Estrogen and skin: the effects of estrogen, menopause, and hormone replacement therapy on the skin.

UNLABELLED: Aging is associated with declining levels of several hormones, including estrogen. Although the effects of estrogen on the skin are still not fully understood, it is known that, in women, declining estrogen levels are associated with a variety of cutaneous changes, many of which can be reversed or improved by estrogen supplementation. Estrogens are C-18 steroids synthesized from cholesterol in the ovary premenopausally and in the peripheral tissue in postmenopausal women. Two estrogen receptors, alpha and beta, have been cloned and found in various tissue types. Studies of postmenopausal women indicate that estrogen deprivation is associated with dryness, atrophy, fine wrinkling, poor healing, and hot flashes. Epidermal thinning, declining dermal collagen content, diminished skin moisture, decreased laxity, and impaired wound healing have been reported in postmenopausal women. This article reviews the effects of declining estrogen levels on the skin and the effects of estrogen supplementation. LEARNING
OBJECTIVE: At the conclusion of this learning activity, participants should be familiar with the pathways of estrogen synthesis, sites of estrogen receptors, age-dependent variations in serum estrogen concentration, the changes seen in postmenopausal skin, and the effects of estrogen supplementation.