The weather is getting colder and many of us us have been dealing with dry skin, particularly dehydration. If you’re approaching or experiencing menopause, this can be even further exacerbated. I’ll be focusing on both of these skin concerns in the following post as they tie in together nicely and so this post can be helpful to more of you.

Some links and codes may be affiliate. The reader doesn’t pay any additional costs but the author gets a small commission from sales which helps support the blog and future content.

Xerosis (dry skin):

Dry skin is referred to as xerosis in the medical literature. It’s important to note that the medical community does not differentiate between dry skin and dehydrated skin, but rather encompasses the latter within the topic of xerosis. While other skin types can be dehydrated, a dry skin type will almost always suffer dehydration as well and I’ll explain why this is below

What is xerosis and what causes it?

Xerosis aka dry skin is often simply defined as dry, rough skin but it’s much more complicated than that. The function of the skin barrier is a critical piece of this, particularly lipid depletion and disorganization of those lipids. Hydration and desquamation of the stratum corneum also plays a role. And despite misinformation to the contrary, sebum production plays a much more minor role compared with oily skin.

Dry skin can be caused by both environmental and internal factors. Things like cold weather, dry air, over cleansing, harsh soaps, exposure to irritating substances, over exfoliation, and even intense sunlight can contribute. The lipids produced at the surface of the skin by skin cells (ceramides, cholesterol, fatty acids, etc) are critical to the function of the skin barrier and its ability to retain water – so if you deplete or disorganize those lipids it will have a tremendous impact on the skin barrier, particularly if you’re also affecting adhesion of skin flora (our good bacteria) too. But you’ve also got endogenous factors like inflammatory skin disorders, inflammatory diseases in the body, medications, and hormonal changes that can cause dryness and compromised skin in general. Which is where menopausal skin comes in.

What changes are often occurring in menopausal skin and what role do hormones like estrogen play?

The skin changes as we get older. We have the degradation of collagen and elastin, production of dermal collagen declines, hyaluronic acid production in the epidermis declines, less sebum is being secreted, and other processes slow down like desquamation and cell turnover. Of course other tissues are impacted as well – facial muscles lengthen, there’s bone loss, and subcutaneous tissue aka adipose fat is redistributed. But estrogen is a really critical hormone to the skin and menopause has a huge impact on the skin as a result.

Estrogen is critical to skin moisture because it plays a role in both producing more skin lipids and in the formation of hyaluronic acid and other mucopolysaccharides which are critical for skin hydration. When these decline, you have a decrease in skin hydration levels and moisture retention which also leads to decreased skin barrier function and can even change the shape of skin cells on the surface of the skin.

Skin aging and menopausal skin is also associated with a decrease in TGF-beta 1, a growth factor important in the wound healing process as well as in the formation of collagen. Animal studies found that topical estrogen therapy restored wound healing and TGF-beta 1 levels as well. The research currently indicates that hormone related aging caused by menopause has a much more pronounced impact on the dermal matrix than chronological aging with women losing 30% more collagen in the first 5 years of menopause and double the collagen loss per year after that compared to pre menopause. Skin thickness also declines each year.

What can we do at home?

First, we can look at the symptoms of dry skin and how we can address this with skincare. This will apply both if you just have dry skin or if you’re also experiencing estrogen- deficient skin.

Critical Components of a Dry Skin Type’s Routine:

• Non-foaming cream or gel cleanser with a low pH level and gentle surfactants
• A gentle AHA that will aid desquamation, help penetration of other skincare ingredients, and hydrate thanks to its humectant properties
• look for hydrating skincare products with humectants that naturally occur in the skin and that also have ingredients focused on skin barrier function
• a very gentle retinoid can help with turnover and normalize skin function
• look for a rich barrier cream that contains skin barrier lipids like ceramides, cholesterol, and fatty acids

My Dry Skin Faves:

• CeraVe Hydrating Cleanser
• La Roche Posay Hydrating Cleanser
• Stratia Skin Velvet Cleansing Milk
• Isntree AHA Essence
• Le Mieux ISO Cell Recovery Solution
• Cezanne High Moist Skin Conditioner
• Rovectin Activating Treatment Lotion
• Imagine Dermatology Hyaluronic Honey
• NCN Pro Skincare 2% All Trans Retinol
• Stratia Skin Night Shift
• Stratia Skin Liquid Gold
• CeraVe Skin Renewing Night Cream
• Le Mieux 24 Hour Age Defying Cream

Get $10 off your $35+ order at Stratia Skin with my referral link.

