Aging, Wrinkles And skin laxity

Facial ageing and skin changes during menopause

So how can aesthetic practitioners help patients going through perimenopause? What about those who are postmenopausal? The answers lie in the effects these phases have on the skin and facial ageing.

From perimenopause onwards, menopause can cause a number of changes to the face. These affect both skin quality and facial ageing.

Menopausal skin changes

During perimenopause and menopause, the following skin changes occur due to oestrogen levels dropping.

• Collagen decline: Collagen is the protein that provides structure and elasticity to the skin so declining levels can result in thinner, more fragile and potentially crepey skin
• Elastin decline: Elastin gives skin its flexibility and ability to bounce back. As such, when elastin production decreases it can lead to sagging skin and loss of firmness
• Dryness: Oestrogen helps the skin to retain moisture so, as supplies dwindle and oil production reduces, the skin can become drier and dehydrated. It may also become more prone to itching.

How facial ageing is accelerated by the menopause

As a result of hormonal changes during perimenopause, as well as skin and subcutaneous volume changes, facial ageing can be accelerated by menopause.

• Volume loss: Oestrogen helps to maintain our youthful facial fullness so, as oestrogen levels decline from perimenopause, the face can experience volume loss. This can be particularly noticeable in the mid-face and temples, causing hollowing or ‘sinking’ and sagging
• Loss of elasticity: Elastin helps to maintain the elasticity of the skin, so as oestrogen levels cause it to decline, the skin can become less elastic and more prone to sagging. This can cause the cheeks to descend and the jawline to become less defined. The lower face may start to become fuller as the mid-face ‘sinks’
• Deepening of wrinkles: The loss of elasticity can also lead to the deepening of wrinkles, particularly around the eyes, mouth and forehead. Fine lines may also become more prominent
• Loss of definition: The loss of volume and elasticity can also cause the face to lose definition. This can make the features appear less sharp, folds to become heavier and face shape to look more rounded. 

Other skin changes that may occur during perimenopause 

• Skin texture changes: Look out for rougher or more uneven textures
• Increased sensitivity: The skin may become more sensitive to irritants and allergens
• Hyperpigmentation: Dark spots or patches may develop or become more pronounced
• Slower wound healing: Wounds may take longer to heal due to the thinner skin and decreased blood flow. This is something to bear in mind when discussing recovery time with your patients, especially for microneedling sessions.

Aesthetic treatments for rejuvenating menopausal skin

When we’re considering treatment plans to address concerns related to menopausal skin, it’s important to remember that every patient is unique. From their anatomical presentation to their medical history and goals.

As always, we cannot stress enough the importance of a thorough and open consultation for the best possible outcomes.

Cosmetic dermatology offers a wealth of impactful treatment options for menopausal skin. These can be considered as standalone treatment courses, or combined with other skin treatments, topical skincare and/or cosmetic injectables.

Equally, there are various injectables that can target the signs of ageing, beautifully.

Here are just a few of the common concerns menopausal patients may enquire about and options for addressing them.

Dryness and dehydration

• I will review the patient’s skincare routine to identify any contributing factors
• Offer recommendations for a bespoke topical skincare programme focussed on hydration, bearing in mind their budget, time commitment and tolerance for multi-step routines. Hyaluronic acid, squalane and ceramides boast richly hydrating properties 
• Skin injectables that offer deep hydration, such as Profhilo, are an efficient yet low-maintenance option.

Uneven skin texture

• Again, a topical skincare routine review and personalised suggestions can be beneficial here. Regular use of a gentle chemical exfoliant and suitable retinol use where appropriate
• Chemical peels featuring AHAs such as glycolic or lactic acid, or a BHA - salicylic acid - are extremely effective at tackling uneven skin texture. Retinol peels can also offer a great solution.

Skin laxity

• Microneedling is a wonderful option as it’s suitable for those who don’t want injectable treatments. Those who are happy with a multi-modal approach can combine injectables with microneedling for best effects
• Skin injectables which hydrate and support the skin’s structure are great candidates for mildly addressing skin laxity. These include Profhilo, skin boosters and polynucleotides.

