Menopause officially begins one year after your last period, and can bring many changes to a woman’s body – especially to the skin. In this article, we explore how menopause affects the skin, traditional estrogen treatment, and promising cosmeceuticals in preventing and treating signs of aging in menopause skin.
How does menopause affect the skin?
Estradiol levels, one of the three major estrogen hormones secreted by the body, declines to nearly zero after menopause. This estrogen-deficient condition can lead to a dramatic reduction in overall skin health and appearance, due to the negative impact on dermal cellular and homeostatic mechanisms. These changes appear in the form of loss of collagen, loss of elasticity, increased MMP (enzymes that break down collagen) activity, which result in dryness, wrinkles, impaired wound healing, decreased antioxidant activity. These changes may affect self-esteem, psychological health, and increased physical perception of aging.
Traditional estrogen treatment
Since the 1940s, estrogen hormone preparations have been a popular treatment for menopausal women to treat symptoms such as hot flush (sudden feeling of heat, mostly over the face, neck and chest). This Menopausal Hormone Treatment (MHT) was later changed to include the addition of progestin to avoid the development of health conditions such as endometrial hyperplasia, and cancer.
There have been few studies that measure the effects of normal dosage of MHT on skin health, with most studies on the effects of estrogen on skin health dating from the time estrogenic dosage of MHT was as much as 10x the amount in present day treatment. Furthermore, in most of the research, there has been large and usually unmeasured and uncontrolled effects of exposure to smoking, environmental aggressors, race, and aging.
Hence, while traditional treatments such as local hormone treatment have generally been regarded as effective in reversing skin aging in estrogen-deficient or menopausal skin, the uncertainty of the long term side effects has led to the development of newer therapeutic agents in the form of botanicals .
Cosmeceuticals to treat estrogen-deficient, menopausal skin
Cosmeceuticals represent the blending of cosmetics and pharmaceuticals. One of the greatest sources of new cosmeceutical ingredients are from plants. Plants are rich in antioxidants as they must survive constant UV exposure. Botanicals are also considered safe as they meet the FDA’s criteria of substances that are safe to use in topical over-the-counter formulations.
Resveratrol, a compound derived from grape, has been well researched for its anti-aging properties, and can be beneficial in the treatment of estrogen-deficient, menopausal skin in post-menopausal women. Recent studies reports that resveratrol has anti-inflammatory properties that protect against UV radiation from the sun, and oxidative stress. It also helps to stimulate production of collagen in fibroblasts, and inhibition of melanogenesis – helping to prevent the formation of pigmentation and dark spots.
The Elixir V Serum is an intensely nourishing concentrate of deep hydrating, lifting and tightening peptides. It contains Larecea™ our trademarked extract of Brassica oleracea (a botanical extract from cruciferous family plants) and a super-power Japanese Knotweed plant extract which is a source of trans-resveratrol, a potent anti-oxidant that enhances cellular regeneration at night, without the irritation effects of traditional retinoids.
Phytoestrogens & Isoflavones
Selective estrogen receptor modulators (SERMs) are examples of possible therapeutic agents that can send estrogen’s important skin health signals in place of decreased estrogen levels. Recent research has found that phytoestrogens (plant-derived compounds) that contain SERMs can play a major role in treatment for aging and estrogen-deficient skin.
The Mineral Booster is a dual function refreshing mist to increase absorption of skincare at night, for a perfect look with make-up & during touch-ups in the day. It contains skin-calming & repairing active ingredients, including precious rice bran extract, licorice extract, and Glycine Max Soybean Extract – that is a rich source of phytoestrogens and isoflavones. Suspended in a purified deep sea water mist harvested 600m below sea level using sophisticated technology. Perfect for tropical and humid climates.
