Most women fear the "change of life" known as menopause because of symptoms like hot flashes, mood swings and loss of libido. However, there are other problems that are less well-known, including skin changes that can cause blotchiness and rashes and affect your appearance. The majority of these aren't serious and can be controlled with over-the-counter treatments.
Menopause is defined as having occurred when you go for 12 consecutive months without a menstrual period. During the months and years leading up to menopause and following, the hormones in your body start fluctuating, and the levels of hormone like progesterone and estrogen gradually decline. Estrogen affects every organ of your body including skin, with estrogen receptors most abundant in the areas of your face, genitals and lower limbs, the reason these areas are frequent sites of skin rashes. Perimenopausal and menopausal women experience thinner, looser and less elastic skin, reduced production of collagen, cessation of oil gland function and dry skin.
Most skin rashes that appear around menopause are caused by excessively dry skin, although temporary red flushing of the skin is also common. However, there are other rarer conditions that can occur around this time, including vulvar lichen sclerosus that causes itchy white spots and patches on the vulva; keratoderma climactericum, with itchy and painful cracking and splitting on the palms and soles; and rosacea, causing facial skin flushing and red, tender acne-like bumps. Since some menopausal women also suffer from thyroid disorders, those conditions can lead to skin problems like pretibial myxoedema that causes an "orange peel" appearance on the shins and feet.
If you suffered from acne during your teen years, then it's likely you may develop an adult form of the condition during menopause. It stems from the imbalance between the estrogen and androgen hormones that over-stimulate the oil glands and hair follicles. This type of acne is typically found on the lower part of the face, jaw and neck and may not respond to the same treatments as teenage acne.
Most mild cases of menopausal skin rashes can be prevented by avoiding harsh soaps and not rubbing the skin and through the use of over-the-counter moisturizers and sunscreen. You should look for skin and hair care products labeled "non-comedogenic" or "non-acnegenic," and never pick, squeeze or pop any lesions. You may need prescription treatments from your doctor for your adult acne and the other types of rarer skin conditions, including topical retinoids and steroid creams or oral medications like antibiotics or tetracycline. Rashes from hot flashes may respond well to antihistamines.
Although hormone replacement therapy was once the gold standard for treating menopausal symptoms, it's now only used in limited cases, due to the increased risk for blood clots, stroke, heart disease and breast cancer. Your doctor will be able to tell if this therapy is worth the risks for you. If your menopausal acne is accompanied by excessive facial hair, thinning hair or bald patches on your scalp, it could be a sign of polycystic ovaries, adrenal hyperplasia, or a hormone-secreting tumor located in your adrenal gland or an ovary. Also, any rash associated with a mole that has suddenly changed size, shape or color, should be examined for signs of skin cancer.