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Estrogen and Skin

An Overview

Abstract

As the population of postmenopausal women increases, interest in the effects of estrogen grows. The influence of estrogen on several body systems has been well-documented; however, one area that has not been explored is the effects of estrogen on skin. Estrogen appears to aid in the prevention of skin aging in several ways. This reproductive hormone prevents a decrease in skin collagen in postmenopausal women; topical and systemic estrogen therapy can increase the skin collagen content and therefore maintain skin thickness. In addition, estrogen maintains skin moisture by increasing acid mucopolysaccharides and hyaluronic acid in the skin and possibly maintaining stratum corneum barrier function. Sebum levels are higher in postmenopausal women receiving hormone replacement therapy. Skin wrinkling also may benefit from estrogen as a result of the effects of the hormone on the elastic fibers and collagen. Outside of its influence on skin aging, it has been suggested that estrogen increases cutaneous wound healing by regulating the levels of a cytokine. In fact, topical estrogen has been found to accelerate and improve wound healing in elderly men and women. The role of estrogen in scarring is unclear but recent studies indicate that the lack of estrogen or the addition of tamoxifen may improve the quality of scarring. Unlike skin aging, the role of endogenous and exogenous estrogen in melanoma has not been well established.

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References

  1. World Health Organization Fact Sheet Number 252. June 2000

  2. Palacios S. Current perspectives on the benefits of HRT in menopausal women. Maturitas 1999; 33: S1–S3

    PubMed  Article  CAS  Google Scholar 

  3. Albright F., Smith P.H., Richardson A.M. Postmenopausal osteoporosis — its clinical features. JAMA 1941; 116: 2465–2474

    Article  Google Scholar 

  4. Meema H.E., Sheppard R.H., Rapoport A. Roentgenographic visualization and measurement of skin thickness and its diagnostic application in acromegaly. Radiology 1964: 82: 411

    PubMed  CAS  Google Scholar 

  5. Black M.M., Bottoms E., Shuster S. Changes in skin collagen and thickness in endocrine disease. Eur J Clin Invest 1970; 1: 127

    Google Scholar 

  6. Lee J.Y., Maibach H.I. Corticosteroid skin atrophogenicity: assessment methods. Skin Res Technol 1998; 4: 161–166

    Article  CAS  Google Scholar 

  7. McConkey B., Fraser G.M., Bligh A.S., et al. Transparent skin and osteoporosis. Lancet 1963; I: 693–695

    Article  Google Scholar 

  8. Brincat M., Kabalan S., Studd J.W.W., et al. A study of the decrease of skin collagen content, skin thickness, and bone mass in the postmenopausal women. Obstet Gynecol 1987; 70: 840–845

    PubMed  CAS  Google Scholar 

  9. Castelo-Branco C., Pons F., Gratacos E., et al. Relationship between skin collagen and bone changes during aging. Maturitas 1994; 18: 199–206

    PubMed  Article  CAS  Google Scholar 

  10. Hasselquist M.B., Goldberg N., Schroeter A., et al. Isolation and characterization of the estrogen receptor in human skin. J Clin Endocrinol Metab 1980; 50: 76–82

    PubMed  Article  CAS  Google Scholar 

  11. Ciocca D.R., Vargas Roig L.M. Estrogen receptors in human nontarget tissues: biological and clinical implications. Endocrine Reviews 1995; 16: 35–62

    PubMed  CAS  Google Scholar 

  12. Castelo-Branco C., Duran M., Gonzales-Merlo J. Skin collagen and bone changes related to age and hormone replacement therapy. Maturitas 1992; 14: 113–119

    Article  Google Scholar 

  13. Affinito P., Palomba S., Sorrentino C., et al. Effects of postmenopausal hypoestrogenism on skin collagen. Maturitas 1999; 33: 239–247

    PubMed  Article  CAS  Google Scholar 

  14. Vasquez F., Palacios S., Aleman N., et al. Changes of the basement membrane and type IV collagen in human skin during aging. Maturitas 1996; 25: 209–215

