What are the recommended application sites for an estrogen (hormone replacement therapy) patch and is it acceptable to apply it over stretch marks (striae)?

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From the Guidelines

Estrogen patches should be applied to clean, dry, hairless skin on the abdomen, upper torso, upper outer arm, or buttocks, but it's not recommended to place them on stretch marks due to potential alterations in skin structure and medication absorption. When considering the application of estrogen patches, it's essential to choose sites that ensure optimal medication delivery and minimize the risk of skin irritation or other adverse effects. According to the study on contraception for adolescents 1, the recommended application sites for the transdermal contraceptive patch include the abdomen, upper torso, upper outer arm, or buttocks. Some key points to consider when applying estrogen patches include:

  • Applying the patch to clean, dry, hairless skin to ensure proper adhesion and medication absorption
  • Rotating application sites with each new patch to prevent skin irritation
  • Avoiding application on areas with stretch marks, as these may have altered skin structure that could affect medication absorption
  • Following the specific instructions provided with the prescription, as different estrogen patch brands may have slightly different recommendations for placement It's also important to note that the risk of pregnancy with correct use of the patch may be slightly higher for women who weigh more than 198 pounds than for women who weigh less, as reported in the study 1. If you're concerned about finding suitable application areas due to extensive stretch marks, it's best to consult your healthcare provider for personalized guidance.

From the Research

Estrogen Patch Application Areas

The studies provided do not specifically mention all the possible places to put an estrogen patch. However, based on the information available, estrogen patches are typically applied to the skin, and the choice of application area may depend on various factors such as skin irritation and adhesion [ 2 ].

Skin Irritation and Adhesion

A study comparing the local tolerability, adhesion, and estradiol delivery of two transdermal patches found that the 5-cm(2) patch had a significantly lower incidence of very slight erythema than the larger 12.5-cm(2) patch [ 2 ]. This suggests that the choice of patch size and application area may affect skin irritation and adhesion.

Application on Stretch Marks

There is no direct evidence in the provided studies regarding the application of estrogen patches on stretch marks. However, it is known that estrogens have a profound influence on skin and can increase skin thickness and improve skin moisture [ 3 ]. Estrogen supplementation has also been shown to improve various cutaneous changes associated with declining estrogen levels, such as dryness, atrophy, and fine wrinkling [ 4 ].

Key Points to Consider

  • Estrogen patches are typically applied to the skin, but the choice of application area may depend on various factors such as skin irritation and adhesion.
  • The size of the patch may affect skin irritation and adhesion, with smaller patches potentially causing less irritation [ 2 ].
  • Estrogens can have beneficial effects on skin, including increasing skin thickness and improving skin moisture [ 3 ].
  • There is no direct evidence regarding the application of estrogen patches on stretch marks, but estrogens may potentially improve skin appearance and reduce the visibility of stretch marks [ 3 , 4 ].

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Comparative study to evaluate skin irritation and adhesion of Estradot and Climara in healthy postmenopausal women.

Climacteric : the journal of the International Menopause Society, 2002

Research

Effect of estrogens on skin aging and the potential role of selective estrogen receptor modulators.

Climacteric : the journal of the International Menopause Society, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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