Your skin serves a critically important role in your health, but most of us pay attention to it because it forms a large part of our external identity. For most of us, the importance of feeling good about our skin cannot be overstated – and this is why cosmetics and skin-care products are billion dollar industries in our society.
Aging is a fact of life. While that is easy to understand, it can be difficult to experience, especially because changes to our skin seem to happen suddenly. It may seem sudden, but in fact changes to your skin have been happening for decades. Daily skin care and constant use of sunscreens can delay signs of aging, but at some point they will become obvious. Additionally, your past behaviours – especially your use of sunscreen and your history of smoking – will have an impact on how quickly your skin shows its age, and how significant those changes are.
Changes in your levels of estrogen during the menopausal transition also play a big role in changes to your skin because estrogen is very involved in your skin’s health and repair (if damaged).
For women, the menopausal transition can lead to multiple symptoms affecting the skin, hair and nails. Common symptoms include:
Acne isn’t just for teenagers. Like teenagers though, the menopausal transition is a time of hormonal fluctuations. Women experience not only a drop in estrogen levels but they may also experience an increase in male androgen hormones including testosterone, due to the imbalances created by the loss of estrogen.
You may still experience menopausal acne even if you’re using hormone therapies (HT) to ease your menopause symptoms. This is because some HTs use an influx of the hormone progestin to replace the estrogen and progesterone your body loses. Introducing this hormone to your system can cause your skin to break out. 
Being out in the sunlight feels good to most people. While some sunlight is healthy, the sun gives off ultraviolet (UV) radiation and this radiation has both health risks and some health benefits. On the benefits side, it is this radiation that gets converted by our skin into vitamin D. The health risks, explained in more detail in the Science section, are directly affected by how much exposure to UV radiation you experience. It is this exposure to UV radiation that causes skin damage – the more exposure you have, the greater the damage will be and the earlier it will show up on your skin. Sun damage that shows up during the menopausal transition includes the presence of brown spots, formally called solar lentigo. These are also called age spots or liver spots. Skin growths may be forms of skin cancer, and they usually result from long-term exposure to UV radiation. If you see any growths or moles on your skin that look different or are changing rapidly, immediately consult your healthcare provider.   
Many women find that they bruise more easily after they enter the menopausal transition. A bruise is simply blood trapped under your skin. Most minor bruises disappear after a day or so, as the body heals, but the length of time to heal from a bruise is variable. Any bump or impact against your skin that impacts the blood vessels below can cause a bruise. The increase in noticeable bruises as you go through the menopausal transition is due to the thinning of your skin and the decrease in the protective layer of fat (subcutaneous fat) that is found right under your skin. Both of these happen because of lower estrogen levels in your body. 
Be aware that bruising easily can be the result of an underlying condition other than the menopausal transition, such as a blood-clotting problem or a blood disease. If you start to see large bruises, especially on your trunk, back or face, or bruises that seem to appear for no known reasons or suddenly begin bruising after starting a new medication, see your healthcare provider immediately. 
Estrogen is responsible for the production of collagen, a protein that is very important to the structure and function of your skin, and estrogen stimulates the production of the natural oils that keep your skin smooth and hydrated. As estrogen levels begin to decrease, the production of your natural oils starts to diminish. When this happens, it immediately affects your skin, making it feel dry and itchy.  
In menopause, skin quickly loses collagen. Collagen is a protein that is essential for your overall body health, and especially for the look and feel of your skin, hair and nails. Studies show that women’s skin loses about 30% of its collagen during the first five years of menopause. After that, the decline is more gradual. Women lose about 2% of their collagen every year for the next 20 years.
As collagen diminishes, our skin loses its firmness and starts to sag, resulting in jowls and large pores. Wrinkles, such as laugh lines, are visible all the time. Other creases become permanent, including frown lines and other lines around the mouth. The slower production of natural oils in your skin, also a result of lower estrogen levels, adds to the visible wrinkles, 
The pH level of our skin changes with age, and this can cause associated changes in the skin’s appearance and sensitivity. Women in the menopausal transition may find that their skin is more irritable and that they develop rashes more easily and frequently. As well, women with existing skin conditions, such as eczema or rosacea, may find that those get worse and flare-ups become more frequent.
