Oestrogen Cream for Ageing Skin: Miracle Menopause Hack or Interesting Science?
If you are a woman somewhere in the broad and occasionally bewildering territory of perimenopause, menopause or post-menopause, you may have noticed something rather annoying happening to your skin. Perhaps it suddenly feels drier, the moisturiser you have happily used for years seems to disappear without trace by lunchtime, or your skin feels thinner, less bouncy or somehow simply… different.
And then, because the internet knows everything you are thinking before you have even thought it, you come across a woman on social media applying oestrogen cream to her face and announcing that she has discovered the secret to reversing skin ageing.
Naturally, I became curious. While I am deeply sceptical of miracle cures, the relationship between oestrogen and the skin is genuinely fascinating. There is, in fact, some real research into applying oestrogen directly to the skin and some of the findings are intriguing. So, is this an exciting new direction in menopausal skincare, or another trend that has raced rather enthusiastically ahead of the evidence? As is so often the case, the answer is somewhere in the middle.
First things first: what does oestrogen have to do with our skin?
Quite a lot, actually. We tend to think of oestrogen in relation to periods, fertility, hot flushes and HRT, but oestrogen receptors are also found in the skin. Oestrogen signalling plays a role in collagen production, skin thickness, hydration, elasticity, barrier function and the production of substances such as hyaluronic acid, which helps the skin hold water.
As oestrogen levels decline around menopause, the skin can become thinner, drier and less resilient. Collagen levels fall, the skin holds less water and changes in firmness and elasticity can become more noticeable. It is one reason why some women feel that their skin has changed surprisingly quickly during this stage of life, even though their skincare routine has remained exactly the same.
This led scientists to ask a fairly obvious question: if falling oestrogen contributes to changes in menopausal skin, could applying oestrogen directly to the skin help? The answer appears to be possibly, but there are several rather important caveats.
What has the research found?
There have been a number of small human studies looking at topical forms of oestrogen on facial and body skin, and some of the findings are genuinely interesting.
One of the better-known early studies, published in 1994, involved 54 postmenopausal women aged between 52 and 70. After 24 weeks, the women using a conjugated oestrogen cream showed improvements in skin thickness and fine wrinkles compared with those using a placebo cream.[1]
Another study compared topical oestradiol and estriol creams in women with signs of skin ageing. Over six months, researchers reported improvements in moisture, firmness, elasticity, wrinkle depth and pore size, along with an increase in collagen III.[2] Interestingly, the changes were not instant. Improvements in moisture and vascularisation appeared after roughly two months, while changes in firmness and elasticity took longer. Improvements in wrinkle depth and pore size appeared later still, at around four months.
In other words, this was not an overnight “I woke up looking a fashionable 35” situation. Skin biology tends to be considerably less dramatic than social media.
A 2003 study produced another interesting finding. Postmenopausal women used either oestradiol cream, glycolic acid, a combination of the two, or a vehicle cream (plain). After six months, epidermal thickness had increased by 23% with oestradiol, 27% with glycolic acid and 38% with the combination treatment.[3]
Other smaller studies have found increases in facial hyaluronic acid and collagen following topical oestradiol treatment.[4,5] Taken together, these studies suggest that certain topical oestrogens may have genuine biological effects on ageing skin. However, before we all start raiding the bathroom cabinet, there is another side to the story.
Unfortunately, it isn't quite that simple
One of the problems with discussing “topical oestrogen” is that this phrase covers several different hormones and formulations. Oestradiol, estriol, oestrone and conjugated oestrogens are not the same thing and we cannot assume that a result found with one formulation will apply to all the others.
This became particularly clear in a more recent randomised controlled trial published in 2014. Eighty postmenopausal women applied either a 1% oestrone cream or a vehicle cream to their faces every day for 24 weeks. The study found no meaningful improvement in wrinkles or skin elasticity. More concerningly, researchers found a significant increase in MMP-1 activity. MMP-1 is an enzyme involved in breaking down collagen, so this was certainly not the hoped-for result.[6]
There is another wrinkle in the story too, if you will forgive the pun. Research suggests that oestrogen may behave differently on sun-protected skin compared with chronically sun-exposed skin. In one study, topical oestradiol stimulated collagen production in sun-protected hip skin but did not produce the same response in photoaged facial and forearm skin.[7]
This matters because the face is not simply a convenient patch of skin on which to test a cream. For most of us, it has had decades of UV exposure, pollution, facial movement and environmental stress. So while the biological theory behind topical oestrogen is compelling, translating that theory into visible facial rejuvenation may be more complicated.
What about using it on the body?
