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How The Skin Changes After Menopause + Real Ways To Minimize Aging

Written by Lindsey Hunter-Ellul, MD on March 1, 2023 3 Comments

menopause woman

One year after menstruating for the last time, a woman officially enters menopause. The transition can cause significant changes to all areas of the body including the skin. Fortunately, adaptions to your lifestyle and skin care regimen can help prevent and slow the visible signs of aging associated with menopause.

Here’s exactly how menopause alters skin health and what you can do to keep your skin looking and feeling its best:

Why Menopause Changes The Skin

When a woman enters menopause, significant physical and hormonal changes occur. Collagen levels drop significantly (up to 30%) during the first 5 years of menopause. This leaves the skin vulnerable to sagging and wrinkling. As less estrogen and progesterone is produced, skin also becomes thinner and dryer. In addition, a shift in body fat storage leaves skin less plump than before and hair often begins to thin.

Menopause occurs for most women around the age of 51 in the United States. At this age, the effects of a lifetime of sun exposure combined with hormonal changes, contribute to the loss of collagen and also skin discoloration. Sun spots and age spots become more apparent.

While nothing can be done to prevent aging, adapting your skincare routine to menopause can help minimize its visible effects.

Common Menopause Skin Issues

Understanding how your skin may change during menopause can help you adjust your skincare routine to help prevent or slow aging’s negative effects. The following are the most common menopause-related skin issues:

Age Spots & Sun Damage

Age and sun spots become more apparent during menopause. Areas where your skin appears darker may show up on your face, neck and chest, arms or hands. These spots can be flat or raised.

Skin cancer is also more common at this age, so be sure to practice regular at-home skin checks in addition to visiting your dermatologist annually.

Acne (Yes, acne)

Hormonal acne can occur at several stages of life, one of which is menopause. As estrogen decreases, androgen levels may not. This hormonal change increases sebum (oil) production which makes pores more likely to get clogged leading to acne and cysts.

Dry Skin

Estrogen helps skin hold on to water. As this hormone decreases, skin becomes dryer. This may be especially noticeable during the winter months. Dry skin also makes wrinkles and other blemishes more visible.

Bruising

Skin thins as estrogen levels decrease. This leaves skin more vulnerable to injury and bruising as there is less structural support in the skin around small vessels, like capillaries. Thinner skin is also more likely to sag, leading to wrinkles.

Rashes

Increased dryness and a change in the pH levels of skin can make menopausal women more vulnerable to skin irritation and rashes. Those who have an existing skin condition, such as rosacea or eczema, can experience an increase in outbreaks.

Drooping Jowls

A rapid decrease in collagen levels and other connective tissues can lead to thinner skin and sagging jowls. After a lifetime of talking, smiling and laughing, the area around the mouth is among the first to show signs of aging. Nasolabial folds and marionette lines are among the first wrinkles to appear more pronounced in this area. A youthful female face is described as a downward-pointing triangle, or “the triangle of youth,” with more facial volume in the mid-face than the lower face. Over time, this facial triangle’s position inverts, leaving less mid-facial volume with cheek flattening and more heaviness on the lower face as the facial skin and volume appears to slide downward with gravity, widening the lower face.

Sagging Skin

Sagging skin, bone loss, and a reduction of subcutaneous fat can lead to baggy circles under the eyes, a slight dip of the tip of the nose and elongated earlobes. Pores may also seem more apparent as skin loses firmness. Skin can become “crepey” in appearance.

Wrinkles

Wrinkles that were once dynamic, appearing only during certain facial expressions, may now become static, or etched into the skin. Wrinkles tend to show up earliest where skin is thinnest. Crow’s feet, forehead lines, and wrinkles around the lips are common.

Can Menopause-Related Skin Changes Be Prevented?

Menopause is a natural part of life and cannot be prevented, nor can the related changes to your skin be completely avoided. There are some things, however, that can minimize the visibility of these changes.

Ways to Minimize the Impact of Menopause on Your Skin

The following tips can help lessen the impact of menopause on your skin. You can begin to adjust your skincare routine as soon as you experience perimenopause.

Use Sun Protection

Consistent sun protection should begin yesterday, regardless of your age. Sun exposure is the primary cause of visibly aging skin in all skin types, so it’s essential to apply a broad-spectrum sunscreen daily with at least an SPF 30. Reapplication of sunscreen depending on your level of sun exposure while driving or spending time outside during the day is a must. Reading the label to determine how long the sunscreen lasts is of utmost importance. Not all sunscreens are water resistant, and the sunscreen label should indicate the length of time the sunscreen lasts on the skin before you need to reapply.

Wearing sunscreen helps prevent wrinkles and sunspots, and will reduce your risk of skin cancer. Just make sure to apply your sunscreen correctly.

Use a Mild Cleanser

Some soaps can be too drying for mature skin. Instead, use a mild hydrating cleanser. If you’re battling hormonal acne, choose a cleanser with salicylic acid, which can help dissolve oil and debris that’s trapped in pores.

Avoid Unnecessary Ingredients

Rashes and skin irritation can be minimized by avoiding products with unnecessary ingredients such as fragrance and dyes.

Moisturize Daily

Even oil-prone skin needs a daily moisturizer. Choosing one with hyaluronic acid, ceramides or glycerin can help hold water in the skin, for a more youthful, plump appearance. Apply shortly after showering or face washing, while skin is still damp.

Exfoliating

Sun spots, acne and dry skin can all be minimized with regular exfoliation. Once or twice weekly is often enough. Exfoliate too often, and you’ll be left with skin that’s either too dry and uncomfortable or overcompensating by producing too much oil in response to dryness.

