Your Skin in Your 50s: What's Normal and What to Get Checked

In your 50s, after menopause, your skin gets drier and thinner, bruises more easily and heals more slowly. Most of that is ordinary aging. The changes worth a doctor's eye are a short list: spots that change, sores that won't heal and bruising out of proportion.

Maybe you've found a purple mark on your forearm you don't remember getting, or a crop of small brown bumps on your cheekbones. The search results probably sent you to serums. The more useful question in this decade is which changes are normal and which need checking.

What Happens to Your Skin After Menopause?

It holds less water, gets thinner and repairs itself more slowly. The American Academy of Dermatology (AAD) says that as estrogen falls, skin becomes thinner, and that thin skin bruises more easily. It also says skin takes longer to heal when hormone levels fall.

Collagen loss is fastest in the first five years of menopause, then slows to a steady decline. What happens to your skin in perimenopause walks through the AAD's figures.

Oil drops too. MedlinePlus, from the National Library of Medicine, says sebaceous glands produce less oil as you age, which makes dryness and itching more likely.

The AAD adds that around 50 your skin's pH changes and skin becomes more sensitive. Why skin gets more reactive with age covers that part in detail.

Why Do I Bruise So Easily Now?

Mostly because the cushioning around your blood vessels is thinner. Mayo Clinic says easy bruising is common with age. As skin thins, it also loses some of the fatty layer that protects blood vessels from knocks.

MedlinePlus says the more fragile vessels lead to bruising and bleeding under the skin, often called senile purpura.

Medicines count too. Mayo Clinic lists aspirin, ibuprofen and naproxen, along with blood thinners such as warfarin, apixaban and rivaroxaban. It says corticosteroids thin the skin, which makes bruising easier, and that ginkgo biloba can raise the risk too.

Don't stop a prescribed medicine on your own. Tell your doctor about every supplement you take instead.

Mayo Clinic says to see a health care professional if you:

• often get large bruises with no clear cause, especially on your chest, stomach, back or face
• bruise easily and also bleed a lot, such as after a small cut
• suddenly start bruising, or bruise more easily, particularly after starting a new medicine
• have relatives who bruise or bleed easily

Why Do Cuts Take So Long to Heal After 50?

MedlinePlus says aging skin repairs itself more slowly than younger skin, with wound healing up to four times slower.

The AAD says that when skin takes longer to heal, you have a greater risk of infection or another skin problem. So keep small wounds clean. Mayo Clinic says to see a health care professional for signs of infection. These include spreading color change, increasing pain, drainage, warmth or swelling.

Thin skin also tears more easily. The AAD warns that if your skin becomes too thin for waxing, it can tear and bleed. If you've been waxing chin or lip hair for years, why women get facial hair goes through the other options.

Slow healing has one important exception. A sore that never heals, or heals and keeps coming back, is one of the AAD's warning signs for skin cancer. It needs a dermatologist, not more patience.

Which New Spots After 50 Are Normal?

Most new spots in your 50s are harmless, but a few look alarming and one type needs checking.

• Age spots: The National Institute on Aging (NIA) describes these as flat, brown spots on the skin, often caused by years of sun.
• Seborrheic keratoses: The AAD says some look like dabs of warm, brown candle wax, and most people get them in middle age or later. They're harmless, but they can look like skin cancer.
• Dermatosis papulosa nigra: These small dark or skin-colored bumps, mainly on the cheeks, temples and forehead, usually start in adolescence. They're most common in people of African and Asian descent, and a clinical review says women are twice as likely to be affected as men.
• Skin tags: small, raised growths, usually skin-colored, which the NIA also describes.
• Actinic keratoses: MedlinePlus describes these as pinkish rough patches that have a small chance of becoming skin cancer. The AAD lists a scaly or rough patch that doesn't go away as a warning sign, so show these to a dermatologist.

The review on dermatosis papulosa nigra says those bumps grow in number and size with age, peaking in the 50s. They carry no cancer risk, and removal is purely cosmetic. The review also warns removal can leave lighter or darker patches, so aggressive treatment should be avoided.

The AAD's advice for age spots applies to any dark spot. Before you buy a treatment, see a dermatologist for a skin exam, because skin cancer sometimes looks like an age spot or other dark spot.

