The changes women experience during menopause don’t just affect their insides. Skin and hair also go through a transition.  If you’re seeing noticeable changes in the health, texture and appearance of your hair and skin, chances are you can blame declining levels of the hormone estrogen. These unwanted and often unexpected changes can be frustrating, but there are things you can do to protect your skin and hair throughout the menopause transition.

Since estrogen is linked to hair growth, density and fullness, as hormone levels decrease, head hair can become dryer, more brittle, and thinner. And due to a greater proportion of androgens (male hormones), you may begin to notice some hair on your face that’s more like male facial hair, particularly on the jaw line. You may also notice a decrease in body hair, including the pubic area.

Declining estrogen also means skin gets thinner and less elastic due to a decrease in collagen. Without their usual supply of estrogen, our bodies produce less of the oil that both softens skin and helps it retain moisture. Menopausal skin loses elasticity and hydration and becomes thinner, dryer, and loose. Many women find they have acne again for the first time since puberty. Skin becomes more prone to rashes and bruising and may heal more slowly during this time.

There are many causes for changes in hair and skin as you age. It's best to visit with a dermatologist for diagnosis and treatment, as well as to rule out any underlying conditions that may be attributed to what you are experiencing.

Medical interventions for unwanted menopausal hair

If you are dealing with unwanted facial hair in menopause, there are a few options to consider, although they can come with some downside:

• Topical treatments – these can be expensive and require continued use or the hair grows back.
• Depilatory creams can be bought over the counter, but they may be a bit stringent for the face, particularly as skin gets more sensitive with age.
• Lasers shoot beams of light over the skin, overheating the hair follicles and destroying them so the hair doesn’t regrow, but this can take several treatments to become permanent, and it doesn’t work on fine or light-colored hairs.
• Zapping hair with electrical current in electrolysis is expensive and slow because it can only destroy one hair at a time. It’s permanent, but can take a long time to complete, hurts, and can potentially scar.

Medical interventions for hair loss

The signs of hair loss in women may include an increase in hair falling out each day, noticing patches of thinner or missing hair, a widening part at the top of your head, or even noticeably smaller ponytails.

Before pursuing hair loss treatment, it's important to talk with your doctor or dermatologist to learn the cause of your hair loss, as well as treatment options that are right for you . Your healthcare provider will do a thorough history as well as order relevant tests to help diagnose your hair loss:

• Blood tests to evaluate ferritin levels, vitamin and mineral levels
• Blood tests to evaluate hormone levels including your thyroid and sex hormones
• Scalp biopsy or Trichoscopy (non-invasive dermoscopic imaging of hair and scalp)
• Hair pull - doctor gently pulls on your hair to see how many hairs come out

If it’s thinning head hair you are experiencing, unfortunately, there are few solutions. The good news is, the loss generally slows as hormones level out.

• Minoxidil (Rogaine) can help you regrow some hair, though you have to keep using it. ‍
• Anti-androgens may work for some women for whom Minoxidil is a non-starter.
• For some women, an iron deficiency may be partly responsible, so an iron supplement can be helpful. Be sure to consult with your doctor before starting any new supplement regimen.
• Hair transplants have come a long way since hair plugs and can be quite effective in filling in patches where hair has thinned.

Medical interventions for changing skin

Before you do anything to aid your age-related skin changes, we recommend locating a dermatologist who has experience with women in menopause, as all skin is different and should be treated with real care. Note that some procedures work best on skin that’s aged from sunlight rather from estrogen loss. Some options include:

• Prescription-level retinoid skin creams, made from vitamin A extract.
• ‍Peptide creams use amino acids (though these are likely less effective than retinoids).
• ‍Microdermabrasion encourages new skin growth by removing the top layer– it is time consuming and expensive and the effects only last about 4 weeks.
• ‍Laser resurfacing of the skin uses high-intensity light to tighten loose skin, improving the look of wrinkles.
• Newer non-ablative laser resurfacing doesn’t cause wounds to the skin, so recovery is quicker. The heat generated by the laser promotes collagen production which causes the skin to tighten and look younger and healthy.‍
• Chemical peels remove the upper layer of the skin and encourage new growth.

Lifestyle modifications for healthy skin and hair

Probably the best thing you can do for your skin and hair, no matter what your age, is protect what you have.

• Reduce sun exposure, and use SPF every day.
• Use gentle products that don’t strip away the remaining moisture.
• Hydration is key. Drink plenty of good, nutritious water to hydrate your body from the inside out.
• Don’t smoke.
• Shower with cooler water for less drying of your skin.
• Moisturize skin and condition hair. Replacing the moisture you’ve lost isn’t entirely possible, but every bit helps.

When it comes to skin, we strongly advise getting to know your skin very well. Checking your skin every month for changes can perhaps mean catching a potentially serious problem like skin cancer while still in its early and more treatable stages.

Natural remedies for skin and hair

For unwanted facial hair, sugaring, tweezing, waxing, and threading may be slow and tedious, but they can be less expensive, less potentially damaging to skin, and reasonably effective, if a bit painful.

To preserve head hair, use gentle styling techniques that require less heat and pulling. Shampoo with zinc or selenium might help with a dry and itchy scalp. A shorter hair style might help make hair appear fuller.

Some say eating estrogenic foods such as soy, dried fruits, and flaxseed can help, though there’s no research to back that up. Others take collagen supplements, though currently there’s little evidence to prove the impact on menopausal hair and skin.

The effect of changing hormones on your hair and skin may seem out of your control, but when you prioritize your wellness during this stage of life, you will support your body and your beauty from the inside out. Keep feeling and looking your best in menopause and beyond by maximizing your nutrition with a healthy and balanced diet, staying hydrated as well as exercising each day. And please visit with your doctor or a dermatologist when it comes to concerning hair and skin changes, no matter what your age.

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^{The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.}

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