Your Estrogen Levels May Be Affecting Your Skin Health

Ever noticed that your skin seems to break out at the most inopportune times? Whether you're dealing with dry patches or persistent pimples, complexion woes are the worst, especially when they seem to coincide with big events. "Any type of stress can manifest in your skin since it's the largest organ in the body. Stress can increase cortisol levels which in turn increases inflammation," Dr. Lara Devgan tells Vogue. 

Although stress is one of the most well-known triggers of inflammation, you may be surprised to learn that cortisol isn't the only antagonist behind your breakouts. It turns out that estrogen may be to blame for many of your skin concerns. Shifts in estrogen are typically associated with the onset of menopause, but hormone imbalances can appear at virtually any age. If topical treatments aren't doing the trick, you may want to consider your estrogen levels. Now, let's take a closer look at estrogen's role in your skin's health and how to care for your complexion in the face of changing hormones.

If you're confused by how hormones work, you're not alone. There are dozens of hormones that support your endocrine system, but estrogen is one of the most vital to your skin's health. Estrogen works alongside other hormones like progesterone, cortisol, and testosterone — which you may already recognize if you've dealt with hormonal acne in the past. "It's the drop of estrogen and progesterone that happens right before [your] period starts that makes people break out," Dr. Eduardo Lara-Torre tells Teen Vogue. When hormones are unbalanced for prolonged periods of time, they can lead to distressing side effects, from cystic acne to hair loss.

Still, healthy estrogen levels are linked to radiant complexions. Per research published in the American Journal of Clinical Dermatology, estrogen is responsible for supporting skin health, from maintaining its moisture to supporting collagen production. "Estrogen aids in the prevention of skin aging when at appropriate levels, and it's for this reason that the features of aging skin appear as we get older," Dr. Rachel Westbay tells InStyle.

It's no secret that hormones play a role in the formation of acne. Many of us can trace our earliest bouts with pimples to the beginning of puberty when wildly fluctuating hormones wreak havoc on sebum production. Hormonal acne can begin during the teenage years, but in some women, persistent breakouts can last well into menopausal age. "Acne lesions focused around the jaw and chin areas are tell-tale signs [of hormonal acne]. A history of 'flaring' acne that coincides with menstrual cycles — especially periods that are particularly long and painful — is also a helpful clue," Dr. Andrew Krakowski tells Practical Dermatology. This type of acne may seem unresponsive to topical treatments and is often characterized by deep, cystic pimples and lingering hyperpigmentation.

Research published in the Journal of Clinical and Aesthetic Dermatology states that estrogen can suppress sebum and testosterone production, potentially alleviating hormonal acne. For this reason, patients with hormonal acne are often treated with birth control pills that contain a form of estrogen and progestin. Unfortunately, an imbalance of either hormone can potentially lead to breakouts, too. "The hormones that cause [hormonal] acne are fluctuations of estrogen and progesterone, which both vary widely throughout the menstrual cycle," Dr. S. Manjula Jegasothy tells Self. Everyone reacts differently to hormonal therapy for acne, so it may take some trial and error to choose the right treatment. Fortunately, there are several oral contraceptives and interventions available, so your doctor can help you choose which is best for you.

As you likely already know, collagen is one of the most talked-about ingredients in skincare, whether used topically or in dietary applications. Collagen is a protein that's associated with firm, resilient skin, and estrogen plays a role in its formation. "High estrogen levels often correlate to high collagen levels, and vice versa. Think about the 'glow' we speak about when women are pregnant — that's caused by high estrogen levels. As we age, both collagen and estrogen levels fall, causing changes to our skin," Dr. Geeta Yadav tells People.

The signs of estrogen deficiency can strike at any age, but they're most commonly seen in women entering menopause. "Estrogen-deficient skin can be characterized by dryness, wrinkling, thinness, and itching. Interestingly, many women don't associate that with menopause, just with getting older," Dr. Diane Berson told The Dermatology Times. Other physical symptoms of estrogen deficiency include slow wound healing and sagging skin, per research published in the International Journal of Women's Dermatology.

One of the easiest ways to gauge your skin's health is by observing how hydrated it is. What's more, identifying dry skin goes beyond looks; it can often feel tight, uncomfortable, or itchy. Since estrogen is closely linked to collagen and sebum production, it makes sense that the hormone can affect the moisture content of your skin. "Low estrogen levels may be associated with slow skin cell turnover, impaired skin barrier function and pH, and decreased collagen production. This translates to dry, dull skin, fine lines, wrinkles, and lax skin," Dr. Joshua Zeichner tells Refinery29. 

When you're well-hydrated, estrogen supports your skin by encouraging healthy levels of essential compounds in the dermis and epidermis. A study published in Phytotherapy Research showed that estrogen was required to produce hyaluronic acid and glycosaminoglycans, two lubricating substances in the body that help the skin retain moisture. If your estrogen levels are out of whack, you may notice drier, duller skin than usual.

As you get older, your estrogen levels naturally begin to decline — and while the process may not be linear, it can have some undesirable effects on your skin. "Mature skin tends to be estrogen-deficient, making it more prone to irritation, dryness, and a dull look," Dr. Jessie Cheung told AARP. One study published by the medical journal Dermato Endocrinology revealed that collagen production can decline "as much as 30% in the first five years after menopause", leading to rapid changes in the skin's thickness and appearance. 

The pronounced signs of aging that accompany declining estrogen can also be due in part to the fact that estrogen provides natural protection against damaging UV rays, per research published in Clinical Interventions in Aging. To counteract this, experts suggest that you always wear daily skincare products containing a broad spectrum SPF of at least 30. "Regular sunscreen use by young and mid-aged adults under 55 brings cosmetic benefits and also decreases the risk of skin cancer," Dr. Adele Green told CNN.

Several factors can lead to estrogen imbalance, like excess stress, an unhealthy diet, or endocrine disorders. The signs of estrogen deficiency can vary depending on the individual, but common things to look out for in your skin include dryness, sensitivity, flushing, and redness. "Skin can become drier and have a loss of elasticity that leads to sagging and more pronounced lines and wrinkles," Dr. Loretta Ciraldo tells CNN. Depending on your skin type, you may notice increased hyperpigmentation or melasma as a result of declining estrogen levels.

It's important to note that symptoms of estrogen imbalance can mimic other conditions. Before you seek treatment for estrogen dominance or deficiency, make sure you speak with your doctor or specialist regarding hormone testing. While there are many at-home hormone testing kits on the market, they may not always be reliable. "Find a doctor that can advise, interpret, and recommend a course of action to take based on [at-home hormone testing kit] results," Dr. Kerri Masutto tells Well + Good.

Perhaps you've taken tests and consulted with your doctor but still find yourself battling skincare troubles caused by estrogen imbalance. In that case, experts suggest that you turn to topical skincare actives like retinoids to address waning collagen levels and their accompanying side effects. "I can't think of anything better for fighting aging and acne than a retinoid. Prescription creams stimulate collagen production to smooth out fine lines and wrinkles, exfoliate surface skin, and fade brown spots," Dr. Sumayah Jamal tells WebMD. Of course, you'll want to supplement with an SPF-containing day cream or sunscreen, as retinoids can cause increased sensitivity to sun exposure.

Another way to combat decreased collagen is through topical treatments containing collagen peptides or oral collagen supplements. While some claim that dietary collagen has little effect on your skin, continuing studies suggest otherwise. Research published in Skin Pharmacology and Physiology demonstrated that elderly women who received oral collagen supplements had significantly improved skin elasticity compared to a placebo group. Strides are constantly being made in the field of skincare research, and we may soon see products that can more effectively address declining estrogen and collagen levels.