5 Things That Might Happen to Your Skin During Menopause

Ah, the joys of being a woman. We navigate our way through so many hormonal shifts throughout our lives—from periods to pregnancy (for some), and the final(ish) frontier for us all: menopause. Along with the mood changes, hot flashes and vaginal dryness, there are a few other changes that can happen to your skin during menopause as well.

We asked two experts to help us better understand exactly what happens to our skin during this time and offer their best recommendations to ease the transition.

• Dr. Sarv Zand is a board-certified dermatologist, specializing in skin cancer, holistic dermatology, and cosmetic enhancements. Zand earned her BS in biomedical engineering from Johns Hopkins University and a dual MD from Harvard Medical School and MIT. At Harvard, she carried out a melanoma research fellowship and trained in dermatology at UC Davis, where she was appointed chief resident. She’s a fellow of the American Academy of Dermatology and the American Society for Mohs Surgery and holds a diploma from the American Board of Dermatology. Dr. Zand currently lives in the Bay Area, where she has her own practice, Zand Dermatology in Marin County. 
• Rochelle Weitzner is the CEO and founder of Pause Well-Aging, a skincare brand that aims to provide effective solutions for women experiencing pain points associated with Menopause. Prior to launching Pause, Rochelle was Chief Executive Officer of Erno Laszlo. Weitzner also served as Chief Financial Officer of Gurwitch Products, the global skincare enterprise best known for its Laura Mercier and RéVive skincare brands.

1. Skin changes can start before actual menopause.

“The years leading up to menopause, known as perimenopause, are marked by fluctuating levels of estrogen, testosterone, and DHEA. There is an overall gradual decline in hormone levels, but it happens somewhat unevenly, bringing on erratic skin behavior. Women may experience hot flashes and skin flushing, and they may notice their skin becoming drier, more sensitive, and more prone toward hormonal acne flares during perimenopause,” explains Zand.

2. Products that you had no issues with before may suddenly be intolerable.

In addition to having flushed skin and hormonal acne on your chin, you may also experience sensitivity to your usual skincare products. “Sunscreens you used to tolerate without any issues may now make your skin burn, and anti-aging products can make you redder and more sensitive than before,” shares Zand.

What happens is as estrogen levels fall, it reduces oil production, and the skin becomes drier. “The dryness can compromise your skin barrier and tiny microtears can form, allowing moisture to escape and irritants to enter. As a result, our skin can become more easily irritated and less tolerant,” she adds.

To reduce irritation, Zand recommends switching from a foaming cleanser to a gentle one, or even ditch your cleanser entirely in the mornings and simply wash your face with lukewarm water. Then, be sure to use a rich moisturizer with nourishing ingredients like squalene and ectoine, twice daily. “Thirsty menopausal skin loves the quenching dewy feel of hyaluronic acid, so try layering it under your favorite moisturizer for extra hydration overnight.”

3. You may experience flushing or redness in your skin.

During perimenopause and menopause, your skin can become more prone toward flushing and redness. Which is precisely where an antioxidant serum with calming ingredients that help combat redness like resveratrol, green tea polyphenols, caffeine and Vitamin C come in handy. (Zand is also a proponent of tea tree oil, particularly in cleansers, because “it minimizes redness quickly and naturally without causing irritation.”)

4. You may experience excessive dryness and breakouts at the same time.

As Weitzner explains, “During perimenopause and menopause, we begin to experience tremendous fluctuations in estrogen. Estrogen has been shown to inhibit sebum secretion leading to excessively dry skin.  At the same time, your androgen levels, such as testosterone remain constant and stimulate sebum secretion.  With estrogen no longer protecting the sebaceous glands and keeping them in check, androgens take over and throw the glands into overdrive, which results in the production of excess sebum leading to blocked pores and breakouts.”

If you’re dealing with particularly stubborn acne, both Weitzner and Zand caution against reaching for your teenager's acne cream. “Commonly used ingredients like benzoyl peroxide and salicylic acid that worked brilliantly when we were younger are much too harsh for more experienced skin later in life,” explains Weitzner.

Instead, Zand says to opt for a gentle over-the-counter retinoid that’s designed for dry skin. And if that doesn’t work, she recommends talking to your dermatologist about topical dapsone cream or oral spironolactone. “Dapsone is my favorite prescription to fight hormonal acne because it shrinks pimples fast without causing any drying or irritation, which is the exact combo you need for menopausal acne. Spironolactone is an androgen blocker that calms acne caused by the imbalance of decreasing estrogen levels, while androgens remain the same,” she adds.

5. Your ankles, shins and heels may begin to get drier and start to thicken in your 40s.

“Sometimes people don’t slow down enough to notice the changes that are developing in their skin during menopause. For many women, they’ll experience dryness in the skin on their lower extremities before any changes start to develop in their facial skin,” says Zand. “Luckily, this can easily be remedied by using a moisturizing cream or oil daily, particularly after bathing.”

Yes, menopause isn’t exactly a walk in the park, but Zand says to try and see it as an opportunity to slow down and honor your body's changes. Her parting advice? “What a delightful time to sink into a practice of self-massage. Why not delight your legs and feet with a one-minute oil rub before getting into bed? As women juggling our careers, relationships, children, homes, pets and aging parents, we often ignore the early signs our bodies are giving us to pay attention, but self-care at this stage is necessary. May it land with more gratitude than guilt as we age. Cultivate it now.”

Here, here, doc!