Menopause has a long list of infamous side effects, from hot flashes to vaginal dryness to hair that appears in totally new places. However, what we don’t often hear about are the changes skin goes through during that period (the average menopausal woman is 51 years old, according to the Mayo Clinic). “From the onset of menopause, estrogen levels in a woman’s body drop. Estrogen hormone plays a huge role in the signs of aging,” says Dr. Manish Shah, a board-certified plastic surgeon in Denver. In addition to the sweating and the unexpected chin hairs, that loss of estrogen means that the skin will go through a major transformation.
We asked the experts what to expect when it comes to menopausal skin—and which products and treatments will help combat any unwanted changes.
Collagen loss
“There’s a 30% drop in collagen during the first five years of menopause,” says Dr. Hadley King, a board-certified dermatologist in New York City. Collagen and elastin are what plump your skin and give it its youthful bounce, so as production levels dip, you may start to notice sagging or loose skin in areas that previously felt taut (or, as Dr. Shah describes it, “arms that keep waving after your hand has stopped”).
Try: Dr. King directs many of her menopausal patients to Empelle, a skin-care line created specifically for this transition period. Both the Empelle Serum ($175) and Empelle Night Cream ($195) contain methyl estradiolpropanoate, which Dr. King describes as “a nonhormonal way to activate the estrogen receptor.” It stimulates the production of estrogen, to reverse menopausal skin issues like sagging and fine lines.
Related: Skin-Care Tips From 7 Influencers Over 50
Fine lines and wrinkles
Due to the collagen dip, you’ll notice an increase in fine lines and wrinkles and a decrease in the skin’s plumpness. “As estrogen levels decrease, there is also less connective tissue [in the skin], which leads to reduced hydration and compromised barrier function. This causes the skin to become thin, atrophic, dry, dull, and wrinkled,” explains Dr. King.
Try: Dermal fillers such as Radiesse, Juvéderm, and Restylane will temporarily replace lost volume in the lips, cheeks, or other sunken areas. Dr. King points out that they also stimulate collagen production, so some of that new plumpness will be due to your skin’s natural reaction to the filler. While fillers only last about 6 to 12 months, results are instant and there is little to no downtime. Bruising and swelling are the most common side effects, but they typically resolve after about a week.
Devices such as Ultherapy and Thermage use ultrasound and radiofrequency waves, respectively, to heat up underlying tissue—which tightens skin laxity and jump-starts collagen production. Ultherapy is FDA-approved to treat the neck, chin, chest, and brow, while Thermage is FDA-approved for skin-tightening on the face and body (most commonly on the stomach, arms, thighs, knees, and butt). Both treatments are safe for all skin types and tones but typically require more than one session to see significant results.
Thin skin
“Many women experience thinner skin that is more prone to tearing and bruising,” says Dr. Shah. This occurs due to the loss of collagen, water, and elastin, which thins the dermis and results in a crepey appearance.
Try: There are a few topical treatments that can help marginally improve the thickness of thinning skin. “Studies have shown, for example, that six months of topical glycolic acid stimulated a 27% increase in epidermal thickness,” says Dr. King. Glycolic acid, which is an alpha hydroxy acid, removes the outermost layer of dead skin cells to reveal healthier, radiant skin beneath. Not only can it improve thin skin, but it also diminishes fine lines and wrinkles and discoloration.
Look for glycolic acid-based lotions like Mario Badescu Glycolic Skin Renewal Complex ($35), Pevonia Botanica Renewing Glycosides Cream ($76), or Peter Thomas Roth 10% Glycolic Solutions Moisturizer ($45). Pause Collagen Boosting Moisturizer ($72) is another great option for those looking to combat paper-thin skin and fine lines, since it’s packed with fruit extracts and tripeptides (in addition to glycolic acid), to help hydrate and plump.
Dry skin
Estrogen is essential for skin hydration, Dr. Shah explains, because it “increases the skin’s production of oil, improves barrier function, and increases water retention. Because menopausal women lose estrogen, dry skin is one of the most common issues they face.
Try: Humectants and emollients will help restore the skin’s moisture barrier and nourish dry skin. Apply your regular lotion on a daily basis,—r turn to a richer version of a beloved cream. Options like Sol de Janeiro Brazilian Nude Body Cream ($44), Jergens Ultra Healing Extra Dry Skin Lotion ($8), or Cetaphil Rich Hydrating Night Cream ($16) are gentle options that suit all skin types.
Dr. Gretchen Frieling, a triple-board-certified dermatopathologist in Boston, also recommends Vichy Neovadiol Compensating Complex Menopausal Replenishing Care ($55). Containing hyaluronic acid, glycerin, and an exfoliating agent called hepes, this product helps revitalize aging skin. “It’s designed to treat four fundamental signs of menopause on skin: loss of skin density, loss of skin structure, sagging, and dryness,” she explains.
Related: How Dermatologists Recommend Treating Dry, Winter Skin
Itchy Skin
Itchy skin, also known as pruritus, can appear during menopause as a side effect of dryness. Skin may appear red and cracked and feel more uncomfortable, the more you touch or scratch the area.
Try: Look for lotions specifically designed to relieve itch, like Lubriderm Therapeutic Lotion ($8) or Curel Itch Defense Lotion ($9). Dermatologists also suggest trying an over-the-counter hydrocortisone cream, available at any drugstore. If the itchiness doesn’t subside with over-the-counter moisturizers within two weeks or is so severe that it interferes with regular activities, it may be time to see a doctor for a prescription treatment.
Acne
“The decrease in estrogen levels and relative increase in androgens can increase sebum production and acne,” says Dr. King. “If you have not had acne since your teens or pregnancy, this can occur again, due to hormonal changes,” adds Dr. Shah.
Try: Dr. King suggests speaking to your dermatologist about a prescription acne medication, which can help regulate hormones, suppress sebum, or otherwise tackle the problem at the root of your breakouts. She recommends anti-acne oral medications, like Spironolactone; topical treatments, like Aczone; or products that contain zit-zapping ingredients, like salicylic acid and benzoyl peroxide. A good over-the-counter option is the Kate Somerville EradiKate Salicylic Acid Acne Treatment ($58), which contains 2% salicylic acid, to significantly diminish the appearance of pimples.
