Dermatológia pre prax 1/2009

Hormonal aging of skin

The skin is one of the largest organs of the body, which is significantly affected by the aging process and menopause. The oestrogen receptor has been detected in the cellular components of the skin. Oestrogen deficiency in menopause particularly involves the fibroblasts of the dermis, and therefore all the components of extracellular matrix – collagen, elastic fibres and the ground substance. The thinning of the skin is primarily related to a decrease in skin collagen content, valueted by Brincat between 1 % and 2 % per year, this decrease is correlated with decline in bone mineral content. Skin elasticity decreases with age, in menopause there may occur degenerative changes of elastic fibres. The decline in fibroblastic synthesis of the dermis ground substance, particularly hyaluronic acid, which is able to bind water, is responsible for a decrease in dermal hydratation. In the epidermis, menopausal oestrogen deficiency slows down the mitotic activity of basal keratinocytes, and consequently leads to epidermal atrophy. A decrease in skin pigmentation may also be observed clinically. Oestrogen deficiency also changes the vulvar mucous membrane, which becomes atrophic and dry, and may lead to pruritus and dyspareunia. Hormone replacement therapy (HRT) has shown beneficial effects on menopausal skin thickness. However some women were shocked by study results on HRT that seemed to show higher risks for myocardial infarction and stroke. Topical application of hormones comes in the center of anti-aging interest (oestradiol, oestriol, testosterone, phytoestrogens, proxylane).

Keywords: hormonal aging, oestrogens, phytoestrogens