Understanding Menopause and Skin Ageing: Embracing the Changes

Ageing is a natural part of life. We all experience it, but it can accelerate during the peri-menopausal period. Oestrogen plays many roles in our bodies. Since the skin is the largest organ, its health is significantly affected by falling oestrogen levels during menopause.

During menopause, oestrogen levels drop due to declining ovarian function. This shift leads to various skin issues such as dryness, photo-damage, fine lines, wrinkles, and thinning skin.

The Impact of Menopause on Skin Health

Dry Skin

As women enter perimenopause, they often experience dry, itchy skin. This condition arises due to a decline in both oestrogen and testosterone.

The Role of Oestrogen

Oestrogen promotes skin hydration by boosting mucopolysaccharides. These substances help keep the skin moisturized. It also enhances the production of hyaluronic acid, a water-loving molecule in the dermis. This keeps the skin plump and hydrated. Additionally, oestrogen encourages the production of ceramides, which help retain moisture and maintain a healthy skin barrier.

Testosterone's Influence

Testosterone also plays a role. It stimulates sebum production from sebaceous glands. Therefore, its decline during menopause leads to less natural hydration, resulting in dry and itchy skin.

Thinning Skin

Another effect of reduced oestrogen is thinning of the epidermis. This thinning can be attributed to diminished collagen synthesis and increased collagen degradation. Research indicates that up to 30% of dermal collagen can be lost in the first five years after menopause. Collagen levels then drop by about 1-2% annually. Consequently, this process creates thin, sagging, and dry skin.

Fine Lines and Wrinkles

Fine lines and wrinkles are also influenced by hormonal changes. During menopause, low oestrogen levels increase wrinkle formation. Additionally, skin elasticity decreases, compounding the issue. Studies show that skin elasticity declines by roughly 1.5% per year in women who do not use hormone replacement therapy (HRT).

Oestrogen creams may help by thickening elastic fibers in the dermis, improving their orientation. This can significantly enhance the appearance of wrinkles. A major U.S. study found that oestrogen replacement therapy can prevent wrinkle formation, likely due to increased skin collagen and glycosaminoglycans levels.

Photo Damage

Chronic UV exposure is the leading cause of extrinsic facial ageing. It generates free radicals and reactive oxygen species (ROS), which can cause oxidative stress, damaging proteins and skin cells. Such damage impairs the skin's ability to remain youthful.

Oestrogen possesses antioxidant properties that protect against photo-damage. After menopause, lower oestrogen levels make the skin more vulnerable to this damage. The absence of oestrogen leads to increased degradation of elastin and collagen fibers in the dermis. Oestrogen can also inhibit enzymes like matrix metalloproteinases (MMPs), which accelerate skin cell damage caused by UV exposure. The loss of oestrogen thus results in deep wrinkles, sagginess, and reduced skin elasticity.

Effective Treatment Options

To combat collagen loss due to oestrogen deficiency, it is essential to use ingredients that promote collagen synthesis in your skincare routine.

Key Ingredients

1. Vitamin A: This vitamin boosts skin cell turnover, improves texture and tone, and stimulates collagen production.

2. Vitamin C: It aids in collagen production and stabilizes collagen molecules through a process called hydroxylation. Vitamin C also offers protection against skin damage.

   
   

Additionally, as oestrogen stimulates hyaluronic acid (HA) production in the skin's deeper layers, its depletion during menopause can result in lower HA levels. Many HA products are available, including creams and serums. However, topical HA may not provide the same effects as intrinsic or injectable forms. Dermal fillers and skin boosters (like Profhilo) can deeply moisturize the skin, restore fullness, and diminish fine lines and wrinkles.

The advantages of HA-based fillers extend beyond enhancing HA levels. They can also address the bony resorption process, which accelerates during menopause.

Hormone Replacement Therapy

To address the underlying issue of oestrogen deficiency, hormone replacement therapy (HRT) is a viable option. This can include oral tablets, transdermal patches, gels, or local applications like pessaries and creams. HRT is associated with increased collagen content, improved skin elasticity, and reduced wrinkle formation.

Importantly, early use of HRT can prevent bone loss, including from the facial skeleton, helping maintain skeletal structure and counteract premature facial ageing.

Studies indicate that women using HRT within a year of their last menstrual period experienced significantly fewer wrinkles and less skin rigidity.

A Holistic Approach to Menopause

Menopause is a natural life stage. It's heartening that it is now discussed openly. Once, women had to endure symptoms in silence. Now, numerous options are available to improve the experience.

Facial ageing is just one symptom of menopause. I believe a holistic approach addressing these changes from the inside out will yield the best results.

Dr. Sophie Gaskell BDS PGDip (Aesth med)

@drsophiegaskell