55O JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS Research activities, carried out in these laboratories have centered about the biology of aging skin. Dissatisfied with merely cataloging the alterations of senescence, a decision was made to try to do something about them. A strictly empirical mode of attack was based on the clinical impression of waning endocrine function with advancing age and utilized pharmacologic doses of topically applied hormones. Repre- sentative steroids from the male, female, and adrenocortical hormones were included in the study. The following report is a brief, composite picture of published work, as well as some still in progress (1, 2). METHODS Approximately 200 residents of the Riverview Home for the Aged have participated in the research program over the past five years. Almost all subjects manifested obvious cutaneous deterioration the median age of the group is 65 years (range 57-88 years). Although equal numbers of men and women were included in each particular project, the sex of the aged subject is irrelevant with regard to the effect of the hormones on the skin. Biopsy samples obtained since the onset of the work amount to more than 1500 individual specimens. It is important to emphasize that only areas of skin with clear-cut aging alterations were used. The face, extensor forearm, and back of the hand, sun exposed sites which graphically illustrate the changes of senescence, were included. The axilla was studied since it also demon- strates recognizable aging, yet it is protected from solar radiation and so suffers less deterioration. The following hormones, compounded either into hydrophilic oint- ment base or alcoholic solutions, were used: testosterone propionate 1.0%, progesterone 1.0%, pregnenolone acetate* 0.5%, ethinyl estradiol 0.5 %, triamcinolone acetonide • 0.5 %, and fluocinolone acetonid e 0.2 % 11. Each unilateral test site received daily topical treatment with approxi- mately 0.5 g of preparation while the contralateral side had the corre- sponding vehicle similarly applied. GROSS PROPERTIES OF AGED SKIN The weather beaten, unsheltered face and hands are familiar land- marks on our aged population. Laced with fine and coarse furrows, such skin possesses a general laxness, sagging, and loss of resiliency. * Supplied by Revlon, Inc., as Eterna 27 Cream. t Supplied by E. R. Squibb & Sons as Kenalog Cream. J• Supplied by Syntex Laboratories, Inc., as Synalar Cream.

EFFECT OF TOPICAL HORMONES ON SKIN Coloring is uneven, with hyperpigmented macules appearing on the susceptible individual in ever-increasing numbers with age. Coarse hairs grow from the rim of the nose and ears of men, while women often acquire stubble on the chin and mustache areas. The sebaceous glands may attain unusual prominence and are easily visible along with sprays of superficial vessels beneath the thinned integument. Fairly large, irregular black and blue splotches are present on the extensor forearm caused by spillage of blood into innocently traumatized skin which barely cushions its vasculature. Characteristic sequelae of these events are seen as roughly linear, small ivory scars. The aged axilla fares somewhat better with the passage of time. There is, however, considerable loss of hair, and that which remains tends to be thin, wispy, and depigmented. The underams are drier than those of the young adult, an observation which correlates well with qualitative studies of eccrine sweating which is considerably diminished. In short, aging skin appears to be a degraded structure which bears little resemblance to its neonatal predecessor. It hardly seemed likely that further alterations were possible. CJROSS RESULTS OF STEROID APPLICATION Approximately six months of treatment are necessary before the hormonal effects become apparent. Ameliorative alterations resulted primarily from androgen application but were clearly defined in only 20% of the subjects with regard to changes in the sun-damaged skin. Figure 1. Cosmetic effect of topical progesterone therapy on the face of a 75-year-old woman. The left side has been treated with the hormone and the right side with the cream vehicle for three years. There is considerable eftacement of the wrinkles on the progesterone-treated side and some stinmlation of downy hair growth