Skin aging begins to accelerate in our 40s as we experience the perimenopausal hormonal changes leading to menopause. These changes, like fine lines, sagging, and sun damage, while very normal, can affect how we feel about ourselves and our confidence in the world.
Today’s article will help you understand skin health and aging. You learn how to stay young from the inside out with integrative approaches.
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Skin Structure and the Importance of Collagen
The skin has three layers: the epidermis, dermis, and hypodermis.
The epidermis is only four or so cells thick and creates the skin barrier, your first line of defense against environmental toxins and pathogens. The epidermis is an integral part of the immune system and interacts with the skin’s microbiome, the bacteria and microbes that live on your skin. The epidermis also has keratin for water resistance and melanin to give the skin pigment.
The dermis is the middle layer and is thicker than the epidermis. It contains nerves, blood vessels, sweat glands, hair follicles, and protein. Collagen is the main protein in the skin, providing structure and firmness. Elastin is another essential protein, allowing for stretch and elasticity of the skin.
Finally, the hypodermis, or subcutaneous tissue, contains fat for warmth and cushioning. You’ll also find connective tissue, including more collagen.
Collagen levels begin declining around age 30, decreasing skin hydration, firmness, and elasticity. Collagen loss correlates with signs of skin aging, such as fine lines, wrinkles, and sagging.
The Gut-Skin Axis
Perhaps you’ve heard of the gut-brain axis, the bidirectional relationship between the gut microbiome (all the microbes in the gut) and brain health. The gut also communicates with the skin. In fact, the digestive tract and skin are similar in their barrier and immune functions.
Gut health and skin health inform each other. Imbalances in the gut microbiome affect the skin microbiome and are a root cause of skin conditions, including acne, dermatitis, psoriasis, dandruff, and more.
The microbiome plays a crucial role in women’s health. Hormonal changes, including those in perimenopause, affect the composition of the gut microbiome. And microbiome changes, in turn, affect hormone balance and skin health.
Skin Changes in Perimenopause
Given all these connections, it’s no wonder women experience many skin symptoms and signs of accelerated aging in perimenopause and beyond.
Aging skin affects women’s perceived attractiveness, mental health, and quality of life. Many women seek cosmetic and medical treatments designed to restore the skin’s physical appearance.
The skin changes of perimenopause primarily have to do with declining estrogen levels. Like many cell types, skin cells contain estrogen receptors. Estrogen binding to receptors is critical for collagen and elastin production, vascularity, and skin cell function.
Estrogen-deficient skin correlates with dryness, wrinkles, reduced barrier function, and increased oxidative stress.
Integrative Approach to Skin Health
At TārāMD, we use integrative approaches to address the underlying causes of accelerated skin aging. While many topical products can be beneficial (like sunscreen and antioxidant serums), many of our interventions address gut health, estrogen levels, and other health habits that influence skin health.
Here are some ways to support skin health in perimenopause from the inside out:
A gut-friendly diet means whole, unprocessed food, including healthy fats, quality protein, and colorful carbohydrates full of bioactive compounds. Here are some gut-friendly foods to add to your diet in perimenopause:
If these foods are difficult to tolerate or you need more support with gut health, please work with your TārāMD provider.
Research suggests supplemental collagen improves wrinkles, skin elasticity, hydration, and skin barrier function. Add collagen protein to smoothies, warm beverages like a turmeric latte, or mix into yogurt, broths, or soups.
Quality collagen protein is available through our patient personalized supplement link.
While you can’t control all toxin exposures, you can make a significant impact with simple interventions and swaps.
To learn more about hormone replacement, please read Menopause, the Women’s Health Initiative, and Hormone Replacement Therapy.
Hormone replacement is a prescription and requires a conversation with your healthcare provider, hormone testing, and regular monitoring. It’s an option we believe is underutilized and should be available to more women when it’s a good fit. Dr. Fenske has extra training in hormone replacement and is certified through the North American Menopause Society.
Aging is a privilege; it’s beautiful, and we don’t have to suffer in silence in perimenopause like our mothers did. Luckily, there are many tools, including some discussed here, to support women through perimenopause and beyond. If you are looking for an integrative approach to improve your skin health and slow the signs of aging, reach out for an appointment today.