Skin problems and hormone imbalance

The hormone oestrogen declines at menopause and often fluctuates in the peri-menopause years causing skin problems and hormone imbalance secondly those menopause symptoms like hot flushes, night sweats, brain fog can aggravate skin problems too. As a result hormone imbalance plays a big role in the signs of aging and keeping skin youthful, with ageing and menopause so interlinked it is difficult to distinguish which causes which. However hormone imbalance  from fluctuations in oestrogen do influence the skin directly and can lead to Skin problems like wrinkles, flushing, dryness and impaired wound healing. Moreover oestrogen may even play a role in protecting the skin from the sun’s harmful UV rays.

Loss of collagen and hormonal imbalance 

Collagen is a protein that gives skin its firmness and elasticity and makes up about 80% of adult skin. So we are born with the highest amount and it decreases in adulthood. Because shockingly up to 30% of collagen is lost in the first five years after menopause, this is what speeds up wrinkling and sagging. Collagen becomes divided and unevenly distributed and its total amount decreases because of increased damaging activity, caused by enzymes and impaired growth factors induced by reactive oxygen species generated during aging . This is what we call free radical damage see my blog.  

Collagen is a major component of extracellular matrix (ECM) in the dermis. Additionally it contains elastic fibers, glycosaminglycans (GAGs), and proteoglycans (PGs). Therefore reduced collagen has a knock on effect that hinders the interaction between these components and other structures like fibroblasts that are the building blocks of the ECM. A decline of fibroblast function further decreases in the amount of dermal collagen. (1)

Skin sagging and wrinkling and menopause

Protein synthesis, particularly that of collagen and elastin are partly controlled by oestrogens so the resulting reduction of elastic fibres and GAGS that normally make your make your skin plump and bouncy can cause facial lines and wrinkles to gradually deepen. Elastin is a protein that coils and recoils like a spring within the elastic fibers of connective tissue and in the skin providing it’s elasticity.

GAGs and (PGs) are polysaccharides that help support and maintain structural proteins like collagen and elastin. You may have heard of the glycosaminoglycans like hyaluronan and chondroitin sulfate in skincare and joint supplements. They function as water-binding molecules that can hold nearly 1000 times their own weight. This capability may provide moisture for the skin matrix and it’s components giving the skin resilience. (2)(3).

Thinning of the skin

The reduction of protein synthesis and resulting loss of collagen and elastin cause loss of  skin volume and elasticity leading to the main causes of other menopause related skin problems. Because of this the dermis starts to thin due to the loss of collagen, GAGs and water causing it to be much more prone to bruising and tearing.

Skin dryness

A common problem in menopause is dryness as oestrogen is essential for skin hydration because it increases the skin’s production of GAGs and oil this directly affects the barrier function and decreases water retention increasing transdermal water loss. In this incidence it can cause Pruritus (skin itching) due to extreme dryness. (1) (4)

Slow wound healing

As previously mentioned the skin becomes thin and fragile, making it more susceptible to bruises and injury and lower hormonal imbalance from low oestrogen is thought to contribute to poor wound healing. Subsequently there is a significant difference in recovery time between pre and postmenopausal women and this tells us that hormones are playing a bigger role in wound healing than chronological age. (4)

Hot flushes and blushing

As many as 50% of women going through menopause have hot flushes and or night sweats and this causes skin flushing. The cause of hot flushes is not completely understood but may be due to a decrease in the skin’s microcirculation due to the effect of hormonal imbalance. This effect on the skin may make it more prone to dilated capillaries, and broken veins causing flushing to last longer than the hot flush. Finally Rosacea can be a complication of this and is often miss understood.  (5)

Acne

Spots at 50? yes this can occur even although you might think you should have outgrown them! Hormonal spots are common at any age in response to the hormone imbalance during the menstrual cycle so fluctuating hormones occur more irregularly in perimenopause. So at this time it may be to a drop in oestrogen levels or an increase in androgen hormones like testosterone. Women do have this hormone normally! Some forms of hormone replacement therapies (HRTs) may also trigger it due to the hormones it introduces. There are many underlying causes so nutritional approaches are often best alongside the correct topical products. (6)

Sun Damage

It seems women may be more prone to the effects of ultra-violet light at menopause, due to the lowered collagen and elastin the repair mechanism is lost and damage is more pronounced if the skin is exposed to ultraviolet rays. For instance UV is very destructive to collagen and will accelerate ageing and diminishing our skin’s resiliency. Yet another condition called elastosis can also occur where elastic fibers that normally decrease in aged skin accumulate abnormally in photo-aged skin causing skin thickening known as elastosis. (7)(2)

In conclusion understanding what’s happening can help us to take of our skin and know what is realistic and it will help us make adjustments. I will be providing more insight into foods, lifestyle changes and topical products that can support skin health helping it look it’s best. (8)

REFERENCES

1.Calleja-Agius J, Brincat M. The effect of menopause on the skin and other connective tissues. Gynecological Endocrinology [Internet]. 2012 [cited 2020 Nov 19];28(4):273–7. Available from: https://www.tandfonline.com/doi/abs/10.3109/09513590.2011.613970 

2. Shin JW, et al. Molecular mechanisms of dermal aging and antiaging approaches. International Journal of Molecular Sciences [Internet]. 2019 May 1 [cited 2020 Nov 19];20(9). Available at: https://doi.org/10.3390/ijms20092126

3. Farage MA, et al., Skin, mucosa and menopause: Management of clinical issues. Skin, Mucosa and Menopause: Management of Clinical Issues. Springer Berlin Heidelberg; 2015. 1–509.

4. Nair P. Dermatosis associated with menopause. Journal of Mid-life Health [Internet]. 2014 [cited 2020 Nov 19];5(4):166. Available from: /pmc/articles/PMC4264279/?report=abstract

5. Duffy OK, Iversen L, Aucott L, Hannaford PC. Factors associated with resilience or vulnerability to hot flushes and night sweats during the menopausal transition. Menopause: The Journal of The North American Menopause Society [Internet]. 2012 Dec [cited 2019 Apr 11];20(4):1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23250082

6.Bhate K, Williams HC. Epidemiology of acne vulgaris. Vol. 168, British Journal of Dermatology. 2013. p. 474–85.

7.Fisher GJ, et al. Pathophysiology of Premature Skin Aging Induced by Ultraviolet Light. New England Journal of Medicine. 1997 Nov 13;337(20):1419–29. https://www.nejm.org/doi/full/10.1056/nejm199711133372003

8. Farage MA, Miller KW, Elsner P, Maibach HI. Intrinsic and extrinsic factors in skin ageing: A review. Vol. 30, International Journal of Cosmetic Science. 2008. p. 87–95. https://doi.org/10.1111/j.1468-2494.2007.00415.x