Understanding Hormones and Your Skin

“How to achieve beautiful, supple and young-looking skin”. You almost can’t avoid it - splashed on magazine covers, reported in newspapers and marketed on television and radio, the message to improve our skin would appear paramount to how we and others view our looks.
How does our skin age?  Skin aging is influenced by:

* Genetic differences
* Hormonal changes, e.g. estrogen and thyroxin
* Chronic sun exposure
* Wind, pollution

Blame it on hormones

Hormones are mostly to blame for skin changes as we age. Hormones are chemical messengers produced in organs such as the ovaries, adrenal glands, and thyroid glands, and all have an effect on other tissues.

Much of the reason why our skin begins to suffer is primarily due to hormones — and there is a massive industry manufacturing products to try to alleviate the results of these hormonal changes, notably as women reach menopause in their 40s and 50s.

As menopause occurs, estrogen is reduced and while it has a direct effect on thinning bones, it also creates significant changes in the skin. Women find:

* their skin becomes drier with increased wrinkles
* skin becomes more fragile, loses some of its elasticity, and is looser because the production of collagen is reduced
* older skin appears paler as the lack of estrogen reduces the number of blood vessels in the skin
* menopause also causes a reduction in the level of testosterone but not as significant a drop as in estrogen

Hormones and dry skin

Another hormone we have is thyroxin, produced by the thyroid gland, which influences skin appearance. Too much thyroxin shows a warm, smooth, sweaty, flushed skin. Under-activity of thyroxin produces a dry, coarse thickening of skin with reduced ability to sweat.

Hormones affect acne

The oil glands of the skin are in part controlled by the level and activity of the hormone testosterone in the skin. Testosterone is required to produce acne. This outcome can be seen in conditions such as polycystic ovary syndrome, which produce some elevation in testosterone, which in turn causes increased facial hair, irregular periods and acne. It has also been found that some birth control pills can block testosterone skin reactors to improve some of the consequences of increasing hormone levels. (See Acne Guide for more acne information)
Thinning hair

Hair will thin after menopause. In some women, genetic factors produce significant thinning. Abnormalities in the level of a thyroid hormone, in addition to the amount of iron stored in the body, can influence the volume of hair.

Estrogen encourages hair to stay in its growing phase (Anagen hair). This is seen in the significant thickening of hair towards the end of pregnancy. After menopause, however, the lower estrogen amount allows the scalp hair to grow towards the falling out stage (Telogen hair).
HRT and skin

Post menopausal women will notice that unlike their scalp, facial hairs increase. This is thought to be because estrogen — which opposes the effect of testosterone — drops relatively more after menopause than testosterone.

Hormone replacement therapy (HRT) has been used over the last 20 years to combat the signs of aging. HRT can promote a fuller-looking skin because the skin then becomes thicker with less loss of subcutaneous fat. Thinning and drying of vaginal surfaces is also minimized. This can also be achieved by using topical estrogen. The use of estrogen creams has been shown to maintain the elasticity and fullness of skin after menopause, although at this time it is not used extensively because of concerns about side effects and the variability of absorption into the body.

See your doctor or dermatologist to determine which solutions best suits your experience with aging skin.

