Hormonal Influences on Wound Healing: A Review of Current Experimental Data

Matthew J. Hardman, PhD; Gillian S. Ashcroft, MA, MRCP, PhD

Disclosures

Wounds. 2005;17(11):313-320. 

In This Article

Abstract and Introduction

Skin, the largest organ in the body, undergoes numerous age-related structural and functional changes, including a delayed wound healing response. Delayed or nonhealing wounds pose an immense problem, leading to increased morbidity and mortality and an estimated cost to the United States health system in excess of $20 billion. In recent years, the important role of hormones in age-related delayed healing has become apparent, and the skin has emerged as a clear target of hormonal action. Reduced estrogen levels post-menopause have major effects on cutaneous healing, altering cytokine profiles to induce a pro-inflammatory state, modulating the balance between matrix synthesis and degradation, and attenuating keratinocyte migration. Exogenous estrogen treatment, via a systemic or topical route, can reverse many of these age-associated changes in both mouse and human models. In contrast, the effects of androgens on healing appear to be detrimental. This review will outline current understanding of hormonal influences on cutaneous healing, focusing on in-vivo and in-vitro data.

Wounds to the skin heal via a complex series of overlapping stages involving numerous cell and tissue types.[1] In young individuals, these events are tightly regulated. However, in elderly subjects, this regulation and synchronization becomes disrupted. Evidence exists that sex hormones have a modulatory function in a range of biological systems. Differences in the timing and quality of cutaneous healing between genders are strongly indicative of hormonal regulation.[2,3]

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