The menopause can play havoc with skin, causing sensitivity, acne and dryness. Help clients manage the symptoms by switching them to a regime designed to nourish oestrogen-depleted complexions, writes Amanda Pauley

With more than half (60%) of UK women confessing to not knowing what early or premature menopause is, according to research conducted by Surrey-based clinic Health & Aesthetics, there has never been a more prudent time to talk about the change. Although the menopause will affect every woman, it’s still a subject that isn’t discussed in the mainstream media as much as it should be, often seen as taboo.

“Discussion about the menopause has been an avoided topic with significant health and wellbeing consequences,” says Candice Gardener, education manager for skincare brand Dermalogica. “For many women, this means they don’t know what to expect and may not be aware of the steps to take that can help them manage the symptoms.”

But this cycle of confusion needs to stop, and the salon and spa environment is the ideal place to educate women on what to expect. The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, causing oestrogen levels to decline, marking the end of a woman’s menstrual cycle. Vital hormones - oestrogen, progesterone and testosterone - start to fluctuate, leading to a number of physical and mental changes.

“This nosedive in hormones causes havoc with the body as it struggles to rebalance and it affects absolutely everything - wellbeing, mood, sleep, digestion, sex drive, energy, memory and, of course, the skin,” explains Tracy Tamaris, director of education at the International Institute of Anti-Ageing (IIAA), which distributes vitamin A-rich skincare range Environ.

How does perimenopause affect the skin?

With there being a staggering “51 different symptoms of menopause, including one where it feels as if ants are crawling on your skin”, according to Spire Nottingham Hospital menopause specialist Dr Joanne Hobson, the change will affect everyone differently, which means you need to be responsive in your approach to treating clients in salon.

The skin will have different requirements during perimenopause, known as the transition phase, and menopause, which the NHS say women reach when they haven’t had a period for 12 months, marking the end of their menstrual cycle.

The perimenopause is known as the beginning of the change, which can start as early as 35 and last for as long as 10 years. Changes are starting to happen in the body and many clients won’t be aware it’s a perimenopausal state they are in,” says skin specialist Martine Jarman, owner of SkinGenius Clinic in Cheshire.

During this phase, there can be a surge of reproductive hormones, which fluctuate wildly - “it’s the body’s way of saying, ‘this is your last chance to get pregnant, time is running out’,” explains Gardener.

“The skin can become more sensitised and respond unpredictably to treatments and products, and the symptoms will vary depending on whether there are high or low oestrogen levels. For some, the vascular hyperactivity can cause issues like telangiectasia (thread-like red lines or patterns on the skin) and rosacea to develop.”

How can it be treated?

The symptoms will also vary according to the client’s inherent skin type - for example, dry or prone to breakouts - so make sure to swot up on their skincare history, as well as analysing the state of their complexion every time they visit, before choosing your skincare protocol. Also, be aware that the changing hormones can lead to difficulties maintaining the water balance in the body, which can result in fluid retention, swollen eyes and puffiness.

Being mindful of the affect these fluctuating hormones will have on the skin is key to helping clients manage the symptoms effectively. “You should be advising the use of vitamin A to normalise and regulate the healthy functioning of the skin cells, as well as hyaluronic acid to hydrate and plump,” adds Tamaris.

“Peptides will also help to stimulate healthy production of collagen and elastin, and vitamin C will strengthen capillaries. All treatments should use enhanced penetration techniques to ensure these active ingredients reach the deeper layers of the skin.”

How does menopause affect the skin?

The menopause brings with it many changes, the most common being hot flushes, vaginal dryness, decreased sex drive, memory fog and increased fat in the stomach area, to name a few. However, the skin is heavily impacted too, which is why clients need to seek help from a trusted specialist to keep it calm and happy.

“The skin gets drier and more sensitive because of the reducing oestrogen levels, and in the first five years of the menopause, clients lose around 30% of their collagen It’s one of the biggest issues, with skin looking thinner and showing more pronounced lines and wrinkles,” explains Harley Street consultant dermatologist Dr Emma Wedgeworth. This is the time to offer clients more advanced treatments like radiofrequency and microneedling, which are good for skin tightening.

TREATMENT ROOM CHECKLIST: Advice from celebrity facialist Teresa Tarmey

• Check the temperature “For clients suffering with hot flushes, turn off the heated bed, avoid wrapping them up too much and be prepared to switch on the aircon.”

• Have alternative tools ready “If your client’s skin is too sensitised for heat-based treatments then have cold options ready, such as cold compresses, cryoglobes or cooling sheet masks.”

• Offer valuable resources “Include helpful leaflets in the room about organisations that can help clients adjust to the change, as well as local clinics that specialise in HRT or BHRT, should they wish to go down that route.”

Cell renewal also drops during this time and the sebaceous glands slow down the production of oil, leading to dull, rough skin, meaning that even the most robust complexions can become more vulnerable to irritation. Therefore, it’s not uncommon for clients to experience sensitivity to products they’ve been using for years.

“The skin barrier, which controls skin sensitivity, becomes more fragile during this time, so you need to increase hydration for clients by choosing products that are a little richer,” adds Wedgeworth. However, avoid poreblocking oils and steer clear of abrasive treatments and deep scrubs because they can break down the skin barrier too.

How can it be treated?

Wedgeworth advises salons look into stocking more advanced skincare options such as Emepelle, a serum and moisturiser range designed specifically for menopausal skin, which “uses intelligent technology to try and reverse hormonal changes by restoring an oestrogen-like effect on the skin”, she adds.

For clients suffering with relentless hot flushes or sensitive skin conditions such as rosacea, reach for cooling gel formulas or those formulated with oats to help calm the irritation in treatment.

Acne breakouts are also common and “they require ingredients that balance the microbiome and reduce inflammation while promoting the healing process, such as niacinamide,” explains Gardener. “Ingredients that even out skin tone such as hexylresorcinol and vitamin C will also reduce post-breakout marks.”

All the experts agree that you should be recommending sulphatefree cleansers packed with antioxidants to help stimulate collagen production and protect against ageing caused by environmental aggressors, as well as steering clear of fragranced products, which can irritate sensitised skin.

Jarman explains that clients bone density also starts to change during this time - the underlying facial skeleton skeleton starts to deteriorate and the deep fascia ligaments become lax, “causing sagging of the skin around the jaw area and sunken, hollow eyes.”

Jarman advises using HIFU (high intensity focused ultrasound) with radiofrequency to tighten the deeper fascia ligaments.

3 WAYS TO REDUCE MENOPAUSAL SYMPTOMS:

• Regular exercise - Yoga and tai chi are said to reduce stress levels. You could partner with a personal trainer to offer a combined treatment and fitness programme for clients.

• Healthy diet - clients should be opting for a diet rich in vegetables, fruits and healthy fats, while cutting down on caffeine and spicy food, which the NHS says can trigger hot flushes.

• Self-talk - “Women can feel less worthy during this time so you have to help build up their confidence,” says Dr Howard Murad, founder of the eponymous skincare range. He recommends giving clients daily affirmations to say to help boost their self-esteem.

If your clients are struggling with all aspects of the change then encourage them to book an appointment with their GP to talk about the options available, including hormone replacement therapy (HRT), a synthetic drug that comes in two forms - oestrogen-only and a combination of oestrogen and progestogen; and bioidentical hormone replacement therapy (BHRT), a hormone preparation made from plant sources that are promoted as being similar to human hormones. PB