Got an itch that you just can’t scratch?
Itchy skin can quite easily drive you bonkers. You try to remind yourself not to scratch, convince yourself you can dig your fingernails in a little to relieve the itch, try some ice cubes or saliva to relieve the itch, but then forget completely and scratch continually, only to make the itch itchier (was that possible?!), your skin red, and eventually break the skin and cause yourself to bleed.
Then repeat that again, and again, and again. Because the itch isn’t relieved, it’s still there!
Itchy, dry, flaky skin can start as you enter menopause; and guess what, oestrogen is the main culprit here.
Oestrogen is often considered the youthful, glowing hormone that makes your face young, your skin full, plump and moisturised, and many other beautiful feminising things. But do you know how it does all these wonderful things? Oestrogen can increase skin collagen content, supporting and increasing skin thickness. It plays a great role in skin moisture and has a positive effect on elastic fibres. It also positively influences fatty tissue deposits, particularly near the face, neck, arms and hands, causing a plumpness that disappears when menopause sets in (and your fat cells redistribute).
If we consider these actions, we can start to understand how the decline in oestrogen during menopause becomes the main culprit in the accelerated aging of the skin. It starts to become apparent that oestrogen, for all its negative associations, has a large positive influence over our skin, our youth, and essentially our barrier and border, stopping our insides from falling out.
But what about that itchy skin that we just can’t relieve?
You guessed it; the dryness, that comes from the lack of oestrogen, can cause an irritation that can be experienced with the urge to itch.
Occasionally the itchy sensation can be likened to feeling as if there are insects crawling under the skin. This is called formication, and this is something we often hear about at the Australian Menopause Centre. This often can’t be relieved by scratching and has a lot to do with your oestrogen levels.
Unfortunately, when the ovaries retire, and the oestrogen production within the body significantly reduces, your skin can dramatically change. It can almost feel like your skin changes overnight, and that might not be too far from the truth.
Interestingly, those who are considered ‘oestrogen dominant’ are often thought of as ‘looking great for their age’ (finally a positive to being oestrogen dominant!).
However, eventually, the ovaries do retire.
For some, oily skin and ‘adult acne’ can develop, as the ‘anti acne’ effect that oestrogen has over the skin glands reduces. This allows testosterone to run rampant, unopposed by oestrogen. This can result in the skin glands creating a thicker oily secretion, changing your skin to an oily and acne prone skin type.
Unfortunately, facial hair can also run rampant due to this oestrogen-testosterone imbalance.
If you have not considered it already, it’s time to consider how you protect your skin from the sun (especially the face if ageing is a concern). Protein construction, particularly that of collagen and elastin (important skin proteins), are somewhat controlled by oestrogen. This means that when your oestrogen levels drop, you lose the construction and also the repair of collagen and elastin fibres. This lack of repair is particularly pronounced if the skin is exposed to UV rays. If we can remember the old government ad stating, ‘tanning is skin cells in trauma’, then we can easily understand that UV rays are particularly destructive to collagen. During a time when our oestrogen levels are diminished, which means our repair mechanism is diminished, we can start to understand how we can look so aged once menopause kicks in.
To add to the importance of being sun smart, we should consider ageing spots. These brown ‘ageing spots’ appear on the face, hands, neck, arms and chest of many menopausal women. Once again oestrogen is playing a regulating effect, but this time on melanin production, keeping its production under control. When we lose the oestrogen regulating effect, and when the skin is exposed to UV sun rays, melanin synthesis increases. The increases in melanin is evident in the appearance of brown spots, commonly referred to as ‘ageing spots’.
And finally, we should delve a little deeper into the dryness factor. Dryness is the most common skin concern of all the menopausal women we speak with (and we have spoken to thousands over the years). Oestrogen (once again) has partial control over the growth and maintenance of blood capillaries within the skin layers. A reduction in blood capillaries means a reduction in blood flow and reach, resulting in less nutrients and oxygen to support and nourish skin health. This impacts the thickness of the skin and reduces the cell turnover rate, leading to poor, thin skin, often accompanied by a dampened skin barrier function and an increase in water loss.
Therefore, oestrogen impacts the dryness of the skin by reducing blood flow to the area, reducing repair to skin cells, reducing skin thickness, reducing the cell turnover rate (making older skin stay present for longer), increasing susceptibility to UV damage and by reducing skin barrier function (leading to increased water loss).
Unfortunately, this impact is body wide (not just the face). Meaning vaginal dryness is almost equally as common as dry skin, and again it is a significant complaint that many women have reported to us. Vaginal dryness should not be ignored.
Understandably, skin sensitivities start to appear in menopause and many women have had to turn to the ‘sensitive’ laundry powders, skin creams and sunscreens.
To support your skin and reduce the impact menopause has over your skin health, I recommend the following:
If you’re not using sunscreen, why not? Go and have a good look at the health food shop or pharmacy and find a sunscreen you are comfortable with and start regularly applying it. I prefer ‘invisible zinc’ and I apply this when I know I will be outside for periods of time.
Stay hydrated! Really work hard on getting your 2+L of water daily. If you lose fluids from sweating (via exercise, hot flushes, night sweats, etc.), vomiting or diarrhoea, you need to replace those fluids, on top of the 2L daily.
Moisturise your whole body regularly. Find a cream that is suitable for your skin type and use it regularly, particularly after a shower (within a few minutes of drying off).
Cigarette smoking can accelerate the dermal aging process within the skin by further reducing blood flow, accelerating or enhancing the dry skin and causing discolouration.
Reassess your soap
Regular soap may have become too harsh or drying for your skin. Try replacing your soap with a mild cleanser or a sensitive option.
If you are still concerned, talk to your GP.
For aging concerns, consider speaking with the Australian Menopause Centre.
 Shah, M. G. and H. I. Maibach (2001). “Estrogen and skin. An overview.” Am J Clin Dermatol 2(3): 143-150.