What Actually Happens to Your Skin When Estrogen Drops
I recently saw an article titled 'Retinol vs. Hyaluronic Acid: Which One Is Better?' and immediately knew it was missing the point. That's like comparing apples to oranges; one hydrates, the other boosts collagen. They're not even in the same category.
Here's the comparison that matters: estrogen vs. retinol. Because here's what most women don't know is that in the first five years after menopause, you lose up to 30% of your skin's collagen. And that's directly linked to estrogen deficiency.
As a former esthetician, clients would ask me how to get rid of fine lines and wrinkles. But that's the wrong question. The real question is: What builds, maintains, and protects collagen; and how does this change with your hormones.
If You're Over 40 and Your Retinol Isn't Delivering, Here's Why
Your collagen production is directly tied to your hormones, specifically estrogen. When your hormones are stable and your body is making plenty of estrogen, retinol can be incredibly effective at building and maintaining collagen as well as thickening your skin barrier. If your skin stays healthy and handles retinol well, you might find that's all you need.
But when hormones start to shift, whether that's during perimenopause, menopause, or due to other hormonal changes, your collagen production changes too. This can happen in your late 30s, your 40s, your 50s, or even later. It's completely individual. For some people, this is when they find skin laxity starts to happen, as estrogen is the key to maintaining skin structure and elasticity.
One important thing to note is that if your skin barrier is already damaged (signs include dryness, redness, irritation, and increased sensitivity), retinol won't repair it and could actually make things worse. A healthy skin barrier is essential for any collagen-boosting ingredient to work effectively.
Estrogen: The Hormone Your Skin Needs
Estrogen cream was first FDA-approved back in 1946 for vaginal conditions, and while it's been around for decades, using it on facial skin for anti-aging is a newer off-label application that's finally getting attention.
Here's why it's a game-changer: Estrogen works by stimulating fibroblasts to make more collagen and elastin. Studies show topical estrogen can thicken skin in months. When you apply it to your skin, it works directly in that area instead of going through your liver and bloodstream like an oral medication.
The good news is that research on vaginal estrogen has been really reassuring; recent studies show it doesn't increase breast cancer risk the way systemic hormone therapy can, as noted by experts like Dr. Mary Claire Haver, author of The New Menopause. However, facial application hasn't been studied as extensively yet, so we have less long-term data on this specific use. (Talk to your doctor, especially if you have a personal or family history of breast cancer or blood clots.)
Estrogen: Pros
- Directly stimulates collagen production at the cellular level
- Provides deep hydration and plumping effects
- Generally well-tolerated with minimal irritation
- Can improve skin thickness and elasticity
- Works synergistically with your body's natural hormone production
- No purging period or adjustment phase (yes, really!)
Estrogen: Cons
- Requires a prescription or consultation with a healthcare provider
- Limited availability and awareness among practitioners for facial use
- Facial anti-aging use is off-label with less research than vaginal applications
- Not right for everyone—discuss your medical history with your provider
Retinol: The OG Anti-Aging Superstar
Retinol, a vitamin A derivative, has been called the "fountain of youth." It speeds cell turnover and tells skin to act younger, boosting collagen production. Research shows retinol increases collagen and improves wrinkles in aging skin.
Prescription tretinoin (Retin-A) was first FDA-approved in 1971 for acne treatment, and it's still highly effective for that today. People soon noticed another benefit: it also reduced wrinkles, earning its place as the original anti-aging superstar. Over-the-counter retinol products, which convert to retinoic acid in the skin, followed and became popular soon after.
Retinol: Pros
- Widely available and extensively researched
- Multiple strengths and formulations to choose from
- Proven track record for anti-aging results
- Stimulates cell turnover and collagen production
- Can address multiple skin concerns (acne, fine lines, texture)
- Works for all ages and skin types (with proper introduction)
Retinol: Cons
- Can cause irritation, dryness, and peeling
- Requires careful introduction and strict sun protection
- Not suitable for sensitive skin types initially
- May worsen skin barrier function during adjustment period
- Can take 3-6 months to see results while dealing with side effects
My Personal Experience: The Retinol Struggle
I’ll be honest: retinol's dryness and irritation were brutal for me. When I was young, I didn't take care of my skin; I grew up without sunscreen and had no idea about retinol's benefits. Later, even as an esthetician, I discovered that strong skincare products weren't my friend. I still use a 'less is more' approach to this day.
I learned the hard way that maintaining healthy collagen requires more than just one ingredient. If your skin barrier isn't strong, even the best collagen boosters won't work well. They'll just make you (and your skin) miserable.
My Personal Experience: The Estrogen Win
Using estrogen cream has been transformative for my skin. I apply it at night, after smoothing the cream onto my face, I lightly mist with Biome Aid's Purifying Hypochlorous Mist and gently massage it in. The mist helps me work the thick cream into my skin more evenly, and the gentle massage action seems to encourage better absorption. By morning, my skin feels hydrated, plump, and smoother than it has in years.
If you've invested heavily in skincare without seeing real results, estrogen cream might be the missing piece you've been searching for.
The Head-to-Head Comparison
When you're in your 20s-30s: Retinol is the answer to keep your skin healthy and strong.
When you hit 40+: Estrogen might be the missing piece, especially if retinol makes your skin angry. When your hormones are changing, your skin may need support that retinol just can't provide.
The winner? It's not either/or... it's completely individual. Retinol builds and maintains when you're younger. Estrogen rescues and rebuilds when hormones decline. I just appreciate having options.
Tips for Success
For Both Ingredients:
- Always consult with a healthcare provider, especially during pregnancy, breastfeeding, or if you have hormone-sensitive conditions
For Estrogen Users:
- Apply at night when skin repair is most active
- Mix with a hydrating mist or serum to improve absorption
- Get your hormone levels tested first to understand your baseline
- Start with the lowest effective dose
- Timeline: Most people see initial hydration and plumping within 2-4 weeks, with more significant collagen improvements after 3-6 months
For Retinol Users:
- Start with 0.25% strength and use only twice a week initially
- Apply to completely dry skin 20 minutes after cleansing
- Use a moisturizer on top if needed
- Never skip sunscreen the next day
- Be patient; it takes 3-6 months to see results
Where To Get Estrogen Cream?
Your options:
- Dermatologists - Some are familiar with topical estrogen for skin aging
- Gynecologists or hormone specialists - Often more knowledgeable about estrogen therapy
- Functional medicine clinics - May be most up-to-date on this application
You'll probably need a consultation and possibly hormone testing. Since many providers aren't familiar with this off-label use for facial skin, it helps to bring your own questions and research.
The Bottom Line
Now that my skin barrier feels the way it should, soft, supple, and a little moist, I might try retinol again, starting slowly and using it on alternate nights from my estrogen cream.
There isn't one answer that works for everyone. Your age, hormones, skin sensitivity, and lifestyle all play a role. If you're over 40 and struggling with your skin and using retinol, don't force it. There may be a hormonal issue that only estrogen can address.
The takeaway here is that our skin reflects what's happening inside your body, and true skin health goes deeper than the latest trending products. It's about supporting your body from within.
Medical Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Facial use of topical estrogen for anti-aging is off-label and has less research than FDA-approved vaginal estrogen. While vaginal estrogen has shown a favorable safety profile in studies, always consult with a qualified healthcare provider before starting any hormone-based therapy to discuss your individual risk factors.