How Does Menopause Affect Your Eczema?

Despite what most think, menopause isn’t a years-long process. It’s actually just the one day that marks a full 12 months since a person’s last menstruation. Everything prior to that is perimenopause and every day after is postmenopause. However, the full cycle from the beginning of perimenopause to crossing into postmenopause is often filled with immense changes to the body, including severe hormonal fluctuations and symptoms like brain fog, hot flashes, mood swings and dry skin. And with all of these changes happening to the body, especially with the impact that hormonal changes have on the skin, it is common for eczema flares to occur too. 

How does menopause impact atopic dermatitis?

Going through menopause is a process that differs for each person in terms of symptoms, and the same goes for how it might impact someone who already has a form of eczema like atopic dermatitis (AD). AD often shows up as dry patches of skin and common symptoms include roughness, scaling and itching among others.  

Regardless of whether you have eczema or not, one of the most notable hormonal fluctuations during menopause is the drop in estrogen. This causes people to experience lower collagen levels, skin dryness and the appearance of wrinkles.^1,2 “Dry, itchy skin is a common problem during menopause,” said Dr. Zelma Chiesa Fuxench, assistant professor of dermatology at the Hospital of the University of Pennsylvania. 

While a lack of hydration can develop in people who are experiencing menopause, it doesn’t always mean that AD will be impacted, but it certainly can be. When the skin is more dry, the eczema flares that you might normally get might feel more irritated because of this. 

“When females undergo menopause, hormonal shifts, such as changes in estrogen production, can result in alterations in skin pH and collagen production, which can impact skin hydration,” said Dr. Chiesa Fuxench. As a result, there is a loss of skin elasticity and strength.¹ She explained that this change in the composition of skin could lead to more itch, a worsening of AD and a harmful itch-scratch cycle.

Do dermatologists see a change in their menopausal patients who have already been diagnosed with AD?

“Research exploring how menopause impacts AD is limited to a small number of studies and much remains to be learned about the association between the two,” said Dr. Chiesa Fuxench. “It is unclear if females who undergo menopause may be at higher risk for developing AD or experience worsening of their AD during this time.” 

When discussing menopause and its relation to AD, it’s important to remember that experiences, symptoms and skin reactions are very nuanced and often fall into a gray area. So when it comes to whether or not dermatologists see a change in their menopausal patients who already have AD, the answer is both “yes and no,” according to Dr. Daniel Butler, dermatologist and director of the Inflammatory and Aging Skin Research Program at the University of Arizona College of Medicine. 

“The reason why I want to say this is that I don’t want people to think that menopause is something that is ultimately going to flare their eczema,” Dr Butler said. “That should not be the perception.” 

However, he notes that there are a few things when it comes to the skin that people should be aware of. “When someone goes through menopause, hormone changes impact the skin because the hormones that are fluctuating have a tendency to decrease the hydration of the skin,” Dr. Butler said. “What we found is that this can impact the microbiome on the skin along with the hydration of the skin. Those are the two things that are impacted by menopause, but not every person who goes through menopause and experiences changes to their skin will have a worsening of eczema flares.”

Does treatment for AD differ during the process of menopause?

“The standard treatments still apply for any forms of eczema, specifically AD,” said Dr. Butler. “You want to make sure you’re hydrating, using sensitive skin practices, staying away from fragrant soaps and products, and then, of course, using topical medications.”  

He also mentioned that anyone who is experiencing very drastic, debilitating menopausal symptoms can look into receiving hormone replacement therapy, either topically via a supplement or systemically. They can get help from an expert, like an ob-gyn, to better regulate hormones that can lead to skin dryness and manage other menopause symptoms. However, this isn’t directly tied to eczema treatments overall. It falls under the broader umbrella of menopause treatments vs. skin treatments. 

“It is important to emphasize that there is very limited data on the efficacy and safety of using hormonal systemic agents — such as hormone pills, patches or implants — for the management of skin-related symptoms and at this time are not part of our usual treatment for patients with AD or eczema,” said Dr. Chiesa Fuxench.

References:

1. Raine-Fenning NJ, Brincat MP, Muscat-Baron Y. Skin aging and menopause: implications for treatment. Am J Clin Dermatol. 2003;4(6):371-378. doi:10.2165/00128071-200304060-00001

2. Rimoin LP, Kwatra SG, Yosipovitch G. Female-specific pruritus from childhood to postmenopause: clinical features, hormonal factors, and treatment considerations. Dermatol Ther. 2013;26(2):157-167. doi:10.1111/dth.12034