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Menopause and skin cancer: what you need to know

Skin changes are common during the menopause so learn how to protect and regularly check yours

  • Age and hormonal changes can make your skin more susceptible to damage
  • Skin cancers, caused by ultraviolet light, continue to increase in occurrence in the UK
  • Learn the ABCDEs of melanoma and whether you can take HRT

During the perimenopause and menopause, most women notice changes to their skin – in fact a British Skin Foundation survey found 85% of women report this, with the most common skin symptom being excessive dryness (21%). Laxity, excessive signs of ageing and alteration in pigment are also frequently reported.

While there’s not a direct link between menopause and skin cancer, age plays a significant role – peak rate of melanoma skin cancer cases in the UK is 85-89, while incidence rates for non-melanoma skin cancer are highest in those aged 90+, according to Cancer Research UK.

Dr Anjali Mahto, a consultant dermatologist and founder of dermatology clinic Self London says: ‘As you age, your skin accumulates more damage from sun exposure and other factors, thus increasing the risk of skin cancer. During menopause, hormonal changes can lead to shifts in skin physiology, making it more susceptible to damage. Additionally, decreasing oestrogen levels can reduce your skin’s ability to repair itself.’

Related: Skin changes during menopause factsheet

Non-melanoma skin cancer is a common type of cancer that starts in the top layer of the skin. The main types are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Since the early 1990s, rates of occurrence in females have increased by more than two-and-a-half times (163%) [1].

Melanoma is a type of skin cancer that can spread to other area of the body. It’s the fifth most common cancer in females in the UK and again, rates of incidence have increased greatly – by 106% since the early 1990s [2]

The main cause of both of these cancers is ultraviolet light, which comes from the sun and is used in sunbeds.

Why is my skin vulnerable?

‘During and after menopause, skin undergoes several changes that can potentially increase vulnerability to skin cancer,’ says Dr Anjali. ‘Firstly, decreased oestrogen levels lead to a reduction in collagen and elastin production, resulting in thinner, less elastic skin that’s more prone to damage. Secondly, your skin’s ability to repair itself diminishes due to slower cell turnover and decreased production of natural moisturising factors. Additionally, cumulative exposure to UV radiation over time causes DNA damage in skin cells, increasing the risk of mutations that can lead to skin cancer.

‘Age-related immune system changes also compromise your skin’s ability to detect and eliminate cancerous cells. These factors collectively contribute to the heightened susceptibility to skin cancer as you age and go through menopause.’

What can I do to limit my risk?

Dr Anjali advises all women to protect their skin from the sun and perform regular skin checks to detect any potential skin cancer early. 

Those at high risk for skin cancer due to factors such as childhood sunburn, fair skin, and freckles should: ‘Prioritise sun protection by wearing broad-spectrum sunscreen with SPF 30 or higher daily, seek shade during peak sunlight hours, typically 11am-2pm, wear protective clothing, hats and sunglasses, and avoid indoor tanning,’ Dr Anjali says.

How can I check my skin? 

‘Regular skin self-examinations are essential for early detection of any suspicious moles or lesions. If you have numerous moles monitoring them can be challenging so it’s crucial to know the ABCDEs of melanoma,’ advises Dr Anjali. This means regularly checking moles for signs of:

  • Asymmetry
  • Borders that are irregular
  • Colour variation – those with two or more colours
  • Diameter greater than 5mm
  • Evolution – if a mole is changing over time

Maintaining a record of your moles and their characteristics will help you track them.  

For anyone with a higher risk of skin cancer, including those with a history of skin cancer, a family history of melanoma or other skin cancers, a large number of moles, fair skin that burns easily, a history of severe sunburns or those with weakened immune systems, Dr Anjali also recommends regular, typically annual, skin checks ideally with a dermatologist. Additionally, individuals with occupational sun exposure or a history of indoor tanning should also consider annual skin checks.  This will help ensure thorough examination and timely intervention if needed.

Can I take HRT?

‘The relationship between hormone replacement therapy and skin cancer risk remains somewhat unclear due to conflicting research findings,’ says Dr Anjali. ‘Some studies suggest a potential link between HRT usage and increased risk of skin cancer, while others do not find a significant association. 

‘One theory proposed is that oestrogen, a component of HRT, may stimulate the rapid growth of skin cells, including melanocytes, which could theoretically increase the risk of skin cancer development. However, it’s important to note that research on this topic is ongoing, and factors such as the type of HRT and individual characteristics may influence any potential associations. Further research is needed to better understand the relationship between HRT and skin cancer risk.’

If you’ve had skin cancer, especially melanoma, it’s crucial to discuss the use of hormone replacement therapy with your doctor. ‘Individual circumstances vary and need to be taken into account. Your doctor can assess your medical history, type of skin cancer and overall health to determine the potential risks and benefits of HRT for you.’

Dr Anjali Mahto is a consultant dermatologist and founder of dermatology clinic Self London: www.selflondon.com 

References

  1. Cancer Research UK
  2. Cancer Research UK
Menopause and skin cancer: what you need to know

Written by
Dr Anjali Mahto

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