For women, perimenopause is a natural stage of life. As hormones change, the ways the body reacts can be unpredictable. Hot flashes and mood swings take center stage, but perimenopause has a wide range of side effects, including changing the way skin, hair, and nails look and feel. According to Amanda Caldwell of U.S. Dermatology Partners Warrensburg, “Dryness, thinning, and brittleness of the skin, hair, and nails are all commonly reported by women in perimenopause. While you can’t stop these changes altogether, there are many ways to slow and reverse these adverse effects with proper at-home care, the right skincare products, and dermatologist support.” In this blog, Amanda Caldwell discusses perimenopause skin, hair, and nail concerns and how to improve health and appearance.
What Happens to Your Skin During Perimenopause?
Skin changes during perimenopause are common and varied. They typically begin to develop in the early 40s, but individuals may experience symptoms earlier or later. This transitional period leads to fluctuation in hormone levels that change hair, skin, and nail health. Estrogen is responsible for keeping skin smooth and taut by stimulating collagen to ensure skin maintains thickness and elasticity. It also boosts hydration, wound healing, and barrier function. Hormonal fluctuation also causes decreased oil production, leading to skin dryness and sensitivity. Finally, age and hormone changes lead to slower skin cell turnover, leaving skin looking uneven. As skin ages, dryness, dehydration, irritation, and loss of elasticity can all occur. Skin feels thinner and more fragile and fine lines and wrinkles become more apparent.
Common Skin Changes During Perimenopause
Common hormonal skin changes include:
- Dryness – this is one of the earliest warning signs of perimenopause skin changes. It occurs when hormonal shifts lead to diminished oil production. Additionally, aging skin becomes thinner, allowing for greater moisture loss. Skin may feel tight, flaky, or rough.
- Sensitivity – thinner skin may become more reactive to environmental aggressors like weather or allergens, leading to frequent redness and irritation.
- Wrinkles – as collagen and elastin production decreases with age, skin may appear more lax, fine lines and wrinkles deepen, and skin may sag.
- Adult acne – like teenage hormonal shifts that trigger acne in adolescents, perimenopause and menopause hormonal shifts can trigger adult acne breakouts. The form of acne is often more painful and resistant to treatment than teen acne.
- Pigmentation changes – a combination of hormonal fluctuation and cumulative sun exposure, may lead to the development of dark spots, uneven skin tone, and melasma. Thinning skin is more vulnerable to UV damage and pigmentation changes, so sunscreen application is essential.
Hair Changes During Perimenopause
When it comes to hair changes with age, Amanda Caldwell says, “If you’re experiencing perimenopause hair loss, thinning, or brittleness, you don’t have to accept these changes as your new normal. There are numerous ways to improve hair health, working with a dermatologist to find the right haircare products.” It may be time to discuss treatment options with your dermatologist if you notice any of the following changes:
- Hair thinning – excessive shedding or thinning hair is often a sign of diminished estrogen production. Estrogen supports hair health by keeping hair in the anagen growth phase longer. With decreased estrogen production, hair stays in the shedding phase longer.
- Hair density decreases – strands of hair may be thinner and there may be a wider part in the hair line, indicating that hair density or general thickness are decreasing.
- Texture changes – hair may feel drier and more brittle. It may look less shiny, and it may even become more difficult to manage. These changes occur due to reduced oil production on the scalp.
- Changes in facial and body hair – while hair on the head may become thinner, facial hair, especially on the chin and upper lip, can be thicker. Hair on arms, legs, and other areas may also thin. These changes occur due to fluctuating levels of estrogen and androgen.
Nail Changes During Perimenopause
If you suddenly notice peeling, brittle nails, perimenopause may be to blame. The effects of hormone changes on nails are often overlooked, but there are a variety of ways perimenopause impacts nails, including:
- Weak nails – as estrogen levels and moisture retention decrease, the structure of nails can be negatively impacted, causing brittleness, splitting, or peeling nails.
- Thin nail plates – the part of the nail that covers and protects fingertips can become thinner and more fragile.
- Slow growth – nails may not regrow as quickly after trimming.
- Changes in texture – vertical ridges, dents, and other changes in the texture of nails may develop.
How to Manage Perimenopause Skin Changes
According to Amanda Caldwell, “When it comes to wrinkles, fine lines, hyperpigmentation, and collagen loss, menopause and perimenopause contribute significantly to skin aging. You may not be able to stop the hands of time or the effects of hormonal changes, but there are numerous skincare steps patients can take to support skin’s health and appearance for the long-term.” The best way to develop a beneficial anti-aging skincare routine is to sit down with your dermatologist to create a personalized plan. Some general skincare recommendations include:
- Use a gentle cleanser – skip the harsh, drying, or abrasive cleansers. Choose a cream-based formula that’s free of fragrances, dyes, and other unnecessary chemicals. A quick shortcut is to check labels for products designated for sensitive skin.
