Menopause: How can women take care of their skin in their 50s and beyond

Jul 28, 2023

Women

In this instalment of CNA Women's series on menopause, we look at how fluctuating hormones affect the skin, what products you should use and avoid, and how to keep your skin healthy and strong.

As a woman reaches menopause, the decrease in the body's oestrogen levels leads to a loss of collagen and elastin, resulting in skin dryness, wrinkles and sagging. (Photo: iStock/PeopleImages)

The skin is the largest organ you have, and it changes with age, including during menopause, when oestrogen levels decline rapidly.

The dip doesn't happen suddenly – it would have started after you hit 30. "Skin collagen and elastin peak around 30 years of age, which corresponds with the peak in oestrogen production," said Dr Lynn Chiam, consultant dermatologist at Children & Adult Skin Hair Laser Clinic.

After the age of 30, oestrogen levels in the body begin to decline. And that's about the time where you might notice the first fine lines and skin roughness.

Thereafter, as you reach menopause, "the rapid decrease in oestrogen leads to loss of collagen and elastin, resulting in skin cellular degradation", she added.

The American Academy of Dermatology said that the collagen in your skin decreases by 30 per cent in the first five years of menopause, and then dips by about 2 per cent every year, for the next 20 years or so, thereafter.

Combine this with the loss of fat – also part of the ageing process – and your skin can become dry, wrinkled, saggy (especially around the neck, jawline and neck) and thinner, as well as have impaired wound healing and decreased antioxidant capacity, said Dr Chiam.

SKIN WOES DURING MENOPAUSE

Skin dryness and wrinkles aside, your skin also produces more oil during menopause. This happens when oestrogen levels fall but other hormones like progesterone and testosterone remain stable.

"It throws the balance off and causes sebum production to increase, which is why some women experience acne during this period," explained Dr Tan Ying Zhou, medical director of Mizu Aesthetics.

Dr Barbara Sturm, founder of Dr Barbara Sturm, told CNA Women that the decrease in oestrogen levels can also lead to the skin becoming sensitive to UV exposure, which can result in increased hyperpigmentation.

Do also look out for increased skin sensitivity, said Dr Chiam. Studies show that the skin's pH increases after age 50 beyond the level at which the skin's microflora and defensive cells operate optimally.

"As the pH level climbs, those cells are less able to help defend the skin and we’re more prone to rashes, sensitivity and dermatitis," she explained.

What this means is that if you have an existing skin condition, such as eczema or rosacea, it could worsen with age.

CARING FOR MENOPAUSAL SKIN STARTS BEFORE 50

Just as you would adjust your skincare routine to address whatever your skin is going through, be it puberty or pregnancy, both doctors advise you do the same for menopause.

Dr Chiam said that some women might begin to notice changes in their skin in their 40s, in the perimenopausal phase, usually a few years before menopause. "Once you notice any of these symptoms, it would be good to change your skincare accordingly."

Such symptoms include:

Here's what to do and avoid, to care for menopausal skin:

1. AVOID GEL OR FOAM CLEANSERS

Your skin gets drier as you age, and even more so when approaching menopause, so it's important not to strip it of the little moisture it has.

"The key is using a cleanser that's right for drier skin," said Dr Chiam – a cleanser with a creamy formula that can help hydrate skin, and avoid moisture-stripping foam or gel cleansers.

Pro tip: Avoid using hot water when cleansing your face, and in the shower – it can further dry out your skin.

2. KEEP SKIN WELL-HYDRATED

"Using the correct skincare to replace lipids and rehydrate the skin is essential," said Dr Sturm.

To combat dryness, Drs Chiam and Tan advised using skincare that contain humectants and emollients.

"Humectants such as hyaluronic acid and glycerine help your skin to hold onto moisture while emollient ingredients such as ceramides and shea butter act like a barrier and seal moisture in," said Dr Tan.

For best results, Dr Chiam recommended applying moisturiser on damp skin to allow the ingredients to be absorbed better, and consider topping it off with a facial oil for even more hydration.

3. CONSIDER INCORPORATING RETINOL OR PEPTIDES INTO YOUR SKINCARE

When it comes to addressing the signs of ageing, retinol and retinoids are often mentioned.

These help repair the skin and stimulate collagen production, explained Dr Chiam, which is what the skin needs when collagen is depleted due to the loss of oestrogen, and to support skin function.

Both retinol and retinoids are derivatives of vitamin A. Retinol is available over the counter in skincare products whereas retinoids must be prescribed by a doctor.

Retinol can cause dryness, so start slow. "Using it a few times a week may be more suitable than daily use," said Dr Chiam.

An added benefit of retinol and retinoids is it has been shown to be effective in dealing with acne, so it can help with hormonal breakouts.

