Does Menopause Cause Dry Skin on Your Face? Yes

Posted by Dr. Natasha Ryz on

Does Menopause Cause Dry Skin on Your Face?

Your skin changes during menopause.

You may notice that your skin feels dry and itchy, or you may begin to see more fine lines and wrinkles.

Menopause can cause dry skin and worsen dry skin symptoms.

During menopause, your ovaries stop producing the hormone estrogen.

Estrogen-deficient skin becomes thin and has a decrease in barrier function.

Estrogen-deficient skin has a loss of moisture and moisture-holding substances, called humectants. Estrogen-deficient skin also has a loss of sebum and a decline in fatty acids that are found naturally in the skin barrier. 

Menopause has a clear impact on the skin and common skin conditions.

This article will cover:

    • What is dry skin?
    • What causes dry skin?
    • What is menopause?
    • Why does skin change during menopause?
    • What is estrogen?
    • How does estrogen affect skin?
    • What is estrogen-deficient skin?
    • How does estrogen affect the moisture content of skin?
    • How does estrogen affect the sebum content of skin?
    • How does estrogen affect the skin barrier?
    • How does estrogen affect antioxidant defense in the skin?
    • Does menopause cause dry skin on your face?
    • References

What is dry skin?

Dry skin appears dry, rough, and may scale and flake. It may also show premature signs of aging, like surface wrinkles and loss of elasticity.

Dry skin is lacking water, humectants and fats. Humectants absorb and hold water, while fats coat the skin and seal in moisture. When there is not enough water, humectants or fats, skin barrier disruption can occur, further worsening symptoms of dry skin.

Symptoms of dry skin include:

  • Loss of skin elasticity.
  • Skin feels tight, dehydrated.
  • Skin appears dull, rough and blotchy.
  • Slight to severe flaking, scaling or peeling.
  • Fine lines and wrinkles are more pronounced.
  • May have irritation and a burning sensation.
  • May have itching.
Learn more: What is Dry Skin? Medical Definitions and References

      Does Menopause Cause Dry Skin on Your Face?

      What causes dry skin?

      Dry skin is very common and can occur for a variety of reasons. You may have naturally dry skin. But even if your skin type is normal or oily, you can still develop dry skin from time to time. Dry skin can affect any part of your body.

      Dry skin can be caused or worsened by:

      • Exposure to cold weather
      • Low humidity levels
      • UV radiation and sunlight
      • Harsh soaps or detergents
      • Swimming in chlorinated pools
      • Long and hot showers or baths
      • Aging
      • Menopause

        Read more: What Causes Dry Skin?

        What is menopause?

        Menopause is the ending of menstruation.

        Menstruation is the process of discharging blood from the lining of the uterus that happens about once a month, as a normal part of the menstrual cycle from puberty until menopause, except during pregnancy. It is also known as having a period.

        Menopause occurs when the ovaries completely stop producing reproductive hormones, including estrogen, and there are no monthly periods for a consecutive twelve months (Mayo Clinic).

        Ovaries stop producing reproductive hormones gradually, when women are in their 40's - 50's. Symptoms like hot flashes, mood changes, stress, fatigue, vaginal drying and itching are common.

        Menopause or the climacteric are often used to name clinical expected events related to the decline in ovarian function.

        While menopause is the ending of menstruation, the climacteric includes perimenopause, menopause and post-menopause. The climacteric is the gradual changes of ovarian function that start before the menopause and continue thereafter for a while (Blümel et al, 2014).

        Menopause is a natural process of aging.

        Menopause can also be triggered by a hysterectomy or surgical removal of the ovaries, which produce hormones. If you have surgery to remove your uterus or ovaries and are not taking hormones, you will experience symptoms of menopause (National Institute on Aging).

        Transgender women can experience symptoms of menopause. Like cis women, the symptoms are in response to hormone fluctuations, even if the root causes differ (National Menopause Association).  

        Does Menopause Cause Dry Skin on Your Face?

        How does skin change during menopause?

        It can be frustrating to notice your skin aging during menopause.

        As we age, the first signs of skin aging start around 30 years of age when estrogen levels begin to decline, the skin thins, dries, wrinkles, and becomes pigmented unevenly with sunspots (reviewed by Lephart et al, 2021). 

        Specifically, the appearance of wrinkles around the eyes and mouth, and frown lines along the forehead are seen with uneven skin color and a general loss of skin tone, compared to youthful skin (Lephart et al, 2021). 

        In women, declining estrogen levels are associated with a variety of skin changes, many of which can be reversed or improved by estrogen supplementation (Hall et al, 2005).

