Skin ageing is a physiological, continuous and irreversible process. Additionally, several hormone-sensitive, age-dependent disorders of the skin may occur. Therapeutic measures might theoretically cure such diseases; however, they could merely attenuate physiological events. Due to the complexity, a large number of variables have been investigated with a variety of methods under different clinical scientific conditions. However, there is no study which would be methodologically qualified to confirm the therapeutic expectations on the hormone therapy (HT). The data available are not consistent and as yet no differentiation has been made for the use of HT in respect of both the treatment of physiological symptoms and age-dependent skin disorders. Apart from general skin ageing, androgenic cutaneous dysfunctions, such as hirsutism and alopecia might also result in a marked psychological stress. Concerning the latter aspect only a few small HT studies have been published and the available data are inconsistent or insufficient. Regarding hormonal drugs containing an anti-androgen progestagen, no studies are available which have investigated the treatment of cutaneous androgenization of older women. Altogether, there is no sufficient or no evidence at all with the view of both issues in a sense that HT may have a positive impact on the skin of the perimenopausal or postmenopausal women. An individual risk-benefit analysis must be taken into account for the decision in cases of severe symptoms with high psychological stress. Formulations including an anti-androgen progestagen should be preferred when HT is indicated in women additionally suffering from cutaneous androgenic symptoms. Similarly strict standards as have been used with reference to HT should be considered for endocrine and non-endocrine therapeutic alternatives.
