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There is a lot of information on social media about the use of estrogen face cream for menopause skin care. Explore this article to find out how changes in hormones at menopause impacts the skin and what you should use as part of your menopause skin care routine.
Menopause and Hormonal Changes
Menopause is the loss of ovarian function that results in reduction in estrogen, progesterone and testosterone production by the ovaries. It can occur naturally at midlife or due to surgical removal of the ovaries or early menopause.
Estrogen receptors are found in the skin and estrogen play an important role in maintaining skin health and integrity. It helps in the production of collagen, a protein that gives skin its elasticity and youthful appearance. It also maintains hydration. Loss of estrogen results in thinner, drier and more fragile skin. It also impacts wound healing.
Additionally, relatively lower estrogen to testosterone cause skin issues such as acne, rosacea and increased skin sensitivity. Lower estrogen levels also impact skin dryness.
This is where estrogen face cream comes in to help with the changes in your skin.
The Menopausal Shift in Hormones and Skin Health
As estradiol levels drop during perimenopause and menopause, there are important changes that occur in the skin including (Lephart, 2021):
loss of type I & III collagen,
loss of elastin and reduced skin elasticity,
loss of fibroblast function,
reduced vascularity of the skin,
increased matrix metalloproteinases & enzymatic activities, resulting in cellular and extracellular degradation
impaired wound healing/barrier function,
decreased antioxidant capacity
increased transepidermal water loss and decreased skin moisture.
These changes contribute to thin, dry, wrinkled and sagging skin. Luckily, topical estrogen face creams or gels can help replenish the hormone levels in the skin and reduce the effects of low estrogen.
The Benefits of Using Estrogen Face Cream for Menopause Skin Care
Since the 1980s numerous studies have examined the effects of both estradiol and estriol, two types of estrogens that decline with menopause. These studies have examined different parameters of skin health and have found that topical estrogens have a number of benefits in the skin.
Increased collagen production (Brincat 1987).
Thickened elastic fibres in the papillary dermis that are also better oriented and slightly increased in number (Punnonen 1987).
Increased epidermal thickness (Punnonen 1987).
Reduced signs of skin ageing: vascularization, firmness, elasticity, moisture, wrinkle depth, and pore size (Schmidt 1994)
Improved skin hydration: estrogen plays a crucial role in maintaining skin hydration through regulating the levels of ceramides. Estrogen cream increases skin hydration (Piérard-Franchimont 1995)
Increased hyaluronic acid (Patriarca 1995)
Choosing and Using Estrogen Face Cream
When choosing an estrogen face cream, products contain either estradiol (E2) or estriol (E3) as active ingredients. These are the two types of estrogens that have been studied extensively for their effects on skin health. The concentrations typically studies includes doese between 0.01-0.06% estradiol and 0.3% estriol.
As estrogen is a type of hormone therapy, even when using as a face cream, it is important to consult with a healthcare professional first. They can assess your individual needs and determine the best type of estrogen cream for you.
You will usually need a prescription for using an estrogen face cream. Estrogen skin care products also come in a gel as well as in a cream.
It is also important to follow the instructions provided by the product label and your healthcare provider.
Typically, estrogen face creams are applied to the face and neck once or twice a day to clean dry skin.
As estrogen creams are low dose and do not significantly increase the serum levels of estrogen they are often able to be continued by postmenopausal women and have been shown to be safe for use after breast cancer, with levels being undetectable except on the first day of use (Moegele 2013).
As topical estrogen therapy is a low dose of estrogen and has low levels of systemic absorption, it can be used alongside systemic estrogen HRT such as estrogen patches or tablets.
Additionally, it is recommended to use sunscreen and avoid exposure to direct sunlight as estrogen can increase the risk of sun sensitivity. Sunscreen is also an important part of menopausal skin care to reduce photo damage from sun rays.
Side effects of Estrogen Face Cream
As the dose of estrogen in a face cream is low as well as low systemic absorption, side effects are uncommon.
