Podcast Summary: Episode 157 – "The Truth About Topical Estrogen for Skin Aging"

Date Released: August 23, 2024

Introduction In Episode 157 of The Treatment Room, host Tessa Zolli welcomes Jan Marini, founder of Jan Marini Skin Research, to discuss the burgeoning topic of topical estrogen in skincare. The conversation delves into the benefits, risks, and ethical considerations surrounding the use of estrogen creams for combating skin aging.

What is Estrogen and Its Role in Skin Health Jan Marini begins by explaining that estrogen is a steroidal hormone primarily associated with female reproductive functions. It plays a crucial role in developing female sexual characteristics, maintaining vaginal wall thickness, promoting lubrication, regulating the menstrual cycle, and stimulating egg follicle growth. Beyond reproductive health, estrogen significantly impacts skin health by maintaining dermal thickness, stimulating hyaluronic acid production, and preserving collagen levels.

Historical Context and Current Interest The interest in topical estrogen for skin aging resurged due to a study from the 1980s, which found that postmenopausal women using vaginal estrogen cream experienced a 40-60% reduction in pore size, smoother skin, increased plumpness, and enhanced hydration. Jan notes, “There was a study that they took females over the age of 60 that were postmenopausal and gave them a vaginal estrogen cream... there was a 40 to 60% lessening in pore size” (01:09).

Types of Estrogen Used in Skincare Estrogen used in skincare comes in three primary forms:

1. Estradiol (E2): The most potent and active form, commonly prescribed for hormone replacement therapy.
2. Estriol (E3): Weaker than estradiol, primarily produced during pregnancy.
3. Estrone (E1): Produced after menopause.

Derivation and Forms of Estrogen Estrogen can be derived from various sources:

• Premarin (Conjugated Estrogens): Derived from pregnant mare urine, commonly used in hormone replacement therapy.
• Bioidentical Hormones: Manufactured to be identical to the body’s natural hormones, often produced using bacteria or yeast as a base. Jan emphasizes, “Bioidentical hormones...compounded by pharmacists can be identical to your own hormones” (06:47).

Effects of Estrogen on the Skin and Aging Process Estrogen impacts the skin by:

• Stimulating Hyaluronic Acid Production: Enhances skin hydration and plumpness.
• Maintaining Collagen Levels: Preserves dermal thickness and reduces wrinkles.
• Reducing Pore Size: Tightens skin texture and minimizes large pores.
• Supporting Bone Health: Prevents bone resorption in the facial structure, maintaining youthful contours.

Jan points out, “When you put that estrogen on, it can help maintain dermal thickness, stimulate hyaluronic acid... it helps to maintain... mucopolysaccharides, the ceramides, the phospholipids” (09:15).

Changes During Perimenopause and Menopause Perimenopause (ages 37-39) and menopause (average ages 49-51) mark significant drops in estrogen levels, leading to:

• Increased Collagen Loss: Accelerates skin aging, thinning dermis, and wrinkle formation.
• Skin Texture Changes: Transition from an anabolic to a catabolic state results in decreased skin elasticity and increased dryness or oiliness.
• Facial Fat Loss: Reduces facial volume, contributing to a saggy appearance.

Jan elaborates, “From about 20, you're going to lose 1 to 2% [collagen] a year... In perimenopause... collagen loss can jump to almost 5% a year” (14:35).

Pros and Cons of Topical Estrogen Pros:

• Reduces Skin Dryness: Topical estrogen can decrease skin dryness by 29-33%.
• Minimizes Wrinkles: May reduce facial wrinkles by 22-24% over time.
• Increases Hyaluronic Acid: Enhances skin hydration and plumpness.

Cons:

• Systemic Absorption Risks: Potential absorption into the bloodstream may pose risks, including reproductive or breast cancer, though studies are inconclusive. Jan states, “There are some studies that say, yes, it could possibly be implicated in [breast or reproductive cancer]” (23:03).
• Limited Immediate Effects: Significant wrinkle reduction may take up to 24 months of consistent use, which may deter users expecting quicker results.
• Does Not Address Sun Damage or DNA Instructions: Estrogen cannot reverse existing sun damage or correct DNA-related skin issues. “Estrogen does not reverse sun damage... it does not manage facial discoloration” (25:33).

