Menopause can bring about a host of unwelcome changes to the skin including dryness, lines and sagging—many women also experience a flare up of problems such as rosacea, spots and acne. A recent study found that as many as 64 per cent of women attending menopause clinics in the UK reported problems such dry, itchy skin (pruritus), increased pigmentation, flushing, rosacea and acne.  

The hormonal shifts triggered by menopause can be challenging enough, but dealing with additional skin complaints can also have a major impact on confidence, as highlighted in a recent study by the Skin Health Alliance. The findings showed that 43 per cent of women felt they had become less attractive, with 28 per cent saying they no longer liked looking in the mirror. 65 per cent reported increased skin sensitivity, 19 per cent said they were more prone to acne and breakouts, and 28 per cent experienced uneven pigmentation.

“During menopause, the sharp drop in oestrogen is the main driver behind skin changes,” says Dr Emmaline Ashley, EV Expert, Cosmetic Physician and Founder, Ashley Aesthetics. “Oestrogen supports collagen, elastin, hydration, and barrier function, so its decline can lead to dryness, thinning, increased sensitivity and pigmentation. A relatively higher proportion of other hormones (androgens) may trigger breakouts. Many women feel like their skin has ‘changed overnight’ which can be very distressing. But, the right skincare and treatments can make a real difference.”

Expert recommended skin solutions 

Redness and rosacea

Rosacea is an inflammatory skin condition that can cause redness, flushing, bumps and pustules mainly around the centre of the face, cheeks, nose and forehead. “Declining oestrogen makes blood vessels more reactive, and skin can become thinner and more sensitive,” says Dr Ashley.  “Menopausal hot flushes can also exacerbate redness, flushing and broken capillaries.
In clinic: “Vascular lasers or intense pulsed light (IPL) are highly effective to treat broken capillaries, diffuse redness and rosacea. They work by targeting blood vessels, causing them to constrict and fade.
At home: “Neostrata Restore Redness Neutralising Serum is specifically formulated for rosacea-prone skin. It cools, calms and reduces redness and irritation.”

Pigmentation

Hyperpigmentation are patches of skin that have become darkened or discoloured. Exposure to the sun stimulates the pigment-producing cells in the skin (melanocytes) to produce melanin. The more time you have spent in the sun, the more likely you are to develop sun damage-induced dark patches and liver spots. Melasma is a skin condition that causes patches of brown, or greyish-brown pigmentation; it is also aggravated by sun exposure. “The hormonal changes that occur with menopause can disrupt melanin regulation,” says Dr Ashley. “This can potentially trigger or make pigmentation and melasma worse, leading to dark spots and uneven skin tone.
In clinic: “Chemical peels and medical-grade lasers, like Pico or Q-switch lasers, target and reduce pigmentation very effectively.
At home:  “CellDerma Pigment Correct is a medical-grade option formulated to target uneven skintone and stubborn pigmentation. It contains three key actives—kojic acid, rumex occidentalis extract and nonapeptide-1 to inhibit melanin production and reduce dark patches caused by sun damage and hormonal fluctuations.”

Dryness and itching

Many women find their skin becomes dry and itchy during menopause. “This is caused by declining oestrogen levels which reduce natural oil production and impairs the skin barrier, leaving skin dry, itchy, and sometimes rough,” says Dr Ashley. “Skin may also feel tight and uncomfortable.
In clinic: “I would recommend Profhilo® or skinboosters, which are injectable hyaluronic acid treatments, as these really do help to restore hydration and improve skin quality.
At home: “Epicutis Hyvia Crème is a deeply hydrating, rich, velvety cream that strengthens the skin barrier, and soothes irritation in compromised skin. It contains organic non-GMO chia seed oil.”
 

Fragile, thinning skin 

You can expect to lose about 30 per cent of collagen in the first five years of menopause. After that it’s around two per cent each year. “Lower collagen and elastin levels make the skin thinner, less resilient, more fragile and prone to irritation, damage or delayed healing,” says EV Expert and Aesthetic Doctor, Dr Vincent Wong.
In clinic: “Skin during menopause needs to be approached with care. So, I would always start with a proper consultation and create an appropriate plan that supports the skin’s needs. Microneedling with PRP (platelet-rich plasma) is a particularly effective treatment for thin, fragile skin.  This helps to stimulate natural collagen production and strengthen the dermis over time.
At home: “Medik8 Liquid Peptides is a lightweight serum that is formulated with advanced peptide technology to support skin structure and elasticity. Use it regularly to help improve skin resilience.”

Spots and acne 

Acne (spots, boils, pustules) is an inflammatory skin condition caused by excess sebum that blocks pores, allowing bacteria to thrive. During menopause, as oestrogen falls more steeply than androgens, relatively higher levels of androgens can overstimulate sebaceous glands, leading to increased oil and breakouts.  “Some women who have a long-term tendency to acne and breakouts, are more likely to suffer at times of hormonal changes such as the menopause,” says Dr Wong. “They are naturally more sensitive to the effects of circulating androgens and the impact these have on their skin.
In clinic: “Salicylic acid peels or blue light LED therapy can reduce breakouts without irritating mature, menopausal skin.
At home: “La Roche-Posay Effaclar Duo is one of my top tried-and-tested recommendations for using on the skin at home, helping to reduce spots, unclog pores and soothes inflammation.”