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Does Estrogen Prevent Skin Aging?  Results From the First National Health and Nutrition Examination Survey (NHANES I)

Laura B. Dunn, AB; Mark Damesyn, MPH; Alison A. Moore, MD; David B. Reuben, MD; Gail A. Greendale, MD
Arch Dermatol. 1997;133(3):339-342. doi:10.1001/archderm.1997.03890390077010.
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Objective:  To evaluate the relation between noncontraceptive estrogen use and skin wrinkling, dryness, and atrophy.

Design:  Cross-sectional analysis of a national probability sample-based cohort study.

Setting:  Multiple community sites throughout the United States.

Participants:  Postmenopausal women (n=3875) aged 40 years and older at baseline.

Measurements:  Skin conditions (wrinkling, dryness, and atrophy) were ascertained using a uniform clinical examination by trained dermatology resident physicians. Self-reported use of estrogen before the baseline examination, sunlight exposure, and smoking history were obtained by standardized interview. Body mass index, a measure of weight in kilograms divided by the square of the height in meters, was evaluated in uniform examination clothing.

Results:  Mean (±SD) age of the participants was 61.6 (±9.0) years and mean (±SD) number of years since menopause was 15.6 (±9.4). Most were white (83.7%), the remainder being African American (15.9%) or another race (0.4%). Atrophy was present in 499 (16.2%), dry skin in 1132 (36.2%), and wrinkled skin in 880 women (28.2%). The prevalence of all 3 skin conditions was lower in African American women compared with white women. Information on hormone use was available for 3403 participants (88%). Among all women, after adjustment for age, body mass index, and sunlight exposure, estrogen use was associated with a statistically significant decrease in the likelihood of senile dry skin (odds ratio, 0.76; 95% confidence interval, 0.60-0.97). The odds of wrinkling were substantially lower in estrogen users, adjusted for age, body mass index, and sun exposure (odds ratio, 0.68; 95% confidence interval, 0.52-0.89) and additionally for smoking (odds ratio, 0.67; 95% confidence interval, 0.44-1.01). In multivariable models, estrogen use was not associated with skin atrophy.

Conclusion:  These results strongly suggest that estrogen use prevents dry skin and skin wrinkling, thus extending the potential benefits of postmenopausal estrogen therapy to include protection against selected ageand menopause-associated dermatologic conditions.Arch Dermatol. 1997;133:339-342

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