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Presenter: Sanjay Kapur, PhD

The skin is one of the main targets of estrogen action. Facial skin on the face expresses much higher concentrations of estrogen receptors than the skin of the breast or the thigh. The menopausal decline in estrogen levels contributes to deterioration in skin health in a number of ways: these include wrinkling, dryness, thinning, reduced collagen content, slower wound healing, and loss of elasticity. Obese men and women often have improved skin health due to higher estrogen levels as a result of increased aromatase activity in fat and skin tissue. Studies of estrogen replacement therapy have shown some improvement in those skin properties affected by low estrogen levels, e.g. increased collagen content, skin thickness, and skin elasticity. HRT has also been found to increase skin surface lipids, which enhances the barrier function and may prevent dryness. Low testosterone in men is associated with thinning skin – testosterone replacement increases skin thickness. Possible mechanisms for this include local conversion to estrogen through the action of aromatase present in the skin. Progesterone has been used in cosmetic skin creams as well as in HRT – it has been found to improve skin thickness and elasticity, and no adverse effects have been noted. Low progesterone levels increase the impact of androgens on sebaceous glands and body and head hair. Topical progesterone may reduce 5-alpha reductase activity in the skin, reducing androgenic side effects such as unwanted facial hair growth in women that tends to appear with ageing or in androgen excess conditions such as PCOS. Hormones contribute to skin discoloration, e.g. brown patches (“chloasma”) associated with pregnancy or with HRT use. Estrogen plays a role in maintaining skin glycoaminoglycan content, which retains moisture. Estrogen and testosterone both have effects on wound healing.