Best hrt for skin and hair

By Dr Valeria Acampora

It certainly isn’t news that hormones are involved in skin and hair health. Therefore the physiological decline in hormones with aging (menopause in women and andropause in men) is a time of significant changes to the skin and hair for both sexes. Around age 45, women’s ovaries begin producing decreasing amounts of estrogen, progesterone and testosterone, while in men it is the testicles’ testosterone production that mainly drops.

Effect on the skin

The skin contains estrogen receptors, as well as receptors for progesterone and testosterone. Therefore deficiencies of these three hormones contribute to skin aging, in both men and women and results in the following symptoms:

• Thinner skin
• A increase in the number and depth of wrinkles
• Increased dryness
• Decreased firmness/elasticity
• Skin becomes more prone to sun damage, pimples and rashes, and can be easily irritated
• Facial hair – as levels of female hormones fall in women, unwanted hair can appear under the chin and along the jawline or above the lip

Effect on hair

During andropause and menopause hair growth can also be affected. In women, when the levels of estrogen and progesterone drop, hair grows more slowly and becomes much thinner. The thinning can occur on the front, sides, or top of the head. Hair may also fall out in large clumps during brushing and showering. In men, hair loss is a result of an imbalance of testosterone in the body. Instead of infusing the hair with healthy testosterone, enzymes break it down to a simpler form known as dihydrotestosterone (DHT). An excess of this hormone has the effect of decreasing the size of hair follicles which eventually break down and make the hair fall off sporadically.

Systemic vs local hormone therapy

Nowadays, there is a lot men and women can do to keep their skin and hair healthy. As we age, we all want not only to feel better, but also to look better and live better. Our wellbeing comes from the inside out. Systemic bio-identical hormone replacement treatment is definitely the first step to keep our body healthy but there is more we can do. In terms of skin & hair health, we also need to work locally. When we take bio-identical hormones systemically, our body distributes the hormones to all our organs and only a small, nominal amount actually gets delivered to the skin and to the hair.

Therefore, it is important that we integrate into our wellbeing journey two further steps: a medical grade home skin and hair care regime, containing various types of different molecules and hormones to apply locally and, eventually, regenerative and corrective procedures.

Playing the long game results in success

There are numerous medical procedures for menopausal and andropausal skin and hair changes. Treatment should be tailored to suit the person’s individual need. In addition, a skin and hair improvement plan is a journey, not a one-off event. We can compare starting a skin and hair improvement plan to joining the gym- we wouldn’t just go once and assume we will be fit for the rest of our life- we need to keep going.

Regenerative procedures:

In order to keep our skin and hair healthy, we need to build a strong foundation: regenerative procedures help the skin and hair help themselves. They improve overall skin and hair quality and slow down the ageing process on a cellular level. They make skin and hair cells act younger so that the skin and hair remains stronger, healthier and more beautiful overall – no matter what our age is.  Regenerative procedures include: hyaluronic acid injections, skinboosters, Platlet Rich Plasma injections, microneedling, mesotherapy, calcium hydroxylapatite injections, chemical peels, etc.

Corrective procedures:

Nowadays it is possible to improve our appearance as we age, without any surgery, thanks to non-surgical corrective procedures. As previously discussed, bio-identical hormone replacement therapy works very well in maintaining our skin health but, as we age, we also lose bone and muscle tissues, ending up with lack of facial volume and contour. They can only be addressed through corrective procedures, we could never get our youthfully plump cheeks back with medical grade skincare or even regenerative treatments. Non-surgical corrective treatments include: wrinkle-relaxing injections, dermal fillers and fat melting. Some common indications for a corrective procedure are chin shaping, fat underneath the chin melting, lip volume, cheeks plumping, zygomas shaping, etc.

