Skin, Hair, and Nail Health
Novel And Emerging Strategies
Bioidentical Hormone Replacement Therapy
Estrogens have an important role in preserving collagen content, thickness, and moisture of skin, protecting against photoaging and improving wound healing. Declining estrogen levels in postmenopausal women intensify the effects of aging on the skin. Estrogen replacement therapy restores skin thickness and reduces wrinkling by increasing the synthesis of collagen and elastin fibers and inhibiting collagen breakdown. Estrogen replacement can also alleviate skin dryness by enhancing production of skin-hydrating hyaluronic acids. However, long-term use of conventional hormone replacement therapy using non-bioidentical (to humans) equine (horse) estrogens and synthetic progestogens (progestins) is associated with higher risk of breast cancer and cardiovascular diseases (Prentice 2014; Rossouw 2002; Manson 2013).
Bioidentical hormones may be a safer method for replacing hormones that have declined with age. Bioidentical hormones are chemically identical to the hormones produced by the body. Bioidentical estrogens include 17 beta-estradiol, estrone, and estriol. Progesterone is also a bioidentical hormone. Many bioidentical hormone preparations are FDA approved (Holtorf 2009; HHP 2006).
In a study in 59 premenopausal women with signs of skin aging, treatment with topical bioidentical estradiol or estriol for six months resulted in substantial improvement in skin elasticity and firmness. Wrinkle depth and pore sizes were reduced by 61‒100%, and skin moisture increased. Chemical analysis revealed a marked increase in collagen levels in the women’s skin (Schmidt 1996).
More information about bioidentical hormone replacement therapy is available in Life Extension’s Female Hormone Restoration protocol.
Platelet-rich plasma (PRP) is an emerging technology that can aid in regeneration and healing of bone, tendons, ligaments, and other tissues including facial skin. PRP is derived from a patient’s own blood that has been subjected to a process that isolates and concentrates platelets (Loesch 2014; Yuksel 2014).
PRP, in both topical and injectable forms, has been investigated as a treatment for wrinkles, pigmentation disorders, and photodamaged skin. It is often used in conjunction with other treatments such as laser resurfacing (Loesch 2014; Kim, Je 2011). In a preliminary trial in 10 healthy volunteers, subjects reported that PRP significantly improved their facial skin’s general appearance, firmness, sagging, and wrinkles (Yuksel 2014). In addition, several studies have found the use of PRP with laser therapy was associated with fewer side effects, shorter healing time, and better overall response than laser therapy alone (Loesch 2014).
Adipose-Derived Stem Cells
Adipose tissue is a source of stem cells that can be used to promote wound healing and tissue regeneration. Evidence from animal studies indicates injections of adipose-derived stem cells may be a promising therapy for aging skin (Zhang 2014; Park 2008; Chen, Qin 2014; Mizuno 2012; Charles-de-Sa 2015), and in a single case study in a human subject, adipose-derived stem cell therapy had positive effects on the condition of photodamaged skin (Park 2008).
In a mouse model of skin aging, injection of adipose-derived stem cells under the skin significantly reduced UVB-induced wrinkles by stimulating collagen synthesis and skin thickening (Kim 2009). In another study, injection of adipose-derived stem cells under the skin was shown to exert anti-aging effects in the skin of mice as measured by changes in molecular markers of senescence. Inhibition of advanced glycation end product (AGE) levels by adipose-derived stem cells contributed to skin regeneration during aging (Zhang 2014).
Radiofrequency is increasingly being used to treat wrinkles and tighten skin. Radiofrequency devices work by generating heat in deeper layers of the skin, stimulating production of new collagen. This technology is sometimes combined with laser resurfacing methods (Dunbar 2015; Gold 2011; Loesch 2014).
Although questions remain regarding the efficacy of radiofrequency therapy (Araujo 2015), patient satisfaction is reported to be high: In a survey of 5700 radiofrequency treatments, 87% of patients noted immediate skin tightening and 92% reported tightening that lasted six months after treatment (Dover 2007). In addition to its aesthetic applications, radiofrequency technology appears to be beneficial in the treatment of acne, acne scars, keloids, and rosacea (Loesch 2014; Krueger 2013). For example, results of one review indicated patients may see improvements of 25‒75% in acne scars after several treatment sessions. The review noted that radiofrequency treatment has been associated with side effects such as temporary pain, scabbing, bruising, redness, and dryness (Simmons 2014).
Mesotherapy is a procedure in which vitamins, minerals, amino acids, hyaluronic acid, and other substances are injected into the superficial layers of the skin. Mesotherapy injections are meant to increase hydration and activate collagen-producing fibroblasts (Prikhnenko 2015; Savoia 2013).
Mesotherapy, popular in Europe for many years, has recently been receiving more attention in the United States. Clinical trials have provided evidence that mesotherapy treatments can improve skin hydration, texture, and firmness, reducing lines and wrinkles and signs of photoaging (Prikhnenko 2015; Savoia 2013; Konda 2013). In a study involving 55 women with signs of skin aging, a 3-month treatment period with a hyaluronic acid-based mesotherapy formulation with mannitol improved parameters of skin elasticity and complexion radiance compared with control (Baspeyras 2013). Other studies have demonstrated mesotherapy to be an effective treatment for facial rejuvenation (Savoia 2013; Iannitti 2014).