Are oestrogen-infused face creams and serums safe and effective? Photo / Joyce Lee, The New York Times
Are oestrogen-infused face creams and serums safe and effective? Photo / Joyce Lee, The New York Times
Some cosmetics companies are marketing oestrogen-infused face creams and serums to people in menopause. Do they work?
Hot flushes, night sweats and vaginal dryness are common symptoms of menopause. But the skin can undergo changes in midlife, too, including sagging, thinning and becoming more dry.
Oestrogenis key to maintaining skin integrity, said Dr Susan Massick, a dermatologist at the Ohio State University Wexner Medical Centre. When oestrogen levels dip during menopause, your skin can become thinner with less collagen and elasticity, potentially causing more dryness or wrinkling.
Some skincare companies sell oestrogen-infused face creams and serums that are supposed to prevent and reverse these changes. One doctor on Instagram even said that using prescription vaginal oestrogen cream on your face can increase collagen production and minimise dryness.
While this use of oestrogen cream “makes sense, in theory”, Massick said, we need more research showing that it is safe and effective. Here is what we know.
In one review published in 2019, researchers analysed the results of about two dozen studies. They involved menopausal and postmenopausal women who used topical oestrogen – including in gels, creams, ointments and patches – on their faces, abdomen, buttocks, forearms and thighs. The authors concluded that it was “plausible” oestrogen could minimise wrinkles and improve skin dryness, texture and elasticity. However, the studies they reviewed had various limitations, including that they looked at small groups of women. And some of the review’s authors were consultants for a skincare pharmaceutical company, presenting a conflict of interest.
Massick said that we need more rigorous research to understand how effective and safe topical oestrogen products are, and what concentrations and forms are best.
Estradiol, the active ingredient in vaginal oestrogen creams that are prescribed for menopause-related vaginal dryness and pain during sex, is a potent and therapeutic form of oestrogen, said Dr Mary Jane Minkin, an OB-GYN at Yale Medicine.
Some of her patients use it off-label to treat dry and wrinkled skin on their faces, she said. But she doesn’t encourage this use – and the dermatologists we spoke with didn’t recommend it either, since it hasn’t been proven safe or effective.
Vaginal creams are not “designed or intended for facial use”, Massick said.
Estriol (a form of oestrogen that is produced during pregnancy) and phytoestrogen (a plant compound that mimics oestrogen in the body) are two ingredients often found in oestrogen-based skincare products, Massick said. But the research on them is limited, too.
Is topical oestrogen safe?
Applying oestrogen to the skin could cause irritation, and trying any new topical product could lead to an allergic reaction, rash or redness, said Dr Jacqueline Watchmaker, a dermatologist in Scottsdale, Arizona.
Oestrogen could also worsen any dark patches and discolouration or make blood vessels more apparent, she added; or it could aggravate skin conditions like eczema and rosacea, said Dr Debra Jaliman, a dermatologist in New York City.
The biggest question surrounding topical oestrogen, however, is how much of the hormone gets absorbed into the bloodstream.
When used vaginally, Minkin said only “minuscule” amounts of oestrogen seem to be absorbed, so it stands to reason the same rules would apply when using it on the face.
But until more research is done, Massick suggested that women who have or are at higher risk of developing “hormone-sensitive conditions” – like breast, uterine or ovarian cancers, or polycystic ovary syndrome – should avoid using oestrogen-based skincare products.
Because of these potential safety concerns and the lack of evidence of benefit, Watchmaker and the other dermatologists recommended not using oestrogen as skincare until more research is done.
What actually works?
There are many well-researched and effective options for addressing menopause- and age-related skin problems, Massick said.
Prescription topical retinoids (like tretinoin) and over-the-counter retinol can increase collagen and elastin, a protein that strengthens and plumps the skin. They can also boost cell turnover, which helps brighten skin and smooth fine lines, Watchmaker said.
Hyaluronic acid can help minimise dryness, she added. And antioxidants like vitamin C and niacinamide can reduce redness, improve discolouration and enhance skin texture, Jaliman said.
In-office treatments can also help, Jaliman added. These include laser resurfacing, which triggers collagen production and evens out skin tone; dermal fillers to add volume and smooth fine lines; and non-surgical skin tightening procedures that stimulate collagen production.
Applying sunscreen with a rating of SPF30 or higher every day is also crucial. Ultraviolet damage accelerates skin ageing and sunscreen will keep problems like wrinkles and thinning from getting worse, Massick said.
If you’re not sure how to address your skin issues, she recommended seeing a dermatologist who can develop a tailored skincare routine for you. Also, check in with a doctor for help addressing other menopausal symptoms.
Sunscreen is one of the most effective tools for combating age-related skin changes. Photo / 123RF