You have sweat glands covering almost every inch of your body. Your sweat glands excrete a fluid that primarily works to regulate body temperature. Body odor happens when bacteria break down this secreted fluid that is mixed with the natural oils on your skin. Excessive sweating during hot flashes and night sweats increases the amount of sweat that women produce, but this doesn’t directly affect your body odour – the amount of sweat is not actually correlated to the strength of your body odour. Your changing hormone levels are more likely to impact your body odour because they affect the production of your natural oils, or change the pH of your skin which affects the type and amount of bacteria living on your skin. Common areas where your odour can noticeably change include under your arms and in the creases of your groin.  
There are many approaches to taking care of your skin that do not require prescriptions, although you should inform your healthcare provider or dermatologist of anything that you are doing – there may be impacts on treatments that they suggest or prescribe.
To prevent minor bruising, take steps to avoiding falls and injuries:
Unfortunately, once a bruise has formed, not much can be done to treat it. Most bruises eventually disappear as the body reabsorbs the blood, although healing might take longer as you age. It might help to elevate the affected area and apply ice. 
Body odour has multiple causes, so if your odour has changed significantly you should talk to your healthcare provider to assess the cause. Home treatments you can try include:
At age 40 find a reliable, educated primary care provider familiar with recognizing and treating symptoms of perimenopause and menopause. The North American Menopause Society provides a list of menopause practitioners here.
Many of the treatments for your skin will be over the counter, home therapies. Regular gentle cleansing with ample moisturizer, for example, is going to be the bedrock of your skin care for most signs of aging and estrogen depletion. There are treatments, however, that need to be overseen by a professional – either your regular healthcare provider or a board certified dermatologist. Hormone Therapy (HT) may be one approach, as the root of menopausal transition problems with skin are driven by changes to your hormones.
Treatments are available to lighten or even remove age spots. These treatments work by treating the pigment of your skin, which is located at the bottom of the upper layer of skin. Decisions on which treatment(s) to apply should be made with your healthcare provider or your dermatologist as side effects are possible and some of these treatments can worsen other existing conditions (such as rosacea). All of the following treatments are done in a doctor’s office. Treatments can come in the form of:
Women and wrinkles. There is a great deal of individual variability in how bothered women are when their skin starts to change and show more and deeper wrinkles. We fully support the idea that we are all beautiful as we are, wrinkles and all, but we also support the idea that addressing signs of aging can be important and can make us feel good. It is important to remember that wrinkle treatments do not actually remove the wrinkles permanently, but they can reduce them, smooth them, or make them less noticeable. Decisions on which treatment(s) to apply must be made with your healthcare provider or your dermatologist as permanent side effects are possible. Treatments include:
  
While over the counter products are available, they may not be adequate to treat your hormonal acne unless it is mild. If your hormonal acne is mild, over-the-counter (OTC) products may be successful, but often, hormonal acne results in cystic bumps that form deep under the skin and topical medications won’t reach them. Consult with your healthcare provider or your dermatologist to determine the best course of treatments for your individual situation. Medical treatments for hormonal acne include:
There are medical treatments for body odour, focused on either reducing the amount you sweat or reducing the amount of bacteria on your skin. The following treatments can be used:
Your skin, hair, and nails together make up your integumentary system, which in addition to containing the largest organ in your body (your skin), also forms the physical barrier that protects your internal environment from the outside world. Its other functions include helping regulate your temperature and fluid balance, making Vitamin D (from sunlight) and sensing stimuli (sense of touch). The skin contains immune cells (including myeloid and lymphoid cells) some of which have the ability to activate the body’s larger immune system if necessary. The skin plays a key role in healing wounds, controlling the coagulation of cells to form a clot (a scab), inflammation, growth of new cells and the final remodeling stage resulting in new healed skin. 
The main parts of the integumentary system are the epidermis, dermis, hypodermis, associated glands, hair, and nails.
Your skin has two layers – the outer layer called the epidermis, and the inner layer called the dermis. The epidermis is the outer shield for your body. When it is damaged or gets old it peels (you will likely be familiar with this if you have ever had a sunburn), with the new epidermal tissue growing up from below. The epidermis does not have its own blood supply – it uses the blood from the dermis to get its nutrients.
