Covering the basics....

"How to achieve beautiful, supple and young-looking skin." You almost can't avoid it - splashed on magazine covers, reported in newspapers and marketed on television and radio, the message to improve our skin would appear paramount to how we and others view our looks.

How does our skin age?

Skin aging is influenced by:

• Genetic differences
• Hormonal changes, e.g. estrogen and thyroxin
• Chronic sun exposure
• Wind, pollution.

Blame it on hormones

Hormones are mostly to blame for skin changes as we age. Hormones are chemical messengers produced in organs such as the ovaries, adrenal glands, and thyroid glands, and all have an effect on other tissues.

Much of the reason why our skin begins to suffer is primarily due to hormones -- and there is a massive industry manufacturing products to try to alleviate the results of these hormonal changes, notably as women reach menopause in their 40s and 50s.

As menopause occurs, estrogen is reduced, and while it has a direct effect on thinning bones, it also creates significant changes in the skin. Women find:

• their skin becomes drier with increased wrinkles
• skin becomes more fragile, loses some of its elasticity, and is looser because the production of collagen is reduced
• older skin appears paler as the lack of estrogen reduces the number of blood vessels in the skin
• menopause also causes a reduction in the level of testosterone but not as significant a drop as in estrogen.

Hormones and dry skin

Another hormone we have is thyroxin, produced by the thyroid gland, which influences skin appearance. Too much thyroxin shows a warm, smooth, sweaty, flushed skin. Under-activity of thyroxin produces a dry, coarse thickening of skin with reduced ability to sweat.

Hormones affect acne

The oil glands of the skin are in part controlled by the level and activity of the hormone testosterone in the skin. Testosterone is required to produce acne. This outcome can be seen in conditions such as polycystic ovary syndrome, which produce some elevation in testosterone and in turn causes increased facial hair, irregular periods and acne. It has also been found that some birth control pills can block testosterone skin reactors to improve some of the consequences of increasing hormone levels. (See Acne Guide for more acne information)

Thinning hair

Hair will thin after menopause. In some women, genetic factors produce significant thinning. Abnormalities in the level of a thyroid hormone, in addition to the amount of iron stored in the body, can influence the volume of hair.

Estrogen encourages hair to stay in its growing phase (Anagen hair). This is seen in the significant thickening of hair towards the end of pregnancy. After menopause, however, the lower estrogen amount allows the scalp hair to grow towards the falling out stage (Telogen hair).

HRT and skin

Post menopausal women will notice that, unlike their scalp, facial hairs increase. This is thought to be because estrogen -- which opposes the effect of testosterone -- drops relatively more after menopause than testosterone.

Hormone replacement therapy (HRT) has been used over the last 20 years to combat the signs of aging. HRT can promote a fuller-looking skin because the skin then becomes thicker with less loss of subcutaneous fat. Thinning and drying of vaginal surfaces is also minimized. This can also be achieved by using topical estrogen. The use of estrogen creams has been shown to maintain the elasticity and fullness of skin after menopause, although at this time it is not used extensively because of concerns about side effects and the variability of absorption into the body. By Richard Thomas, MD See your doctor or dermatologist to determine which solutions best suits your experience with aging skin.