Navigating Menopause: Understanding Hormones and Skin Changes

The fall in oestrogen during the menopausal transition can cause a wide range of symptoms. Besides the commonly known vasomotor symptoms like hot flushes and night sweats, women can also experience a range of other issues, such as irritability, sleeping difficulties, joint pain and vaginal dryness to name just a few of many.

It is less often mentioned how the menopause affects changes to the quality of the skin and the effects hormone replacement therapy have on the biggest organ of our body, the skin.

Loss of oestrogen causes changes to the skin

As we age our skin becomes thinner and it loses elasticity. As the architecture of our skin changes, the skin becomes drier. A third of dermal collagen may be lost in the first five years after menopause and we continue to lose approximately 2,1% of our collagen per year. The  skin thickness decreases by 1,1% every year. Our skin becomes more prone to injuries and bruising, we notice that wound healing becomes slower. The fat compartments in the cheeks descend causing marionette lines and jowls to appear in the face, making it look more saggy.

Understanding the natural ageing process 

Ageing of the face is a natural process that is influenced by extrinsic and intrinsic factors. Extrinsic factors like UV exposure are often preventable. Sunlight will cause photodamage to the skin, causing pigmentation and fine wrinkles. Smoking is another extrinsic factor, which  can damage collagen and therefor accelerating the loss of elasticity over time.

Our diet plays an important role in the glycation of collagen, which can contribute to premature skin ageing and the elastic fibers of the skin becoming rigid.

Sleep deprivation is an example of an intrinsic factor. The lack of sleep can make us age faster. Women in the perimenopause are often troubled by sleeping problems, most commonly women in the menopausal transition complain that they are waking up early. This can start years before the first hot flushes occur. Sleep deprivation can increase DNA damage and decrease the body’s ability to repair damaged DNA. The loss of sleep also drives up inflammation. If a patient doesn’t sleep well, they may feel more irritable and their concentration may be reduced, which can have a huge impact on their work and their relationship.

When we give combined bioidentical HRT containing micronised progesterone, one of the benefits that many women appreciate is that women are able to sleep again, which is a big improvement for their quality of life.

Bioidentical HRT helps to maintain bone mass and reduce the risk of fractures caused by Osteoporosis. We can perform a DEXA scan to check your bone health in the hip and spine for the years to come. From an aesthetic perspective, it is interesting that over the years we even lose bone structure in the face. We have learnt from studies that as we age, our eye sockets widen and that our brow bone and chin recede, which affects the soft tissue above and the appearance of the face and neck.

So how does Oestrogen work on the skin?

We know that there are two receptors, the oestrogen receptor alpha and oestrogen receptor beta.  The latter is the receptor, which is expressed on skin cells. During the perimenopause this receptor becomes less expressed in the skin and additionally the levels of oestrogen drop as the body can produce less endogenously.

Oestrogen may protect against oxidative damage, it increases the synthesis of elastic fibre, collagen type II and Hyaluronic Acid. It therefor helps to protect the skin, to keep it elastic and hydrated.

How can you look after your skin? 

The photo damage caused by UV exposure is avoidable by wearing a good sunscreen with high UVA and UVB protection. In my opinion, prevention is key and I wear a light SPF50, which is not greasy or shiny, every day to protect my skin from sun damage. However you then have to consider, if you your body is able to build enough Vitamin D or if you require supplementation. We can offer a blood test to check your level.

A diet low in sugar will slow down the loss of collagen alongside other long-term metabolic benefits. If you’re a smoker, your GP can support you with smoking cessation increasing the success rates of stopping, preventing the worsening of perioral lines.

Skin boosters can help rehydrate the skin from inside and boost it with antioxidants. Dermal fillers can help to restore the volume of the cheeks counteracting the gradual descend of the fat pads.

What if I have perimenopausal symptoms? 

If you’re troubled by perimenopausal symptoms like hot flushes, night sweats and sleeping difficulties, please speak to a doctor about the risks and benefits of treatment with bioidentical hormone replacement therapy and if it may be suitable for you.

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Ten ways to make your face look younger

mSkin’s Dr Liz McCulloch offers some advice on how to look great for your age.

Whether it’s your sleeping patterns, stress levels, eating habits, exercise regime or skincare routine – all of this has an impact on your face and the health of your skin.

It makes sense that if you want to bring about any changes in the way you look, you’ll have to make a few changes in the way you live.

Here are ten ways of reviving your skin, with nothing to lose but a few wrinkles!

1. Protection from the sun

Exposure to ultraviolet light breaks down collagen, causes age spots, deep wrinkles and sagging. Wear sunscreen that is broad spectrum (UVA/UVB) all year round to reduce the risk of future damage and to protect you against skin cancer.

Tip: don’t forget to protect the tops of the ears, the hands and the “V” of the neck.


