MON-203 Dermatological Effects Of Hormone Replacement Therapy

Abstract Disclosure: F. Shifaly: None. L. Yousif: None. S. Verma: None. P.I. Godspower: None. C. Dominguez-Bali: None. A. Dominguez-Bali: None. Postmenopausal women frequently report symptoms such as severe pruritus, skin dryness, increased wrinkles, and prone to bruising. These symptoms are secondary to loss of skin collagen. It has been shown that upto 30% of skin collagen is lost within the first five years after menopause. Hormone Replacement Therapy (HRT) plays a crucial role in the induction of collagen in the dermal layer of skin. We aim to call to attention the effects of topical HRT, specifically estradiol and estradiol-testosterone combinations, on Type I and III skin collagen synthesis in postmenopausal women. We have reviewed and synthesized findings from multiple in vivo studies, including observational and randomized control trials. These studies examined collagen changes using histological analysis, biochemical assays, and radionuclide-labeled antibodies to look at molecular signalling pathways of collagen production. Savvas et al. (1993) and Sauerbronn et al. (2000) investigated the effects of HRT using subcutaneous estradiol and testosterone, and found a significant increase in Type III collagen in the skin of women receiving HRT. Son et al. (2005) demonstrated the effects of topical 17β-estradiol in restoring collagen via the activation of the TGF-β signaling pathway, resulting in increased Type I procollagen mRNA and subsequent protein synthesis. This suggests a molecular mechanism by which estradiol induces collagen production. Estradiol also upregulated Smad 3 protein expression which was shown to inhibit matrix metalloproteinase-1 in aged skin. Rittié et al. (2008) demonstrated significant dose dependant increase in procollagen I and III mRNA expression, as well as collagen I protein synthesis at 1% and 2.5% estradiol concentration (p<0.05) in sun-protected skin compared to photoaged areas, highlighting the environmental factors on hormonal functions. Additionally, Savvas et al.(1993) also found that only 6 month of therapy was required to achieve the same effects of collagen induction as seen in women treated for median duration of 8 years. Skin collagen deposition appeared to plateau after 1-2 years, once optimum collagen levels has been reached (Brincat, Savvass and Sauerbronn). Grosman et al.(1971) also demonstrated the effect of estrogen to significantly increases hyaluronic acid levels, which indirectly helps to increase skin hydration by supporting the extracellular matrix integrity within the dermal layer. HRT has been shown to greatly benefit postmenopausal women by counteracting the adverse skin effects secondary to loss of collagen such as reduced elasticity, impaired wound healing, and skin dryness. In addition, HRT can help maintain the nail structure and function, prevent hair loss and wrinkles, and preserve the integrity and trophism of mucosal tissue as well as increase vascularization of skin. Presentation: Monday, July 14, 2025