Are your girlish looks suddenly changing? As a result of declining estrogen levels, many skin changes become increasingly evident at menopause.

Estrogen plays a large role in the biology of skin. It is responsible for the distribution of subcutaneous fat under the epidermis which provides firmness and support. Estrogen also helps to maintain water in tissues, encourages oil production and the formation of collagen.

There is an increased and significant loss of skin collagen and thickness after the onset of menopause. These declines are similar to the increased rates of bone loss that occur after menopause. That is why many menopausal women find that their skin becomes more prone to bruising and there may be an increase in pigmentation, commonly referred to as "liver spots".

Wrinkles are also a very common skin change, primarily resulting from sun damage and tobacco use combined with the loss of collagen. Skin also becomes more susceptible to greater amounts of minor cuts, abrasions and scrapes because it is less pliant. Some researchers believe that taking estrogen improves skin tone by slowing down the loss of collagen. Studies have shown that the skin of women taking estrogen therapy is thicker than the skin of women not taking estrogen therapy.

"Nature gives you the face you have at twenty; it's up to you to merit the face you have at fifty" - Coco Chanel

Sensible Suggestions

• Stay out of the sun and wear a sunscreen on your face and hands every day.
• Apply moisturizer daily to damp skin to help reduce the loss of water from the skin.
• Skip soap; instead wash with a mild cleanser and warm water.
• Drink plenty of water.
• Avoid dehydrators such as alcohol and tobacco smoke. Both increase wrinkles.
• Avoid caffeine and diuretics (unless your doctor prescribes them to treat high blood pressure).
• Maintain an active lifestyle incorporating exercise and good nutrition.
• Get adequate rest. Sleep deficits can cause unhealthy looking skin.
• Visit your dermatologist and discuss prescribed treatments like estrogen therapy or topical creams which have been developed to diminish fine lines, wrinkles and liver spots.
• Over-the-counter products are also available, like alpha-hydroxy acids.
• Dermabrasion, peels, laser, injectable fine line treatments (i.e., Botox, Restylane) and cosmetic surgery are also ways to treat wrinkles.
• Realize your beauty is not skin deep, that you have earned the title of "wise woman", and that some wrinkles are an inevitable badge of your status that you may wear proudly.