We Need to Be Talking More About Skincare During Menopause

In the United States, the average age a woman begins menopause is 51, though it can generally come about anytime in your 40s or 50s. In 2020, 50 million American women will be at the average age for menopause, and yet the conversation around the physical and mental changes that happen during this inevitable time in a woman's life as well the resources available to her are limited at best. Jill Angelo, the founder of Gennev, an online clinic for middle-aged women, says that only 7% of patients are getting the treatment they need even though there are upwards of 34 common symptoms associated with menopause.

On the topic of beauty alone, it is estimated that up to a third of your dermal collagen (or the matter that keeps your skin looking plump and lifted) will be lost in the first five years after menopause, after which time it decreases approximately 2% per year, according to Robin Gmyrek, MD. But our social media feeds and the shelves of popular beauty stores are flooded with products that serve a much younger age bracket—girls whose collagen is flourishing and whose oil production is regulated. In other words, products specifically formulated to target the general degradation of skin during this pivotal time are few and far between, and the education to support how women should be treating their skin following these changes is scarce. So we're here to help shift the conversation—we spoke with Gmyrek, Rochelle Weitzner, founder and CEO of Pause Well Aging, and Lena Korres, co-founder and chief innovation officer of Korres for their thoughts.

The Three Stages of Menopause

Generally, we talk about menopause as one overarching concept, but it's actually a three-part phase: Perimenopause, menopause, and postmenopause. Perimenopause can begin eight to 10 years before menopause when the ovaries progressively produce less estrogen and can start as young as your 30s; menopause is the year-long period when a woman doesn't have her menstrual period; and postmenopause comes after menopause and can last for up to a decade or longer.

How Your Skin Changes During This Time

According to Gmyrek, you'll begin to see thinning, sagging, wrinkling, and poor wound healing during perimenopause as declining ovarian function leads to decreased estrogen levels. Then once you hit menopause, "there is complete estrogen deficiency and the skin changes are much more pronounced," she explains. These include:

• Dryness: As estrogen levels decrease, women will experience increased dryness due to decreased sebum (or oil) production.
• Dehydration: As we age, our hyaluronic acid levels (which keep the skin hydrated) decrease.
• Enlarged pores: Pores will appear larger due to weaker collagen and elastic tissue.
• Acne: Due to hormonal changes, women may break out during peri-menopause and menopause.
• Sun spots or age spots: Gmyrek says this is not specifically related to estrogen withdrawl, but rather occurs concomitantly due to life stage and age.

What changes to skincare should women make as they enter these different stages of menopause?

For dryness: Gmyrek says that as these stages begin, you should swap your foaming, soap-based cleansers for something more gentle and nourishing like cream (non-soap) cleansers. This is because soap-based formulas tends to pull oil from the skin. Gmyrek also recommends moisturizing with cream moisturizers that contain ceramides, glycerin, or hyaluronic acid (not lotions, as these are water- and/or alcohol-based and don't lock in hydration as much as an emollient-rich, oil-based moisturizer). She recommends applying moisturizer while the skin is still damp for better absorption.

For acne: Because the skin is thinner and drier during menopause, you'll want to steer clear of harsh acne remedies. Gmyrek recommends a soap-free cleanser with salicylic acid to unclog pores as well as topical adapalane gel 2 to 3 times per week.

For wrinkles and fine lines: "Most over-the-counter products available without a prescription are difficult to evaluate scientifically because study data are not available," says Gmyrek. "The two ingredients I recommend most are topical vitamin A in the form of retinoids or retinol and topical vitamin C." She recommends buying a product in a light-protected container or tube as vitamin A is inactivated by sunlight, and, for this very reason, she also recommends only applying it at night before bed. If your skin doesn't respond well to retinoids, she also recommends bakuchiol, a naturally-derived plant extract that offers the same benefits as a retinol but is less irritating and better tolerated by sensitive skin. In terms of vitamin C, Gmyrek says this is essential as it helps boost collagen and protect the skin from oxidative damage. She recommends SkinCeuticals CE Ferulic serum "because it was shown in peer-reviewed studies to be stable and therefore active on the skin."

