RESEARCH

Oestrogen plays many important roles in the skin. Keratinocytes, Langerhans cells, melanocytes, sebaceous glands and fibroblasts are all under hormonal influence. Hence, decreased oestrogen levels result in a decreased capillary blood-flow velocity to the skin.

Wrinkles are thought to be caused by changes in the dermal tissue, which is composed of fibroblasts. Older skin has been shown in multiple studies to have decreased amounts of collagen, elastin, and hyaluronic acid. Much research has gone into how to prevent the loss of these three main components of the dermis. Although dermal fillers

containing collagen and hyaluronic acid have been developed to replace these components in the skin, much interest has focused on preventing the loss of these vital components. Skin ageing seems to accelerate after menopause. It is known that the decline in skin collagen that occurs with aging occurs at a greater rate during the first few years after menopause. In fact, some 30% of skin collagen is lost in the first 5 years after menopause.

The free radical theory of ageing, proposed in 1956, is one of the most widely accepted theories to explain the cause of ageing. Free radicals lead to inflammation, damaged DNA, and damaged cell membranes. Therefore, free radicals alone can cause the breakdown of collagen, even in the absence of UV exposure.

The use of antioxidants to prevent photoaging and the breakdown of collagen, elastin, and hyaluronic acid has become very popular in the dermatology and skin care fields. Numerous studies have supported the use of green tea extract, vitamin C, vitamin E, coenzyme Q10, lutein, lycopene and red clover to prevent photoaging. Antioxidants can be applied topically and must also be taken orally to achieve maximum success. Most formulations on the market contain too little of those beneficial extracts to have any effect to have any effect on your skin. In addition, antioxidants can be very unstable, hence be easily destroyed by the other ingredients in these products, such as synthetic preservatives. For example, vitamin C has the added benefit of increasing collagen synthesis; however, it is a molecule that is difficult to stabilize, and proper formulation is essential to achieve efficacy.

Natural derivatives of vitamin A, an important anti-oxidant, have long been known to improve wrinkled skin. A plethora of clinical trials confirmed early observations that those treated with vitamin A derivatives for acne had less photoaging than those not treated with it. More recently, evidence suggests that vitamin A derivatives also play a role in the prevention of ageing. This occurs because of its inhibitory effects on damaging several collagen-degrading enzymes. It has been demonstrated that in particular a specific derivative of vitamin A inhibits the production of these harmful enzymes.

In addition, UV exposure has also been shown to decrease collagen production. Clinical trials demonstrated that collagen is substantially reduced within 24 hours after a single UV exposure. Pre-treatment of the skin with vitamin A derivatives was shown to inhibit this loss of collagen. Therefore, pre-treatment of the skin with the right and natural derivative of vitamin A, when used consistently, is very beneficial in preventing as well as treating photodamage.

Oestrogen also plays a role in maintaining collagen and hyaluronic acid. In fact, the naturally occurring oestrogen in our body was found to be as effective as all natural vitamin A derivatives in stimulating the development of new connective repair zones in photodamaged skin, which resulted in a skin thickening response. The increase in skin thickness among patients receiving plant-based estrogens (Phytooestrogens) has been observed. It is currently believed that these skin thickness changes seen with ageing are due to hormonal effects on collagen, elastic fibres and dermal hyaluronic acid content.

Prevention of skin ageing is a concern for many. I have developed a new customised approach to skincare which addresses each individual’s unique differences. Based on sound scientific principles, each patient is treated internally and externally to their specific condition. The preventative treatments focus on preserving collagen, hyaluronic acid and elastic tissue. The naturally preserved, bio-organic skincare products are handmade and customised for each patient. This is combined with an internal, customised treatment of plant derived anti-oxidants, not in supplement form but as phytomedical (plant based medicine preparations) and phytooestrogens (extracted from plants).

References

E.F. Wolff, D. Narayan and H.S. Taylor, Long-term effects of hormone therapy on skin rigidity and wrinkles, Fertil Steril 84 (2005), pp. 285–288.

P.G. Sator, J.B. Schmidt, T. Rabe and C.C. Zouboulis, Skin aging and sex hormones in women —clinical perspectives for intervention by hormone replacement therapy, Exp Dermatol 13 (2004) (Suppl 4), pp. 36–40.

M. Brincat, C.F. Moniz, J.W. Studd, A.J. Darby, A. Magos and D. Cooper, Sex hormones and skin collagen content in postmenopausal women, Br Med J (Clin Res Ed) 287 (1983), pp. 1337–1338.

G.J. Fisher, Z.Q. Wang, S.C. Datta, J. Varani, S. Kang and J.J. Voorhees, Pathophysiology of premature skin aging induced by ultraviolet light, N Engl J Med 337 (1997), pp. 1419–1428.

S.E. Fligiel, J. Varani, S.C. Datta, S. Kang, G.J. Fisher and J.J. Voorhees, Collagen degradation in aged/photodamaged skin in vivo and after exposure to matrix metalloproteinase-1 in vitro, J Invest Dermatol 120 (2003), pp. 842–848.

G.J. Fisher, S.C. Datta, H.S. Talwar, Z.Q. Wang, J. Varani and S. Kang et al., Molecular basis of sun-induced premature skin ageing and retinoid antagonism, Nature 379 (1996), pp. 335–339.

S. Kang, J.H. Chung, J.H. Lee, G.J. Fisher, Y.S. Wan and E.A. Duell et al., Topical N-acetyl cysteine and genistein prevent ultraviolet-light-induced signaling that leads to photoaging in human skin in vivo, J Invest Dermatol 120 (2003), pp. 835–841.

S.K. Katiyar, Skin photoprotection by green tea antioxidant and immunomodulatory effects, Curr Drug Targets Immune Endocr Metabol Disord 3 (2003), pp. 234–242.

B.V. Nusgens, P. Humbert, A. Rougier, A.C. Colige, M. Haftek and C.A. Lambert et al., Topically applied vitamin C enhances the mRNA level of collagens I and III, their processing enzymes and tissue inhibitor of matrix metalloproteinase 1 in the human dermis, J Invest Dermatol 116 (2001), pp. 853–859.

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