Q. Since menopause, my skin has become chronically itchy. Why is that—and what can I do for it?
A. Skin typically gets drier with age and sun damage due to reduced production of sebum and other moisturizing factors. But it’s believed that the drop in estrogen (and other hormones) that occurs with menopause may worsen this. And dry skin can become itchy.
Low estrogen levels affect the ability of skin to hold onto moisture by reducing its content of lipids (fat) and polysaccharides called glycosaminoglycans, which together are important for keeping skin moist and maintaining a good barrier in order to reduce water loss and exposure to allergens or other factors that can result in itching. In addition, low estrogen levels may worsen or trigger skin conditions that are associated with dryness and itchiness, such as psoriasis and atopic dermatitis.
Of note, premenopausal women may also experience increased skin dryness and itchiness just before and during menstruation, when levels of estrogen and progesterone drop.
It’s not surprising that these hormones may play a role in skin health since the skin’s epidermis and dermis (the outer and inner layers, respectively) have receptors for estrogen and, to a lesser extent, progesterone. And in preliminary studies, postmenopausal women on hormone therapy appear to have skin that holds onto water better than women not on hormones.
To help with dry itchy skin, use mild cleansers or body washes in place of soaps, particularly deodorant soaps, which are more drying. Take shorter showers in warm water rather than long hot showers or baths. Use a moisturizer after bathing or showering (preferably before the skin dries) and throughout the day as needed. Look for a perfume-free moisturizer, which is less irritating.
To ease itchiness, you can take a lukewarm bath with colloidal oatmeal, a fine powdered form of oatmeal that helps soothe the skin. Colloidal oatmeal can be purchased in any pharmacy, or you can make it yourself by pulverizing raw oats in a blender on a high setting (use one cup per bath). Applying a cool compress may also feel good, but it can dry skin, so apply a moisturizer after.
For more stubborn itchiness, over-the-counter topical treatments may provide some relief. These include mild (1%) cortisone creams (use for a week or two at most to avoid skin thinning) and anesthetic creams, such as those containing pramoxine.