title: Does estrogen prevent skin aging? Results from the First National Health and Nutrition Examination Survey (NHANES I)
abstract: OBJECTIVE
  To evaluate the relation between noncontraceptive estrogen use and skin wrinkling, dryness, and atrophy.
  
  
  METHODS
  Cross-sectional analysis of a national probability sample-based cohort study.
  
  
  METHODS
  Multiple community sites throughout the United States.
  
  
  METHODS
  Postmenopausal women (n = 3875) aged 40 years and older at baseline.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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 age- and menopause-associated dermatologic conditions.
authors.affiliation: University of California at San Francisco, School of Medicine, USA.
authors.forename: L B
authors.initials: LB
authors.lastname: Dunn
authors.forename: M
authors.initials: M
authors.lastname: Damesyn
authors.forename: A A
authors.initials: AA
authors.lastname: Moore
authors.forename: D B
authors.initials: DB
authors.lastname: Reuben
authors.forename: G A
authors.initials: GA
authors.lastname: Greendale
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D015595:Skin Aging / Q000187:drug effects*; D014481:United States
chemical_list: D004967:Estrogens