Dr Keira Barr is a double board-certified dermatologist who specialises in the menopause. Her theory is that your skin is a window into your entire body function, you just need to understand the signs and how to care for the skin as it changes during menopause. Here she shares what she has learned about managing the menopause through your skin – and vice versa.
“I had never trained in menopause and women’s health in midlife, in fact it was personal circumstance that drew my attention. In my late thirties I was very fit, running ultra marathons, eating well, but managing life, family and work in the usual high stress juggle. I wasn’t sleeping properly and noticed something strange on my skin which was diagnosed as an atypical lesion.
In fact what was happening was I was entering early menopause and my skin was changing. Medical colleagues wanted to prescribe me pills, but I sought out other practitioners, such as acupuncture. Eventually I was advised to have a hysterectomy – I was 42. My ovary function had declined, I was on HRT, I was anxious, not sleeping and totally confused. I thought, I’m a physician of 20 years and I don’t know how to help myself – how is the average woman meant to help herself?
Does Early Menopause Cause Changes in Your Skin?
So I did some training and began a deep dive into women's health in midlife through the lens of my dermatological training. What I have always known is that changes in your skin and hair, is essentially your body talking to you about things getting out of whack. As our largest organ our skin is an incredible window into emotional and mental wellbeing, as well as our physical state. When we see things on our skin, we immediately think ‘I need to fix it – let’s cover it up.’
However, when things show up on your skin, it’s an opportunity to ask what is my body asking of me, what is it lacking? Or if your skin is glowing, then take the time to celebrate it.
But our hormones are always shifting, and in our 30s, 40s, 50s we may well notice some significant changes.
For me personally, I realised I was in early menopause. but women might enter the peri menopause up to ten years before menopause. And – here’s a little know fact - menopause is a milestone that’s actually only a single day – it’s the anniversary of the year since your last period. After that, you are termed ‘post menopausal’.
The average age of menopause is 51, but there’s plenty of leeway either side – with lots coming down to lifestyle and epigenetics. Women may start to notice changes to skin, hair and nails from their mid to late 30s.
Can Menopause Cause Skin Changes? Ask Your Hormones
Our sex hormones are interconnected to all our other hormones – insulin, thyroid, cortisol and so on. Your body is a whole symphony of hormones and they are all interconnected.
Progesterone is the first hormone that starts to decline in menopause. It plays a role in skin elasticity and hydration, and also, in its relationship with testosterone, also influences our hair follicles, potentially decreasing our hair density and causing hairs to be finer and thinner. So you might well notice thinning of the hair as your progesterone levels start to decline, (in the same way pregnant women might notice thicker hair from raised progesterone levels.)
Oestrogen plays a crucial role in the elasticity and buoyancy of skin, because of its involvement in collagen formation. You might notice more fine lines, more dryness (and therefore sometimes more vulnerability to irritation). As our hormone levels shift, the pH can change too – skin becomes more alkaline. So you might find products you have always used need changing or switching up.
Soreness in sex stems from the same issue: oestrogen depletion dries out vaginal skin which will make skin more sensitive.
The Knock On Effect
In the way that everything in our body is connected, as oestrogen decreases, the microbiome gets upset which impacts our ability to absorb nutrients. This in turn affects our ability to nourish our skin, hair and nails from within. We have to go beyond skin deep and topical products to think how we can help.
And let’s not underestimate the importance of sleep. Melatonin, the sleep hormone, one of most important anti-oxidants in our body and helps repair all the damage that goes on to our skin during the day. Sleep rebalances skin hydration and helps to regenerate hormones that repair.
Our primary stress hormone cortisol can have a massive impact in creating hormonal imbalances. Cortisol, and the stress which causes it, can make your menopause symptoms much worse and accelerate problems with skin, hair and nails. Cortisol not only breaks down collagen, it prevents its production in the body.
Manage Your Stress To Keep Your Hormone Levels Up
The recognition of this led me on a journey. I found I was prescribing bio identical hormones to my patients, but then when I dug deeper I found that a much more significant aid was the ability to self regulate their emotions, calm their nervous system, lift their mood and sleep better. This made a huge difference to their skin. I believe stress is the elephant in the room – the hidden beauty secret people under estimate.
Some stress is good stress – but most women already feel so overloaded and overwhelmed, it is often a compounding and negative addition. Fretting about what happened in the past which we cannot change, or fretting about what may happen in the future which we cannot control does not serve us.
Stress can be managed: we don’t pay attention to our breathing – how we are breathing and why we are breathing. We may hold our breath, or breath in with our chest. Taking two or three belly breaths, in through the nose and out through the mouth can be a game changer in the moment: it just takes our mind off what you are spinning about.
Likewise a compassionate touch – a hand on your chest, or running a hand up your leg when you’re stuck in traffic or held up in a queue just reminds you to be calm – to just give yourself a moment.
Your body will prioritise cortisol production over sex hormones, cortisol is a survival hormone. So when we are stressed other functions of your body may get side-lined. Prioritising sleep, looking at your diet, tuning into what feels good In our body, managing stress (ask yourself who you spend your time with, and do they serve you) are always to manage and even delay menopause.
Supplements also help support our ability to streamline lifestyle factors. Ashwaganda is key for stress; saffron helps lift mood and tackle depression, curcumin has significant anti inflammatory properties, Keratin specifically supports hair skin and nails. The LYMA supplement is my go to at the moment.
For me, it’s always food first and making good habits, and then supplements really help."
Skin Saviours: How To Nourish It With Oils
A good organic oil applied topically can help ease dryness. I recommend jojoba and grape seed oil, or pomegranate seed oil if your skin is really dry. Sea buckthorn oil has anti inflammatory properties.
However before you spend any money on topical products I would first advocate eating a plant powered diet, and learning to regulate your stress response. Supporting your system from the inside out so you don’t have to spend so much money doing it from the outside in.
Nourish yourself with things that bring you joy – this is a time of life when you can unapologetically show up as you, and that should be celebrated.
Your Skin Routine To Support A Healthy Menopause
- Wash your face in the morning
- Apply an anti oxidant serum rich in vitamins C and E to repair DNA
- Use a tinted moisturiser with SPF 30+ (see above)
- Wash your face with a gentle cleanser in the evening as air pollution is right behind UV rays in causing hyper pigmentation
- Add another layer of serum
- Apply a topical retinoid to help skin cell turnover and rejuvenation (Bakuchiol is a good alternative to retinoid if you need one)
Originally published Dec 1, 2021.
Written by Dr Keira Barr.