Can topical facial estrogen be used alongside systemic hormone therapy safely?

Yes, you can safely use topical facial estrogen alongside systemic hormone therapy. Here at Alloy, we lean on both the science and decades of experience with local estrogens, and everything points in the same direction: topical estriol used on the face doesn’t raise systemic estrogen levels.

Studies show that low dose topical estriol behaves the same way topical vaginal estrogen does, meaning it stays local to the skin and does not increase serum estrogen levels. Our M4 face cream was designed with that in mind, and you can use it on its own or together with systemic MHT. You can take a look at M4 here if you want to see the details of the formulation or the clinical study results: M4 Estriol Face Cream.

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If you’d like to hear it explained by our medical experts, the topical estrogen safety chapter from our webinar breaks it down clearly. You can watch it here: Topical Estrogen Safety.

The short version is that systemic hormones travel through your bloodstream to many tissues, while topical estriol works right in the skin where you put it, so the two don’t interfere with each other.


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