CPD Article - Managing Menopausal Rosacea and Skin Changes
Julie Scott shares her insights and experience with managing menopausal skin changes
Are you an aesthetic practitioner looking to enhance your expertise in managing menopausal skin changes?
With hormonal fluctuations exacerbating conditions like rosacea, it’s crucial to adopt a nuanced approach to skincare and treatment. This article aims to help you understand the unique skin challenges faced by menopausal women.
Learn how to effectively tailor your skincare regimens with key ingredients, employ advanced in-clinic treatments, and provide holistic care that addresses both the aesthetic and emotional needs of your patients. Drawing from years of clinical experience, I share insights into the prevalence of rosacea among menopausal patients and the strategies that have proven successful in my practice.
Unlock radiant skin during menopause
Over the years, I have noticed a marked prevalence of rosacea among my menopausal patients. This isn’t surprising, given that hormonal changes during menopause can significantly impact the skin. The decline in oestrogen levels that accompanies menopause can lead to increased sensitivity and a tendency towards redness and inflammation. For many women, these changes bring on new skin challenges, including the development or worsening of rosacea. In my practice, about 40% of menopausal patients report a noticeable onset or exacerbation of rosacea symptoms during their transition into menopause.
The impact of menopause on skin
The impact of menopause on the skin has made me ask, ‘Why are menopausal women more prone to Rosacea?’
Hormonal fluctuations during menopause, especially reduced oestrogen and increased androgens, can boost blood flow to the skin’s surface, resulting in flushing, redness, and rosacea-like symptoms. Alongside this, decreased collagen and natural oils make the skin thinner, drier, and more sensitive to irritation and inflammation. Many women who have not previously experienced rosacea may see new symptoms arise, while those with a history may notice their symptoms worsening. In addition to rosacea, menopause often brings issues such as dryness, reduced firmness, and increased sensitivity as the skin becomes more susceptible to irritants. Addressing these concerns holistically, with the medical needs in mind, is essential for effective management.
Understanding rosacea in menopausal skin
Rosacea is a chronic inflammatory skin condition that manifests as persistent redness, flushing, visible blood vessels, and, at times, acne-like bumps. For menopausal women, this condition can be particularly impactful, both physically and emotionally, due to increased skin sensitivity and visible symptoms that can affect self-confidence.
Identifying rosacea vs. other skin concerns: During menopause, various skin issues such as dryness, fine lines, and sensitivity often arise, which can sometimes mask or mimic rosacea symptoms. It’s essential to differentiate rosacea from other concerns like eczema or menopausal flushing. Unlike transient menopausal flushes, rosacea redness tends to be more persistent and localised, often affecting the central areas of the face.
Common triggers for menopausal rosacea: Menopausal skin is especially susceptible to external triggers that can worsen rosacea symptoms. Factors like sun exposure, spicy foods, alcohol, and temperature changes can all exacerbate redness and flushing. Additionally, psychological stress common during this life stage can trigger flare-ups, making stress management an essential part of managing rosacea.
Emotional and psychological impact: Rosacea often brings a visible aspect to menopausal changes, which can impact confidence and self-esteem. For some, this condition may feel like an unwelcome reminder of ageing, adding a layer of emotional complexity. As practitioners, it’s essential to recognise the psychological impact and incorporate supportive, empathetic care into treatment plans.
Tailoring skincare for menopausal patients with rosacea
When treating rosacea in menopausal patients, it’s important to understand the unique challenges. Menopausal skin is not only more sensitive but also more prone to dryness and irritation. Therefore, a tailored approach to skincare is essential to manage rosacea effectively while also addressing broader skin concerns.
Key skincare ingredients for rosacea management:
- Niacinamide: A form of vitamin B3 with strong anti-inflammatory effects, niacinamide reduces redness and irritation, ideal for sensitive, rosacea-prone skin. It also strengthens the skin barrier, enhancing hydration and resilience.
- Azelaic acid: This gentle acid reduces inflammation, targets acne-causing bacteria, and minimises hyperpigmentation, helping even skin tone especially useful for menopausal rosacea flare-ups.
- Sulfur: With anti-inflammatory and antibacterial benefits, sulfur reduces inflammation and absorbs excess oil, which can trigger rosacea. I often recommend sulfur masks, like the ZO Sulfur Mask, to control oil and soothe the skin.
- Retinol: Known for anti-ageing, retinol also improves texture and boosts cell turnover, preventing clogged pores that exacerbate rosacea. I use it cautiously with rosacea patients, starting at lower concentrations and monitoring their skin’s response.
- Ceramides: Essential lipids that repair and protect the compromised skin barrier, helping retain moisture and shield against irritants that trigger inflammation.
