According to Cosmetic Dermatology, a textbook of the field written by Dr. Leslie Baumann, it has been established that hormones affect acne levels, skin thickness, wrinkles, and hair growth. Understanding of how hormones affect skin is particularly beneficial for women who are postmenopausal and considering HRT, or restoring hormonal levels after cancer treatment.
How do hormones affect acne?
As acne generally begins with puberty and the emergence of hormones, many women blame estrogen and testosterone for their acne troubles. However, according to Cosmetic Dermatology, a surprising 2000 study by Cibula et. al found that there is no correlation between androgens and acne levels. This finding is in line with the fact that some women continue to experience acne as they age and hormonal levels decline.
However, hormones still have proven effective in the fight against acne. Many women find that their acne lessens with oral contraceptive use: a Baumann-cited 1997 study by Redmond et. al found that Ortho Tri-Cyclen Lo reduced acne lesions by 46.4 percent, as compared to 33.9 percent with placebo. In addition, a second Baumann-cited study by Koulianos et. al found that no low-dose combination oral contraceptive is more effective in treating acne than another. As such, even though acne has not young women with acne may benefit somewhat from treatment with low-dose oral contraceptives.
How does estrogen affect skin thickness?
According to L’Oréal, the average woman’s skin decreases in thickness by 7% every ten years. According to Baumann, this is most likely due to the effect of decreasing hormone levels on collagen, elastic fibers, glycoaminoglycans, and hyaluronic acid content. However, skin thickness may be better preserved with hormone replacement therapy. A Baumann-cited 1996 study by Callens et. al found greater skin thickness in women who have undergone hormone replacement therapy than in women who have not undergone hormone replacement therapy. In addition, time plays a role: a Baumann-cited study by Brimcat et. al found that 30 percent of collagen is lost in the first five years after menopause, with an average decline of 2.1 percent per postmenopausal year over a period of twenty years. So the sooner hormone replacement therapy is begun after menopause, the higher the levels of collagen available to be preserved.
How does estrogen affect wrinkles?
According to a 2003 review by Shah et. al., there seems to be no direct answer to this question, but many possibilities. Estrogen prevents a decrease in skin collagen in postmenopausal women, and decreases in collagen types IV and VII are present in the bottom of wrinkles. In addition, estrogen maintains skin moisture by increasing acid mucopolysaccharides and hyaluronic acid in the skin, and increasing sebum levels, which all naturally plump up the skin, decreasing the appearance of wrinkles. Outside of its influence on skin aging, it has been suggested that estrogen increases cutaneous wound healing by regulating the levels of a cytokine, and so it is probable (but certainly not proven) that estrogen may signal for the repair of wrinkles as well.
How does estrogen affect hair growth?
According to the Baumann-cited study by Shuster et. al., estrogen regulates the anagen-telogen cycle, in which the hair grows during the anagen cycle and telogen the resting phase. Increased amounts of estrogen, such as those seen during pregnancy, increase the proportion of hair in the anagen cycle. Conversely, as would be expected in postmenopausal women with decreased levels of estrogen, the proportion of hair in the telogen, or resting, cycle is increased. Although hair growth and loss is certainly more complex than can be determined from estrogen levels, the correlation certainly is influential.
In summary, young women experiencing acne may be advised to try low-dose oral contraceptives to treat their acne symptoms, as these have been shown to have beneficial results in clinical trials. In addition, postmenopausal women are encouraged to weigh the risks, as it has been determined that undergoing hormonal replacement therapy as soon as possible has many benefits for the skin and hair, including maintained skin thickness and elasticity and decreased hair loss and wrinkle formation.
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