:i,):,. COSMETIC ASPECTS OF i•.': • plete absorption, in contradistinc- iii.' i t•ion to percutaneous application. ii::i•i:i •:: An experiment with a cosmetic ?-i hormone cream (containing 7500 :,::. I.U. per ounce) was conducted by :•:.i'::• Curth (1) on women ranging in age :.i',, from 26 to 65 years. For a period of ß •!:!•:i:• four weeks the hormone cream was :?. applied to one thigh, and the cream , . ' ?:::without the hormone to the other .:i: thigh every day, preceded by '•': cleansing with soap and water. The ::i' subjects did not know which cream contained the hormone principle. At the end of the four-week period, •':' biopsies were performed on each of ':• the areas treated. The most constant finding was a succulence of the epidermal cells in the biopsies of the skin treated with the active cream. Another experiment with the ' same cream formula was carried out by Traub and co-workers (2) as a control, the cream vehicle which did not contain the hormonal substances was used on the opposite side of each subject. Twenty-five women, ranging between the ages of 35 and 55, were selected for this experiment. They were given the hormone cream to use on the right side of the face, neck, and the right hand. The con- trol cream was used on the left side of the face, neck, and back of the left hand. The subjects used the creams for a period of more than six months continuously. They were under the observation of a number of physicians, and a nurse was in constant charge of the experiment. None of the subjects confused the cream by using it on the wrong side. ESTROGENIC HORMONES 4O7 At the conclusion 6f the experi- ment, twenty-four of the patients showed a greater improvement on the hormone-treated right hand, as com- pared with that on the left. In one of the cases, no difference could be noted between the two sides. Twen- ty-three of the women appeared to have improved more decidedly on the hormone-treated right side of the face and neck than on the left. In one, the opposite side appeared to be better. In one case no appre- ciable difference could be noted be- tween the two sides. There were no untoward local effects whatever ob- served on the skin, or complained of during the course of the experiment, nor was there any evidence of sys- temic action, although no special study was undertaken to verify this point. A comparative histologic study was undertaken using the original sections of skin, one from each hand, removed from the subjects prior to the onset of the experiment, and those from the same subjects at its conclusion. The dermatological in- terpretation of these findings may be summarized as follows: 1. The original section con- formed to the histologic picture of the skin of the back of women's hands ranging between the ages of 35 and 55. 2. The final sections, both from the hormone-treated side and the control side showed that the use of the creams did not affect the epider- mis. 3. It was possible from the his- tologic sections to differentiate be-

408 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS tween the active and the control sides. 4. The active side was recog- nized by observing various degrees of dilatation of the blood vessels, an increase in simple cellular elements, a greater succulence of the derma, as well as a betterment of the elastic tissue. There appeared to be no es- sential changes in the basophilic strands when the final sections re- moved at the conclusion of the ex- periment were compared with the original sections of the skin. Gross examination indicated also a tendency toward the diminution of senile pigmentation or freckling. Moreover, it could be shown by a comparatively simple experiment that skin areas treated with the hor- mone cream developed a greater avidity for taking up fluids (phys- iological saline) than the control areas. In two more recent publications, Goldzieher (3) reported upon the topical application of hormone creams to senile skin. He used one preparation assayed at 10,000 I.U. to the ounce, and another one con- taining the synthetic estrogen, di- ethylstilbestrol (1 milligram per ounce). With biopsies taken from both the treated and untreated areas (of the inner surfaces of the thighs and forearms) he found •triking changes following a daily applica- tion of the hormone-bearing oint- ments over a period of six weeks. There was evidence of a regenera- tion of the surface epithelium. There were also significant changes in the mesoderm thus the water content of the estrogen-treated site waõ greater, the number and size of the capillaries seemed increased, the bundles of collagenous fibers ap- peared less fragmented, and the elastic fibrils were more numerous. No such changes were elicited with the hormone-free ointment base. It is argued that topical applica- tion ofestrogens affects the skin to a much greater degree than oral or parenteral administration because by the latter modes of administra- tion substantial amounts are lost for the skin through excretion, through inactivation by the liver, through attraction to the genital and mammary tissues, and through dilution by body fluids. In Goldzie- her's opinion, the demonstrated ab- sorption and utilization by the skin of topically applied estrogens opens a new field of therapy applicable to skin conditions not only induced by a hormone deficiency, but also to those involving other pathologic changes. Jaff• (4) who reported earlier upon the treatment with follicular hormones of dermatoses of ovarian origin states that the stimulating effect upon the regeneration of the epithelium is in evidence also in the case of a healthy skin. He advo- cates, therefore, the application of a hormone cream in those cases (of flabbiness, etc.) where its positive action is likely to produce the ap- pearance of a younger skin, owing to an improved skin tone and to an in- tensified capillary circulation. He indicates his awareness of the tern-