The use of bioidentical hormone replacement therapy (BHRT) in dermatology is preferable to using synthetic hormones because potential overdose is less hazardous, and bioidentical hormones are not known to be carcinogenic, says Julie T. Hunter, M.D., founder and director of Wholistic Dermatology in Beverly Hills, Calif.
Acknowledging that mimicking nature's dosing is "always the goal," Dr. Hunter says BHRT "slows down the clock, because hormone supplementation helps you, your brain, skin, energy, and many organs function younger and longer." Cosmetic procedures and surgery don't provide the same results without the use of topical hormones to rejuvenate the skin, she says.
As with any therapy, dermatologists need to counsel the patient regarding reasonable expectations of treatment with bioidentical hormones. "People need to understand that life leads to death. You're going to age." However, she says, "you can slow it down" with BHRT.
The treating physician needs to know all of the medications a patient is taking to avoid hormone-hormone interaction, Dr. Hunter says. For example, a patient on thyroid supplementation can experience thyroid suppression when taking supplemental estrogen. Excessive estrogen can cause breast tenderness and weight gain, because estrogen promotes the storage of fat. Excessive dehydroepiandrosterone (DHEA) and testosterone are linked to acne, oily skin, irritability and aggression.
The symptoms of hormone overdose with bioidentical hormones are obvious, Dr. Hunter says, so the dose can be easily adjusted if such symptoms occur.