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Publication:
Dermatology Department, Brighton and Sussex Medical School
Author:
Dr Claudia DeGiovanni,
Date:
June 20th 2022
Article Summary
This research paper is absolutely fascinating - it's one of the most comprehensive reviews I've seen on how menopause affects skin!
So it turns out that 64% of women attending menopause clinics report skin problems, and this comprehensive medical review explains exactly why. Your skin has estrogen receptors throughout, with the highest concentrations on your face, genital area, and legs. When estrogen drops during menopause, these receptors essentially go into decline mode.
Here's what's happening: you lose nearly a third of your skin's collagen in the first five years after menopause (not just from ageing - this is specifically hormone-related). Your skin's barrier function weakens, leading to increased water loss and dryness. Sebaceous glands shrink, resulting in reduced natural oil production.
The paper confirms that multiple skin conditions either worsen or first appear during menopause, including severe dry skin (xerosis), itching (pruritus), eczema, acne (resulting from the relative increase in androgens when estrogen levels drop), rosacea, hidradenitis suppurativa, and even psoriasis. About 75% of menopausal women experience hot flushes, which can trigger or worsen rosacea.
Interestingly, some conditions improve with menopause, like systemic lupus, which flares less frequently after menopause.
The research shows HRT can reverse many of these changes. Estrogen therapy increases collagen levels to pre-menopausal levels within 3 months and can help prevent further collagen loss.
However, HRT can also cause some skin issues like hirsutism, acne, and may trigger lupus flares in susceptible individuals.
The HotFlush Fix - Your Menopausal Skin Action Plan
BASIC SKIN BARRIER PROTECTION
• Use low-pH emollients at least once daily
• Use humidifiers to combat environmental dryness
• Reduce bathing time and avoid harsh soaps
• Switch to fragrance-free, gentle cleansers
COLLAGEN PRESERVATION
• Discuss HRT benefits with your GP - can increase collagen levels within 3 months
• Consider topical estrogen for specific areas (may be safer than systemic)
• Use broad-spectrum sunscreen daily to prevent further collagen breakdown
• Include vitamin C serums for collagen support
CONDITION-SPECIFIC CARE
• Hot flashes/flushing: Try paced breathing, relaxation techniques, consider HRT
• Dry, itchy skin: Emollients, humidifiers, avoid irritants
• Menopausal acne: Standard topical treatments, consider spironolactone
• Rosacea: Gentle skincare, avoid known triggers including hot flushes
HRT CONSIDERATIONS
• Know that estrogen can reverse skin ageing changes effectively
• Be aware that HRT may cause hirsutism, acne, or androgenic hair loss in some
• Topical preparations have fewer systemic risks
• Combined estrogen/progesterone affects sebum production differently than estrogen alone
IMMEDIATE STEPS
• Start using a daily emollient today
• Book skin assessment with dermatologist if multiple issues present
• Discuss skin concerns specifically when considering HRT
• Take photos to track changes over time
Just a friendly reminder: I'm sharing what I've learned, not prescribing what you should do. Always chat with your GP about what's right for your unique situation!
