Category: Menopause Clinic

How should we take care of our skin during menopause?

Four different issues matter in menopausal skin care. Cleansing, moisturizing, antiaging and protection.

Estrogen plays an important role in hydration, in how much moisture our skin retains. When their levels drop, the skin becomes drier, thinner and more sensitive. In addition, they play an important role in how much collagen we synthesize. Collagen is an essential protein in our skin that gives support and firmness. When it decreases the skin changes... We see it thinner, with more wrinkles and sagging. We know that in the first 5 years after menopause we lose about 30% of our skin's collagen.

So how should we take care of our skin during menopause...

 

1. The cleanser should be gentle. After all, common alkaline soaps in combination with hot water significantly dry the skin, even at young ages. So we need to use non-drying cleansers, without fragrances and agents that in other decades might be useful, such as salicylic acid, lactic acid or fruit acids.
2. The hydration. Its purpose is to improve dryness and repair the skin's barrier. Here we use lipids (for example ceramides) and ingredients that retain a lot of water such as hyaluronic acid and glycerin. At menopause we also have a decrease in estrogen and a relative increase in androgens – so some women have a tendency to suddenly develop pimples. It is therefore of great importance that our moisturizers provide the necessary lipids but not be food-borne.
3. To apply anti-aging products. What does this mean; Products whose ingredients activate collagen production. Such are retinol or other topical retinoids that may belong to drugs, and vitamin C. Another approach is to apply substances or replacement complexes that mimic estrogen (without being) because their chemical structures are similar.
4. It's never too late to start applying sunscreen daily – there's a significant window of prevention in the 60s-70s-80s. Sunscreens protect us from discolouration, gradual thinning from wrinkles and relaxation caused by UV rays.

 

Finally, skin care has to do with other issues that are generally related to a life with good quality – well-being. Proper nutrition, enough sleep, no cigarettes, stress reduction – everything matters in the good condition of our skin

Immediately below our epidermis, in the second layer of the skin, there are the proteins collagen and elastin. Collagen forms a network, a mesh that supports the skin, gives it firmness. Elastin is a protein that gives elasticity, which enables the skin to return to its position when stretched. As the years pass these proteins are produced at a lower rate and are broken down more quickly. So when they are reduced, sagging and wrinkles appear on the skin. Some people show more sagging, others more wrinkles. This depends on our genes.

Menopause, i.e. the significant decrease in estrogen, significantly accelerates this process. Consider that women in the first 5 years from its onset we lose approximately 30% of our skin's collagen. And skin elasticity in postmenopausal women decreases by 0.55% per year.

What external factors increase relaxation during menopause?

Also, it is very important the role of the environment in this reduction of the substances that give a youthful image to our skin. Diet, smoking, sleep clearly have a role in skin aging. However, the most aggravating factor from the environment remains the exposure to the sun. Ultraviolet radiation it destroys the elasticity of the skin in the areas that have been exposed for decades, and it is the main factor responsible for sagging and wrinkles on the face, neck, hands as well as the sagging of the skin on the body.

Skin relaxation can also be affected the big weight loss and the redistribution of fat that occurs with age. It is a myth that running causes relaxation and that relaxation is linked to how we sleep.

What do we do for relaxation?

1. Prevention by avoiding the sun.
2. Long-term application of topical retinoids, antioxidants, peptides.
3. In addition, our dermatologist advises us on possible in-office treatments aimed precisely at preventing or correcting sagging.

Over the years brown or black marks appear on the face, mainly in the areas exposed to the sun, on the face and hands. These marks may have different names but they are all darker than the surrounding skin which is why they are called “spots" the "discolorations». The most common are the melasma (or panada) and the solar lenses.

How do these come about? In our skin, we all have melanocytes, i.e. cells that produce a substance, melanin, which is responsible for our color. Darker-skinned people have more active melanocytes that produce more melanin, while lighter-skinned people have less. The melanin is then distributed evenly to the keratinocytes, the main cells of our skin. When our skin is significantly exposed to the sun, at some point the melanocytes produce more melanin in certain places and this causes solar lentils and melasma. As for melasma, it is also often triggered by hormonal changes such as pregnancy, contraceptives or replacement therapies that we may take at menopause. It gets worse with UV light, but we know visible light and infrared from devices also affect it.

So what can we do about dyschromias?

First thought is always the prevention. It is never too late to prevent our discolorations from getting worse or new ones appearing. We know that the sun is to blame for their appearance and of course when we avoid it they decrease. Even when the weather is not good, ultraviolet rays (mainly UVA) penetrate the clouds and reach our skin to stimulate melanin production. It is also known that both visible and perhaps infrared light can induce melanin production, especially in dark skin. That is why it is very important to apply sunscreen every day 365 days a year and for darker skin choose sunscreen products with special natural filters or pigments that also protect against visible light. It's never too late to get the right behavior in the sun, seek the shade, wear a hat and apply the right sunscreen every day.

