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Hormonal Effects on Skin
Let's Rethink 'Aging Skin': Skin Changes can be symptoms of Hormones in Flux
UV exposure has been well established as the most important cause of skin aging. This information is not new. Women who come to our clinic inquire about additional factors which impact skin integrity. With the loss of sex steroid hormones, (peri)menopause accelerates many mechanisms of female aging. Treatments using botox and fillers are literally merely skin deep when considering the underlying effects on skin for women facing a decline in ovarian hormonal synthesis. You may not have considered ovarian aging as an aspect of skincare because this fascinating topic is not well known, and is otherwise routinely ignored when a woman asks her doctor for help with skin aging issues. Dr. Parker attempts to address this gap in care to help level up her patients' options when it comes to staving off some features of aging.
The slow-drip decline of estrogen with age and menopause causes systemic changes in a woman's body, and these effects are the major drivers of telltale signs of aging. The skin's dermal layer has a prolific relationship between estrogen and collagen, where cellular membranes within the dermis contain estrogen receptors. The presence of robust levels of estrogen thereby stimulates the production of fibroblasts and collagen, and these features of youth generate plump, more resilient skin. Aging is associated with declines in estrogen and collagen breakdown, in addition to cumulative sun exposure and overall health status. The skin of a woman undergoing hormonal transition, with loss of progesterone, growth hormone and especially estrogen, produces less elastin fibers, less glycosaminoglycans and less hyalauronic acid. To the naked eye, these relative losses are expressed as skin which looks less hydrated, is more prone to wrinkling and does not possess the same plump firmness. Women often report that their skin has morphed into a texture of a "baked apple" or "raisin", that their features are shifting, in addition to reporting eyelid hooding and overall skin sagging. Complaints regarding delayed wound healing, increased bruising frequency, increased prominence of veins and bones are related to compromised synthesis of estrogen-related growth factors and repair enzymes. Bone loss of the facial skeleton leads to contour changes as well as sagging skin, and a shift in the presence of facial fat further exaggerates skin wrinkling and sagging of the jowls, as well as facial hallowing.
Estrogen's decline also influences microvasculature in the head, neck and face. Impairments in blood flow result in decreased formation of blood vessels and less oxygenation transport to the skin's protective sheath, known as the stratum corneum layer, which is expressed as skin thinning, poor wound healing and a dullness of complexion. Since even melanocytes (melanin-producing cells) respond to estrogen, fluctuations in this hormone can show up as blotchy patches as well as hypo- and hyperpigmentation issues in skin exposed to sun.
In Dr. Parker's practice, estrogen receptor-targeted therapeutics can be considered as a central component of slowing down multiple processes involved in aesthetic aging. Peptides, botanicals and nutrient cosmeceuticals may also be offered. Prescriptions are individualized based on a woman's unique health history, goals and skin characteristics. Rational use of exogenous estrogen treatment as part of a holistic regime can improve, reverse and stave off some of these processes. While no treatment can truly be touted as anti-aging, innovations in the use of estrogen-based therapies can make a difference for many women. When paired with senolytic medicine (substances which have been shown to activate the SIRT-1 pathway, as well as other pathways involved in regulating lifespan), there may be further potential for improvements arising from estrogen receptor-targeted therapeutics.
References:
Ashcroft GS, Greenwell-Wild T, Horan MA, Wahl SM, Ferguson MW. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol. 1999 Oct;155(4):1137-46. PMID: 10514397
Horng HC, Chang WH, Yeh CC, Huang BS, Chang CP, Chen YJ, Tsui KH, Wang PH. Estrogen Effects on Wound Healing. Int J Mol Sci. 2017 Nov 3;18(11):2325. PMID: 29099810.
Wilkinson HN, Hardman MJ. The role of estrogen in cutaneous ageing and repair. Maturitas. 2017 Sep;103:60-64. PMID: 28778334
Inquire into Your Hormones for Holistic Beauty
A woman whose heart is true to herself radiates self-renewing beauty, immutable to time. Skin care can be healing when they generate the repair and rejuvenation of underlying health issues. Yet our idea of beauty is not one that gives rise to lost sleep and a gnawing need to emulate impossible and unnatural beauty standards. Navigating concepts of self-care and beauty at menopause may be akin to a zen koan even to liberated and self-assured minds. Over the ten year arc of menopause, stress modulation is influenced by excessive androgen hormones, lowered estrogen, lowered progesterone, thyroid imbalances, disturbed sleep, improper diet and nutrient status, all of which all impact radiance factors. You can work on factors which promote healthy skin in a non-judgemental safe space, where these prescriptions are often quite affordable and natural, where you can reveal vulnerabilities without fear that the conversation will usher you towards a complete makeover.
Menopausal status is a significant factor on collagen integrity, since women lose about 30% of types 1 & 3 collagen within just the first two years after their last cycle. This has a system-wide impact on many features which impact how she presents herself to the world. Based upon her training in regenerative medicine at menopause, Dr. Parker combines advancements in medical technology with clinical expertise to rejuvenate features that change with age. These include concerns with collagen laxity, photo-aging and duller complexion. If facial collagen loss is a concern, a holistic skincare plan may use prescription peptides which have been formulated based on your genetic testing, as well as antioxidants and other nutrients. Our results are subtle and transformation is achieved over time. We do not provide botox and fillers, and focus instead on helping you create renewal from the inside out. Foundational treatments assess inflammation and nutrients, hormonal status, diet and lifestyle factors.