Get 20% off Le Mieux if you shop at https://skinbeautifulrx.com with code “mira20”

What else can we do?

Beyond just focusing our skincare on alleviating the symptoms of dry skin and decreasing exposure to environmental causes, we can attempt to go a step further and see if we can actually make changes to the skin that will help. It’s important to note that while the research here isn’t as conclusive, the products and ingredients mentioned all have other great benefits to the skin as well so it’s a win either way.

HA Precursors

Glucuronic acid and N-Acetyl Glucosamine are the building blocks of hyaluronic acid and therefore considered precursors. One article I read suggested that having more available will enable more production of hyaluronic acid.

The two I’ve been using are:

• Stratia Rewind Serum. This has the N-Acetyl Glucosamine mentioned as well as niacinamide which is anti aging and can help skin barrier function. Paired together, the two ingredients work synergistically to brighten skin and you’ve also got DMAE for helping firm the skin and decrease wrinkle depth.
• Hylamide SubQ Skin. A more recent addition, this has the glucoronic acid as well as a peptide that serves as a retinol alternative, 5 molecular weights of hyaluronic acid, and some other nice ingredients.

Growth Factors and Peptides

We can also use growth factors which are critical for the wound healing process in the skin as well as peptides that increase their activity.

Palmitoyl Tripeptide-5 aka Syn-Coll is a synthetic peptide shown to increase activation of TGF-B 1 here and here.

Products with Palmitoyl Tripeptide-5:

• Le Mieux TGF-B Booster (code “mira20” for 20% off)
• Silk Naturals Facelift Serum with Vit C, DMAE, and Syn-Coll
• InstaNatural Anti Aging Peptide Complex Serum

My favorite all-inclusive growth factor serum is the Bradceuticals Double Concentration Mesenchymal Serum which features 60% growth factor rich, bone marrow stem cell derived conditioned media and a blend of peptides, DMAE, Vit C, and humectants. Non-affiliate code “mira2020” will get you 15% off on Amazon till the end of the year.

Early intervention

The American Academy of Dermatology recommends early intervention in regards to both estrogen supplementation and stimulating collagen. Read more on this here.

There are many ways to stimulate collagen but the one I would suggest most for home use here is the NEWA Radio Frequency Skin Tightening Device. It’s amazing for stimulating new collagen formation – you’ll typically see an increase in collagen content by 4% in 3 months (about 4 years of collagen loss). But it also helps with elastin and hyaluronic acid production, making it a great option for menopausal or even just dry skin focused on preventing aging. It’s also the most tested home treatment with over 40 clinical studies and the same medical grade technology ENDYMED uses in office.

NEWA is currently having a sale and my affiliate code “mira10” will a stack with the sale.

My second choice will be microneedling since it can aid product penetration and thicken the epidermis too. Please see our Skincare Group on Facebook for more information and I have future posts coming too.

You’ll want to see your doctor about estrogen therapy as not everyone is a candidate. If oral or topical estrodiol is not for you, speak to your doctor about Emepelle or isoflavones though there’s less evidence.

Additional reading

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451761/

https://jamanetwork.com/journals/jamadermatology/fullarticle/420008

https://onlinelibrary.wiley.com/doi/10.1111/ddg.13906

https://www.sciencedirect.com/topics/medicine-and-dentistry/xerosis

I found this to be a really interesting post to write and I hope it was helpful! Comment below if you enjoyed it and what you’d like to see next.