Menopause is accompanied by a multitude of notorious side effects, ranging from hot flashes to vaginal dryness and hair emerging in unexpected locations. Nevertheless, what often goes unnoticed are the alterations the skin undergoes during this period (the average menopausal woman is 51 years old, as per the Mayo Clinic). “From the beginning of menopause, the estrogen levels in a woman’s body decline. The estrogen hormone plays a significant role in the signs of aging,” remarks Dr. Manish Shah, a board-certified plastic surgeon in Denver. Alongside the sweating and the unexpected chin hairs, this loss of estrogen implies that the skin will undergo a substantial transformation.
We sought advice from the experts on what to anticipate regarding menopausal skin – and which products and treatments can assist in combating any undesirable changes.
Collagen loss
“A 30% reduction in collagen occurs during the initial five years of menopause,” states Dr. Hadley King, a board-certified dermatologist in New York City. Collagen and elastin are what give your skin its fullness and youthful elasticity. Hence, as the production levels decrease, you might start observing sagging or loose skin in areas that were previously firm (or, as Dr. Shah puts it, “arms that keep moving even after your hand has stopped”).
Try: Dr. King guides many of her menopausal patients towards Empelle, a skincare line specifically developed for this transitional phase. Both the Empelle Serum ($175) and Empelle Night Cream ($195) contain methyl estradiolpropanoate, which Dr. King describes as “a non-hormonal means to activate the estrogen receptor.” It stimulates the production of estrogen, to counter menopausal skin problems such as sagging and fine lines.
Related: Skin-Care Tips From 7 Influencers Over 50
Fine lines and wrinkles
Owing to the dip in collagen, you’ll notice a rise in fine lines and wrinkles and a reduction in the skin’s plumpness. “As estrogen levels drop, there is also less connective tissue [in the skin], which leads to decreased hydration and compromised barrier function. This causes the skin to become thin, atrophied, dry, lackluster, and wrinkled,” explains Dr. King.
Try: Dermal fillers like Radiesse, Juvéderm, and Restylane will temporarily replenish lost volume in the lips, cheeks, or other sunken areas. Dr. King points out that they also stimulate collagen production, so some of that new fullness will be due to your skin’s natural response to the filler. While fillers typically last around 6 to 12 months, the results are immediate and there is minimal to no recovery time. Bruising and swelling are the most common side effects, but they usually resolve within about a week.
Devices such as Ultherapy and Thermage employ ultrasound and radiofrequency waves respectively to heat the underlying tissue – which tightens loose skin and initiates collagen production. Ultherapy is FDA-approved to treat the neck, chin, chest, and brow, while Thermage is FDA-approved for skin tightening on the face and body (most commonly on the stomach, arms, thighs, knees, and butt). Both treatments are safe for all skin types and tones but often require more than one session to yield significant outcomes.
Thin skin
“Many women encounter thinner skin that is more susceptible to tearing and bruising,” says Dr. Shah. This happens due to the loss of collagen, water, and elastin, which thins the dermis and results in a crepe-like appearance.
Try : There are several topical treatments that can marginally enhance the thickness of thinning skin. “Studies have demonstrated, for instance, that six months of topical glycolic acid stimulated a 27% increase in epidermal thickness,” says Dr. King. Glycolic acid, being an alpha hydroxy acid, removes the outermost layer of dead skin cells to expose healthier, radiant skin beneath. Not only can it improve thin skin, but it also reduces fine lines and wrinkles and discoloration.
Look for glycolic acid-based lotions such as Mario Badescu Glycolic Skin Renewal Complex ($35), Pevonia Botanica Renewing Glycosides Cream ($76), or Peter Thomas Roth 10% Glycolic Solutions Moisturizer ($45). Pause Collagen Boosting Moisturizer ($72) is another excellent choice for those aiming to combat extremely thin skin and fine lines, as it is packed with fruit extracts and tripeptides (in addition to glycolic acid), to aid in hydration and plumping.
Dry skin
Estrogen is crucial for skin hydration, Dr. Shah elaborates, because it “increases the skin’s production of oil, improves barrier function, and boosts water retention. Since menopausal women lose estrogen, dry skin is one of the most prevalent issues they confront.
Try: Humectants and emollients will help restore the skin’s moisture barrier and nourish dry skin. Apply your regular lotion daily, or opt for a richer version of a favorite cream. Options like Sol de Janeiro Brazilian Nude Body Cream ($44), Jergens Ultra Healing Extra Dry Skin Lotion ($8), or Cetaphil Rich Hydrating Night Cream ($16) are gentle alternatives that suit all skin types.
Dr. Gretchen Frieling, a triple-board-certified dermatopathologist in Boston, also recommends Vichy Neovadiol Compensating Complex Menopausal Replenishing Care ($55). Containing hyaluronic acid, glycerin, and an exfoliating agent called hepes, this product helps rejuvenate aging skin. “It’s designed to address four fundamental signs of menopause on the skin: loss of skin density, loss of skin structure, sagging, and dryness,” she explains.
Related: How Dermatologists Recommend Treating Dry, Winter Skin
Itchy Skin
Itchy skin, also known as pruritus, can manifest during menopause as a consequence of dryness. The skin might appear red and cracked and feel increasingly uncomfortable the more it is touched or scratched.
Try: Search for lotions specifically formulated to alleviate itch, such as Lubriderm Therapeutic Lotion ($8) or Curel Itch Defense Lotion ($9). Dermatologists also suggest trying an over-the-counter hydrocortisone cream, available at any drugstore. If the itchiness does not subside with over-the-counter moisturizers within two weeks or is so severe that it interferes with normal activities, it might be time to consult a doctor for a prescribed treatment.
Acne
“The decline in estrogen levels and the relative increase in androgens can enhance sebum production and cause acne,” says Dr. King. “If you haven’t had acne since your teenage years or pregnancy, this can recur due to hormonal changes,” adds Dr. Shah.
Try: Dr. King suggests discussing with your dermatologist about a prescribed acne medication, which can help regulate hormones, suppress sebum, or otherwise address the root cause of your breakouts. She recommends anti-acne oral medications, like Spironolactone; topical treatments, like Aczone; or products that contain acne-fighting ingredients, like salicylic acid and benzoyl peroxide. A good over-the-counter option is the Kate Somerville EradiKate Salicylic Acid Acne Treatment ($58), which contains 2% salicylic acid, to significantly reduce the appearance of pimples.
