeworth: Make sure you’re not coming into contact with anything that causes irritation, like certain make-ups and fragrances. Keep your skincare as simple as possible, Avene is a good unfragranced range for eczema and dry or sensitive skin. If you can, try eliminating certain products and phasing them back in to see if there’s a pattern. If you can’t tackle it yourself, speak to your GP as there are anti-inflammatory creams which can help.
Henpicked: We’ve talked about food supplements, but what about collagen supplements?
Dr Emma Wedgeworth: I’m not a fan of collagen supplements. There are much better ways of boosting your skin’s collagen – it goes back to lots of protein in your diet, sun protection, and retinol or retinoid creams.
Henpicked: Is itchy skin a menopausal symptom?
Dr Emma Wedgeworth: It can be. If you have intense itching, go to your GP for some blood tests. But the most common reason for itchy skin is dry skin, so hydration is one of most effective things. Be careful what you wash with, use gentle products like E45 and Eucerin.