By Richard Thomas, MD

Acne Terms and Causes

Acne: Words to Know
Androgen:
A male sex hormone found in both males and females.
Anti-androgen:
A drug that slows down the production of androgens.
Antibiotic:
A drug that kills bacteria.
Comedo:
A hard plug that develops in the pores of the skin composed of sebum and dead skin cells. The mildest form of acne.
Comedolytic:
Drugs that break up comedos and open clogged pores.
Isotretinoin:
A drug that decreases sebum production and dries up acne pimples.
Sebum:
An oily material produced by sebaceous glands that keeps the skin moist.
Tretinoin:
A drug that increases the rate at which skin cells are formed and die.
CAUSES
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The exact cause of acne is not known, however, several risk factors have been identified.
• Age. Because of the effect of sex hormones, teenagers are quite likely to develop acne.
• Cosmetics. Make-up and hair sprays that contain oils can make acne worse.
• Diet. Acne is not caused by diet, but some foods can make the disease more serious.
• Disease. Hormonal disorders can increase the severity of acne problems in girls.
• Drugs. Acne can develop as a result of using certain drugs, such as tranquilizers, antibiotics, oral contraceptives, and anabolic steroids. Steroids are synthetic hormones that may sometimes be abused by athletes to increase the size of their muscles.
• Environment. Acne can become worse as a result of exposure to oils, greases, and polluted air. Sweating in hot weather can also make the condition worse.
• Gender. Boys are more likely to develop acne and tend to have more serious cases than girls.
• Heredity. Acne is more common in some families than in others.
• Hormonal changes. Acne can flare up during menstruation, pregnancy, and menopause. Menopause is the period in a woman’s life when her body stops producing certain hormones.
• Personal hygiene. Strong soaps, hard scrubbing, and picking at pimples can make acne worse.
• Stress. Emotional stress can contribute to acne.

Chloasma - skin changes through pregnancy

Chloasma or the “Mask of Pregnancy” can cause blotchy discoloration on your face and splashes of darkened skin that may appear on the forehead, nose, and cheeks in a mask-like configuration on some pregnant women — more often in dark-skinned women.

What causes chloasma: Those mischievous pregnancy hormones are toying with you again, causing hyperpigmentation on many parts of your body. You might have noticed your freckles and moles are darker now, there’s probably a dark line down the center of your abdomen (the linea nigra), and your areolas are probably a deeper shade as well. (You might as well decide this is sexy.) Dark-skinned women usually notice such hyperpigmentation more, but light-skinned women aren’t off the hook completely — they too will get their fair share of darkening skin, though it may not be as noticeable.

Despite have clear skin most of their lives, many women find another “new experience” awaiting them once they discover a pregnancy. The beginning stages can be small and unnoticeable pimples - usually showing around the jaw line or forehead due to hormonal fluctuations.

Three main factors contribute to acne: increased oil production, clogged pores, and a bacteria called P acnes. First, oil causes the dead skin cells to stick together, leading to a clogged pore, which is called a blackhead or a whitehead. Bacteria then moves into the pore, producing inflammation, which manifests as redness and pus. Addressing acne requires medications or treatments that decrease oil secretion, unclog pores, and kill bacteria.

As the pregnancy progresses, the acne will worsen. It is at this point, many women may frantically search for cures in their local drugstore or try home remedies. Perhaps they feel overwhelmed by the choices or confused by the long list of ingredients and decide to give up finding a solution. In some cases, the acne can grow to included pigmented or “age” spots as well.

All of these changes typically last the duration of the pregnancy and are due to hormonal changes and increased oil production, resulting in acne, while higher estrogen levels will activate skin color cells to make dark spots. This occurrence is so common in pregnancy that it’s been given the name “mask of pregnancy.” Sun exposure will exacerbate the issue further without a good sunscreen or sun protection.

Like many others, when facial skin suddenly becomes oily, the first reaction is to take away all moisture or anything ‘greasy’ that can increase the feel of oil on the skin layer.

Never fear, these again are temporary problems with easy fixes. First, stop using anything oil-based and switch to gel-based or water based sunscreens and moisturizers for the time being. Treat you skin as if it were the acne-prone, pigmented type and finally ask your doctor or dermatologist for a baby-safe acne treatment if the situation is really uncomfortable. Your skin should return to its previous condition soon after your baby is born.

• In the meantime - Eat foods that contain folic acid (you’ll also get plenty in your prenatal supplement), since studies have shown that a folate deficiency can be related to hyperpigmentation. Good choices include green leafy vegetables, oranges, whole-wheat bread, and whole-grain cereal.
• Stay out of the sun as much as possible and wear a sunscreen of at least SPF 15 (sunlight can also intensify hyperpigmentation). A hat and long sleeves are a good idea if you’re fair-skinned, headed to the beach, or have a historically sensitive complexion.

• If you like, use a good concealer to cover particularly pesky spots, but skip bleaches or other chemically based lightening treatments until after you give birth. No peels or lasers, either.