Sex hormones: can they also influence the skin?


Sex Hormones (Androgens, estrogens, and progestins) are chemical messengers produced by glands that can also be synthesized in different tissues [1]. These hormones play a key role in the reproduction and development of secondary sexual characteristics; furthermore, they are also involved in the modulation of various physiological processes related to skin functions and features[1–3].


The following is an example of some of the effects that sex hormones can have on the skin, let’s view some of them.

Androgens: Epidermal permeability barrier homeostasis

Testosterone modulates skin barrier function and influences permeability barrier homeostasis[4]. The skin barrier is a mechanism of our body to prevent dehydration from excessive water loss and to protect the body from the entry of exogenous substances [5]. Skin barrier homeostasis is mediated by extracellular lipids obtained after the secretion of lamellar bodies [6,7].

One study showed that testosterone repletion induces a decrease in lamellar bodies formation and secretion [7]. This action has a direct effect on the skin, as it leads to a reduction in extracellular lamellar membranes and extracellular lipids – key elements for skin barrier formation– in the stratum corneum. Ultimately leading to a decrease in epidermal thickness and compromising the skin barrier activity. The previous case shows the influence of testosterone levels in skin barrier function modulation that consequently impacts skin barrier homeostasis [7].

Estrogens: Aging and skin moisture

Estrogens may influence skin aging manifestations and skin moisture. It is not a secret that a few of the most common emerging signs of aging are skin looseness, dryness, loss of firmness, and fragility wrinkling [3,8]. Some studies have elucidated a direct influence of estrogens over three main substances in the dermis. The first one is collagen, which is related to skin thickness and elasticity, whereas the second and the third are acid mucopolysaccharides and hyaluronic acid, which are related to skin water holding capacity [8,9].

  • Collagen provides support for skin resistance in two different ways: type I collagen provides strength to the skin, and type III collagen is responsible for elastic properties. It has been demonstrated that skin thickness is proportional to collagen content [9]. Likewise, sundry clinical trials have elucidated the effect of estrogens on collagen, being able to increase collagen synthesis and thus increasing its content in the dermis [9].


  • On the other hand, estrogens are also related to the augmentation of mucopolysaccharide and hyaluronic acid in the dermis [9]. These substances are well known for their high capacity to bind and hold water, as a result, there is an increase in water content of the dermis, thus consequently enhancement of skin moisture [9]. This indicates that estrogen plays an important role in modulating characteristics of the skin, which ultimately have an impact on its functions [10].

At this point, it is clear that sex hormones can modulate and influence skin properties. However, the level of these hormones is not stable during a person’s lifetime. It is subject to changes due to various factors, such as age, menopause, medications, and others [11]. Given that, it can be asked, what are the possible effects on the skin when someone is undergoing hormone replacement treatment therapy? What is the impact of sex hormone imbalances on the skin? Science is at work to answer these and other relevant questions.


References:

1. Nelson LR, Bulun SE. Estrogen production and action. Journal of the American Academy of Dermatology. 2001;45(3):S116-S124. doi:10.1067/mjd.2001.117432

2. McEwen BS. Central Role of the Brain in Stress and Adaptation: Allostasis, Biological Embedding, and Cumulative Change. In: Stress: Concepts, Cognition, Emotion, and Behavior: Handbook of Stress. Elsevier; 2016:39-55. doi:10.1016/B978-0-12-800951-2.00005-4

3. Sartor PG, Schmidt JB, Rabe T, Zouboulis CC. Skin aging and sex hormones in women-clinical perspectives for intervention by hormone replacement therapy. Published online 2004:36-40.

4. Kao JS, Garg A, Mao-Qiang M, et al. Testosterone perturbs epidermal permeability barrier homeostasis. Journal of Investigative Dermatology. 2001;116(3):443-451. doi:10.1046/j.1523-1747.2001.01281.x

5. Cartlidge P. The epidermal barrier. Seminars in Neonatology. 2000;5(4):273-280. doi:10.1053/siny.2000.0013

6. Feingold KR, Elias PM. Role of lipids in the formation and maintenance of the cutaneous permeability barrier. Biochimica et Biophysica Acta - Molecular and Cell Biology of Lipids. 2014;1841(3):280-294. doi:10.1016/j.bbalip.2013.11.007

7. Feingold KR, Denda M. Regulation of permeability barrier homeostasis. Clinics in Dermatology. 2012;30(3):263-268. doi:10.1016/j.clindermatol.2011.08.008

8. Zouboulis CC, Chen WC, Thornton MJ, Qin K, Rosenfield R. Sexual hormones in human skin. Hormone and Metabolic Research. 2007;39(2):85-95. doi:10.1055/s-2007-961807

9. Shah MG, Maibach HI. Estrogen and Skin, An overview. American Journal of Clinical Dermatology . 2001;2(3):143-150.

10. Rzepecki AK, Murase JE, Juran R, Fabi SG, McLellan BN. Estrogen-deficient skin: The role of topical therapy. International Journal of Women’s Dermatology. 2019;5(2):85-90. doi:10.1016/j.ijwd.2019.01.001

11. Ceccarelli I, Bioletti L, Peparini S, et al. Estrogens and phytoestrogens in body functions. Neuroscience & Biobehavioral Reviews. 2022;132:648-663. doi:10.1016/j.neubiorev.2021.12.007


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