Treatment for Perimenopausal & Menopausal Skin
Essential 3 Steps – Replace Oestrogen Deficiency First
The transition between perimenopause and menopause brings profound hormonal changes that affect the appearance, skin, hair, and weight. Dr Anastasia provides a range of tailored menopausal skin treatments and skin care to address these changes.
Once you enter the perimenopausal phase, your production of oestrogen plummets to zero (or near zero) at menopause. Your skin cells are then oestrogen-deficient. Though many people understand the impact of perimenopause on mood, tummy weight gain, and hot flashes, few understand the profound effect it has on skin ageing and other aesthetic and health-related skin and body changes. To address the changes that occur, the oestrogen deficiency must be addressed. Addressing this essential step improves the outcome of all subsequent skin treatments.
The cost of a Perimenopausal | Menopausal Skin Consultation is $150. If you decide to proceed, $100 of this can be redeemed on your first Tixel skin treatment. Please book online or call 3350 5447 for a consultation with Dr Anastasia.
Dr. Anastasia Steps to Perimenopausal and Menopausal Skin Treatment.
We recommend Steps 1-3 for everyone.
Starting earlier and implementing proactive prevention and protection is optimal.
Some of the steps are multimodal, e.g., the recommended topicals and some of the treatments will help address more than one issue.
Depending on your assessment, concerns, and the modality recommended, you may not need all of the following steps.
Eight Step Options in Menopausal Skin Treatment
HRT is indicated for the treatment of perimenopause and menopause symptoms, including hot flashes, genitourinary symptoms and osteoporosis. It is not currently considered the sole treatment for aesthetic changes such as dry, ageing skin, itching or poor skin healing, hair loss, or menopause weight gain. However, after HRT, many studies have shown a positive impact on skin collagen and elastin levels, improved barrier function, wound healing, and decreased wrinkling. Many women have been using an estriol cream ‘off label’ on the face and ‘bioidentical’ hormone creams. Dr Anastasia consults on options for replacing oestrogen deficiency in the skin, including estriol cream. Other topical options include phytoestrogens such as soy isoflavones, the best studied being Genestein, Daidzen and Equol. (these are currently not found in Australian skincare products.). There is a wide range of plant phytoestrogens added to skincare, but studies have not been performed on their effectiveness on balance; as they are anti-inflammatory and calming (such as Centella Asiatica), we recommend using them.
One profound change to the skin at the time of perimenopause and menopause is an impaired skin barrier. The cause of this is multifactorial, but the fundamental cause is oestrogen deficiency combined with elements of intrinsic and extrinsic skin ageing. The prominent damage to the barrier is caused by a rising pH (the skin becomes less acidic), changes to skin barrier lipids (cholesterol, free fatty acids and ceramides) and chronic low-grade inflammation (known as inflammageing). Other factors such as UV damage, pollution, incorrect skin products applied to the skin, and internal factors such as rosacea also contribute to barrier damage.
The aim of skin barrier repair is restore pH and skin lipids (in a 3:1:1 ration) and decrease inflammation. Ongoing skin protection is essential with sunscreen worn every day as part of your skin routine.
1. Skin1004 Centella and Pribio-Cica ranges provide affordable (and cosmetically elegant) skin barrier repair elements.
2. Oestrogen replacement, topical retinoids, and anti-inflammatory and antioxidant plant-based nutrients also help.
3. Tixel in open channel mode also benefits barrier repair.
Dryness and itching associated with menopausal skin are mainly due to skin barrier impairment.
Skin quality changes accelerate during perimenopause as declining oestrogen levels lead to less collagen production, thinner skin, and decreased hydration. Visible changes include increased wrinkles, loss of elasticity, and dryness. Intrinsic and extrinsic skin ageing exacerbate the changes from oestrogen loss. Tixel provides an exceptional therapeutic intervention to boost collagen, elastin, and hyaluronic acid levels.
Tixel is a pure heart (thermomechanical therapy) with various facial, eye area, neck, and décolletage treatment settings. The Tixel treatment should be combined with other collagen and photodamage repair elements, such as prescription retinoids. We recommend this as one of our essential three steps to address menopausal skin changes.
A series of 4-6 is recommended depending on your concerns and desired outcomes. You can reclaim $100 of the initial consult fee on the first Tixel treatment.
Pigmentation, redness, and skin texture changes develop mainly from the accumulation of sun damage. Oestrogen-deficient skin has weaker blood vessels and repair functions, which worsens skin discolouration and intrinsic ageing changes, such as skin cell senescence and reduced mitochondrial function.
Topical pigment inhibitors (niacinamide, tranexamic acid) and retinoids can help lighten the skin, but peels or BBL lasers are usually the best ways to restore the skin’s more even colour.
Perimenopause and menopause accelerate skin sagging due to several factors:
Collagen Loss: During menopause, the body’s production of collagen, essential for maintaining skin firmness and structure, declines. In the first five years of menopause, women can lose as much as 30% of their collagen, with a 2% loss per year for the following 20 years.
Skin Elasticity: The reduction in elastin results in decreased skin elasticity, contributing to the sagging appearance.
