Still thinking that hormone replacement therapy (HRT) can improve the appearance of aging skin? You may want to think again.
This past March, dermatologists at the American Academy of Dermatologists’ annual meeting once again debunked claims that HRT can improve the appearance of aging, photo-damaged skin. Although I’ve written on this topic previously, the subject is interesting (and relevant) enough to revisit.
Undoubtedly, certain areas of the body are more receptive to estrogen than others, e.g., cells comprising the skin on the face. And while estrogen can increase collagen, help the skin retain water and promote elasticity, its ability to reverse the effects of aging remain questionable.
Dr. Margaret Parsons, assistance clinical professor of dermatology at the University of California-Davis, says that she does not prescribe estrogen to improve skin’s appearance because data have not consistently shown any benefit. Not only doesn’t she believe that topical or oral estrogens offer any sort of long-term solution, but she also points to the risks involved in their use, such as breast cancer.
Consider the evidence (or lack, thereof):
- In a study published last year in the Journal of the American Academy of Dermatology, researchers evaluated whether or not low-dose HRT could improve the appearance of fine lines and wrinkles, skin dryness/texture and sagging. Study participants were 485 women who had been menopausal for about five years. No significant improvements were seen after 48 weeks of treatment, although researchers suggested that longer use of hormones or different doses might lead to better results.
- In another study, which I wrote about last year, applying topical estrogen to sun-damaged skin, likewise, did not improve the skin’s appearance, although it did appear to promote collagen production in areas that had not seen the light of day, i.e. the hip.
- A third study, published in the early 90s, suggests that use of a topical cream early in menopause and for a longer period of time, may improve the appearance of aging skin. However, this study was only conducted in 18 women over a period of six months, making it difficult to reach any definitive conclusions.
It appears that the jury is still out but deliberations don’t look too promising.
Think about it: are you willing to risk the adverse effects of HRT – cancer, death from lung disease, heart disease – for your appearance?
If you are deadset on erasing a few lines and a few years, there are effective therapies that dermatologist regularly suggest to improve skin’s appearance, for example retinoids, glycolic acid or procedures such as chemical peels, lasers, botox and skin fillers. While they might hit your pocketbook harder than HRT, most do not come with the same degree of health risks. You can learn more about taking care of mature skin in this issue of the American Academy of Dermatology’s SKIN e-newsletter.
Obviously, the best advice is to wear sunscreen regularly, avoid smoking and use a topical retinoid. We may not be able to turn back the clock but we can preserve what we have more responsibly. Estrogen might not be the ounce of prevention that works best.
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This is really interesting. Thanks for the good info. I was wondering if you might consider a Q&A page? For instance, I was recently prescribed an estrogen cream for my va-j-j, to help with dryness. The doctor warned me to use very small amounts and said two things I didn't know: (1) women who use too much vaginal estrogen have actually re-started their periods - which the doctor warned is not healthy and should this happen to me return immediately, and (2) as women lose estrogen some encounter a loss of bladder control, which requires some estrogen to remain tight. As an added benefit, using a vaginal estrogen cream can strengthen the bladder muscles. But again, use sparingly. So, I've still not used the cream because I have this nagging feeling I'd be better off without it. What's your take on it? I know you've written about it before but, back to the Q&A page, it would be easier for people like me to throw out a question. I can do my own research on goggle, for instance, but I get confused by the language I encounter and I never really know how accurate the info is. Just food for thought.