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Child: Welcome to my Mommy’s podcast.
Hello and welcome to The Wellness Mama podcast. I’m Katie from wellnessmama.com. And this episode is round two with Dr. Mary Alice Mina, touching on the aspects of skincare and how to take care of our skin as we age, and especially before, during, and after menopause and how our hormone changes affect our skin during those times, as well as if you are interested, what procedures can be helpful and which ones to avoid. And I personally have not done any skincare procedures. Definitely personally avoid things like filler and Botox, but it’s great information to know for the future of which ones can be helpful and not harmful to the skin if I wanted to look into that. And Dr. Mary Alice Mina is a Harvard-trained, double board-certified dermatologist and dermatologic surgeon, and a leading expert on skin health and skincare. She’s also the host of The Skin Real podcast for people looking to go deeper on this topic, and she has some resources available on her website that are linked in the show notes as well. So let’s jump in with Dr. Mary Alice. Dr. Mina, welcome back.
Dr. Mina: Thank you so much, Katie. I’m thrilled to be here.
Katie: You guys who missed it, the first episode with Dr. Mina, we covered how to simplify your skincare routine and focus on the things that actually work, kind of take a minimum effective dose approach. And I’ll link to that episode in the show notes for this one. And in this episode, Dr. Mina, I’m really excited to go deep on specifically skin as we age, and especially around the time of menopause. Because as we briefly touched on in our first episode, obviously there’s a lot of hormonal changes happening there. The body’s changing in a lot of different ways. And that of course includes our skin. And so I’m not quite to that point yet, but it’s something I’m aware of as I get older. So for people who are maybe perimenopause or moving into menopause or even post-menopause, what do we need to know about what’s going on in our body and how that affects our skin in that phase of life?
Dr. Mina: Gosh, well, I would say the first thing to know is you are not alone. And I love that there seems to be this movement of women who are like, why have we never talked about menopause before? And I think I know why, because we weren’t really experiencing it a hundred years ago or in the turn of the century, 1900, the average lifespan for someone was 46 years old, which that just boggles my mind. And now the lifespan of someone for someone born today, a girl born today is about a hundred, right? So we are living way, way longer than we’ve ever lived before. And unfortunately, medical science and research has not kept up with women’s health beyond their reproductive years. It’s almost like women become menopausal and we’re just forgotten about, and no one talks about it. So I love that there’s this movement of particularly women physicians, also sort of advocates out there saying like, wait a minute, we’re struggling. These are side effects that are really impacting our lives. And we want, we don’t want to live the next half of our life or a third of our life like this. And so I think it’s just wonderful we’re even having this conversation.
And sometimes people ask me like, why are you so obsessed with menopause if you’re not even like menopausal yet? But I see it coming. I know it’s coming. And even. If you’re in your mid-30s, chances are you’re probably experiencing some perimenopausal symptoms. Maybe you don’t even realize it, right? But basically menopause is when our ovaries stop producing eggs and we stop producing estrogen. And so our estrogen levels are way up here. And well, they do cycle, right, for monthly, throughout our lives. But then all of a sudden in menopause, they plummet and they’re essentially barely above zero. And what we’re learning is that this really affects so many organs in our body. It affects our mind. It affects our GI. It affects our skin. It affects everything.
And so it’s important that, first of all, women know you’re not going crazy if you’re having hot flashes and all these symptoms. And really, it’s universal. Every woman’s going to go through this if you live long enough. So skin-wise, lots of changes occur, too. Estrogen really helps us keep our skin plump and kind of radiant looking. It helps with collagen. It helps keep our hair thick and full. And so when that goes away, you can notice things like hair thinning, hair loss. You can feel like your face just melted overnight and you lose that collagen, that vibrancy. And it can be really distressing for women. And also, especially because we have these unrealistic goals or unrealistic expectations, I should say, that as women, we’re really not allowed to age. We’re supposed to continue to look the same as when we were in our 20s and 30s. You know, men are allowed to age, right? They’re allowed to become distinguished, but a woman doesn’t. So I think we need to change the narrative on that as well and not really fear aging, but kind of understand, okay, what’s going on? It’s normal. It is natural. But that doesn’t mean we can’t help some of the symptoms, especially when they’re debilitating.
