10:48 AM CDT on Monday, May 2, 2005

Meg Farris / Medical Reporter

It starts with perimenopause in your 40's when a woman's ovaries don't make as much estrogen. Then in the early 50's, with menopause, estrogen stops affecting every cell and every organ. And the largest organ in the body is the skin.

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Before and after shots of a woman who used the estrogen cream on her skin.

In fact, 30 percent of skin collagen, which keeps your skin firm and wrinkle-free, is lost in just the first five years of menopause. And the decline continues by more than two percent every year thereafter. That is why doctors see a huge improvement in a woman's skin when she goes on hormone replacement therapy through patches, injections, implants, gels or pills.

“There are a number of studies, large objective clinical studies, that have demonstrated that hormone replacement therapy does improve skin thickness,” said Dermatologist Patricia Farris. “It increases collagen production in women and so we know that HRT overall is beneficial in aging skin.”

But something happened in the last few years when women across the U.S. stopped taking their hormones due to questions after a government study.

“We're now starting to see a backlash from that,” said Farris. “A lot of patients are coming in with skin complaints, with thin skin, dry skin, excessive wrinkling or accelerated aging and all of these are due to lack of estrogen.”

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Premarin Vaginal Cream is said to help eliminate or prevent wrinkles when applied to the face.

Recently Eyewitness News received calls and Internet chat rooms were abuzz when a 58-year-old-women went on a talk show and told her age-defying secret no one seemed to know about. For 20 years she had been using her Premarin vaginal cream on her face to help eliminate and prevent wrinkles. Dermatologists said they'd known that secret for years - even decades.

“What the estrogen does is it moisturizes the skin and it plumps it up,” said Dermatologist Elizabeth McBurney of the LSU Health Sciences Center. “We have lots of estrogen receptors in our skin and it stimulates new collagen formation.”

They say it improves texture, thickness, wrinkles, dryness and even the good layer of fat that makes you look young. They even site scientific studies that show a difference in wrinkles from the outside and, new collagen growth from the inside. And they especially like how it works when used every other night with prescriptions retinoids like Retin-A and Tazorac, keeping the skin from getting flaky and irritated.

“Patients seem to like it, especially if they're menopausal. They feel that their skin plumps up, looks better,” said Tulane Dermatologist Mary Lupo. “I think within 4-6 months of regular use you should see a significant benefit, and if you don't then I would recommend that you stop it.”

But all the doctors we spoke with have this caution; Premarin may not absorb into thicker facial skin like it is designed to do in thinner vaginal skin. While studies show little Premarin gets into the blood system, other formulations of estrogen creams and gels are designed to be used as full hormone replacement, going into the blood stream and treating the full body and not just the skin it's rubbed on. There are people who have had breast and uterine cancer who should not use it. And, of great concern is how easy it is for women to get all sorts of estrogen gels off the Internet with out a prescription.

“I wouldn't just take your Premarin cream out of the closet and start using it,” said Dr. William P. Coleman, a dermatologic surgeon.

But under your dermatologists and ob-gyn's care, they say the good news is all you need is one tube to last an entire year.

“It’s cheaper than something at the department store,” said McBurney. “And it works and there is good data.”

Doctors said the prescription estrogen cream is beneficial for women in their 40s and older, or those who have had their ovaries removed.

They say all you need is a small amount and that larger applications could have the opposite effect.