Use Anti-Aging Serums

Add an anti-aging serum to your skincare routine. Look for ingredients like retinol, vitamin C, niacinamide, stem cells and growth factors or other anti-aging peptides. Certain serums brighten the skin and boost collage production which can lead to a smoother skin appearance.

Eat a Balanced, Healthy Diet

Eat a balanced diet and supplement with vitamins if there’s something you’re missing. Focusing on antioxidants can help reduce free radicals, which lead to damaged skin cells. Look for fruits and vegetables that represent all colors of the rainbow. Alcohol and highly processed foods are not your skin’s friend. To date, the small amount of available research has not shown oral collagen supplements to be detrimental, but the data is not showing any overwhelming benefits either. Much research is still needed to determine if dietary collagen supplements are overall helpful for the skin. It can be difficult to find a comprehensive list of all of the active and inactive ingredients in these over-the-counter collagen supplements. Additionally, it is unknown whether these widely available products actually perform in a way that their labels promote as the evidence is largely lacking. To date, the U.S. FDA has not reviewed these collagen supplements for their effectiveness or safety. Much of the currently available research has been funded by the industries that may derive a financial gain from producing positive results, so there are concerns about potential conflicts of interest and bias in this area.

Exercise Regularly

Regular movement reduces stress, allowing skin to repair itself more quickly. It also improves circulation, maintaining the efficient delivery of nutrients and oxygen to the skin’s surface.

Stay Hydrated

Staying hydrated is just as important as applying a moisturizer daily. Drink at least 8 glasses of water (or the equivalent) each day. Cut back on alcohol, caffeine and other diuretics.

Sleep Well

If you’re not getting enough sleep, anything else you might do for your skin becomes less effective. While sleeping, the body repairs damaged skin cells and does the important work of rejuvenation. Lack of sleep further dysregulates hormone levels, which only makes menopause harder on your skin.

In-Office Treatments

In addition to a customized home skin care routine, menopausal patients may benefit from the following in-office treatments:

Botox, Dysport, Xeomin, and Daxxify

Neuromodulators such as these can help prevent static, etched in wrinkles from forming, and can soften any stubborn wrinkles in the areas that are treated. These treatments relax muscles so the skin above can appear smoother and more refreshed over time. Some treated areas can also give a lifting effect. These treatments are temporary, lasting 3-9 months.

Hyaluronic Acid and Biostimulant Fillers

Injectables can plump skin where a loss of fat has occurred. They are also used to recontour the face and reduce the appearance of sagging. Hyaluronic acid fillers (Restylane, Juvéderm, Belotero, RHA) plump the skin by holding up to 1000 times their weight in water to temporarily add volume, contour and improve the appearance of wrinkles. Biostimulant injectables (Platelet Rich Plasma/PRP, Sculptra, Radiesse, Bellafill) can add volume, but they are used to stimulate your body to make collagen from cells already present in your skin. Hyaluronic acid fillers are absorbed by the body over 6-18 months on average, whereas the biostimulants gradually help the body over 4-6 weeks make new collagen that can last up to 24 months. Certain fillers and biostimulants can be used both on the face and body. PRP is unique in that it is all natural as your own blood is drawn and processed during your visit, then infused into the skin with microneedling or injections in strategic areas to help stimulate collagen and elastin production in addition to hair stem cells on the scalp to produce thicker, healthier, more voluminous hair.

Laser Resurfacing, Peels, Skin Tightening Devices and Microneedling

Resurfacing treatments can help tighten skin and reduce the appearance of pores. Laser treatments and microneedling can be used to combat thinning skin and pigment concerns. Some lasers are also used to help lessen the appearance of redness and small vessels that develop over time. Chemical peels come in varying strengths with a broad array of active ingredients that can combat skin texture, acne and pigment concerns. There are devices utilizing other energy modalities, such as ultrasound and radiofrequency, that have been shown to help “tighten” the skin as well. There are several lasers that can also combat unwanted dark facial hair that may arise after menopause. Multiple lasers, chemical peel, skin tightening treatments, and/or microneedling sessions in conjunction with topical and oral therapies are often necessary to achieve an improved appearance of the skin. It is important to find a clinician who knows which treatments are safest for your skin type and needs.

For menopausal patients who would like a more dramatic change, plastic surgery options such as a facelift, eye lift, neck lift and/or liposuction can significantly roll back the hands of time for a dramatically more youthful appearance.


Lindsey Hunter-Ellul, MD

Lindsey Hunter-Ellul, MD, FAAD is a Board Certified Dermatologist and is recognized as a Texas Monthly Super Doctors Rising Star. She has years of experience in medical dermatology, skin cancer, procedural and cosmetic dermatology, treating patients of all ages and skin types. Dr. Hunter-Ellul has served on several committees for the American Academy of Dermatology, Texas Dermatological Society, and was the Physician Editor for the AAD Directions in Residency Newsletter.


3 Responses to “How The Skin Changes After Menopause + Real Ways To Minimize Aging”

  1. Avatar Janet says:

    I will be 70 later this year. I am told I look good for my age. But one I know I need is I was a smoker a long time ago and I have the little lines all around my mouth. Can you tell me what specific procedures you would use for that. Thank you.

    • WD Staff WD Staff says:

      Hi Janet,

      Thanks for the treat comment and question. We actually wrote a great blog post on that issue here: https://www.westlakedermatology.com/blog/smokers-lip-treatment-options/. There are many great options available including Botox, fillers, and laser resurfacing. Your best bet would be to see a Board Certified cosmetic specialist for an in-person consultation. Such an assessment will help the provider assess your specific needs and come up with the best treatment plan.

      I hope that helps!

      Thanks,
      WD Staff

  2. Avatar Sadie says:

    These are some great tips! I’d second using more milder products and moisturize, moisturize, moisturize!

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