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How hormones affect the skin

What are hormones? Hormones are the body’s essential ‘chemical messengers’ which, transported through the blood, operate a regulatory mechanism upon the body’s systems by stimulating particular cells, organs or tissues into action and maintaining homeostasis: the body’s essential, natural balance.

Hormones are vital to the skin’s good health and yet any imbalance - even very slight - can lead rapidly to skin problems. The hormones which most principally affect the skin are the sex hormones oestrogen and testosterone, and the stress hormone, cortisol. The natural state for all hormones is to fluctuate according to the needs of the body’s systems - and yet both fluctuations and stasis in hormonal levels can cause problems which manifest themselves in our skin.

Chronic and acute breakouts, dehydration and dryness, sudden flushing: all of these can occur as the result of the body’s natural hormonal production. While skincare products and treatments cannot alter the production of your hormones - only prescribed medication has this ability - they can do much to protect the skin against their effects and offset them, treating the issues that they may cause from the outside in. Knowing the issues that hormones may cause also enables anticipation of their treatment: for instance, short-term changes that occur within the monthly cycle or longer-term changes that occur over time with age.

The slowing of hormonal production which happens naturally with age - resulting in declining fertility, for instance - also has visible and important effects on your skin. Oestrogen, considered the ‘female’ hormone, declines more rapidly than testosterone, initially leaving testosterone dominant.

Because testosterone is androgenic, the effects which will result are typically masculine: which means, in the case of your skin, increased oil production leading to congestion and in approximately a third of women, adult-onset acne (entirely regardless of whether they have experienced acne previously). This type of acne is typically predominant along the jawline, the chin area and around the mouth. Testosterone also encourages body and facial hair to grow and pores to develop an enlarged appearance. Oestrogen, on the other hand, makes skin look plump and healthy and gives pores a smaller appearance as the skin becomes ‘plumped’.

Another problem that can result from fluctuations in the level of oestrogen, including excessively high levels of oestrogen and which is thus often seen in pregnancy or when taking oral contraception, is melasma, the patchy ‘mask’ of pigmentation that often occurs for the first time in pregnancy: oestrogen triggers the production of melanin pigment leading to an over-production. Unfortunately, melasma or associated pigmentation will often persist beyond pregnancy but, like most pigmentation, can be targeted with the right active ingredients in products.

We know, of course, that skin loses its elasticity and natural levels of hydration with age, but why? The epidermis begins to lose hyaluronic acid by the 30s, mostly due to the decline in oestrogen as cells start slowing down their production of oestrogen in response to declining reproductive needs.

The dips in hormonal levels that occur with age also thin the skin, making it less pliable and more prone to developing lines - which, combined with the natural slowdown in the skin’s own renewal process, the regular sloughing of the epidermis, can leave skin looking dull and dry. Of course, becoming drier results rapidly in skin that is sensitive and reactive, or even further sensitised than before.

Crucially, oestrogen is stored in fat, so the degree of fat present in your skin will also determine the visible effects of oestrogen: the less fat, the less oestrogen can be stored and put to use. As well as hyaluronic acid production, oestrogen also affects collagen and elastin levels: with every year of age gained it is thought that collagen declines by around 1 per cent, and while active ingredients such as the peptides and retinoids that we use at Skinesis are immensely beneficial in supporting the skin, elastin is not as easy to replicate synthetically. Without the elasticity that is bestowed by elastin, over time skin becomes looser and less flexible. Wrinkles, in essence, occur when the skin expands beyond the capacity of the structural tissue underneath, which is also why the first fine lines to be detected on the face are often on the forehead and around the eyes in the periorbital region, where skin is thinnest.

After oestrogen, testosterone also begins to decline. Testosterone is vital for its ability to stimulate the exocrine sebaceous glands which produce sebum, providing protection for skin and the maintenance of its resilience but an overproduction of testosterone can lead to acne.
Age-related shifts in testosterone - whether sudden fluctuations or a gradual increase - will lead to acne yet when testosterone declines the texture and resilience of skin declines further. Cortisol, often known as the ‘stress’ hormone, is released from the adrenal glands and while cortisol is essential to ongoing physical and mental wellbeing, a surge (such as that released by acute or long-term chronic stress, for instance) can trigger a sudden increase in sebum production which in turn results in acne and breakouts. An excess of cortisol in the blood also leads quickly to an increase in inflammation - which will exacerbate almost any existing or dormant skin condition from acne to eczema. In addition, levels of cortisol which remain high chronically (that is, for an extended period of time as opposed to acute fluctuations which occur quickly and then taper off again quickly) frequently lead to sugar cravings, yet another trigger for skin and systemic inflammation.

Finally, the menopause is, unsurprisingly, often a critical time for skin: 30 per cent of collagen is lost in the first three to five years after menopause occurs. In addition the hormone-related loss of bone density has the effect of ‘sinking’ facial structure, particularly noticeable around the orbital bone and eye sockets, leading to the appearance of sunken and dark circles under the eyes and exacerbating the appearance of skin which is already dehydrated and slackening.

Further reading and research

Clinical Interventions in Ageing, 2007 Sep; vol. 2(3): 283-297
Effect of estrogens on skin aging and the potential role of SERMs (Selective Estrogen Receptor Modulators)
Susan Stevenson and Julie Thornton


Textbook of Aging Skin, 29 September 2016; pp 2131-2152
Brain-Skin Connection: Impact of Psychological Stress on Skin
Ying Chen, Robert Maidof and John Lyga


Dermatoendocrinology, 2013 Apr 1;5(2):264-70. doi: 10.4161/derm.23872
Oestrogens and aging skin
MJ Thornton


Inflammation and Allergy Drug Targets, 2014 Jun; 13(3): 177–190
Brain-Skin Connection: Stress, Inflammation and Skin Aging
Ying Chen and John Lyga


Int. Journal of Fertility and Women’s Med. 1999 Mar-Apr; 44(2):83-95
A lifetime of healthy skin: implications for women
WF Bergfeld