Affected hair, skin & nails

How does menopause affect your skin, hair and nails? Dr Naomi Potter explains what it does and what can help.

Menopause is so much more than hot flushes and night sweats. There are more than 40 symptoms that signal declining oestrogen levels, and many affect our skin, hair and nails. As skin is the body’s largest organ it plays an important role in keeping us healthy, so it’s vital that we keep it in good condition.

Here Harley Street Emporium’s Dr Naomi Potter, a London-based GP with a special interest in menopause, runs through some of the common skin symptoms she sees in her clinic, and gives her tips on what can be done to relieve them.

1. Dry Skin 

“This is really common. As we age our oestrogen levels decline but it’s not just collagen that’s affected, we lose the fatty lipid layer that sits on the skin barrier and protects it too. Because it’s compromised we lose more water via the skin – this is what’s called transepidermal water loss, or TEWL. The skin feels dry, looks dull and may be flaky.  Often women will say their skin has become more sensitive around this time too.”

What can help?

“HRT is the first thing – it won’t stop the aging process but it can go some way towards relieving symptoms. A good emollient, especially one that contain ceramides –  the fatty acids that help protect the skin are a good choice. Retinol is great for boosting collagen but it also helps with pigmentation and encouraging cell turnover. So, it helps improve the appearance of the skin and normalises the skin barrier. Vitamin C is another good one. It helps protect and repair the skin.”

What can make it worse?

“Long, hot showers or baths. As uncomfortable as it sounds, try to reduce the temperature of your showers or baths as hot water strips the natural oils, and look for soap-free and fragrance-free products.”

“It’s tempting to think scrubs and strong exfoliators will fix the flakiness, but you have to repair the skin barrier first, so try to avoid these.”

This affects 49% of women according to a Harley Street Emporium survey.

• Rashes

“An increase in allergies or new onset allergies is quite common. I see a lot of women with itchy rashes, and if they have rosacea they’ll often say that it gets worse.

“Again, declining oestrogen levels plays a role. One area of research on this that’s growing is the interaction between oestrogen and histamine production. It’s thought that fluctuating hormone levels may interfere with the way we get rid of the histamines that are produced from the foods we eat, leading to an excess which can trigger what’s called a histamine intolerance.

What can help?

“Getting to the bottom of this can be a long road as it involves looking closely at the diet to identify possible triggers. It’s best to see a dietician for this.

“Topical antihistamines can give some relief, but always follow the instructions and see a doctor if things don’t resolve.”

• Itchy scalp and calves

“Some women say it feels like there have ants crawling on their skin and they can’t stop scratching. The scalp and calves are the areas they mention most. Again – it all comes back to oestrogen and the depletion of the fatty lipid layer on the skin.

What can help?

“Keep the showers short and cooler, apply a fragrance-free good emollient after bathing and go soap free. Consider oatmeal or coal tar-based shampoos and soaps– you may not love the smell initially but they can really help reduce the itching.”

This affects 16% of women according to a Harley Street Emporium survey.

• Itching, burning vulva and thrush-like symptoms

“It’s not just the skin on our face that thins with declining oestrogen, our internal and external genitalia is also affected. The mucosa in the vagina thins and the vagina becomes dry making sex painful, and the vulval skin can thin and split too. It can feel like it’s burning and irritated and can be so extreme that some women can barely sit or have clothing touching it.

“There may be a discharge and often women think it’s thrush (often intensely itchy with a thick white discharge), or bacterial vaginosis, which has an unpleasant smell. Vaginal infections are more likely to occur if there is an oestrogen deficiency, so by treating the hormones they are less likely to recur. There may be an increase in UTI’s too, which again, are oestrogen related.”

What can help? 

“Topical oestrogen can make a huge difference and it can be used by the vast majority of women very safely, and for as long as they like.

“There are a number of vaginal moisturisers and lubricants on the market that may help. Water-based ones may be preferable but make sure they are the right pH – somewhere between 3.8-4.5. Try to avoid ingredients like parabens, nonoxynol and chlorehexadine.”

What can make it worse?

“Self-treating. Because many women think it’s thrush they often self-treat with thrush treatments. They may provide some temporary relief, but it’s really important to get it checked out to make sure these symptoms aren’t caused by any other underlying condition.”

This affects 23% of women according to a Harley Street Emporium survey.

• Hair loss

“This can be very distressing for women and it affects a lot of us. Declining oestrogen is often a reason for it, especially if it is receding on the temples. If you are losing a lot of hair it is vital that you see someone to make sure there are no other underlying conditions that could be causing it. Stress, nutritional deficiencies and auto-immune conditions can also be causes.”

What can help?

“If the cause is oestrogen related, HRT may go some way to stopping the loss and perhaps even seeing it reverse to some extent. There are topical sprays like Minoxidil that work for some women. I’m not an enormous fan of supplements unless you have a deficiency but some women find supplements with biotin in them helpful.”

This affects 54% of women according to a Harley Street Emporium survey.

• Brittle Nails

“Sometimes a deficiency in iron, folate or a thyroid issue can be involved, but more often than not, it’s oestrogen.”

What can help?

“Eating a well-balanced diet with plenty of fruit and veggies and omega 3 and 6 is great for your overall health as well as your nails.”

This affects 25% of women according to a Harley Street Emporium survey.

• Burning tongue and mouth

“Declining oestrogen levels can result in a drop in saliva production, leading to a dry mouth and what some women describe as a burning tongue or mouth. It can come and go as hormones fluctuate, and stress, anxiety and depression can make it worse.”

What can help?
“There are artificial saliva products that can provide temporary relief and if it isn’t caused by any other underlying condition, HRT”

This affects 8% of women according to a Harley Street Emporium survey.

• Dry eyes

“Another one that affects a lot of women. It can may the eyes feel tired, itchy or gritty and ironically, they water a lot, especially in cold or windy weather so you look like you’re crying.  Again, in many cases, it’s the declining oestrogen that’s to blame.”

What can help?

“There are a number of eyedrops that can help give moisture to the eye or act as artificial tears. Again, HRT may help relieve it. It is important to make sure there are no other underlying causes, so speak to your GP.”

This affects 36% of women according to a Harley Street Emporium survey.

• Bleeding gums

“This is another one where oestrogen may play a role by increasing the dryness in the mouth. Declining oestrogen can lead to less saliva production which means the bacteria that that would usually get swished around and removed sits for longer on the gums and can contribute to bad breath and gum disease.”

What can help?

“Flossing regularly, cleaning your teeth, drinking more fluids or gargling with mouthwash, and HRT.”

This affects 21% of women according to a Harley Street Emporium survey.

1. Changes in body odour

“This is another interesting one and there are a couple of reasons. Drops in oestrogen levels can cause night sweats and hot flushes which means more sweat, and often women find they’re generally sweating more. More sweat can lead to a build-up of bacteria which produces an odour.

“The other cause, and this can have a sudden onset, is stress or anxiety – which again increases as oestrogen drops. This kind of sweat comes from different glands and the sweat it produces has a stronger odour.”

What can help?

“HRT is great for both vasomotor symptoms like the night sweats and flushes, and it can help with anxiety as well. A good antiperspirant can help control sweat production and there are treatments that involve injecting botulinum toxin into the armpits to help stop excessive sweating.”

This affects 33% of women according to a Harley Street Emporium survey.

Always see your GP if you are having difficulty coping with your menopause symptoms or if you have questions about your skin, hair and nails.

You can find out more about Dr Potter and book directly here.