Here’s why you may want to consider adding prescription topical estriol to your skincare regimen.
What is estriol?
Estriol is one of three forms of the hormone estrogen that our bodies naturally produce. While women have the most estrogen, it’s in men’s bodies too, just at much lower levels.
These are the three types of estrogen:
Estrone (E1) is weakest during a woman’s reproductive years, then becomes the dominant form of estrogen in menopause when estradiol plummets. The body can also convert estrone into estradiol when needed.
Estradiol (E2) is the most potent and abundant form of estrogen during reproductive years. It oversees the female reproductive system, along with playing a critical role in regulating body systems including the cardiovascular, neurologic, skeletal, and vascular systems.
Estriol (E3) is made by the placenta during pregnancy. Outside of pregnancy, estriol is still present in a woman’s body, just in very low, often undetectable levels.
What is the connection between estrogen and skin?
We think of estrogen as mainly impacting the reproductive system, but it also has a significant influence on the skin. “Estrogen helps promote the skin’s generation of elastin, collagen, and hyaluronic acid,” says Michael Krathen, M.D., a board-certified dermatologist in Natick, Massachusetts, and Chief Medical Advisor for Cottonball.
As our body transitions into menopause, we experience a sharp drop in estrogen, primarily estradiol. This typically begins in our mid-40s with perimenopause and can last up to a decade. “It can create an imbalance in the skin where collagen, elastin, and hyaluronic acid are no longer being produced as regularly and abundantly as they once were,” says Dr. Krathen.
As these core structural and hydrating components deplete, you may experience dry, rough-feeling skin with more noticeable wrinkles, crepiness, and sagging. You may also find that the skincare you’ve always relied on doesn’t seem to be as nourishing or effective as it once was.
Stop the menopause madness. Renewal for your skin, right this way…
This is partly due to the direct correlation between estrogen deficiency and loss of skin elasticity. In fact, up to 30% of skin’s collagen is potentially lost in the first 5 years after menopause (menopause officially begins when you haven't had a period for 12 consecutive months). From there, skin’s collagen continues depleting by about 2% a year, and skin thickness decreases by just over 1% per year.
There’s even evidence that estrogen may help protect skin cells against the oxidative damage caused by free radicals. When estrogen levels drop off in menopause, skin may become more susceptible to the aging effects of the sun’s UV rays, environmental pollutants, and other harmful elements.
How can prescription topical estriol benefit menopausal skin?
Now, the good news: Prescription topical estrogen products, and specifically ones with estriol, are helping women regain softer, smoother, firmer skin in menopause.
Available in face serums and creams (like Cottonball VX.3 Hormone Renewal Complex) at low concentrations, “topical estriol is shown to increase skin’s collagen,” says Dr. Krathen. “Clinical studies demonstrate that it helps reduce fine lines, increase skin thickness, and improve skin’s elasticity.”
In one study, women who applied 0.03% estriol on their face for six months had markedly firmer skin with improved elasticity and moisture levels and significant reduction in wrinkle depth and pore size. Their skin also showed a significant increase in collagen. Cottonball VX.3 Hormone Renewal Complex contains 0.03% estriol.
A key benefit of topical estriol is that in low concentrations, it delivers localized skin benefits with what most medical professionals consider little systemic absorption. That means it doesn’t appear to be significantly absorbed into the bloodstream and circulate throughout the body. Yet it’s shown to be just as effective as other types of topical estrogen at smoothing wrinkles, reducing pore size, and boosting skin’s moisture.
Are there any potential side effects of topical estriol?
Using 0.03% topical estriol on your face is generally considered safe, says Dr. Krathen. While concerns were raised two decades ago over whether certain forms of hormone replacement therapy can increase a woman’s risk of breast cancer, heart disease, and blood clots, more recent research has found that low-dose, non-oral hormone treatments pose little risk.
