Bioidentical Hormones (BHRT) & Your Skin

We all want to look good!

Part of looking good is skin that looks good. Aging is an enemy of youthful skin, as older skin is dryer, flatter, and less “pretty” than younger skin.

Also, older skin often is prone to feeling dryer, and itching and often heals much more slowly. Darn it.

What helps skin look good?

Estrogen supports collagen. Preventing aging of the skin is all about maintaining collagen levels in the skin, closer to younger levels. That’s what microabrasion, certain peels, CO2 laser, some new fillers, and other aesthetic interventions try to promote; healthier younger looking collagen-fluffed-up skin.

Little is known or published though, about the use of bioidentical hormones and dermatologic uses, such as anti-aging effects.

Why does skin age?

Older skin mostly looks older, due to “estrogen deficiency”.(Even in males as we also give estriol facial cream to many of our male adult patients).

Menopause is a “deficient estrogen” (and other hormones) state.

Loss of estrogen accelerates collagen breakdown, decreased elastin, and dehydration and is the major cause of impaired wound healing (along with decreased overall circulation).

Loss of collagen makes skin lose tone and look less youthful. And, physiologically become more vulnerable to damage with fewer repair mechanisms on board.

Overall, less estrogen promotes more dry and itchy skin.

Other hormone loss issues show up as hair growth in the wrong places, such as hair sprouting more on the chin and less on the head.

My best friend Janet complained, “There aren’t enough hours in the day for me to do all I need to plus pluck all my chin hairs!”

Did you know?

• Twenty-six percent of menopausal women complain of hair thinning and loss.

• Thirty-nine percent of menopausal women start to sprout chin hairs (which become harder to see, harder to get rid of, and frustrating as heck.)

Hormone therapies plump up skin thickness and dermal density.

Women on long-term estrogen therapy have more elastic and younger-looking skin and less severe wrinkling. This is enough for me to sign up, but I also love all the other benefits, energy, a thinner waistline, and healthier sleep. Oh, let me count the ways!

Treatment of estrogen on the skin for a year has been shown to increase the thickness of the skin, reduce skin atrophy (thinner older skin), and improve the barrier function and water-retaining capacity of the skin.

DHEA

As long as women stay on hormone therapies, these benefits continue. These improvements go away when hormone replacement stops. Alas.

DHEA (real name is dehyroepiandrosterone) supplementation (oral, OTC, and/or by script) increases sebum production. This plumps up the skin and makes it shine. Especially great for those over 70 getting powdery, duller, thinner-looking skin. But some women break out from this hormone due to this fact. So, move slowly with the dosing of this great “shiny skin” hormone.

DHEA reduces yellowish tones of aging skin and also improves hand skin thickness, so hands don’t appear so wrinkled, at least in one study of women taking oral DHEA at 50 mg a day for a year. But this is a pretty high dose that I don’t recommend.

Bioidentical Hormones and Skin Aging

What about bioidentical hormones and skin aging? A survey of 401 pharmacists found that approximately 25% said BHRT carried fewer risks than patentable non-BHRT meds.

Also, these professionals felt BHRT provided many benefits.

But hormones can cause some acne and some chin hair growth if you are not on balanced formulas that have been correctly individualized for you.

Aging, for both males and females, is less daunting when you have healthier hormones on board. Even for your skin.

Dr. B.

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References:

The effect of menopause on the skin and other connective tissues. Gynecol Endocrinol. 2012 Apr;28(4):273-7. DOI: 10.3109/09513590.2011.613970. Epub 2011 Oct 4. PMID: 21970508.

Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci U S A. 2000 Apr 11;97(8):4279-84. doi: 10.1073/pnas.97.8.4279. PMID: 10760294; PMCID: PMC18228.

Beliefs about bioidentical hormone therapy: a cross-sectional survey of pharmacists. Maturitas. 2013 Feb;74(2):196-202. doi: 10.1016/j.maturitas.2012.11.007. Epub 2012 Dec 20. PMID: 23265304.

Bioidentical hormone therapy in menopause: relevance in dermatology. Dermatol Online J. 2019 Jan 15;25(1):13030/qt4c20m28z. PMID: 30710894.