Do you look in the mirror and see a furrowed brow? Thinking about how to erase those lines that suggest you are worried or angry even when you’re not? You’re likely very aware that Botox does the trick and safely erases “the elevens” between the eyes. But did you ever wonder if forehead lines are an indicator that other tissues, not visible to the naked eye, are also showing signs of wear?
Bone Density Study
Researchers at Yale posed the same question about a decade ago and looked at bone density in 114 women in their late 40s and 50s who were within three years of menopause and not on hormone or bone density drug therapy. They measured the number and depth of the women’s forehead, face and neck wrinkles, as well as the skin’s firmness or rigidity, and then tested their bone density by x-ray and ultrasound. They excluded women who had undergone any cosmetic skin procedures or who may have damaged their skin by tanning beds or extensive sun exposure. The small study demonstrated only an association between decreased bone density and early skin wrinkling, and to my knowledge, there haven’t been larger follow-up studies confirming the observation.
Although there may be insufficient data to confirm the association, it’s an interesting idea to think about since the scaffolding of both skin and bones is a group of proteins called collagens. As we age, the changes in collagen that visibly cause the skin to sag and wrinkle are also invisibly affecting bone quality and quantity. According to the CDC, the prevalence of low bone mass, a precursor of osteoporosis, at either the femur neck or lumbar spine or both among adults aged 50 and over was 43.1%. This was higher among women (51.5%) compared with men (33.5%).
Of the estimated 10 million Americans with osteoporosis, about eight million or 80% are women. Approximately one in two women over age 50 will break a bone because of osteoporosis. Furthermore, a woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer. There are 1.5 million osteoporotic fractures in the United States each year, leading to more than half a million hospitalizations, over 800,000 emergency room encounters, more than 2,600,000 physician office visits, and the placement of nearly 180,000 individuals into nursing homes. Hip fractures are by far the most devastating type of fracture, accounting for about 300,000 hospitalizations each year.
Bone Density Screening
Many women (and men) don’t know they have low bone density until it has progressed to the point of fracture that requires both surgical intervention and the initiation of treatment with bisphosphonates. The key is finding out early when you can do something about it. Talk to your physician about a screening bone scan, especially if you have a family history of osteoporosis, if you are a woman over age 65 or if you have risk factors (such as past fracture, certain medical conditions or medications, or cigarette or alcohol use).
Healthy Lifestyle Habits for Skin & Bones
We don’t know whether wrinkles really are a sign that your bone density is low, but we do know that many of the same measures that keep your skin healthy are also beneficial to your bones. Some lifestyle habits you can adopt that promote both healthy skin and bones:
1. Don’t smoke: Avoiding or quitting smoking is strongly recommended for bone health because smoking cigarettes is known to increase bone loss.
2. Alcohol in moderation: Excess alcohol decreases bone density by 2%, dehydrates the skin and exacerbates conditions such as rosacea.
3. Exercise: Weight-bearing exercise increases bone density and it’s also great for your skin: By getting the heart rate up and improving blood circulation, exercise can help to deliver oxygen and nutrients to the skin which stimulates collagen production, and promotes new skin cells, keeping the skin glowing and also helping with anti-aging. An interesting study in Japanese post-menopausal women demonstrated increased bone density in the hip after standing on one foot for 1 minute 3 times per day.
4. Diet: Sufficient Calcium and Vitamin D (through diet and not the sun in order to protect your skin!) are foundational for good bone health. Topical solutions include Solaana MD Healthy Base Layer, which is a Vitamin D enriched cream (available through our online store). Also important is a diet rich with fruits, vegetables and seafood in order to obtain sufficient Vitamins A, B, C, E, K, Potassium, Magnesium and Silica, which are all beneficial to both your skin and bones.
So as you embrace the Mediterranean diet and exercise regularly, you can be assured that you are simultaneously doing what’s best for your skin AND bones. Get your Vitamin D through your diet and supplements and apply sunscreen regularly; you can even apply it while standing on one leg to continue multitasking!
Brooks M. Skin wrinkles may provide a glimpse into Bone Health. Medscape. https://www.medscape.com/viewarticle/744027. Published July 25, 2020.
Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville (MD): Office of the Surgeon General (US); 2004. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK45513/
Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DP. Dietary approaches for bone health: Lessons from the Framingham Osteoporosis Study. Current Osteoporosis Reports. 2015;13(4):245-255. doi:10.1007/s11914-015-0272-1
Sakai A, Oshige T, Zenke Y, Yamanaka Y, Nagaishi H, Nakamura T. Unipedal standing exercise and hip bone mineral density in postmenopausal women: a randomized controlled trial. J Bone Miner Metab. 2010;28(1):42-8. doi: 10.1007/s00774-009-0100-8. Epub 2009 Jun 12. PMID: 19521657.
Sarafrazi N, Shepherd JA, Wambogo EA. Osteoporosis or low bone mass in older adults: United States, 2017-2018. NCHS Data Brief No 405. March 2021. doi:10.15620/cdc:103477 What women need to know. Bone Health & Osteoporosis Foundation. https://www.bonehealthandosteoporosis.org/preventing-fractures/general-facts/what-women-need-to-know/. Published February 24, 2022.