Managing Estrogen-Deficient Skin: A Narrative Review on the Role of Hormone Replacement Therapy and Emerging Estrogen-Modulating Therapies

Estrogen deficiency due to menopause accelerates skin aging, affecting collagen, elasticity, and hydration. This review examines systemic hormone replacement therapy (HRT), topical estrogen, and emerging estrogen-modulating treatments for managing estrogen-deficient skin. While systemic HRT improves skin properties, its use is limited by risks like venous thromboembolism and breast cancer. Transdermal HRT offers a safer alternative, but systemic therapy is not recommended solely for skin benefits. Interest is growing in localized treatments like topical estrogen, SERMs, and phytoestrogens, which may improve skin quality with less systemic risk, though long-term safety and efficacy need further study. Future research should focus on dermatologic trials and personalized treatment strategies to enhance safety and effectiveness.