Studies show how estrogen deficiency in women decreases skin firmness, impairs wound healing, increases the number and depth of wrinkles, and contributes to skin thinning and dryness.

by Chelsea Turner, PharmD Candidate, Clinical Services Intern, and Beau Harger, PharmD, PCCA Clinical Compounding Pharmacist/Training Instructor

Skin aging can simply be defined as changes to the skin that occur due to growing older.¹ Oftentimes, many think skin aging correlates with chronological age; however, skin aging actually correlates to the period of estrogen deficiency, especially in menopausal women.² Studies indicate both collagen atrophy and estrogen deficiency have implications on the skin’s elasticity and firmness, as well as wrinkles.³ Estrogen replacement therapy might be an answer for aging skin, as it can increase collagen content, dermal thickness and elasticity; stimulate connective-tissue turnover; and decrease the likelihood of dry skin.⁴

Estrogen’s Role

Estrogen has more than 400 functions in a woman’s body and manifestations of estrogen deficiency may appear in various ways. In menopausal and postmenopausal women, estrogen deficiency is evidenced by decreased skin firmness, impaired wound healing, increased number and depth of wrinkles, skin thinning and skin dryness.

An extremely important role of estrogen is its relationship with structural components — collagen and elastin fibers — that naturally occur in human skin.

The reduction of collagen is traditionally considered the principal factor in the progressive degeneration of skin elasticity; retaining estrogen levels, however, inhibits collagen degradation by helping to maintain collagen balance. Elastin fibers are another structurally important component of skin that help prevent accelerated degenerative changes in the dermis. Studies indicate topical estrogen increases the number and thickness of elastic fibers in the skin.

One of the most common complaints from older women regarding their skin is dryness. Healthy skin requires a substantial amount of water content, which is significantly impacted by a woman’s menstrual cycle and age. Clinical studies indicate topical estrogen therapy can lead to increased water capacity by increasing naturally occurring moisturizing factors such as hyaluronic acid.² The activity of sebaceous secretions is also very important, as their activity is regulated by levels of circulating hormones. Estrogen replacement alone has a sebum-suppressive effect, which can decrease the size and number of sebaceous glands; the addition of progesterone, however, results in increased skin surface lipids.⁵

Topical Estrogen Replacement

The number of estrogen receptors is much greater in facial skin than in breast or thigh skin.⁶ Topical estrogens, such as estriol, have improved both elasticity and firmness, as well as decreased wrinkle depth and pore size by 61–100 percent, when applied to the face and neck.⁷

Compounded preparations offer individualized treatment options for patients and can include a wide variety of active pharmaceutical ingredients. For example, a formula of a topical estrogen, such as estriol, could be prescribed by a practitioner and compounded with VersaBase Cream by a pharmacist to potentially prevent signs of aging in the skin and possibly minimize systemic effects. VersaBase Cream is a great option for application to the face and neck, as it stimulates the natural moisturizing barrier through its emulsion system, leaving a soft and silky feel. VersaBase Cream is noncomedogenic, hypoallergenic, nonirritating and odor-free.

PCCA members with clinical services access may contact our Clinical Services team for help with antiaging formulas and other compounding concerns.

References

1. Wong, Q. Y. A., & Chew, F. T. (2021). Defining skin aging and its risk factors: a systematic review and meta-analysis. Scientific reports, 11(1), 22075. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/34764376/
2. Brincat, M. P., Baron, Y. M., & Galea, R. (2005). Estrogens and the skin. Climacteric : the journal of the International Menopause Society, 8(2), 110–123. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/16096167/
3. Calleja-Agius, J., Muscat-Baron, Y., & Brincat, M. P. (2007). Skin ageing. Menopause international, 13(2), 60–64. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/17540135/
4. Calleja-Agius, J., & Brincat, M. P. (2009). Effects of hormone replacement therapy on connective tissue: why is this important?. Best practice & research. Clinical obstetrics & gynaecology, 23(1), 121–127. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/19095501/
5. Sator, P. G., Schmidt, J. B., Sator, M. O., Huber, J. C., & Hönigsmann, H. (2001). The influence of hormone replacement therapy on skin ageing: a pilot study. Maturitas, 39(1), 43–55. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/11451620/
6. Punnonen, R., Lövgren, T., & Kouvonen, I. (1980). Demonstration of estrogen receptors in the skin. Journal of endocrinological investigation, 3(3), 217–221. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/7430556/
7. Schmidt, J. B., Binder, M., Demschik, G., Bieglmayer, C., & Reiner, A. (1996). Treatment of skin aging with topical estrogens. International journal of dermatology, 35(9), 669–674. Int J Pharm Compd. 1998;2(4):270-274. Accessed July 2024 at https://pubmed.ncbi.nlm.nih.gov/8876303/

These statements are provided for educational purposes only. They have not been evaluated by the Food and Drug Administration, and are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care or encourage its abandonment.