I've been thinking a lot about menopause lately. I'm 41 and — as my gynecologist recently told me — perimenopause isn't far off. Perimenopause is a precursor to the big M-word none of us wants to say; it's the beginning of the hormonal shifts that send your periods haywire and don't do many favors for your skin. It can happen as early as your thirties, though most women experience it in their forties. Hollywood loves to use menopause as a punchline about angry harridans and their hot flashes, but there's a lot more to it than that. And while I'm personally excited as hell to stop dealing with birth control, I'm also learning that the change brings with it some skin issues I may already be dealing with — and not entirely correctly.
Menopause is only confirmed when a woman has already missed her period for one year, or 12 months in a row. This usually happens between 40 and 58, though it can happen earlier or later, of course. Perimenopause, or the phase when you are pre-menopausal, is when your menstrual periods start to become irregular. This can last from four to eight years on average, so for many women, we're talking about your thirties.
And what's actually happening in your body during that time? As your ovaries age just like the rest of you, they release fewer hormones, throwing off the balance of estrogen, progesterone, and testosterone. The results may not be too noticeable in the first few years of perimenopause, but the drop in hormones like estrogen will definitely make for thinner, less resilient skin. As Nurse Jamie, founder of Beauty Park Spa and the skincare line Nurse Jamie Healthy Skin Solutions, says, "Your body stops making as much collagen. You lose some fat under your skin, and your skin's elasticity drops."
You may be thinking "anti-aging skincare, I get it," but the skin changes as a result of pre-menopausal hormone changes do require some specific know-how. Dr. Ellen Marmur, dermatologist and founder of MM Skincare, says there are some main concerns to be aware of and address. "Your skin is going to show all its sun damage, it's going to repair itself less, and it's going to start being more dry." This probably does not come as a shock to women in their forties and fifties, who report fine lines, wrinkles, and a loss of elasticity as their biggest skincare concerns.
I'd always assumed that tough love was better: slather and exfoliate, push my aging skin hard, and I could turn back time. But then I started researching, talking to women who were on the cusp or through the looking glass of menopause, and talking to skincare specialists. And turns out — I'm sorry! — the skin of your twenties is not coming back.
But! The skin of your forties, fifties, and beyond can be beautiful and healthy. Here's the secret: Put down the sandblaster. Start babying your skin instead. Below, the biggest skincare concerns before and during menopause, and what women are doing about them right now.
Dryness
This has been the biggest change for me. My skin has been super oily since puberty, so the idea of moisturizer on my face is vaguely terrifying to me. But I've had to start, because if I don't I look like I haven't slept for a week. "After menopause," says Nurse Jamie, "your skin can also get drier because oil glands aren't as active. Try to give skin more moisture with a heavier cream."
Many of the women I spoke to were experiencing dryness. Dr. Marmur says that unfortunately what a lot of what women are doing to combat aging can actually make it worse. "I'm probably one of the outlier dermatologists, but I think there's a common misconception that retinol is the best and only anti-aging ingredient. But it's something that's drying out your skin, just when you're losing the ability to make your own lipids."
Wait a minute. How will my cells know they're supposed to turn over? Dr. Marmur laughs. "The skin is an organ, and just like your heart knows how to take care of itself, our skin is actually programmed to regenerate itself. Your skin is already turning over its cells. What you need to do is help those cells live as long as possible with a nice skin barrier."
Peg Aloi, 56, is post-menopausal and is doing a lot to simplify her beauty routine now, in order to provide that barrier. "Neal's Yard Wild Rose Beauty Balm," she says. "I use this as a cleanser and it's very moisturizing and leaves my skin glowing; I use it on my neck also." And Martina Skelly, 45 and perimenopausal, says that for replenishing her skin, "Clarins Rose Radiance Super Restorative Cream is really good. My skin is brighter and clearer since starting to use it."
Dr. Marmur says that anything that's a humectant is great for menopausal and perimenopausal skin. "Aloe, hyaluronic acid – these are great ingredients that just hold moisture to the skin."
