I’m a tad obsessed with this right now. “Estrogens and aging skin” is a 2013 publication I am looking at, which is in the weeds of the nitty gritty, published in the Journal of Dermato-Endocrinology.
“Menopause and Skin Aging” had some super interesting facts cited from other studies. Please take this all with a grain of salt. If you see enough scientific publications, you know these are complex issues. But I am trying to suss out what the changes are, and what the treatments can be, what the treatments do if anything, and how to apply those treatments. This journal article was a metanalysis of what studies are out there.
They state many of the effects of estrogen on aging are seen by comparing post menopausal women who took estrogen replacement vs. those who did not.
WHAT DO THEY SEE?
- increase in epidermal thickness in human female skin following 6 months of oral estrogen
- TOPICAL estrogen increases keratinocyte proliferation and epidermal thickness after only 2 weeks
- in estrogen deficient women skin thickness is reduced by 1.13% and collagen content by 2% per post menopausal year
- type I and III skin collagen decreases by as much as 30% in the first 5 years after menopause
- a parallel reduction in bone mass if observed in post menopausal women
- The decrease in skin thickness and collagen content in elderly women correlates with the period of estrogen deficiency rather than the chronological age
- decrease in collagen types I and II and reduction in the III/I ratio, correlating again not with age but with period of estrogen deficiency
- A randomized double blind placebo controlled trial showed one year of oral estrogen can increase dermal thickness by 30% in post menopausal women
- A similar trial showed 6 months of treatment with oral estrogen increases skin collagen by 6.5%
- other studies show an increase specifically in type III collagen
- The increase in response to estrogen therapy is related to initial collagen content, so in those with low skin collagen to begin with estrogen is therapeutic and then prophylactic. (those with thicker initial collagen it is prophylactic)
- Women who took oral estrogen for 5 years were compared with those who did not, and they found the average wrinkle score was significantly lower in the estrogen treated group.
- TOPICAL estrogen can increase skin collagen, but it is confined to the area it is applied.
- TOPICAL estrogen was shown to increase type I and III procollagen, tropoelastin, and TGF beta expression
- TOPICAL estrogen thickens elastic fibers, increases the number of fibers, and improves their orientation in the papillary dermis
- Skin elasticity decreases by 1.5% / year. This leads to skin wrinkling.
My thoughts?
Pretty compelling. This doesn’t answer my other questions- what level is okay? when do you start? topical vs oral? breast cancer risks? blood clotting risks? But there are numerous studies with biopsies and evaluations showing objective differences.
Stay tuned for more.