The Estrogen Effect

The Estrogen Effect: Counteracting the Havoc of Hormones on Skin

It happens like clockwork (literally): Menopause arrives, and with it a seemingly instantaneous shift in facial skin’s look and feel. The hormonal mechanism behind it has been at work for years, with skin fluctuating in thickness each month—from lowest at the start of the menstrual cycle to highest as estrogen reaches its peak at the finish. But many women notice it for the first time when plummeting post-menopause hormones accompany a sudden onset of skin aging: thinner skin, an increase in the number and depth of wrinkles, more dryness, less firmness/elasticity.

 

Are there other factors that catch up with us—and our skin—as we age? Absolutely. Environmental factors such as UV exposure, tobacco exposure, and stress can result in elastic degeneration, bringing about dull skin and showcasing the wrinkles that come naturally with time. But estrogen is a key culprit behind these changes.

 

Aging gracefully, however, need not mean passively accepting our genetic hand, or our endocrine system’s whims. There are two key ways to counteract these complexion changes.

 

Hormone Therapies

Topical estradiol, a synthetic estrogen derivative, can reduce the epidermal thinning associated with aging skin, and maintain skin thickness. Topical estrogen therapy has clinically demonstrated a reduction in skin wrinkling after a 24-week period. 

 

In addition, hormone replacement therapy (HRT) has been shown to increase epidermal hydration, elasticity, and skin thickness, while reducing wrinkles, while enhancing collagen quality and vascularization. HRT has also been shown to improve skin hydration when estrogen is administered systemically or topically.

 

Overall, estrogen-based approaches are effective in stimulating collagen synthesis and turnover, and boosting skin’s hydration, yielding a fresher appearance for many post-menopausal women. Since there are many advantages and disadvantages to these hormonal approaches, especially HRT, it’s best for women to consult their primary care physician or OB/GYN to discuss the best approach. 

 

Hold-the-Hormone Therapies

There are non-hormonal pathways we can take to reverse signs of aging in the skin. One of my favorites is topical tretinoin, or retinoic acid, shown to think the stratum corneum—the upper-most waxy layer of the skin—and reverse cellular atypia associated with photoaging. It’s also clinically proven to increase the synthesis of collagen and address uneven pigmentation for a smoother appearance. 

 

No matter which approach you take, a proactive approach is possible—for every woman—when it comes to counterbalancing the estrogen effect.

 


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Author
Kaete Archer, MD Facial Plastic Surgeon

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