Tell us what drew you to research the role of hormones and skin
My initial research into hormones came back from my PhD studies. I was looking at hormonal interactions in the aging brain, so I was looking at estrogens and progesterone and how they interact to protect the brain from neurodegenerative diseases like Alzheimer’s. Because most people who get Alzheimer’s disease are women, we have a link with menopause and these kinds of diseases.
I started working in skin care immediately after PhD and the first area I was looking at was stress. Looking at the effects of stress on the skin was really looking at the stress hormones on the skin, and that really exploded to all the other hormones such as female hormones, male sex hormones, thyroid hormones, growth hormones, and their affects on our body, in particular the skin.
What is estrogen and what is the role of estrogen with aging and collagen protection?
Estrogen is actually a misnomer. We should be calling it estrogens because it is a family of like hormones. The estrogens include estradiol, and estradiol is the primary hormone that we’re talking about when we talk about estrogen deficiency, estrogen therapy, estrogen path, and hormone pills. Estradiol is the primary form of estrogen in a normal, cycling woman. After menopause and during pregnancy, there are other kinds of estrogens that are more pronounced.
The role that this has in aging, skin, and the brain is really broad. We’ve always thought of estrogen as being a female hormone, and it is produced by the ovaries in premenopausal women, but post-menopausal women still produce estrogen through their skin instead of the ovaries.
When you look at someone who has already gone through menopause, any estradiol left is probably being produced by the skin.
How do the interactions between estrogens and progesterone affect our skin health?
There’s a couple of things that estradiol does to promote skin plumpness, elasticity, and even hydration. Estradiol, while you’re pre-menopausal, promotes lipids on the skin. We always think of testosterone as being linked with oil, which is true, but estrogens are also linked to the oil production through biochemical processes. That’s one way it maintains hydration of the skin.
Another way is it promotes hydraulic acid. Hydraulic acid is part of a compound called glycosaminoglycans which are produced in the dermis, which is the deeper part of the skin. Estrogens can promote a deeper part of this production by the fibroblasts, which are the skin cells in the dermis. Estrogens are very important for skin hydration as they increase water content and oil content.
When someon’es going through pregnancy, you can tell their estrogen levels are really elevated because their skin is really plump, smooth, and shiny. When someone is menstruating, you see the effects of the interplay between estrogen and progesterone, luteinizing hormone, and testosterone. The balance is going to affect collagen, hydration, and oil production.
Estrogen also increases collagen production, and you can be in an estrogen deficiency state when you have a hysterectomy or go through menopause. This is linked to a loss in collagen and increase in enzymes that chop up the collagen. It’s a double whammy for losing collagen when you lose your estrogens.
How does hormonal imbalance affect the skin?
Any hormonal imbalance will inevitably show up on the skin, especially if it means estrogen levels are going to go down. When we enter perimenopause in our 20’s, the first thing that goes down is progesterone. Estrogen will hold more of a steady state until you reach menopause, but progesterone starts to go down.
Also, growth hormone starts to go down after your teenage years because you’re done growing. Growth hormone is linked to insulin growth factor 1, which is very important for our body and our skin. It’s linked to acne, inflammation in the gut, and estrogens.
The changes in the hormone levels will affect the skin and body, which will then go back and affect the ovaries, the ovarian function, the brain, and cortisol. Women are more finely tuned and balanced by our hormones, so excess amounts of cortisol, the stress hormone, can affect the balance of all the other hormones we need for our menstrual and mental health. Our mood is also linked to our hormonal balance.
What are the effects of perimenopause and menopause on skin health?
When the hormonal balance naturally changes during perimenopause, we begin to see more changes. In the skin, we see loss of elasticity, dryness, and wrinkles. There are studies that show that when you replace the estrogen in the body, you can rescue the skin.
It is illegal in the U.S. to use hormones as skin care, but there are phytoestrogens, which are plant based estrogens in foods like soy and yam, which can promote collagen synthesis, elasticity, and hydration.
How can one tell if their skin changes are due to internal factors such as hormones or their environment?
It’s pretty tricky, you have to be in tune with your own lifestyle and understand where skin changes are coming from. Changes in diet, stress, and genetics can also affect your skin health.
One of the best ways to know something is going on inside you is to look at your skin. If you start getting breakouts near the jaw and under the skin, which is the male dominated hormonal area of our face, it means testosterone is high, estrogen is low, or progesterone is low. Breakouts around here are a clear sign that your hormones are imbalanced. Breakouts near the forehead are more likely a result of hydration unless you are a teenager.
What are the anti-oxidants powerhouses you recommend?
Besides the hormones themselves, which are very powerful, antioxidants are great because as we age, our skin breaks down and UV damage can cause free radical formation in the skin. One of my favorite antioxidants is NAC, which is a glutathione promoter. Glutathione is one of our best antioxidants out there, and you have to talk to your doctor about this, but I recommend taking supplements for that.
Topically, vitamin C is a very powerful antioxidant. There’s a lot of different types of vitamin C out there and the main type is L-ascorbic acid, and it’s hard to formulate because as soon as you expose it to air, it oxidizes. Vitamin E is also really important, and through your diet, you can naturally increase it by taking a supplement, or taking Omegas, which improve the lipids in the skin.
We also don’t often think of melatonin as an antioxidant, but keeping your melatonin intact will help keep your body healthy. You can do this by sleeping 7-8 hours at night, and you need to reduce the level of blue light exposure to your eyes and skin to make sure your melatonin is produced properly.
When you wake up in the morning, your brain is more exposed to blue light. In the evening, you see orange and pink hues that signal the body to release melatonin as it is getting dark. When you’re watching TV or looking at your phone, you’re exposing your brain to blue light and your brain stops producing melatonin and prolactin. This creates changes in your body and you might not ovulate because you’ve been having sleep deprivation, so you should try to limit your screen time.
How do Thyroid hormones affect skin health?
Hypothyroidism is typically linked to drier skin, hair loss, and brittle nails. Hyperthyroidism is linked to more glory skin, but it comes from pigmentation and sweat that result from an overactive thyroid.
What are some recommendations you have to improve skin health?
It”s a good time to set some habits and incorporate your skin routine into your bedtime routine. The skin is very different during the day and night. In the day, it is busy fighting and protecting, so it needs antioxidants. At night, it is busy regenerating and restructuring so you need Vitamin A. Make sure you protect yourself with sunscreen and look for vitamin A, which is found in things like retinoids, during the night. You also need to be hydrated and consume prebiotics, which are found in the form of fiber, to keep your gut microbiome healthy.
In terms of products, you need something to hydrate, so you could use a toner or a moisturizer. When you get dry skin, microbes and viruses can enter, so you want to prevent dry cracks in the skin. We also lose most of our water content in the skin during the night, so you can use serums or oils to moisturize before bedtime.
One of our objectives is to remove the stigma of the “hormone talk”. What’s your take on it?
Hormones talk. They are our body’s messengers, so they’re constantly in communication and always change. They are the master controllers of our life, so it’s important to have clear conversations. They are not only linked to mood or periods, they are linked to everything.