Many studies have examined phytoestrogens which act as SERMs and help to send estrogen’s signals in place of decreased levels of estrogen. Isoflavone is a phenolic compound classified as an phytoestrogen. Isoflavones are found in high quantities in soybeans and other legumes. Phytoestrogens have been found to act as an anti-aging ingredient, resulting in increased production of collagen and hyaluronic acid in the skin.
They are also potent antioxidants, with anti-inflammatory properties. Studies conducted in 30 post-menopausal women found that treatment with isoflavone-rich, concentrated soy extract caused significant increase in skin thickness and number of collagen and elastin fibres. Additionally, creams and lotions containing phytoestrogens and isoflavones in a 12-24 week study showed improvement in skin dryness, thickness, facial wrinkles, increased hyaluronic acid, and type I and III collagen production. In these studies, no significant adverse effects after topical application of these cosmeceuticals.
Novel botanical compounds
In a study conducted by Lephart and Naftolin, two plant-derived compounds have been shown to improve the condition of the skin, especially in estrogen-deficient, menopausal skin. 4’acetoxy resveratrol (4AR) and equol are 2 novel botanical compounds that were associated with improvements in 8 skin parameters in a cohort of post-menopausal women.
The results show that for skin firmness around the eyes, Equol was associated with a 78% improvement, while 4AR associated with 68% improvement from baseline. For skin smoothness, equol was associated with 63% and 71% improvement for 4AR, while rates of frown lines and wrinkles were 72% for equol, and 77% for 4AR. Even skin tone improved 70% for equol and 83% for 4AR. Radiance and brightness rates were similar (73% for equol, 72% for 4AR), while rates of pore size (52% vs 63%), skin spots and discoloration (56% vs 73%), and hydration showed slight favoring of 4AR with equol at 71% and 4AR at 72%.
Overall, the percentage improvements were very similar for the 2 botanical compounds. This indicates that topical application of plant compounds with SERMs can play a major role as cosmeceuticals in the skin care industry, showing significant improvement in estrogen-deficient skin.
Lephart, E.D., Naftolin, F. Menopause and the Skin: Old Favorites and New Innovations in Cosmeceuticals for Estrogen-Deficient Skin. Dermatol Ther (Heidelb) (2020). https://doi.org/10.1007/s13555-020-00468-7
Desmawati, D., & Sulastri, D. (2019). Phytoestrogens and Their Health Effect. Open access Macedonian journal of medical sciences, 7(3), 495–499. https://doi.org/10.3889/oamjms.2019.044
Do neck creams differ from other anti-ageing products out there (for example, as compared to moisturiser)?
In terms of the composition of neck creams vs a very good moisturizer, for example, they do not differ very much. A lot of this, sadly, is due to marketing. But in terms of what is beneficial for anti-aging, the neck area is prone to lines and sagging with age. These can be concerns for aging women as well. Active ingredients that will help to target this should contain those that treat surface wrinkling such as antioxidants. Some brands use superficial chemical peel acids such as alpha-hydroxy and beta-hydroxy acids. That, together with retinol, does help with surface wrinkling, and these are all over-the-counter ingredients. However, in my experience, it tends to cause a bit of skin sensitivity. The formulations I look for would thus be those that contain more moisturizing ingredients such as ceramide. Our Multi–CERAM™ Moisturiser is an ultra intensive skin moisturiser for total skin barrier repair with pharmaceutical grade ingredients featuring phytoceramides. For the wrinkle component, I use in my personal formulation, in our Radiancé Fluide™ Hydrating Emulsion which is also meant for use over the neck area, oligopeptides which have been discussed in dermatology literature as a good substitute for retinol or retinoids, which can be irritating over the long term. Essentially, what peptides do is that they mimic the cells’ DNA so that it stimulates collagen production and it is without the adverse effects.