Hyperpigmentation

• I will encourage my patients to wear broad spectrum SPF30 or SPF 50 every day, all year round, in the correct amount, reapplied as directed! Educate them as to how this can help to improve their ageing features and hyperpigmentation, as cosmetic improvements may be the push you need to improve diligence.
• Skincare recommendations for products which promote a more even skin tone, such as retinol or retinal, vitamin C and alpha arbutin, are useful for pigmentation issues. I can address your specific needs with PCA products available online or within clinic. 
• Chemical peels are an effective way to tackle mild to moderate hyperpigmentation without the need for extensive skincare routines at home - not counting that non-negotiable SPF use!
• Polynucleotides have been shown to have skin brightening properties for both under-eye and full-face applications.

Wrinkles

• Retinol or retinoid use is a great at-home solution for minimising the appearance of fine lines and wrinkles
• For a clinical skin treatment, microneedling is a frontline collagen induction therapy which can be effective at reducing fine lines. 
• When it comes to injectables, botox is the primary treatment for dynamic wrinkle reduction, especially in the upper third of the face, the ‘bunny lines’ and the chin
• Profhilo offers another injectable option for those who aren’t keen on toxin, especially if the lines and wrinkles are enhanced by dehydration.

Volume loss

• Judicious use of dermal filler, where the appropriate product is used in the correct dose and injected using the optimal tools, in the right way, will provide meaningful volume restoration results for menopausal facial rejuvenation
• Consider the face as a whole, with potentially smaller doses but more areas being treated, for a more natural result that retains the patient’s authentic appearance. Full-face or ‘multi area’ filler treatment plans can be incredibly effective for this concern. They may benefit from being part of a holistic approach that considers the skin first in order to better prepare the ‘canvas’ of the face for fillers
• Profhilo Structura is a newer addition to the aesthetic practitioner’s toolkit and offers filler-like results by regenerating subcutaneous fat to restore volume in patients with ‘sinking’ and ‘sagging’ facial indications.Menopause 

Teeth grinding, also known as bruxism, is a condition where a person clenches or grinds their teeth, often unconsciously. It can occur during the day or at night while sleeping, with sleep bruxism being particularly common and harder to control. Causes of teeth grinding include stress, anxiety, an abnormal bite, crooked teeth, or sleep disorders like sleep apnea. Over time, bruxism can lead to worn tooth enamel, increased tooth sensitivity, jaw pain, headaches, and even damage to dental restorations. Treatment often involves stress management, behavioral therapies, the use of mouthguards at night, and addressing any underlying dental or medical issues. Early detection and intervention are important to prevent long-term damage.

Botox injected in to the Masseter Muscle can relieve the tension and prevent the grinding 

At Primrose-aesthetics, we provide a wide range of cosmetic services including removal of thread veins. Microsclerotheraphy is  the most preferable treatment for thread veins below the heart.

As thread and spider veins are minute. A tiny needle is used to inject a small amount of sclerosant which destroys the vein. 

To achieve optimum results, the treated area needs to have continuous compression for 7 days and nights. 

A consultation is required prior to the appointment for the procedure to assess the areas to be treated and measure you for compression stockings. These can then be brought to the clinic on the day of the procedure. 

The stockings can be ordered for you at an additional cost. 

The consultation fee is part payment for the procedure. 

Hay Fever Injections (Kenalog 40mg) belong to a group of medicine called corticosteroids (steroids). Kenalog IM Injection is for the treatment of joint pain, swelling and stiffness in inflammatory disorders such as rheumatoid arthritis. 

A Kenalog injection helps many people with their symptoms of severe hay-fever. For many people it completely relieves the symptoms for the entire season and for others it reduces the severity of the symptoms to a point where adding other treatments can allow life as normal. 

A full consultation and assessment is required prior to the medication being prescribed.