    Article  Google Scholar 

  15. Rauramo L., Pnnonen R. Wirkung einer oralen ostrogenotherapie mit ostriolsuccinat auf die Hautt kastrierter Frauen. Z Haut Geschl Kr 1969; 44: 463–470

    CAS  Google Scholar 

  16. Bullough HF. Cyclical changes in the skin of the mouse during estrous cycle. J Endocrinol 1943; 280–287

    Google Scholar 

  17. Brincat M., Yuen A.W., Studd J.W., et al. Response of skin thickness and metacarpal index to estradiol therapy in postmenopausal women. Obstet Gynecol 1987 Oct; 70 (4): 538–541

    PubMed  CAS  Google Scholar 

  18. Callens A., Valliant L., Lecomte P., et al. 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. Dermatology 1996; 193: 289–294

    PubMed  Article  CAS  Google Scholar 

  19. Maheux R., Naud F., Rioux M., et al. A randomized, double-blind, placebo-controlled study on the effect of conjugated estrogens on skin thickness. Am J Obstet Gynecol 1994; 170: 642–649

    PubMed  CAS  Google Scholar 

  20. Sauerbronn A.V.D., Fonseca A.M., Bagnoli V.R., et al. The effects of systemic hormone replacement therapy on the skin of the postmenopausal women. Int J Gynecol Obstet 2000; 68: 35–41

    Article  CAS  Google Scholar 

  21. Varila E., Rantala I., Oikarinen A., et al. The effect of topical oestradiol on skin collagen of postmenopausal women. Br J Obstet Gynaecol 1995 Dec; 102 (12): 985–989

    PubMed  Article  CAS  Google Scholar 

  22. Haapasari K., Raudaskoski T., Kallioinen M., et al. Systemic therapy with estrogen or estrogon with progestin has no effect on skin collagen in postmenopausal women. Maturitas 1997; 27: 153–162

    Article  Google Scholar 

  23. Savvas M., Laurent G. Type III collagen content in the skin of postmenopausal women receiving estradiol and testosterone implants. Br J Obstet Gynaecol Feb 1993; 100: 154–156

    Article  CAS  Google Scholar 

  24. Brincat M., Versi E., Moniz C., Skin collagen changes in postmenopausal women. BMJ 1987; 70 (1): 12

    Google Scholar 

  25. Dunn L., Damesyn M., Moore A., et al. Does estrogen prevent skin aging? Results from the First National Health and Nutritional Examination Survey. Arch Dematol 1997; 133: 339–342

    Article  CAS  Google Scholar 

  26. Schmidt J., Binder M., Demschik G., et al. Treatment of skin aging with topical estrogens. Int J Dermatol 1996; 35: 669–674

    PubMed  Article  CAS  Google Scholar 

  27. Grosman N., Hridbey E., Schon J. The effect of estrogenic treatment on the acid mucopolysaccharide pattern in the skin of mice. Acta Pharmacol Toxicol 1971; 30: 458–464

    Article  CAS  Google Scholar 

  28. Grosman N. Studies on the hyaluronic acid protein complex the molecular size of hyaluronic acid and the exchangability of chloride in skin of mice before and after estrogen treatment. Acta Pharmacol Toxicol 1973; 33: 201–208

    Article  CAS  Google Scholar 

  29. Pochi P.E., Strauss J.S., Downing D. Age related changes in sebaceous gland activity. J Invest Dermatol 1979; 73: 108–111

    PubMed  Article  CAS  Google Scholar 

  30. Pierard-Franchimont C., Letawe C., Goffin V., et al. Skin water-holding capacity and transdermal estrogen therapy for menopause: a pilot study. Maturitas 1995; 22: 151–154

    PubMed  Article  CAS  Google Scholar 

  31. Paquet F., Pierard-Franchimont C., Fuman I., et al. Sensitive skin at menopause; dew point and electrometric properties of the stratum corneum. Maturitas 1998; 28: 221–227

