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10.7554/eLife.33006 Elife 103 LiangH.ZhaoH.GleichmanA.MachnickiM.TelangS.TangS.et al (2019)

Estrogen has been shown to upregulate endogenous MOTS-c expression in preclinical models, which may partly explain why metabolic deterioration accelerates in perimenopause when estrogen falls precipitously [2]

In summary, elevated levels of inflammatory factors partly initiated by microglia and other recruited immune cells causes a phenotypic switch in astrocytes that contributes to functionally perpetuating inflammation via the release of pro-inflammatory cytokines and recruitment of peripheral immune cells

Since the skin is a living organ, it is susceptible to undergoing changes overtime