This is a question I get asked a lot by clients, particularly women over 40 navigating perimenopause and menopause. Many have begun using topical oestrogen gels to relieve menopausal symptoms, only to notice new moles or increased pigmentation appearing on their skin. Naturally, this can feel worrying and raises the question, is there a connection? Let’s explore what we know.

While the research is still emerging, clinical experience and available evidence suggest that yes, topical oestrogen can potentially influence skin pigmentation and even the appearance of moles especially when applied to sun-exposed areas.

As a registered nutritional and beauty therapist, I see skin changes like this regularly in clinic. And while every woman is different, there are some common patterns worth understanding.

Understanding the Link Between Oestrogen Gel and Skin Changes

Oestrogen plays a big role in skin health it’s involved in collagen production, elasticity, hydration, and pigmentation. When applied topically, oestrogen can have a more localised effect on the skin, influencing how it behaves in that area.

1. It Can Stimulate Melanocytes (Pigment-Producing Cells)

Melanocytes are the cells that produce melanin the pigment that gives our skin its colour. Oestrogen can stimulate these cells, and in some cases, this leads to hyperpigmentation. A published case study described a 47-year-old woman who developed melasma (dark patches) on her arms after applying oestrogen cream, reinforcing the idea that topical hormones can trigger pigmentation changes.

2. It May Increase Photosensitivity

Oestrogen can also make your skin more sensitive to UV radiation. This increased sensitivity means that when you're out in the sun even briefly you’re more likely to develop pigmentation, freckles, or even new moles. If you’re applying your cream to areas like your face, neck, or hands, which are regularly exposed to sunlight, this is particularly important to know.

3. Hormonal Changes May Influence Mole Formation

Hormonal fluctuations whether from puberty, pregnancy, or menopause can influence mole growth. While systemic (oral) oestrogen has been linked to changes in moles, topical oestrogen gels may also cause localised effects. Some women notice new moles or changes to existing ones in the areas where they apply their gel.

What the Research Says

There isn’t a large body of research specifically on oestrogen creams and new moles, but several studies offer valuable insights:

Melasma and pigmentation have been linked to both systemic and topical oestrogen use.
Topical oestrogen has been shown to stimulate collagen and affect skin cell turnover, which may impact pigmentation and mole development.
Cancer risk does not appear to be significantly increased by oestrogen cream, according to research from the Women’s Health Initiative, which showed no major link to melanoma or non-melanoma skin cancer.

What I Recommend to My Clients

If you're using a topical oestrogen gel and you've noticed skin changes, here’s what you can do:

1. Monitor your skin

Keep an eye on any new moles or changes to existing ones. Use the ABCDE method:

Asymmetry
Border irregularity
Colour variation
Diameter larger than 6mm
Evolving over time
If you notice anything unusual, always check with your doctor/dermatologist.

2. Use high-quality sun protection

Apply a broad-spectrum SPF 30 or higher daily to the areas where you use the cream. Wearing a wide-brimmed hat or covering up when outdoors also helps reduce UV exposure and pigmentation risk.

3. Think about where you apply it

If you're concerned about skin changes, speak with your healthcare provider about applying the gel or patch to areas that are less exposed to sunlight, such as the inner thighs or lower abdomen.

4. Get professional advice

Before making any changes to your routine, always consult your healthcare provider. They’ll be able to guide you based on your personal health needs.

HRT Patches and Skin Pigmentation

Hormone Replacement Therapy (HRT) patches are a convenient method for delivering oestrogen through the skin. Some women may experience skin reactions at the application site, such as redness or irritation. In rare cases, these reactions can lead to post-inflammatory hyperpigmentation, resulting in darker patches of skin where the patch was applied. To minimise this risk, it’s advisable to rotate the patch placement and apply it to clean, dry, and less sun-exposed areas of the body.

Melasma and Hormonal Changes

Melasma, often referred to as the “mask of pregnancy,” manifests as brown or gray-brown patches, typically on the face. This condition is closely linked to hormonal fluctuations, including those experienced during pregnancy, oral contraceptive use, and menopause. Notably, Hormone Replacement Therapy (HRT) has been associated with the onset or worsening of melasma in some women. The exact mechanism isn’t fully understood, but it’s believed that oestrogen and progesterone can stimulate melanocytes, the cells responsible for pigment production, leading to these discoloured patches.

Managing and Preventing Melasma

For women undergoing HRT who develop melasma, it’s essential to adopt protective measures:

• Sun Protection: Ultraviolet (UV) exposure can exacerbate melasma. Regular use of a broad-spectrum sunscreen with an SPF of 30 or higher, along with wearing hats and seeking shade, can help prevent further pigmentation.

• Skincare Products: Incorporating topical agents like hydroquinone, tretinoin, or azelaic acid may assist in lightening dark patches. However, these should be used under the guidance of a dermatologist/doctor to ensure safety and efficacy.

• Consultation: If melasma develops or worsens during HRT, discussing alternative therapies or adjustments with a healthcare provider is recommended. They can offer personalised advice and potential treatment options tailored to individual needs.

Final Thoughts

Oestrogen gel can be incredibly helpful for managing menopausal symptoms, but it’s important to be aware of its potential effects on your skin especially when it comes to pigmentation and moles.

I see this concern often in clinic, and with the right support and awareness, these changes can be managed effectively. Your skin reflects what’s going on inside and out, so don’t ignore it, it’s your body’s way of talking to you.

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References

Cohen, P.R. (2015) 'Letter to the Editor: Topical Anti-Estrogen Therapy To Treat Melasma', Journal of Clinical and Aesthetic Dermatology, 8(4), pp. 40–41. Available at: https://jcadonline.com/letter-to-the-editor-topical-anti-estrogen-therapy-to-treat-melasma/ (Accessed: 25 March 2025).
Gendler Dermatology (2022) 'Menopause, Topical Estrogen, and Skin Health'. Available at: https://gendlerdermatology.com/skin-care/menopause-topical-estrogen-skin-health/ (Accessed: 25 March 2025).
Rzepecki, A.K., Murase, J.E., Juran, R. & Bergfeld, W. (2019) 'Estrogen-deficient skin: The role of topical therapy', International Journal of Women's Dermatology, 5(2), pp. 85–90. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451761/ (Accessed: 25 March 2025).
Snyder, A., Schiechert, R.A. & Zaiac, M.N. (2017) 'Melasma Associated with Topical Estrogen Cream', Journal of Clinical and Aesthetic Dermatology, 10(2), pp. 57–58. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367874/ (Accessed: 25 March 2025).
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Svoboda, R.M., Del Rosso, J.Q., Zeichner, J.A. & Draelos, Z.D. (2016) 'Revisiting the Beneficial Effects of Estrogen on the Skin: A Comprehensive Review of the Literature and a Look to the Future', SKIN The Journal of Cutaneous Medicine, 1(3), pp. 115–121. Available at: https://jofskin.org/index.php/skin/article/view/383 (Accessed: 25 March 2025).
Tang, J.Y., Spaunhurst, K., Chlebowski, R.T. et al. (2011) 'Menopausal Hormone Therapy and Risks of Melanoma and Nonmelanoma Skin Cancers: Women's Health Initiative Randomized Trials', Journal of the National Cancer Institute, 103(19), pp. 1469–1475. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3187840/ (Accessed: 25 March 2025).
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Can Oestrogen Gel Applied to the Skin Cause New Moles or Pigmentation?