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Vaginal estrogen cream is prescribed to ease genital dryness, irritation and discomfort that results from the loss of estrogen during menopause.
The name tells you exactly where to put it. Yet a new trend has been making the rounds on social media. People are calling vaginal estrogen cream the new “filler” for the face and other body parts, claiming it can smooth wrinkles, reduce dryness and sagginess and plump up the skin.
“Patients are definitely asking about this, usually after seeing videos on TikTok or Instagram,” says Dr Oma Agbai, associate clinical professor of dermatology at the University of California Davis School of Medicine. Online, people suggest “applying it to the face, particularly around the eyes, mouth, neck, and chest, and some are also using it on areas like the thighs, buttocks or abdomen”.
“A small number of patients admit they’ve tried it,” Agbai says. “Some report their skin feels less dry or slightly softer. That’s not surprising, because estrogen is known to affect skin hydration. But subjective improvement doesn’t equal proven safety or long-term benefit.”
The Food and Drug Administration, which regulates the safety and efficacy of drugs, has not approved these creams for use anywhere on the body other than the vagina, and the American Academy of Dermatology does not include them among acceptable facial fillers or as a treatment for wrinkles and dryness.
However, once the FDA approves a medicine for a specific purpose, it is not uncommon for physicians or patients to engage in so-called “off-label” uses.
We asked experts what science has to say about the trend.
Should you use vaginal estrogen cream on your face?
It seems logical that vaginal estrogen might help facial skin, since the body’s natural estrogen helps stimulate the skin’s collagen production. It also increases hyaluronic acid, which promotes hydration, and enhances elasticity and dermal thickness. When estrogen declines at menopause, skin can age, thin out and become dry.
“The biology makes sense, so the concept isn’t coming from nowhere,” says Dr Adam Friedman, professor and chair of dermatology at the George Washington University school of medicine and health sciences.
But many experts do not recommend this off-label use.
“This is far from a simple answer with limited support by evidence, which is why I am not a fan,” says Friedman.
Theoretically, “one could have an improvement in markers of skin aging,” says Dr Maral Skelsey, clinical professor of dermatology at Georgetown University’s school of medicine and director of the Dermatologic Surgery Center of Washington. “But we really don’t know how and where to use it and what it’s going to do.”
Dr Ellen Gendler, a cosmetic dermatologist and clinical associate professor of dermatology at NYU Langone medical center, says that using a little bit of vaginal estrogen cream around the eyes likely won’t hurt; she herself uses it on the undereye area and advises applying just “a tiny dot”. But she doesn’t recommend using it on the entire face, or on other areas of the body.
Research on using vaginal estrogen cream as skincare is scarce, although several small, short-term studies suggest positive results.
One 1994 trial of conjugated estrogen (Premarin) cream applied nightly for 24 weeks showed a statistically significant increase in skin thickness and improvement in fine wrinkles compared to a placebo, according to Friedman. In a 2008 study, topical estradiol (a form of estrogen) increased total collagen content in abdominal skin by 38% after three months and increased procollagen (the precursor to collagen) in hip skin by 58%, he says.
“But vaginal estrogen as a face filler’? I think not,” Friedman says, describing the clinical data for topical estrogen on facial aging as “limited, heterogeneous, and not a green light for do-it-yourself repurposing of genital formulations”.
Agbai agrees. “What we need are larger, long-term studies evaluating safety, dosing and cancer risk before any widespread recommendation could be made,” she says.
What are the possible risks?
“The potential downsides are real,” Agbai says.
It’s possible for topical estrogen to circulate to other areas of the body via the bloodstream, known as systemic absorption – “especially when used on large surface areas, thin skin, or over long periods of time”, she says.
“That raises concerns about hormonal side effects such as breast tenderness or abnormal bleeding, and theoretical risks in estrogen-sensitive conditions like breast, ovarian or endometrial cancer, particularly in higher-risk individuals.”
“Systemic absorption is not hypothetical,” Friedman says. “The FDA’s prescribing information for estradiol vaginal cream explicitly states that systemic absorption may occur.”
They agree that absorption is likely “minimal” but not zero if the cream is applied to small areas on the face. “It depends on how much you use and in what areas of the body,” Skelsey says.
Applications to larger locations, such as the abdomen, thighs or buttocks, “are exactly the scenarios where caution is needed”, Agbai says.
Gendler does not recommend it for pre-menopausal women but believes there is no harm for perimenopausal or post-menopausal women who use it sparingly around their eyes.
“We know that local vaginal estrogen is safe and helpful in thickening the vaginal epithelium and, in my clinical experience over decades, it seems to have a similar effect in the thin delicate skin under the eyes,” she says.
Experts say it’s possible that users might develop a local reaction on the face, such as skin irritation or acne. If skin conditions like rosacea or melasma – a common, chronic disorder characterized by blotchy, brown-to-gray patches – are already present, they might get worse.
Are there safe and effective alternatives?
Yes. Dermatologists stress that there are many time-tested procedures and products for the skin which are safe and effective, with long-term scientific evidence supporting their use.
“The good news is that patients don’t need to experiment with vaginal estrogen to improve skin aging,” Agbai says. “We already have well-studied, effective options like prescription topical retinoids, daily broad-spectrum sunscreen, topical antioxidants such as vitamin C serum, barrier-repair moisturizers, and in-office treatments like lasers, microneedling, and injectables when appropriate. These treatments have strong evidence behind them and a much clearer safety profile.”
Estrogen-infused face creams are available over-the-counter or by prescription, and shouldn’t be confused with vaginal estrogen creams. “Some prescription or compounded estrogen-containing facial creams exist and may be used selectively under medical supervision,” Agbai says. “Even then, they are not first-line anti-aging treatments and are not appropriate for everyone, especially patients with hormone-sensitive cancer risks.”
The bottom line
Estrogen does help maintain collagen, elasticity, skin thickness and hydration. But many skin experts urge caution in considering off-label use of products that contain it.
“Using vaginal estrogen on the face or body is not evidence-based and not something I recommend,” Agbai says. “Using it off-label introduces safety concerns without any proven benefit.”
“The problem is formulation and dosing,” she adds. “Vaginal estrogen products are designed for a completely different tissue type and absorption profile. Something made for the vagina is not necessarily effective or safe for the face or other parts of the body and may increase systemic exposure in unpredictable ways.”
