Original of this article was published on ZRT Laboratory Blog. Last reviewed: May 2026.
It certainly isn’t news that hormones are involved in skin health. But it may be news that the effects of declining oestrogen levels are more obvious on the skin of the face than elsewhere on the body. How so? Read on.
Lower Hormone Levels, Lower Skin Vitality
Women and their doctors have known for a long time that the decline in hormone levels as we age has a negative impact on skin properties, and we typically see skin thinning, wrinkling, discoloration, and dryness. This is because hormones are intrinsically involved with maintaining collagen content, skin lipid levels, elasticity, wound healing, and glycosaminoglycan content. Not only do hormones act at prolific receptor sites throughout the skin, but several cellular components of skin — including the sebaceous glands, fibroblasts, sweat gland cells, subcutaneous fat cells, and epidermal keratinocytes — actively produce androgens and oestrogens for local use.
Facial skin expresses much higher concentrations of oestrogen receptors than the skin of the breast or the thigh. This means that the effects of declining oestrogen levels as women progress through menopause are more obvious on the skin of the face than on the skin covering other parts of the body. Reduced availability of oestrogen affects skin health in a number of ways: wrinkling, dryness, thinning, reduced collagen content, slower wound healing and loss of elasticity.
Higher Oestrogen Means Better Skin – But Don’t Overdo It
Obese men and women often don’t show this deterioration in skin health to the same extent as normal weight people; this is because they maintain higher oestrogen levels as a result of increased aromatase activity in fat and skin tissue. Aromatase is an enzyme that converts testosterone into oestradiol and androstenedione into oestrone, and it is present in large quantities in fat tissue, including the fat layer just below the skin.
Studies of oestrogen replacement therapy have shown some improvement in those skin properties affected by low oestrogen levels — increased collagen content, skin thickness, and skin elasticity. Hormone replacement has also been found to increase skin surface lipids, which enhances the barrier function and may prevent dryness. Oestrogen also plays a role in maintaining skin glycosaminoglycan content, which retains moisture.
However, it’s important to remember that hormones applied topically are absorbed systemically. Serum testing does not reveal the extent of hormone absorption from topical preparations, yet saliva testing does reflect exposure of tissues to hormone distributed throughout the body after being absorbed through the skin. ZRT tests hormones in saliva and can therefore detect whether excessive amounts of hormone are being absorbed from either prescription or over-the-counter hormone creams. Excess exposure to hormones carries a risk of cancer and other health problems, and high oestrogen levels are also associated with melasma, a dark discoloration seen in up to 70% of pregnant women and up to a third of women using birth control pills or HRT.
Other Hormones That Affect Skin Quality
Low testosterone in men is also associated with thinning skin, as there is less testosterone available for local conversion to oestrogen through aromatase in the skin. Testosterone replacement has been found to increase skin thickness.
Low progesterone levels are thought to increase the impact of androgens on sebaceous glands and body and head hair. This is because progesterone reduces 5-alpha reductase activity, which converts testosterone to its active metabolite dihydrotestosterone (DHT). DHT is the culprit for androgenic side effects in women such as unwanted facial hair growth, which tends to appear with ageing or in androgen excess conditions such as PCOS. In both men and women, excess DHT in the skin contributes to acne, and in the skin of the scalp it is responsible for male pattern baldness.
If you are experiencing acne, oily skin or unwanted hair growth, our Acne Test (LCMS) measures the key androgens — including testosterone, DHEA-S and cortisol — that drive sebaceous gland activity and DHT-related skin changes, from a simple at-home saliva sample.
The Roles of Thyroid, Cortisol, Vitamin D and Psychodermatology
Thyroid dysfunction is characterised by a plethora of associated skin problems, ranging from rashes to myxoedema — a classic indicator of severe hypothyroidism caused by increased glycosaminoglycan deposition that results in swelling and facial puffiness. Hypothyroidism can also result in rough, scaly skin and dryness because of reduced sebum production and reduced sweating. Overproduction of thyroid hormones in Graves’ Disease results in thickening of the skin’s outer layers and increased skin pigmentation, erythema, smoothness, and sweating.
Stress too has a large impact on skin health; many skin disorders are linked to emotional and psychological problems, spawning a whole health field known as psychodermatology. Our All Day Cortisol Test (LCMS) measures cortisol across four time points throughout the day — helping to assess the extent of disturbance in hypothalamic-pituitary-adrenal axis function as a result of chronic stress and its impact on skin health.
The skin contains vitamin D receptors, and adequate vitamin D is needed to regulate epidermal proliferation and differentiation to maintain its barrier function and suppress tumour cell formation. Vitamin D is also important for proper immune system function; a compromised immune system can exacerbate psoriasis and acne, and can impede wound healing. Vitamin D analogues are being used for the topical treatment of plaque psoriasis. Our Vitamin D Test (Vitamin D2, D3 and D Total) uses a simple at-home dried blood spot collection to accurately measure your total vitamin D status — essential for anyone experiencing chronic skin conditions that may have an immune or inflammatory component.
Original of this article was published on ZRT Laboratory Blog.