They also have a role in the prevention of discoloration antioxidants, and this is because it has been proven that oxidative damage from exhaust gases in cities increases the possibility of discoloration. Antioxidants neutralize this risk to a certain extent.

Then, next step after prevention is trying to eliminate dark marks, spots. This might be done with creams containing bleaching substances which reduce melanin production by melanocytes. Such substances are hydroquinone (which has restrictions on its use in Europe and is prescribed by dermatologists), azelaic acid, kochic acid, cysteamine, tranexamic acid and other substances. Another approach is the substances that prevent the transfer of melanin to keratinocytes, for example niacinamide. We can also apply substances that cause keratolysis, that is, they remove from the skin keratinocytes that have increased pigment and thus the color of the skin is more uniform. For example fruit acids, topical retinoids or salicylic acid. Ideally, when we talk about skin whitening with creams, we deal with the problem from many sides, we combine different substances with different actions for a better result.

Our dermatologist suggests which combination is best for each person. Of course, the dermatologist's job during the examination is also to confirm that the discoloration is harmless to our health and that it is not a cancerous or precancerous lesion. Also, the dermatologist may reinforce the whitening effort with creams with special treatments that are done in the doctor's office.

When estrogen drops greatly at menopause, the skin produces less collagen and elastin. The collagen forms a network, one support mesh below the surface of the skin. THE elastin is one protein that gives elasticity, which enables the skin to return to its position when we pull it. When these proteins are reduced, wrinkles and sagging appear. What can we do about it? There is certain routine that we should follow at home, daily and long-term, which delays the signs of aging. There are also procedures that one does in the dermatology clinic, which depending on the case give anti-aging results. Regarding the work that we recommend someone to do at home, it concerns:

 

• Application of topical retinoids at night. Retinoids are derivatives of vitamin A and are the substances with the most evidence for antiaging action. Epidermal cells usually need a month to complete their life cycle, that is, to reach the outer parts and fall off. With retinoids, this happens faster, in 2 weeks the rate of their multiplication is accelerated. Retinoids also prevent the breakdown of collagen and aid in the synthesis of new collagen, thus fighting wrinkles.
• Application of appropriate antioxidants, such as vitamin C or ferulic acid or other molecules. These help to neutralize the oxidant radicals produced by sun exposure, may also help with discoloration and make the skin brighter and more radiant.
• To treat wrinkles we can also look for products that they contain peptides in their composition. Peptides are small protein molecules that help produce collagen.
• Of course it is good moisturizer containing hyaluronic acid, glycerin to retain a lot of water and lipids to strengthen the skin's barrier cannot be missing from daily care
• We do not forget that the 90% of the signs of aging that we have on our face are due to exposure to the sun. So dealing with antiaging requires that we use some form product with sun protection (which also provides protection against skin cancers).

 

At the dermatology clinic there are many options and they are personalized according to the needs of each person. They target either the enhancement of collagen production diffusely in the skin or specifically at wrinkles and relaxation.

Many menopausal women describe a change in their skin from oily or combination skin to dry. This is because when estrogen decreases the skin produces less sebum (i.e. lipids) and has less ability to retain water. Care must therefore be adjusted accordingly.

1. Firstly, The cleaning must be done with suitable gentle products. Common alkaline soaps combined with hot water significantly dry the skin, even at young ages. So we must use cleansers that are not drying, without perfumes and agents that in other decades when we may have acne or oiliness are useful such as salicylic acid, lactic acid or fruit acids. A wrong cleanser can remove fat molecules or sebum from the skin that we need, otherwise the skin becomes drier and may show irritation and redness.

2. Secondly, has role one good moisturizer. But what does this mean? What is a good moisturizer? The outer part of the skin, the one we touch, has rows of cells closely stacked on top of each other and between them are lipids. Such, for example, are the tiles. When we touch our skin and it feels dry we are practically grabbing the edges of the keratinocytes that are about to fall off and that have peeled off, or folded because they are not held in place by the lipids – the skin barrier is not working properly. Then the skin's water content is not ideal, i.e. between 20-35%. The role of a good product in menopause is twofold:

1. 1. To give enough lipids to the skin and to restore the ratio of Omega 3-6-9 fatty acids.

• a. The goal is to replace their loss and their ratio, so that the skin barrier works properly.

1. 2. Moisturizers are a must also contain hygroscopic agents, i.e. substances that can hold a lot of water, such as hyaluronic acid and glycerin.

 

In addition, some menopausal women they complain that their skin suddenly became sensitive. In other words, things that did not bother them in the past, suddenly the skin does not tolerate them, they have the feeling that they it stings, pulls or displays redness and pimples. For example, they are bothered by woolen clothing or products that were previously tolerated without problems. This is because when we don't have estrogen we synthesize less lipids and in that the skin becomes thinner. We have a lower rate of proliferation of the outer cells (keratinocytes) but also less collagen in deeper layers of the skin. So we need gentle cleansing and the right moisturizers without fragrances or irritants.