The dermis supports the epidermis and contains all of the structures of the skin, including the blood and vessels, nerves, sweat and sebaceous glands, hair follicles and the tiny erector muscles that pull your hair up when you get goosebumps.
The hypodermis, also called the subcutaneous layer, is a third layer below the dermis that forms ‘padding’ between the skin and the organs beneath the skin. It is made up of adipose tissue (fat) and areolar tissue (loose connective tissue or LCT). This layer provides both cushioning and insulation, and is found all over the body. 
Your skin contains four different types of glands – sweat glands, sebaceous glands, ceruminous glands and mammary glands. There are two types of sweat glands – eccrine glands and apocrine glands. Eccrine glands excrete a fluid directly to the surface of the epidermis, your skin, and as this sweat evaporates it cools your body and regulates your body temperature. This sweat doesn’t usually cause any smells. The second type of sweat gland, apocrine glands, excrete a sweat into your hair follicles, not directly to the surface of your skin. The sweat that these glands excrete doesn’t smell until it combines with bacteria on the surface of your skin. The bacteria break down this secreted fluid and it is this process that causes body odour. Apocrine glands do not become active until puberty, which is why children do not have body odour. Sebaceous glands are found in the pilosebaceous unit, so they are associated with a hair follicle and shaft. These glands secrete a substance called sebum that makes up the natural oils covering your skin in a thin film. This adds a protective layer on top of the epidermis and works to repel bacteria as well as keep your skin moisturized.  
The sun produces a massive amount of energy and some of that energy hits the Earth in the form of UltraViolet (UV) light radiation. On the electromagnetic or light spectrum, UV light has shorter wavelengths (measured in nanometers or nm) than visible light, so your eyes can’t see UV, but your skin can feel it. Tanning beds also emit UV light radiation.
Two types of ultraviolet light called Ultraviolet A (UVA) and Ultraviolet B (UVB) light are damaging to your skin. UVA has a longer wavelength, and is associated with skin aging and cancers while UVB has a shorter wavelength and is associated with skin burning. UVA accounts for up to 95 percent of the UV radiation reaching the earth.
Sunscreen products are all labeled with a Sun Protection Factor (SPF) that tells you how long it will take UVB (and some UVA rays) to redden your skin when using that product compared to the time it would take without using sunscreen. UVB rays can damage your skin all year long, not just in the summer. The greatest risk is late-morning to mid-afternoon from spring to fall in temperate climates like North America, but the risk is also high at high altitudes or on reflective surfaces like snow, ice, or water. UVB rays can be filtered out, for example, they do not penetrate through glass.
Sunscreens were initially made to screen UVB rays but as understanding of the risks associated with UVA increased, sunscreens started to add ingredients to make them “broad-spectrum” and current products labeled broad-spectrum protect against both UVA and UVB rays. Note that UVA rays do not get filtered easily and can penetrate glass and cloud cover unless you purchase specialty film filters for the glass in your home and car.
If your skin is not protected from exposure to UVA and UVB, they damage the DNA in skin cells and produce mutations that can lead to skin cancer as well as premature aging. They can also cause eye damage, including cataracts and eyelid cancers.
UV radiation is proven to cause skin cancer – either basal cell carcinoma and/or squamous cell carcinoma – both of which usually appear on skin that has been exposed to the sun. These types of cancers respond well to treatment if they are caught early so it is important to check any sun-exposed areas of skin for growths or moles that seem to be changing.
Sunburn caused by UVB has been proven to be associated with developing melanoma, the most dangerous form of skin cancer. The UV rays that damage skin can also alter the gene that suppresses tumors increasing the risk that skin damaged by the sun will develop skin cancer.
While it all seems overwhelming and dangerous, protecting your skin against UVA and UVB exposure is easy. Broad-spectrum sunscreen and sun-safe clothing, hats and eyewear are easily available. All you need to do is use them! 
No. Absolutely not.
