What Wrinkles Reveal About Women's Health

Day in Health

A very surprising Yale School of Medicine study reports that wrinkles on a woman’s face may predict her risk for bone fractures later in life. In findings presented on June 6 at the Endocrine Society Meeting in Boston, the researchers said that the severity and pattern of skin wrinkles, as well as overall skin firmness, may offer important clues about bone mineral density in women entering menopause.

What’s the link between a furrowed brow and risk for broken bones? “Skin and bones share common building blocks - proteins,” said Lubna Pal, associate professor in the department of obstetrics, gynecology and reproductive science at Yale, in a statement. She and the rest of the research team found that the more severe facial and neck wrinkling was in early post-menopausal women, the lower their bone density was likely to be, an indication of risk for future fractures. Here’s a closer look at this intriguing study—and how women can protect bone health as they age.

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How was the study conducted?  As part of an ongoing study, the Yale researchers examined the skin of 114 post-menopausal women who were within three years of their last period. Measurements of skin firmness were made in 11 areas of the face and neck, both visually and with a device called a durometer. Bone mass and density were checked with a portable ultrasound machine and X-ray.

What did the researchers learn? “We found that the worse the wrinkles, the lesser the bone density,” adds Pal. “This relationship was independent of age or factors known to influence bone mass,” such as smoking, age, multi-vitamin use, race and ethnicity (African-American women in the study, on average, had fewer winkles in the facial and neck areas examined). Conversely, women with firmer skin had better bone density, suggesting lower risk for fractures later in life.

Why might wrinkles be linked to bone health? These results suggest that skin and bones may age on parallel tracks after menopause. The study is the first to find any connection between women’s skin quality (wrinkles and firmness) and their bones (density and mass), according to the researchers. The researchers say that skin and bones share common building blocks, proteins called collagens, which might explain the link observed between wrinkles and bone mass and density.

How might these findings affect healthcare? If further studies confirm that skin quality and bone health are indeed related, then in the future, MDs might be able to screen for osteoporosis—the brittle bone disease that can lead to fractures later in life--by checking patients’ skin, instead of using the costly X-ray test now considered the gold standard: DXA (dual energy X-ray absorptiometry). To find out if women with worse wrinkles lose bone mass at a faster rate after menopause than do women with firmer skin, the researchers plan to continue their study.

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How serious is osteoporosis? Osteoporosis leads to fractures in 1 in 3 women over age 50, and 1 in 5 men over 50, according to the International Osteoporosis Foundation. Since it’s a silent disease with no symptoms until it gets bad enough to cause fractures, screening is the only way to detect early, so patients can be treated to reduce risk for broken bones. Osteoporosis can also lead to stooped posture, loss of height, disability and deformity, such as “dowager’s hump,” a severe rounding of the upper back, due to compression fractures in the vertebrae weakened by the disease.

Who should be screened? The National Osteoporosis Foundation recommends getting a bone density test if you are a woman age 65 or older, a man age 70 or older, or if you break a bone after age 50 due to a relatively minor injury. NOF also advises testing for post-menopausal women under age 65 if they have risk factors for the disease, which include smoking, family history, eating disorders, deficiencies of calcium or vitamin D, excessive alcohol consumption, and use of certain medications.

What’s the best prevention? It may surprise you that your skeleton isn’t a rigid, unchanging frame. Your body continuously tears down old sections of bone and replaces them with new sections, a process called remodeling. Until age 25, bone is built faster than it is lost and after menopause, the opposite in true in women. Think of it as a retirement account: the more bone you “bank” when you’re young, the more reserves you’ll have to draw on when you’re older. Genes also play a role in determining your peak bone mass. To keep your bones as healthy, avoid smoking, eat a diet rich in vitamin D and calcium, and engage in regular weight-bearing exercise, such as jogging, walking, or jumping rope.

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