Hormones and complexion: an interplay

The messenger substances from the body’s own chemical laboratory influence our mood, who we fall in love with – and they also affect the complexion. What exactly happens in which phase of life, what care is required and when you should see a professional: a small guide.

Hormones accompany us throughout our lives. 30 different ones alone are active in the skin cells. According to the latest findings, the subcutaneous fatty tissue even produces oestrogens, the female sex hormones. But even a tiny excess or a micro-deficiency of one or the other messenger substance can mess up the fragile structure – and lead to pimples, dry skin, wrinkles, red veins, rosacea or hair loss. Our experts Elsa Devillechabrolle, scientific director of La Roche-Posay, the gynecologist Dr. Sheila de Liz and endocrinologist Prof. Dr. Christoph Bamberger clarify.

1. Puberty

Happens: Due to too much male sex hormones (androgens) and not enough estrogens, the sebaceous glands produce more fat – the skin becomes horny faster. In combination with propionibacteria, which are part of the natural skin flora, inflammation and pimples can develop. Incidentally, chocolate is rarely the cause: “The severity of acne is 80 percent genetic,” explains the Hamburg endocrinologist Prof. Dr. Christopher Bamberger.
This care helps: Ingredients such as zinc have a sebum-regulating effect; Salicylic or glycolic acid prevent excessive keratinization. Lots of moisture in creams is also important: “If the skin dries out too much, this weakens the barrier layer, which can lead to new pimples,” explains Elsa Devillechabrolle, Scientific Director at La Roche-Posay.
Better to go pro: When pimples do not respond to care products and are very painful. Dermatologists can treat with creams that have a peeling and anti-inflammatory effect, such as azelaic acid or – brand new – trifarotene, a retinoid (related to vitamin A). If that does not help, tablets with antibiotics such as tetracycline are an option.

2. The sandwich phase

Happens: In the early or mid-20s, starting a job or balancing work and children are challenging. These factors increase the flood of cortisol through the body, a stress hormone that literally makes us look old. “Cortisol inhibits estrogen production, stimulates the production of free radicals and promotes the breakdown of connective tissue. This makes the skin thinner and more sensitive,” says endocrinologist Christoph Bamberger.
This care helps: Antioxidants such as vitamins C and E help keep cell-damaging free radicals in check. Moisturizers such as hyaluronic acid or glycerine plump up the skin, liquorice root or oat extracts have a calming effect.
Better to go pro: The combination of stress and too much (well-intentioned) grooming can trigger perioral dermatitis – red, burning skin with pustules around the mouth, especially between the ages of 20 and 40. Helpful: medicinal creams with soothing, antibacterial agents such as metronidazole.

3. Pregnancy

Happens: This time is a real “let’s dance” of the hormones: not only do estrogen and progesterone levels rise steeply early on, other messenger substances also get involved. The thyroid-stimulating pregnancy hormone hCG, for example, increases blood circulation: the skin becomes rosier – but dilated veins and spider veins can also form. And: “The hormone MSH produced in the placenta in turn leads to pigment changes on the body, but also on the face – called melasma,” says endocrinologist Christoph Bamberger.
This care helps: Since increased sweating is normal during pregnancy, light moisturizers without heavy lipids are perfect. Thermal water spray helps against reddening of the face, swelling caused by water retention in the face can be relieved with a cooling gemstone roller. And with heavy legs, decongesting, vein-strengthening fluids with horse chestnut help.
Better to go pro: Pigmentation disorders on the face often disappear within a year after the birth of the child. It’s different with the dilated veins on the face and legs. However, they can be treated with a KTP or Nd-Yag laser almost painlessly and without the risk of scarring. Important: In the first three months, it is essential to have the hormone levels of the thyroid gland determined in order to rule out a malfunction. Because it harms mother and child.

4. In middle age

Happens: In women in their early 40s, estrogen levels begin to slowly decline. The hormone progesterone, on the other hand, falls more rapidly. One of its jobs is to inhibit the so-called matrix metalloproteinases, biochemical scissors that cut collagen fibers. The result: the skin appears less plump and elastic. This is sometimes accompanied by another challenge: adult acne, also known as acne tarda. “This problem is often seen in women who have stopped taking the pill after many years, but also after pregnancy, because the estrogen effect that protects the skin is suddenly missing,” says hormone expert Dr. Christopher Bamberger.
This care helps: “It’s important to use products from a range for adult acne skin that are particularly gentle,” advises La Roche Posay expert Elsa Devillechabrolle. Instead of classic alpha and beta hydroxy acids, they often contain milder pore cleaners such as LHAs (lipo hydroxy acids) or PHAs (poly hydroxy acids), which also have a calming and moisturizing effect – or they combine these active ingredients.
Better to go pro:If late acne is very stubborn, anti-androgenic drugs can help. “Women who use the pill for contraception can also switch to a preparation that contains an anti-androgenic progestin in addition to estrogen,” says Dr. Sheila de Liz, gynecologist and author from Wiesbaden. Brand new: a cream with the androgen inhibitor clascoterone.

5. The menopause

Happens: At the end of perimenopause (the years immediately before and after the last menstrual period) there is a fairly rapid drop in estrogen levels. As a result, the skin can store less water and becomes drier, thinner and less elastic. Experts suspect that the falling estrogen level also leads to an increased release of stress hormones and a malfunction of the central thermocouple in the brain – this could be a cause of the heat flare-ups. The process of collagen build-up and breakdown also slows down, which promotes the first sagging areas and red veins. The imbalance of male and female hormones can also lead to hair loss.
This care helps: Trust the most effective miracle cure for aging: retinol (vitamin A). It stimulates cell renewal, collagen production and prevents collagen-degrading enzymes from working. To avoid intolerance, initially use only once or twice a week in the evening. Better to go pro: If, in addition to skin changes, there are also water retention, heat or mood swings, bioidentical hormones such as 17beta-estradiol and progesterone can help. “These hormones are a 1:1 copy of what the ovary used to make itself. The body cannot tell the difference, there are hardly any side effects,” explains gynecologist Dr. Sheila de Liz. However, an increased risk of breast cancer or thrombosis must be ruled out beforehand. “Sometimes progesterone alone helps, swallowed as a capsule. In some cases, a combination with an estradiol gel or patch makes sense.” As an alternative to bioidentical hormones, gentler phytohormones such as diosgenin from yams or stigmasterol from soybeans can also be used.

6. The post-menopause

Happens: The production of estrogen and progesterone is almost gone, only the adipose tissue still produces small amounts of estrogen. “The skin becomes extremely dry, and also very thin and sensitive due to diminishing subcutaneous fatty tissue and a weakened protective skin barrier,” explains Elsa Devillecha brolle from La Roche-Posay. The mucous membranes of the eyes, nose and genital area are also affected.
This care helps: Skin-like vegetable fats, which rebuild the skin’s barrier layer and thus alleviate dryness symptoms, are particularly important. Ideal: Products with rich lipids such as shea butter, safflower, argan or evening primrose oil. Moisturizing eye and nose drops with hyaluronic acid (at least 2%) and panthenol help against dry mucous membranes. Ointments, gels and suppositories, which also contain hyaluronic acid, glycerol and some fats, reduce vaginal dryness.
Better to go pro: In the case of an extremely dry genital zone, which is often also psychologically stressful, prescription ointments and suppositories with the low-dose estrogen estriol (0.03 to 0.5%) can provide relief. Hormone expert Bamberger: “Oestriol has only about 10% of the biological effect of estrogen estradiol and, when applied locally, has hardly any systemic effects, i.e. on the whole body.”

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09/2021
Bridget

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