    PubMed  Article  CAS  Google Scholar 

  32. Henry F., Pierard-Franchimont C., Cauwenbergh G., et al. Age-related changes in facial skin contours and rheology. J Am Geriatr Soc 1997; 45: 220–222

    PubMed  CAS  Google Scholar 

  33. Creidi P., Faivre B., Agache P., et al. Effect of a conjugated oestrogen (Premarin) cream on ageing facial skin. A comparative study with a placebo cream. Maturitas 1994; 19: 211–223

    PubMed  Article  CAS  Google Scholar 

  34. Schmidt J., Binder M., Demschik G., et al. Treatment of skin aging with topical estrogens. Int J Dermatol 1996; 35: 669–674

    PubMed  Article  CAS  Google Scholar 

  35. Punnonen R., Vaajalahti P., Teisala K. Local estriol treatment improves the structure of elastic fibers in the skin of postmenopausal women. Ann Chir Gynaecol 1987; 202 Suppl.: 39–41

    CAS  Google Scholar 

  36. Castelo-Branco C., Figueras F., Martinez de Osaba M., et al. Facial wrinkling in postmenopausal women. Effects of smoking status and hormone replacement therapy. Maturitas 1998; 29: 75–86

    PubMed  Article  CAS  Google Scholar 

  37. Agner T., Damm P., Skouby S.O. Menstrual cycle and skin reactivity. J Am Acad Dermatol 1991 Apr; 24 (4): 566–570

    PubMed  Article  CAS  Google Scholar 

  38. Harvell J., Hussona-Saeed I., Maibach H.I. Changes in transepidermal water loss and cutaneous blood flow during the menstrual cycle. Contact Dermatitis 1992; 27: 294–301

    PubMed  Article  CAS  Google Scholar 

  39. Ashcroft G.S., Dodsworth J., Boxtel E.V., et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-B1 levels. Nature Med 1997 Nov; 3 (11): 1209–1215

    PubMed  Article  CAS  Google Scholar 

  40. Sporn M.B., Roberts A.B. Transforming growth factor-B: Recent progress and new challenges. J Cell Biol 1992; 119: 1017–1021

    PubMed  Article  CAS  Google Scholar 

  41. Ashcroft G.S., Greenwell-Wild T., Horan M.A., et al. Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response. Am J Pathol 1999; 155 (4): 1137–1146

    PubMed  Article  CAS  Google Scholar 

  42. Ashcroft G.S., Horan M.A., Ferguson M.W., et al. Aging is associated with reduced deposition of specific extracellular matrix components, an upregulation of angiogenesis, and an altered inflammatory response in a murine incisional wound healing model. J Invest Derm 1997; 108: 430–437

    PubMed  Article  CAS  Google Scholar 

  43. Herrick S.E., Ashcroft G.S., Ireland G., et al. Up-regulation of elastase in acute wounds of healthy aged humans and chronic venous leg ulcers is associated with matrix degradation. Lab Invest 1996; 77: 281–288

    Google Scholar 

  44. Harian J.M., Liu D.Y. Adhesion: its role in inflammatory disease. W.H. Freeman: New York, 1992: 98–103

    Google Scholar 

  45. Whitby D.J., Ferguson M.W.J. Immunohistochemical localization of growth factors in fetal wound healing. Dev Biol 1991; 147: 207–215

    PubMed  Article  CAS  Google Scholar 

  46. Frazier-Jessen M.R. Estrogen suppression of connective tissue deposition in a murine model of peritoneal adhesion formation. J Immunol 1996; 156: 3036

    PubMed  CAS  Google Scholar 

  47. Shah M., Foreman D.M., Ferguson M.W.J. Control of scarring in adult wounds by neutralizing antibody to transforming growth factor B. Lancet 1992; 339: 213–214

    PubMed  Article  CAS  Google Scholar 

  48. Hu D., Hughes M.A., Cherry G.W. Topical tamoxifen — a potential therapeutic regime in treating excessive dermal scarring? Br J Plast Surg 1998 Sep; 51 (6): 462–469

