Microsoft word - effects of estriol on skin.rtf

International Journal of Dermatology, Vol. 35, No. 9, September 1996 PHARMACOLOGY AND THERAPEUTICS
JOLANTA B. SCHMIDT, M.D.,
MARTINA BINDER, M.D., GABRIELE DEMSCHIK, M.D.,
CHRISTIAN BIEGLMAYER, PH.D., AND ANGELIKA REINER, M.D.
Conclusions. Both estrogen compounds were found to be highly Background. The coincidence of climacteric symptoms and the effective in preventing or treating skin aging in peri-menopausal beginning of skin aging suggests that estrogen deficiency may be a women, clinically, by measurement data, and by an increase in common and important factor in the perimeno-pausal woman. Often hormones have been considered important in endogenous aging of the skin, but their role has not been clearly defined. Therefore, we investigated, whether topical treatment of the skin with estrogen Topical tretinoin was the first substance with which could reverse some of the changes in the aging skin. significant improvements of skin appearance1 could be correlated with histologic and in vitro findings.2"4 Tretinoin Materials and Methods. The effects of 0.01% estradiol and 0.3% is a very effective agent against solar radiation-induced estriol compounds were compared in 59 preclimac-teric women exogenous skin aging.5 In contrast, so far no agents were with skin aging symptoms. Monthly determinations of estradiol found to be effective in endogenous aging. Although (E2), follicle-stimulating hormone (FSH), and prolactin (PRL) were hormones often were considered as important factors in done and the monthly clinical monitoring was supplemented by endogenous skin aging, the scient i f i c background of a measurements of skin hydration by corneometry and profilometry. hormonal role in the aging processes of the skin still In 10 patients, skin biopsies were taken for immunohistochemical determination of collagen types I and III. In gynecology, the therapeutic effects of topical es- trogens on atrophy of the vaginal and vulvar epithelia have Results. After treatment for 6 months, elasticity and firmness of been well described for many years.6,7 During the past the skin had markedly improved and the wrinkle depth and pore years, estrogen supplementation of the climacteric woman sizes had decreased by 61 to 100% in both groups. Furthermore, has opened new aspects on the wide variability of estrogen skin moisture had increased and the measurement of wrinkles effects in various tissues. Beneficial effects on serum using skin profilometry, revealed significant, or even highly cholesterol,8 on vascular actions in context with the significant, decreases of wrinkle depth in the estradiol and the myocardial infarction rate,9 and improvement and estriol groups, respectively. Onimmunohistochemistry, significant prevention of osteoporosis10 are only some of the increases of Type III collagen labeling were combined with increased numbers of collagen fibers at the end of the treatment In skin tissue—an active target site of estrogens as period. As to hormone levels, only those of PRL had increased shown by estrogen receptor determinations significantly and no systemic hormonal side effects were noted. gens increase vascularization and show effects at various levels of dermal tissue. Improvement of the structure of From the Department of Dermatology, Division of Special and elastic fibers after use of estriol cream13 has been described. Environmental Dermatology, University of Vienna Medical Furthermore, increases of acid mucopolysaccharides and of School, Vienna, Austria; the Institute for Medical and hyaluronic acid14'1;> augment the dermal water content. Chemi-al Laboratory Diagnostics, Department of Hormone Distinct trophic effects of estrogen compounds—and also of Analysis, pretsiry of Vienna, Vienna, Austria; and the Institute estriol—on vaginal atrophy by increasing the maturation of Qmcal Pathology, University of Vienna, Vienna, Austria. index associated with an increase of the number of superficial epithelial cells, support the epithelial actions of ifctss for correspondence: Jolanta B. Schmidt, M.D., De-ranmcnt of Dermatology, Division of Special and These actions of estrogens prompted us to investigate Environ-j Kntal Dermatology, University of Vienna Medical whether topical estrogen treatment of the skin could reverse School, Wahringer Giirtel 18-20, A-1090 Vienna, Austria. aging symptoms in estrogen-deficient women. In a preliminary study, the effects of a 0.3% topical estriol compound on the facial skin of climacteric women had been investigated17 and compared

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