How to Check Your Skin for Cancer After 50

The AAD says skin cancer and pre-cancerous skin growths become more common in menopause. The NIA suggests checking your skin every month. For moles and dark spots, the AAD uses the ABCDEs of melanoma:

• A, asymmetry: one half doesn't match the other.
• B, border: the edge is irregular, scalloped or poorly defined.
• C, color: shades vary from one area to the next, such as tan, brown or black, or areas of white, red or blue.
• D, diameter: melanomas are usually larger than 6 mm (about the size of a pencil eraser), but they can be smaller.
• E, evolving: the spot looks different from the others, or is changing in size, shape or color.

On brown and black skin, look somewhere else as well. The AAD says skin cancer in darker skin may show up in areas that receive little, if any, sun. That includes the palms, the soles, fingers and toes, the nails, the mouth and the genitals.

Nails need a specific look. The AAD lists a dark line or streak in a nail, or darker skin next to the nail, as warning signs. A bruise under a nail grows out, and the AAD says skin cancer doesn't.

It also says that in darker skin, cancer is often advanced by the time it's found. Many people never think to check their feet.

So add your soles, between your toes and every nail to the monthly check. The AAD also suggests booking a skin cancer screening with a dermatologist and asking how often to check yourself.

Does Hormone Therapy Help Aging Skin?

It isn't a skin treatment. Mayo Clinic says menopause hormone therapy is most often used to treat common menopause symptoms, such as hot flashes and vaginal discomfort. It also prevents bone loss and reduces fractures. Mayo Clinic's page doesn't mention skin.

The risks depend on your age, your health, and the type and dose of hormones. For some women, Mayo Clinic says it may raise the risk of heart disease, stroke, blood clots, breast cancer, gallbladder disease and endometrial cancer. If you still have a uterus, you'd usually take a progestogen with the estrogen, because estrogen alone can raise endometrial cancer risk.

Timing matters. The benefits may outweigh the risks if you start before 60 or within 10 years of menopause. Starting later raises the risk of serious complications. Mayo Clinic advises the lowest dose that helps, for only as long as you need it.

If hot flashes or bone health already have you weighing it, ask your doctor how it fits your own risks. Just don't start it for your skin.

What Helps Skin in Your 50s

Keep it short and gentle. The NIA suggests mild soap and warm, not hot, water, then a lotion, cream or ointment every day. The AAD says a moisturizer with hyaluronic acid or glycerin can be especially helpful.

Sunscreen helps with thinning too. The AAD advises broad-spectrum SPF 30 or higher every day, even in winter. It says this can't thicken skin, but it can prevent further thinning.

For wrinkles and sagging, the AAD suggests considering a product with retinol or peptides, which it says can increase collagen. For thin skin that bruises easily, it says a retinoid cream can help some people, and laser treatment may be another option. Ask a dermatologist which suits you.

On deeper skin tones, using retinol on dark skin explains how to start without leaving dark marks. See a dermatologist before trying exfoliation or microdermabrasion too, since the AAD says trying them at home on thin skin can cause harm.

When to See a Doctor About Skin Changes After 50

Most of what happens to your skin in your 50s can wait for a routine appointment. These can't:

• a mole or spot that's new, different from the others or changing, or one that itches or bleeds
• a sore that doesn't heal, or heals and returns
• a dark streak in a nail, darker skin next to a nail, a bump under a nail, or a nail that lifts or splits
• a scaly or rough patch that doesn't go away
• large or sudden bruising, or bruising with heavy bleeding
• a wound that shows signs of infection

Skin infections can turn into cellulitis, which Mayo Clinic says can spread rapidly through the body. It says to seek emergency care for a swollen rash, a rash that's changing rapidly, or a fever. Without a fever, see a health care professional within 24 hours for a swollen or growing rash. In an emergency, call 911 (999 in the UK) or go to the nearest ER.

Frequently Asked Questions

Does Menopause Cause Sagging Skin?

Yes. The AAD says that as collagen diminishes after menopause, skin loses its firmness and begins to sag.

Is It Normal to Bruise Easily After Menopause?

Usually, yes, because thinner skin and fragile blood vessels bruise more easily. See a doctor if bruises are large, sudden or come with heavy bleeding, or if they started with a new medicine.

Can You Reverse Skin Aging After 50?

Not fully, but you can slow some of it. Daily sunscreen can prevent further thinning, and the AAD suggests retinol or peptide products for lines. A dermatologist can talk you through retinoid cream or laser treatment.