Hypoestrogenism affects the skin, producing less hydration
and thinning the skin; therefore, its replacement, when
well prescribed, including hormones in topical formulations,
is effective in rehydration, collagen increase, and dermal
thickness.16
Long-term prospective, randomized, double-blind, placebo-controlled
studies on hormone replacement therapy in
women have shown that skin aging signs were reversed
and skin elasticity, hydration, and thickness were significantly
increased.67
Enhancing collagen production with topical estradiol
seems to be restricted to intrinsically aged skin51; however,
long-term studies to evaluate the safety of systemic HRT
for skin anti-aging purposes are necessary because
contraindication to HRT includes a history of breast cancer
or endometrial cancer, recent undiagnosed genital bleeding,
active severe liver disease, and a history of thromboembolism.
On the other hand, topical therapy with estradiol
preparations was reported to have significant anti-aging
effects and may therefore provide an alternative to
systemic therapy