Vaillant L, Callens A
Service de Dermatologie, CHU Tours, France.
Therapie. 1996 Jan-Feb;51(1):67-70.
Ageing of the skin results from the synergistic effects of intrinsic ageing (due to age and genetic factors), photoageing (due to ultraviolet radiation) and, for women, hormonal ageing (due to oestrogen deficiency in postmenopausal women). Oestrogens receptors and metabolism or inactivation of oestradiol have been demonstrated in the skin, and the pilosebaceous unit is a target for sexual steroids. Could hormonal replacement therapy (HRT) be a treatment for the symptoms of skin ageing (dryness, roughness, burning and atrophy of the skin, itching, cold intolerance, wrinkles, hyperpilosity, alopecia)? In some experimental studies oestrogens increase the activity of fibroblasts and water, hyaluronic acid and collagen dermal contents. Some studies have demonstrated that oestrogen treatment increases skin thickness, mitotic activity of keratinocytes, and dermal collagen content in postmenopausal women. Thus HRT could theoretically treat skin ageing. It has been shown that HRT alleviates some symptoms of skin ageing (dryness of hair and skin) and that flushes disappear. We demonstrated that non-invasive measurements of physical parameters of the skin can reveal increase in skin thickness (+10 to +20 per cent) in women treated by HRT vs non treated, especially in the application area of oestrogen and in the non-sun-exposed areas. In our study HRT alleviated the hyposeborrhoea usually seen after menopause and could contribute to the amelioration of some complaints of post menopausal women such as roughness or dehydrated skin. Hormonal ageing is quantitatively less than actinic ageing, but its treatment is easier. Moreover HRT increases skin thickness, contributing to the prevention of atrophy (with fragile and fading skin) due to intrinsic ageing, and it limits the masculinization of facial hair and skin experienced by women as a sign of ageing. In conclusion HRT treats oestrogen deficiency and can be used to treat skin ageing.
皮肤老化是由内在老化（由于年龄和遗传因素）、光老化（由于紫外线辐射）以及对女性而言的激素老化（由于绝经后女性雌激素缺乏）的协同作用导致的。皮肤中已证实存在雌激素受体以及雌二醇的代谢或失活情况，而皮脂腺单位是性类固醇的作用靶点。激素替代疗法（HRT）能否用于治疗皮肤老化的症状（皮肤干燥、粗糙、灼痛、萎缩、瘙痒、不耐寒、皱纹、多毛症、脱发）呢？在一些实验研究中，雌激素可增加成纤维细胞的活性以及皮肤中的水分、透明质酸和胶原蛋白含量。一些研究表明，雌激素治疗可增加绝经后女性的皮肤厚度、角质形成细胞的有丝分裂活性以及真皮胶原蛋白含量。因此，从理论上讲HRT可以治疗皮肤老化。研究表明，HRT可缓解皮肤老化的一些症状（头发和皮肤干燥），且潮热现象会消失。我们证明，对皮肤物理参数进行非侵入性测量可发现，接受HRT治疗的女性与未接受治疗的女性相比，皮肤厚度增加了（10%至20%），尤其是在雌激素涂抹区域和非阳光暴露区域。在我们的研究中，HRT缓解了绝经后常见的皮脂分泌过少问题，并有助于改善绝经后女性的一些不适症状，如皮肤粗糙或脱水。激素老化在数量上比光化性老化少，但其治疗更容易。此外，HRT可增加皮肤厚度，有助于预防因内在老化导致的萎缩（皮肤脆弱和色泽减退），并可减少女性因老化出现的面部毛发增多和皮肤男性化现象。总之，HRT可治疗雌激素缺乏，并可用于治疗皮肤老化。
