How does hrt affect the skin

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Diet and exercise play an important role, obviously. However, there is no treatment or regimen that will improve health, wellness, aesthetics and overall wellbeing as well as replacing and optimizing hormones that decline with age.

Several studies suggest there are benefits from using bioidentical hormones to alleviate symptoms from dry, itchy, thin and fragile skin, as these hormone treatments can increase skin hydration and reduce skin atrophy, according to a review published January in the Dermatology Online Journal. Moy says there are a number of hormones that tighten and thicken skin. As one ages, collagen is lost in the skin, which affects skin thickness, texture and hydration. Dehydroepiandrosterone DHEA , testosterone, estradiol estrogen and the thyroid all affect the integrity and health of skin.

DHEA, which patients can buy in topical or oral form over the counter, has been shown in studies to thicken and tighten skin and in a case report in the Journal of the American Academy of Dermatology to help prevent tears in atopic skin, according to Dr. However, this is where the expertise of the clinician comes into play, as Dr. Moy will adjust doses of the pharmaceutical hormones based on serum levels, symptoms and personal desires. Testosterone, in cream or pill form, is by prescription and can improve skin health and appearance, according to Dr.

It also not only thickens skin but increases [the ability to develop] muscles. Moy cautions. Testosterone is a tissue building, fat melting and aesthetic hormone. It is the best hormone for maintaining that youthful appearance.

It also provides the best effect of maintaining strength and energy. Without testosterone, exercise will show little benefit on maintaining muscle and metabolism. Add testosterone to the mix and that is where the fat burning aesthetic benefits of exercise are maximized. Testosterone also helps decrease osteoporosis risk. Estrogens and skin biology A number of studies have shown that estrogens have many important beneficial and protective roles in skin physiology reviewed in Thornton , The epidermis Epidermal thinning is associated with aging, and topical estradiol has been shown to reduce epidermal thinning in aging skin and maintain skin thickness Shah and Maibach Open in a separate window.

Figure 1. The dermis Autoradiography following administration of systemic or topical estrogen has demonstrated that radio-labeled estradiol binds to dermal fibroblasts in rat and mouse skin Stumpf et al ; Bidmon et al The hair follicle Hair follicles have a built in rhythm of activity that results in the periodic regeneration of new hairs and the molting of old ones. Melanocytes and melanoma Chloasma is a common hyperpigmentation of the face seen in pregnant women, often accompanied by increased pigmentation in other areas including the areolae, linea alba and perineal skin, all of which usually fade following parturition Kroumpouzos and Cohen The menopause Post-menopausal skin has been shown to have increased dryness Sator et al , decreased elasticity Henry et al ; Sumino et al , and increased wrinkling Dunn et al Hormone replacement therapy Further understanding of estrogen effects on human skin is derived from comparisons between post-menopausal women taking estrogen replacement therapy and those who have not.

Skin and aging Although estrogen deficiency is associated with skin changes, intrinsic aging also affects skin physiology. Mechanism of estrogen action Estrogens are the terminal ligand in the biosynthetic pathway of gonadal steroid hormones and are synthesized from androgens by the loss of the C angular methyl group and the formation of an aromatic A ring by the aromatase complex Payne and Hales Figure 2.

Figure 3. Figure 4. SERMs and skin biology Despite the well documented effects of estrogen on skin physiology and aging, there is very limited data on the effect of SERMs on the skin. Figure 5. Potential SERMs in development Recently much emphasis has been placed on developing SERMS, which have tissue specific estrogen actions that can separate the positive biological effects from the undesirable ones.

Figure 6. Conclusion Evident changes associated with skin aging are thinning of the skin, increased dryness and reduced vascularity. Acknowledgments We are indebted to the following for their help and encouragement relating to various aspects of this article, Professor David Sharpe, Dr Louisa Nelson and Dr Ian Laing.

Estrogen and tamoxifen induce cytoskeletal remodeling and migration in endometrial cancer cells. Effects of postmenopausal hypoestrogenism on skin collagen. Estrogen action via the cAMP signaling pathway: stimulation of adenylate cyclase and cAMP-regulated gene transcription. Estrogen improves endothelial function. J Vasc Surg. Potential role of estrogens in wound healing. The effects of aging on cutaneous wound-healing in mammals. J Anat. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response.

Am J Pathol. Age-related differences in the temporal and spatial regulation of matrix metalloproteinases MMPs in normal skin and acute cutaneous wounds of healthy humans. Cell Tissue Res. Tamoxifen—induced female androgenetic alopecia in a patient with breast cancer.

Annals of Internal Medicine. Gender differences in mouse skin morphology and specific effects of sex steroids and dehydroepiandrosterone.

J Invest Dermatol. Fertil Steril. Pseudoprecocious puberty in infants caused by a dermal ointment containing estrogens. J Pediatr. Estradiol signalling via sequestrable surface receptors. Estradiol distribution and penetration in rat skin after topical application, studied by high resolution autoradiography. Psoriasis and pregnancy: hormone and immune system interaction.

Int J Dermatol. Skin collagen changes in post-menopausal women receiving different regimens of estrogen therapy. Obstet Gynecol. Long-term effects of the menopause and sex hormones on skin thickness. Br J Obstet Gynaecol. Hormone replacement therapy and the skin. Estrogens and the skin. Brady Phase III, multicenter, double-blind, randomized study of letrozole, an aromatase inhibitor, for advanced breast cancer versus megestrol acetate.

