Can Topical Estrogen Cream Cause Melasma?

If you’re one of the many women who struggle with melasma, a common skin condition characterized by patches of skin discoloration, you probably already know that it can be difficult to pinpoint its trigger. To help you better navigate your skin condition and get to the bottom of what could be causing it, take a look at this overview of melasma and how topical estrogen creams could be related.

What Is Melasma, and What Causes It?

Although melasma isn’t a medical concern, it can be a distressing cosmetic issue for many women. It is most commonly associated with the development of brown or grayish patches of skin on the face, forearms, chest, or neck, and can be caused or worsened by sun exposure, heat, and hormone fluctuations (American Academy of Dermatology). In fact, hormones are such a common melasma trigger that this condition is often referred to as “the mask of pregnancy,” as it tends to come and go along with the surge of pregnancy hormones.

A Case Study

In the past, hormone replacement therapy has been linked with melasma. This is because estrogen stimulates the cells that make skin pigment (melanocytes). For years we have known that estrogen causes melasma. A recent case study involving a patient who had been regularly using a topical estrogen cream shows that even topically applied estrogen can cause skin pigmentation and melasma. The case report, published in the Journal of Clinical and Aesthetic Dermatology, described a post-menopausal woman who had developed melasma only in the areas on her body where she was applying a prescribed topical estrogen cream.

This is the first known case report that demonstrates a link between topical estrogen and skin discoloration, even though there has been evidence of a connection between skin discoloration and systemic hormone replacement therapy for many years. Melasma or unwanted skin darkening be listed as a side effect on these types of products and this skin condition should be discussed prior to beginning any type of estrogen treatment.

How to Treat Melasma

If you have melasma and are currently using a topical estrogen cream, there are a few options that can help you clear your skin:

  1. Discontinue use of topical estrogen cream.
  2. Wear sun protective clothing on areas where estrogen cream is applied.
  3. Avoid sun exposure, and wear sunscreen every day.
  4. Avoid heat exposure because heat will also cause melasma
  5. Avoid strong peels and laser treatments to treat melasma. It may temporarily improve but it usually comes back worse in a few months.

You can also talk with your dermatologist about using topical antioxidants and skin-soothing and calming products to help improve the appearance of melasma (The Dermatologist). Depending on the severity of melasma, however, this condition can be challenging to treat.So far, the most effective method for getting rid of these brown spots on your skin is to be diligent about wearing sunscreen and avoiding prolonged sun exposure, especially during midday hours (Journal of Clinical and Aesthetic Dermatology) and using the proper skin care regimen for your skin type EVERY DAY.

In Summary

Topical estrogen creams are often prescribed to help alleviate menopausal symptoms. Estrogen also has an antiaging effect on the skin. However, you’ll need to weigh the pros and cons of continuing to use this treatment if it results in melasma.

If you have additional questions about melasma that aren’t answered here, feel free to drop us a line on our Facebook page, or find an STS-approved dermatologist in your area to help you better understand your specific treatment options.

Dr. Leslie Baumann, M.D. and her team at Baumann Cosmetic Dermatology believe in proof, not promises. World-recognized for both cosmetic and general dermatology, our treatment strategies rely exclusively on evidence-based, scientifically verified products and procedures that promote skin health and a natural appearance. We combine effective medical procedures with individualized instruction on proper skincare, nutrition, supplementation and lifestyle in order to maximize the health of the skin and body as a whole while minimizing the effects of aging. For more, visit Dr. Baumann’s blog for daily updates Monday through Friday, or inquire about an appointment through

September 13, 2017 Melasma