Does Hormone Therapy Fight Wrinkles Too?

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Menopause: the time that marks the end of a woman's menstrual cycle and the word so many of us don't want to hear. Hot flashes, thin, dry skin, emotional highs and lows—the symptoms vary greatly from person to person, but unfortunately there's currently no way to prevent menopause, which is why many women experiment with treatments like hormone replacement therapy (HRT) to find some relief. Although the treatments are often linked to dangerous side effects, they're also sometimes touted as a wrinkle-fighting solution for younger-looking skin, which has piqued the interest of researchers, as well as doctors and dermatologists. Here, we asked our experts to weigh in.

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According to New York dermatologist Estee Williams, MD, menopausal women not only produce less collagen, but they actually undergo collagen destruction, too. "The lack of estrogen associated with this period in a woman's life directly causes structural changes in the skin that lead to dryness, wrinkles and poor elasticity," she explains. "Hormone replacement therapy can help manage the estrogen deficiency that comes with menopause, but it has been associated with breast cancer and heart disease, among other medical issues, and it’s not a solution for everyone." 

Whether replacing estrogen, either orally or topically, can delay the onset of facial skin aging—or not—has been studied for some time. "There are dozens of observational studies that concluded that estrogen replacement can improve skin thickness, boost collagen, and improve hydration," Dr. Williams says. "However, in the largest study, which was the Kronos Early Estrogen Prevention Study (KEEPS Trial), they looked at women ages 42–58 who were within three years of their last period, and randomized them into different groups. They found that women who received hormonal therapy with estrogen did not have fewer wrinkles than those not receiving estrogen. One limitation was that they were already menopausal; perhaps we need to intervene with estrogen replacement earlier. So while it’s clear that estrogen plays a major role in keeping skin youthful, we still don’t know which patients, and at what age, it is likely to help. A majority of studies have been observational, conducted in women who were already menopausal, or used subjective assessments. Also, the use of different estrogen preparations and doses with, or without, the simultaneous use of progesterone or testosterone, offers further complications."

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Although systemic hormone replacement therapy is recommended by some doctors, Melville, NY dermatologist Kally Papantoniou, MD notes that there are significant risks, which should be evaluated with a doctor before starting any treatment. And to be on the safe side, she recommends using topical phytoestrogens, which "are a safer way to promote youthful skin with much lower risk." Naturally occurring compounds from plants, phytoestrogens function similarly to estrogen in the body and are used in skin care to combat the effects of reduced levels of estrogen that occur around menopause and contribute to accelerated signs of skin aging. “They’re much more widely used in skin regimens now than in previous years thanks to more research and development using today’s standards, and they’ve been proven to promote skin cells to hold onto water, as well as stimulate collagen production at the dermis. Benefits include fewer superficial wrinkles and dark spots caused by sun damage and improved overall texture of the skin,” Dr. Papantoniou adds.

A few phytoestrogen-rich products we love? VENeffect Skin Calming Mask ($60), Murad Age-Balancing Night Cream ($77) and REN Sirtuin Phytohormone Replenishing Cream ($84). Despite which route you choose—HRT, phytoestrogen-rich skin care or none of the above—check with your doctor or dermatologist before beginning treatment to ensure it's the best option for your individual needs and concerns.

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