        Many studies have shown that upon entering menopause, women start noticing skin changes (Thornton, 2013). One of the first symptoms experienced is increased skin dryness, followed by decreased firmness and elasticity (Castelo-Branco et al, 1992). These symptoms correspond with structural and architectural changes, such as decreased sebum production, collagen content, dermal thickness, and elastin fibers (reviewed by Rzepecki et al, 2019).

        What is estrogen?

        Estrogen is a group of sex hormones responsible for the development and regulation of the female reproductive system and secondary sex characteristics (Huether et al, 2019; Satoskar et al, 2017).

        There are three major estrogens made by the body that have estrogenic hormonal activity, estrone (E1), estradiol (E2) and estriol (E3). Estradiol is the most potent and prevalent. Another estrogen called estetrol (E4) is made only during pregnancy (Huether et al, 2019).

        In addition to their role as natural hormones, estrogens are used as medications, for instance in hormonal birth control, hormone replacement therapy (Khul et al, 2005) and feminizing hormone therapy for transgender women and nonbinary people (Wesp et al, 2017). 

        While estrogens are present in both women and men, they are usually present at significantly higher levels in women of reproductive age. Estrogens promote the development of female secondary sexual characteristics, such as breasts, and are also involved in the thickening of the endometrium and regulating the menstrual cycle.

        How does estrogen affect skin?

        Estrogen plays a key role in maintaining the skin’s structural and functional integrity, with evidence showing that estrogens are essential for skin hydration, sebum production, improved barrier function of the stratum corneum, and increased collagen and elastin content (Duarte et al., 2016; Verdier-Sévrain DS, 2007).

        What is estrogen-deficient skin?

        Estrogen-deficient skin becomes thin and has a decrease in skin barrier function and is at greater risk of becoming damaged. 

        Estrogen-deficient skin has a loss of moisture and moisture-holding substances, called humectants. Estrogen-deficient skin also has a loss of sebum and a decline in fatty acids that are found naturally in the skin barrier (Rzepecki et al, 2019)

        Does Menopause Cause Dry Skin on Your Face?

        How does estrogen affect the moisture content of skin?

        Estrogen-deficienct skin has a loss of moisture, leading to dry, itchy skin.

        There is evidence that estrogen is implicated in transepidermal water loss (Kamp et al, 2022). Furthermore, the use of transepidermal estrogen has been shown to reduce transepidermal water loss and improved skin barrier function (Duarte et al, 2016).   

        Normal Skin Hydration

        Water is essential for the normal functioning of the skin.

        The water content of skin is remarkably high - the epidermis (the outer skin layer) contains more than 70% water, while its outermost layer, the stratum corneum has been shown to contain ~15 - 25% water (Warner et al, 1988; Caspers et al, 2001; Caspers et al, 2003).

        Adequate hydration of the stratum corneum serves three major functions (Fowler, 2012):
        1. it maintains plasticity of the skin, protecting it from damage
        2. it contributes to optimum stratum corneum barrier function
        3. it allows hydrolytic enzymes to function in the process of desquamation

        When the water content of the stratum corneum falls below 10%, scaling on the skin surface becomes visible (Rycroft, 1985).

        The retention of water in the skin is dependent on:

        1. Natural moisturizing factors (NMFs) and other humectants (such as glycerol and hyaluronic acid) to attract and hold onto moisture
        2. Intercellular lipids (fats) that form a barrier to prevent transepidermal water loss (TEWL) (Verdier-Sévrain et al, 2007). 

        Learn more: What is Dehydrated Skin?

        Estrogen can influence the moisture content of skin via hyaluronic acid, mucopolysaccharides, and sebum production (Rzepecki et al, 2019).

        Estrogen maintains skin moisture by increasing acid mucopolysaccharides and hyaluronic acid in the skin (Shah et al, 2001).

        Hyaluronic acid is well known as one of the major components of the dermis, and is highly hygroscopic, meaning it can absorb moisture from the air. Hyaluronic acid provides hydration and structural integrity to the dermis (Verdier-Sévrain et al, 2007).

        Interestingly, in preliminary research studies, estrogen therapy has been shown to elevate the levels of mucopolysaccharides and hyaluronic acids in the dermis to keep the skin hydrated (Grosman, 1973; Grosman et al, 1971). 

        How does estrogen affect the sebum content of skin?

        Estrogen helps retain and restore skin moisture through the promotion of sebum secretion, primarily by regulating the expression of insulin-like growth factor receptors and increasing the production of insulin-like growth factors from fibroblasts (Ashcroft et al., 1997), which in turn induces lipogenesis in human sebocytes and leads to moisture retention (Rzepecki et al, 2019).

        The surface of your skin is covered by a layer of protective lipids (fats), including epidermal lipids and sebum.

