Skin wrinkles and rigidity in early postmenopausal women vary by race/ethnicity: baseline characteristics of the skin ancillary study of the KEEPS trial

doi:10.1016/j.fertnstert.2010.09.025

Fertility and Sterility

Volume 95, Issue 2, February 2011, Pages 658-662.e3

https://doi.org/10.1016/j.fertnstert.2010.09.025 Get rights and content

Objective

To characterize skin wrinkles and rigidity in recently menopausal women.

Design

Baseline assessment of participants before randomization to study drug.

Setting

Multicenter trial, university medical centers.

Patient(s)

Recently menopausal participants enrolled in the Kronos Early Estrogen Prevention Study (KEEPS).

Intervention(s)

Skin wrinkles were assessed at 11 locations on the face and neck using the Lemperle wrinkle scale. Skin rigidity was assessed at the forehead and cheek using a durometer.

Main Outcome Measure(s)

Skin wrinkles and rigidity were compared among race/ethnic groups. Skin wrinkles and rigidity were correlated with age, time since menopause, weight, and body mass index (BMI).

Result(s)

In early menopausal women, wrinkles, but not skin rigidity, vary significantly among races, where black women have the lowest wrinkle scores. In white women, chronological age was significantly correlated with worsening skin wrinkles, but not with rigidity. Skin rigidity correlated with increasing length of time since menopause, however, only in the white subgroup. In the combined study group, increasing weight was associated with less skin wrinkling.

Conclusion(s)

Skin characteristics of recently menopausal women are not well studied. Ethnic differences in skin characteristics are widely accepted, but poorly described. In recently menopausal women not using hormone therapy (HT), significant racial differences in skin wrinkling and rigidity exist. Continued study of the KEEPS population will provide evidence of the effects of HT on the skin aging process in early menopausal women.

Section snippets

Materials and methods

The KEEPS trial is a multicenter, double-blind, randomized placebo-controlled trial designed to compare the effects of early initiation of oval versus transdermal E, each with cyclic P, on cardiovascular end points. Subjects enrolled in the parent KEEPS trial were offered participation in this ancillary skin study to evaluate the effects of HT on skin aging at two of the nine participating sites (Yale University, New Haven, CT and Albert Einstein College of Medicine, Bronx, NY) under approved

Demographics

Baseline skin assessment was completed in 106 participants from KEEPS. Mean age of these participants was 53.3 years (±2.7 years) and had an average duration of 1.8 years (±1.0 year) since menopause. Baseline demographics were also analyzed by racial group, which were broken into black (n = 21), white (n = 65), and other (n = 16). Race was not recorded for three participants (Table 1). Past or current tobacco smoking, age and years since onset of menopause were comparable among racial groups,

Discussion

Although the effects of E on the skin are widely studied, characterization of the skin near the menopausal transition is lacking. Furthermore, data on racial differences in skin aging are sparse and conflicting (33). In the present study we describe skin characteristics in recently menopausal women, and also delineate skin differences that exist among racial groups. Our finding that black women have significantly fewer wrinkles overall is the first to quantify such a racial difference in

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Cited by (28)

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
2016, Fertility and Sterility
To measure skin wrinkles and rigidity in menopausal women of varying race/ethnicity with or without hormone therapy (HT) for up to four years.
Randomized, double-blind, placebo-controlled trial.
Academic medical centers.
Women (42–58 years of age) within 36 months of last menstrual period and enrolled in the Kronos Early Estrogen Prevention Study (KEEPS).
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.
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.
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.
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.
NCT00154180.
The post-mortem resilience of facial creases and the possibility for use in identification of the dead
2014, Forensic Science International
Citation Excerpt :
The lack of dermal elasticity increases the likelihood of skin sagging. However, research utilising a durometer showed no correlation between body mass index (BMI) and skin wrinkles at eleven locations on the face in early postmenopausal women [26]. Some facial creases are utilised for identification of the living [27], but the use of facial creases for identification of the dead has not been previously studied.
The post-mortem resilience of facial creases was studied using donated bodies in order to establish the efficacy of crease analysis for identification of the dead. Creases were studied on normal (pre-embalmed) and bloated (embalmed) cadavers at the Centre for Anatomy and Human Identification (CAHID) to establish whether facial bloating would affect facial crease visibility. Embalming was chosen to simulate the effects produced by post-mortem bloating. The results suggested that creases are resilient and changes were only detected for creases located on the periphery of the face, particularly at areas where the skin is thick, such as at the cheeks. Two new creases not previously classified were identified; these creases were called the vertical superciliary arch line and the lateral nose crease. This research suggests that facial creases may be resilient enough after death to be utilised for human identification.
Dermatological Changes during Menopause and HRT: What to Expect?
2024, Cosmetics
The Relationship between Time, Race, and Estrogen Receptor Alpha in Estradiol-Induced Dermal Fibrosis
2024, Biomedicines
Use of a novel indentometer to evaluate skin stiffness in healthy and diseased human skin
2023, Skin Research and Technology
Skin Aging Exposome in Skin of Color Populations: Review of the Literature
2023, Dermatologic Surgery

View all citing articles on Scopus

: E.W. has nothing to disclose. L.P. has nothing to disclose. T.A. has nothing to disclose. R.M. has nothing to disclose. R.F. has nothing to disclose. H.A. has nothing to disclose. M.H. has nothing to disclose. N.S. has nothing to disclose. H.S.T. has nothing to disclose.

: Supported by the Kronos Longevity Research Institute; the Reproductive Scientist Development Program NIH K12HD00849 and The Berlex Foundation to Erin Wolff; and the National Institutes of Health grant U54 HD052668 to Hugh S. Taylor.

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MenopauseSkin wrinkles and rigidity in early postmenopausal women vary by race/ethnicity: baseline characteristics of the skin ancillary study of the KEEPS trial

Objective

Design

Setting

Patient(s)

Intervention(s)

Main Outcome Measure(s)

Result(s)

Conclusion(s)

Section snippets

Materials and methods

Demographics

Discussion

Maturitas

Maturitas

Am J Pathol

Exp Gerontol

Fertil Steril

Fertil Steril

J Am Acad Dermatol

J Dermatol Sci

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

The direct effect of steroids on the senile human skin

J Gerontol

Studies on aging: correlation of skin morphology with age and hormone excretion

J Gerontol

[Effect of oral estrogen treatment with estriol succinate on the skin of castrated women]

Z Haut Geschlechtskr

Long-term effects of the menopause and sex hormones on skin thickness

Br J Obstet Gynaecol

Skin thickness in different menopausal status

J Med Assoc Thai

Menopause
Skin wrinkles and rigidity in early postmenopausal women vary by race/ethnicity: baseline characteristics of the skin ancillary study of the KEEPS trial