Does hormone therapy improve age-related skin changes in postmenopausal women?

Background

In postmenopausal women, declining estrogen levels are associated with a variety of skin changes, many of which are reportedly improved by estrogen supplementation.

Objective

A study was conducted to assess the effects of continuous combined norethindrone acetate (NA) and ethinyl estradiol (EE) in the control of mild to moderate age-related skin changes in postmenopausal women.

Methods

Four hundred eighty-five subjects were enrolled in this 48-week randomized, double-blind study. Subjects were randomized to one of three study arms: placebo group (165 subjects), 1 mg NA/5 μg EE group (162 subjects), or a 1 mg NA/10 μg EE group (158 subjects). The primary efficacy parameters of the study were investigator global assessment of coarse and fine facial wrinkling at week 48 and subjective self-assessment of changes in wrinkling from baseline at week 48. Secondary parameters included investigator global assessment of skin laxity/sagging at week 48, investigator global assessment of skin texture/dryness at week 48, patient self-assessment of laxity/sagging, texture/dryness, and wrinkle depth determined by image analysis of skin replicas of the periorbital (crow's feet) and jowl areas, and skin elasticity determined by timed deformation and recoil.

Results

There were similar scores in investigator global assessment in wrinkling and sagging modules at baseline across all three treatment groups. There were slight decreases in all parameters for all treatment groups for the primary subject end points, but there were no statistically significant differences between the NA/EE groups and placebo. For subject self-assessment of overall severity of skin wrinkling, there were no significant changes at weeks 24 and 48 compared to baseline. These data were unaffected by smoking status or alcohol consumption.

Limitations

This study assessed the effects of 48 weeks of low-dose estrogen upon facial skin in women who were, on average, 5 years postmenopausal. The effects of higher estrogen doses, longer treatment duration, or effects upon perimenopausal women cannot be extrapolated from this study.

Conclusion

Low-dose hormone therapy for 48 weeks in postmenopausal women did not significantly alter mild to moderate age-related facial skin changes.

Abbreviations used: ANCOVA, analysis of covariance, ANOVA, analysis of variance, EE, ethinyl estradiol, HT, hormone therapy, LED, light-emitting diode, NA, norethindrone acetate, RA, replica analysis, WSM, Wrinkling and Sagging Module