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Hormones and the Skin: The Role
Hormones Play As We Age
(press release from AAD)
NEW YORK (October 18, 2006)- Many people say that aging is
just a state of mind. However, many dermatologists will tell you that aging can
be affected by your hormone levels. Whether low or high, your hormones affect
your skin, hair and nails as you age.
Speaking today at the American Academy of Dermatology's (Academy) Academy,
dermatologist Debra Jaliman, MD, FAAD, an assistant clinical professor at Mt.
Sinai School of Medicine in New York, NY, discussed how hormones levels in your
20s, 30s, 40s and beyond can affect a woman's skin.
"Fluctuating levels of hormones can have an impact on the skin, hair and nails
that can be physically and emotionally challenging," commented Dr. Jaliman.
"That's why it's important to consult with a dermatologist who can identify
problem areas and recommend treatments that will keep them healthy no matter
what a woman's stage of life."
Acne typically first appears during adolescence and can persist well into
adulthood. The cause of acne is most often linked to androgens, which are the
hormones that stimulate the sebaceous or oil glands in the skin. When the
sebaceous glands are over-stimulated by androgens, acne flare-ups can occur.
For women affected by acne, especially those in the early-to-mid twenties and
older, oral contraceptives (OCPs) can be an effective part of their acne
treatment plan in conjunction with other therapies. Current OCPs help decrease
androgen levels, and therefore decrease acne.
In addition, a dermatologist may prescribe oral medications or topical creams,
gels, or lotions with vitamin A derivatives, benzoyl peroxide, or antibiotics to
help unblock the pores and reduce bacteria.
Fluctuations in androgens also can cause hirsutism, a condition characterized by
excessive growth of hair on the female face and body. Male-like patterns of
hair may appear on the upper lip and chin, and more hair growth than usual may
be seen on the arms and legs and even the chest and groin area. Hirsutism can
be treated with topical treatments, such as eflornithine cream, as well as many
modes of hair removal including waxing, shaving and laser treatments.
Dr. Jaliman emphasized that acne with hirsutism could indicate a more serious
medical condition for which acne is just one symptom. "When persistent acne is
accompanied by hirsutism and hair loss or thinning hair, it could signal
increased androgen production common in conditions such as polycystic ovaries
and adrenal hyperplasia," said Dr. Jaliman. "In addition, women with hormonal
acne also may experience irregular menstrual cycles, obesity, infertility or
diabetes. It's vitally important for these women to consult with their
physician, as a blood test can determine the cause of these symptoms and the
best treatment option."
As a woman enters her child-bearing years, many hormonal changes can occur,
especially during pregnancy. The estrogen-related change of pregnancy that is
most noticeable is melasma, also known as the "mask of pregnancy." This benign
condition is attributed to an overproduction of melanin, a natural substance in
the body that gives color to the hair, skin and eyes. Treatment options
available from a dermatologist include topical prescriptions for or
over-the-counter products containing hydroquinone, or prescriptions for
retinoids, azeleic acid or hydroxy-acids. In-office procedures, such as the use
of lasers and peels, can be used after pregnancy to remove the pigment. No
treatment of melasma is complete without the daily, year-round use of a
broad-spectrum sunscreen – one that protects against both ultraviolet A and
ultraviolet B rays – with a Sun Protection Factor (SPF) of 30 or higher to
prevent the further darkening of the skin, recommends Dr. Jaliman.
While pregnant, most women experience a thickening of the hair. Three to six
months after delivery, some women will experience hair loss and thinning, called
telogen effluvium. This temporary shedding can be sudden and very alarming to
some women, according to Dr. Jaliman. However, hair growth will subsequently
return to normal approximately four to six months following pregnancy. Nails
also are affected by the hormonal changes of pregnancy with most women
experiencing brittle nails, although some may be diagnosed with distal
onycholysis, a separation of the nail plate from the underlying nail bed.
As a woman enters menopause, several hormonal changes occur. The estrogen level
in the body begins to lower and women will begin to notice a thinning of their
skin and loss of elasticity.
"As we age, the skin often becomes drier and more sensitive than it was during
adolescence and our 20s and 30s," stated Dr. Jaliman. "At this point in life, I
would recommend a skin care regimen including a prescription retinoid, either
tretinoin or tazarotene, or over-the-counter products such as retinol, alpha-hydroxy
acids, antioxidants or peptides."
As women age, hair also is affected by the changing levels of hormones. Some
women may experience a pattern of hair loss known as androgenetic alopecia, in
which hair thins on the vertex or top of their head and hair becomes finer in
texture. Women retain their hairline better than men with this type of
alopecia, which is primarily genetic. This type of female hair loss is treated
with topical minoxidil and other therapies including oral medications which can
block the effect of androgens, such as hormone replacement therapy and
"As you age, making slight modifications to your daily skin and body care
regimen can go a long way in improving the appearance of your skin, hair and
nails," said Dr. Jaliman. "Your dermatologist is the best source of information
when choosing skin, hair and nail products that can enhance your appearance no
matter what your age."
Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations. With a membership of more than
15,000 dermatologists worldwide, the Academy is committed to: advancing the
diagnosis and medical, surgical and cosmetic treatment of the skin, hair and
nails; advocating high standards in clinical practice, education, and research
in dermatology; and supporting and enhancing patient care for a lifetime of
healthier skin, hair and nails. For more information, contact the Academy at
1-888-462-DERM (3376) or www.aad.org.
Knowledge is Power.
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