- Hyaluronic acid: Provides deep hydration without clogging pores, soothing dry, sensitive skin and helping maintain moisture balance.
Creating a Comprehensive Skincare Regimen:
For my menopausal patients with rosacea, I emphasise a gentle and hydrating skincare regime focused on strengthening the skin barrier and reducing inflammation. Key aspects include:
- Cleansing: Encourage patients to remove any soaps from their skincare routine, as soaps tend to have a high pH that can disrupt the skin barrier. Instead, use a mild, non-foaming cleanser with a slightly acidic pH to maintain the skin’s natural oils.
- Hydration and barrier repair: Incorporate serums and products with niacinamide, ceramides, panthenol, and hyaluronic acid to soothe and deeply hydrate the skin, reinforcing its natural barrier.
- Targeted treatments: Avoid high-pH products and harsh actives. For gentle exfoliation, consider PHAs (polyhydroxy acids) instead of AHAs, as they are less irritating. Additionally, retinal (a gentler form of vitamin A) is often better tolerated than retinoic acid for rosacea-prone skin.
- Sun protection: Recommend mineral or zinc-based sunscreens, as they are often better tolerated by sensitive skin. These provide broad-spectrum protection without the irritation that can come with chemical sunscreens.
- Hero products: Incorporate PHAs and salicylic acid where appropriate, as these ingredients are often well-tolerated by sensitive, rosacea-prone skin. Retinal, with its gentler profile, is generally preferred over retinol for these patients.
Some words of caution:
- Caution with vitamin C: When the skin barrier is compromised, avoid high-pH vitamin C formulations. If using vitamin C, opt for gentler versions with a pH suited to sensitive skin.
- Consider hormone testing: For patients presenting with both acne and rosacea, I suggest hormone testing to check levels of prolactin, androgens, and cortisol, which can influence skin health.
- pH sensitivity: For these patients, prioritise products with a pH no higher than 6.5, as this helps minimise irritation and supports a healthier skin barrier.
Innovative in-clinic approaches for menopausal rosacea
In addition to a tailored skincare routine, I am conducting a research study focused on exploring advanced in-clinic treatments specifically for menopausal rosacea patients. The aim of the study is to assess the effectiveness of Profhilo, exosomes, and polynucleotides in reducing inflammation and managing rosacea symptoms in this demographic.
Profhilo: Known primarily for its hydrating and skin rejuvenation properties, Profhilo is being evaluated for its ability to strengthen skin structure and reduce inflammatory symptoms associated with rosacea. By stimulating collagen and elastin production, it may offer a unique benefit in managing the delicate and sensitive skin of menopausal patients.
Exosomes: These cell-derived vesicles are rich in growth factors and anti-inflammatory agents, making them a promising option for rosacea treatment. The study examines how Exosomes can accelerate skin healing, reduce inflammation, and improve skin resilience, potentially offering a novel approach to managing rosacea.
Polynucleotides: These molecules work to enhance cellular structure, elasticity, and tissue regeneration. By strengthening the skin’s foundational layers, polynucleotides may provide long-term improvement in rosacea symptoms and help menopausal skin better resist external triggers.
These studies aim to provide a deeper understanding of how these advanced treatments can offer more effective and sustained relief for rosacea symptoms, specifically in menopausal patients. It’s essential to follow up regularly with patients to monitor their progress and adjust treatments as needed. Menopausal skin can be unpredictable, and what works at one stage may need to be adjusted as their skin continues to change.
Addressing the emotional impact of menopausal skin changes
Menopause can bring about profound physical and emotional shifts, and skin issues like rosacea often add to the emotional strain. The visible symptoms of rosacea can affect self-esteem and create a sense of self-consciousness that impacts overall mental well-being. Providing empathetic, holistic care is essential; by managing these skin changes effectively, we can help women feel more at ease during this life transition. A combination of personalised skincare, targeted in-clinic treatments, and ongoing emotional support allows patients to feel truly cared for, addressing both their physical symptoms and their emotional needs. Educating patients about the underlying causes and treatment options also fosters a sense of control, reducing anxiety and promoting a more positive outlook on their skincare journey. This compassionate approach empowers women to embrace this stage of life with confidence.
And finally
Supporting menopausal patients with rosacea means addressing both the visible changes and the deeper emotional impact that often accompanies them. Many of my patients tell me how much they value the way I care for both their skin and their mental well-being, especially during this period of life. Menopause can be challenging, and rosacea’s visible symptoms can sometimes make women feel more self-conscious. I aim to give patients a renewed sense of confidence, knowing they have someone who genuinely cares about their overall wellness makes a world of difference.