Menopause is defined as the cessation of menstruation for a consecutive 12-month period, without any apparent physiological or pathological causes or clinical intervention. The transitional years leading up to menopause are termed perimenopause. The median age for menopause is typically around 51 years, and the perimenopausal phase can span a duration of approximately 2 to 8 years.
As an inevitable natural process of aging, menopause impacts every woman. During menopause, the ovaries stop to produce eggs, and the levels of key sex hormones, such as estrogen, progesterone, and testosterone, decline. These hormones have multi-system effects, and their deficiency leads to a vast range of symptoms.
Skin Changes
Skin symptoms during menopause often receive less attention than other associated symptoms. Menopause is characterized by low levels of estrogen, leading to a hypoestrogenic state. This substantial hormonal shift is linked to a loss of skin structural architecture and an increased vulnerability to damage. The hypoestrogenic state stands as one of the most significant intrinsic causes of aging in women. It is associated with an acceleration in skin dryness, thinning of the skin, the emergence of fine lines and wrinkles, diminished firmness and elasticity, and heightened susceptibility to photodamage.
The evidence indicates that up to 30% of dermal collagen may be lost in the initial 5 years following menopause, with collagen content further diminishing by approximately 1-2% each subsequent year. This decline is correlated with a reduction in skin thickness by 1.1% per year. The cumulative effect is a combination of thin, sagging, and dry skin, which starkly contrasts with the thicker and more resilient nature of pre-menopausal youthful skin.
Moreover, the increased formation of wrinkles is closely tied to, and exacerbated by, a decrease in skin elasticity during menopause. In post-menopausal women, skin elasticity diminishes by 1.5% per year, a decline not observed to the same extent in women undergoing hormone replacement therapy (HRT). These findings underscore the intricate relationship between hormonal changes during menopause and the visible signs of skin aging, emphasizing the potential benefits of interventions like hormone replacement therapy in mitigating these effects.
How To Tackle with Post-menopausal Skin?
To tackle the signs of aging skin associated with the menopause we must address the underlying cause – oestrogen deficiency. Therefore, the most important preventative and restorative treatment option for aging skin is the replacement of oestrogen in the form of Hormone Replacement Therapy (HRT). The use of estrogen has been linked to increased collagen content, augmented dermal thickness, improved skin elasticity, reduced formation of wrinkles, and a decreased likelihood of developing dry skin.
Research has demonstrated that women who consistently used Hormone Replacement Therapy (HRT) within one year of their last menstrual period exhibited significantly fewer wrinkles and less skin rigidity. Menopause is associated with substantial bone loss, including in the facial skeleton. This bone loss contributes to the aging process by leading to the development of prominent nasolabial folds, tear trough deformities, and jowls, resulting in a diminishing contoured appearance of the face.
The early initiation of HRT has been shown to prevent bony resorption, thereby helping to maintain skeletal structure. This preventive effect has the potential to counteract premature facial aging by addressing deficiencies in the facial skeletal framework. Understanding the impact of HRT on both skin and bone health underscores its potential role in promoting a more youthful and resilient facial appearance during the menopausal phase.
Undeniably, systemic HRT is generally not advocated to solely treat skin aging, however, it could be considered at the forefront of treatment options. Its primary role is to restore hormonal balance, fostering overall well-being and improving the quality of life for women navigating through the menopausal transition, comprehensively addressing the diverse challenges posed by menopause. Nevertheless, it's essential to undergo a comprehensive consultation before initiating HRT. This step is fundamental to exclude any contraindications to the prescription of HRT and ensure that the treatment plan aligns with individual health considerations and needs. This personalized approach ensures the safe and effective use of HRT for managing menopausal symptoms and, potentially, addressing skin aging concerns.
Skincare
As described earlier, menopausal skin is classically dry due to the reduction of sebum, ceramides and hyaluronic acid; loss of skin firmness and elasticity with the appearance of wrinkles due to skin collagen loss are the main skin changes. Therefore, daily skincare products with the right content are essential. What are the best skincare ingredients for menopausal skin? Here are some beneficial skincare ingredients for menopausal skin:
Hyaluronic Acid: Helps in retaining moisture, promoting hydration, and improving the skin's elasticity.
Retinoids (Retinol): Stimulates collagen production, aids in reducing fine lines and wrinkles, and promotes skin renewal.
Vitamin C: Known for its antioxidant properties, Vitamin C helps protect the skin from free radical damage and supports collagen synthesis.
Peptides: These small proteins can help stimulate collagen production and improve skin firmness.
Ceramides: Essential for maintaining the skin barrier function, ceramides help in preventing moisture loss and promoting hydration.
Niacinamide (Vitamin B3): Addresses uneven skin tone, improves elasticity, and helps in managing fine lines.
Glycolic Acid: An alpha hydroxy acid (AHA) that exfoliates the skin, promoting cell turnover and reducing the appearance of fine lines and age spots.
Vitamin E: An antioxidant that helps protect the skin from oxidative stress and supports overall skin health.
Omega-3 Fatty Acids: Found in certain oils and supplements, omega-3 fatty acids contribute to skin hydration and may help manage inflammation.
In-Clinic Treatment
Indeed, oestrogen stimulates the production of hyaluronic acid (HA) within the deep dermis of the skin. Therefore, topical application of HA, which sits on the outer surface of the skin, will not have the same effects as intrinsic production which draws water in, restores skin fullness, maintains skin turgor and reduces fine lines. To address both the outer and inner layers of the skin and replenish levels of HA, injections may be considered. Bio-remodelling treatments, such as Profhilo and Radiesse, along with HA-based dermal fillers like Juvederm, are popular options.
Bio-remodelling treatments are designed to boost the biosynthetic capacity of fibroblasts, with the goal of restoring an optimal physiological environment. This process enhances cellular activity, hydration, and the synthesis of key components like hyaluronic acid (HA), collagen, and elastin. Furthermore, these bio-remodelling treatments are effective in tackling skin atrophy, a natural consequence of menopause, by restoring facial volume. They contribute to softening the appearance of fine lines and wrinkles associated with aging, providing a holistic approach to facial rejuvenation. Meanwhile, HA-based fillers are used to address the accelerated bony resorption process observed during menopause.
Conclusion
In conclusion, embracing the journey through menopause doesn't mean compromising on the vibrancy and radiance of your skin. At Dream Clinic, we understand the unique needs of menopausal skin and offer a range of advanced aesthetic treatments tailored to enhance your natural beauty during this transformative phase of life. Schedule a consultation with us today, and let us guide you on a personalised journey to embrace the beauty that comes with age.
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