Do You Need to Estrogen Cream for Your Face? Doctors Weigh In.

At 45, Keenya Kelly gets more compliments on her skin than ever. But when she began experiencing perimenopause symptoms in her 30s, Kelly says her typically oily and plump skin became “almost like a Brillo pad overnight.” A friend told her to try putting estrogen-infused moisturizer on her face. So, every night for the past year, the video marketing strategist from Houston has religiously included estrogen cream, which she buys from the telehealth platform Musely, in her skin-care regimen. “People ask me what I’ve done to my face, and I say ‘It’s just estrogen.’”

Everybody seems to be talking about perimenopause and menopause, and that’s in many ways a good thing. Increased awareness about this often-stigmatized life phase, and the sometimes debilitating symptoms that can come with it, has made many women feel less alone in these mid-life trenches, where temperatures often spike suddenly and sleep can be hard to come by. It’s also helped them understand the range of treatment options, and advocate for themselves. But there comes a moment when we move from public health literacy (good!) to “wow, this is a really great market opportunity” (predatory?). A recent Wired report on the “perimenopause industrial complex” found that four leading telehealth startups in the space saw a 490% increase in web traffic from 2023 to 2026. Most of those companies do not accept insurance, charging up to $200 per month for custom hormone therapy in a variety of forms.

One of those forms: Skin-care creams with estrogen, purported to increase collagen and improve skin elasticity. The hormone-laced salves seem to be creeping toward a peak moment, with looksmaxxing and menopause influencers alike swearing that these formulas transformed their faces. Especially if you are a woman with a birthdate before 1990, a scroll through social media might be enough to convince you that slathering estrogen on your skin is commonplace. However, in our reporting, it was tough to find anyone outside of the professional social media creator career track who wanted to chat about their experience doing so. So first things first: Whatever the algorithm would have you believe, not all mid-life women with glowy skin have added estrogen-infused products to their skin-care routine.

Those who have made the addition are availing themselves of one of two types of estrogen commonly used in topical creams: estradiol and estriol. Estradiol is the “stronger” version, meaning it binds more strongly to estrogen receptors and generally produces more potent effects than estriol, the “weaker” one. Vaginal estrogen cream is a well-studied treatment for vaginal dryness, typically formulated with 0.01% estradiol, and frequently prescribed by gynecologists for women during the menopause transition. Estrogen skin-care creams are more commonly formulated with estriol (usually at 0.3%) and will always also include typical skin-care ingredients, such as hyaluronic acid.

But experts say more estrogen isn’t always better. Some of the doctors who spoke to Allure for this story voiced concerns that it comes with an elevated cancer risk. One recent review of existing clinical data on topical estrogen for skin care found “most controlled trials failing to demonstrate reproducible improvements in visible aging” while "safety data remain inconclusive.” Ultimately, the study's authors advised clinicians to “use caution” when deciding whether to recommend these estrogen-infused skin-care creams to their patients.

Nevertheless, it’s not hard to get some if you want it. Some dermatologists prescribe estrogen skin cream off-label via compounding pharmacies, or you can use a telemedicine platform like Musely, Alloy, or Midi to order it yourself. But should you?

Meet the experts:

• Jacqueline Marecheau, MD, is a board-certified ob/gyn and chair of obstetrics and gynecology at Episcopal Health Services in New York City
• Emily Lebowitz, MD, is a board-certified dermatologist in New York City
• Corinne Erickson, MD, is a board-certified dermatologist in Atlanta.
• Justine Park, MD, is a board-certified pediatric and cosmetic dermatologist in Thousand Oaks, California
• Debra Jaliman, MD, is a board-certified cosmetic dermatologist in New York City
• Viktoryia Kazlouskaya, MD, is a double board-certified cosmetic and medical dermatologist and hair loss specialist at Dermatology Circle in New York City
• Kelly Dobos is a cosmetic chemist and educator based in Cincinnati, Ohio

How Estrogen—and a Lack of It—Affects the Skin

Estrogen works hard for us. It doesn’t only regulate our menstrual cycles, it also affects our hearts, our bones, our brains, and, yes, our skin, says Jacqueline Marecheau, MD, chair of obstetrics and gynecology at Episcopal Health Services in New York City. It’s no wonder that perimenopause, when estrogen ebbs and flows before periods stop for good, can wreak so much physical and mental havoc.

