Hormonal Update Volume 3 Number 3

Can Hormones Provide a Natural Face Lift?

In just the last decade it has been discovered that your skin may play an unexpected, and quite profound, role in your health and immunity. Your skin is no longer looked upon as simply the barrier that protects your internal organs, bones and muscles from the outside world. It’s now believed to be a kind of go-between, mediating the relationship your inner body has with its outer environment, and our hormones seem to be at the center of it all. In fact, new dermatological research suggests that there is so much hormonal activity going on in your skin that it may function as a “second” endocrine system.

It is well known that surface irritants can cause skin problems. However, we now know that many skin conditions are actually systemic, originating from physiological and hormonal imbalances. For example, hirsutism is the medical name for excess body or facial hair in women. Excess androgens, or male hormones, are generally the cause. Assessing a woman’s androgen levels can provide her healthcare practitioner with effective guidelines for treating hirsutism. 

As a woman’s hormones begin to fluctuate during perimenopause, skin changes are often the things she notices. Wrinkles, dryness, and loss of luster and elasticity can all result from declining sex steroid hormone levels.

Estrogen and the Skin

Scientific studies have shown that estrogen replacement can:

Estrogen also plays a role in the way fat is distributed under the skin. Loss of this layer of fat can make skin look older than it should, by contributing to sagging and loss of fullness. 

When estrogen levels decline, skin tissue in other areas of the body, such as the vagina, also begins to lose elasticity and moisture. This can leave the vaginal walls dry and sensitive, and can negatively impact a woman’s sexuality by making it uncomfortable to have sex.

As a woman ages, and her skin becomes thinner, drier, and flakier it may actually compromise her skin's integrity and function. In a recent study involving wound healing it was found that estrogen replacement actually speeds healing by regulating cytokine levels. Cytokines are cells necessary for healing. The topical application of estrogen was found to significantly accelerate and improve the healing of wounds in the elderly. Interestingly, the stress hormone cortisol can delay the delivery of cytokines to a wound. Too much cortisol, as the result of too much stress, can prevent the skin from healing properly.

Testosterone and the Skin

Almost everyone has experienced periodic skin breakouts. The occasional whitehead, blackhead or even red “zit” can easily be tolerated, but acne is another story. Acne can contribute to stress, depression, and lower self-esteem. 

Acne usually occurs for the first time during adolescence, when production of the male hormone testosterone begins to kick in. Testosterone helps stimulate oil production in the sebaceous glands. Sebaceous glands produce sebum, the oily substance that helps keep skin soft and supple. If testosterone production escalates rapidly and too much is produced, it can cause the sebaceous glands to produce too much sebum. This in turn can clog pores and cause acne. 

During perimenopause and menopause when a woman’s hormones are shifting and declining, an imbalance in testosterone can often cause skin changes. For example, perimenopause is a time when many women experience a resurgence of acne. Just like during adolescence, too much testosterone can cause excessive oil production, which can lead to clogged pores and acne. However, thin, dry skin can also be result of an imbalance in testosterone. Too little testosterone can mean not enough sebum. Remember, sebum helps moisturize the outer layer of skin. Replenishing testosterone to the appropriate level can rejuvenate sebum production and restore skin’s more youthful look. 

The relationship among hormones and the synchronicity between them is vitally important in how they function. The right amount of testosterone, prescribed with a balanced dosage of estrogen can help regulate the skin’s oil gland activity. Women who take a combination HRT program that includes estrogen and testosterone have been shown to have skin that is 48% thicker and suppler than women who do not take hormones.

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that strikes between 5 and 10% of all women, and is one of the leading causes of infertility. Among the symptoms of PCOS are skin and hair changes, such as acne, increased facial and body hair, and scalp hair thinning. PCOS is believed to be the result an imbalance between estrogen and testosterone production, causing testosterone to be too high.

New Frontiers in Skin Research

The hormones DHEA and melatonin are both found in the skin, DHEA abundantly, and melatonin in small amounts. It is still too early in the research to fully understand the role these hormones play in the health of our skin; however, scientists are suggesting that they may play multiple roles. 

DHEA has been found to aid in burn healing, and to have antioxidant and anti-inflammatory actions in the skin. In the body DHEA can be converted to estrogen and testosterone, potentially allowing both hormones to benefit the skin. Readily absorbed by the skin, the skin activity of DHEA when applied topically is 85 to 90% greater than when taken orally. Research is underway to determine the effects of DHEA supplementation on the skin. 

Melatonin may also help heal burns and help protect against UV radiation. It’s been found that people with eczema and psoriasis tend to have “valleys” in melatonin production when they should have peaks. In other words during the day when melatonin levels should be low, they are high. At night when melatonin should be high it is actually low. Monitoring melatonin levels may help healthcare practitioners treat these skin disorders. 

Human skin regenerates mostly during the night. The stress hormone cortisol, when elevated at night due to chronic or unrelenting stress, can impede this process. With higher night cortisol values, less skin regeneration takes place. This suggests that a normal cortisol rhythm is essential for optimal skin tone and health. Cortisol levels should be higher in the morning and lowest at bedtime. Testing salivary cortisol levels throughout a 24-hour period can help determine whether or not your cortisol level matches the normal pattern.

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