Most importantly, she recommends consistently applying the gold standard, sunscreen. "You need sunscreen more than ever after menopause," Gmyrek urges. "The skin is thinner and more fragile, so protecting it from the sun is important. Use a sunscreen labeled SPF 30 (or higher—the SPF factor is a measure of protection against UVB light only) in order to be sure you are protected against UVA light as well as make sure the label says 'broad spectrum.' Age spots will be worse if you continue to get sun."

Exfoliation: Aging skin will see more dead skin cells accumulating on the top layer, but because the skin is thin and more sensitive, you'll need to tread lightly with trying to slough them off. "Exfoliation can help remove dead cells quickly and easily, encouraging cell renewal, but you have to be extra careful and choose, first of all, a gentle at-home exfoliating product and use it no more than twice a week," warns Korres.

Gmyrek recommends using a cream containing 12% lactic acid, which helps to chip away at the dead skin layer while moisturizing at the same time.

Invest in quality products: While menopause-specific products may not be at the forefront of the skincare landscape, two progressive brands are moving the needle and developing formulas targeted at menopausal women based off of their unique needs with ingredients that are proven to work.

Pause Well Aging, a brand devoted to the physiological changes that happen during the three stages of menopause, fortifies its products with its Pause Complex which is a proprietary blend of vitamins, antioxidants, and peptides that work together synergistically to spark collagen production, alleviate excessive dryness, improve skin density, and focus on radiance (its fan-favorite Hot Flash Cooling Mist is a game-changer). The brand has also developed a fascial stimulating tool, a patented FDA registered class 1 medical device, which improves vascularity (blood flow) to return radiance to the skin. Better yet, Pause is a brand that not only walks the walk, it talks the talk: "We never say the words anti-aging: To us, this suggests we are against aging, which we most certainly are not," says Weitzner. " We talk about Well-Aging: aging well, on our terms, the way we choose to. We believe everyone should have the tools to embrace aging on their own terms."

Korres skincare is also work to solve the problems women see in their skin during menopause. Its White Pine Meno-Reverse line is clinically proven to enhance elasticity, firm, decrease the appearance of deep wrinkles, increase skin’s resilience, and fight age spots. It also brings vital water levels and skin density back to pre-menopausal levels. "The discovery was so precious and valuable that it stunned the universities involved in the research," says Korres. "This global-first ingredient [ed. note: white pine] was added to the W-INCI (world INCI directory) under [the] Korres name."

See your dermatologist: If your budget allows, Gmyrek says resurfacing treatments like laser and micro-needle radiofrequency can help to stimulate collagen. "These treatments gently wound the skin in a very controlled fashion," she explains. "This controlled injury causes a wound healing response that stimulates the production of new collagen and elastic tissue."

Other Lifestyle Changes You Can Make

• Exercise: Moving physically benefits your skin by increasing the delivery of oxygen and nutrients as it increases blood flow, which also helps to remove toxins from the skin that cause further collagen and elastin breakdown. In addition, exercise has been shown to improve sleep patterns. Which brings us to our next point…
• Sleep: "Sleep is the time that your body repairs damage," says Gmyrek. "If you do not get quality sleep, you will repair less of your collagen and elastin daily damage. A study showed that even pre–menopausal women who did not sleep well exhibited more extensive signs of skin aging including fine lines, uneven pigmentation, and reduced skin elasticity." If you're having trouble falling and/or staying asleep, she recommends a visit to your physician.
• Eat well: Gmyrek recommends eating essential fatty acids, like the omega-3s found in salmon, walnuts, fortified eggs, algae oils, flax, safflower oil, and sardines to keep the skin's barrier in tact, a key factor in retaining skin moisture. She also encourages veggies and fruits for their antioxidants which can help preserve skin health.