However if you experience :
skin irritation,
nausea/vomiting,
bloating,
breast tenderness,
headache, or
weight changes,
or any other symptoms you suspect could be related to the use of estrogen topically, you should tell your doctor or pharmacist promptly and get their advice.
Melasma and estrogen cream
There is a case report of a woman developing melasma when using a combined estradiol and estriol facial cream twice daily (Melasma Associated with Topical Estrogen Cream).
Melasma is skin hyperpigmentation in blotchy patches. Melasma has multiple causes including;
Family history
Sun exposure: both ultraviolet & visible light promotes melanin production
Hormones: any situation that involves hormones can contribute to melasma including pregnancy, oestrogen/progestin-containing oral contraceptives, intrauterine devices, implants, and hormone replacement therapy, and thyroid disorders.
Medications and fragrances: some newer cancer therapies, perfumed soaps, toiletries, and cosmetics can cause a reaction in conjuncton with sun exposure to trigger melasma.
Prevention of melasma when using any form of HRT is best achieved, with year-round, life-long sun protection that includes a broad-brimmed hat, sunscreen containing iron oxides (SPF50+), that is applied regularly in hot sun, and seeking shade in the hottest parts of the day.
If you do develop melasma discuss with your healthcare provider and it is likely they will discontinue hormonal therapy.
Alternatives to Estrogen Face Cream
If you are unable to use estrogen face cream for any reason, there are other options available. These include:
Phytoestrogens: These are plant-based compounds that mimic the effects of estrogen in the body. Some studies have shown that phytoestrogens such as genistein 4% (Silva 2017) or 0.015% isoflavones (Bayerl 2002) can help improve skin elasticity, collagen production, and moisture levels.
Hyaluronic acid: This natural substance helps to maintain skin hydration and can be found in topical skincare products.
Retinoids: These Vitamin A derivatives have been shown to improve skin texture and reduce wrinkles. However, they may cause irritation in some individuals, especially at pharmaceutical doses. Also these should be used an night and you should use adequate sunscreen as it increases photosensitivity.
Antioxidants: Topical antioxidants include: Vitamin C and E, Co-enzyme Q10, green tea, and resveratrol. These antioxidants help to protect the skin from damage caused by free radicals.These can help protect the skin from oxidative damage and support overall skin health.
By incorporating these ingredients into your menopause skin care routine, along with using estrogen face cream, you can help mitigate the effects of hormonal changes on your skin and promote a healthy, radiant complexion.
Additional Menopausal Skin Care Tips
Estrogen is not the only beneficial support for healthy skin for menopausal women. It is important to consider diet, hydration and avoiding toxicity for your skin.
1. Food to promote health skin
Eating a healthy, balanced diet rich in antioxidants such as:
Carotenoids found in Carrots, Orange/yellow/red bell peppers, kumara/sweet potato, Apricots,
Leafy greens such as kale, spinach and swiss chard contain many antioxidants including : vitamins C and E, beta-carotene, lutein and zeaxanthin
Vitamin E rich foods: Almonds, sunflower seeds, spinach, avocados
Vitamin C rich foods: Oranges, strawberries, kiwifruit
Omega-3 fatty acid rich foods: oily fish such as salmon, mackerel and sardines as well as vegan sources such as flaxseeds, chia seeds, walnuts and edamame (soy beans).
2. Hydration for Healthy Skin
Staying hydrated by drinking plenty of water.
Green Tea contains antioxidants and polyphenols to promote skin health, so it is a useful drink to include for skin care.
3. Avoid skin damage
Skin damage occurs when your skin is exposed to environmental factors, that accelerates damage by free radicals . In order to protect your skin, you should:
Always wear sunscreen with sun protective factor (SPF) 50 or higher and containing iron oxide - especially if you are using an estrogen facial cream, or any other form of hormone replacement therapy.
Avoid tanning beds and excess sun exposure, especially when the UV is at it's highest.
Quit smoking: Smoking damages the collagen and elastin in your skin, leading to premature skin aging.
