Whether with acne, skin aging, premature hair loss or the so-called lady's beard - hormones are usually the trigger.
The skin is the body's protective shell, guardian of the immune system and sensory organ, temperature regulator, means of communication and supplier of vitamin D.
It also has complex endocrine properties.
A few decades ago it was assumed that bacteria and an improper diet are the main causes of acne, but today we know that stress hormones and androgen, i.e. male sex hormones, have a decisive influence on the development of acne in both women and men.
The term “male hormones” is fundamentally misleading, since women also produce androgens such as testosterone. Androgens mainly affect the sebum glands in the skin and the composition of the sebum. In addition, increased androgen levels can lead to abnormal keratinization, which clogs the pores of the sebum glands. In this way, in addition to the sebum, bacteria such as Propionibacterium acnes are also included, which are then able to grow and trigger immunological reactions.
Too much androgen can also lead to what is known as a lady's beard. Hairiness in women that is similar to the male distribution pattern, i.e. chin, upper lip, neck, back and chest, is defined as hirsutism in medicine. The characteristics can vary from very mild to very strong. Antiandrogen has proven itself as a therapeutic agent for both acne and hirsutism. Last but not least, due to the good therapeutic successes, antiandrogen is still prescribed to this day despite severe side effects such as thrombosis or pulmonary embolism.
After stopping the pill
Many women can notice changes in the skin even after they have stopped taking oral contraceptives. Quite a few complained about a visible deterioration of the skin condition afterwards. If the skin was previously normal but now suddenly acne-typical efflorescences can be seen. This is very likely due to the loss of the additional hormones taken with the pill and thus also to the anti-androgenic effect of oral contraceptives. After discontinuing the oral contraceptive, your own hormonal balance has to "level off" again. How long this takes and what specific side effects are to be expected after stopping the pill with regard to skin and hair cannot be found in the literature.
There is a lack of prospective studies.
In a study published in 2006, however, the question of how quickly and how the menstrual cycle settles again after stopping the pill was investigated for the first time.
175 women who had taken the pill were observed and compared with 284 women who had never taken an oral contraceptive. The scientists were able to determine that the cycle length of the post-pill group up to the new cycle was significantly longer than in the control group. However, 51% of post-pill beginners already had an unremarkable first cycle. The results indicate that every second woman after stopping the pill can expect hormonal side effects for almost six months, which can also affect the condition of the skin.
During pregnancy
Androgen also plays a role during pregnancy and influences the skin of the expectant mother. Even women who did not suffer from blemishes before pregnancy suddenly have numerous efflorescences. In this case, one speaks of the so-called pregnancy acne, the acne gravidarum. Furthermore, acne can literally "bloom" again during pregnancy or existing acne can become significantly worse.
In addition to the sex hormones, the thyroid hormones have an influence on our skin or on the skin appendages. For example, an underactive thyroid, known as hypothyroidism, often causes brittle and brittle hair and increased hair loss. The quality of the skin is also impaired, as the skin usually appears drier.
During menopause
A particularly clear effect of the influence of hormones on skin quality can be seen in women during and after menopause. During menopause and postmenopausal there is a significant decrease in the estrogen concentration, which remains stable at a low level from around the age of 60. In addition to many complaints, there is visible aging of the skin, which is noticeable, among other things, through a lack of lipid content.
A significant decrease in glycosaminoglycans such as hyaluronic acid can also be documented. The resulting lack of moisture and lipids leads to classic dryness with age and a loss of elasticity in the skin.
During this time, many women notice that their daily care is no longer adequate and that they need new, richer products. Furthermore, estrogens influence the metabolism of the skin cells, so that after weight loss there is a reduction in skin thickness and, moreover, a reduction in collagen and elastin fibres. This becomes visible in the form of a loss of firmness and elasticity and not least in the form of wrinkles on the skin. Since men do not experience such a rapid and drastic drop in hormones, the intrinsic skin aging processes also take place more slowly.
Skin produces hormones
More recent findings show that our skin is not only dependent on hormones but also produces hormones itself. Skin cells basically have the ability to produce glucocorticoids, androgen and estrogen, either from systemic precursors or by converting cholesterol into the prohormone pregnenolone, which in turn is converted into biologically active steroids.
An example of this process is the formation of cortisol or testosterone. Compared to the actual endocrine glands such as the adrenal gland or thyroid gland, the skin has very low levels of hormones. However, after ovarian function has ceased, the production of estrogen in the subcutaneous fatty tissue represents a relevant part. The researchers assume that a total of around thirty different hormones and hormone groups are active in the cells of the skin and the subcutaneous fatty tissue.
In principle, there is still a great need for research in the area of dermatological endocrinology. To date, it has not been clearly clarified how skin and hormones influence each other and what part of the system's own production has.
Article by Dr. phil. Meike Streker,
Cosmetic Scientist, Scientific Advice / Cosmetic Consulting,