Introduction:
Aging has several effects on the skin. This primarily happens because the level of hormones in the body may decrease with age. These hormones are estrogen, testosterone, dehydroepiandrosterone sulfate, as well as growth hormones. Of all these hormones, estrogen is known to contribute more to skin aging. Hormonal replacement therapy (HRT) can improve skin aging signs that may occur after menopause.
What Are the Signs of Aging on Skin Due to Hormonal Changes?
Hormonal changes in the body cause several changes in the skin, such as:
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Significantly increase the dryness of the skin.
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Loss of skin elasticity.
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Loss of skin firmness.
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The appearance of wrinkles on the skin.
What Are the Effects of Estrogen Hormones on Aging Skin?
Estrogen hormone regulates the physiology of the skin, sweat glands, hair follicles, and melanin-forming cells (melanocytes). They also enhance wound healing, immunity, and the formation of new blood vessels (angiogenesis).
A decrease in estrogen levels causes the following skin changes:
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Decrease vascularity.
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Loss of elasticity.
The effects of estrogen hormones on other factors are:
1. On Oxidative Stress:
Oxidative stress has a major role in skin aging. It is a condition that develops when the balance between free radicals and the antioxidant defense in the body gets disturbed. This usually happens due to a decreased level of antioxidants.
According to a study conducted recently, the estrogen hormone provides protection against oxidative stress, and this hormone has an antioxidant property. So, this hormone can effectively reduce oxidative stress and hence prevents skin aging.
In addition, ultraviolet light (UV) has also been associated with skin aging, and this primarily causes premature skin aging.
2. On Skin Thickness and Collagen Content:
In many studies, it has been found that postmenstrual women have low levels of collagen and reduced thickness of skin due to low levels of estrogen in their bodies after menopause. These studies also showed an increase in collagen levels and skin thickness after the estrogen hormone replacement therapy.
3. On Skin Moisture:
Estrogen hormone deficiency increases dryness in the skin. The stratum corneum (the outermost layer of the skin) can hold water which maintains the skin’s moisture. Estrogen deficiency causes loss of skin moisture and makes skin dry. In some studies, it was found that estrogen hormone replacement increases the water-holding capacity of the stratum corneum.
4. On Skin Wrinkling:
A decrease in estrogen hormone levels causes a decrease in collagen in the skin and hence causes wrinkles to appear. In postmenstrual women, skin elasticity decreases because of a lack of estrogen.
5. On Skin Pigmentation:
Estrogen hormone modulates pigmentation in the skin. An increase in estrogen results in hyperpigmentation of the skin, which is commonly called melasma. This condition occurs during pregnancy or in women who take contraceptive pills having estrogen. The pigment-forming cells, melanocytes, respond to increased levels of estrogen by increasing pigmentation levels.
6. On Hair Growth:
Estrogen hormone plays an important role in hair growth as this hormone affects the hair cycle. After menopause, a decrease in the estrogen hormone level results in hair loss and hair thinning. This can be treated with hormone replacement therapy.
7. On Wound Healing:
Skin aging is also associated with impaired healing of the wound. Estrogen hormones play an important role in the wound healing phases. In a study conducted on venous and pressure ulcers, it was found that postmenstrual women who were not taking estrogen replacement therapy were more susceptible to developing these ulcers than those who were taking the therapy.
8. On Menopause:
Menopause in women is associated with a drop in estrogen levels. So, after menopause, all the signs of skin aging occur, which is linked to estrogen levels. These are thinning of the skin with low collagen content, increased skin dryness, and increased skin wrinkling. These signs of aging can be treated with estrogen hormone replacement therapy.
What Is Hormonal Replacement Therapy (HRT) for Skin Aging?
The HRT is used in treating side effects of menopause, including effects on the skin. In studies, it has been proved that skin aging signs can be treated with HRT.
What Are the Forms of HRT?
This therapy can be given in the form of tablets, skin patches, vaginal routes, or in the form of gel.
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Tablets: This is the most common route of HRT therapy and is easy to take.
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Skin Patches: This form of HRT is applied to the skin and then replaced as suggested by the doctor. These patches prevent the side effects of tablets, such as indigestion, nausea, or vomiting.
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Gel: This form is very easy to apply as it is in gel form. It is applied topically on the skin.
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Vaginal Estrogen: These help with dryness of the vagina caused due to low levels of estrogen after menopause. This is available in the form of a cream or tablet that could be inserted inside the vagina.
What Are the Side Effects of Hormonal Replacement Therapy?
As hormones are replaced in this therapy, they have some side effects too. These are:
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Bloating.
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Cramps in the leg.
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Tenderness or swelling in the breast.
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Headache.
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Swelling in the body.
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Sickness.
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It is a risk factor for breast and uterine cancer.
However, these side effects last for a few weeks, and a good and healthy diet that is low in fat and high in carbohydrates should be taken to reduce tenderness in certain areas of the body. Cramps in the legs can be reduced by stretching and exercises. Side effects related to the stomach (bloating and indigestion) can be cured by taking medicine with food.
Conclusion:
The skin undergoes many changes as age advances, the primary cause being a decrease in hormonal levels. These hormones play an important role in various activities related to the skin, like collagen production, wound healing, skin hydration, etc. So, when their levels drop down, skin loses its elasticity, impairs the wound healing process, skin becomes excessively dry, and wrinkles appear on the skin. This can be treated with hormone replacement therapy, but it has some side effects too.