        Epidermal lipids are released from keratinocytes (skin cells), and are a mixture of ceramides, free fatty acids and cholesterol. These lipids are released from skin cells and fill the spaces between the cells, like mortar or cement (Pappas, 2009).

        Sebum is an oily, waxy substance produced by your body’s sebaceous glands and eventually released to the surface of the skin. Sebum is primarily made up of non-polar lipids as triglycerides, wax esters and squalene. Sebum coats the skin, seals in moisture, and protects your skin from getting too dry (Pappas, 2009). 

        Learn more: Beneficial Fats Found Naturally in Your Skin Barrier

        Estrogen-deficient skin has a loss of sebum

        Estrogen-deficient skin has decreased sebum production. 

        The use of combined estrogen and progesterone hormone replacement therapy (HRT) has been associated with an increase in sebum production and skin surface lipids (Monteleone et al, 2018)

        However, sole use of estrogen is associated with reduction in the number and size of sebaceous glands and associated reduction in skin sebum levels (Brincat et al, 2005)

        Does Menopause Cause Dry Skin on Your Face?

        How does estrogen affect the skin barrier?

        Estrogen-deficient skin has a weakened skin barrier, and becomes thin and fragile (reviewed by Lephart et al, 2021). 

        The skin barrier includes the outermost layers of skin, called the stratum corneum.

        Your skin barrier is essentially what you can see and touch on the surface of your body.

        When your skin barrier is healthy, it feels and appears smooth, soft, and plump.

        In contrast, a damaged skin barrier looks dry, rough, dull, and dehydrated, and may become irritated and inflamed.

        The stratum corneum can be thought of as a brick wall that protects you.

        The "bricks" are the skin cells, called corneocytes, and the "mortar" that holds the bricks together is the lipids or fats, that together create the outer barrier.

        The stratum corneum is the most outer layer of the epidermis and is the layer directly exposed to the external environment.

        The structure of the stratum corneum can be described as a ‘brick and mortar’ model, in which the protein-rich corneocytes are the bricks, and the mortar is the lipid‐rich matrix containing ceramides, cholesterol, and fatty acids.

        Learn More: What is The Skin Barrier?

        How does estrogen affect antioxidant defense in the skin?

        Estrogens also play a role in antioxidant defense of the skin barrier. 

        Antioxidants protect your skin by preventing free radical damage.

        Free radicals are unstable molecules or atoms that can damage skin cells.

        Free radicals are generated from normal aging, and by daily environmental damage - such as UV radiation from the sun and air pollution. Free radicals cause destruction to your cells and tissues, and accelerate skin aging (Masaki et al, 2010).

        Antioxidants protect your skin by neutralizing unstable free radicals.

        Experimental studies have shown that the presence of estrogen may protect skin cells against oxidative damage, and the dramatic decrease of estrogen levels during menopause could make your skin more susceptible to oxidative damage (Bottai et al, 2013)

        Additional positive influences of estrogen include counteracting radical oxygen species (ROS) and oxidative stress (OS) via its antioxidant properties, and activating nuclear factor erythroid 2-related factor (NRf2) that leads to the increased expression of other antioxidants and detoxifying enzymes (Lephart et al, 2021). 

        Does Menopause Cause Dry Skin on Your Face?

        Does menopause cause dry skin on your face?

        Does menopause cause dry skin on your face? Yes.

        Menopause causes dry skin, and can worsen symptoms of dry skin, especially on your face.

        During menopause, your ovaries stop producing estrogen.

        Estrogen plays a key role in maintaining your skin, with evidence showing that estrogens are essential for skin hydration, sebum production, improved barrier function of the stratum corneum, and increased collagen and elastin content.

        Although the effects of estrogen on the skin are still not fully understood, it is known that, in women, declining estrogen levels are associated with a variety of cutaneous changes, many of which can be reversed or improved by estrogen supplementation (Hall et al, 2005).

        Estrogen administration has positive effects on human skin by delaying or preventing skin aging manifestations, but the use of estrogen replacement is a risk factor in breast and uterine cancer (Thorton et al, 2013).

        Further research is needed to understand the mechanisms and explore therapeutic options.

        References

        Menopause - Symptoms and causes - Mayo Clinic

        Blümel JE, Lavín P, Vallejo MS, Sarrá S. Menopause or climacteric, just a semantic discussion or has it clinical implications? Climacteric. 2014 Jun;17(3):235-41.

        Bottai G, Mancina R, Muratori M, Gennaro PD, Lotti T. 17β-estradiol protects human skin fibroblasts and keratinocytes against oxidative damage. J Eur Acad Dermatol Venereol 2013;27(10):1236–43.

        Brincat MP, Baron YM, Galea R. Estrogens and the skin. Climacteric. 2005 Jun;8(2):110-23. 