Your skin is not your muscles – you don’t want to feel the burn. If your skin burns, stings or tingles when you use a product it means your skin is being irritated. Stinging and burning are also indicators that the pH of your skin is being altered and your natural oils are being stripped off of the surface of the epidermis. These can all lead to more acne, blemishes, dryness or wrinkles. Be kind to your skin and use products that make it feel good.
Genetics plays a role in how you age and when your age starts to show, but like most other factors in life, there is also a large role played by your behaviour and your environment. Your natural aging process will be affected by your skin care routine and by the amount of exposure you have to sun and UV light. Other environmental factors, such as cigarette smoke, pollution, heavy drinking or chronic insomnia, can also speed up the appearance of aging.
Wrinkles are usually the first thing that people notice as they age, but there are other signs that trained dermatologists or skin care technicians can see, including skin tone, fine lines, colour changes and changes in texture. It is never too early to start a good skin care routine that will delay the signs of aging for as long as possible.
Research suggests that prolonged sun exposure does not increase levels of vitamin D because the body can only absorb a limited amount of vitamin D at a time. Prolonged sun exposure will, however, increase the risk of skin cancer and premature aging. Most people need about 10-20 minutes of sunlight a day to meet their vitamin D requirements. This varies slightly based on the lightness or darkness of your skin tone. You should get more than enough sun exposure walking to your corner store. If you think you could be at risk of a vitamin D deficiency speak to your healthcare provider.
It sounds like SPF 50 is way stronger than SPF 30 but the truth is that SPF 30 sunscreens filter about 96.7% of UV radiation while SPF 50 sunscreens filter 98% of UV radiation.  Your sunscreen should be a minimum of SPF 30, and remember to reapply it every two hours, after swimming, sweating, or towel drying.
Darker skin tones are still susceptible to cancer because UVA and UVB rays still penetrate the epidermis to the dermis. Regardless of skin type, exposure to UV radiation from the sun and other artificial sources can cause skin to be permanently damaged.
Yes, unless the cosmetic product is labeled SPF30 or higher, is also a broad-spectrum sunblock, and you are only out for a short period of time in the sun. You will need to wear additional sunscreen under your makeup if you’re going to be in the sun for an extended period. For longer periods of time in the sun, use a separate sunscreen and reapply it every two hours. Look for the label – most cosmetics offer no sun protection whatsoever.
Not at all.
Having darker skin from a fake tan does not block UVA or UVB rays. To do this you need to use a proper broad-spectrum sunscreen. Some fake tanning products are rated with an SPF (sun protection factor), so if the SPF is above a 30 and if the product is certified broad-spectrum, you may be fine for limited exposure right after you apply it. Remember that all sunscreens need to be reapplied every few hours and after getting wet so don’t rely on your fake tan with sunscreen for long-term protection beyond what you would get with a regular sunscreen.
Not true at all.
You can get sun damage on windy, cloudy and cool days because sun damage is caused by ultraviolet (UV) light radiation, not temperature. UV radiation penetrates cloud cover and remember it is a light wave – it doesn’t get blown around. Sun damage is also possible on cloudy days, as UV radiation can penetrate some clouds, and may even be more intense due to reflection off the clouds. Most weather apps have a UV forecast that can indicate the true level of UVA and UVB rays on any given day so you can check and this will remind you to put on a broad-spectrum sunscreen.
[4a] Herman, J., Rost-Roszkowska, M., & Skotnicka-Graca, U. (2013). Skin care during the menopause period: noninvasive procedures of beauty studies. Postepy dermatologii i alergologii, 30(6), 388–395. https://doi.org/10.5114/pdia.2013.39430
[4c] Man, M. Q., Xin, S. J., Song, S. P., Cho, S. Y., Zhang, X. J., Tu, C. X., Feingold, K. R., & Elias, P. M. (2009). Variation of skin surface pH, sebum content and stratum corneum hydration with age and gender in a large Chinese population. Skin pharmacology and physiology, 22(4), 190–199. https://doi.org/10.1159/000231524
 Stevenson, S., & Thornton, J. (2007). Effect of estrogens on skin aging and the potential role of SERMs. Clinical interventions in aging, 2(3), 283–297. https://doi.org/10.2147/cia.s798
 Kim JY, Dao H. Physiology, Integument. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554386/