Effect of hormone replacement therapy on epidermal barrier lipids

Current evidence of the effect of hormone replacement therapy (HRT) on skin lipids, of postmenopausal women is scanty and indirect. Here, we report the ultrastructural differences in epidermal lipids between postmenopausal subjects who were and were not on HRT and a comparison is made with younger subjects. Biopsies were obtained from arms and legs, in a blinded, no-treatment, study conducted on postmenopausal subjects who were and were not on HRT and younger subjects. The ultrastructure of skin lipids and the lipid coverage of underlying corneocytes were compared for biopsies obtained from different subjects. Qualitative assessment as well as quantitative estimation of lipid-covered regions of corneocytes shows that skin lipids do not cover corneocytes effectively in postmenopausal women who are not on HRT. However, women who are on HRT show significantly improved lipid coverage of corneocytes, which is comparable with the younger subjects. This implies that HRT should improve the lipid coverage and skin condition of postmenopausal women.