Dr. Teo Wan Lin is an accredited dermatologist and an expert on cosmeceutical skincare research and development. She is the author of “Skincare Bible – Dermatologist’s Tips for Cosmeceutical Skincare” which was published July 2019 by leading bookstores Barnes & Noble, Baker & Taylor and Apple Books and available in bookstores islandwide from January 2020. She heads up Dr.TWL Dermaceuticals, a specialist cosmeceutical skincare line with evidence-based active ingredients for anti-ageing and skin health. Its subsidiaries, the Pi- Cosmeceutical Custom Makeup Lab and the Conscious Mask Bar are part of the Conscious Concept Pharmacy launched in December featuring environmentally sustainable makeup and skincare materials. In this series “Dermatologist Talks” she shares her top tips on common skincare topics. In this article, she shares about the importance of taking care of your neck area.
Do you think there is a need to use neck cream in the first place?
I think it is absolutely essential because a lot of skincare regimens neglect the neck area. It is one of the first areas to show signs of aging with the lines and wrinkles. I have seen some patients who are older, who just focus on their face and neglect the neck, even with some protection, there is a very dramatic difference between their facial areas and neck area. It is important to bear in mind that our skin should be viewed in totality so it does not mean that you focus all anti-aging on the face. Your hands and neck area will also show all these signs of biological aging. If you are constantly just applying the cosmeceuticals on your face, you are neglecting other areas and a visible difference can be seen.
Most dermatologists and plastic surgeons would agree that the aging process actively starts from age 25 onwards. You may wonder why a child or teenager exposed to the same stresses such as UV, pollution and mental stress, and aging does not take place until a certain age. The reason is because our body is empowered with these antioxidants abilities to fight free radicals that contribute to ageing of all our organs. After the age of 25, the research seems to indicate that all of these start to decline and that is why we need to amend the body’s response to the aging response by supplementing it with topical antioxidants. I think it is good practice for all men and women to start a proper cosmeceutical regimen for anti-aging, and including the neck area. You can use the same moisturizer as long as it is formulated correctly for the face and the neck area. If for example, somebody has already much more wrinkles on the neck than the face for whatever reason, I would add on something which is rather new, and I believe it is the only one in the Singapore market right now, would be a polymer patch. I have been using these polymer patches in my clinic for the last 6 months. It is known as a Qraser patch and it recreates the optimal environment for your skin to start stimulating more collagen formation from the inside. How this works is that it is a bio-mimetic material. It convinces your skin that it is super healthy by forming a micro-environment on the surface and it starts to generate more of its own collagen. We have one special cut out for the neck area.
Is your neck more susceptible to signs of ageing as compared to your face, body, etc?
The neck area is not more susceptible but it tends to be an area that is very visible because of our clothing. For people who are always out in the sun, and are conscious of only using sunblock on their faces and limbs, and forget about their neck area, they will find that indeed, there is accelerated aging in that area. There are some individuals with neck eczema, which is a common sight for skin irritation, where their neck area may appear to age a bit faster than other parts of the body. It is what we called a flexural area, where there is skin to skin contact, like in obese people for example who are very prone to getting these neck folds and can develop fungal infections and eczema there as well.
Are there any specific neck creams in the market you’d recommend?
In terms of specific neck creams, I would say that a good moisturizer should have a few components to it. The first would be repairing the skin barrier itself. If your skin barrier is defective, it does not matter what anti-aging ingredients you have in there because your skin is just going to be dry. It is not going to look plump and elastic. Ceramide is the current state of technology for skin barrier restoration and it can be derived from two sources: Phytoceramide from plant seed oils and bovine ceramide (synthetic ceramide). The moisturizer that I personally prescribe in our clinic is manufactured by our pharmacy as a Multi–CERAM™ Moisturiser and I always recommend that for the neck area. For anti-aging, the Radiancé Fluide™ Hydrating Emulsion which is fortified with oligopeptides and a plant extract LARECEA from Brassica oleracea which is a family of kale, broccoli and cauliflower, that is very effective for anti-aging. It is good to use retinol-free and AHA and BHA-free anti-aging formulation simply because the neck area is much more sensitive and you are perhaps more prone to getting eczema.
