Hormones and Skin

There is a close connection between our hormones and our skin. The most well known sign for this is the typical flare-up many female acne sufferers experience just before or during their menstruation. At this time of the month, women often observe development of pimples and spots, caused by a change in the levels and ratios of sex hormones in our body. For that reason, certain contraceptive pills (those with ‘anti-androgenic’ effects, ie reducing some of the unwanted effects of male hormones). You see, not only men, but also women have male hormones such as testosterone in their bodies, albeit it much, much lower levels. However, if the effects of these male hormones becomes overbearing, this can lead to acne flare-ups. But although certain contraceptive pills can have positive effects on women with a tendency for acne, as a dermatologist I don’t usually recommend starting the contraceptive pill to control your acne. If you are taking them for their contraceptive action, then of course make sure your GP selects one which also has anti-androgenic effects, if possible. However, if the contraceptive effect is not what you are after primarily, then there are better options to control your acne, some of which even have the ability to switch off acne for good. Make an appointment with your dermatologist to find out more.

Acne flare-ups are however not the only unwanted sign of changes in sex hormones. In the longer run this group of hormones also influences our skin’s firmness and elasticity. During menopause, the levels of oestrogen and progesterone for example decline and this will lead to loss of collagen in our skin. Collagen is our main structural skin protein; it’s situated in the crucial middle layer of our skin – the dermis. With declining collagen levels in the dermis, our skin becomes visibly less firm and will develop more lines, wrinkles and sagginess over time. Studies have reported an astonishing loss of up to 30% of our skin’s collagen content within the first 5 years after menopause!

We also know from studies that HRT (hormone replacement therapy) can mitigate some of the negative effects of menopause on our skin quality. Generally speaking, the skin of women who are on HRT ages ‘better’ than that of women without a ‘helping hand’. Having said that, I would not recommend taking HRT solely to slow down your skin’s ageing process. HRT influences our entire body and there are a variety of pro’s and con’s that need to be taken into careful consideration before deciding for a against HRT. The best thing is to discuss this with your GP or gynecologist when the times comes.

There are of course certain over-the-counter remedies such as red clover extracts, which are said to help with balancing the hormonal changes that come with menopause. But although they have been reported as helpful for menopausal symptoms for as flushing, to my knowledge there are no well controlled clinical studies to investigate, whether long-term supplementation might also have positive effects on our skin quality. Another interesting study looked at supplementation with melatonin, our ‘sleep hormone’ (and a powerful antioxidant!) and it has been reported that taking melatonin might even have the potential to delay menopause to some extend. I shall be interested to see further studies on this.

In the meantime, what I often prescribe for my female patients, who are entering the menopause without HRT and are concerned about their skin quality, are topical prescription creams with low levels of oestrogen, progesterone and melatonin. These are tailor made for each patient in our partner pharmacy in Germany and because of the very low levels of hormones, they work only in the skin, without systemic side effects.

While sex hormones are the most well known types of hormones, there are many other hormones with influence on our skin floating through our body. When we feel chronically stressed for example, the level of cortisol (one of our major stress hormones) remains high throughout the day. Cortisol is sometimes referred to as ‘death hormone’. Normally cortisol levels are high in the morning, just after waking up (they get us ready to face the day!), but then go down throughout the day. Stress however can lead to persistently high levels of cortisol. Studies have shown that cortisol levels are connected to not only how long we are likely to live (centenarians tend to have lower levels of cortisol), but also to how old our face looks!

And then there is insulin, which is often referred to as the ‘master hormone’. Insulin is well known for regulating our blood sugar levels. Type 2 diabetes for example is caused by insulin resistance, leading to elevated blood sugar levels with all its negative consequences. Also, if we eat a lot of sugary and starchy foods, our blood sugar level goes up and with it our insulin level. High blood sugar and insulin levels lead to micro-inflammation in the skin and premature skin ageing.

For more information, please read my book ‘Future Proof Your Skin! Slow down the biological clock by changing the way you eat’, which is available on Amazon.