On the epidermal front, estrogen helps maintain the thickness and elasticity that make our skin look firm and bouncy. The hormone is one of the things that lights a fire under our fibroblasts (the cells that create collagen), and it also helps hold on to the collagen we already have, board-certified dermatologist Mona Gohara, MD, an associate clinical professor of dermatology at Yale School of Medicine, has explained to Allure. That’s why estrogen and collagen tend to wane in tandem: “There’s evidence that collagen levels start to decline very gradually even before menopause occurs,” says Emily Lebowitz, MD, a board-certified dermatologist in New York City. This decrease goes from gradual to sharper dropoff as you enter perimenopause. “Once this transition of menopause is complete, a woman may have lost up to 60 to 70 percent of the collagen that she had in her youth,” New York City-based board-certified dermatologist Melissa Levin, MD, previously told Allure. As estrogen and collagen decline, elasticity decreases, contributing to thinner, looser, and more wrinkled skin. Dryness, as Kelly experienced, is another common side effect—as skin structure changes, it can lose its ability to hold water.

This dryness often affects the vagina. One of the most common perimenopause symptoms is genitourinary syndrome of menopause (GSM), which can cause thinning vaginal skin, vaginal dryness, and pain with sex. The primary treatment is menopausal hormone therapy (MHT), often referred to as hormone replacement therapy (HRT), which can come in the form of an estrogen patch, a pill, and/or a topical cream applied directly to the vagina (extra lube can help, too). While vaginal tissue and facial skin aren’t the same thing, they both contain estrogen receptors, which means hormonal shifts can affect them.

Forty-eight-year-old Laura Pucker, a Delray Beach, Florida-based content creator and digital marketing professional, started noticing significant changes to her face and neck when she entered perimenopause in her early 40s. She’d always had combination skin, but as her estrogen levels plummeted, it became dry and flaky, and she noticed sagging around her jawline and crepiness on her neck. “It got progressively worse as I got [further] into perimenopause,” she says.

Board-certified dermatologist Corinne Erickson, MD, has given this common group of hair- and skin-related symptoms a name: pilocutaneous syndrome of menopause (PSM). She hopes giving doctors this framework will help even non-menopause specialists identify when a patient’s complaint could be an early sign of perimenopause, and hopefully guide them to treatment earlier. “When you have a name, you have a stronger ability to do research,” she says. “You have a framework and a foundation to talk to patients.” She’s published her findings online as a whitepaper and has submitted it for peer-reviewed publication.

Estrogen facial creams could, in theory, be one of the treatments doctors armed with that framework might recommend. The idea behind estrogen facial creams is similar to hormone therapy (but make it skin care). Those aforementioned estrogen receptors mean that, theoretically, applying estriol to the face could address these issues by stimulating the production of collagen, says Viktoryia Kazlouskaya, MD, a board-certified dermatologist and hair loss specialist at Dermatology Circle in New York City. “But in reality, we don’t have that much data yet,” she says. As a result, doctors have differing opinions about whether topical estrogen is a safe—or even effective—option for tackling menopause-related skin changes.

What We Know (and Don’t Know) About Estrogen Skin Care

There are two main (and opposing) concerns about this new spate of estrogen skin-care products. One, that you might be absorbing more estrogen than is considered safe into your bloodstream. Two, that you might not be absorbing any estrogen at all from the cream, rendering it a useless-but-expensive addition to an already effective formula. (It’s almost definitely useless to anyone who isn’t in perimenopause yet, Dr. Erickson says: “The estrogen needs to be replacing something that’s lost for it to have benefit.”)

While estrogen has many protective effects—including reducing the risk of osteoporosis and heart disease—the conversation around hormone therapy is nuanced. Taking too much estrogen for too long, for example, has been linked to an increased risk of breast cancer, although the incidence is rare and similar to the risk profile of other commonly-prescribed drugs. “There’s still the question of how much absorption is considered safe,” says Dr. Marecheau.

Hormone therapy—including the estrogen patch, pill, and vaginal cream—is FDA-approved for managing symptoms of perimenopause and menopause. Estrogen, which Dr. Kazlouskaya says the FDA classifies as a drug even if it’s being used in facial skin care, is not approved for treating wrinkles or other age-related skin conditions. The women who are using these estrogen creams are all getting them through prescription at a compounding pharmacy; by law, compounded medications are not FDA-approved and do not have to go through any pre-market safety testing. According to a 2025 paper published in the Journal of Cosmetic Dermatology, “peer-reviewed and FDA-reviewed data on [topical estriol cream’s] safety and efficacy in facial applications remain limited.”

