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

552 JOURNAL OF THE SOCIAT¾ OF COSMETIC CHEMISTS . - .:•"•.'. .,• •,•.. :' (A) (B) Figure 2. Comparison of hair growth in testosterone treated (A) versus control axilla (B) of 77-year-old woman. The untreated site typifies the great regression of axillary hair in old age. Note that the testosterone effect is strictly limited to the hormone treated side, where there is remarkable regrowth of hair Fully three quarters of the individuals, however, showed unmistakable axillary responses. The wrinkled appearance of the face and dorsum of the hand was considerably smoothed, and the skin felt firmer and thicker (Fig. 1). The lax integument of the back of the hand which formerly tented for a finite time when pulled up and stretched now sprang back quickly. A remarkable stimulation of terminal hair growth was found in the axilla (Fig. 2) and to a lesser extent on the forearms and face (Fig. 3). Similar augmentation was produced on the abdomen, back, and thigh. Eccrine function of the axilla, assessed using Wada's iodine-starch-castor oil procedure, was also enhanced. This effect is due