Managing Skin Allergies During Menopause: Symptoms and Treatments

Skin allergy

Hello Dr.
Wu! I have been experiencing menopause for the past two years, and my skin has also shown some issues.
My cheeks tend to flush by the afternoon, which I didn't find unusual, but in the past six months, I've started to develop one or two red papules on my nose (initially thought they were mosquito bites).
Whenever I sweat and feel hot, my nose begins to itch, and it even affects my sleep.
Additionally, if my neck and above are excessively exposed to sunlight, certain areas become red and itchy.
I also occasionally have small red spots around my mouth that itch and feel very dry (mainly around the nose and mouth, which is uncomfortable).

I consulted two dermatologists, and they had different opinions.
The first one said it was a skin infection on my nose and prescribed Mometasone Furoate Cream (which I applied locally twice, and it was very effective; the itching stopped).
Later, I learned it was a steroid.
The second dermatologist suggested I had rosacea, stating that people with fair skin are more prone to it (but my skin tone is not fair, and my family does not have rosacea).
He prescribed Metronidazole cream (and advised against using steroid medications) and also gave me Doxycycline antibiotics (two pills a day for two weeks).
However, after taking three pills, I experienced a drug allergy, and the redness in my mouth worsened, so I quickly stopped the medication and informed the doctor afterward.
Now, I am simply washing my face and applying an allergy lotion (as recommended by the doctor).
I am using Metronidazole cream locally on my nose.
After researching, I found that my affected areas resemble two conditions (rosacea and seborrheic dermatitis).
Based on my description, what do you think my symptoms are similar to? The main areas affected are my nose and around my mouth.
If my rash subsides, should I continue applying the medication, or only when it flares up? Why has it worsened after menopause? Is it due to a change in my constitution? The doctor advised me to use sunscreen and avoid sun exposure, but I have osteoporosis and a vitamin D deficiency (as indicated by my blood test).
What should I do? Currently, I try to expose my limbs to sunlight for 10 minutes around 8:30 AM while keeping my face covered.
Is that acceptable? I am quite distressed; could you please advise me on how to protect and care for my skin (I feel that extreme temperatures, whether hot or cold, trigger my symptoms)? Thank you for your response.

Janice, 50~59 year old female. Ask Date: 2018/09/28

Dr. Wu Yuxin reply Dermatology

Rosacea and seborrheic dermatitis can be clinically differentiated.
Without observing the lesions, it is not possible to determine the exact issue.
Any subsequent discussions will be hypothetical.
If you are experiencing significant distress, please seek medical attention promptly.

Reply Date: 2018/09/28

More Info

Managing skin allergies during menopause can be particularly challenging due to hormonal changes that affect skin sensitivity and overall health. Your symptoms, including redness, itching, and the appearance of red bumps, are common complaints among women experiencing menopause. Let's break down your concerns and explore potential treatments and management strategies.

Understanding Your Symptoms
1. Skin Redness and Itching: The redness on your cheeks and the red bumps on your nose could be indicative of several conditions, including rosacea, seborrheic dermatitis, or even allergic reactions. Rosacea is characterized by facial redness, visible blood vessels, and sometimes acne-like bumps. It can be exacerbated by heat, spicy foods, and alcohol. Seborrheic dermatitis often presents as red, flaky patches, particularly in oily areas of the face.

2. Hormonal Changes: During menopause, estrogen levels decline, which can lead to changes in skin hydration and elasticity. This hormonal shift can make the skin more reactive and sensitive, leading to conditions like rosacea or exacerbating existing skin issues.

3. Allergic Reactions: Your experience with medication allergies, such as the reaction to doxycycline, highlights the importance of monitoring how your skin responds to various treatments. Allergic reactions can manifest as increased redness and irritation.

Treatment Options
1. Topical Treatments:
- Mometasone Furoate Cream: This is a topical corticosteroid that can effectively reduce inflammation and itching. However, prolonged use can lead to skin thinning, so it should be used cautiously and typically not for extended periods.

- Metronidazole: This is often prescribed for rosacea and can help reduce inflammation and redness. If your symptoms improve, you may not need to continue using it indefinitely; using it during flare-ups may be sufficient.

2. Oral Medications: If topical treatments are not effective, your dermatologist may consider oral medications. However, given your previous allergic reaction to doxycycline, it’s essential to discuss alternative options with your healthcare provider.

3. Moisturizers and Sunscreen: Keeping your skin hydrated is crucial, especially during menopause. Use a gentle, hypoallergenic moisturizer to help maintain skin barrier function. Sunscreen is also vital; consider a broad-spectrum sunscreen with SPF 30 or higher to protect against UV rays, which can exacerbate skin conditions.

Lifestyle Modifications
1. Sun Exposure: While vitamin D is essential, excessive sun exposure can worsen skin conditions. Your plan to get limited sun exposure while protecting your face is wise. Aim for short periods of sun exposure in the morning when UV rays are less intense, and always apply sunscreen afterward.

2. Diet and Hydration: A balanced diet rich in antioxidants can support skin health. Foods high in omega-3 fatty acids, such as fish and flaxseeds, can help reduce inflammation. Staying hydrated is also crucial for maintaining skin moisture.

3. Stress Management: Stress can exacerbate skin conditions, so incorporating stress-reducing activities like yoga, meditation, or gentle exercise can be beneficial.

When to Seek Further Help
If your symptoms persist or worsen despite treatment, or if you experience new symptoms, it’s essential to follow up with your dermatologist. They may consider patch testing to identify specific allergens or recommend a different treatment approach tailored to your needs.

In conclusion, managing skin allergies during menopause requires a multifaceted approach, including appropriate topical treatments, lifestyle modifications, and ongoing communication with your healthcare provider. By understanding your skin's needs and being proactive in your care, you can find relief and improve your skin's condition.

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