Minimise alcohol intake as it impairs the antioxidants in your skin and accelerates skin aging.
Avoid chemical irritants such as skincare products that you react to. Use Skin Deep's cosmetic database to check your products.
4. Manage stress levels
Stress can also affect your skin health by increasing inflammation in the body. Finding ways to reduce stress such as exercise, meditation, or therapy can help improve overall skin health.
Also ensuring you get sufficient rest each night so your body and skin has time to rest and repair is essential for healthy skin.
Ensuring the lights are dim in the evening so you have adequate melatonin production is important as melatonin is a powerful antioxidant for the skin and also supports sleep.
By incorporating these tips and ingredients into your menopause skin care routine, along with using estrogen face cream, you can help mitigate the effects of hormonal changes on your skin and promote a healthy, radiant complexion.
Estrogen Face Cream: The Takeaways
Estrogen levels decline during menopause, lead to changes in the skin such as dryness, thinning, reduced collagen, reduced elasticity, reduced thickness and reduced hydration.
Topical estrogen face creams can be a helpful tool in managing these changes and promoting healthy skin.
Consider using estrogen face cream as part of your menopausal skincare routine, along with other self-care practices. Consult your health provider for the best estradiol/estriol options.
If estrogen face cream is not an option, there are other alternatives available such as phytoestrogens, antioxidants, hyaluronic acid, and retinoids.
Make sure you include diverse plant foods in your diet, get adequate hydration, rest & recovery and manage your stress for healthy skin too!
As a women's health & menopause doctor, Dr Deb Brunt @ Ōtepoti Integrative Health would love to support you through the perimenopause and menopausal stages of life, supporting all aspects of your health and wellbeing.
Dr Deb Brunt is a menopause doctor in Dunedin, New Zealand and also provides menopause health coaching internationally to support optimal health habits for aging well so you can live your best life.
Schedule an appointment with Dr Deb Brunt | Ōtepoti Integrative Health | Book Appointment
Additional Resources and References:
Rzepecki AK, Murase JE, Juran R, et al. Estrogen-deficient skin: The role of topical therapy. Int J Womens Dermatol. 2019 Mar 15;5(2):85-90.
Lephart ED, Naftolin F. Menopause and the Skin: Old Favorites and New Innovations in Cosmeceuticals for Estrogen-Deficient Skin. Dermatol Ther (Heidelb). 2021 Feb;11(1):53-69.
Brincat M., Versi E., Moniz C.F., et al. Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy. Obstet Gynecol. 1987;70(1):123–127.
Punnonen R., Vaajalahti P., Teisala K. Local oestriol treatment improves the structure of elastic fibers in the skin of postmenopausal women. Ann Chir Gynaecol Suppl. 1987;202:39–41.
Schmidt J.B., Binder M., Macheiner W, et al. Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds. A pilot study. Maturitas. 1994;20(1):25–30.
Piérard-Franchimont C., Letawe C., Goffin V., Piérard G.E. Skin water-holding capacity and transdermal estrogen therapy for menopause: A pilot study. Maturitas. 1995;22(2):151–154.
Patriarca M.T., Barbosa de Moraes A.R., Nader H.B., et al. Hyaluronic acid concentration in postmenopausal facial skin after topical estradiol and genistein treatment: A double-blind, randomized clinical trial of efficacy. Menopause. 2013;20(3):336–341.
Silva L.A., Carbonel A.A., de Moraes A.R.B., et al. Collagen concentration on the facial skin of postmenopausal women after topical treatment with estradiol and genistein: A randomized double-blind controlled trial. Gynecol Endocrinol. 2017;33(11):845–848.
Bayerl C., Keil D. Isoflavonoide in der behandlung der hautalterung postmenopausaler frauen. Aktuelle Dermatol. 2002;28:S14–S18.
Moegele M, Buchholz S, Seitz S, et al. Vaginal Estrogen Therapy for Patients with Breast Cancer. Geburtshilfe Frauenheilkd. 2013 Oct;73(10):1017-1022.
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