        Calleja-Agius J, Brincat M. The effect of menopause on the skin and other connective tissues. Gynecol Endocrinol. 2012 Apr;28(4):273-7. 

        Caspers PJ, Lucassen GW, Carter EA et al. In vivo confocal Raman microspectroscopy of the skin: noninvasive determination of molecular concentration profiles. J Invest Dermatol 2001; 116:434– 42.

        Caspers PJ, Lucassen GW, Puppels GJ. Combined in vivo confocal Raman spectroscopy and confocal microscopy of human skin. Biophys J 2003 July; 85: 572-80.

        Duarte GV, Trigo AC, Paim de Oliveira Mde F. Skin disorders during menopause. Cutis 2016;97(2):E16–23. 

        Fowler J. Understanding the Role of Natural Moisturizing Factor in Skin Hydration. Practical Dermatology. 2012; July. 36-40.

        Grosman N. Study on the hyaluronic acid-protein complex, the molecular size of hyaluronic acid and the exchangeability of chloride in skin of mice before and after oestrogen treatment. Acta Pharmacol Toxicol (Copenh) 1973;33(3):201–8.

        Grosman N, Hvidberg E, Schou J. The effect of oestrogenic treatment on the acid mucopolysaccharide pattern in skin of mice. Acta Pharmacol Toxicol (Copenh) 1971;30(5):458–64.

        Hall G, Phillips TJ. Estrogen and skin: the effects of estrogen, menopause, and hormone replacement therapy on the skin. J Am Acad Dermatol. 2005 Oct;53(4):555-68; quiz 569-72. 

        Huether SE, McCance KL (2019). Understanding Pathophysiology. Elsevier Health Sciences. p. 767.

        Jéquier, E., & Constant, F. Water as an essential nutrient: the physiological basis of hydration. European journal of clinical nutrition. 2010. 64(2), 115-123. 

        Kamp E, Ashraf M, Musbahi E, DeGiovanni C. Menopause, skin and common dermatosis: part 2. Clin Exp Dermatol. 2022 Jun 21.

        Kuhl H. Pharmacology of estrogens and progestogens: influence of different routes of administration. Climacteric. 2005. 8 (Suppl 1): 3–63. August.

        Lephart, E. D., & Naftolin, F. (2021). Menopause and the skin: old favorites and new innovations in cosmeceuticals for estrogen-deficient skin. Dermatology and Therapy11(1), 53-69.

        Masaki H. Role of antioxidants in the skin: anti-aging effects. J Dermatol Sci. 2010 May;58(2):85-90.

        Monteleone P, Mascagni G, Giannini A, Genazzani A, Simoncini T. Symptoms of menopause — global prevalence, physiology and implications. Nature Reviews Endocrinology. 2018;14(4) :199-215.

        National Menopause Association. Accessed October 5, 2022. Available: https://nationalmenopauseassociation.com/do-transgender-women-experience-menopause.

        Pappas A. Epidermal surface lipids. Dermatoendocrinol. 2009 Mar;1(2):72-6.

        Raine-Fenning NJ, Brincat MP, Muscat-Baron Y. Skin aging and menopause: implications for treatment. Am J Clin Dermatol. 2003;4(6):371-8.

        Rzepecki AK, Murase JE, Juran R, Fabi SG, McLellan BN. Estrogen-deficient skin: the role of topical therapy. Int J Womens Dermatol. 2019;5:85–90.

        Satoskar RS, Rege N, Bhandarkar SD (2017). Pharmacology and Pharmacotherapeutics. Elsevier Health Sciences. p. 943. 

        Shah MG, Maibach HI. Estrogen and skin. An overview. Am J Clin Dermatol. 2001;2(3):143-50.

        Thornton MJ. Estrogens and skin aging. Dermatoendocrinology. 2013;5:264–70.

        Verdier‐Sévrain, S., Bonté, F., & Gilchrest, B. (2006). Biology of estrogens in skin: implications for skin aging. Experimental dermatology15(2), 83-94.

        Verdier-Sévrain S, Bonté F. Skin hydration: a review on its molecular mechanisms. J Cosmet Dermatol. 2007 Jun;6(2):75-82.

        Verdier-Sévrain DS. Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators. Climacteric 2007;10(4):289–97.

        Warner RR, Myers MC, Taylor DA. Electron probe analysis of human skin: determination of the water concentration profile. J Invest Dermatol 1988; 90: 218–24.

        Wesp LM, Deutsch MB. Hormonal and Surgical Treatment Options for Transgender Women and Transfeminine Spectrum Persons. The Psychiatric Clinics of North America. 2017. 40 (1): 99–111. March.

        What Is Menopause? | National Institute on Aging (nih.gov).

        Aging Skin Dry Skin Menopause Skin Barrier

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