Hormone cream is a form of transdermal hormone replacement therapy (HRT) that delivers medication through the skin and directly into the bloodstream. This method bypasses the liver, allowing for a lower dosage and avoiding the initial metabolic breakdown of oral medications. The effectiveness and safety of this therapy depend on precise application, as the location determines how quickly the hormone is absorbed. Understanding the correct application site is necessary to achieve stable hormone levels and optimal therapeutic results.
Why Application Sites Matter
Choosing the right application site is based on the skin’s biological structure. Certain areas are more permeable to the large molecules in hormone creams. Optimal transdermal delivery relies on the thinness of the epidermis, which offers less resistance to the hormone’s passage.
Locations with a high density of capillaries enhance absorption by allowing the hormone to enter the systemic circulation rapidly. Once the hormone passes through the skin, it needs immediate access to the bloodstream for distribution. Robust microcirculation facilitates quick transfer, preventing local storage.
Underlying fat tissue influences absorption, particularly with certain hormones. Fat can act as a reservoir, storing the hormone and potentially converting it into other compounds, which leads to inconsistent release. Sites are selected to minimize this storage effect while maximizing direct entry into the circulatory system.
Recommended Areas for Systemic Absorption
For systemic absorption, target areas that provide a consistent pathway to the blood. Standard recommendations include the inner forearms, wrists, upper thighs, and the lower abdominal area. These regions combine thinner skin and a rich underlying blood supply, making them excellent conduits for transfer.
Dispense the prescribed dose onto clean, dry skin. Spread the cream over a large surface area—such as the size of a small plate—to prevent saturation. Applying the cream widely ensures maximum skin contact for absorption, helping the body take in the full dose.
Rub the cream into the skin until it is absorbed (typically 60 to 120 seconds). Wait 10 to 20 minutes before covering the area with clothing. This ensures the medication is dried and absorbed, preventing transfer onto clothes.
Avoid washing the application site for at least one hour after use. Applying the cream after a shower can be beneficial, as warmth may increase microcirculation. Consistency is achieved by applying the cream at the same time each day, as directed by the physician.
Avoiding Transfer and Site Rotation
Maintaining therapy effectiveness requires attention to two protocols: preventing transfer and rotating application sites. Rotation involves moving the exact application spot daily or weekly within recommended areas, such as alternating between the left and right inner arm or thigh. This prevents skin saturation, which could lead to localized irritation or decreased absorption efficiency.
Preventing accidental hormone transfer is a safety measure, as unintended exposure can affect partners, children, or pets. After the cream is applied, thoroughly wash hands with soap and water to remove any residual cream that could be transferred through touch.
Application sites are often chosen because they can be easily covered by clothing, minimizing skin-to-skin contact. If contact is anticipated, the application area should be washed well beforehand. Hormone transfer has caused unintended exposure in children, underscoring the importance of these precautions.
Specialized Application for Specific Hormones
Application guidelines vary based on the specific hormone compound to optimize its absorption profile, though general HRT creams often use the inner arm or thigh. For transdermal testosterone, patients are advised to avoid areas with significant fat tissue, such as the abdomen. Fat cells contain an enzyme that can convert testosterone into estrogen, potentially reducing desired effects.
Men applying testosterone cream are directed to use the upper arms, shoulders, or upper back, which are larger, muscular areas with less fat. This placement helps achieve a more consistent hormone level in the bloodstream. Estrogen is commonly applied to the inner arms, inner thighs, or lower abdomen for systemic effects, aiming for a steady release.
Progesterone cream for systemic use is often applied to the inner arms or thighs. Specific estrogen creams are sometimes prescribed for localized issues, such as vaginal dryness, requiring direct application to the genital area. This localized application works only on the vaginal tissue with minimal systemic absorption, matching the site to the therapeutic goal.