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Doctor’s Journey Through Perimenopause #8: Wrinkles, meet saggy’s surprise party!

Menopause brings a cascade of changes to a woman’s body, and the skin, as our largest organ, is no exception. From dryness to thinning, sagging, and an increase in fine lines, many women find their skin evolves drastically during this phase of life.


As a doctor—and someone who has paid close attention to my own skin since my teenage years—I’ve learned that caring for our skin is both a science and a personal journey. In this blog, I’ll share how I’ve adapted my skincare routine over the decades, explain the underlying causes of menopausal skin changes, and explore how certain ingredients and therapies can help keep skin healthy, vibrant, and glowing.

The Skin Changes of Menopause: Causes and Challenges


During menopause, the body undergoes significant hormonal shifts, particularly a decline in estrogen and progesterone levels. These hormones play a critical role in maintaining skin health, and their reduction can lead to:


1. Thinner Skin: Estrogen stimulates the production of collagen, elastin, and hyaluronic acid, which are essential for plump, firm, and hydrated skin. As estrogen levels drop, the skin loses these vital components.


2. Dryness: Sebaceous glands, which produce oil to keep the skin hydrated, become less active, resulting in dry and flaky skin.


3. Loss of Elasticity: With reduced collagen and elastin, the skin becomes less firm and more prone to sagging.


4. Increased Wrinkles: The decline in collagen also leads to more pronounced fine lines and wrinkles.


5. Hyperpigmentation: Hormonal changes can trigger uneven pigmentation, age spots, and an overall dull complexion.


6. Slower Wound Healing: Reduced cell turnover means that the skin takes longer to heal from cuts, blemishes, or other damage.


Understanding these changes has shaped how I approach my own skin—and how I recommend others do as well.





My Skincare Journey: From Teen Years to Menopause


Teen Years: The Foundation of Healthy Skin


My skincare journey started in my teens when I learned the importance of protecting my skin from the sun. Sunscreen became a daily ritual—one of the best habits I’ve ever formed. The harmful effects of UV rays, such as premature aging, hyperpigmentation, and even skin cancer, cannot be overstated. Regular use of sunscreen kept my skin even-toned and protected its collagen.


Moisturizers also became a staple in my routine. Keeping the skin hydrated is crucial for maintaining its barrier function and preventing dryness. Occasional facials and massages were also part of my routine. These treatments weren’t just a luxury—they supported healthy circulation and provided relaxation.


Twenties and Thirties: Anti-Aging Preventative Measures


In my twenties and thirties, I began to understand that prevention is better than cure. I incorporated gentle anti-aging products, particularly those targeted at the delicate skin around the eyes. The skin in this area is much thinner and more sensitive, making it prone to fine lines and puffiness. A light, hydrating eye cream with ingredients like peptides and antioxidants became part of my regimen.


Facials continued, but I also added acupuncture for its rejuvenating benefits. Acupuncture enhances blood flow, reduces inflammation, and stimulates collagen production—making it an excellent natural therapy for maintaining healthy, glowing skin.


Forties: Embracing Active Ingredients and Hormones


In my forties, the effects of hormonal changes on my skin became more noticeable, and I adjusted my routine accordingly. I introduced scientifically proven ingredients like retinol, estriol creams, and potent antioxidants like vitamins C and E to address specific concerns:


1. Retinol: This vitamin A derivative is a powerhouse for promoting cell turnover, reducing fine lines, and improving skin texture. While retinol can initially cause dryness or irritation, I started with a lower concentration and gradually increased usage, which helped my skin adapt.


2. Estriol Creams: Estriol is a milder form of estrogen that can be applied topically to improve skin thickness, hydration, and elasticity. This hormone mimics some of the collagen-boosting effects of estrogen, making it a valuable tool for menopausal skin.


3. Vitamin C: A potent antioxidant, vitamin C brightens the skin, evens out skin tone, and stimulates collagen production. I used serums with stabilized forms of vitamin C to protect against free radical damage and improve my skin’s radiance.


4. Vitamin E: Known for its healing properties, vitamin E pairs beautifully with vitamin C to enhance skin repair and hydration. It’s especially effective in reducing UV damage and soothing dry or irritated skin.