References 1. Utian WH. Skin: Impact of menopause, ageing and hormones. Menopause Management. 2009: May/June: 11-13. 2. Sator PG. Skin treatments and dermatological procedures to promote youthful skin. Clin Interv Aging. 2006; 1(1): 51-6. 3. Verdier-Sevrain S, Bonte F, Gilchrest B. Biology of estrogens in skin: implications for skin aging. Experimental Dertmatol. 2005; 15(2): 83-94. 4. Raine-Fenning NJ, Brincat MP, Muscat-Baron Y. Skin aging and menopause: implications for treatment. Am J Clin Dermatol. 2003; 4(6): 371-8. 5. Krahn-Bertel E, Dos Santos E, Damour E, et al. Expression of estrogen related receptor B (EERβ) in human skin. Eu J Dermatol. 2010; 20(6): 719-23. 6. National Health and Medical Research Council. Hormone Replacement Therapy: Exploring the Options for Women. 2005. 7. Verdier-Sevrain S. Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators. Climacteric. 2007; 10(4): 289-97. 8. W. S. Look great, not done, 2018. 9. Calvin M. Oestrogens and wound healing. Mauritas. 2000; 34(3): 195-210. 10. Mercurio MG (1998) Gender and dermatology. JGendSpecif Med1:16-20.

11. Ashcroft GS, Dodsworth J, Van Boxtel E, et al. Estrogen accelerates cutaneous wound healing associated with an increase in TGF-β1 levels. Nature Med. 1997; 3: 1209-15. [Abstract]

For centuries, humans searched for the mythical spring known as the Fountain of Youth. According to legend, drinking or bathing in its restorative waters would turn back time and leave you looking and feeling as you did in younger years. Today, the search is no longer literal, but continues in metaphorical form and with enduring enthusiasm. In fact, as we live longer and in a culture that vigorously celebrates youth, the desire to recapture the appearance and energy levels of youth is perhaps keener than ever. This fight against aging leads many to wonder: does HRT make you look longer?

Hormone levels shift throughout life, guiding our development through childhood, puberty, and the childbearing years. These shifts are also intimately related to how we age. Falling testosterone levels in men and the fluctuations of estrogen and progesterone that trigger perimenopause and menopause result in a host of physiological changes. Some of these changes are neutral or merely inconvenient. But others can have a profound and destructive impact.

In particular, the physical changes caused by changing hormone levels can significantly affect how you feel about yourself. And it’s more than skin deep; social and emotional insecurities triggered by a changing appearance can impact your interpersonal relationships and your confidence level as you move through daily life. Because many of these changes are related to hormone levels, hormone replacement therapy (HRT) has the potential to shape how you look and feel as you age.

How Sex Hormones Affect the Aging Process

Sex hormones help to chart the course of your life, from fetal development in utero to sexual development in puberty, to reproductive capacity as adults. However, the effects of sex hormones aren’t limited to sex and reproduction. Rather, their influence is seen and felt in a wide range of physical attributes, behaviors, and emotional states.

As women approach menopause, levels of estrogen and progesterone can fluctuate significantly before plummeting to mark the end of the reproductive years. Men, on the other hand, experience a more gradual hormonal shift, with testosterone levels falling about 1-2% per year after the age of 30. But for both men and women, the hormonal changes that come with aging have a profound effect on various body tissues and systems, influencing how we look and feel. These include: 

• Sex drive and sexual function: Perhaps the most obvious function of sex hormones is the impact on sex drive and sexual health. Menopause, perimenopause, and andropause, with all of the related symptoms and sequelae, can leave you with diminished sexual desire present and, in the case of women, even result in painful sex. This may leave you not only undesiring, but undesirable and feeling out of touch with your body.
• Body composition: In men, low testosterone levels are associated with central obesity and a loss of lean muscle mass. Likewise, women lose much of the protective and restorative properties estrogen has on muscles once they enter menopause, and hormone-related changes in fat distribution lead to increased abdominal fat deposition. Changing fat distribution and a loss of muscle tone can rob you of your youthful physique and compromise the strength and integrity of your musculoskeletal system.
• Bone health: There is a direct correlation between age-related decreases in sex hormones and the loss of bone density. This commonly occurs in women post-menopause and in men after age 65—or sooner if they are experiencing abnormally low testosterone levels. Bone loss may be reflected in your posture, but it also leaves you more susceptible to fractures and can keep you from feeling strong and healthy.
• Metabolism and energy level: The loss of muscle mass plays a role in slowing metabolism, which can not only change how you look, but also cause fatigue and lack of energy. The result may be a less active lifestyle that further accelerates weight gain and the loss of bone and muscle.
• Skin, hair, and nails: The integumentary system, which includes your skin, hair, and nails, is where many observable changes become evident as sex hormone levels decrease. Skin becomes thinner, less elastic, and drier; wrinkles develop and skin sags. At the same time, some of the skin’s protective mechanisms become less efficient, which increases susceptibility to cancer and impairs wound healing. Aging is also associated with hair loss and changes in pigmentation. All of these changes are challenging as we strive to look our best.

