Difference in Facial Appearance in Twin Using Hormones

How different would the faces of identical twins look at age 71 if one took hormone replacement therapy for 22 years and the other did not?  Genetics is a big factor in how we look as we age. Eliminating that variable by using twins with identical genes really helps us be able to dial in on factors like lifestyle, healthcare choices, and environmental exposures.  Identical twins are really valuable research subjects. Virtually indistinguishable in their youth, they slowly begin to look more and more different from each other over the years as a result of these outside factors, especially as they get into their 50s and 60s when aging becomes more visible.  We typically form our initial impression of a person’s age by how their face has weathered the years. It seems facial structure and skin betray us first. And the controllable factors that make us look old the fastest are sun exposure, smoking (no surprise), being too thin, and, wait for it, depletion of hormones.  The photos from this study are really useful because they were taken by professional photographers in standardized light to eliminate that variable.

Look at the difference in this 58 year-old set of twins. The one on the right had a 14.7-point lower body mass index. No other lifestyle factor difference was identified other than body weight. With less weight, there’s less muscle mass, subcutaneous fat, and soft tissue. We lose contour and fullness in the face. If someone is too thin, the perception is, that person is older. The plastic surgeon authors of the study put the perceived age difference between these two at 5.25 years. So weighing less is a bad thing? Definitely not. Remember this is not a reflection of general health, just factors that contribute to aging in the face.

Let’s look at the effects of sun exposure on these 61 year-old identical twins. The one on the right had about 10 more hours per week of sun exposure than the one on the left. And the one on the left had a BMI 2.7 points higher, so she weighed more, but not that much. So you can see what the combination of those two factors does. The perceived age difference here was 11.25 years! So sun exposure is a big deal.

Now, smoking. These twins are 52 years old. Which one had a 20 year greater smoking history? Yeah. The one on the left. Each 10 years of smoking makes you look about 2.5 years older.

And here’s the factor you probably didn’t know about. These twins are age 71. The twin on the right had 22 more years of hormone replacement therapy than her sister on the left. Her eyebrows look fuller, more lashes, eyelids less droopy, fewer wrinkles around the mouth and cheeks, neck skin is tighter and thicker. What do you notice the most? There’s quite a difference. The perceived age difference is 7.25 years. AND…  the one who used hormones had a BMI 1.2 points lower, which, as we’ve learned tips the scale on the side of looking older, but the hormone use seems to negate that effect, and she looks healthy.

I show you these images today so you can see in these rare photos, graphic evidence of hormone depletion as a significant contributor to looking older. It’s right up there with sun exposure and smoking, and by the way, testosterone depletion does the same thing to men.