This month we tackle another question we get semi-regularly in the office. Some things sound too good to be true, and others become a trend before we know enough about them. In general, products can vary so much that it makes it very difficult to compare one form to another, 🍎 to 🍊. We will try to break this topic down for you with what we know so far!
Can vaginal estrogen cream be used on the face? Does it even work?
Some people on social media are promoting the idea of using vaginal estrogen cream on the face to reduce wrinkles and improve aging skin. However, researchers say there is not enough good-quality evidence to know whether this is safe or effective.
What did the research find?
Researchers reviewed studies of different estrogen creams applied to the skin. Keep in mind these were overall small and short studies. Overall:
- Estradiol (a form of estrogen) appeared to:
- Increase signs of skin thickness.
- Boost collagen, which helps keep skin firm.
- Estriol might improve:
- Wrinkles.
- Skin firmness.
- Hydration.
- Plant-based estrogens (phytoestrogens)showed some benefit but were generally less effective than estradiol.
- Estrone did not improve wrinkles or skin elasticity and may even increase an enzyme that breaks down collagen.
What are the concerns?
The studies had many limitations:
- Most were small and short-term.
- Only one was a high-quality randomized controlled trial.
- Different studies measured different outcomes, making it hard to compare results.
- Many used compounded (custom-made) estrogen creams that are not FDA-approved, meaning the strength and consistency of the product may vary.
Researchers are particularly concerned that:
- More estrogen absorbed through the skin could increase risks, but this has not been well studied.
- Potential side effects include skin darkening (hyperpigmentation/melasma), breast tenderness, and possibly effects on the uterus (endometrial stimulation), especially in women who still have a uterus and are not taking progesterone.
- No studies examined the safety of using both vaginal estrogen and facial estrogen at the same time.
How does it compare with other anti-aging treatments?
There were no studies comparing estrogen creams with retinoids, which are well-established anti-aging treatments. One study found estradiol was slightly less effective than glycolic acid.
What do the experts recommend?
The lead researcher emphasized an important distinction:
- FDA-approved vaginal estrogen, when used as directed for vaginal symptoms of menopause, has decades of safety data, minimal absorption into the bloodstream, and is considered a safe and effective treatment.
- Applying estrogen to the face for cosmetic purposes is different. There is much less evidence that it works, and its long-term safety is unknown.
Bottom line
Although topical estrogen may improve some signs of skin aging, the evidence is still weak. Experts do not recommend using vaginal estrogen cream on the face based on current research, especially compounded products with uncertain dosing. Larger, well-designed studies are needed to determine whether facial estrogen is both effective and safe over the long term.