Author : Jiddi Adibia, MD
Supervised by : Adniana Nareswari, MD., Dermatologist
Skin aging is a multifaceted process influenced by both intrinsic and extrinsic factors. Intrinsic aging, also known as chronological aging, is driven by genetic and metabolic processes, leading to gradual structural and functional changes over time. Extrinsic aging results from environmental exposures such as ultraviolet (UV) radiation, pollution, and toxins. These factors collectively contribute to the degradation of skin components, including collagen and elastin, resulting in wrinkles, sagging, and loss of elasticity.
There are some several key mechanisms contributing to skin aging :
- Glycation: The non-enzymatic attachment of sugars to proteins, leading to the formation of advanced glycation end-products (AGEs) that impair skin elasticity.
- Oxidative Stress: An imbalance between free radicals and antioxidants causes cellular damage, accelerating the aging process.
- Cellular Senescence: A state of irreversible cell cycle arrest that affects skin regeneration and repair.
- Hormonal Changes: Declining hormone levels, particularly estrogen, affect skin thickness, hydration, and elasticity.
Various mechanisms that occur will lead to several structural and functional changes in the skin indicating the aging process, such as :
- Epidermal Changes: Aging leads to a thinning of the epidermis, resulting in a diminished barrier function and increased susceptibility to injuries.
- Dermal Alterations: There’s a reduction in collagen and elastin fibers, causing decreased skin elasticity and the formation of wrinkles.
- Vascular Modifications: The dermal blood vessels become more fragile, leading to a higher incidence of bruising and slower wound healing.
- Cellular Senescence: Accumulation of senescent cells in the skin contributes to aging by secreting pro-inflammatory cytokines that degrade the skin matrix.
All functional changes in the skin associated with aging and their clinical implications include aging impairs the skin’s barrier function, leading to increased transepidermal water loss and dryness, there’s a notable decrease in stratum corneum hydration, contributing to xerosis (dry skin) commonly seen in the elderly. Aging also increase in skin surface pH with age can disrupt the skin’s microbiome and enzyme activity, potentially leading to conditions like dermatitis. Another effect that also occurs is aging will decreased the skin’s ability to recover from external stresses, such as UV exposure or mechanical injury.
Hormonal Changes in aging skin may affect skin condition and skin appearance. There are two hormones that play a key role in the skin aging process, namely dehydroepiandrosterone (DHEA) and estrogens. Dehydroepiandrosterone (DHEA) is a steroid hormone produced by the adrenal glands and serves as a precursor for sex hormones such as estrogen and testosterone. As aging progresses, DHEA levels decline, which can negatively impact skin health. The reduction in DHEA is associated with decreased sebum production, leading to dry skin and increased susceptibility to wrinkles and skin damage. Additionally, DHEA has antioxidant properties that help protect the skin from oxidative stress caused by free radicals.
Estrogen plays a crucial role in maintaining skin health. It helps preserve skin thickness, hydration, and elasticity by stimulating collagen production and retaining moisture. After menopause, estrogen levels drop significantly, leading to reduced skin thickness, elasticity, and hydration, along with an increase in wrinkles and dryness. Hormone replacement therapy with estrogen has been shown to improve collagen content, skin thickness, and elasticity in postmenopausal women.
Decrease in levels of DHEA and estrogen during the aging process contributes to structural and functional changes in the skin, including decreased sebum production, reduced skin thickness and elasticity, and an increase in wrinkles and dryness. Understanding the role of these hormones in skin aging can aid in the development of strategies to maintain skin health as aging progresses.
Recent research highlights the importance of hormones like estrogen, progesterone, and androgens in maintaining skin integrity and highlights potential therapeutic approaches to mitigate adverse skin conditions resulting from hormonal fluctuations. Here are some treatment strategies formulated to slow down the aging process of the skin :
- Topical Agents: Products containing retinoids, antioxidants, and peptides that promote collagen synthesis and protect against oxidative damage.
- Systemic Therapies: Hormone replacement therapy (HRT) to address hormonal deficiencies affecting the skin.
- Procedural Interventions: Techniques such as laser resurfacing, chemical peels, and dermal fillers to improve skin appearance.
- Nanotechnology-Based Formulations: Emerging treatments utilizing nanoparticles for enhanced delivery of active ingredients to target skin aging at a molecular level.
Conclusion :
Hormonal changes, especially the decline in estrogen and DHEA, play a major role in skin aging. As hormone levels drop, the skin loses collagen, elasticity, and hydration, leading to wrinkles, dryness, and thinning.
Understanding hormonal influences on skin health is crucial for developing effective dermatological treatments. Research highlights how estrogen, progesterone, and androgens affect skin aging, elasticity, pigmentation, and acne formation. Future therapies focusing on hormonal balance may provide better skincare solutions and improve overall skin health.
References :
- Chaudhary M, Khan A, Gupta M. Skin Ageing: Pathophysiology and Current Market Treatment Approaches. Curr Aging Sci. 2020;13
- Wang Z, Man MQ, Li T, et al. Aging-associated alterations in epidermal function and their clinical significance. Aging. 2020 Mar 27;12
- Chaudhary M, Khan A, Gupta M. Skin Ageing: Pathophysiology and Current Market Treatment Approaches. Curr Aging Sci. 2020;13