As women age, hormone levels shift. This shift is a normal and predictable change that occurs over the years, beginning in the fourth decade. Though these are normal and expected hormone shifts, there are often unwanted skin, hair, and nail changes. The shift in hormones is known as menopause and it can change your skin. 

Why Do Skin, Hair, and Nails Change Over Time?

Not all of the changes related to aging are exclusive to hormone shifts. Skin changes can be attributed to chronic sun exposure and chronic moisture loss, leaving the skin with an increased number of sunspots, premature laxity, ruddy tone, and texture, etc.  The weather in Nashville, TN can be drying in the winter and very sunny in the summer. These external factors can make skin changes from menopause more pronounced.

The dermis of the skin, which is the thick layer of skin below the epidermis, also produces less elastin and collagen as we age. The combination of chronic sun exposure leading to premature skin breakdown and decreased production of elastin and collagen contributes to most age-related skin complaints. 

A few basic principles for healthy skin, hair, and nails:

1. Zinc Based SPF is your best friend. Use it on your face, neck, and chest every day in Tennessee. Use it on your body when outdoors as best as you are able. Zinc is clean, organic, long-lasting, and safe over decades of use! 
2. Take a Women’s Multivitamin with Omega acids every day. There are countless benefits to ensuring you have enough Vitamin C, D, B Vitamins, Calcium, Iron, Omega 3, Omega 6. As always, make sure you consult your care provider if you have any medical conditions or take any medications.  
3. Be intentional about water intake. Most of us don’t even hit the 64oz per day recommendation. Make that your goal, and then increase as needed for the activity or season in Nashville.  
4. Talk honestly with your care providers about these changes, and don’t be embarrassed or scared! There is nothing you can ask that we haven’t already heard! If you don’t feel like your questions were not addressed, seek a second opinion. It can genuinely be challenging to keep up with all of the dermatology studies and advancements. Tennessee Telederm offers online appointments for dermatology needs which may make you feel more comfortable.
5. Age with a friend 🙂 There’s nothing better than feeling comfortable in your skin, surrounded by honest and healthy friendships.  

 

This blog will focus on the most common complaints associated with aging and methods to combat these issues. As always, speak with your healthcare provider before trying any new supplementation.

Skin dryness from decreased estrogen, leading to increased moisture loss that occurs over years to decades.

Most effectively combated by:

1. Gentle chemical exfoliation to remove dry, dead skin cells on the surface relieves dryness. This removal allows moisturizer to be better absorbed into the skin vs. sitting on top of the skin. Lactic acid solutions are tolerated well by most skin types. Glycolic acid and retinoids work very well also but tend to require a dose titration plan, and some formulations are prescription only. Tennessee TeleDerm can guide you through this process if you are not currently using an acid exfoliant.  
2. Moisturizing twice daily with a combination of hyaluronic acid (draws water in) and ceramides or emollients (hold moisture in the skin by forming a barrier on top of the skin). Make sure your morning moisturizer has an SPF of 30+. 
3. Increased water intake for whole body water replenishment, which is partially lost through the skin. This water intake should be in coordination with your care provider as certain medical conditions and medications require a delicate balance of appropriate fluid intake. A schedule for water intake is helpful too. Our thirst response can dim as we age, leading to fewer cues to stimulate thirst and water intake.  

Fine lines and wrinkles resulting from cumulative sun exposure, loss of dermal thickness, dry skin, gravity pulling the skin down, and repetitive facial muscle movement.

Most effectively combated by:

1. Chemical exfoliation with an acid, either daily or incrementally in office (chemical peels)
2. Proper moisturizing as noted above
3. Collagen supplementation*
4. Laser resurfacing
5. Microneedling
6. Botulinum toxin injections for dynamic facial muscle movement and fillers to “fill in” gaps left by the ever-thinning dermis and gravity.  

Decreased firmness and elasticity related to decreased collagen and elastin in the dermis, cumulative sun exposure, and effects of gravity over time.

Most effectively combated by:

1. Proper moisturizing, including moisturizers with green tea/caffeine, which have a temporary tightening effect.  
2. Collagen supplementation*
3. Filler injections
4. PRP procedures (platelet-rich plasma) to stimulate collagen
5. Other procedures as directed by a plastic surgeon

Skin tone and texture changes that are more superficial than wrinkles.

1. Morning moisturizer with zinc based SPF 30+ to prevent UV and blue light damage to the skin. We prefer a tinted moisturizer. Iron Oxides used to add tint to moisturizers offer additional protection from UV from the Nashville sun and Blue Light (light from electronics).
2. Acid exfoliation, as noted above to remove dull, dead skin cells from the surface of the skin.
3. Use of an antioxidant serum/cream. OPC, Green Tea, and Vitamin C are the most stable antioxidants on the skin. They protect the skin from a variety of environmental assaults, while also brightening the skin. Many daily moisturizers with SPF also contain antioxidants. However, studies have shown that the reparative processes of the skin are performed mostly at night. Therefore it is most important to use antioxidants at night. 
4. Consider taking Heliocare, an OTC supplement that protects all skin from the daily assault of free radicals. There is excellent science behind the effectiveness of this product, and I have recommended it for more than a decade. This supplement is especially beneficial when large areas of the skin are regularly exposed to the sun and anti-aging creams aren’t enough.  
5. Dark spot correctors containing hydroquinone for sunspots. These are found OTC or by RX.
6. Redness reducing products containing nicotinamide/niacinamide (B3). Available OTC.

Hair loss/hair breakage as a result of changes in estrogen, androgen, and moisture loss.

1. Most important of all, hair loss absolutely needs to be assessed by a dermatologist or dermatology nurse practitioner! Though hair loss is often attributed to age, there are medical conditions of the scalp and systemic medical conditions that can attribute to hair loss. Schedule an appointment with Tennessee TeleDerm to have your hair loss accurately diagnosed. 
2. Supplementation with Nutrafol**, an OTC supplement with collagen, saw palmetto, and other natural sources, is proven to combat hair loss associated with aging and weakened hair structure. 
3. Multivitamins, as noted above to ensure that the basic needs for hair growth are met. 
4. Add moisture and prevent breakage by using a leave-in conditioner like Pureology. Use gentle non-sulfa-containing hair products. Avoid excessive heat on the hair.

Brittle nails, secondary to decreased estrogen, collagen.

1. Keep nails trimmed shorter. The longer the nail grows, the weaker the tip becomes.
2. Add hand cream often. Moister supports the nail plate by adding a temporary emollient barrier, protecting nails from everyday chemicals, soaps, and detergents, etc.
3. Wear gloves to protect the nails when cleaning/household chores.   
4. Multivitamin and Nutrafol** supplementation.

 

Schedule an Online Consultation for Menopausal Skin Changes

If you have noticed changes in your skin, hair, or nails with age, Tennesse Telederm can help you with your dermatology needs. Advanced Practice Registered Nurse, Kristen Stirling, can provide you with an easy, online skin and hair consultation. You will receive a customized treatment plan to restore your skin after menopause. Schedule an online health appointment with ease from Nashville or anywhere else in Tennessee.

 

*Collagen supplementation has numerous studies supporting its benefit to skin hair and nails. However, the dosing of collagen is somewhat ambiguous. Always follow the instructions on the label of any supplement. 

**Nutrafol is a clinically studied combination of natural ingredients proven to increase hair growth and hair thickness in the setting of hormone-related hair loss. Tennessee TeleDerm does not receive compensation for this product; it is simply the proprietary blend with clinical evidence to back its effectiveness.