Menopause and Dry Skin

What is dry skin during menopause?

Dry skin is when your skin becomes dehydrated, flaky, and more prone to irritation which can be uncomfortable and undesirable. 

What causes dry skin during menopause?

Declining estrogen levels often begin during your 40’s, even before perimenopause, and these hormone decreases cause changes in the body that lead skin to become drier, thinner, and less firm. As a result, the skin becomes more sensitive and prone to irritation and sagging. A simultaneous decline in testosterone levels can also exacerbate dryness.

What’s happening inside your body?

The loss of estrogen during menopause causes several changes in the body that contribute to skin dryness. Estrogen promotes water retention in skin cells, so when it starts to decline, so does the capacity of cells to hold water, causing a reduction in volume that makes the skin dry and appear less full. The drop in estrogen also causes the top layers of skin, known as the epidermis, to become thinner, increasing dryness and sensitivity. 

The broader aging process also causes atrophy of the cells in the epidermis, the dermis layer below it, and the layer of fat under the skin, which contributes to thinning skin. At the same time, skin cell turnover slows with aging, so skin can appear dull.

These changes coincide with decreases in elasticity and the production of collagen, a protein that provides tissues with structure. Without this support, the skin begins to lose volume and appears less full. 

Furthermore, the loss of testosterone during menopause is linked to decreased activity of the skin’s sebaceous glands, which produce oil. This, too, can make your skin drier and more sensitive. 

What are some non-medical treatments for dry skin in menopause that you can do at home?

It is important to know most treatments for dry skin during menopause are non-medical and they primarily aim to provide support to your skin as it changes.

• Moisturizers: As the skin loses its ability to retain water, locking in moisture becomes especially important. Moisturizing products for the face can include creamy cleansers, heavier night creams, and substances that help the skin hold onto water, like hyaluronic acid or ceramides. Avoid products that are drying, like foaming products, and those containing alcohol, alpha-hydroxy acids, or salicylic acids. For the body, use a cream rather than a lotion, and look for products designed for sensitive skin.‍
• ‍Retinols: Derived from vitamin A, retinols are over-the-counter substances applied topically to reduce dryness and signs of aging. They penetrate through the epidermis to the middle layer of the skin, called the dermis, and help reduce fine lines and wrinkles and promote collagen production. Retinols are related to but milder than retinoids, which require a prescription. ‍
• Avoid hot showers and baths: Bathing in hot water can strip skin of oils and proteins that keep it moist and supple. Opting for lukewarm water, patting, not rubbing dry, post-bathing and moisturizing immediately after bathing can lock in moisture.
• Use SPF daily: Thinning, dry skin is more vulnerable to harmful damage from UV rays, which can also cause spots and discoloration. Daily use of a broad-spectrum sunscreen of at least SPF 30 can help protect it from further damage and irritation. It is also important to reapply every 2 hours especially after sweating or getting wet. Dr. Leah Millheiser, Chief Medical Officer of Evernow, recommends brands like CeraVe, Neutrogena, Supergoop, Elta MD, Black Girl Sunscreen, and La Roche-Posay Anthelios.
• Cover up: Dark spots like freckles and age spots can be worsened by the sun, so covering exposed skin by wearing UV-protective clothing, a wide-brimmed hat, or driving gloves can add another layer of protection.

What are effective medical-provider-prescribed treatments for menopausal dry skin?

• Hormone therapy: If skin issues related to menopause become especially difficult to manage, a medical professional may recommend hormone therapy. This treatment comes in the form of a prescription that restores dropping estrogen levels, alleviating the root cause of skin dryness or thinning. Research suggests that hormone replacement therapy (HRT) can improve skin hydration, elasticity, and thickness; boost collagen production; and reduce wrinkling. 
• Prescription retinoids: Closely related to retinols but much stronger, these substances reduce dryness and signs of aging through a number of mechanisms. Applied topically, they encourage cellular turnover in the skin, allowing newer and brighter layers of skin cells to surface. They also promote cell proliferation, which makes skin thicker and less prone to wrinkles and fine lines.  Retinoid use also increases production of hyaluronic acid, a substance that helps retain water. 

• Lasers: Laser treatments can effectively brighten dull skin and address melasma, which is discoloration caused by hormonal changes and other types of hyperpigmentation.

What should you do next? 

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