The skin (and the rest of our body) start to go through a lot of changes as we reach perimenopause – the time leading up to menopause, which typically happens between the ages of 45 and 55, when periods stop due to hormone levels. Perimenopause can last anything from months through to several years and during this time we can experience a number of different symptoms, aside from hot flushes and night sweats, which are typically associated with menopause. Anxiety, brain fog, mood swings, irregular periods, sleep disturbance, palpitations, joint aches, itchy/dry skin and decreased libido are just some of the other symptoms that we can experience. It’s a lot, and I’ve been in the throes of it for the last few years (I’m 49 in a couple of months). Whilst HRT has helped to reduce or eliminate many of these symptoms, I’ve also had to make other lifestyle changes to support my body during this time.
I wanted to focus more specifically on the impact of perimenopause / menopause on the skin, as I have observed changes in my skin which have required a tweak in my previous (but very consistent!) routine, and share this with you. One thing I want you to keep in mind though, is the importance of understanding how your own skin is changing, as we may not all experience these changes in the same way. This is one of the many reasons that I don’t like the idea of “menopause skincare”. Whilst we know that declining oestrogen reduces the skin’s ability to retain water, causing the skin to regularly feel dehydrated, fluctuating hormones can cause other changes too. Some women report skin becoming drier, which is understandable as this naturally happens with age due to the skin’s lipids (ceramides) depleting, but others may experience increased oiliness and even acne breakouts. A “menopause skincare range” is unlikely to tackle all of these issues. Also, as I’ve mentioned in this previous blog post, there are no specific ingredients that help peri-/menopausal skin that you can’t find in most standard skincare ranges. It’s unfortunately a marketing tactic, which often comes with a premium price tag so please don’t be fooled!
So with all that said, I’ll explain the changes I’ve noticed in my skin in the last couple of years. I have definitely noticed my skin being more prone to dehydration – which is unsurprising given the role of declining oestrogen. I’ve also noticed my skin becoming slightly drier and more sensitive to actives that I previously had no issues with. Some people can find it hard to distinguish between dehydration and dryness (you can have both at the same time!). Dehydration is down to water loss in the skin whereas dryness is down to a depletion of the natural lipids in the skin. They can feel and look the same in terms of how they appear though – tightness, dull skin, flakiness. For me, the easiest way to tell whether it’s dehydration or dryness is to test how my skin responds to different formulations. Historically I’ve always struggled with rich, occlusive products (great for dry skin) as my skin was very prone to comedonal acne (non-inflammatory acne causing clogged pores). So it generally responded well to (lighter weight) products that were humectant-rich (great for hydrating the surface layer of the skin) but not too lipid-rich. Now I’m finding I still need these humectant-rich products but I also need something more lipid-rich and occlusive for my skin. It’s worth mentioning here that how heavy / thick a product is doesn’t really tell you how occlusive a product is. Similarly a product can be quite lightweight in texture but still be quite effective in skin occlusion and replenishing skin lipids. Ingredients to look out for that help dry skin include dimethicone, petrolatum, waxes, butters. Oils can help with emolliency (skin softening), but aren’t as effective with occlusion. That said, it really comes down to product formulation, so I would encourage you to sample / test products to see how they suit your skin as that’s really the only way to properly tell (and that’s exactly why I offer sets of samples to purchase on my website!).
In terms of the other main change I’ve seen due to perimenopause – increased skin sensitivity, this has been a big one for me. I’ve always been quite diligent with my use of skincare actives because skin health always comes first for me! But you’ll know from my previous blog posts that I was an avid user of tretinoin (prescription retinoid / vitamin A) for a while. I used it regularly for 6 years to manage my mild comedonal acne but it also helped with “healthy ageing” i.e. minimising fine lines, improving pigmentation and overall skin radiance. My journey with tretinoin was very smooth – I acclimated to it easily (though I was very careful with the introduction of it) and have used it for all those years with no issues at all. But early last year I started to notice my skin just didn’t look very “happy” anymore. There wasn’t any dramatic irritation or peeling etc, but I know my skin well enough to notice even subtle, early warning signs of impaired barrier function. My skin just looked a bit lacklustre, a little blotchy and tighter than usual. Around this time I had barrier renew retinal serum in product development and I needed to test it before it went into final testing. So I started to substitute it for tretinoin – initially just 1-2 times a week. At this point, I must admit I was really worried that the comedonal acne I had such a good handle on would return. I was then due to go on holiday for a couple of weeks and didn’t want to take both products with me, so I only took my retinal. At this point I started using it exclusively instead of tretinoin. 10 months later and I’m still only using my retinal and even I’m surprised by how much better my skin looks now!