Menopause and Beyond: Advanced Skincare Strategies


As I entered menopause, I embraced additional strategies to counteract the more pronounced effects of hormonal shifts. My skin became drier and thinner, so I prioritized hydration, repair, and barrier support.


1. Hydrating Ingredients: I sought out products with hyaluronic acid, ceramides, and glycerin to lock in moisture and restore the skin’s natural barrier.


2. Collagen Supplements: Although topical products are essential, I began taking collagen supplements to promote skin elasticity and hydration from within.


3. Professional Treatments: Chemical peels, micro-needling, and laser treatments became part of my regimen to boost collagen production and address pigmentation concerns.


4. Hormonal Therapy: Hormone replacement therapy (HRT) played a critical role not only in reducing menopausal symptoms but also in improving my skin. By replenishing estrogen levels, HRT helps restore skin elasticity, thickness, and hydration.



Breaking Down the Science Behind Key Skincare Ingredients


Let’s take a closer look at some of the star ingredients I’ve relied on throughout my journey:


Sunscreen: The Ultimate Anti-Aging Tool


Why It Works: Sunscreen protects against UVA and UVB rays, which cause premature aging and damage DNA.

Tips: Choose a broad-spectrum sunscreen with SPF 30 or higher, and reapply every two hours when outdoors.


Moisturizers: Hydration Heroes


Why It Works: Moisturizers help maintain the skin’s barrier function, preventing water loss and protecting against environmental damage.

Tips: Look for ingredients like ceramides, hyaluronic acid, and squalane.

Retinol: The Gold Standard for Anti-Aging


Why It Works: Retinol stimulates collagen production, improves cell turnover, and reduces the appearance of fine lines and wrinkles.

Tips: Use retinol at night and always apply sunscreen during the day to prevent sensitivity.

Estriol Creams: Hormonal Boosters for Skin


Why It Works: Topical estriol improves skin hydration, elasticity, and thickness by mimicking estrogen’s effects.

Tips: Consult a doctor before incorporating estriol into your routine.

Vitamin C: The Brightening Antioxidant


Why It Works: Vitamin C neutralizes free radicals, boosts collagen production, and brightens skin tone.


Tips: Use a stabilized serum in the morning to maximize its protective benefits.


Vitamin E: The Skin Soother


Why It Works: Vitamin E repairs the skin, improves hydration, and enhances UV protection.


Tips: Pair with vitamin C for maximum effectiveness.

Hyaluronic Acid: The Hydration Magnet


Why It Works: Hyaluronic acid attracts and retains water, plumping the skin and reducing the appearance of fine lines.

Tips: Apply to damp skin and seal with a moisturizer for best results.


Lifestyle Factors for Healthy Skin in Menopause


While topical products are essential, overall skin health depends on a holistic approach:


1. Balanced Diet: Eat foods rich in antioxidants, omega-3 fatty acids, and vitamins to support skin health. Foods like salmon, berries, nuts, and leafy greens are excellent choices.


2. Hydration: Drink plenty of water to keep your skin hydrated from the inside out.


3. Exercise: Regular physical activity boosts circulation and helps deliver nutrients to the skin.


4. Stress Management: Chronic stress can accelerate aging and exacerbate skin issues. Incorporate practices like yoga, meditation, or deep breathing into your daily routine.


5. Sleep: During sleep, the body repairs and regenerates skin cells. Aim for 7–9 hours of quality sleep each night.


Final Thoughts: A Lifelong Commitment to Skin Health


Menopause is a time of transition, and skin changes can feel challenging. However, with the right knowledge and tools, you can maintain healthy, radiant skin at any age. My personal journey—from sunscreen in my teenage years to incorporating retinol, estriol, and professional treatments in my forties and beyond—has taught me that consistent care and adaptation are key.


Remember, your skin is a reflection of your overall health. Nourish it from the inside out, protect it from environmental damage, and give it the love and attention it deserves. By doing so, you can confidently embrace the beauty of every stage of life.



If you’re experiencing significant skin changes during menopause and want personalized advice, don’t hesitate to consult a skincare professional or reach out to a functional medicine practitioner for a holistic approach to skin health.









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