Life expectancy for humans has doubled during the past 100 years. Because of this, clients living with skin affected by hormonal issues have to learn to manage them for a longer period of time. Hormones are the body’s chemicals that send signals between cells. They control and regulate many functions in the body, including temperature and blood pressure, and they support other diverse functions, such as growth, cell repair, metabolism, fertility and reproduction. The communication that a hormone has with organs in the body, along with other hormones, can also affect the skin of both women and men at various stages of their lives.
With all the skin conditions that can arise due to too many or too few hormones, skin care professionals must be aware of everything they can do to treat their clients, from the initial consultation to professional treatments to home care recommendations. Understanding the types of hormones that women deal with during the different stages will help skin care professionals when analyzing the skin. Side effects can be from one end of the scale with overly dry skin, to the other end—acne breakouts.
Understanding body chemistry
There are naturally occurring changes in body chemistry as people age, such as menopause. These changes can affect hormonal release from glands, thus disturbing their balance. Diabetes is another fairly common hormonal imbalance that occurs when there is not enough insulin, a hormone produced in the pancreas that affects metabolism. Hyper- or hypo-thyroidism is also quite common and is sometimes even detected in children. All these imbalances can manifest themselves in a wide variety of physical and emotional symptoms. Sustained hormonal imbalance can have severe—and potentially fatal—complications, so a diagnosis and treatment is critical for general health and well-being. The main hormones that affect the skin include estrogens, testosterone and thyroid hormones.
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Estrogen. Estrogen is the most commonly discussed hormone, but is often misrepresented because it is not only a female hormone, but is also found in men and in tissues outside the ovaries. Estrogens are made up of hormones that are chemically similar.
Testosterone. Testosterone is not just a male-based hormone. It affects hair growth and loss, causes coarser skin and increased levels of oil during different stages of a woman’s life.
Thyroid. The thyroid gland makes two hormones, which, if not balanced, will affect the skin. Too many of the hormones cause the skin to become sweaty, featuring enlarged pores that are warm to touch and even flushed. Too little production can cause the skin to go to other end of the spectrum, and become dry, coarse and thick.
A crucial consultation
The initial consultation is essential in order to collect necessary information for the client to be on the proper path to controlling and relieving the skin conditions she’s experiencing. Ask questions about her last menstrual cycle, because this could affect the treatment since many have reactions around their cycle time. These reactions can result in inflammation, burns from peels and even blistering or the possibility of hyperpigmentation.
Make sure to ask about medications the client is currently taking. Medications for any issue, including hormonally health-challenged skin, can easily affect the professional treatment plan.
Once you have your answers from the consultation, look at where the client is in her life cycle and consider the possible skin conditions that can occur due to hormonal imbalance at that time. Three easy times of life to look at for the female client are young adulthood, pregnancy and menopause. Although there are many stages in between, there are some definite issues that can happen during these three that disrupt the skin. A woman’s life expectancy has increased throughout the years, however the age that a woman reaches menopause has remained much the same: approximately age 50. This means that women are living longer in a hormone-deprived state. On the other end of the spectrum, girls are reaching puberty much earlier, which causes many hormone-related skin issues to occur.
Young adulthood. During young adulthood (adolescence to adulthood), acne often comes into play. Androgen hormones will stimulate the sebaceous glands in the skin. If they are overstimulated, acne will occur. Clients with hormonal acne may also experience irregular menstrual cycles, hair loss, diabetes and infertility. These health challenges can also lead to other skin conditions.
Hormonal acne will benefit from more gentle, effective treatments, because this skin can be sensitive and aggressive treatments may cause unwanted reactions. In the treatment room, a combination of deep cleaning treatments, enzymes and light-to-medium peels are effective. Home care should include products that are antibacterial, antimicrobial, anti-inflammatory, soothing and hydrating. Vitamin A derivatives, salicylic acid, totarol and benzoyl peroxide-like ingredients—such as glycyrrhiza inflata root extract (licorice)—can be effective for oil control.
Pregnancy. Another highly imbalanced hormonal stage occurs during pregnancy, and often results in melasma, also commonly known as “pregnancy mask.” This condition occurs when there is an overproduction of melanin. Professional treatments that can help include lasers and peels, but they are only recommended after the child is born. A series of microdermabrasion facials also can be helpful. (See Treatment How-to: Microdermabrasion Facial.) Home care during pregnancy can include natural brighteners, such as vitamin C, bearberry and daisy. After the pregnancy, home care may need to become more aggressive, using products such as hydroquinone and tretinoin-like ingredients. During the course of the pregnancy and beyond, always recommend a broad-spectrum sunscreen of SPF 30 or higher, since this will help prevent further pigmentation problems.
Pregnancy may also cause side effects to the scalp and nails, which, in turn, can affect head massage and hand/foot treatments. Most women tend to experience hair growth during pregnancy; however, after birth, they can experience hair thinning due to the loss of hormones. This usually calms and returns to normal about six months post delivery. Treatment serums to stimulate and strengthen the hair follicle are greatly beneficial during this time.
Nails often become very brittle and can also suffer from distal oncyholysis, which is a separation from the underlying nail bed and the nail plate. Treatments on the hands or feet with either condition should include antimicrobial, anti-inflammatory, antibacterial and hydration, along with gentle pressure to nurture the nails back to a healthy state.
Menopause. The major phase of hormonal skin condition changes is menopause. Menopause can happen naturally as women age or be induced prematurely due to illnesses, surgeries and medications. Because the main source of female hormones, the ovaries, shut down at this time, many side effects can affect the skin, as well as the treatments done by the professional. Menopause is the state of an absence of menstrual periods for at least twelve months. There is usually a transitional period to menopause, which can include smaller stages of periomenopause, the transitional time of hormone fluctuation and post-menopause, the period of time after the very last menstrual cycle occurrence. Because each woman experiences menopause differently, treatments may need to be altered.
Skin can be affected from a variety of issues during menopause, such as thinning, acne, dryness, excessive hair growth in odd places and even hair loss. When aging, the skin also becomes more sensitive, so more aggressive treatments and products used during youth may need to be altered because they are too stimulating for menopausal skin. Clients will still want anti-aging ingredients, such as peptides, alpha hydroxy acids (AHAs) and antioxidants, but they just need to be more cautious when dealing with more sensitive skin. As clients age, more medications will come into play due to illnesses that come with aging, and they will also play an important part in your consultations. Make sure the treatments are the right ones at the right time with the right dosage in order to avoid a reaction on the skin, but still give the results of the rejuvenated, healthier-looking skin the client desires.
Hormones do not discriminate
Hormonal issues do not discriminate, and can affect both women and men. By reviewing the consultation done with each client to assess skin conditions that may be present from hormonal imbalance, skin care professionals can improve the skin with proper treatments.
Kris Campbell is the CEO of Tecniche and is a certified oncology esthetician who teams up with Morag Currin—author of Oncology Esthetics: A Practitioner’s Guide (Alluredbooks, 2009) and Health-Challenged Skin: The Estheticians’ Desk Reference (Alluredbooks, 2012)—to address the skin concerns of clients going through cancer treatments. She can be reached at 480-699-5676 or firstname.lastname@example.org.