Hormones & The Collagen Quagmire

By: Dr. Kathleen Welsh


You’re probably not shocked when I say collagen isn’t forever.

On average, we lose 7% of our collagen production every 10 years after age 21. That means  by the time we’re in our fifties, our collagen stores have dramatically dropped by over 20%. Other factors, which we’ll discuss here, have an even starker impact on our skin once we hit 60.

Factors impacting  skin’s collagen and elastin production fall into two categories, extrinsic and intrinsic. Extrinsic factors include sun damage, smoking, stress, dietary factors, alcohol and environmental pollution.

Intrinsic factors include the natural loss of progesterone and estrogen that comes with menopause.

Men, in contrast, enjoy a more gradual decline in testosterone so their collagen is supported longer. This results in thicker skin, fewer wrinkles and less sagging. The great news is collagen loss is not a foregone conclusion and we have control over how both type of factors impact our skin.

We can slow collagen’s decline and even have options available to us now to help maintain and increase our existing collagen stores.


While scientists have a handle on what progesterone and estrogen does for the skin, less is known about how the hormones do it. But with longer life spans equating to a larger portion of lives spent in a hormone depleted state, research is focused on finding out more.


Many factors may lead you to consider hormone replacement therapy (HRT). Hormones administered by pill, patch or topically have resulted in improvements to women’s skin elasticity, moisture and thickness. Unfortunately, a recent study found sun damaged skin, the skin we want to help most, was not benefited by HRT.

The medical risks of HRT may outweigh the rewards for women concerned about breast or uterine cancers.

Hormones may be standard FDA approved estrogen (estradiol in patch form is commonly used, available by prescription and is a bio-identical hormone) or compounded bioidentical; there are no studies to show that one is safer than another or more efficacious.

Are you using compounded hormones? Be sure you’re taking the lowest effective dose and the compounding pharmacy is FDA regulated.


What if you don’t want to take prescription hormone supplements? Another option is plant-based estrogens or isoflavones. The highest concentrations of phytoestrogens are derived from soy products. Or you can take a supplement if you are not on HRT of 70mg Isoflavones a day. This is not recommended for women with estrogen dependent breast cancers.

Nutrition Graph

So what can we do to help support the collagen we have now and build more?


80 percent of aging skin is directly related to sun damage. You only need to compare the skin on the back of your hand to the sun protected skin on your buttocks to graphically demonstrate this point.

Follow guidelines for sunscreen and wear protective clothing and hats. Many have heard me say, “Save your décolletage for evening wear!”

I always carry a scarf in my bag to protect the fragile skin of my neck. I wear mock turtle or crew neck shirts when exercising outdoors for prolonged periods. And I promise, it is never too late to protect your skin from harmful UV rays.


Consider adopting a whole food, plant-based diet or at least make it a goal to eat this way a couple of times a week.

Whole fruits and veggies are teeming with vitamin A, vitamin C, antioxidants, water, chlorophyll, and vitamin E, all of which do amazing things for our skin.

Some of your best bets are apples, oranges, berries, greens, broccoli, carrots, sweet potatoes, avocados, lemons, beets, squash, and tomatoes. Foods rich in omega-3 fats like chia and flax, along with leafy greens can lower inflammation that causes skin breakdown.


How do you choose from the wide selection of products available?

All of my staff memorizes the acronym GRASSE, to help us remember the six

anti-aging products that belong in all of our skincare routines:





Specialty Products

Eye Treatments

The products we offer have been thoroughly vetted by board-certified dermatologists and meet GRASSE criteria. We are happy to evaluate your skin care program and make sure it’s up-to-date.


Neurmodulators like Xeomin and Botox prevent tissue breakdown by restricting the areas injected from contracting (which also softens and prevents wrinkles).

Fillers, like Sculptra and Radiesse not only provide instant fullness but can often

augment our body’s natural collagen production as well.

Chemical Peels, Ultherapy, Thermage, Fraxel, Microneedling, Clear and Brilliant, LED and Radiofrequency treatments can generate even more dramatic collagen and elastin

production. Some can increase your collagen by as much as 3%! That’s what we call ‘Aging backwards’ or ‘The Benjamin Button Effect.’

How do you know what’s best for your skin? My staff and I specialize in tailoring treatment plans based on your budget, lifestyle and the amount of downtime you can tolerate. Many of our treatments don’t have any downtime at all.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.