Can Oestrogen Really Reverse Skin Ageing? MC Investigates Beauty’s Next Hormonal Frontier

Hot flushes, night sweats and brain fog aren’t the only unwelcome side effects of perimenopause. Declining oestrogen levels can also accelerate changes in the skin, from collagen loss and wrinkles to a noticeable decline in elasticity. For decades, the beauty industry has focused on finding ways to treat these visible signs of ageing, but what if the answer lies in addressing the hormonal changes behind them? With topical oestrogen emerging as a potential answer to reversing ‘menopause face’, and hormone-based skincare becoming increasingly accessible, Marie Claire investigates whether it really represents a breakthrough in skin ageing—or whether the hype is running ahead of the science.

What Does Oestrogen Actually Do to Your Skin?

Oestrogen is actually a group of three hormones—estradiol, estrone and estriol—produced primarily by the ovaries. While best known for regulating the menstrual cycle and fertility, it also plays a crucial role in skin health. “It prompts fibroblasts, the cells in the deeper layer of the skin, to make collagen and elastin, which give skin its firmness and bounce, and slows the breakdown of the collagen you already have,” explains Dr Toni Burke, Co-founder of Skin Prescribed and Fitzrovia Clinic. “It boosts hyaluronic acid, which keeps skin plump, and helps maintain the barrier that keeps moisture in and irritants out.”

It’s a connection most of us give little thought to until perimenopause, when fluctuating oestrogen levels can contribute to everything from dryness and thinning to acne and pigmentation. Perhaps most significant, however, is the impact on collagen. Research by Dr Mark Brincat at the University of Malta suggests that postmenopausal women lose an average of 2.1 per cent of their skin’s collagen each year.

Can Topical Oestrogen Really Reverse Skin Ageing?

If declining oestrogen contributes to collagen loss, surely replacing it could help slow the visible signs of ageing? It’s a theory gaining traction amongst beauty-focussed creators on social media, and women are increasingly experimenting with topical oestrogen in pursuit of firmer, plumper skin.

There is some science behind the idea. Studies suggest that systemic hormone replacement therapy (HRT) can improve skin hydration, collagen, thickness and elasticity, although the evidence specifically relating to facial skin remains limited. “But not every woman benefits equally,” explains Burke, who points to the established use of vaginal oestrogen alongside systemic HRT as a possible argument for more targeted treatment.

Miriam Martinez Callejas, Chief Clinical Pharmacist and Co-founder of Roseway Labs, highlights a small, double-blind trial involving 54 women, which found that an oestrogen cream improved skin thickness and fine wrinkles more than a hormone-free equivalent over 24 weeks. “That matters because it suggests an effect beyond moisturisation alone,” she explains.

But not everyone is convinced. “When it comes to applying oestrogen to the face rather than the vulvovaginal area, the evidence is very limited and what is available is not particularly strong,” says Dr Emma Craythorne, Consultant Dermatologist and Founder of Klira. More concerningly, she explains that topical oestrogen can be absorbed into the bloodstream, potentially producing systemic effects rather than acting exclusively on the skin.

Unlike conventional skincare ingredients, oestrogen comes with important medical considerations, particularly for women with certain hormone-sensitive cancers or a history of blood clots. And while Martinez Callejas says the intention is for the hormone to act locally, she acknowledges that without testing the finished formulation, its systemic absorption cannot be quantified.

It's why Burke insists that prescribing is never automatic. “We look at each woman’s overall risk, and there are clear reasons we wouldn’t prescribe, such as a history of breast, womb or other oestrogen-sensitive cancer, unexplained vaginal bleeding, or pregnancy.”

The Problem With Putting Vaginal Oestrogen on Your Face

Of course, not everyone has the means to see a private doctor for a bespoke prescription face cream. Instead, a growing number of women are taking matters into their own hands, applying their prescribed vaginal oestrogen cream (typically formulated with estriol, a less potent form of oestrogen) directly to their faces.

But just because something is safe for one part of the body doesn’t mean the same applies elsewhere. “A prescription for vaginal oestrogen is not a prescription for facial rejuvenation,” warns Dr Tiina Meder, cosmetic safety expert and founder of Meder. “There is no established facial dosing or long-term safety protocol for this practice.”

Despite this, dermatologists, particularly in the US, are advocating the practice on Instagram and TikTok, alongside women sharing glowing testimonials about plumper, smoother skin. The problem? Anecdotal results are no substitute for clinical evidence, particularly when we’re dealing with hormones.

There are practical considerations, too. Vaginal oestrogen creams are often thick and occlusive, designed to remain in place rather than sit comfortably beneath make-up. On the face, particularly with frequent application, they may contribute to congestion, milia and breakouts.

Certain skin conditions also warrant extra caution, whether you’re using a dedicated facial oestrogen cream or repurposing a vaginal prescription. “Melasma is the one condition we’re most careful with,” explains Burke. While there’s no conclusive evidence that topical oestrogen causes melasma, hormonal changes combined with UV exposure can exacerbate pigmentation in those already prone to it. Rosacea may also be a concern, with some studies linking systemic HRT to an increased risk of the condition.

And for anyone hoping to get ahead of the ageing process, there’s another important caveat. “There's no evidence it slows ageing in younger women whose oestrogen levels are still normal,” cautions Burke. In fact, research into topical oestrogen outside of perimenopausal and postmenopausal skin is virtually non-existent.

So, Is Topical Oestrogen Actually Worth It?

The growing interest in oestrogen-based skincare is undoubtedly encouraging for women whose needs have historically been overlooked by the beauty industry. But excitement isn’t evidence. Particularly when, as Burke admits, the most noticeable improvements tend to be in hydration and overall skin quality. “Fine lines can look a little less obvious and skin slightly plumper, but we’re not talking about wrinkles disappearing.”

Which begs the question: is it worth experimenting with prescription hormones when the supporting studies remain small and, in some cases, lack adequate controls? Especially when established skincare ingredients such as retinoids, vitamin C and niacinamide already have considerably stronger evidence behind them.

There are also hormone-inspired alternatives. Phytoestrogens, plant-derived compounds found in ingredients such as soy and resveratrol, can interact with oestrogen receptors and may help support collagen production, elasticity and hydration. Products such as Meder Vita-Long Serum, £145, and Lixirskin Night Switch Phytoestrogen & Peptide, £35, use these ingredients to address some of the visible changes associated with menopause, although their cosmetic effects shouldn’t be confused with those of HRT.

“More robust evidence demonstrating meaningful and visible benefits would be needed before I would feel confident recommending topical oestrogen for facial skin,” says Craythorne. Meder agrees, warning against the growing trend for self-experimentation. “Women deserve better research, intelligent formulations and clear explanations of what a product can and cannot do. Menopause should not become another opportunity for fearmongering.”

Burke, however, argues that a lack of evidence doesn’t necessarily mean a lack of benefit. “The estriol studies we do have are encouraging, the biology makes sense, and estriol itself has been used for decades in vaginal treatments.” For her, the answer lies in careful prescribing rather than leaving women to experiment with products intended for entirely different purposes.

It’s also worth remembering that facial ageing involves far more than collagen loss. Changes in facial fat, bone and muscle all contribute to how we look as we get older, none of which can be reversed by a face cream, hormonal or otherwise.

Ultimately, topical oestrogen is an intriguing area of dermatological research, but we’re some way from calling it a breakthrough. Until larger, more rigorous studies establish both its efficacy and long-term safety, claims that it can reverse ‘menopause face’ remain premature. And if you’re considering trying it, a conversation with a doctor specialising in menopause care should come before any prescription cream touches your face.