Dr. Stember’s 5 Essential E3 Enhancements

Welcome to Fountain SKIN!

Estriol (E3) works by supporting the skin’s natural collagen and repair pathways, but like many treatments in medicine, results are often even better when the body has the right support.

Below are five easy yet powerful habits I recommend to patients who want to get the most from their estriol-based skincare.

Following these habits can help lead to the best results for healthier, younger-looking skin!

E3 Enhancement #1: Protect Your Collagen With Daily SPF

Most people know they should wear sunscreen. Yet what many don’t realize is how much daily UV exposure accelerates collagen loss, even when you’re not spending long hours in the sun.

Research shows that up to 80–90% of visible skin aging is linked to cumulative sun exposure, which gradually breaks down collagen and elastin — the very structures that keep skin firm and smooth.

That matters even more when you’re using hormone-supportive skincare like estriol, which works by supporting the pathways responsible for collagen production and skin structure.

That’s why I always recommend daily SPF as a non-negotiable foundation for skin restoration.

Here are some guidelines to follow:

• Use a broad-spectrum SPF 30 or higher every morning

• Apply it as the final step in your skincare routine

• Re-apply if you’re spending extended time outdoors

I always recommend sunscreens that are zinc- or mineral-based as opposed to chemical-based for daily use as these stay on the skin and do not get absorbed as easily by the body.

E3 Enhancement #2: Support Collagen Production With Bone Broth or Collagen Peptides

Estriol works by turning on your skin’s collagen-building network. And while it will work great on its own, you can support this process by giving your body the building blocks it needs to make healthy, youthful collagen.

Studies show that supplementing with collagen peptides can help improve skin elasticity and hydration, and may support the structural proteins that keep skin firm and resilient. Many people add collagen peptides to their coffee or morning smoothie, which is great, but another healthy way is by consuming bone broth.

Here are some easy ways to incorporate bone broth into your daily routine:

1. Drink one cup in the morning – hot or cold. Bone broth is easy on the stomach, high in protein, and can even help keep appetite in check.
2. If you’re preparing rice or making a sauce, replace the water you would normally use with bone broth. This adds a delicious, savory element to any dish.
3. Simmer bone broth over the stove with ginger and lemon as a warming night-time tea. Bone broth contains glycine and trace elements like magnesium, which can help with calming the system and getting the body ready for sleep.

Note: bone broth is not the same as regular broth or stock, which is often watered down and can have other ingredients. Bone broth contains the important nutrients needed. If you’re new to bone broth, try both chicken and beef varieties to see which you like best!

E3 Enhancement #3: Break a Sweat 2–3 Times Per Week

Most people think about exercise primarily for weight management or cardiovascular health, but regular physical activity can play an important role in skin health, too.

When you exercise and break a sweat, circulation increases throughout the body, including to the skin. This improved blood flow helps deliver oxygen and nutrients to skin cells while supporting the natural repair processes that keep skin looking firm and vibrant.

Better circulation also supports collagen maintenance and cellular turnover, both of which are important for maintaining healthy skin as we age.

That’s why I recommend getting your heart rate up and breaking a sweat at least 2-3 times per week as part of a skin-supportive routine. This doesn’t mean you need intense workouts. The goal is simply to elevate your heart rate long enough to stimulate circulation and produce a light sweat.

Here are some fun ways to incorporate this into your routine:

• Take a brisk 30-minute walk where your heart rate increases and you begin to sweat lightly. This is great to do first thing in the morning while the mind is still waking up.

• Try a new exercise. Many women can find a big sense of accomplishment in trying something new like strength training or Pilates. Hot yoga has also become a very popular trend!

• Sit in for a sauna session. A sauna can help stimulate circulation even on non-workout days. (If you have a skin condition like rosacea, check with your doctor before using a sauna, as heat can sometimes aggravate certain conditions.)

Regular movement and sweating help support the body’s natural repair systems, creating a healthier environment for skin to stay firm, resilient, and well-nourished, inside and out!

E3 Enhancement #4: Drink half your body weight in ounces of water

Everyone’s heard they should drink more water. And there's a good reason – even mild dehydration can affect skin hydration, elasticity, and barrier function.A simple rule many patients find helpful is to aim for roughly half your body weight in ounces of water per day. For example, someone who weighs 150 pounds might aim for around 75 ounces of water daily.

But here’s the thing: drinking water alone is sometimes not enough. Your body also needs electrolytes, which are essential minerals like potassium, sodium, and magnesium, to help cells absorb and retain water effectively.

Skin cells rely on adequate hydration with electrolytes to maintain their structure and resilience. If the body can’t absorb water properly, the skin can appear duller, less plump, and more prone to fine lines.

Here are some easy ways to add electrolytes and improve hydration:

1. Keep a water bottle with you throughout the day and sip consistently rather than trying to drink large amounts all at once.
2. Eat water-rich, mineral-rich foods like cucumbers, watermelon, oranges, and leafy greens, which naturally provide both hydration and electrolytes.
3. Replace regular table salt with mineral salt or sea salt. These types of salt provide the same flavor enhancement, while also being filled with electrolytes.
4. Add a tiny pinch of salt to your water. It sounds counterproductive, but sodium in reasonable amounts helps the body absorb water and send it where it's needed, like your muscles and your skin. (If your doctor has advised a low-sodium diet, skip this one or check with them first.)
5. Consume additional electrolytes if you’ve been exercising. A lot of people love adding electrolyte powder to their water for an easy, tasty sports drink. Just be sure to check the nutrition label for one that’s low in sugar.

Small hydration habits like these help support the internal environment that keeps skin smooth, resilient, and well-supported.

E3 Enhancement #5: Get Morning Sunlight to Support Skin Repair

When thinking about recovery and repair, a lot of people think about sleep. And it’s true, even for your skin, sleep is when much of your cellular repair and regeneration take place. But what many don’t know is that much of your sleep quality actually starts in the morning.

Your body runs on an internal clock called the circadian rhythm, which helps regulate when hormones rise and fall throughout the day. When this rhythm is working properly, the body produces deeper, more restorative sleep.

And one of the strongest signals that sets this internal clock is morning sunlight.

When your eyes and skin are exposed to natural light early in the day, it helps trigger a cascade of hormonal signals that continue throughout the day and into the evening. This helps regulate energy levels, sleep timing, and the body’s overnight repair processes, including those that support healthy skin.

That’s why I recommend getting natural sunlight (with SPF sunblock applied) within the first hour of waking up whenever possible to optimize skin-restorative sleep in the evening.

If you’re looking to combine all these skin-supporting habits into one ultimate routine, you could try:

• First thing in the morning, apply a small amount of sunscreen to the face
• Then pour some bone broth into a cup or plastic bottle
• Step outside for a 20-30 minute walk under the morning sun
• When you come back, refill your container with water and stay hydrated throughout the day

And just like that, you’ve already jumpstarted sun protection, skin hydration, collagen, circulation, and your circadian rhythm – all before the day has really begun!

Thank you for reading. Now that you have these 5 Essential E3 enhancements, I can’t wait for you to start experiencing even greater age-defying results with your new skin routine.

With care,

Dr. Doron Stember
Chief Medical Officer
Fountain Vitality