Journal of Clinical Oncology. Does hormonal skin aging exist? A study of the influence of different hormone therapy regimens on the skin of postmenopausal women using non-invasive measurement techniques. Skin collagen changes related to age and hormone replacement therapy. Facial wrinkling in postmenopausal women. Effects of smoking status and hormone replacement therapy.

Microvascular effects of corticotropin-releasing hormone in human skin vary in relation to estrogen concentration during the menstrual cycle.

J Endocrinol. Estrogens and human scalp hair growth-still more questions than answers. Estrogens and the hair follicle. J German Soc Dermatol. Estrogen receptors alpha and beta form heterodimers on DNA. J Biol Chem. Effect of a conjugated oestrogen Premarin cream on ageing facial skin. A comparative study with a placebo cream. Tamoxifen, 17beta-oestradiol and the calmodulin antagonist J8 inhibit human melanoma cell invasion through fibronectin. Br J Cancer.

Tissue-specific estrogenic response and molecular mechanisms. Toxicol Lett. Topical and oral estrogens revisited for antiaging purposes. Does estrogen prevent skin aging? Psoriasis: improvement during and worsening after pregnancy. Br J Dermatol. Hormone replacement therapy and malignant melanoma: to prescribe or not to prescribe? The influence of female sex hormones on skin thickness: evaluation using 20 MHz sonography.

Estrogen and estrogen receptor antagonists stimulate transcription from the human retinoic acid receptor-alpha 1 promoter via a novel sequence. Mol Endocrinol. Human estrogen receptor beta-gene structure, chromosomal localization, and expression pattern. J Clin Endocrinol Metab. Alopecia and breast disease. British Medical Journal. Estrogen receptor beta: re-evaluation of estrogen and antiestrogen signalling.

Cardiovascular disease outcomes during 6. Estrogen receptor beta — a new dimension in estrogen mechanism of action. Systemic therapy with estrogen or estrogen with progestin has no effect on skin collagen in postmenopausal women. Human cultured skin fibroblasts express estrogen receptor alpha and beta.

Int J Mol Med. Differential effects of estradiol, raloxifene and tamoxifen on estrogen receptor expression in cultured human skin fibroblasts. Skin and hormone therapy. Clin Obstet Gynecol. Isolation and characterization of the estrogen receptor in human skin. Effect of estrogen on in vivo and in vitro collagen biosynthesis and maturation in old and young female guinea pigs. Age-related changes in facial skin contours and rheology. J Am Geriatr Soc. Estrogen induces different responses in dermal and lung fibroblasts: special reference to collagen.

Connect Tissue Res. Topical tamoxifen — a potential therapeutic regime in treating excessive dermal scarring? Br J Plast Surg. The effects of tamoxifen on rat skin. Eur J Gynaecol Oncol. Designer estrogens. Sci Am. Tamoxifen-induced cell death in malignant melanoma cells: possible involvement of the insulin-like growth factor-1 IGF-1 pathway.

Mol Cell Endocrinol. Estrogen receptor interaction with estrogen response elements. Nucleic Acids Res. Reversal of bone loss in mice by nongenotropic signaling of sex steroids. Kinase-mediated regulation of common transcription factors accounts for the bone-protective effects of sex steroids. J Clin Invest. Dermatoses of pregnancy. J Am Acad Dermatol. Comparison of the ligand binding specificity and transcript tissue distribution of estrogen receptors alpha and beta.

Estrogen receptor pathways to AP Steroid Biochem Mol Biol. Adrenal androgens and intracrinology. Semin Reprod Med. Sensitivity of human melanoma cells to oestrogens, tamoxifen and quercetin: is there any relationship with type I and II oestrogen binding site expression? Melanoma Res. Cellular functions of plasma membrane estrogen receptors.

Cell signaling and estrogens in female rat osteoblasts: a possible involvement of unconventional nonnuclear receptors. J Bone Mineral Res. Effect of pregnancy on the human hair cycle.

A randomized, double-blind, placebo-controlled study on the effect of conjugated estrogens on skin thickness. Am J Obstet Gynecol. Distinct nongenomic signal transduction pathways controlled by 17beta-estradiol regulate DNA synthesis and cyclin D 1 gene transcription in HepG2 cells.

Mol Biol Cell. Estrogen signaling: a subtle balance between ER alpha and ER beta. Mol Interv. Effect of tamoxifen on transforming growth factor beta1 production by keloid and fetal fibroblasts. Arch Facial Plast Surg. Gender and cutaneous melanoma. Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis. Estrogen receptor alpha, but not estrogen receptor beta, is involved in the regulation of the hair follicle cycling as well as the thickness of epidermis in male mice.

The plasma membrane estrogen receptor: nuclear or unclear? Trends in Pharm Sci. Prevention during the menopause is critical for good health: skin studies support protracted hormone therapy. Endocrinology of melanoma. Semin Surg Oncol. Estrogen production and action. Tamoxifen, screening and new oestrogen receptor modulators. Membrane estrogen receptors identified by multiple antibody labelling and impeded-ligand binding.

Ageing alters zonation in the adrenal cortex of men. Effects of topical estradiol on the facial skin collagen of postmenopausal women under oral hormone therapy: a pilot study. Overview of steroidogenic enzymes in the pathway from cholesterol to active steroid hormones.