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Estrogen and Skin

Therapeutic Options

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Abstract

Aging of the skin is associated with skin thinning, atrophy, dryness, wrinkling, and delayed wound healing. These undesirable aging effects are exacerbated by declining estrogen levels in postmenopausal women. With the rise in interest in long-term postmenopausal skin management, studies on the restorative benefits that estrogen may have on aged skin have expanded. Systemic estrogen replacement therapy (ERT) has been shown to improve some aspects of skin. Estrogen restores skin thickness by increasing collagen synthesis while limiting excessive collagen degradation. Wrinkling is improved following estrogen treatment since estrogen enhances the morphology and synthesis of elastic fibers, collagen type III, and hyaluronic acids. Dryness is also alleviated through increased water-holding capacity, increased sebum production, and improved barrier function of the skin. Furthermore, estrogen modulates local inflammation, granulation, re-epithelialization, and possibly wound contraction, which collectively accelerates wound healing at the expense of forming lower quality scars.

Despite its promises, long-term ERT has been associated with harmful systemic effects. In the search for safe and effective alternatives with more focused effects on the skin, topical estrogens, phytoestrogens, and tissuespecific drugs called selective estrogen receptor modulators (SERMs) have been explored. We discuss the promises and challenges of utilizing topical estrogens, SERMs, and phytoestrogens in postmenopausal skin management.

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Acknowledgments

We respectfully acknowledge Ms Gloria Won, Research and Reference Librarian from H.M. Fishbon Memorial Library for her assistance in the relevant literature search. No sources of funding were used to prepare this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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  1. School of Medicine and Public Health, University of Wisconsin, 5001 Sheboygan Ave, Apt 209, Madison, WI, 53705, USA

    Yu Yu Shu

  2. School of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Howard I. Maibach

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Shu, Y.Y., Maibach, H.I. Estrogen and Skin. Am J Clin Dermatol 12, 297–311 (2011). https://doi.org/10.2165/11589180-000000000-00000

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