Skincare expert reveals why Botox is not as effective on menopausal skin

As we hit our late 40s and early 50s, menopause can lead to increased skin laxity, so Dr Mehvish Khan recommends a lesser amount of Botox, strategically placed, to give good results

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Paula Lenihan

15:36, 3 OCT 2023

During menopause, our hormone levels decrease, leading to a whole host of changes in our skin.

Aesthetic practitioner, Dr Mehvish Khan, says skin reddening along with pigmentation is a common concern women have during menopause, along with Botox not being as effective.

However, there are ways to treat these skin complaints, with the owner of MK Aesthetics in Wexford sharing her advice on caring for menopausal skin.

Skin Reddening: Causes and treatments

The reduction of collagen causes vascular fragility, giving rise to broken vessels, Dr Khan says. "A decline in skin lipids promotes a compromised skin barrier and consequent skin sensitivity, redness and dryness. Inflammation within the skin is also increased causing hot and red flushes."

Laser or thermocoagulation can be used to treat the broken vessels but the mainstay treatment for these individuals would be lifestyle adjustments and skincare, even prescriptive skincare when needed, Dr Khan says.

Reducing alcohol intake and consumption of spicy foods can also be helpful, as can the use of niacinamide, azelaic acid, a low grade retinol and ceramides, which are crucial for prevention of flare-ups.

"LED light therapy and light peels can also help to strengthen the skin barrier. Your skin practitioner can advise the best option for you," Dr Khan says.

Pigmentation: Causes and treatments

Pigmentation that has been lying under the skin for many years may surface in menopause. Dr Khan says. "Incorporating good-quality anti-pigmentation prescription grade products can be quite effective in lifting pigmentation.

"A TCA peel is very strong and can only be done by a medical practitioner. It’s a medium depth peel so any stubborn pigmentation that hasn’t been lifted with the skincare products can be lifted with the peel. Laser to remove pigmentation is another option."

Botox efficacy on menopausal skin

Dr Khan explains that practitioners are a lot more cautious when injecting Botox in the upper face of women aged 50 onwards, who may be suffering from aging skin that has lost its laxity.

"A lesser amount of Botox, strategically placed, is recommended in these patients, and this may be the very reason why the Botox doesn’t last as long as in someone who has had a higher dose.

"I would recommend a skin tightening procedure to counter the laxity and this will improve Botox."

Skincare routine for menopause

Regular check-ins with a good skincare practitioner is important to see if your products are still working for you, according to Dr Khan. "The skin goes through many changes with time and with seasons and it is vital to have your skincare and skin health assessed regularly. The skincare products that you were using in your 30s will not give you the same result in your 50s.

Recovering your sparkle inside and out

"It is our role as good practitioners to understand their emotion in this phase of their life and recommend only what is in their best interest and also to be very compassionate in our approach," Dr Khan says.

"Recommending a 360 degree treatment plan is vital which will include an effective skin regime, relevant supplements, in-clinic treatments, injectables, hormone replacement and lifestyle changes."

Dr Khan's top products for menopausal skin:

Invest in a gentle cleanser such as the Obagi Nu-Derm Gentle Cleanser, or NeoStrata for those suffering with menopausal acne.
An exfoliator for shedding of dead, dull skin.
Vitamin A – I would recommend the Obagi Retinol 1.0 or a prescription grade retinol to increase cellular turnover.
Obagi 15% Professional C Serum for collagen stimulation, skin brightness, vascular strength and target inflammation.
Anti-pigmentation serum/cream to tackle areas of pigmentation. The Obagi NuDerm System is highly recommended.
The Obagi Hydro-Drops for those with dull, dry skin and skin sensitivity as it contains niacinamide.
Obagi Hydrate/Hydrate Luxe for long-lasting hydration.
SPF – The Heliocare brand has a large range to suit all skin types.

Follow Dr Khan on Instagram: @mk_aesthetics.

To read our full menopause special, pick up a copy of the October issue of RSVP magazine, out now.

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