**Hormonal Changes During Menopause**

Not only do we have to contend with irritability, difficulty sleeping, night sweats, and hot flushes in the lead-up to menopause and beyond - but the hormonal shifts, namely a major decrease in oestrogen, also result in significant changes to the health of our skin.

“Skin cells have numerous hormone receptors, so when there’s a significant decrease in circulating hormones, these receptors are no longer ‘fired up’ and can have consequences for the skin. Collagen levels decline rapidly, and the loss of oestrogen can greatly impact skin barrier health. Pigment production can go into overdrive, and for some women, their hormonal imbalances mean that they become androgen-dominant. This shift can lead to excess sebum production, breakouts and even hair loss,” shares aesthetic doctor and Illuminate Skin Clinic founder Sophie Shotter.

**What is Menopause?**

It’s only in recent years that we’ve all been talking more openly about the menopause, so if you’re not totally sure about the ins and outs of this hormonal change, you’re probably not the only one.

“The menopause is a single day of your life - the day where you haven’t had a period for one year. The time of hormone fluctuation and decline before this is called perimenopause, and the phase of a woman’s life after menopause is called post-menopause. During perimenopause, hormone levels can fluctuate wildly, which is why symptoms are not linear and usually come and go. The entire process where a woman experiences significant symptoms can take around 10 years - there will be a lot of variation between women, and not every woman experiences severe symptoms. Some symptoms do last beyond this period of flux - for example, many women find their sleep is never as good post-menopause as it was pre-menopause. However, the impact of this steady period of hormonal decline gets progressively worse when it comes to the skin and hair,” explains Shotter.

Sadly, it’s an inevitable part of ageing, but thankfully, when it comes to the impact the menopause has on the skin, there’s lots that can be done to help you feel like you again.

**Dealing with menopausal acne**

If you thought you’d waved goodbye to acne for good in your late teens, think again. ‘When oestrogen levels drop dramatically compared to levels of testosterone and progesterone, overproduction of sebum can ensue, and acne to develop. Ultimately, helping to balance hormones will be the best solution for women who can and are keen to take hormone replacement therapy (HRT). Plus, sometimes even topical HRT formulations for the face containing oestrogen can help balance out sebum production,” shares Shotter. However, adjusting your skincare activities and practices is also worth adjusting to accommodate this change. “Salicylic acid and retinoids help reduce oil production. While excellent in-clinic options like chemical peels and AviClear - the laser treatment that targets the sebaceous gland to suppress sebum production - are worth giving a go,” says Shotter, who’s also a fan of blue light therapy.

The **CurrentBody Anti-Blemish LED Light Therapy Face Mask**, £299, cleverly combines blue light to eliminate blemish-causing bacteria with red light to quell inflammation and calm the skin. This LED light tag team has been shown to give your skin a break from breakouts and users rave about the benefits.

**How can you replenish collagen during Menopause?**

You may need to brace yourself before hearing that collagen levels decline very rapidly pre-menopause, with women losing around 30 per cent of their collagen within the first 5 years of perimenopause, leading to a loss of firmness, laxity, crepiness and fine lines and wrinkles.

To replenish collagen stores and firm up the skin, Shotter recommends “collagen-stimulating peptides. They are a great option and suitable for all women, including those with increased skin sensitivity during perimenopause. Retinoids can also be very beneficial for those who can tolerate them. In-clinic treatments like Sofwave, a personal favourite, use ultrasound to heat the dermis and stimulate collagen production to redefine the contours of the face and target sagging. Also, radiofrequency microneedling can work wonders,” says Shotter.

The latter uses electromagnetic waves to heat the dermis, which triggers a release of proteins. These proteins stimulate new collagen fibres, while the tiny needles inserted into the skin trigger our natural healing response, boosting collagen production. However, if needles make you shudder, opt for the **CurrentBody RF Radio Frequency Skin Tightening Device**, £299. It’s a painless, non-invasive facelift alternative that heats the skin to boost collagen and target loose, sagging skin – with 89 per cent of users reporting an improvement in skin tightness in just eight weeks.

**Is hair loss a side effect of Menopause?**

Hair loss on the head can be the result of both a decline in oestrogen levels and a relative increase in androgen levels. Add into the mix that thyroid hormone levels often become disrupted in perimenopause as well, and you have the perfect hormonal storm that can leave you with an overall decrease in density, thinning of your centre parting, or hair loss around the temples. “I recommend thorough diagnostics to check micronutrient balance (Vitamin D, Vitamin B12, Iron, Folate) and hormone levels to ensure these are all optimal. We also use a DNA test called Trichotest to guide any prescription topical medication we may advise. This could include oestrogen, prostaglandins, Minoxidil and Finasteride depending on a patient’s needs,” shares Shotter.

In the clinic, she uses growth factors or exosomes combined with microneedling to stimulate hair growth. While at home, the **CurrentBody LED Hair Growth Helmet**, £650, can increase growth by 128 per cent in 12 weeks, noticeably thickening and increasing density thanks to the power of red light.

**How to restore the skin barrier**

Our skin acts like a barrier protecting our organs, but what protects our skin? That would be our skin barrier, which stops the skin from losing water and protects it against toxins, harmful bacteria, viruses and allergens. Rather irritatingly, the levels of lipids - which play an essential role in the skin's barrier function, namely keeping skin well hydrated – decrease during perimenopause. So, too, does the production of hydrating hyaluronic acid; this can lead to dry, dehydrated, dull-looking complexions.

Not only that, because the skin barrier is more fragile, “skin will often become more reactive in perimenopause, and in extreme cases, rosacea can also develop,” reveals Shotter. This makes barrier repair, support and added hydration key for menopausal skin.

“A good approach will be to include a hyaluronic acid-based serum and nourishing, lipid-rich moisturisers into your daily skincare routine. Taking a hyaluronic acid supplement like the EverNutri EverHydra is also beneficial,” adds Shotter. To up the ante, add the **CurrentBody Hydrogel Face Mask**, from £7.50, to your arsenal, and use the hyaluronic acid-packed mask weekly to ensure you sport a plump, radiant, healthy complexion.

**How to banish age spots**

“Age spots can appear more dramatically and abundantly in perimenopause, as the skin thins and also seems to react more dramatically to UV exposure. Melasma can also present in perimenopause, particularly in women on HRT. I would add pigment-suppressing ingredients like cysteamine to your at-home skincare routine to combat this,” explains Shotter.

Daily SPF on all areas exposed to UV is also a must if you want to reduce further the possibility of developing age spots. And don’t skip the hands, as they tend to show your age, and age spots are prevalent in this zone of the body. Cue the **CurrentBody LED Hand Perfector**, £189. It uses professional strength red and near-infrared wavelengths to reduce the appearance of hyperpigmentation and age spots while firming the skin and targeting fine lines, as well as wrinkles to boot.