This is an interesting question and one I suspect we will hear much more about in the future. Because some of the research suggests that sun-protected skin may respond differently from heavily photoaged facial skin, there is a plausible scientific reason to investigate topical hormonal treatments on areas such as the arms, abdomen or other sites affected by thinning and crepiness.
However, we do not yet have enough high-quality clinical research to recommend applying oestrogen cream broadly across the body for cosmetic purposes. The amount applied, the size of the area treated and the duration of use may all influence how much hormone is absorbed systemically and this brings us neatly to the biggest unresolved question.
Is putting oestrogen cream on your face safe?
The short answer is that we do not know enough yet. Some of the small facial studies are reassuring. For example, a 1993 study of 17 women using oestradiol or estriol ointment on the face for three months found no significant changes in measured serum hormones or vaginal cytology.[8]
However, these studies were small and short. They were not designed to tell us whether applying oestrogen cream to the face for years might affect breast health, the endometrium or the risk of blood clots. We also know from regulated topical oestrogen products used for other medical purposes that systemic absorption can occur, particularly depending on the strength of the product, the amount applied, the size of the area being treated and the duration of use.
That does not mean that applying a small amount to the face necessarily carries the same risk as systemic HRT. It simply means that we do not yet have enough evidence to confidently say that long-term cosmetic use is risk-free.
There have also been occasional reports of local effects including skin irritation and hyperpigmentation and a case report has linked topical oestrogen exposure with melasma.[9] For women with a history of oestrogen-dependent cancer, unexplained vaginal bleeding, significant thrombotic risk or other hormone-related contraindications, this is very much a conversation to have with an appropriately qualified medical professional and not an experiment to begin after watching a 30-second Reel.
It is also important to know that the oestrogen creams discussed in this area of research are not routinely licensed as facial rejuvenation treatments.
So… should we all be putting oestrogen cream on our faces?
At the moment, I would say: not so fast.
The science is interesting and there is enough evidence to suggest that the idea is not nonsense. Certain forms of topical oestrogen appear capable of influencing skin thickness, hydration, collagen and hyaluronic acid, and some studies have shown improvements in fine wrinkling and elasticity.
However, the evidence base is still small. Many of the studies are old, participant numbers are limited and results have not always been consistent. We also lack good long-term safety data specifically for facial or cosmetic body use.
What I find most interesting is not the idea that we have discovered another miracle anti-ageing cream, because we haven't. It is the growing recognition that the skin of a 55-year-old woman is biologically different from the skin of a 25-year-old woman and perhaps deserves skincare and treatment strategies designed with that biology in mind.
For far too long, the beauty industry has approached ageing skin largely by telling women to exfoliate it more aggressively, stimulate it harder and buy increasingly expensive jars of moisturiser. The hormonal changes taking place within the skin have received comparatively little attention, and I think that is beginning to change.
My view from the treatment room
At Glow Sanctum, I am interested in treatments that work with the skin rather than waging war against age. For women in their forties, fifties, sixties and beyond, good skin treatment is rarely about one magic ingredient or one heroic treatment. It is about understanding what the skin needs now.
That might mean supporting hydration and barrier function. It might mean stimulating collagen in a controlled way. It might involve microneedling, skin boosters, polynucleotides, carefully chosen home skincare and lifestyle factors. In time and with better evidence, perhaps we can add more targeted hormonal approaches to the skin.
I will continue watching this area of research with great interest, but for now my advice is simple: be curious, but be cautious. Menopausal skin deserves much more research and far more intelligent conversation and thankfully, I think we are finally beginning to have it.
References
Creidi P, et al. Effect of a conjugated oestrogen cream on ageing facial skin. 1994. Randomised, double-blind, placebo-controlled study in postmenopausal women.
Schmidt JB, et al. Topical oestrogen treatment of skin ageing symptoms. 1996. Comparative study of topical oestradiol and estriol.
Fuchs KO, et al. Effects of topical oestrogen and glycolic acid on postmenopausal facial skin. 2003.
Patriarca MT, et al. Study of topical 17β-oestradiol and genistein on facial hyaluronic acid in postmenopausal women. 2013.
Silva LA, et al. Effects of topical oestrogen and genistein on facial collagen in postmenopausal women. 2017.
Yoon HS, et al. Randomised vehicle-controlled study of topical oestrone on photoaged facial skin. 2014.
Rittié L, et al. Study examining the effects of topical oestradiol on collagen production in sun-protected and photoaged skin. 2008.
Kainz C, et al. Study of systemic hormonal effects following facial application of oestradiol and estriol ointments. 1993.
Case literature describing melasma associated with topical oestrogen exposure. 2017.
This article is for general information and education only. It is not medical advice and should not be used as a substitute for individual advice from a qualified healthcare professional. Hormonal medicines should only be used as prescribed and discussed with an appropriate medical professional.
