Dry and itchy skin

Skin that is drier, rougher or itchier than it used to be. It can start in perimenopause and carry on afterwards.

The NHS website lists dry and itchy skin among the symptoms of menopause and perimenopause, and says itching is common after the menopause. The Pakistan Menopause Society lists skin dryness and thinning among the longer-term changes after menopause (Table 1). For acne, oiliness and the wider picture, see skin changes.

Tight after washing. Rough to the touch. Itching that gets worse at night or in a warm room. Creams that used to be enough, and are not any more. Some women also describe a crawling or tingling feeling under the skin; that has its own page, tingling or numbness.

The Pakistan Menopause Society lists skin dryness and thinning together with wrinkling and loss of collagen and elasticity (Table 1). It also reminds doctors that age, lifestyle and other conditions shape the changes of midlife, not falling estrogen alone. Neither it nor the NHS website goes further into why.

The NHS itchy skin page lists other common causes worth knowing: dry, cracked or irritated skin, reactions to heat or to something you are allergic to, eczema and psoriasis, and fungal infections. Less commonly, it says, itching can be a sign of a thyroid, liver or kidney problem.

The NHS website suggests:

• an unperfumed moisturiser or emollient, used regularly
• patting or tapping the skin instead of scratching it, and holding something cool on it, like a damp towel
• cool or lukewarm baths or showers, and not staying in too long
• loose cotton or silk clothing, rather than tight, woollen or synthetic fabrics
• a laundry liquid or powder for sensitive skin
• short, clean nails

It advises against perfumed soaps, deodorants and moisturisers. A pharmacist can also suggest products, such as antihistamines for some kinds of itch, or cooling creams.

For what the guidance says about drinking enough, see hydration.

The NHS website says a GP might prescribe creams, lotions or tablets, depending on the cause, may arrange a blood test, and may refer you to a skin specialist.

If the itch is under an HRT patch, the NHS website lists a mild rash or itching among the possible side effects of estrogen, and says side effects often settle within a few weeks. If it does not, ask about a different type or route; estrogen patches explains more.

The NHS website says to see a GP if itchy skin is affecting your daily life, does not get better with self-care or keeps coming back, is all over your body, is severe, or comes with a new rash, lump or swelling that worries you.

Wudu means washing hands, face, arms and feet several times a day, and for women with dry skin that raises a practical question: whether a moisturiser or cream on the skin affects wudu, and when to put it on. Women ask this and get different answers. It belongs with a qualified scholar, and Roshara does not rule on it.

At home, scratching at night can disturb a shared bed and a light sleeper. Naming it as a menopause symptom, rather than a rash nobody can explain, makes it easier to deal with.