Burning Skin During Menopause

Why Does My Skin Feel Like It’s on Fire?

Does your skin ever feel like it’s burning, stinging or strangely hot, even though there’s nothing there?

No rash. No sunburn. Nothing obvious to explain why your skin suddenly feels like it’s on fire.

For some women, these unusual skin sensations appear for the first time during perimenopause or menopause. They may come and go, move around the body, or affect one particular area.

And while hormonal changes can potentially contribute, burning skin is one symptom I wouldn’t automatically put down to menopause.

There are other possible causes worth considering too.

What does burning skin feel like?

Women describe it in all sorts of ways:

• burning or hot skin

• a sunburn-like feeling

• stinging or prickling

• pins and needles

• crawling sensations

• increased sensitivity to clothing or touch

• areas of skin that feel unusually hot despite looking completely normal

It may affect the face, scalp, arms, legs, back, hands or feet, or seem to move around.

Some women also describe a more difficult-to-explain internal burning sensation, where they feel intensely hot or burning inside even though their skin doesn't necessarily feel hot to touch.

These sensations can fall under the broad umbrella of paraesthesia, abnormal sensations that occur when sensory nerves are irritated or their signalling changes.

Could menopause cause burning skin?

Potentially.

Oestrogen does much more than regulate your menstrual cycle. Oestrogen receptors are found throughout the skin, blood vessels, brain and nervous system.

As oestrogen fluctuates and eventually declines, it can influence several systems involved in how we experience sensations.

Your nervous system

Oestrogen interacts with neurotransmitters and pathways involved in pain perception and sensory processing.

Changes during perimenopause may therefore alter the way some women perceive touch, temperature, tingling and pain.

This could help explain why unusual sensations such as burning, prickling, crawling or pins and needles sometimes appear around menopause.

Your skin

Oestrogen also supports collagen production, skin thickness, hydration and barrier function.

As levels decline, skin can become thinner, drier and more sensitive. Something that previously caused no irritation, such as a skincare product, hot shower, fabric or change in temperature, may suddenly feel uncomfortable.

Sometimes what feels like nerve pain may actually be very sensitive, dry or irritated skin.

Temperature regulation

Hot flushes are the obvious example of menopause affecting temperature perception.

Hormonal changes influence the hypothalamus (the part of your brain involved in regulating body temperature). During menopause, the body's thermoneutral zone can narrow, meaning relatively small changes can trigger an exaggerated heat response.

For some women, this may contribute to sensations of intense heat or burning.

But don't assume it's menopause

This is important.

If you're in your 40s or 50s and a new symptom appears, it's very easy to add it to the growing list of "weird things menopause does."

But burning skin can have many causes.

Depending on your symptoms and health history, it may be worth considering:

Nutrient deficiencies
Several B vitamins are important for healthy nerve function. Vitamin B12 deficiency is well known for causing tingling, numbness and burning sensations. Vitamin B1 deficiency can also contribute to peripheral neuropathy and burning pain, particularly in the feet and lower legs. Vitamin B6 is another nutrient worth considering. Both inadequate and excessive amounts can be problematic.

Folate, iron and other nutrient deficiencies may also be relevant depending on your individual circumstances.

Blood sugar problems
Insulin resistance, prediabetes and diabetes can affect peripheral nerves. Burning feet are particularly associated with peripheral neuropathy, although nerve symptoms can occur elsewhere.

Thyroid dysfunction
Thyroid disorders can affect the skin, temperature regulation and nervous system and may sometimes contribute to unusual sensory symptoms.

Nerve irritation and neuropathy
Burning that follows a particular pathway or remains in one area may be related to an irritated or compressed nerve.

Another consideration is small fibre neuropathy, which affects the small sensory nerves responsible for detecting pain and temperature. It can cause burning, prickling, tingling or unusual sensitivity even when the skin looks completely normal.

Shingles
Burning, tingling or pain can sometimes occur before the characteristic shingles rash appears. Occasionally nerve pain can persist after the rash has resolved.

Skin conditions and allergies
Dermatitis, rosacea, contact reactions and other inflammatory skin conditions can cause burning, sometimes before obvious skin changes appear.

Histamine and mast cell activity
Histamine can contribute to flushing, itching, redness, warmth and burning or stinging sensations in the skin.

If your burning tends to occur alongside flushing, hives, headaches, digestive symptoms or reactions to alcohol, certain foods, heat or stress, histamine may be worth considering.

Hormonal fluctuations may also influence mast cell and histamine activity in some women, potentially helping to explain why these symptoms can become more noticeable during perimenopause.

Medications and supplements
Some medications and supplements can contribute to altered nerve sensations. This is another reason why it's important to consider everything you're taking, including products you may have been using for a long time.

If your symptoms started soon after beginning or changing a medication, supplement or hormone therapy, discuss the timing with your healthcare practitioner rather than automatically assuming the symptom is due to menopause itself.

There are also neurological, autoimmune, infectious and vascular conditions that can cause burning sensations.

This doesn't mean you need to assume something serious is wrong.

It simply means new or persistent burning deserves investigation rather than automatically being labelled menopause.

What can you do about burning skin?

Start by looking for patterns.

Where does the burning occur? How long does it last? Is it associated with hot flushes? Does exercise, alcohol, heat, stress, clothing, skincare or certain foods make it worse?

Does it happen at a particular time of day? Did it start after changing a medication, supplement or hormone therapy?

And importantly, is there anything visible on the skin?

Keeping a simple symptom diary for a couple of weeks may help you identify connections that aren't immediately obvious.

If the sensation is persistent or recurring, your healthcare practitioner may consider investigating areas such as:

• B vitamins

• iron status

• blood glucose and HbA1c

• thyroid function

• kidney and liver function

• medication and supplement use

• neurological signs and symptoms

Your individual history will determine whether further investigation is needed.

From a naturopathic perspective, I would also be interested in the bigger picture: nutrient status, blood sugar regulation, inflammation, nervous-system health, circulation, skin barrier health, diet, alcohol intake, stress and your overall menopausal experience.

Supporting sensitive menopausal skin

If your burning appears to be coming from dry or increasingly reactive skin, simplifying your skincare can sometimes make a surprising difference.

Choose gentle, fragrance-free products, avoid very hot showers and consider a good-quality moisturiser that supports the skin barrier.

Healthy fats, adequate protein, hydration and nutrients required for healthy skin and nerve function are also important.

If you identify a nutritional deficiency, blood sugar issue, thyroid problem or another underlying driver, addressing that cause is likely to be more useful than simply trying to suppress the burning sensation.

And if hot flushes seem to trigger the sensation, addressing the underlying vasomotor symptoms may help reduce the burning episodes as well.

The bottom line

Burning skin can be one of those strange symptoms that appears around perimenopause and leaves you wondering what on earth is happening to your body.

Hormonal changes may be part of the picture.

But they shouldn't automatically be considered the whole picture.

If your skin feels like it's burning, stinging, prickling or unusually hot, especially when there's no obvious explanation, it's worth looking at your skin, nervous system, nutrient status, metabolic health and hormones together.

Because menopause may provide a clue.

It shouldn't stop us from asking why.