    PubMed  Article  CAS  Google Scholar 

  49. Miller B.A., Ries L.A.G., Hankey B.K., et al. Cancer Statistics Review: 1973–1989. Bethesda (MD): National Cancer Institute, 1992

    Google Scholar 

  50. Snell R.S., Bischitz P.G. The effect of large doses of estrogen and progesterone on melanin pigmentation. J Invest Dermatol 1960; 35: 73–82

    PubMed  CAS  Google Scholar 

  51. Jelinek J.E. Cutaneous side effects of oral contraceptives. Arch Dermatol 1970; 101: 181–186

    PubMed  Article  CAS  Google Scholar 

  52. Chaudhuri P.K., Walker M.J., Briele H.A., et al. Incidence of estrogen receptors in benign nevi and human malignant melanoma. JAMA 1980; 244: 791–793

    PubMed  Article  CAS  Google Scholar 

  53. Beral V., Ramcharan S., Faris R. Malignant melanoma and oral contraceptive use among women in California. Br J Cancer 1977; 36: 804–809

    PubMed  Article  CAS  Google Scholar 

  54. Holman C.D.J., Armstrong B.K., Heenan P.J. Cutaneous malignant melanoma in women: exogenous sex hormones and reproductive factors. Br J Cancer 1984; 50: 673–680

    PubMed  Article  CAS  Google Scholar 

  55. Gallagher R.P., Elwood J.M., Hill G.B., et al. Reproductive factors, oral contraceptive and risk of malignant melanoma: Western Canada Melanoma Study. Br J Cancer 1985; 52: 901–907

    PubMed  Article  CAS  Google Scholar 

  56. Green A., Bain C. Hormonal factors and melanoma in women. Med J Aust 1985; 142: 446–448

    PubMed  CAS  Google Scholar 

  57. Osterlind A., Tucker M.A., Stone B.J., et al. The Danish case-control study of cutaneous malignant melanoma. III. Hormonal and reproductive factors in women. Int J Cancer 1988; 42: 821–824

    PubMed  Article  CAS  Google Scholar 

  58. Zanetti R., Franceschi S., Rosso S., et al. Cutaneous malignant melanoma in females: the role of hormonal and reproductive factors. Int J Epidemiol 1990; 19 (3): 522–526

    PubMed  Article  CAS  Google Scholar 

  59. Smith M.A., Fine J.A., Barnhill R.L., et al. Hormonal and reproductive influences and risk of melanoma in women. Int J Epidemiol 1998; 27: 751–757

    PubMed  Article  CAS  Google Scholar 

  60. Holly E.A., Cresss R.D., Ahn D.K. Cutaneous melanoma in relation to exogenous hormones and reproductive factors. J Natl Cancer Inst 1983; 70: 827–831

    PubMed  CAS  Google Scholar 

  61. Haas J.F. Pregnancy in association with a newly diagnosed cancer: a populationbased epidemiologic assessment. Int J Cancer 1984; 34: 229–235

    PubMed  Article  CAS  Google Scholar 

  62. Lambe M., Thorn M., Sparen P., et al. Malignant melanoma: reduced risk associated with early childbearing and mulitparity. Melanoma Res 1996; 6: 147–153

    PubMed  Article  CAS  Google Scholar 

  63. Holly E.A., Cress R.D., Ahn D.K. Cutaneous melanoma in women: ovulatory life, menopause, and use of exogenous estrogens. Cancer Epidemiol Biomarkers Prevention 1994; Vol 3: 661–668

    CAS  Google Scholar 

  64. Vessey M.P., Painter R., Powell J. Skin disorders in relation to oral contraception and other factors, including age, social class, smoking and body mass index. Findings in a large cohort study. Br J Dermatol 2000; 143 (4): 815–820

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Howard I. Maibach.

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Shah, M.G., Maibach, H.I. Estrogen and Skin. Am J Clin Dermatol 2, 143–150 (2001). https://doi.org/10.2165/00128071-200102030-00003

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Keywords

  • Melanoma
  • Estrogen
  • Postmenopausal Woman
  • Hyaluronic Acid
  • Hormone Replacement Therapy