What are the best ways to prevent your skin from ageing pre-maturely?
The take-home point is that for the neck area, if you are in doubt, just use a dermatologist-recommended moisturizer. Some anti-aging formulation that you use on the face contains retinol and when applied on the neck, you may develop sensitivity. Another important area of research now is using materials to increase the absorption of topicals. I personally would add that to my regimen. I think we are probably the only brand that is focusing on that right now. We have a polysaccharide material from plant root fibers which forms micro-reservoirs that release cosmeceuticals over a period of time and this is proven to increase the absorption of skincare.
The other thing would be the polymer patch. One of the best ways of preventing your skin from aging prematurely would be to have a good cosmeceutical regimen that is never like a one-step thing. In order for an active ingredient to be stable, it has to be sometimes formulated in a certain way and you can just combine everything into one and hope for the best. We also need to cleanse our skin. For the neck area, I would recommend cleansing with the same cleanser you use for your face and hopefully, it is a gentle one.
The second thing would be the application of serums such as the Vita C Gold Serum or Hyaluronic Acid Serum because serums are able to carry a high concentration of certain active ingredients. They are also readily-absorbed by the skin.
In recent years, the beauty and cosmetic industry has experienced a shift towards products which contain bioactive ingredients with the effects of medical drugs. Argireline-based dermal creams, lotions and ointments are among the emerging cosmeceuticals with promises for anti-wrinkle and anti-aging effects from the comfort of home, replacing the need for extensive botox, laser treatments and surgeries to achieve that youthful look.
Argireline is an established and innovative product used in the cosmetic market as creams, lotions and ointments and is well-known for its anti-aging properties. It is a synthetic hexapeptide produced in the lab, which is composed of chains of amino acids and patterned from the N-terminal end of the protein SNAP-25.
It inhibits the movement of facial muscles, allegedly improving skin texture and tone. Research suggests that Argireline may not penetrate deep enough into the skin to consistently provide benefits.
Argireline is a synthetic hexapeptide peptide that is patterned from the N-terminal end of the protein SNAP-25 and has been shown to reduce the degree of facial wrinkles. It is reported to inhibit vesicle docking by preventing formation of the ternary SNARE complex and by interfering in catecholamine release. The anti-wrinkle efficacy of argireline has not been studied in Chinese subjects.
How does argireline reduce the effects anti-aging?
Argireline reduces periorbital wrinkles and prevents the formation of skin lines in a similar way the botulinum toxin (Botox) works, by inhibiting neurotransmitter release at the neuromuscular junction. When argireline is applied to the skin, it is absorbed into the body and its chemical composition causes the facial muscles to contract with less force. This diminishes the appearance of wrinkles and can smooth out fine lines that appear with aging. Argireline-based creams can be quite effective, and in some cases, users of argireline-based serums can experience as much as a 30% reduction in fine lines and wrinkles.
A randomized, placebo-controlled study by Wang, Y. conducted in 2013 has also shown that argireline reduced the depth of the wrinkles with a total anti wrinkle efficiency of 48.9% in 60 patients. When the same test was performed on mice, there were notable improvements in the morphology of skin tissue and the amount of Type Ⅰ collagen fibers increased while the amount of type Ⅲ collagen fibers decreased.
The total anti-wrinkle efficacy in the group with patients tested with argireline was 48.9 % whereas the efficacy was 0 % in the placebo group. The parameters of roughness were all decreased in the argireline group, while no decrease was observed in the placebo group.
Dr. TWL’s Oligopeptide vegetal capsules contain argireline. With its clinically proven anti-aging properties, our Oligopeptide capsules relaxes facial tension lines resulting in less noticeable fine lines and wrinkles.
