Hormonal replacement therapy both improves, inflames skin of postmenopausal women
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Key takeaways:
- Women receiving hormone replacement therapy experienced enhanced skin barrier responses.
- They also experienced elevated levels of skin inflammation.
Hormone replacement therapy may render the skin of postmenopausal women both more prone to inflammation and more capable of repairing itself, according to a study.
“Changes to ovarian function following menopause lead to a significant reduction in levels of estrogen and progesterone,” Orsolya Kiss, a research scientist at Salford Royal NHS Foundation Trust and a faculty member at The University of Manchester, and colleagues wrote. “Estrogen in particular, plays a crucial role in maintaining skin health [and] is known to be a potent immunomodulator.”
According to the authors, hormone replacement therapy (HRT) could be a helpful tool for mitigating the negative skin changes that post-menopausal women go through. To investigate this claim further, they conducted a study to specifically examine HRT’s effect on the skin barrier and immune cell composition in post-menopausal women following the application of a skin irritant.
Two cohorts of post-menopausal women, one treated with HRT (n = 8; mean age, 54 years) and the other untreated (n = 10; mean age, 56.5 years), underwent a skin irritant challenge where 1.25% topical sodium lauryl sulfate (Merck Life Science) was applied via a patch to occluded buttock skin for 48 hours. After 24 hours following patch removal, investigators graded the skin’s irritation and found that there were no clinical differences between the cohorts but there were some visible differences.
In response to the irritant challenge, women receiving HRT saw a significant increase in transepidermal water loss (P < .05), filaggrin deposition and keratin-10-positive cell layers (P < .01) vs. those not taking HRT, which demonstrated an enhanced skin barrier response.
On the other hand, HRT users also exhibited elevated levels of skin inflammation following the challenge. The investigators observed a significant reduction of CD207+ cells in the epidermis and an increase of these cells in the dermis in those taking HRT (P < .01), which is indicative of migrating Lagerhans cells. Those receiving HRT also saw elevated counts of inflammatory dendritic cells and macrophages in the dermis compared with those not taking HRT.
“Our findings suggest that HRT may render skin both more prone to inflammation and possibly more capable of clearing it, while also promoting skin repair,” the authors concluded. “However, whether HRT promotes a more competent skin immune compartment and efficient resolution of the inflammatory response requires further investigation.”
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