How to deal with hormonal effects on your skin

The Hurricane of Hormones: They Impact Skin at Every Age

Teens: The power and presence of hormones explodes during puberty. Following are some common troubling skin problems "triggered by "teen" hormones:

- Issue 1: Acne triggered by androgenic hormones including testosterones and DHEAs… The affect of these hormones is to increase the secretion of sticky oil in the hair follicle. When mixed with dead skin cells, this produces a plug, the initial event in the acne cycle. And although you might be tempted to just attack it when you see it, believe it or not, it takes a full 2-3 weeks for a blemish to surface. The bump that appears on skin is actually a final step in the process, making spot treatments largely ineffective. Additionally, some people continue to endure the aftermath of acne in the form of post-inflammatory hyperpigmentation (PIH) - a pink/brown discoloration at the site of the healed blemish that lasts long after the acne has cleared.

- Treatment: Fortunately, while not curable, acne is treatable, controllable and preventable. What skin needs is targeted medicines that penetrate to where the problem originates - to stop acne before it's visible on the skin's surface and to treat the damage it has left behind. You need a full-face, ongoing treatment to treat each step in the acne cycle - unclogging pores (salicylic acid, alpha hydroxy acids, retinoids and sulfur are ingredients capable of disrupting the plug-forming union of cells and oil to keep pores clear), killing bacteria (benzoyl peroxide at 2.5% is our preferred anti-bacterial agent for long-term control of acne), and reducing inflammation (sulfur or oral antibiotics are commonly used). In addition, prescription birth control pills such as Yaz are also effective in controlling breakouts because they help to mitigate the impact of hormonal fluctuations on the skin. Once you get it under control, you must stick with a daily skincare program to maintain clear skin. You can treat it. Interesting fact: The younger acne begins, the more severe it is…

- Issue 2: Cellulite: a deposit of fat that pushes against the connective tissue just below the surface of the skin, causing skin to look dimply and puckered). Estrogen appears to initiate the development of cellulite.

- Treatment: There isn't anything you can do to truly combat cellulite. However, it tends to be more common in overweight teens, so weight loss and exercise may help. Thermage laser performed by a derm. Is showing promise as a long-term treatment

- Issue 3: Dandruff: Can be initiated by androgenic hormones. It may be worse in winter because of lack of humidity.

- Treatment: There are very effective over-the-counter medicated shampoos and creams (active ingredients include tar, pyrithione zinc, salicylic acid, sulfur). For extreme cases, see a dermatologist.

Childbearing Years: Pregnant women produce between 30% and 50% more blood than non-pregnant women. The result: skin appears brighter, pinker, and more vibrant. And that's just the beginning. Because of the profound hormonal changes during pregnancy, nothing is quite the same. From thicker hair and strange discolorations on skin to protruding veins and an itchy belly, there is something new almost daily…Following are some of the most common dermatologic changes…

- Issue 1: Telangiectasis: Often referred to as "broken capillaries," they aren't really broken, but small, dilated new vessels under the skin's surface that are offshoots from deeper blood vessels. Can be triggered by hormones, topical agents like Retin A, activities such as hot saunas or sunbathing.

- Treatment: Laser treatment: Attracted to the red color in the vessel, green lasers weld the visible vein shut. Retreatment after a year or so is necessary. Avoid steam baths, saunas or over aggressive exfoliation

- Issue 2: Melasma: The "mask of pregnancy". The most visible manifestation of the effect of hormones on skin during pregnancy.

- Treatment: Strict sun protection during pregnancy - use broad spectrum UVA/UVB blocker daily Pigment-fading treatment with a medication called hydroquinone is quite effective after delivery and nursing is behind you…

- Issue 3: Acne: Acne is unpredictable. Approximately 30%-40% of women develop ace at one time or another during their adult years, with some suffering with it for up to 20 years. The difference is that as we age, pimples tend to move south on the face, with adults more commonly experiencing acne around the mouth and on the jawline, while ten acne tends to cluster on the forehead and cheeks. Overall, pimples in adults are fewer in number but bigger in size.

- Treatment: The same as with teen acne.

- Issue 4: Stretch Marks: Literally rips or microscars in the dermal layer of skin, stretch marks appear as skin is increasingly stretched during pregnancy. 75-90% of women experience them during pregnancy.

- Treatment: Unfortunately, you can't prevent stretch marks. No amount of cocoa butter, vitamin E, or alpha hydroxyl acid will help. Take comfort in knowing these streaks will often fade to silvery white, faint lines after delivery. Topical treatments such as Retin A may help diminish their appearance and can be used following nursing. New laser treatments such as Fraxel and Thermage are also showing promise.

- Issue 5: Skin Tags: Small lose growths of skin that usually appear under arms and breasts and on neck. They are caused by skin rubbing against skin.

- Treatment: They may disappear within 6 months after delivery. If they don't, see your dermatologist. A quick snip with surgical scissors or a quick touch with an electrosurgical spark will painlessly remove skin tags.

Mid Years (Perimenopause) - late 40s & 50s - The physical changes that occur during our late forties through our fifties can be very disconcerting, to say the least. The reduction in female hormones causes significant changes in appearance - fat redistributes from our face to our fanny, our eyebrows flatten, and our lips lose their red color and plump volume. Skin gets blotchy and thinner and our skeleton starts to shrink. However, skin can be beautiful when it is nurtured, well cared for, and sun protected.

