Wrinkles and bone health: Connection

By Dr. Ananya Mandal, MDJun 5 2011

According to a new study, women who have severe skin wrinkles during the first few years of menopause also appear to have lower bone mineral density.

For their study, lead researcher Lubna Pal and colleagues explored the relationship of bone mineral density or BMD with skin wrinkles and skin rigidity in a cohort of 114 menopausal women. Skin wrinkles were assessed using the Lemperle wrinkle scale at 11 sites on the face and neck; skin rigidity was measured by durometer at the forehead and cheek; and BMD was assessed via DXA scan at the lumbar spine, left hip and total body.

All of the women included in the study were enrolled in the Kronos Early Estrogen Prevention Study (KEEPS), a longitudinal trial of menopausal hormone therapy, and were also participating in a skin ancillary study. All of the women had their last menstrual period within the past 3 years and were not using HT.

The results showed an inverse relationship between skin wrinkling and BMD at the spine and femoral neck, and also with total body BMD. The higher the score, greater severity of the wrinkles and the lower the BMD. This finding was observed at all skeletal sites, including the hip, heel and lumbar spine, and was independent of risk factors known to affect BMD. Additionally, increased skin rigidity at the face and forehead was an independent determinant of BMD at the hip, the spine and of ultrasound attenuation.

Pal, who is a reproductive endocrinologist and associate professor at Yale School of Medicine said, “Although the connection between bones and skin may seem unclear, they share common building blocks – collagens… As we age, changes in collagen occur that account for age-related skin changes, including worsening skin wrinkles and sagging skin. They also contribute to deterioration in bone quality and quantity.” She explained, “In postmenopausal women, the appearance of the skin may offer a glimpse of the skeletal well-being, a relationship not previously described. This information may allow for the possibility of identifying postmenopausal women at fracture risk at a glance, without dependence on costly tests.”

However, she cautioned that these study findings demonstrate only an association between bone density and skin wrinkling. “It is a powerful potential relevance that needs to be substantiated,” she said at a press conference. Longer-term studies are needed to confirm a relationship between wrinkles and the risk for bone fractures, she said.

The findings are set to be presented at the Endocrine Society annual meeting in Boston, MA.