Loss of subcutaneous fat: leads to less support for the skin and a decrease in firmness.
This is visible with skin laxity, hooding of the eyes, and undereye bags. Tixel is particularly beneficial for treating skin laxity around the eyes.
HIFU, PDO mono threads, TIXEL, and collagen biostimulators can all promote skin tightening by replenishing skin elements. In cases of significant skin sagging, surgical intervention may be necessary to address severe laxity. We do not provide cosmetic surgery; you must consult a plastic surgeon to address this.
Oestrogen deficiency can greatly contribute to developing wrinkles and volume loss in the face during menopause. Here’s how:
Not only is collagen production decreased, which is vital for maintaining skin elasticity and firmness, but there is also volume loss across all layers of the face (skin, fat, muscle, and bony face structures). With altered barriers and dryness, wrinkles can become more pronounced.
Other factors exacerbate the perimenopausal and menopausal skin changes:
Cumulative sun damage over time can cause premature ageing and increase wrinkles. Lifestyle factors such as smoking, a poor diet, and lack of sleep can accelerate the skin’s ageing process. Your genetics play a role in how quickly your skin ages.
Your consultation includes discussing wrinkle treatment and volume loss options.
With perimenopause and menopause, fat is redistributed in the body compartments. Changes occur in fat facial pads (see volumising), increasing fat on neck, tummy (and visceral fat), and decreasing fat in hands. There are a range of treatments that address these changes.
- Submental fat treatment
- Medical weight loss can assist in shifting menopausal weight changes, treating submental fat, and identifying areas of loss. Anastasia has specific knowledge of nutrition, body composition, and muscle building.
- Hand rejuvenating treatments (Tixel +/- volumisers)
To maintain the appearance of skin after menopause, a holistic approach is necessary. This involves a combination of lifestyle changes and ongoing skincare practices:
When medically appropriate, continued oestrogen replacement can help mitigate the effects of oestrogen deficiency on the skin.
Protecting the skin from sun damage with SPF is crucial.
Maintaining a healthy skin barrier with quality barrier repair serums .
A healthy lifestyle, including a balanced diet, regular exercise, especially strength training, adequate sleep, and stress reduction, contributes to overall skin health.
Finally, periodic professional treatments like Tixel, BBL, or consultations with our doctors can address specific concerns and provide targeted interventions to maintain youthful skin.
Personalised Perimenopause and Menopausal Skincare Matters
The foundation of effective skincare begins with a personalised approach. Dr. Anastasia will work with you to develop a skincare plan that may include prescription creams alongside high-quality, affordable products to target the underlying causes of ageing related to oestrogen loss, intrinsic ageing, and extrinsic ageing factors like sun damage.
Step 1. Restore Skin Oestrogen
Fix the Oestrogen Deficiency First: Options for oestrogen replacement include HRT, estriol cream, and phytoestrogen-containing creams.
Not everyone is eligible for hormone replacement therapy, and this must be discussed with your doctor.
Relevant research points to the importance of oestrogen in both men and women for skin healing and quality. It shows that aesthetic treatments such as lasers, other medical treatments, and topical creams do not work as well without adequate oestrogen levels. Correcting oestrogen deficiency is the first step in addressing menopausal and perimenopausal skin changes. Phytoestrogens in the diet (found in soy products, among others) have been shown to have benefits, as do topically applied phytoestrogens; however, neither of these has the direct effect of estriol cream topically.
Centella Asiatica contains phytoestrogens, and we recommend SKIN1004 as our central skin care because it contains high concentrations of this ingredient. However, we do not know (and doubt) if there is sufficient to impact skin receptors. There are other phytoestrogens in skin care; you can find more information here.
Step 2. Restore Skin Barrier (Skin Care Designed to Repair Barrier + SPF)
Your skin is a significant organ with several important roles for protection and survival. It is a barrier protecting you from external assaults (UV, infection, pollution, and other harmful elements). It plays a role in maintaining body balance (body temperature, pH, inflammation, immune function) and producing hormones vital for full body function. With oestrogen deficiency and intrinsic and extrinsic ageing, your skin barrier becomes disturbed. We cannot state this with more emphasis: restoring your skin barrier function is essential and fundamental for skin health (and body health).
We recommend Korean skincare because it is one of the central features of many Korean brands—repairing damaged skin barriers. Few brands worldwide are as good as this, but hopefully, this is changing as we cosmetic doctors finally give this the recognition it deserves.
At Pearl, we recommend the SKIN1004 Centella and Probio-Cica ranges, which contain not only phytoestrogens but also products designed to restore skin barrier function ph, physiologic lipids in a ratio of 3:1:1 and anti-inflammatory) and are also very affordable!!!
SPF is essential; UV radiation significantly contributes to barrier function disruption and extrinsic skin aging.
Step 3: Tixel Restore Skin Elements (Collagen, Elastin and Hyaluronic Acid)
is highly effective in either rejuvenation or assisted drug delivery mode and resetting skin collagen, elastin, and hyaluronic levels. We recommend a Vitamin A prescription (minimum 2 weeks before Tixel).