Comparison with Other Skincare Treatments Jan contrasts topical estrogen with other proven skincare treatments:

• Retinoids: The gold standard for acne, discoloration, rosacea, and aging. They can thicken the dermis by up to 80% within a year, correcting DNA instructions for skin renewal.
• Glycolic Acid: Thins and compacts the stratum corneum, stimulates glycosaminoglycans, and reduces inflammation, thickening the dermis by about 33%.
• Siesta Serum & Transformation Cream: Advanced formulations that address muscle tone, collagen production, and DNA repair, offering more comprehensive and quicker results compared to estrogen.

Jan emphasizes, “Retinoids correct instructions coming from your DNA... retinol thickens your dermis by 80%” (27:52).

Phytoestrogens and Age Intervention Cream Jan highlights the benefits of phytoestrogens—plant-based estrogens found in soy and red clover. Her company’s “Age Intervention” cream combines phytoestrogens with other active ingredients to:

• Enhance Moisturization: Users report a “significant difference in terms of the moisturization of the skin” (36:45).
• Boost Immune Function: Contains Interferon Alpha 2B, which can enhance the skin’s immune response.
• Repair DNA Damage: Includes algae-derived compounds that can repair up to 47% of DNA damage.
• Protect Against Cancer: According to the National Institute of Cancer, phytoestrogens can block harmful estrogens and are protective against breast and reproductive cancers.

Ethical Considerations in Selling Topical Estrogen Jan addresses concerns about the ethical implications of selling topical estrogen over the counter:

• Potential for Misuse: Online companies may not adequately screen users for contraindications, posing health risks.
• Lack of Regulation: Easy accessibility without proper medical oversight can lead to inappropriate usage.
• Market Hype: The surge in popularity may overshadow the nuanced understanding of estrogen’s benefits and risks.

Jan warns, “You have to really kind of read through all the hype... are these the things that I want to address?” (44:28).

Future of Estrogen in Skincare Jan predicts that while topical estrogen is currently trending, it may eventually be supplanted by emerging technologies such as exosomes and advanced peptides. However, she advocates for a balanced approach, integrating estrogen with other proven treatments like retinoids and glycolic acid for optimal skin health. “Phytoestrogens... have something in there that maybe makes the skin feel a little bit better, but you just kind of have to put it in perspective” (50:36).

Conclusion The episode underscores that while topical estrogen can offer benefits for skin aging, it is not a standalone solution. Comprehensive skincare requires a multifaceted approach, incorporating proven treatments like retinoids and glycolic acid alongside supportive agents like phytoestrogens. Jan Marini advises listeners to consult with healthcare professionals before starting estrogen therapy and to critically evaluate the myriad of skincare options available to address specific skin concerns effectively.

Notable Quotes

• Jan Marini (01:09): “There was a study that they took females over the age of 60 that were postmenopausal and gave them a vaginal estrogen cream... there was a 40 to 60% lessening in pore size.”

• Jan Marini (14:35): “From about 20, you're going to lose 1 to 2% [collagen] a year... In perimenopause... collagen loss can jump to almost 5% a year.”

• Jan Marini (23:03): “There are some studies that say, yes, it could possibly be implicated in [breast or reproductive cancer].”

• Jan Marini (27:52): “Retinoids correct instructions coming from your DNA... retinol thickens your dermis by 80%.”

• Jan Marini (36:45): “Users report a significant difference in terms of the moisturization of the skin.”

• Jan Marini (44:28): “You have to really kind of read through all the hype... are these the things that I want to address?”

This comprehensive discussion provides estheticians and skincare enthusiasts with a balanced perspective on the use of topical estrogen, highlighting its potential benefits and inherent risks, and emphasizing the importance of a holistic approach to skin health.