What do we know about using estrogen for skin care? A few blogs ago, we discussed transdermal and topical estrogen (estradiol.) We lightly mentioned that’s there’s some buzz about using estrogen as an anti-aging tool in skin care and to soften and slow facial hair growth.
We’ve been able to pull some articles on how estrogen affects skin and hair, but not as many as we would have liked for a robust evidence review (side note – we also got side-tracked with all of the stuff going on in the United States recently, and well, we didn’t have as many spoons for a deep dive into the evidence as we thought we might.)
We haven’t found any articles specifically discussing using estrogens for softening or thinning facial or body hair.
But, we are happy to share what we have found!
The Studies
*Note – these studies mostly looked at cisgender women and skin changes in peri-menopause and menopause, when estrogen levels drop. We don’t know of any studies looking at skin changes in trans folk using estrogen for skin care.
Estrogen For Skin Thickness and Collagen:
Collagen is what makes skin resilient. We know that skin that is exposed to estrogen is thicker, has more elasticity, and has more robust collagen. It appears that this is not because estrogen increases collagen-building in the skin, but because it decreases collagen-breakdown. (1, 4)
Estrogen For Skin Healing and Blood Vessels:
We know that estrogen helps keep blood vessels elastic (blood vessels are made of collagen!) This is one of the reasons why bodies exposed to testosterone and bodies that experience decreases in estrogen levels have higher rates of cardiovascular disease: blood vessels get less stretchy.
We don’t really understand how estrogen impacts skin healing, but we do know that skin that has lost exposure to estrogens is more fragile and bruises more easily. We know that wounds take longer to heal in older folx who have lower levels of hormones in their bodies.
In studies on animals seem to indicate that estrogen may reduce inflammation in wounds, thus helping them to heal. How estrogen impacts collagen production may also play a big role in how skin heals when exposed to more or less estrogen. Studies in humans showed that topical estrogen applied to elderly skin helped wounds heal faster. (4) This may be because the tiny blood vessels in skin tissue that has more available estrogen are better able to bring nutrients to tissues.
Estrogen For Skin Moisture:
How skin is moisturized is pretty complex, but estrogen plays a role.
The top layer of skin is made up of dead skin cells layered in fat compounds (lipids.) It’s called the stratum corneum. (2) How these cells are organized creates the skin barrier: this is the ability of the skin to absorb and keep moisture, and helps keep the skin healthier by keeping out damaging environmental factors.
This top layer of skin has about 10 to 25 layers of cells within it. Those cells are often described as “bricks in mortar.” The skin cells containing moisture are the bricks, held together and cushioned by fatty mortar. Topical substances cannot get through this layer and penetrate deeper into the body. Transdermal substances, which are typically fat-soluble (they can be dissolved in fats) can pass through this layer to be absorbed by deeper tissues and blood vessels.
Skin exposed to more estrogen may be able to contain more water in those outermost cell layers. Studies indicate that skin exposed to more estrogen is less dry. (1, 4) This may be because estrogen increases amounts pf the chemicals in skin cells that hold on to water such as hyaluronic acid (yep, the stuff in all those skin product ads!) It may be because skin with more hydration is thicker (both due to collagen and layers of cells in the stratum corneum) and moisture has to travel farther to get out of the body. (2)
Estrogen For Skin Wrinkles:
Wrinkles happen due to age and sun exposure, and are influenced by genetics, hormones, presence or absence of disease, and the environment. What we know of wrinkles is that they occur when collagen and other elastic fibers in the skin lose their oomph.
There are several studies that show that applying an estrogen cream to the face reduces the appearance of fine wrinkles. (1, 4, 5)
Estrogen For Hair Growth
Hair growth has three stages: anagen (when hair grows,) catagen (when hair stops growing and falls out,) and telogen (when the hair follicle rests.)
It appears that higher levels of estrogen create a longer hair growth stage, and sudden drops in estrogen can trigger a telogen stage. We are attempting to get access to an article that theorizes that estrogen may be able to reduce the amount of testosterone and dihydrotestosterone (DHT) available to hair follicles, and thus affect hair growth and loss. (3) The medicines finasteride and dutasteride lower the body’s production of DHT or the ability of hair follicles to use DHT and thus prevent some balding. It may be that estrogen applied to the skin acts like finasteride or dutasteride at the hair follicle.