The cost of a Perimenopausal | Menopausal Skin Consultation is $150. If you decide to proceed, $100 of this can be redeemed on your first Tixel skin treatment. Please book online or call 3350 5447 for a consultation with Dr Anastasia.
Treatment Menu Guide for Perimenopausal | Menopausal Skin
Dr. Anastasia can offer a variety of treatments designed to address menopausal skin changes and works alongside our nurses, therapists and other doctors to provide complete options to protect, prevent, and rejuvenate perimenopause, menopause, and sun-damaged skin ageing, including:
- Prescription skincare: tailored treatments, including estriol, pigment inhibitors, and topical vitamin A. Starting with prescription treatments can prime your skin for enhanced results.
- Over-the-counter skincare and SPF Barrier Repair: Anti-ageing, phytoestrogen-containing, and skin barrier repair skincare products, such as Skin1004’s Probio-Cica range, can restore your skin barrier, balance pH levels, reduce inflammation, and promote collagen and elastin production.
- Tixel Treatment: This revolutionary skin rejuvenation therapy uses non-ablative fractional technology to stimulate collagen production, elastin, and hyaluronic acid and improve skin texture. Tixel effectively treats collagen loss, fine lines, and wrinkles associated with menopause. t can be used in low-setting mode to introduce a range of actives into your skin (NCTF, vitamin serums, and specifically formulated prescription treatments); it is also highly successful at treating under-eye bags and sagging of upper lids Tixel eye treatment). A series of 4-6 treatments are recommended depending on your skin condition and
- CO2 Laser: Once a gold standard for rejuvenation, this treatment targets textural changes, fine lines, and sun damage or optimal results; expect a series of 3–4 treatments.
- BBL Laser: Perfect for addressing pigmentation and redness, the BBL laser features a ‘Forever Young’ setting that, with regular maintenance, can activate youthful gene expression in the skin.
- Pico Laser: Ideal for Asian and darker skin, this no-downtime treatment lightens pigmentation and stimulates collagen production.
- HIFU (high-intensity focused ultrasound): This treatment lifts sagging skin, particularly around the jowls, jawline, neck, and eyes, by targeting deep collagen layers.
- PDO Mono Threads: Used alone or with HIFU, these threads stimulate collagen production and improve skin texture, making them ideal for addressing fine lines and wrinkles. The Korean V Lift is a combination of HIFU and PDO mono threads.
- Biostimulators: These treatments stimulate new collagen production and can help with perimenopausal, menopausal, and sun damage changes. A series of 3-4 treatments is typically needed for maximum results. Recommended for more advanced sagging and sun damage, a series of 3-4 treatments spaced 6-12 weeks apart gives long-lasting results.
- Wrinkle Treatments: Various methods are available for addressing wrinkles caused by overactivity of facial expression muscles, and Dr Anastasia will consult with you on the best options for your needs. Volumisers restore lost volume and enhance facial contours, aiming to provide natural-looking results that help you regain a youthful appearance.
- Submental Fat Treatment: If you have unwanted fat under the chin, Dr Anastasia offers consultations and treatments to address this common concern.
- Medical weight loss for menopausal weight gain and redistribution.
- Prevention and ongoing maintenance: Preventative measures, including HRT, topical oestrogen, and retinoids, can help delay further skin aging. Daily sunscreen and lifestyle adjustments are also crucial for maintaining skin health, as is developing a maintenance programme as part of your plan.
A Holistic View of Perimenopausal and Menopausal Skin Care.
At Pearl Medispa, we believe in a holistic approach to perimenopausal and menopausal skin treatment and overall wellness. Anastasia not only focuses on menopausal skin changes but also consults on medical weight loss for menopausal weight gain and hair loss, ensuring you receive comprehensive care.
Book a consultation with Dr. Anastasia today to discuss your skin health options during this transformative phase. Together, you can create a personalised treatment plan that helps you navigate the changes of perimenopause and menopause.
The cost of a Perimenopausal | Menopausal Skin Consultation is $150. If you decide to proceed, $100 of this can be redeemed on your first Tixel skin treatment. Please book online or call 3350 5447 for a consultation with Dr Anastasia.
References
Jiao, Q., Zhi, L., You, B., Wang, G., Wu, N., & Jia, Y. (2024). Skin homeostasis: Mechanism and influencing factors. Journal of Cosmetic Dermatology, 23(5), 1518-1526. https://doi.org/10.1111/jocd.16155
Madnani, N., Deo, J., Dalal, K., Benjamin, B., Murthy, V. V., Hegde, R., & Shetty, T. (2024). Revitalizing the skin: Exploring the role of barrier repair moisturizers. Journal of Cosmetic Dermatology, 23(5), 1533-1540. https://doi.org/10.1111/jocd.16171
Fitriana, L. A., Fitri, M., Komarudin, K., & Sulastri, A. (2024). The Effect of Centella asiatica and Aerobic Exercises on Estradiol, Cognition, and Balance in Menopausal Women. Malaysian Journal of Medicine & Health Sciences, 20.