The skin is the largest organ in the human body. It is not just a covering to keep internal organs and bones in place, it has multiple uses. As well as protecting the individual from external hazards the skin helps to regulate water levels, communicate touch sensations to the brain, regulate temperature and store fat and water.
The structure of skin is complex and vast, consisting of three main layers: the epidermis, (outer layer), dermis and subcutaneous tissue. The epidermis acts as protection against infection and other external factors whilst keeping moisture in. The dermis contains nerve endings for sensation, hair follicles and small blood vessels called capillaries along with glands that produce oil and sweat. The subcutaneous layer is made up of fat, larger blood vessels, nerves and connective tissue.
The skin is durable but like any organ can be prone to damage. Common skin complaints can include Acne, Psoriasis, Eczema and fungal infections amongst others. It is estimated that 1 in 4 individuals will experience a skin problem at some time in their lives.
What happens to skin in perimenopause?
During perimenopause, as Oestrogen levels fluctuate the skin, like most parts of the body, begins to experience changes. It can appear thinner as the fat layer reduces, and dryer as moisture is lost. Approximately 30% of collagen is lost in the first 5 years of menopause alone and continues to deplete as skin ages.
Oestrogen helps keep the epidermis waterproof and prevent fluid loss, also, it aids in the production of oil which keeps the skin soft and supple, so when the Oestrogen levels drop the skin loses moisture and stops producing natural oil leaving the skin dry and prone to cracking.
Another problem caused by depleting levels of Oestrogen occurs when Testosterone levels remain stable. This causes an overproduction of oil, blocking pores and causing Acne.
For those individuals who suffer with chronic skin conditions pre-menopause often see a worsening of their conditions with the onset of perimenopause and menopause. Psoriasis is an autoimmune condition that causes dry, itchy, scaly patches to form on the skin. Oestrogen acts on the immune system as well as skin therefore any decrease in levels will impact greatly causing a worsening of Psoriatic symptoms and more regular flare-ups.
Another problem caused by lowering levels of Oestrogen is believed to be a change in the skin’s natural microbiomes. These are the microscopic organisms that live without issue on the skin naturally. When Oestrogen lowers these micro-organisms change becoming less tolerable. So, when the skin becomes dryer and prone to cracking this creates a portal for these more noxious bacteria to enter the body and cause or exacerbate problems such as eczema flare ups.
What can I do to improve my skin during (peri)menopause?
As many common skin complaints can be triggered or exacerbated by fluctuating Oestrogen levels it would be easy to believe adding Hormone Replacement Therapy, (HRT) into the mix would improve these conditions. However, research is limited and shows only small improvements in Psoriasis but better in Eczema.
Overall HRT is known to help menopausal skin in general by improving skin hydration and reducing shrinkage and wrinkling as well as improving dermal collagen levels. As a result, this can have an impact on reducing skin damage caused by other skin conditions.
Other ways to look after menopausal skin include:
- Using moisturising creams (twice a day)
- Avoid extended exposure to sunlight (or sunbeds)
- Wear SPF 30 or above all year round
- Drink plenty of water to maintain hydration.
- Avoid smoking as this has a very negative impact on dulling the skin.
- Get plenty of sleep to ensure you are well-rested
As with every aspect of the body, skin deteriorates naturally with age and menopause can add to its problems. Ongoing, chronic skin conditions can flare up and make this period of life more difficult. HRT may benefit many skin conditions, but more research is needed in this area. Until this is established individuals should take measures to protect their skin with a few lifestyle changes which will benefit health overall.
If you’re troubled by skin changes, talk to your doctor or dermatologist.
If you would like to discuss this or any other menopause issues book a 1-1 with a menopause expert at myTamarin via the website or app.
Biology Dictionary, (2019) Skin, (Anatomy) - Function, Types and Structure. www.biologydictionary.net
Brannon, H.L., (2023) Skin Layers: Function, Anatomy and More. www.verywellhealth.com
Johnson, J. & Shannon, A., (2023) Skin Disease: A List of Common Skin Conditions and Symptoms. www.medicalnewstoday.com
Gallagher, G., (2022) Understanding How Your Skin Changes During Menopause. www.healthline.com
Chung, J. (2022) Psoriasis and Hormones: How Hormonal Changes Can Affect You. www.mypsoriasisteam.com
Dennis, H. (2022) Menopause and Eczema. www.eczema.org
Turner, S. (2023) How to Manage Skin Problems in the Menopause. www.patient.info
Wheeler, R.B., (2021) How Hormones, Menstruation and Pregnancy Affect Psoriasis and PsA. www.webmd.com
Dr Meyer, (2020) HRT and our Skin. www.menopausetreatment.co.uk
In the next article in our Menopause and Chronic Conditions series, Moira looks into epilepsy and menopause.Read post