Climacteric skin concerns involve complex scientific mechanisms that cannot simply be blamed on age alone. The decline of kidney water, which preserves internal moisture and vitality, aligns closely with the decrease in estrogen in modern medicine. Estrogen stimulates collagen and elastin synthesis in the skin, increases moisture-binding hyaluronic acid, and maintains skin barrier function. It is one of the most critical hormones for preserving youthful, healthy skin.
During the climacteric, estrogen levels drop sharply, driving significant skin changes. First, the production of collagen, the main structural support of the skin, decreases by about 1% each year, and the quality of elastin fibers responsible for elasticity deteriorates. As a result, the skin gradually thins, loses firmness, develops deeper wrinkles, and visibly loses elasticity.
Second, hyaluronic acid levels decline, leaving the skin markedly dry and rough. As the skin barrier function weakens, transepidermal water loss increases and defense against external irritants drops, allowing the skin to redden or react to minor triggers. The fluid deficiency described in the Donguibogam corresponds directly to this modern state of dryness and heightened sensitivity.
Third, inflammatory responses and rising reactive oxygen species accelerate oxidative stress during the climacteric. This inflammaging damages skin cells and activates collagen-degrading enzymes, speeding up aging. A deficiency of qi and blood leads to microcirculatory impairment, which obstructs oxygen and nutrient delivery to skin cells and slows waste removal, leaving the complexion dull and tired.
Climacteric skin aging is therefore not merely a passage of time, but the combined result of hormonal changes, structural and functional decline in the skin, and accelerated inflammation. Surface care alone has clear limits, making an internal approach that restores balance essential.
