BC10: The impact of menopause on the skin and ageing process

Erin Kamp,¹ Esra Musbahi,¹ Mariha Ashraf,¹ Ginny Ponsford² and Claudia DeGiovanni¹

¹Dermatology Department, University Hospitals Sussex; and ²Ball Tree Surgery, Brighton, UK

Menopause usually occurs in women aged 45–55 years (Wines N, Willsteed E. Menopause and the skin. Australas J Dermatol 2001; 42: 149–60). The implications on cardiovascular and bone health are well documented. However, the impact on the skin and ageing process is often not appreciated (Wines and Willsteed). We performed a literature review to assess the impact of the menopause and perimenopause on the skin and the aesthetic changes associated. The menopause has a clear impact on collagen synthesis with a loss of nearly 30% in the first 5 years after menopause (Duarte G, Trigo A, de Oliveira M. Skin disorders during menopause. Cutis 2016; 97: E16–23). Oestrogen replacement led to restoration of collagen levels to those seen premenopausally and increased dermal thickness within 3 months of starting therapy. Elastin degeneration, seen clinically as slackness and wrinkling, increases with menopause. Research is conflicted as to the benefits of hormone replacement therapy (HRT); however, some studies have reported an increase in total elastin with topical oestrogen. The implications of the menopause on the epidermis and subcutis are less well researched. Skin ageing is a multifactorial process; however, the impact of menopause, particularly on the dermis, is clearly documented. The use of HRT has been demonstrated to improve wrinkles, although these changes were not seen in smokers. Other treatment options include photo protection, topical retinoids and antioxidants. The impact of ageing, particularly the rapid changes occurring following menopause, can impact body image and quality of life. The role of HRT therapy on reducing wrinkles and increasing skin thickness if often not recognized by dermatologists. Further research is required to evaluate the role of the menopause on the epidermis and subcutaneous tissue.