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March 1997

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

Author Affiliations

From the University of California at San Francisco, School of Medicine (Ms Dunn); UCLA School of Public Health (Mr Damesyn) and Division of Geriatrics, UCLA School of Medicine (Drs Moore, Reuben, and Greendale), Los Angeles, Calif.

Arch Dermatol. 1997;133(3):339-342. doi:10.1001/archderm.1997.03890390077010

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