2. Nicotine

There is evidence that smokers suffer from more lines and wrinkles than non- smokers. Nicotine causes narrowing of the blood vessels in the top layers of your skin. This impairs blood flow to your skin, reducing the amount of oxygen and nutrients it gets, such as vitamin A. The thousands of chemicals in tobacco smoke damage collagen and elastin, which are fibers that give your skin its strength and elasticity. Pursing of lips when inhaling and squinting of eyes to keep out smoke also cause wrinkles.

Tip: your GP surgery can book you an appointment for Smoking Cessation Advice and Support.


3. Avoid sugar

Sugars break down collagen and accelerate ageing in the skin, leading to sagginess. Cutting down on the sweet stuff will make your skin firmer, noticeably clearer and brighter.

Tip: try a sugar-free day and if it goes well extend it to a week or even a month.


4. Practise relaxation or take up meditation

Stress is ageing. Getting into the habit of relaxing your face, whether its through deep breathing, yoga or meditation will ease the lines of tension and worry that we all develop with the years. Relaxing also aids sleep – the time when cells are busy repairing DNA damage from the day before. Beauty sleep really isn’t a myth!

Tip: get up 15 minutes earlier every day to practice meditation or simple stretches.


5. Wrinkle-relaxing treatments and Dermal Fillers

Forget frozen foreheads, it’s not about looking ten years younger overnight. It’s okay to have a few laughter lines but injections of Botulinum Toxin A can prevent and soften facial expression lines, such as frown lines and crows’ feet. Dermal fillers can make an immediate difference to laughter lines and increase the volume beneath the skin, giving a fuller, more youthful appearance.

Tip: ensure the person offering the treatment is professionally trained, qualified and experienced.


6. Laser treatments and chemical peels

Intense pulsed light treatment (IPL) can be used to remove age spots and fine lines caused by too much ultraviolet exposure. The laser treatments smooth wrinkles by destroying old skin and forcing the skin to regenerate itself, breaking up the pigment that forms the spots. Two or three treatments are usually required, depending on the extent of pigmentation. A course of skin peels is another effective way to remove older, mottled, wrinkled skin and reveal fresher layers beneath.

Tip: do your research and make sure the procedure is carried out by a healthcare professional.


7. Drink plenty of water and cut down on alcohol

When we’re dehydrated the body uses the water available for essential organs such as the heart and liver. The skin is not given biological importance. Boosting your intake ensures that water, needed for skin cell formation, goes to the skin too.

Drinking water improves the way your insides work and good gut health is soon reflected in glowing skin. Alcohol not only dehydrates the body but it has a general inflammatory effect that encourages ageing.

Tip: sometimes our body confuses a thirst signal for a hunger signal. Drink a glass of water before a meal or a snack.


8. Use Retinoids

These vitamin A derivatives have been proven to boost collagen production (reducing wrinkles and preventing fine lines), even out discolouration, brighten skin tone, unclog pores and reduce acne. Retinoid creams make the skin supersensitive to sunlight so use them before bed and apply a sunscreen every morning.

Tip: Use retinoids sparingly and only at night.


9. Antioxidants

Antioxidants are our body’s defences against free radicals that may lead to premature ageing and disease. Eat plenty of anti-ageing foods, including

carrots and tomatoes (stimulates skin cell growth and builds collagen for skin elasticity). Hazelnuts and brazil nuts are good too, they contain essential fatty acids that help replenish collagen, naturally moisturise the skin and promote skin firmness.

Tip: jazz up green salads with grated carrot, beetroot and apple.


10. Exercise regularly

Anything that gets you moving will improve your circulation, which helps with skin renewal as it promotes blood flow and transports nutrients to the skin’s surface, creating a healthy, youth-enhancing glow.

Tip: sign up for a morning workout session with a friend and start getting your weekly endorphins flowing.


For more information about dermal fillers and wrinkle-relaxing treatments contact


Dr Liz McCulloch is a GP and Cosmetic Practitioner based in Brighton and Hove.

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Thinking of Dracula therapy? Dr Kambiz Golchin, a leading expert in the field of skin rejuvenation, offers some words of advice.

Dracula therapy works using your own blood to rejuvenate the skin. It’s a 100% natural skin care treatment.

Also known as Platelet Rich Plasma (PRP) Injections, it’s used to stimulate the growth of collagen and to improve the skin’s texture and tone.

During the procedure, a small amount of blood is drawn from the arm into a sterile tube, much like a standard blood sample.

The tube containing the blood is placed into a piece of equipment that separates the plasma and platelets from the other blood components.

Using a small sterile needle the plasma and platelets are injected into the face, rejuvenating the skin and reducing any obvious facial lines, wrinkles or acne scars.


Advice from the expert

Dr Kambiz Golchin, a consultant ENT and facial plastic surgeon who carries out the method in London and at his clinic in Ireland, says it has many benefits:  “PRP is a great skin care treatment on its own or in combination with other treatments. It can be considered as an ‘organic’ treatment, which can especially suit patients who are keen on a more natural approach.”

It can lead to healthier skin, he says, and a glow that is still present weeks down the line.