Hormone therapy typically contains estradiol, while estrogen skin-care creams are usually formulated with the weaker version, estriol. According to Dr. Lebowitz, one could extrapolate that if the stronger vaginal cream doesn’t cause systemic absorption of estrogen, the weaker facial cream may not, either. “But the academic answer is we still need more studies,” she says.

Unlike with the FDA-approved hormone therapy products—which have been studied to determine dosing, absorption, and systemic estrogen exposure—it’s hard to know exactly how much estrogen you’re absorbing from these facial creams. While most estrogen creams label the percentage of active ingredients (for example, Musely’s product contains 0.3% estriol), it’s not clear how much of that estrogen actually gets absorbed by the body. “We don’t know with the skin creams how much you get,” says Debra Jaliman, MD, a board-certified cosmetic dermatologist in New York City. “That’s concerning because facial skin is the thinnest skin in the body, so it will absorb the estrogen much more than if you put a patch [somewhere else] on your body.”

Another point: Though a face cream’s percentage and form of estrogen are weaker, it’s applied to a greater surface area than in the vagina, says Kelly Dobos, a cosmetic chemist and educator based in Cincinnati, Ohio. Because of its molecular weight (300 grams per mole) and lipophilic (fat-loving) properties, plus the penetration enhancers at least some brands include in their estrogen skin-care creams, Dobos says it’s likely that the estriol in these formulas is getting through the skin barrier. However, she continues, if you store your cream in a spot where it’s exposed to heat and light or the container isn’t sealed well, those once-effective ingredients could degrade.

Given the lack of research, there’s also no official dosage for estrogen cream. If someone applies more of the cream, or applies it on thinner areas like around the eyes, or uses it for many years, they could unknowingly increase their risk of systemic estrogen. While Dr. Jaliman says she fields questions about estrogen skin cream from several patients a week, she won’t prescribe it because she’s concerned about the risk profile.

When the new telehealth skin-care brand Cottonball soft launched in January, it was selling a cream with 0.3% estriol to customers who reported perimenopause- and menopause-related concerns. However, when Allure reached out for comment for this story, a spokesperson for the brand said that the company had reviewed the most recent findings on the risk of systemic absorption from topical estrogen creams and decided to reformulate that product, called VX.3, with the input of “multiple experts, including dermatologists, chemists, and gynecologists” and “will begin promoting the treatment once we’ve created a new ingredient blend that ensures both safety and efficacy.”

Efficacy is, indeed, another big question. Users report a range of results: Kelly says the product was a game-changer for her skin, while Pucker says she didn’t see any noticeable results after two months of daily use (she’s since stopped using it). Even some creators being paid to love their estrogen creams are fairly measured when reporting their results, which include less reactivity and more hydration. The very limited research on estrogen facial creams is far less bullish. “There are small studies that potentially confirm the idea that there may be improved collagen synthesis, but this is all studied under the microscope,” says Dr. Kazlouskaya. “In real life, it’s not clear if it projects into cosmetic improvement.”

Monica Molenaar became an “estrogen activist by accidentally going into menopause at age 40,” when she had her ovaries prophylactically removed and started hormone therapy. It’s why she started Alloy, a telehealth company that specializes in providing various forms of hormone therapy to women in perimenopause and menopause. It’s also the company that came up as an ad partner most often when we were watching many (many) videos touting estrogen skin care on Instagram. Dr. Erickson is also a medical advisor for the company.

For Molenaar, topical estrogen was a miracle product and she feels frustrated by all this concern about safety. “Anyone who says that it’s unsafe probably really doesn’t understand the mechanism and all of the data that we have about estrogen generally,” she says. “I’m so mad about the misinformation that we’ve all been fed.” In an effort to combat what Molenaar sees as harmful levels of hesitation to prescribe topical estrogen, Alloy commissioned a randomized, double-blind, placebo-controlled study that compared the brand’s 0.3% estriol cream, 0.01% estradiol cream, and a placebo to examine efficacy and whether there would be an increase in estrogen levels in the subjects’ blood.

That study—which is currently being reviewed for journal publication—had results that let Alloy claim its estriol-based cream improves moisture, restores elasticity, and rebuilds collagen on the face, and it’s "clinically proven to improve firmness, bounce, and texture in 12 weeks—with 88% improvement in elasticity.” The study also found no statistically significant change in estriol levels in the blood from the baseline to week 12. There was a slight increase in estradiol levels, which Molenaar says the lab they used attributed to an error.

