This column first ran in Valerie Monroe’s newsletter, How Not to F*ck Up Your Face, which you can subscribe to on Substack.
Q: I’ve recently seen a few influencer types recommending estrogen cream, intended for vaginal use, for the face. The thinking is that estrogen is abundant in younger skin and, thus, it would be beneficial to us postmenopausal ladies. Should I be sneaking some of my .01% estradiol cream on my puss instead of my … (oh never mind, you know what I mean)?
A: When I first heard about using estradiol on the face, I was intrigued. If estrogen can make vaginal skin healthier, why wouldn’t it do something similar for the face?
I tried my estradiol cream on my under-eye bags for a couple of nights. But then I discovered the joys of DNA repair enzymes and, because I refuse to apply more than two skin-care products at once (a DNA repair serum + my prescription retinoid), I decided to skip the estradiol. It’s easy to see why the idea of applying vaginal estrogen cream to your face is appealing.
“Estrogens have a significant impact on skin; they increase collagen and skin thickness and improve skin hydration,” says dermatologist Connie Yang. During menopause, a decrease in estrogen accelerates skin aging. A study on postmenopausal women showed that topical estrogen application on facial skin for 24 weeks increased type I and type III collagen — collagen responsible for skin elasticity and firmness — making topical estradiol a promising option for combating skin aging, adds Yang.
Dermatologist Ellen Gendler is a proponent of estrogen cream used sparingly on the face and the backs of the hands. “There are countless studies on the use of topical estrogen on the skin and on the vagina,” she says. “In both areas, there is virtually no significant systemic absorption; several studies corroborate this, including a recent study for more than three months by Alloy Women’s Health that showed no increase in blood levels of either estriol or estradiol when applied to the skin.” For a deeper dive into the Alloy website, read this. And for a completely different take on the safety aspect of using estrogen creams on the face, read this.
Most studies on topical estrogen have shown benefits in several parameters, Gendler says. Though there are no long-term studies to determine if topical estrogen impacts skin laxity overall, Gendler believes using it on limited areas has benefits once estrogen supplies diminish. She points out that this advice isn’t intended for younger, fully estrogenized women. Fully estrogenized! Those were the days!
“The female body makes three types of estrogen: estradiol, estrone, and estriol,” says dermatologist Jessica Weiser.
Estradiol is the most potent, reaching its highest levels during reproductive years and thought to help maintain bone density.
Estriol, the least potent that’s primarily present during pregnancy (and is the kind of estrogen in the Alloy cream), has been studied for around 20 years for potential anti-aging benefits, says Weiser. There are minor risks, including skin irritation, exacerbating melasma, and (unlikely but not impossible) internal absorption of the hormone (which at significant levels can cause endometrial hyperplasia and, more rarely, breast cancer).
As for layering the cream, estriol or estradiol can be applied to clean skin and absorbed like other active ingredients for five to ten minutes, says Weiser. After that, you can apply a hydrating serum containing glycerin, sodium PCA (a humectant), hyaluronic acid (if you like it and respond well), and, finally, a heavier moisturizer to trap actives in the skin.
Yang points out it’s important to manage expectations. An estrogen cream won’t diminish deep wrinkles. But with consistent use, you could see improvement in moisture retention, skin hydration, increased thickness, and/or reduced appearance of fine lines. This sounds like the results I’ve been getting for years from my prescription retinoid, which has decades of robust studies supporting its safety and effectiveness. So I’ll be wearing my estradiol only below deck for now.
Originally published on October 8.