Argireline. (2019, April 05). Retrieved from https://thedermreview.com/argireline/
The anti-wrinkle efficacy of argireline, a synthetic hexapeptide, in Chinese subjects: a randomized, placebo-controlled study. Wang Y, Wang M, Xiao S, Pan P, Li P, Huo J. Am J Clin Dermatol. 2013 Apr;14(2):147-53.
The anti wrinkle efficacy of synthetic hexapeptide (Argireline) in Chinese Subjects. Wang Y, Wang M, Xiao XS, Pan P, Li P, Huo J. J Cosmet Laser Ther. 2013 Apr 22.
The study of cellular cytotoxicity of argireline – an anti-aging peptide. Grosicki M, Latacz G, Szopa A, Cukier A, Kieć-Kononowicz K. Acta Biochim Pol. 2014;61(1):29-32. Epub 2014 Mar 17.
The ageing process is different for each person, but there are certain signs of ageing that are considered “premature” if you notice them before you turn 35. Our environment and lifestyle choices can cause our skin to age prematurely. We will discuss here 3 ways on how to prevent premature ageing.
1. Use an anti-ageing sunscreen
The sun emits a type of energy known as the ultraviolet radiation. There are 2 types of UV radiation— UVA rays which is mainly the culprit behind Premature Ageing (wrinkles, dark spots, and sagging skin) while UVB rays is responsible for sunburn, and both contribute to skin cancer.
One way to protect your skin from premature ageing and of course skin cancer is to wear a sunscreen that has SPF and is broad-spectrum.
SPF only measures protection against UVB so it’s important to wear a ‘broad spectrum’ sunscreen which blocks both UVA and UVB.
The fix: Shield, repair, and brighten your skin from the harmful sun rays with Dr. TWL Dermaceuticals SunProtector™️
✔️ Broad Spectrum
Contains Collagen Hydrosylate for skin regeneration, Oligopeptides for skin repair, and Portulaca Oleracea Extract for skin soothing.
2. Avoid dragging your skin to reduce ageing effects
Our skin is very delicate and we want to avoid excessively tugging it whenever we apply our skincare or makeup products because this can cause our skin to show early signs of ageing. Mishandling of the skin especially around our eyes like aggressive removal of eye makeup and heavily dragging eye care products and any other skincare product unto our skin can cause eye wrinkles, crow’s feet, and other skin irritations. It is especially important to take extra care with the under-eye area which has thinner and more delicate skin.
The fix: Use your ring finger in applying your skincare/makeup products. Our ring finger is said to have the lightest touch and it distributes an equal amount of pressure when used upon the skin.
Using a Jade Roller is also proven effective in applying skincare products like serum and cream for complete absorption while lifting our skin.
The benefits of Vitamin C are well-known – an efficient collagen booster, and an amazing ability to treat effects of photoageing and hyperpigmentation. A favoured ingredient in skincare products, this vitamin helps to gently brighten and smoothen the skin.
Whilst Vitamin C is a naturally occurring antioxidant in the botanical world, humans do not possess the enzyme L-glucono-gamma lactone oxidase for the production of Vitamin C. When administered orally, Vitamin C is not efficiently delivered to the dermis. The concentration of the vitamin when introduced into the body is not sufficient to allow an activated effect. In the practice of dermatology, topical vitamin C is frequently recommended as an adjunct to treatments, which results in a drive towards newer advanced delivery forms of the vitamin into the dermis or discovery of more stable Vitamin C compounds.
Vitamin C exists in two forms – L-ascorbic acid and D-ascorbic acid. L-ascorbic acid is the chemically active form of Vitamin C, but it is not stable in nature. When exposed to light, Vitamin C may get oxidized to Dehydro Ascorbic Acid for example, which loses the beneficial activity of the vitamin. This gives rise to the interest of stable ascorbate molecules for dermatological uses.
What are the common Vitamin C derivatives?
Not all forms are physiologically effective as some will not be delivered to the dermis in sufficient quantity, or will not convert to a chemically active form in the skin.
