What are alternatives to using Premarin?

A full cosmetic consultation is required to answer your question, if hormones are the issue bioidentical hormones are the way to go.

It is not clear from your question whether you are looking to treat vaginal atrophy or skin atrophy on your face. Vaginal hormone replacement is both very effective and safe over the long term, however, if you choose not to use it there are excellent alternative available with use of the MonaLisa Touch C02 laser or Tempsure Vitalia radiofrequency treatments. If you are looking to treat facial atrophy, then many options exist, including hyaluronic acid fillers, growth serums, retinols, C02 laser. Ideally, you would be able to find a doctor with expertise in all these areas, but if not available in your area, you may need to consult a gynecologist for the hormone treatments/vaginal laser and a cosmetic doctor for the facial treatments. Best, Dr. Tkatch

Hormone replacement when used properly and under medical supervision can be both safe and highly effective for treatment of atrophied skinThe other treatment for the skin without the use of hormones is having autologous fat grafting when the face is being addressed. Properly chosen fat contains a great deal of stem cells which when injected under the skin, change the physiology of the skin which starts to look considerably more youthful. I hope this helps and good luck from New York City plastic surgery