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Acne and Discoloration
Some of the women I spoke to, especially women of color, were more concerned about acne, discoloration issues, and dark circles under the eyes. This isn't surprising; in the InStyle State of Skin survey, women of color reported dark circles and uneven skin tone among their biggest concerns. Cam Colton is 59 and done with menopause, and she says, "I can get acne in two days if I eat the wrong food."
Tara Isabel Zambrano, 48, is just starting to experience perimenopause, and she deals with dark spots and dark circles. "I use Olay Nighttime Recovery Gel on my face, and Olay Eye Cream for the circles," she says.
Sun Damage
Many of us in our forties and older were teenagers when tanning was a way of life. We soaked up rays like it was our job. And now, unfortunately, we're reaping the rewards of all that time in the sun. "It all catches up to us," says Dr. Marmur. "Don't forget sun damage is your number one enemy with aging."
But you can still prevent damage with good sun protection. Skin is less able to repair sun damage during and after menopause, which means you need to wear sunscreen and cover up diligently in the sun. Peg notes, "I am noticing some sun damage. I think I wasn't doing a good enough job with sunscreen; I'm more careful now."Dr. Marmur agrees. "You really can wear sunscreen or sun protection every day. It's your own money in the bank against future procedures."
It's important to note that SPF isn't just for women with lighter skin — women with more melanin in their skin need it, too. Not only is it important to prevent damage from UV rays, it also helps prevent hyperpigmentation.
Sagginess and Wrinkles
"My skin is definitely changing," says Rebecca M., 51 and perimenopausal. "My eyelids are drooping, and I'm getting new smile lines on my cheeks and little lines around my lips."
Nurse Jamie says that's totally normal. "Some of the common lines and wrinkles you get with menopause are often crow's feet and lines above the upper lip."
This is where moisturizers, serums, and some gentle, sparing use of acids and retinols can help. "I'm using a glycolic acid product," says Rebecca, who currently likes The Ordinary Glycolic Acid 7%.
Amber Clark, 43, says she has already experienced sagging skin and a loss of elasticity. She created a regimen and says it's really improved her skin: "I use The Ordinary Hylamide or The Ordinary Buffet, mixed with niacinamide. Then a moisturizer with SPF, and a serum: squalane oil, and a resveratrol with ferulic acid."
There are other things you can do at home for sagging and wrinkles. Dr. Murmur recommends something called photobiomodulation, which is a "non-invasive therapy that uses near infrared light to stimulate cells to produce more energy and essentially do self-repair of the skin." She says LED lights "do good things for your skin." (Want to try it at home? She sells such a device for $795, here.)
If you're not quite ready to shell out that much for a home device but still want to be proactive, a satin pillowcase or pillow can make a difference, too. The smooth, frictionless satin can help prevent sleep lines and the eventual formation of wrinkles. Nurse Jamie recommends "a [pillow] shape that will help train you to back sleep, or that at least has an opening for your face so that the most delicate areas around the eyes, cheeks, and neck do not form permanent wrinkles." (Her entry into this category is called the Beauty Bear, $69.)
Dr. Marmur says cosmetic procedures are always an option with sagging or crepey skin. "I call it preservation aging. You want to preserve your skin as best as possible for as long as possible — I'd do two 'tox' treatments a year and two laser treatments, and one filler." Amber* who has had Botox and fillers, is very pleased with the results. "I look like me again," she says.
Getting older? It’s time to baby your skin.
Everyone I spoke with emphasized the importance, once perimenopause hits, of taking care of what you've got. As Nurse Jamie says, "My beauty mantra is that it is better to maintain than reclaim."
Since I started researching this piece, I've given up my tough-love approach. I've loaded up on products with hyaluronic acid and all the good stuff that tells my aging cells to hold moisture in. Even though it freaks me out (Oil! Cream! In my pores!) I've been using a moisturizer, and using my retinol a couple of times a week instead of every night. I've been careful not to skip my SPF, even on cloudy days. And lo and behold, my skin actually looks better, plumper, and younger than it has in years. And damned if I don't intend to keep it that way.