Most women associate hot flashes with menopause, but many are not aware that menopausal changes in skin, hair, and nails are not uncommon. These changes often appear in peri-menopause and continue through menopause as a result of declining levels of estrogen. Women experience skin sagging, itching, and dryness, slower hair growth and more shedding, and brittle nails. Estrogen regulates hydration, as well as keratin and collagen levels. Keratin is a protein that makes up nails, hair, and skin. Collagen is the most abundant protein in the body and makes up approximately 70-80% of the dry weight of skin, according to the National Institutes of Health. In addition to skin, collagen is found in connective tissues, such as cartilage, tendons and fat, as well as bones, organs, eyeballs, hair, and nails. Collagen in joints is what helps us move smoothly without feeling bones grate against each other. As estrogen levels and, consequently, keratin and collagen levels decrease, and dehydration becomes more of a problem, women experience symptoms in all of these areas.
You can usually manage post-menopause skin, hair, and nail issues with a good home care routine. Notably, although it seems logical to take collagen supplements or eat high-collagen foods like bone broth to counteract the decrease in collagen, there are not enough controlled studies to prove that it will help. Similarly, some studies have shown benefits from light therapy, but the data are lacking to determine if it definitively helps. In general, it doesn't appear that either strategy is dangerous when used as directed, but both are costly and may not work. On the other hand, we know these things will help:
Give yourself regular facial massages. The massaging motion stimulates your skin's own collagen production.
Moisturize, moisturize, moisturize. Maintaining skin hydration will reduce sagging and make skin appear more youthful. Moisturizers that contain hyaluronic acid may help hold in water. Moisturizers with antioxidants like vitamin C may reduce free radicals that also contribute to aging. But avoid aggravating ingredients like fragrances, alcohols, or colors.
Skip the acne products designed for teenagers since they are too harsh for menopausal skin. Try a gentle cleanser that contains salicylic acid. If you find those products aren't effective, see your doctor for prescription options.
Wear sunscreen. Every day, all day, even when it's cloudy and/or cold. We know that UV light causes the same kinds of damage to skin that is observed with aging.
Drink lots of water. Dehydration can result in sagging skin.
Eat a healthy diet. Include lots of fruits and vegetables to help with hydration and keep your levels of antioxidants high. Eat healthy fats like salmon and avocado. Increase your protein consumption since menopausal women do not process it as well. Make sure you are getting enough Vitamin D in your diet and through short, daily exposure to sunshine (don't forget the sunscreen!)
Protect your nails by keeping them short so they will be less prone to break when bumped or if they catch on clothing, wear gloves during household chores, use nail polish to help with breaking or chipping, and avoid the acetone-based polish removers since they dry out the nails. Avoid biting or picking your nails or cuticles.
To care for menopausal hair, use gentle, moisturizing hair products, experiment with different haircuts and styles, and minimize use of heat styling tools. Over-the-counter (OTC) products with the ingredient minoxidil can help with hair thinning. Your doctor can prescribe other hair growth options if the OTC medications don't help.
Avoid smoking. Data links smoking with decreases in collagen production.
Limit caffeine. Collagen production may be disrupted by caffeine consumption.
Take a multivitamin. I recommend using a pre-natal vitamin. Even when you're long past your pregnancy days, a good multivitamin will ensure that you're getting enough of the right nutrients. We know that prenatal vitamins help with hair growth for pregnant women. Prenatal vitamins I recommend include Nature Made Prenatal Multivitamin Folic Acid + DHA and Ritual Prenatal Vitamin. Both are USP certified and have what you need at a reasonable price from many retail and online suppliers. Don't forget to take your vitamins with food to avoid stomach issues.
In addition to the issues with skin, hair, and nails addressed above, many women experience unwanted hair growth and dark skin spots, particularly on their face. The dark spots, sometimes called age spots, can be difficult to treat at home. Prescriptions creams that contain retinoid may work. If not, dermatologist-performed facial peels or laser treatments can fade the spots. Unwanted facial hair can be challenging to manage at home because the tried-and-true methods of tweezing, waxes, and removal creams can cause damage to thinning menopausal skin. Electrolysis is a permanent hair removal solution that destroys the growth cells in hair follicles. Make sure you have a licensed professional perform this therapy. Laser hair removal can also get rid of unwanted facial hair, but it only works on dark hair. If your facial hair is light in color, laser hair removal will not work. As with electrolysis, make sure the therapy is done by a licensed professional
In addition to menopausal changes, if you notice any of these signs, see your doctor:
Hair - Distinct circle-shaped bald spots on the scalp, loss that occurs with itching, burning or pain, pimple-like bumps on the hairline, hair coming out in clumps, or a rash.
Nails - Dark streaks, lifting up from nail bed, redness & swelling, greenish-black color, pitting, yellow color, deep grooves or gaps, thickening, thinning, washboarding, curving, or any other color change.
Skin - Unexplained peeling, infection, pain, burning, numbness, tingling, rash, itching, skin growths that get bigger over time, any brown spot (mole or birthmark) that changes color, size, or texture, moles with an odd or uneven shape or bigger than a pencil eraser, or sores that don’t heal in 3 weeks.
Make sure to tell your doctor about any changes in your hair, skin, and nails, even if they don't seem serious to you, since more serious medical conditions have similar symptoms.
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