“There is new data that shows topical estrogens are considered safe for vaginal health, for example, in women with a history of breast cancer,” says Kavita Mariwalla, M.D., a double board-certified dermatologist and Mohs Surgeon in West Islip, NY. (As there is more opportunity for absorption through the vaginal lining than via face skin, the logical conclusion is that topical estrogens would be safe for application on the face.) “It is safer than creas containing estradiol or estrone.”
That said, if a patient has a history of hormone-positive breast cancer, “you want to talk to your oncologist before embarking on any skincare that has estrogen in it,” says Dr. Mariwalla, who was previously the director of cutaneous oncology at the Beth Israel Cancer Center in Manhattan. “I would recommend if you carry any genetics that predispose you to breast cancer, I would avoid estrogen-containing creams.” It’s equally important to speak with your doctor if you have other estrogen-related health issues, such as uterine or ovarian cancer or polycystic ovary syndrome (PCOS), before using an estrogen facial cream.
What’s the best way to use topical estriol?
Topical estriol is available only via prescription, which ensures you’re getting a product that’s potent enough to make a visible difference in your skin without being absorbed by your body.
Estriol is well-tolerated by most skin types, though some people may experience mild redness or sensitivity when they begin using the treatment. “In some people, it can cause redness and can increase the prevalence of broken blood vessels,” says Dr. Mariwalla. “If you have rosacea, it can potentially worsen it. It may also potentially give you some mild acne. Some patients will complain of burning and redness when starting estriol creams, but understand that this is a normal activity of the ingredient and does not mean they are allergic to it. It could just be that they are intolerant of it.”
Cottonball VX.3 Hormone Renewal Complex is customized to each person’s skin needs and can be formulated for sensitive skin to minimize any potential reaction.
The VX.3 Complex is gentle enough for daily use morning and night. Apply it to clean, dry skin before any other skincare. If you use anti-aging serums or products (including cleansers) that contains exfoliating acids such as glycolic acid, lactic acid, citric acid, or salicylic acid, avoid using at the same time as your estriol product. Instead, use your exfoliant in the evening, then wait until the next morning to apply the VX.3 Complex.
What other skincare works well with topical estriol?
In Cottonball VX.3 Hormone Renewal Complex, prescription estriol is combined with ingredients that maximize its hydrating, complexion-enhancing benefits. Hyaluronic acid attracts and holds in moisture for long-lasting hydration and a plumper, more supple complexion, while anti-inflammatory antioxidant resveratrol soothes and protects.
Then the formula is customized to your skin with the right level of skin-brightening, collagen-boosting vitamin C and, if you are dealing with hormone-induced acne, the ingredient azelaic acid. Together, this supercharged complex restores radiance, boosts skin’s elasticity, and deeply nourishes menopausal skin.
Estriol also pairs well with the prescription retinoid tretinoin, says Dr. Krathen. Both ingredients are proven to boost skin’s collagen and elastin growth, but they work through different mechanisms. “It would be like looking for a job using ZipRecruiter and Indeed,” explains Dr. Krathen. “Using two separate pathways to stimulate anti-aging is probably better than just one.” In other words, they’re a dream team for maintaining smooth, firm, even-toned mature skin.
Dr. Krathen notes that you can safely use both ingredients in the same regimen, and Dr. Kavita suggests that if you are going to use a moisturizer with tretinoin, to layer the moisturize on above it. You may want to consider adding Cottonball VX.1 Advanced Anti-Aging & Repair Complex, which delivers prescription tretinoin in a custom concentration for your skin along with rapamycin, another collagen booster; or Cottonball VX.2 Wrinkle-Smoothing & Prevention Complex, which offers prescription tretinoin in concentrations up to 0.10%.
With its proven ability to counteract menopausal skin changes, prescription estriol offers a safe, science-backed solution to help you reclaim a smooth, supple, glowing complexion.
Is prescription estriol right for you? Take this short quiz to find out.
RAISE YOUR INGREDIENT IQ
