Adrenopause

The enzymatic machinery of the adrenal zona reticularis fails in aging men and women.However, the ability of the zona fasciculata to produce cortisol is preserved (based on ACTH infusion, insulin tolerance, and metyrapone testing). Mineralocorticoid and glucocorticoid receptors in the hippocampus are variably down regulated in aging humans. Excessive lifelong adrenal cortisol feedback on the brain may exacerbate the aging-associated loss in neuronal synapses and plasticity. Potential implications of aging skin includes a decrease in vascular responsiveness due to involution of the dermal vascular bed, which decreases thermoregulation and contributes to skin pallor; there is a decrease in subcutaneous fat and changes in distribution that may limit conductive heat loss that decreases the protective ability in bony areas such as the ischial tuberosities; and there is a delayed recovery of the stratum corneum’s function as a barrier, which may increase the penetration of certain types of topical medications leading to systemic absorption [9].