A study looking at applying estradiol valerate (the injectable oil formula!) directly to the scalp in menopausal cis women with hair loss found an increase in the time that hair follicles were in their growth phase compared to their resting phases. However the study did not see an increase in hair regrowth for hair already lost. A small subset of patients did have increased blood levels of estrogen, but it is not clear if those were due to the estradiol valerate. (6)
It does not appear that applying estrogen to skin or hair will slow hair growth.
Is it Topical or Transdermal?
Whether or not estrogens applied to the skin can get into the bloodstream and affect other tissues in the body appears to be controlled by what estrogen is used in which form.
A study of a bioidentical estradiol and estriol (two different kinds of estrogen) cream applied to cis women’s faces for 6 months found increased skin moisture, elasticity and firmness, and decreased wrinkle depth. Blood hormone levels showed no significant change.
However, a study using a conjugated estrogen (not chemically identical to the estrogens that human bodies make) found increased hormone levels in the body, along with skin changes. (1)
The study we mentioned above about estradiol valerate in oil maybe was absorbed into the blood stream by less than 5% of the study participants. (6)
A comparison of studies looking at the effects of topical estrogen for postmenopausal skin found that adverse side effects were rare and mild. Most studies did not report any broad effects on other body systems or hormone levels. One study looking at application of estradiol gel on the forearm found a decrease in fine wrinkles at the application site (the arm) and on the cheek, which could indicate that the estradiol was absorbed into the bloodstream. (5)
What Does It All Mean?
If you’re interested in trying an estrogen product for skin care, we’re happy to talk about what we know and don’t know. We’re likely to recommend using a bioidentical estrogen, and we may want to monitor your blood levels and adjust other dosages as necessary. Estrogen for skin may add to your glow and decrease fine wrinkles.
It isn’t clear, but seems unlikely that estrogen applied to facial hair will significantly thin this hair or make it softer. Application of creams may act as conditioners. There are other alternatives like compounded eflornithine (previously available as the prescription cream Vaniqua) either alone or in combination with anti-androgen creams – that may be more effective in diminishing or slowing facial hair growth. Eflornithine inhibits an enzyme that is used by hair follicles to grow hair.
Related Articles
- Managing Hair: Grow it, Keep it, Get Rid of It
- Direct Contact Estrogen, September 2024
- What should I know before using a compounding pharmacy?
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Citations
- Dr S. Verdier-Sévrain (2007) Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators, Climacteric, 10:4, 289-297, DOI: 10.1080/13697130701467157
- J. van Smeden, M. Janssens, G.S. Gooris, J.A. Bouwstra, The important role of stratum corneum lipids for the cutaneous barrier function, Biochimica et Biophysica Acta (BBA) – Molecular and Cell Biology of Lipids, Volume 1841, Issue 3, 2014, Pages 295-313, ISSN 1388-1981, https://doi.org/10.1016/j.bbalip.2013.11.006.
(https://www.sciencedirect.com/science/article/pii/S1388198113002485) - Niiyama S, Happle R, Hoffmann R. Influence of estrogens on the androgen metabolism in different subunits of human hair follicles. EJD European journal of dermatology. 2001;11(3):195-198.
- MP Brincat, Y Muscat Baron & R Galea (2005) Estrogens and the skin, Climacteric, 8:2, 110-123, DOI: 10.1080/13697130500118100
- Alexandra K. Rzepecki, Jenny E. Murase, Rupal Juran, Sabrina G. Fabi, Beth N. McLellan, Estrogen-deficient skin: The role of topical therapy, International Journal of Women’s Dermatology, Volume 5, Issue 2, 2019, Pages 85-90, ISSN 2352-6475,
https://doi.org/10.1016/j.ijwd.2019.01.001.
(https://www.sciencedirect.com/science/article/pii/S2352647519300012) - Georgala S, Katoulis AC, Georgala C, Moussatou V, Bozi E, Stavrianeas NG. Topical Estrogen Therapy for Androgenetic Alopecia in Menopausal Females. Dermatology (Basel). 2004;208(2):178-179. doi:10.1159/000076497
