In the early days of hormone replacement therapies, putting oestrogen and progesterone into face creams was very popular.
By the 1930s, scientists had worked out that replacing declining hormone levels could be beneficial for women in perimenopause and menopause. HRT was widely touted as an anti-aging wonder drug with early proponents, such as Dr Robert Wilson, author of Feminine Forever, calling it essential if a woman was to maintain a “fully feminine appearance”.
So, why not bung it in an anti-wrinkle cream as well? If it’s good for bone density and vaginal dryness, it must be good for your face too, right?
Well, no. Not really. Eventually, the health authorities decided that rubbing unregulated amounts of oestrogen on your face probably wasn’t the best idea. Hormones were banned in over-the counter-products by the European Commission in 1976, but you could still buy them in America until 1993. These early products were eventually banned in the US on health grounds. The authorities were worried that plastering oneself in unknown amounts of hormone might cause cancer.
But what goes around comes around, and it seems that putting oestrogen cream on your face to smooth out a few wrinkles is making something of a comeback.
A whole host of menopause and wellness influencers are promoting vaginal oestrogen cream as an off-label anti-wrinkle treatment. Yes, you did read that correctly. Women are putting vaginal oestrogen cream on their face.
Vaginal oestrogen cream contains the active ingredient estriol, a weak form of oestrogen, at a concentration of about 0.01 per cent. It’s prescribed to relieve vaginal dryness and irritation, which is quite common when hormone levels decrease during perimenopause/menopause. It works by increasing oestrogen levels in the vagina, which improves elasticity, increases moisture and thickens the skin.
So, once again, the leap was made. If it’s good enough for my vulva, it must be good enough for my face! I’ve seen influencers slapping this stuff on and calling it “a game changer” and even dermatologists saying it helps the skin “wake up”. (The skin on your face, not your vulva, though I hope that’s perky too.)
In America, there are now telemedicine companies offering prescriptions for oestrogen face creams, rather than vaginal ones, none of which are FDA-approved or have the actual dose disclosed. In the UK, it’s difficult to get oestrogen creams without a prescription.
US companies selling these creams claim to have all kinds of studies to prove their products work, but for some reason none of them have been subjected to peer review or published in notable journals. Seems odd to me. If it really does work, then why not prove it? But that’s America. If you’re in the UK and you want to put oestrogen on your face, you’ll probably have to lie to a doctor or a pharmacist about needing it for your hoohah, because it is not available as a cosmetic cream here.
I had intended to try this “game-changer” myself and report back to you all, but I was quickly disavowed of this plan. My ever-patient editor gently explained that not only can we not condone getting prescriptions through deception, but our insurance won’t cover my applying vaginal hormone cream to my face because an influencer told me to. Which brings me to a very important point: please do not lie to healthcare professionals or put hormones on your face without a prescription.
So, I decided to dig into the science instead. Does it work? Is it safe? Would topical oestrogen cream knock out a few facial wrinkles, or simply give me nostrils I could have pain-free intercourse in for the next 24 hours?
I am quite glad I was prevented from experimenting on myself as just last week a new review on this very subject was published in The American Academy of Dermatology, and I have to say the science for using topical oestrogen as a wrinkle cream isn’t great.
Since the 80s, there have been just 14 peer-reviewed studies on the benefits of topical oestrogen for cosmetic purposes. To put that into perspective, between 1970 and 2021, there have been 16,114 papers published on erectile dysfunction. Some of the 14 studies showed promising results when it came to increasing collagen production, epidermal thickening and fibroblast activation.
However, and this is a big however, most studies were not controlled with a placebo, and various types of oestrogen were used, at different doses, on a variety of women, some of whom were already taking HRT and some of whom were not. Most studies were very short with a small number of participants, and there was no follow-up data. So, we really have no way of knowing if any improvements to the skin that were observed were the result of topical oestrogen.
In short, we do not have the evidence to say with any authority that putting oestrogen cream on your face improves your skin. Or, to quote the research directly: “Despite encouraging histological changes, clinical endpoints remain inconclusive. Few controlled trials report visible or patient-perceived improvements, and results vary by site and methodology.”
So, not quite the “game-changer” I had been hoping for.
You might be thinking: “It’s still worth a shot, Kate! I’ll take my chances.” But a note of caution. Some of these studies indicated that, even at very low levels, the oestrogen in these creams was absorbed into the system – causing breast tenderness, spikes in prolactin, skin sensitivity and changes to the pigmentation of the skin. If that is correct and if the oestrogen does get into your system, we just don’t know what the long-term effects of this will be.
I spoke to Dr Deepali Misra-Sharp, a GP and menopause specialist about applying topical oestrogen cream for cosmetic reasons. “We know that even low-dose oestrogen applied to the skin can be systemically absorbed, so using it on the face – an area it was never designed or tested for – means we simply don’t know the long-term safety implications,” she explained. “Until better quality research is available, it’s sensible to avoid using prescription hormone treatments off-label for cosmetic purpose.”
It was sounding less and less like the miracle I was after. Low doses of oestrogen are a safe treatment for vulvovaginal atrophy, but that doesn’t mean the same cream is safe to be used on the face, every day, for the rest of your life. To quote the research paper again: “Despite the expectation of lower absorption through keratinised facial skin, the area, amount, and pattern of application differ, and cumulative exposure has not been evaluated in systemic-safety studies.”
And when they say “systemic-safety” they mean that the “long-term cancer-risk data are lacking”.
What is so silly about all of this is that there are treatments out there that really do improve the quality of your skin. Glycolic acid, retinoids and vitamin C have all been conclusively proven to boost skin cell turnover, increase collagen production and reduce wrinkles. No one needs to be slathering their mush in experimental fanny creams to try and achieve a youthful visage.
Sadly, the recent popularity of oestrogen face creams online has outpaced the research available on them. Claims are now being made about their benefits that are completely unsubstantiated, and usually by the same menopause influencers and experts who regularly bemoan how woefully under-researched women’s health is. If research is really important to these people, why are they now ignoring it?
This is something that menopause specialist and gynaecologist Dr Jen Gunter finds particularly frustrating. “Estrogen face cream is essentially unstudied in a scientifically meaningful way,” she explained. “This means we do not know the risks or the benefits. I find it fascinating that some doctors and other creators decry the lack of research in women’s health and yet make videos applying these creams or recommending it. So, the lack of funding in women’s health is something to exploit for views and tune off when it is financially inconvenient?”
Maybe oestrogen creams improve your skin, but maybe they don’t; it’s all very inconclusive. Clearly, more research is needed before anyone can say anything with any certainty. So, for now, just stick to the vitamin C serums.
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