If you know what to look for, the reflection of your face in a mirror can reveal signs of a hormone imbalance. Let’s start at the top to see what you might find.

If you are losing hair at the crown of your head, you might have a thyroid deficiency. Thyroid hormone affects the thickness of the hair shaft and the abundance of hair. Adequate amounts of the sex hormones, such as the estrogens and testosterone, also contribute to hair luster. Another factor to consider is your diet — your hair might need more minerals and proteins. Insufficient intake of these nutrients in your diet, or the inability to assimilate those nutrients, can also contribute to hair problems. Low stomach acid makes it difficult to absorb minerals and protein. Because digestive enzymes are needed to break down protein so it can be absorbed, supplements may be needed.

If you have thinning eyebrows, or you have lost the outer third of your eyebrows, this is called the “Sign of Hertoghe,” named after the endocrinologist who first made this observation. This is also typically a sign of low thyroid function.

If your eyelids are drooping over your eyes, many people resort to plastic surgery to snip away at the extra tissue. Growth hormone deficiencies contribute to the loss of elasticity of this tissue. Dark circles under the eyes may be related to cortisol deficiency.

If your eyes are constantly dry or watering unexpectedly, it may be due to an inability to build the fatty layer of your tears. Proper production of tears has been shown to be influenced by testosterone, DHEA, progesterone, and the estrogen hormones.

Eyelashes are considered a point of beauty in our society. Both hypo- and hyperthyroid states can lead to loss of eyelashes. Sex hormone deficits associated with aging can also contribute to losing eyelashes, and is second only to allergies as a cause of eyelash loss. Having allergies is also an indicator of low adrenal hormones, such has hydrocortisone.

Although you may not readily see it in your face, nasal stuffiness is associated with the ebb and flow of hormones. When estrogens peak mid-cycle, you might find that nasal stuffiness also peaks. If you are also plagued with an itching nose and develop a habit of rubbing your nose in an upward fashion, you may develop a horizontal crease across your nose.

Moving down to the upper lip, let’s look for signs of a problem called melasma. Melasma is hyperpigmentation of the skin associated with hormone disturbances, especially with pregnancy and birth control pill use. Sun exposure may trigger melasma, or make it worse. However, the underlying hormone responsible is melanocyte stimulating hormone (MSH). This hormone increases the production of melanin, which is responsible for darkening the skin.

The upper lip is a frequent location, but you may find dark spots in other areas as well. These are sometimes called liver spots, age spots, or sun spots. An increase in areas of darkened skin can actually be related to adrenal fatigue. As you become stressed, your body produces more and more cortisol to help cope with the stress. As more cortisol is produced, the precursor hormones like progesterone and pregnenolone are depleted, which leaves the estrogens in an unbalanced situation. This extra estrogen stimulation actually increases MSH, which in turn increases the amount of melanin deposited. Re-establishing hormone balance and relieving stress can help prevent this, and may even help reverse it.

While you are looking at the lips, do you notice wrinkles vertical to the lips? These wrinkles may indicate an estrogen deficiency, as well as a testosterone deficiency, both of which accompany menopause. Dry or cracked lips are also frequently associated with menopause. It is certainly true that older women do not have the full luscious lips of their youth, and applying lipstick may just emphasize the cracks in the lip tissue. Some advocate treating menopausal lips with a progesterone cream applied directly to the lips. Just as a side note, vitamin D may enhance the effectiveness of progesterone, and vitamin D deficiency is rampant in North America.

And what about one of the most annoying features of menopause, which is the proliferation of chin hairs? You can tweeze, you can shave, you can wax or use a string, you can use lasers and electrolysis, but what is really going on? In general, as women age, the androgen hormones start to predominate, including testosterone, dihydrotestosterone, and androstenedione. These hormones are believed to become more active as other hormones, such as the estrogens, progesterone, and cortisol are depleted.

Chin hair growth is especially egregious if polycystic ovary syndrome (PCOS) has developed. These chin hairs resemble the hairs on our head rather than the soft downy hairs we associate with femininity. The solution should include a careful evaluation of hormone balance. Progesterone deficit likely plays a role. As estrogen levels decline, less of the carrier protein sex hormone binding globulin (SHBG) is produced, which means that more of the testosterone-like hormones are unbound and therefore more active. Restoring estrogen may help as well. Some synthetic drug options include blocking receptor sites for the testosterone-like hormones, or blocking conversion of testosterone to its more active form, dihydrotestosterone.

Another factor potentially contributing to the problem of unwanted facial hair in women is the dysregulation of insulin and glucose, which also occurs with PCOS. Some women have reported diminished facial hair growth with a gluten free diet.

Moving on to the neck area, do you notice any skin tags? These little growths of excess skin are commonly found in the neck area and on the eyelids. Skin tags are also considered to be related to glucose and insulin hormone imbalances. Skin tags are prevalent with metabolic syndrome, pre-diabetes, diabetes, and PCOS.  Although skin tags are painless, and can be easily removed surgically or at home using kits from the pharmacy, skin tags are an indicator of hormone imbalances that can be addressed.

There might also be deposits of fat around the neck, resulting in a double chin or moon face appearance. This appearance has been linked to glucose and cortisol imbalances, and diminished thyroid function. The neck can also be flabby, like waddles on a turkey neck, or have lines of extra skin. Solutions may include neck exercises, yoga, and surgery. However this neck tissue is thin and changes quickly become apparent with losses in hormones, such as progesterone, pregnenolone, and DHEA.

Now let’s look at your face overall. Is your skin pale? Thyroid hormone ensures blood circulation to the skin and, when it is compromised, pallor is evident, rather than a healthy rosiness. Are your cheeks sagging? The androgenic hormones such as DHEA, testosterone, dihydrotestosterone, and growth hormone may be deficient.

Is your skin dehydrated, as in shriveled and shrunken, or plump? If it is dry, an obvious cause may be that you are not drinking enough water. Additionally, according to Dr. David Brownstein, you may not be using enough natural whole salt. The many minerals available in whole salt allow the body to hold on to the water in the cells. And there’s a hormone connection: if you are not getting enough salt and water, the adrenal glands suffer and eventually become exhausted. The hormones affected include DHEA, progesterone, cortisol, aldosterone, the estrogens, pregnenolone, and testosterone. Furthermore, adequate thyroid function is dependent upon the adrenals.

Looking at your face in the mirror can provide clues about your hormone health, especially as you age. Your face is a reflection of potential hormone issues that affect your entire body. Take notice of the changes you might first see in your face, then work with your healthcare practitioner to restore your hormone balance. Your face, as well as the rest of your body, will reflect the results.