Treating menopausal skin

Published 02nd Oct 2024 by Michelle Duffield

Dr Maryam Zamani and Dr Amélie Seghers share their tips on how to help your clients with menopausal skin.

As your clients transition into the menopause, hormone levels drop resulting in various skin changes. While the skin can bear effects of the menopause, advising holistic approach is an effective strategy for targeting the face and complexion. Oculoplastic surgeon and facial aesthetics doctor, Maryam Zamani and consultant dermatologist at the clinic by Dr Maryam Zamani, Dr Amélie Seghers share three pillars for treating menopausal skin.

The importance of the ingredients in skincare products

“With the decline of intrinsic hormones with menopause, there is a substantial and rapid decline in collagen production as well as changes of the skin in general. After menopause, our skin experiences a slowdown in oil production and cell turnover. An effective routine for menopausal skin incorporates products that employ humectants, emollients and occlusives, like glycerine, hyaluronic acid and ceramides. These help to replenish and retain cell moisture. A key ingredient for brightening a dull complexion and diminishing sunspots is Vitamin C, which supports with fighting against free radical damage that causes oxidative stress and skin ageing while brightening skin. Providing a retinoid is essential to brighten the complexion while helping increase cell turnover and promoting the proliferation of collagen and elastin.” -Dr Maryam Zamani

“Studies show that collagen levels reduce by as much as 30% in the first 5 years of menopause due to a decrease in oestrogen levels which can lead to sagging and thinning of the skin. There is also an important reduction in sebum, hyaluronic acid and ceramides which can result in drier skin. Taking this into account, advise your patients to focus on products that include ingredients for stimulating collagen production such as retinol and tretinoin, as well as hydrating ingredients such as hyaluronic acid and ceramides.

Further changes that can be seen in the skin due to lower levels of oestrogen include a decline in melanin regulation, making the skin more prone to photodamage, which means it is never too late to start using daily sunscreen. If pigmentary changes are already seen, prescription creams containing hydroquinone could be recommended for certain patients.” - Dr Amélie Seghers

Explaining hormone levels

“A lot of the skin changes seen in menopause and perimenopause are the result of lower levels of oestrogen. However, you can help your clients understand that oestrogen is not the only hormone playing a role. Progesterone is also thought to contribute towards preventing collagen breakdown (progesterone has an inhibitory effect on tissue degrading MMPs) and when levels drop in perimenopause, this can contribute to loss of firmness of the skin. Some women experience increases in testosterone levels, resulting in acne.

The role of bio-identical hormonal therapy targeting each of these hormones should be discussed when patients are also suffering from other menopausal symptoms which are less responsive or non-responsive to dermatological treatments. For example, there is an accelerated postmenopausal loss of bone leading to the well-known osteoporosis but what is less well known is that the same loss of bone in the jaw and chin can lead to jowling. Of course, as always, bio-identical hormonal therapy combined with more targeted skin treatments can lead to even better results.” - Dr Amélie Seghers

Thinking about skin texture and facial structure changes

“There are concerns at every age. I generally like to evaluate specific concerns the patient presents with. These concerns will fall into;

1. Skin optimisation (addressing skin elasticity, skin tone, skin texture and pigmentary/vascular changes to the skin).

2. Volumetric changes in the face that can happen with time (descent of the facial fat pads, resorption of fat pads or increase in volume of fat pads).

3. Structural or bone changes of the face that can affect how the skin sits on the bone (jowling, excess skin, loss of definition).

Tweakments can be adjusted or altered to focus on the issue at every level and often require a multi-factorial strategy.” – Dr Maryam Zamani

“It’s hard to give a single, one-size-fits-all but you might want to focus on what their main problem may be. Is their skin too dry? You might want to consider injectable moisturisers such as Profhilo. If you want to focus on tightening the skin, you might want to think about microneedling treatments, Morpheus8 or Ultherapy. If the brown sun-induced spots on the face are of concern, you might want to consider IPL/BBL.” - Dr Amélie Seghers.

Michelle Duffield

Michelle Duffield

Published 02nd Oct 2024

Michelle is the editorial assistant to Aesthetic Medicine magazine.

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