While much attention is given to the more commonly discussed symptoms, such as hot flashes and mood swings during menopause, the impact on the skin is frequently overlooked. Understanding skin health issues is crucial for women navigating this life stage, as it empowers them to adopt effective skincare routines that address their evolving needs.

Dr Saroj Poudel, a dermatologist and hair transplant surgeon, is the director and co-founder of Nirvana Skin Clinic and Hair Transplant Centre, Lazimpat, Kathmandu. He demystifies common skin problems during menopause, myths surrounding it and skin care tips that benefit menopausal skin.

How do hormonal changes during menopause affect the skin?

As we age, our skin undergoes changes, which can be notably affected by perimenopause and menopause. Perimenopause, the phase leading up to menopause, is marked by hormonal fluctuations, irregular periods, hot flashes, and night sweats. Typically occurring between ages 45 and 55, this transition can last from three to ten years and varies widely among individuals. During this time, the ovaries gradually reduce and eventually cease the production of estrogen and progesterone, hormones essential for regulating the menstrual cycle.

Reduced estrogen and progesterone levels may result in itchy, thinner skin that is more susceptible to menopause-related rashes and can also slow the healing process. Additionally, collagen, which gives the skin structure and firmness, decreases as estrogen levels fall. The American Academy of Dermatology notes that collagen levels can drop 30 percent within the first five years of menopause, leading to sagging, lines, and wrinkles.

Hormonal fluctuations also alter the skin’s pH balance, increasing sensitivity, irritation, and the likelihood of developing menopause-related rashes.

What are the most common skin problems that women experience during menopause?

In addition to dry, sagging, and itchy skin, menopausal acne is common. During menopause, the production and turnover of skin cells slow down, resulting in duller, more acne-prone skin. While estrogen levels drop, androgen levels might remain stable or rise, leading to increased oil production that can clog pores.

Sun damage accumulated over time can also cause dark spots or hyperpigmentation during menopause. Hormonal changes may contribute to unwanted facial hair growth and hair loss on the scalp. Additionally, hormonal fluctuations can result in thinning skin, increased susceptibility to bruising, and fragile blood vessels, leading to greater injury risk, dryness, loss of elasticity, and overall skin fragility.

Are there any skincare myths related to menopause that you'd like to debunk?

Many wrongly assume menopause affects everyone’s skin similarly, but experiences can vary widely. Some women may face dry skin, while others deal with oily skin and unexpected breakouts. The impact of menopause on skin differs from person to person, influenced by factors such as genetics, lifestyle, and prior skincare routines. Just as each woman’s menopause experience is unique, so is her skin’s response to hormonal changes.

Additionally, the belief that you leave acne behind once you reach your 20s is a misconception. Perimenopausal acne and breakouts are quite common and can occur even as your skin matures. Although targeted skincare can improve your skin, it won’t work miracles. To achieve healthy, radiant skin during perimenopause, it’s crucial to also focus on a balanced diet and healthy lifestyle.

How early should women start preparing their skin for the changes that come with menopause?

As women approach menopause, typically from their mid-40s to late 40s, they may observe their skin becoming drier. Also, elastin levels begin to decline in your 20s, leading to sagging around the eyes, neck, and cheeks—areas where fat is naturally more concentrated. Maintaining a consistent skincare routine can help delay the visible effects of menopause on the skin. Starting an active skincare regimen early can be beneficial in managing these changes.

Are there specific skin care tips that are beneficial for menopausal skin?

As your body changes during menopause, adapting your skincare routine is essential. Avoid tanning, excessive caffeine and alcohol, and smoking to help prevent ageing skin.

Here’s a suggested skincare routine:

Cleansing: Gently cleanse your skin twice a day with a mild cleanser. Washing your face in the morning and evening removes dead skin cells, makeup, and dirt. Choose non-foaming, gentle cleansers for ageing skin unless your skin is oily. For menopausal acne, look for cleansers containing salicylic acid.

Water Temperature: Use warm water, not hot, for bathing. Hot water can strip the skin of oils, increasing dryness and itchiness. Warm water helps retain moisture and prevents dry skin.

Moisturising: Apply moisturiser immediately after patting your face dry. Avoid rubbing your face; pat it dry and apply moisturiser while damping your skin. Moisturisers with hyaluronic acid, ceramides, or glycerin are particularly effective at hydrating skin.

Exfoliation: Regular exfoliation can help reduce age spots and acne. Exfoliate once a week for the best results, as over-exfoliation can lead to dryness and irritation.