If you’re worried about the side effects of retinol, Dr Tan recommended including peptides in your skincare as "they also help build collagen and elastin".

4. PROTECT YOUR SKIN WITH VITAMIN C AND SUNSCREEN

The skin's barrier function weakens during menopause, said Dr Tan, and "this means your skin is less able to defend itself against environmental aggressors".

A potent antioxidant like Vitamin C can help neutralise free radicals and protect skin cells. It also stimulates collagen production and brightens the skin, helping to address the increase in hyperpigmentation that can happen during menopause, said Dr Tan.

Also important is sunscreen. Dr Sturm explained that as hormonal levels change, menopausal skin can become thinner and more delicate, and more vulnerable to UV damage.

ARE PHYTOESTROGENS IN SKINCARE THE WAY TO GO?

Phytoestrogens are compounds that naturally occur in plants. Dr Chiam explained: "Phytoestrogens exert a weak oestrogen-like effect."

While commonly associated with food, such as vegetables, legumes and some grains, phytoestrogens have become a research hotspot in the fight against skin ageing in recent years.

In skincare, plant-derived phytoestrogen actives such as resveratrol and equol are often used. Dr Chiam said these have been found to "help increase collagen and hyaluronic acid production, and have antioxidant and anti-inflammatory effects".

Paula Begoun, founder of Paula's Choice Skincare, told CNA Women that the effects of oestrogen loss on the skin can be "greatly minimised and even reversed" when phytoestrogens and even prescription oestrogen are used.

"Phytoestrogens are the only cosmetic ingredient that can help oestrogen-deprived skin," said Begoun. "There is overwhelming proof of efficacy and safety showing that topical application of phytoestrogens can significantly improve the appearance of skin experiencing oestrogen loss."

When used correctly, phytoestrogens "communicate to the skin cells that they have plenty of oestrogen, which restores the benefits oestrogen provides skin", she added.

LET’S TALK ABOUT SKINCARE MADE FOR MENOPAUSAL SKIN

The interest in such products is more to do with women no longer being embarrassed or reluctant to talk about how menopause is impacting their body and skin, said Begoun.

Added Dr Sturm: "We’re finally breaking down the stigma around speaking about ageing and menopause, which is naturally generating more interest and inspiring more conversations around wellness, skincare and health."

This interest and demand is also growing in Singapore, where the majority of the population is between 30 and 59 years old, said Grace Tay, a trainer at beauty brand Clarins.

Women are curious about how they can take better care of their skin when they reach menopause. And Tay said that menopause-specific skincare products target the root cause of the concern, such as skin slackening caused by the loss of oestrogen during this period.

But ultimately, Dr Chiam said that what matters is the ingredients used in these products. "As long as they contain ingredients that replace moisture and target the different skin woes without causing any irritation."

CARING FOR YOUR MENOPAUSAL SKIN FROM TOP TO TOE

When it comes to caring for the skin, think top-to-toe, rather than merely above the neck. Dryness doesn't just apply to the skin on your face, but all over your body, said Dr Tan.

"Skin isn't just about facial care. Every area of the skin on our bodies has different pH levels and a different microbiome, including our very sensitive intimate area," said Dr Sturm.

So consider including a body lotion or cream to your daily routine.

Yet another oft-overlooked area is your scalp. "Studies have shown that the condition of the scalp plays a vital part in the production of healthy, strong hair," said Dr Sturm.

As levels of female hormones fall, it's common to notice thinning hair. Dr Chiam said the first sign is when your hairline starts to recede. And the opposite: Hormonal fluctuations can also cause unwanted hair on the chin and along the jawline, and above the lip, to grow.

OTHER NON-SKINCARE CARE FOR MENOPAUSAL SKIN

Aside from using appropriate skincare, your lifestyle plays a part too. Regular exercise, for one.

Said Dr Chiam: "Exercise helps the skin in two ways. First, it relieves stress. Exercise also boosts circulation, which begins to slow with age. The extra oxygen and blood flow can help your skin look brighter and healthier."

Manage stress well. Stress makes the skin drier and more sensitive, explained Dr Chiam, and also triggers skin conditions like dermatitis, or skin irritation, in the form of a rash, or itchy dry skin.

And of course, eat well. In addition to coloured fruits and vegetables, Dr Chiam advised women to consume vitamin D-rich foods like cod liver oil and fish. Vitamin D can "help improve skin health and keep skin firm, supporting its repair mechanisms and activating its anti-microbial systems".

For a holistic dietary approach, Dr Sturm suggested having an anti-inflammatory diet rich in foods like fatty fish, avocados, broccoli and green leafy vegetables, while avoiding inflammatory substances such as alcohol, sugar, excessive salt and processed or fried foods.

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