- Issue 1: Skin Dryness and Skin Turnover: Dryness and menopause go hand-in-hand. With decline in hormone production, secretions from tear ducts and salivary and sebaceous glands slow. End result, dry skin. Skin cell production slows, causing an overall thin and crepey texture. Skin looks dull, drab and sallow.

- Treatment: Both chemical and physical exfoliation help increase epidermal cell turnover. It's the quickest and easiest way to get your skin to act younger than its years.

- Issue 2: Fat, Collagen and Elastin Reduction: Skin starts to wrinkle, droop and sag. Lack of hormones and cumulative sun damage result in net loss of collagen and elastin fibers. (30% of skin collagen is lost in the first five years after menopause). Additionally, like a deflated balloon, the redistribution of fat from the face to the fanny accounts for some of the most profound changes in the aging face.

- Treatment: Add products with retinoids and peptides to your skincare regimen. The vit. A based compounds are the most studied and proven anti-aging ingredient, which speed up cell turnover, and build and preserve collagen. Boost hydration with a richer moisturizer in the morning and at night (products work better when you sleep). Apply when skin is damp to seal in moisture. Consider amping it up a bit…Deep wrinkles and serious pigmentation may require a trip to the derm. Treatments like Botox, fillers and peels can take years off your appearance.

- Issue 3: Enlarged Pores…The universal complaint for the over 30 crowd is, "I hate my pores". As we age pores get bigger. Pores are surrounded by collagen fibers. With age, as collagen production slows and collagen breakdown accelerates, pores lose support, flatten out, and widen.

- Treatment: Exfoliating cleansers with salicylic acid work like Drano in your skin to unclog oily pores. As you age, retinoids and peptides help increase collagen production, which keeps pores smaller. Additionally, salicylic acid peels and microdermabrasion help.

About Dr. Katie Rodan and Dr. Kathy Fields:
Dr. Katie Rodan and Dr. Kathy Fields are Stanford-trained practicing dermatologists and co-developers of Rodan + Fields Dermatologists and world-renown Proactiv® Solution*. Astute businesswomen, accomplished doctors and successful entrepreneurs, Drs. Rodan and Fields have touched the lives of more than 10 million people with their targeted skin care solutions. In fact, in 2003 they received the prestigious Cosmetic Executive Women's Award for changing the direction of the industry with the success of Proactiv Solution.

Having met as young residents fresh out of medical school, Drs. Rodan and Fields took their dream of educating the public about common dermatologic conditions a step further by making dermatology advice-based treatment and therapeutic solutions available to everyone. In the process, this powerful team revolutionized the skin care industry.

Rodan + Fields Dermatologists, developed in 2002 by Drs. Fields and Rodan, is at the forefront of clinical skin care, merging effective over-the-counter medicines with soothing botanicals to provide real and visible results. Committed to bringing dermatology to the home, the brand offers solutions for everyday skin issues, including acne, sun damage, wrinkles and sensitive skin, targeting them with dedicated regimens designed to take the guesswork out of skin treatment. Each regimen consists of a step-by-step Multi-Med® Therapy system addressing all aspects of a skin condition.

As co-founders of Rodan + Fields, Drs. Fields and Rodan are the creative force behind the brand and intimately involved in all aspects of the company. They directly oversee the creation and development of products, brand imaging and conceptual design as well as the implementation of brand initiatives. As dynamic speakers and inspirational leaders, they serve as the "face" and "voice" of Rodan + Fields.

Both doctors are Fellows of the American Academy of Dermatology and members of numerous medical societies, including the American Society of Dermatologic Surgery and the California Medical Association. They have co-authored Write Your Skin a Prescription for Change, which offers clinical and lifestyle tips for maintaining healthy, younger looking skin and UNBLEMISH, a revolutionary guide and 30-day program for treating acne - a complicated and stigmatizing condition. They are frequent contributors to medical journals on breakthrough technology, as well as invited speakers to dermatology conferences.

Dr. Rodan and Dr. Fields have been featured on national and local TV and radio shows, including ABC's The View and Later Today. They are frequently quoted as leading experts on skin in the country's most popular magazines and newspapers including Allure, Harper's Bazaar, Glamour, People and Prevention.

Dr. Katie Rodan is an adjunct Clinical Associate Professor of Dermatology at Stanford University School of Medicine. She completed her dermatology residency at Stanford, which included a year as an NIH clinical research fellow and another year as Chief Resident. She received her B.A. in history from the University of Virginia and her medical degree from the University of Southern California School of Medicine in Los Angeles. She is intimately involved with The Bessie Pregerson Child Care Center, The Head-Royce School's Heads Up Summer Program and Larkin Street Youth Services - California-based programs that help underpriveledged children. An avid hiker, skier and food enthusiast, Dr. Rodan lives in the San Francisco Bay area with her husband and two daughters.

Dr. Kathy Fields is an Assistant Clinical Professor of Dermatology at UC San Francisco. She received her B.S. in neurobiological chemistry from the University of Florida, her medical degree from the University of Miami School of Medicine and completed her dermatologic residency at Stanford University Medical Center. She is passionate about her community and dedicates time to various school activities and local volunteer organizations. A life-long athlete, Dr. Fields' hobbies include skiing, swimming and scuba diving. She lives in the San Francisco Bay area with her husband and two children.

* Proactiv® Solution is a registered trademark of Guthy-Renker.


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