While some people go through age-related hormone changes with little difficulty and are unbothered by the changes to their appearance, for others it is a highly distressing experience. 

So, Does HRT Make You Look Younger? 

Wanting to look younger is natural—after all, there’s a reason Fountain of Youth lore spans across cultures and continues to resonate with us. Age-related changes to your appearance suggest a loss of vitality. They can affect how you see yourself, how you are seen by others, and how you experience the world around you. Often, it can feel as though you become a stranger in your own skin, as your appearance no longer reflects the way you feel inside. 

If you are struggling with the impact of age-related hormonal shifts, seeking the guidance of a highly trained practitioner who specializes in HRT can help counteract many of the physical changes that make you look and feel older. By supplementing your body’s natural hormone levels, HRT can help you maintain a more youthful body composition. While this effect is particularly evident in men, research suggests that women can also benefit. HRT is also known to help women maintain softer, smoother skin, resulting in a younger look. 

In addition to—and, often, as a result of—these physical changes, HRT often changes how you see yourself. In very real ways, using HRT to address symptoms of hormonal change can help you feel younger. It can give you more energy, elevate mood, and increase sex drive. It can make sex more comfortable and improve sleep in both men and women. All of these things may help you not only feel better and more confident, they can also spur you to stay active and take better care of yourself. In other words, they can help you feel like yourself and allow you to present your best self to the world.

A Holistic Defense Against the Effects of Aging

While HRT can be a critical piece of the puzzle, it is not the only strategy for those who want to look and feel their best as they age. Many actions, including lifestyle changes, can help you counteract the effects of aging and hormonal decline. These include:

• Emphasize weight-bearing and resistance exercise: Exercise takes on extra importance as you age, as it can help to counteract the bone loss that leads to osteoporosis. Weight-bearing exercise utilizes the body’s effort against gravity to build muscles and strengthen bones. Likewise, resistance training with weights or bands can promote muscle strength and help build bone density. These activities can also help you maintain a healthy weight and minimize unwanted changes to body composition.
• Focus on a healthy diet: The importance of a healthy diet cannot be underestimated at any stage of life. A well-balanced diet as part of a healthy lifestyle can have both curative and protective effects while also helping you look the way you want.
• Consider nutritional supplements: Certain vitamin and mineral supplements may have a significant impact on your overall health, energy level, and appearance as you age. Additionally, if not adequately provided in the diet, nutritional supplements can help to compensate for lacking essential nutrients. 

A hormone specialist can help you create a holistic strategy that integrates the best therapies and lifestyle strategies to combat the unwanted effects of aging. With a tailored approach that combines proven treatments, you can ensure that you are on the right path for this new stage of life.

Hormone replacement therapy may not be the elusive Fountain of Youth, but it can help you live your best life. As part of a healthy and proactive lifestyle, HRT presents new possibilities for aging comfortably and gracefully. The physical and emotional boost it provides may have you looking and feeling more youthful and energetic for years to come.

If you want to learn more about the possibilities of HRT,  BodyLogicMD can help. As top specialists in hormonal health, the practitioners in the BodyLogicMD network have a wealth of experience in providing customized solutions to age-related hormone changes. Contact a local practitioner in your area to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz to learn more about how your hormones may be impacting your daily life. 

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.