Spa Business: Skin and the Hormonal Connection

How menopause and perimenopause affect the skin.
The demographic of older adults is growing, and that means that more of your spa clients are in, or entering into, menopause. The time is ripe to educate—or re-educate—yourself and your skincare staff about the specific effects that this time of life has on the skin, and what can be done on the spa level to address them.

We know that hormone fluctuations and their resulting imbalances are largely responsible for the skin changes we experience throughout our lives. The acne that blossoms in adolescence and young adulthood, for instance, is the result of increased hormone levels that stimulate the skin’s sebaceous glands. And the melasma often seen in pregnant women occurs when melanocyte-stimulating hormone—which is actually a group of hormones produced by the pituitary gland, hypothalamus and skin cells—triggers an overproduction of melanin in the skin, resulting in that patchy, uneven complexion often referred to as “pregnancy mask”.

But what happens when the group that most likely constitutes the majority of your clients, the age 35-to-55 set, begins to experience the effects of flagging and roller-coaster-ing hormones? The better you understand what’s going on, the better you can explain it in simple terms to your distressed clients, and set about creating a professional and at-home skincare regimen that will help keep it under control.

Perimenopause, which may begin as early as age 35, marks the beginning of unpredictability in skin behavior, thanks to the relentlessly yo-yo-ing levels of estrogen and progesterone released by women’s hormonal glands during this time. Estrogen is directly related to two key characteristics of skin: moisture levels and thickness. As both of these begin to wane, the drying and thinning skin begins to sag and wrinkle. Not as much is understood about the effect of progesterone, or lack thereof, on the skin, though research is currently underway.

“Estrogens can increase glycosaminoglycans (GAGs), such as hyaluronic acid, to maintain fluid balance and structural integrity. They can also increase collagen production in the skin, where they maintain epidermal thickness and allow skin to remain plump, hydrated and wrinkle-free,” says Claudia Aguirre, Ph.D., scientific communications manager for The International Dermal Institute and Dermalogica.

Thyroid hormones also play a role, rising and falling during perimenopause and wreaking havoc on just about every aspect of a woman’s physiology, including her skin. Too-low levels lead to dry, rough skin; too-high levels causes flushing and sweating. In general, redness and blotchiness, even rosacea, characterize the transition into menopause.

With all the focus on estrogen and progesterone, it’s easy to forget that women also have testosterone, and it can play a role here too. Imbalances in hormone ratios can result in relatively elevated testosterone, kicking off a stimulation of sebaceous gland activity that leads to acne. How often have you heard your 40-something female clients wailing, “I’m middle-aged and breaking out for the first time since my teens! I have both wrinkles and pimples. How is that fair?” Well, fairness has nothing to do with it, but testosterone does. Even more upsetting is the co-existence of excess oiliness and skin dryness, often a new experience for the client.

Clients going through the skin changes that occur with perimenopause and menopause need more than a sympathetic ear; they need targeted treatment. A skin-healthy diet that includes generous portions of fruits and vegetables, omega-3-rich foods and plenty of water, can get clients halfway there. Some will also opt for medically supervised hormone replacement therapy (make sure to ask clients if they’re undergoing HRT). Refraining from smoking, exercising, avoiding sun exposure and practicing stress management are also crucial.

For topical in-spa and at-home treatment, the following skincare product ingredients are helpful in addressing the typical symptoms of this challenging time.

For controlling pigmentation:
• Retinoids
• Vitamin C

For increasing collagen and elastin production:
• Peptides (amino acids)

For countering redness caused by inflammation and hot flashes:
• Essential fatty acids
• Antioxidants, such as those found in botanicals like chamomile and green tea
• Anti-inflammatory botanicals, such as cucumber and licorice

For addressing dryness:
• Hyaluronic acid
• Essential oils
• Salicylic acid (to exfoliate and enable moisturizers to penetrate pores)