- Apply sunscreen daily – as skin ages, it becomes thinner and more vulnerable to damage caused by the sun’s ultraviolet (UV) rays. Sun damage leads to accelerated signs of aging, including wrinkles, pigmentation, and collagen loss. Apply a broad-spectrum, SPF 30+ sunscreen daily.
- Retinoids – one of the most powerful ingredients in anti-aging skincare, retinoids stimulate collagen production and improve skin texture by increasing skin cell turnover. With regular use, retinoids reduce the appearance of fine lines and wrinkles, minimize acne breakouts, and generally improve skin health.
- Hyaluronic acid – skin thinning with age also means increased moisture loss, leading to dryer skin. This makes fine lines and wrinkles more noticeable. Hyaluronic acid plumps, hydrates, and softens skin.
- Peptides – these amino acids support skin repair, improve firmness, and strengthen skin’s protective barrier.
Professional Anti-Aging Skin Treatments
If you’re looking for a professional anti-aging skin treatment to improve the appearance of stubborn fine lines, wrinkles, uneven pigmentation, and other skin changes during perimenopause, it’s time discuss your options with a dermatologist. Each patient’s treatment plan will be customized to their unique needs and skin health concerns, but some of the most beneficial anti-aging skin treatments include:
- Chemical peels – these peels use chemicals to remove dead skin, which improves texture and reduces pigmentation concerns. These treatments can be customized to meet specific needs.
- Laser treatments – laser light waves are used to target and remove damaged skin cells or completely resurface the outer layers of skin. With one or more treatment visits, laser therapy improves the appearance of sun damage, uneven pigmentation, and fine lines. It also stimulates collagen production.
- Microneedling – using a uniquely designed handheld tool, microscopic injuries are made in skin’s surface. This jumpstarts the body’s natural healing response to promote collagen and elastin production and improve skin’s texture and appearance.
- Injectables – neuromodulators like Botox may be used to relax facial muscles and reduce the appearance of wrinkles. Dermal fillers are recommended to restore lost volume and improve facial contour.
Hair & Nail Care Strategies
When it comes to improving hair and nail health, there are a few simple steps you can take at home:
Hair Care Tips
- Use sulfate-free shampoos and conditioners. Sulfates are drying, and they worsen perimenopausal moisture loss.
- Limit styling with heated tools that can dry and damage hair.
- Don’t over-process hair with harsh chemicals and dyes.
- Start moisturizing hair and minimizing stress on hair early.
Nail Care Tips
- Use cuticle oil to keep sensitive skin around nails hydrated.
- Don’t overuse nail polish removers.
- Trim nails to prevent breaking and peeling.
- Apply topical strengthening treatments as needed.
Nutritional Support
Nutrition is essential for both hair and nails. To improve health from the inside out, ensure you consume nutrient-rich foods. You can also take supplements, under the direction of a medical professional, that contain nutrients like biotin, protein, and omega-3 fatty acids.
Lifestyle Factors That Support Healthy Aging
In addition to skincare and dermatologic treatments, there are daily habits that impact your skin, hair, and nail health during perimenopause. Below, we outline a few of the lifestyle factors that can be adjusted to support healthy aging:
- Nutritious diet – lean proteins support collagen production, healthy fats and Omega-3 fatty acids boost skin hydration, and antioxidant-rich fruits and vegetables protect against sun damage.
- Hydration – keeping skin moisturized starts from the inside out. Drinking enough water supports overall health as well as boosting skin elasticity and cellular function.
- Exercise – when we exercise, circulation increases. This delivers oxygen and nutrients throughout the body, including to the skin. Exercise is also known to reduce stress and improve hormonal balance.
- Hormone replacement therapy – also referred to simply as HRT, this uses hormonal supplements to alleviate skin and whole-body symptoms of perimenopause.
When to See a Dermatologist
Many skin changes are natural, and they don’t necessarily require treatment. However, it’s important to seek out dermatologic support if you notice any of the following:
- Sudden or severe hair loss.
- Adult acne that doesn’t clear with over-the-counter treatment.
- Extreme levels of skin dryness or sensitivity.
- Rapid changes in skin’s appearance or texture.
- Changes in pigmentation.
Early Intervention Is Essential
According to Amanda Caldwell, “Whether you’re dealing with brittle hair and nails, skin dryness, loss of elasticity, or adult acne, menopause and perimenopause can wreak havoc. While many of these changes seem like a natural part of aging, that doesn’t mean you have to accept every new line and wrinkle. Instead, start early with an effective, anti-aging skincare routine and stick with it!”
Schedule an Anti-Aging Dermatology Consultation
The U.S. Dermatology Partners team is here to support you at every stage of your skin, hair, and nail health journey. For those in perimenopause and menopause, it’s important to partner with your dermatologist to develop an ongoing routine to prevent and address the impact this phase of life has on skin, hair, and nails. Getting started with a local U.S. Dermatology Partners team only takes a few moments. Fill out our online request form, and a team member will reach out to finalize the details.
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