Today’s report also covers research into the efficacy of topical gabapentin in women with PCMA, insurance coverage of injectables for gender affirmation, and more (1,225 words, 6 minutes)
The Women in Dermatology e-newsletter is supported without restriction by Galderma Canada
Good morning, and welcome to the Women in Dermatology e-newsletter from Chronicle Companies. We’re pleased to have you join us. This biweekly bulletin will update you on new findings regarding dermatologic issues that affect women and the female dermatologists who care for them. We welcome your feedback and opinions, so let us know if you have any comments, observations, or suggestions. You can email them to us at health@chronicle.org
Researchers surveyed 463 postmenopausal women aged 42-83 to assess the effects of menopause and hormone replacement therapy on skin and hair health. Their findings were published in Cosmetics (Jan. 2024; 11(1):9).
The questions covered demographics, skin type, menopause onset, HRT use, and quality of life impact. The authors also conducted a statistical analysis to identify the associations between HRT use and dermatologic complaints. Most participants reported that menopause had significantly affected their quality of life.
Among the population surveyed, dermatologic concerns were significant. The findings revealed that 70% of participants experienced skin laxity, 53% had dry skin, 47% had skin rhytids, 43% reported a loss of skin vigour, 35% had hyperpigmentation, 31% experienced undereye dark circles, and 30% had a decrease in skin thickness.
Hair and nail quality were also affected. The most common hair-related complaints were hair loss, reduced hair volume, increased white hair, dryness, fragility, and loss of shine. At the same time, the most prevalent nail-related issues were weak and brittle nails, peeling, and decreased speed of nail growth.
The results showed that hot flashes were the most common symptom and were prevalent in 57% of the participants. The study also found that 56% of women reported loss of libido, 53% insomnia, 45% weight gain, 44% tiredness, 42% emotional lability, 39% increase in visceral fat, 27% vaginal atrophy, 23% facial hair growth, and 19% osteoporosis. Additionally, 53% of participants agreed that menopause negatively impacted their self-esteem.
Of the 216 women undergoing HRT, 91 were receiving androgen therapy. Most of the participants in the HRT group feared the adverse effects of the medication, with weight gain, increased body hair, hyperpigmentation, and acne being the primary concerns. Notably, women on HRT exhibited significant improvements in menopausal symptoms.
Bottom line
Menopausal symptoms such as hot flashes, insomnia, loss of libido, and emotional lability are prevalent and impact self-esteem. Menopause also significantly affects skin quality in women, enhancing skin dryness, laxity, and hyperpigmentation. It also causes changes in hair and nail quality. Women on HRT fear adverse effects, but HRT has been shown to mitigate many menopausal symptoms.
Correlations between serum cytokine levels and moisturizer use in elderly women
Research published in Clinical, Cosmetic and Investigational Dermatology assessed the effects of using a moisturizer on skin conditions and systemic inflammation in older women. The researchers found that using a moisturizer on the entire body improved subjective and objective skin conditions and may also reduce the levels of circulating inflammatory cytokines in older women.
For this study, 75 participants were randomly assigned to either a control or a moisturizer group. The moisturizer group used Grafa Moisture Keep Milk MC twice daily on the entire body below the neck for four weeks. The results showed that the moisturizer group experienced a significant reduction in serum IL-6 levels compared to the control group. Additionally, an inverse correlation was found between serum IL-5 levels and subjective moisturizing effects, showing that the moisturizer improved subjective symptoms of dryness.
Limited U.S. health insurance coverage of injectable neurotoxins and fillers for gender affirmation
A study published in the International Journal of Women’s Dermatology examined the coverage of gender-affirming injectable neurotoxin and filler procedures by the U.S. Affordable Care Act (ACA) silver plans and Medicaid policies. The researchers found that most ACA Silver and Medicaid plans do not cover gender-affirming neurotoxin or filler procedures.
For this cross-sectional study, the authors reviewed 915 plans—864 ACA Silver plans and all 51 Medicaid policies—and found none potentially covered neurotoxins. Only 72 plans potentially covered fillers, specifically collagen injections and lipofilling. However, most of these plans outlined cosmetic exclusions, possibly nullifying the coverage. The authors highlighted the need for policy changes to improve accessibility to these procedures.
The impact of oral isotretinoin on ovarian functions of acne patients with polycystic ovarian syndrome
A study in the Journal of Ovarian Research assessed the impact of oral isotretinoin on ovarian functions in women with polycystic ovarian syndrome (PCOS) and acne. The researchers found that treatment with oral isotretinoin resulted in a significant reduction in acne severity, ovarian volume, free testosterone levels, and hirsutism scores in women with PCOS and acne.
For this study, 40 women diagnosed with both acne and PCOS were treated with oral isotretinoin. The authors evaluated hormone levels, acne severity, follicle count, and ovarian volumes before and after treatment. The findings suggest that isotretinoin may have beneficial effects on hyperandrogenic women with PCOS.
The efficacy of topical gabapentin in women with primary macular amyloidosis
Research in the Journal of Cosmetic Dermatology evaluated the efficacy of topical gabapentin for the treatment of primary cutaneous macular amyloidosis (PCMA) in women. The researchers found that topical gabapentin may effectively reduce itching associated with PCMA in women.
For this triple-blind clinical trial, 34 female participants diagnosed with PCMA were treated with either topical gabapentin or a control cream. The results showed that both groups experienced a significant reduction in itching scores compared to baseline. The gabapentin group showed a notable decrease in pigmentation scores compared to the control group after one month, but differences between groups were not significant after two and three months.
VIDEO: Connective tissue disease: The intersection between rheumatology and dermatology
In this video, Chicago-based dermatologist Dr. Mariam A. Siddiqui delves into the relationship between connective tissue diseases and the skin. She explains the common cutaneous manifestations observed in patients with these conditions, highlighting the importance of interdisciplinary collaboration in diagnosing, treating and optimizing patient care. She also explores advances in managing connective tissue diseases and their dermatologic manifestations.
Two cases of Lipschütz ulcers due to SARS-CoV-2 infection
A case report published in the International Journal of Women’s Dermatology described two young girls, aged 12 and nine, who presented with sudden-onset, painful vulvar ulcers. Both patients tested positive for SARS-CoV-2 and showed no other related symptoms. Various diagnostic tests ruled out sexual abuse, infectious diseases, and autoimmune conditions. They were diagnosed with Lipschütz ulcers (LU). Treatment for the girls included intravenous nonsteroidal analgesia, topical betamethasone/gentamycin, an oral nonsteroidal anti-inflammatory, topical 2% eosin aqueous solution, and a gauze dressing containing hyaluronic acid. Both patients experienced complete remission of lesions without scarring within three weeks.
“Kids and tweens should be educated to focus on skin health, and the #sephorakids trend is an opportunity to have a healthy discussion about good skin hygiene practices and habits. If kids or young teens want to explore the trend, they can consider hyaluronic acid serums, ceramide-based moisturizers, lip balms/gloss with plant-based ingredients, vitamins and/or natural oils, or hydrating face masks.”
— Dr. Monica Li, a dermatologist based in Vancouver, in an interview with CTV News.
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