Skin in menopause and perimenopause - what this top skin doctor recommends

There are times in our lives where we experience a 'jump' in skin ageing and menopause (as well as perimenopause, the years of hormonal change leading up to the time when your periods stop) is a major one, says Dr Sophie Shotter, medical director and founder of the Illuminate Skin Clinic in Kent.  She treats many women in their 40s, 50s and beyond in her clinic with symptoms such as sudden adult acne, dryness and sagging related to hormonal changes. But what's surprising is that many of us don't know that hormones could be responsible.

A study of 1000 menopausal and perimenopausal women was commissioned by menopausal skincare makers  Emepelle  and it found that 49 per cent of women had no idea of the major impact menopause could have on the skin; 47 per cent said they suffered from an increase in dry skin, 45 per cent noticed an increase in lines and wrinkles, while 27 per cent felt their complexion had dulled. Many also said that their usual skincare products didn’t have their usual effect and almost half said the changes to their skin had knocked their confidence.

Help is at hand however. It may be as simple as switching up a few of your skincare basics. More targeted in-clinic treatments can boost the skin too. Dr Sophie gives us her skin symptom checklist and the treatments you could benefit from.

1. Dry skin in the menopause

"During the menopause our skin produces fewer natural oils, which are what keeps our skin looking dewy and nourished, plus they keep water in our skin," explains Dr Sophie. "As our lipid (oil) barrier deteriorates we suffer from transepidermal water loss so the skin gets much dryer than they were pre-menopause."

The solution: ceramides and hyaluronic acid

To help the skin feel less Sahara-like, Sophie recommends using skincare with ceramides  in. Ceramides are fatty acids that form part of the skin's barrier. They will help to nourish and restore the membranes in our skin that help keep moisture inside. Hyaluronic acid  will also help you wage the war against dryness in the menopause, she says. "It's your skin's natural sponge to help it hang on to more water." Increasing your fluid intake is always a good thing, but it might not be the magic bullet for your skin, she says, unless you have the right moisture-locking skincare. "Drinking more water will actually do very little for your skin unless you're using products that will lock the moisture into the skin." So hyaluronic acid, followed by ceramides should be in your routine.

Sophie recommends:  SkinCeuticals Triple Lipid Restore 2:4:2 Ceramide Lipid Cream , £135 for 48ml

MORE GLOSS: 17 hyaluronic acid skin care products that really plump your skin

2. Loss of firmness and elasticity in the menopause

"In the first five years of menopause we lose 30 per cent of our collagen and afterwards it continues at an accelerated rate compared with pre-menopause," Sophie says. "I've always believed we age in spurts just like we grow in spurts in puberty. Menopause is a big ageing spurt. All of a sudden you might age dramatically and the change in your appearance might start to bother you. This ageing is driven by loss of elasticity and collagen."

The solution: retinol, HRT or non-hormonal creams

To combat the loss of firmness Sophie recommends using retinol . It stimulates cells to produce more collagen, bakuchiol  is also shown to stimulate collagen and can be used as an alternative if retinol doesn't agree with your skin.

MORE GLOSS: The best retinol creams, serums and oils and why we rate them

Sophie also recommends taking an oestrogen  analogue for firmness. She recognises not everyone wants to take HRT and explains there are alternative options.

Many women notice that after menopause their skincare doesn't deliver the same results as it did pre-menopause. This is because the lack of oestrogen means your cells don't work as hard to produce new collagen. There are now non-hormonal products such as Emepelle's Night Cream and Serum, £170  and even QMS new Collagen Recovery Day and Night Cream, £130  with red clover which help skin think it has more oestrogen in it and therefore preserve its elasticity and firmness.

3. Fine lines and wrinkles in the menopause

Many women start to notice fine lines and wrinkles during the menopause driven by the loss of collagen ; the loss of collagen means our skin loses structural integrity resulting in the fine lines.

The solution: peptides

Using peptides  in skincare can be helpful. There are some peptides that behave like in-clinic treatments to relax wrinkles and on a micro-level, muscle movement too. Hyaluronic acid works here too, to plump out fine lines.

Sophie recommends:  SkinBetter Science Alpha Ret Overnight Cream POA

4. Menopausal breakouts and acne

Dr Sophie explains that many women who have had great skin throughout their adult life can find they're plagued with breakouts once they hit menopause. This is because despite all of our hormone levels dropping, oestrogen drops much quicker than testosterone so you're left with unbalanced oestrogen and progesterone levels which can result in both unwanted hair growth and spots.

The solution: salicylic acid

Sophie advises treating this with hormone balancing or treatments for adult acne such as salicylic acid or benzoyl peroxide.

Sophie recommends:  Institut Esthederm Intensive Propolis Serum , £37 for 30ml

5. Dull skin in the menopause

During the menopause and perimenopause, the turnover of our skin slows down; new skin cells come through much slower and so women experience a build-up of dead skin cells, resulting in a lack of radiance and less healthy-looking skin.

The solution: an exfoliating acid toner

Sophie suggests using chemical exfoliants; glycolic and lactic acid mainly. Facial scrubs are fine if you choose carefully. She recommends microdermabrasion crystals and products with round beads. A physical scrub should never be used more than twice a week and avoid physical scrubs altogether if you're prone to red skin.

Sophie recommends:  Medik8 Press & Glow , £25 for 200ml

MORE GLOSS: PHA: a guide to the most gentle chemical exfoliant of all

6. Rosacea in menopause

A lot of women start to suffer from rosacea  in the menopause, triggered by the hormonal shift. If your skin is more sensitive, redder, bumpy or has thread veins it could be a sign of rosacea.

The solution: book in to see a skin specialist

Sophie suggests seeking professional help if you've suddenly started suffering with rosacea. There are prescription creams available benefits can be seen from laser or IPL treatment. Read our doctor-approved advice on dealing with rosacea  for more ways to lessen the condition.

Product wise, Sophie recommends  SkinCeuticals Phyto Corrective Masque Gel , £60 for 60ml.

Dr Sophie Shotter is the founder and medical director of the Illuminate Skin Clinic, Kent.