Other companies make similar claims about what their estriol creams can do. Still, it’s hard to know whether it’s estrogen or the well-studied moisturizing, plumping ingredients found in these creams—such as hyaluronic acid or glycerin—driving the change. “I think it’s the other ingredients that are really doing the work, and not necessarily the estrogen, until we have a better clue of if it’s penetrating the skin a sufficient amount,” Dobos says. “That’s something that would need to be tested and proven.” She reviewed the Alloy study and said the efficacy results were “not incredibly impressive, in my opinion” but thought the lack of higher levels of estriol or estradiol in the blood at the end of the study are “a positive, if we don’t want elevated levels of those compounds in the bloodstream.”

Chalene Johnson, a 57-year-old podcaster who lives in Miami Beach, Florida, first tried applying her vaginal estrogen cream to her face but didn’t like the texture, which she says didn’t sit well under makeup. Her primary care doctor recommended she try a skin-specific product from a compounding pharmacy, and she’s now been using one every morning and night for more than six months. Johnson likes that the product is affordable ($149 for a 90-day supply) and uncomplicated, and she’s noticed her skin “looks younger.” Johnson has always paid for the cream, though she recently took on Midi as an advertiser on her podcast because of her positive experience with the product. “If I look at pictures, I can see improvement,” she says. “But it’s hard to isolate that to one thing.” For example, she also quit drinking around the same time she started the cream, a lifestyle change that is widely understood to have a positive effect on your skin.

Even if it were safe and effective—currently a big if—estrogen cream, like any skin-care product, isn’t for everyone. Justine Park, MD, a board-certified pediatric and cosmetic dermatologist in Thousand Oaks, California, says she prescribes estrogen skin cream to patients about twice a week—but not without screening them first. Given concerns about long-term estrogen use, Dr. Park says she would never prescribe it to anyone under age 40, or to someone with a history of breast cancer. She also doesn’t recommend it for patients with certain skin conditions: Estrogen, she says, can worsen acne and melasma, a condition that causes dark patches on the skin. The product could also worsen rosacea. “Estrogen can affect blood vessels, and flushing can sometimes be a little more common in high estrogen states,” says Dr. Kazlouskaya.

What’s the Best Way to Improve Skin During and After Perimenopause?

Right now, research about the safety and efficacy of estrogen skin cream just hasn’t caught up to the evidence on other kinds of hormonal therapy. Of the doctors interviewed for this piece, only Dr. Erickson (who is on the medical advisory board of a company that sells estrogen cream) and Dr. Park currently prescribe it to their patients. But there are still lots of options to keep your skin looking younger—even ones that involve estrogen. For those in perimenopause or menopause, traditional hormone therapy could pose benefits to aging skin—and its risks and benefits are well-studied, to the point of FDA approval.

As far as skin care goes, “the great thing is there are other non-hormonal options that don’t raise a red flag at all,” Dr. Erickson says. Other topical treatments—such as retinoids, peptides, and vitamin C—are backed by years of research on safety and effectiveness. “There are so many things that make the skin look better,” says Dr. Jaliman. “It’s not [estrogen] or nothing.” The Cottonball spokesperson says that even when the company offered an estriol cream during its soft launch, more people in the perimenopause and menopause age range selected V1.X (which has more widely known ingredients like tretinoin, bakuchiol, and niacinamide). Dr. Park is a fan of Neutrogena Collagen Bank as an inexpensive over-the-counter solution for targeting age-related collagen decline with micro-peptides and bakuchiol, a plant-derived alternative to retinol. Retinoids are incredibly well-proven to strengthen and thicken skin, preventing age-related changes with consistent use. Over-the-counter strength retinoids—retinol or retinal—are a good first step. Dr. Kazlouskaya recommends SkinBetter Science AlfaRet or Avène Retrinal. For a more affordable OTC option, Dr. Lebowitz recommends ROC Retinol Correxion—or, for extra plumping, try a retinol cream with a humectant like hyaluronic acid (such as Cerave Skin Renewing Retinol Serum). For more dramatic results, you can get topical tretinoin with a prescription: Cottonball’s VX.1 and VX.2 creams both contain tretinoin and were more commonly selected by customers in the perimenopause/menopause age range than the estriol-infused VX.3 in the company’s soft launch phase, the rep reports.

Perimenopause can feel a lot like riding a rollercoaster—a sensation your algorithm has probably picked up on it. Before jumping to buy products that may not actually change your face (or ones that could actually make things worse), have a conversation with your doctor: Ideally, a specialist in this period of hormonal chaos. And by all means, if a doctor-approved treatment is making you feel better, go forth. But remember: Just because everyone’s selling something doesn’t necessarily mean that thing is worth buying.