title: Effects of hormones on skin wrinkles and rigidity vary by race/ethnicity: four-year follow-up from the ancillary skin study of the Kronos Early Estrogen Prevention Study.
abstract: OBJECTIVE
  To measure skin wrinkles and rigidity in menopausal women of varying race/ethnicity with or without hormone therapy (HT) for up to four years.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled trial.
  
  
  METHODS
  Academic medical centers.
  
  
  METHODS
  Women (42-58 years of age) within 36 months of last menstrual period and enrolled in the Kronos Early Estrogen Prevention Study (KEEPS).
  
  
  METHODS
  Treatment with 0.45 mg oral conjugated equine estrogens (CEE), transdermal E2(50 μg/d) with micronized P (200 mg daily), or placebo for 4 years.
  
  
  METHODS
  Skin wrinkles were assessed at 11 locations on the face and neck, and skin rigidity was assessed at the forehead and cheek at baseline and yearly for 4 years.
  
  
  RESULTS
  Neither total wrinkle score nor total rigidity score was significantly different at baseline or over the 4-year follow-up among patients randomized to CEE, E2, or placebo. Skin wrinkle and rigidity scores were primarily affected by race/ethnicity, with scores being significantly different between races for almost all of the wrinkle parameters and for all of the rigidity measures. There was no association between race and response to HT for total wrinkle or rigidity scores. Black women had the lowest wrinkle scores compared with white women across all 4 years. In general, skin rigidity decreased in all groups over time, but black women had significantly reduced total facial rigidity compared with white women after 4 years.
  
  
  CONCLUSIONS
  Race is the strongest predictor of the advancement of skin aging in the 4 years following menopause. HT does not appear to affect skin wrinkles or rigidity at most facial locations.
  
  
  BACKGROUND
  NCT00154180.
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: carter.owen@mail.nih.gov.
authors.forename: Carter M
authors.initials: CM
authors.lastname: Owen
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, Connecticut.
authors.forename: Lubna
authors.initials: L
authors.lastname: Pal
authors.affiliation: Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.affiliation: Obstetrics and Gynecology and Women's Health, Division of Reproductive Endocrinology and Infertility, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Ruth
authors.initials: R
authors.lastname: Freeman
authors.affiliation: Obstetrics and Gynecology and Women's Health, Division of Reproductive Endocrinology and Infertility, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Barbara
authors.initials: B
authors.lastname: Isaac
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, Connecticut.
authors.forename: Linda
authors.initials: L
authors.lastname: McDonald
authors.affiliation: Department of Obstetrics and Gynecology and Women's Health, University of Colorado-Denver School of Medicine, Aurora, Colorado.
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, New Haven, Connecticut.
authors.forename: Hugh S
authors.initials: HS
authors.lastname: Taylor
authors.affiliation: Celmatix, New York, New York.
authors.forename: Erin F
authors.initials: EF
authors.lastname: Wolff
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D001741:Black or African American; D004311:Double-Blind Method; D004338:Drug Combinations; D004548:Elasticity; D004958:Estradiol / Q000008:administration & dosage* / Q000009:adverse effects; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D011374:Progesterone / Q000008:administration & dosage* / Q000009:adverse effects; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D015595:Skin Aging / Q000187:drug effects* / Q000208:ethnology; D013997:Time Factors; D057968:Transdermal Patch; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); D011374:Progesterone; D004958:Estradiol
keywords: Menopause; hormone therapy; race; skin rigidity; skin wrinkles