Some stable derivatives of L-ascorbic acid are Magnesium Ascorbate, Magnesium Ascorbyl Phospahte, Sodium Ascorbate, Sodium Ascorbyl Phospate, and Calcium Ascorbate, with varying effectiveness.
What is the most stable Vitamin C derivative?
Sodium ascorbyl phosphate is a stable and effective derivative of Vitamin C. It is significantly more stable than magnesium ascorbyl phosphate and ascorbyl palmitate. The stability is attributed to the introduction of a phosphate group into the second position of the cyclic ring.
How does sodium ascorbyl phosphate work?
At our skin’s pH of 7, ascorbic acid is present in a form called ascorbate anion. This form has poor penetration ability into the skin and is unable to prevent effects of photodamaging due to low antioxidant concentrations.
With sodium ascorbyl phosphate, antioxidant levels are substantial and can be absorbed into deeper skin layers and allow effective photoprotection. With ongoing research on this stable derivative, it is understood that sodium ascorbyl phosphate is absorbed in the skin and converted by enzymes into ascorbic acid, increasing the intracellular concentration of ascorbic acid.
Skin cells continuously take up sodium ascorbyl phosphate and convert it into ascorbic acid by the process of dephosphorylation, with the help of the enzyme acid phosphatase in the skin layer. This process allows elevated levels of ascorbic acid in the skin long after the introduction of sodium ascorbyl phosphate to the skin.
How does sodium ascorbyl phosphate help acne?
As a potent antioxidant, sodium ascorbyl phosphate can help improve acne conditions by combating oxidation of sebum and comedogenesis.
According to Dr Teo Wan Lin, an accredited dermatologist at TWL Specialist Skin and Laser Centre, she said: “Patients with acne are found to have a higher concentration of polar lipids, which are by-products of squalene oxidation. Squalene is most abundant lipid in our skin and is highly susceptible to oxidation due to its structure. It has six carbon double bonds, allowing atmospheric oxygen to bind. This produces squalene oxides that are highly comedogenic, as it causes inflammatory reactions that further depletes the level of antioxidants in our skin and leads to acne. Sodium ascorbyl phosphate is useful in acne treatment as it prevents sebum oxidation.”
How does sodium ascorbyl phosphate prevent sebum oxidation?
Sodium ascorbyl phosphate works as an antioxidant to neutralise free radicals, reducing oxidative stress. When exposed to UV light, reactive oxygen species such as the superoxide ion, peroxide and singlet oxygen are generated. Sodium ascorbyl phosphate works to protect the skin from oxidative damage to sebum by donating electrons to neutralise the free radicals.
How does sodium ascorbyl phosphate fight ageing?
Sodium ascorbyl phosphate is an oxygen species scavenger, protecting against UV damaging and enhancing properties of sunscreen. Photodamage such as sunburn cell formation, DNA fragmentation and lipid peroxidation can be prevented. The protective effect of sodium ascorbyl phosphate comes from the maintenance of a healthy ascorbic acid level in the skin tissue.
Sodium ascorbyl phosphate reduces UV susceptibility and protects against damage from UV exposure.
Are there any side effects of sodium ascorbyl phosphate?
Formulations containing sodium ascorbyl phosphate are considered safe and has shown no side effects in multiple clinical studies conducted.
Which Vitamin C serum should I use?
Although sodium ascorbyl phosphate boasts many desirable benefits, it is important to choose a Vitamin C serum that is well-formulated to allow its benefits to be realised. Avoid concocting your own serum of Vitamin C, as it may lead to phytophotodermatitis if you include ingredients such as lemon, lime or bergamot oranges.
For a reliable and effective serum, you may consider Vita C Gold™ Serum. Dermatologist-formulated and tested for bio-activity in a laboratory, it is completely safe for use. It is a concentrated serum containing nano-formulated sodium ascorbyl phosphate as a powerful and stable antioxidant.