Overview of Aging, Skin Health, Estrogen, Menopause and HRT.

While skin aging is inevitable, healthy habits, sun protection, skincare, and medical interventions can slow visible skin changes; estrogen is also crucial. In 2002, the Women's Health Initiative (WHI) results contributed to the subsequent trend toward fear and avoidance of hormone replacement therapy (HRT). Since 2002, the WHI results have been re-evaluated and caused the US FDA to announce "the removal of the misleading FDA warnings on HRT", stating that "estrogen is a key hormone for women's health where every single part of a woman's body depends on estrogen to operate at its best-including the brain, bones, heart, and muscles". This overview explores this transformation of scientific information/perspective on HRT via (a) aging and skin health; (b) the importance and changes in estrogen in women with a focus on dermal parameters; (c) provides a brief review of the WHI result, impact, and current status of this report; (d) explores the "timing hypothesis" for HRT interventions; and (e) proposes that HRT might be considered not only for symptomatic women but also for esthetic treatment in perimenopause and menopause patients. The latest reviews support a recent large-scale systematic review and meta-analysis on skin parameters, which suggests that HRT may have a place in esthetic treatment. However, beyond esthetic benefits, the positive implications of HRT on several other health parameters in women during aging are briefly presented. Of course, hormonal and numerous other treatments require a review of the risks/benefits and their discussion among the patient and medical professionals to determine the most effective interventions for treating hormone-related skin changes, but this shift in perspective warrants further investigation and validation.