Menopause: What impact does it have on my skin?

The skin is composed of three layers, from the most superficial to the deepest:

• Epidermis:

  This is the most superficial layer of the skin. It contains several cellular populations (keratinocytes, melanocytes, Langerhans cells, etc...).

  Thekeratinocytesare present at various levels of the epidermis. They synthesise keratin, a fibrous and water-insoluble protein, which gives the skin its waterproof nature. It thus protects the skin from external aggressions.

  The primary role of the epidermis is its function as a skin protector thanks to keratinocytes and the stratum corneum. Indeed, the stratum corneum is composed of various epidermal lipids that shield the skin from external aggressions and transepidermal dehydration. Moreover, it is covered by a hydrolipidic film which acts as an additional protective barrier. This hydrolipidic film is primarily composed of sebum secreted by the sebaceous glands.

  The skin also containsmelanocytes. When exposed to UV rays, melanocytes synthesise melanin, a pigment that serves to protect our skin from UV rays. Therefore, tanning is actually a defence mechanism of the skin!

• Dermis:

  It is at the level of the dermis that new skin cells multiply in order to replace those that are eliminated. Furthermore, the dermis contains the fibroblasts which synthesise collagen fibres, elastin, as well as hyaluronic acid, responsible for the density, elasticity and firmness of the skin.

• Hypodermis:

  Its primary role is to manage the storage and release of lipids. It also plays a part in thermoregulation.

Menopause is the stage in a woman's life characterised by thecessation of ovulation and theend of periods (menstruation). It generally occurs between 45 and 55 years of age.

Multiple symptoms emerge, such as hot flushes, sleep disturbances, fatigue, irritability. The risk of disease also increases (osteoporosis and cardiovascular diseases). At the time of menopause, women's skin also undergoes numerous changes.

All these changes can be explained by a decrease in hormonal activity. Indeed, the ovaries no longer secreteoestrogen and progesterone.

The secretion of hormones has an impact on the skin:

• Estrogens :

  Under the influence of oestrogens, the fibroblasts present in the dermis synthesise more collagen fibres, elastin, as well as hyaluronic acid, providing the skin with improved density, elasticity and firmness. Furthermore, oestrogens increase the number of keratinocytes whose role is to synthesise keratin, a protein that protects the skin.

• Progesterone :

  The role of progesterone in relation to the skin is still not well understood. It appears that it increases the secretion of sebum. Furthermore, progesterone has a known anti-androgenic effect.

To note : Androgens are sexual hormones that trigger the onset and development of male sexual characteristics.

During menopause, the cessation of ovulation leads to a halt in the hormonal activity of oestrogen and progesterone. Consequently, the reduction in oestrogen production results in a dermal and epidermal atrophy : the skin thins and loses its suppleness, elasticity and firmness. Moreover, due to a loss in hyaluronic acid and inactivity of the sebaceous glands, the skin becomes dehydrated and the hydrolipidic film is weakened. The skin then becomes more susceptible to external aggressions and transepidermal dehydration.

In addition to a decrease in oestrogen and progesterone, the level of androgen increases, which is the cause of the onset of unwanted facial hair and the exacerbation of hair loss.

Changes in the internal structure of the skin reveal signs at the level of the epidermis. As previously mentioned, the sebaceous glands are no longer able to fully perform their role. This is the cause of the reduction in the formation of the hydrolipidic film, and therefore of the dehydration of the skin, and a low resistance to external aggressions.

It should be noted that a loss of skin hydration can cause it to lose its glow, which is why you end up with a dull complexion. With the decrease in collagen and elastin, the skin tends to lose its elasticity and the wrinkles begin to deepen.

• PIERARD G. & al. La peau et le temps de la ménopause. La Revue Médicale de Liège (2006).

• PUIZINA-IVIC N. Skin aging. Acta Dermatovenerologica Alpina Pannonica et Adriatica (2008).

• DESMOULIERE A. & al. Skin changes during ageing. Subcellular Biochemistry (2019).