Something else I’ve incorporated a little more, is the use of mild chemical exfoliants. When I was on tretinoin, I typically avoided these or used them very occasionally as I didn’t really feel I needed them. Chemical exfoliants work by dissolving the bonds that hold skin cells together. Usually our skin naturally sheds cells as part of our skin cycle, but as skin naturally ages, this process slows which can cause a build up of skin cells (which you’ll see as dullness and flaky skin). I notice this is most apparent as I get to the end of my menstrual cycle (I love looking for patterns in skin changes!). So I now use a mild chemical exfoliant twice a week. I emphasise mild as I’m still very careful with the use of exfoliating acids. My personal preference is for lactic acid but my skin will tolerate a well formulated glycolic acid once a week too. You know I always say that formulation matters, and this is particularly important with exfoliating acids. Most people are simply drawn to the percentage of acid on a product label, but there are other factors which influence how aggressive or mild an acid will be. Primarily the pH, which in turn influences the free acid value. So not only does a high percentage of acid affect the strength, a very low pH will also make an exfoliant feel more aggressive on the skin. You also want the addition of soothing, hydrating ingredients to buffer the effects of the acid. Contrary to what you may have heard, an acid doesn’t need to “tingle” or “sting” in order to be effective. I only use gentle, well-formulated acids that don’t cause any unpleasant sensations on my skin, yet really help to refine it. As I said before, for me, the goal is always skin health first!
Whilst I realise that HRT may have also helped with my skin, it’s worth mentioning that I’ve been on HRT for over 2 years now, whereas it’s since I’ve switched from tretinoin to retinal that my skin looks healthier overall. That’s not to say I don’t think people should use tretinoin – I still believe it’s an excellent option, particularly for acne-prone skin. It just became a bit too much for my increasingly sensitive skin. Thankfully I haven’t had any issues with comedonal acne (aside from the occasional breakout), and my skin looks and feels healthy / radiant. I haven’t even had any professional treatments in the last 10 months (I’m saving up for microneedling or laser at some point). So I’m feeling pretty good about my current routine!
Want to know what I’m using? For context, my skin is “balanced” to slightly dry, dehydrated and has been prone to comedonal acne.
AM:
· Before, I would just rinse my face with water in the morning but now cleanse my face with a tiny amount of gentle cleansing gel (as I’m using a more occlusive moisturiser/balm at night now) just to remove any residue from the night before
· NB. not shown in image, but twice a week I use a gentle acid exfoliator (usually lactic, but sometimes glycolic once a week max)
· Skin quenching essence – ALWAYS in my morning and evening routine!
· Barrier support serum + barrier defence AOX serum – apply a small amount of each together
· Skin quenching moisturiser (just a small amount as sunscreen alone isn’t hydrating enough for me)
· EVY sunscreen SPF30 (I often use SPF50 on hotter days)
PM:
· Single cleanse with comforting cleansing oil (I only double cleanse if wearing lots of make up or I’ve been into London!)
· Skin quenching essence
· Barrier support serum
· Barrier renew retinal (4 nights a week) – on my nights off I’m currently trying out a copper peptide (too early to say if it's doing anything!)
· Comforting moisturiser (+ a night balm I’m currently working on!)
This may sound like a lot of steps for some people but both routines take just a couple of minutes!
I’ve been following this routine for about 10 months now (the night balm and copper peptide are more recent though). I may need to switch back to skin quenching moisturiser at night in the summer months, depending on how my skin looks and feels. As always, this is why I recommend getting to know your skin well so you can adapt your skincare routine accordingly.
If you could take just two things away from this blog post, they are: the importance of learning to understand your own skin’s needs / how they change over time; and that you don’t need to buy “menopause skincare” – instead focus on the concerns and treat those accordingly. As always, if you need guidance with this, please feel free to get in touch with me for some personalised advice (from a real human who knows skin rather than an AI-bot!).