He says that there are different types of PRP so advises anyone considering having the treatment to do their research. “Check which PRP you are having. Not all PRPs are the same. The concentration and the quality of PRP makes a big difference.”

He adds that it’s essential that the procedure is carried out by a skilled medical practitioner: “Not every practitioner can do this. It should be performed by a skilled medical practitioner with excellent knowledge of anatomy and the products for contouring the face.”


General information

Are there different types of PRP?

Yes. There are three main types of PRP treatments.

The first involves injecting plasma and platelets from your own blood; the second combines this procedure with a Hyaluronic acid dermal filler and the third combines it with laser therapy.

Are the results immediate?

No. Swelling from the fluid is what you will see and feel first. Over the days/weeks there will be more collagen growth.

Are there side effects?

Minimal swelling, bruising and redness for 12 to 24 hours.

How long does it take?

30 to 45 minutes.

How many treatments will I need?

Most people will require one to three sessions. The results last up to 18 months.

Can it be combined with other treatments?

Yes. It can be combined with other treatments, including wrinkle-relaxing injections and Dermal Fillers.

Dr Kambiz Golchin

Dr Kambiz Golchin

For more information about dermal fillers and wrinkle-relaxing treatments contact



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Austrian dermatologist Martin Zikeli talks to mSkin about his top skincare tips and the future of anti-ageing.

Skin ageing is influenced by a person’s genetics, hormones and metabolism as well as their sun exposure, nutrition, stress levels and whether they smoke and exercise.

A good anti-ageing regime is a holistic one, combining skin-ageing prevention with various therapeutic methods.

My top anti-ageing tips include:-

1)   Avoid sun, smoking and stress.

2)  Have a daily skincare routine with sunscreens in the morning and a cream containing retinol (one of the animal forms of vitamin A) in the evening.

3) Include antioxidants in your diet, such as vitamin C, B3, E, polyphenols (found largely in fruits, vegetables, coffee, tea, nuts, legumes and cereals) and flavonoids (found in virtually all fruits, vegetables, herbs and spices). The powerful antioxidant Resveratrol has anti-ageing benefits too and can be found in foods such as blueberries, grapes, peanuts and jackfruit.

The future of anti-ageing   

In the future we will develop technologies to deliver skin nourishment, such as antioxidants, directly into the cells of our skin and our whole body.

We will also be influenced by epigenetics – the science of how environmental factors such as stress levels at work, exposure to toxins and what we eat might be subtly altering our genes – and hence the way we look.

Dermal fillers and wrinkle-relaxing injections

For now though, dermal injections of hyaluronic acid can be effective in promoting skin rejuvenation by increasing both hydration and plumping the skin.

Wrinkle-relaxing injections on a regular basis can slow down the visible ageing process by helping in the management of certain facial lines and wrinkles.

It’s important to remember though, that in clinical practice, “to look better” doesn’t mean “to look younger”.

That is why it’s essential to understand patients’ wishes and have a realistic therapeutic goal.



Martin is a dermatologist and a consultant in the Department of Dermatology at the State Hospital Wiener Neustadt near Vienna. He also has a medical practice.


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Face yoga expert Julia Anastasiou talks to mSkin about the benefits of a facial workout


What is facial yoga? 

I teach the Danielle Collins method of facial yoga. It is a combination of exercises, massage, acupressure and relaxation for the face. It also involves wellbeing techniques for the mind, body and soul.

How does it work?

It is designed to rejuvenate and tone the face and neck.

The idea is that just as our body needs regular exercise to stay toned and firm, the face and neck muscles also need to be exercised.

I teach you how to isolate and strengthen your facial muscles. In time the muscles become firmer and the skin attached to the muscles is lifted and tautened.

Massaging the face helps to increase the circulation, lymph flow and remove toxins.

The acupressure works by pressing certain points on the face to reduce tension and increase circulation.

Face yoga works on a mental and emotional level too. Through breathing techniques and guided visualisations I teach you to relax the face, which helps to prevent the deep sets lines and wrinkles often caused by stress. Taking time to relax can make you feel calmer and more energised – with the results showing in your skin.

How can it benefit our skin?

It helps you achieve a rosy glow, prevent new lines and wrinkles forming, a firmer jaw line and improved skin tone.


What areas of the face does it help most?

It works most commonly on the eyes, cheeks and jawline.

It can help you look brighter around the eyes, have greater fullness around the cheeks and a more toned jaw.

How long is the exercise programme?

There are 18 main techniques for the face. Each workout takes 20 minutes (10 minutes for the upper face and 10 minutes for the lower face). We advise that the 20-minute programme is done daily, six times a week with one day’s rest.

How can we learn the exercises?

You can attend a class or have Skype sessions. There is also a DVD available.

More details about the Danielle Collins facial yoga method here:

and here


The content within this blog post raises awareness of current and new ways of caring for your body and skin. mSkin cannot accept responsibility for efficacy of any of those treatments or how the readers of this blog post choose to use or act upon its content.

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New year resolutions for your skin

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