Katie: I love that you brought up the sort of double standard that exists for men and women and how they get to be called distinguished when they age and how for women, there’s just the expectation to never age. I love that we’re hopefully starting to shift that conversation. And I would guess women sort of intuitively can feel that obviously that big hormone shifts like menopause would also have an effect on the skin because we’ve probably noticed that throughout our cycles as our hormones shift each month. Like I know anybody watching on video, I had to like cover up a little zit that I had this morning because I’m on my period and that’s been, it’s gotten less and less and less the healthier I’ve gotten over the years, but it still sometimes happens. And so we see these hormone changes affecting us. So it makes sense that when there’s a big one, we might see a big effect.
You use that term, your face melting overnight. And I love that you explain it that way. I’m curious if there’s anything we can do to kind of circumvent that and/or reverse that as we get older. Cause I haven’t hit my forties yet, but I did lose a lot of weight about five years ago. And I had that similar effect. And I’ve been sort of trying to like rehab it since then. So any suggestions for women who do feel like their face kind of melted overnight?
Dr. Mina: Yeah, absolutely. So, you know, a lot of things. And again, first is just perspective, knowing that, okay, this is normal and not necessarily trying to totally reverse and look like you’re 20, but to really help you look the best that you can right then and there and in that stage. I would say focusing, like we talked about in your previous episode, just on your whole-body health is super impactful. But specifically for skin, using a vitamin A derivative like a retinoid is such a powerful way to boost collagen.
So we’re losing collagen even starting in our mid-20s, which sounds crazy, right? But there’s a huge drop in our collagen, about 30% once we hit menopause. And that’s why people feel like their skin has just fallen. There’s some maybe questionable or early data suggesting that maybe collagen powders and supplements can benefit collagen in your skin, but there are also procedures that we can do to help improve collagen in the skin with things called biostimulants, if someone is interested in doing a procedure. And, you know, lots of devices, lasers, things like that, you can kind of go down a rabbit hole with that. But I would say hormone replacement therapy. So talking with your doctor about whether that is a good option for you and balancing the risk and benefits and things like that.
But what I think we’ve really learned as people are starting to study menopause is that estrogen is such a protective and preventative hormone in our bodies. And that when we lose it, we see so many challenges, even well beyond the skin that can really affect women and the quality of their life. So there are certainly things we can do for that sort of face falling. A lot of them are procedures. And I would say also just don’t give up on a basic skin routine. I would incorporate a vitamin A and then also focus on your overall health. That’s going to really be impactful as well.
Katie: What are some of the most common changes that people come to you with in menopause? And like, what do you typically recommend for the different changes that women experience in menopause?
Dr. Mina: So I do a good bit of procedural dermatology. So a lot of times they’re coming to me seeking out a potential procedure. I get a lot of women coming in with hormonal or I’m sorry, with acne in this stage and wanting to kind of talk through that. So it’s not uncommon to see acne in menopause, which people think I thought that was something that just happened when I’m a teenager. But again, with the fluctuating hormones and then your testosterone levels being relatively higher than your estrogen, you can see acne. So acne is a common one. A vitamin A cream like a retinol can be really helpful for that.
Hair loss. That is a huge one that I’m seeing a lot of. Fortunately, there are some great products out there that help. Minoxidil got a lot of attention. It’s an old medication that we’ve had for decades, but it got sort of a renewed interest when the New York Times published a piece on it. And in very, very low doses, it is quite effective for women who are getting that hair thinning that we see with menopause. And a lot of women are coming in seeking out procedures like fillers or biostimulants or tightening or rejuvenation procedures as well.
Katie: Okay. So let’s talk about procedures because I know there’s like almost endless options in this now in the skincare world. And I know that some people listening and I would put myself in this category, like I don’t really want to do things like Botox and fillers, but I know there are also many other options beyond that, that are not sort of putting things into the skin, but helping the skin improve. So walk us through the wide world of procedures.
Dr. Mina: Yeah, it kind of can seem like the wild world. I was actually just talking with a girlfriend last night and she was saying, what laser, what lasers do you like? What should I do? What should I? And she had amazing, beautiful skin. And I was like, well, there are a lot of lasers and a lot of them are quite effective, but, what you don’t need it, right? So I would first say, and this is what I do when I see a patient is, well, what bothers you, right? Because what I see may be different from what you see. And I give them a mirror and say, when you look in the mirror, what bothers you? Is it the jowling? Is it your neck? Is it crepey skin? I need to know because that’s going to tailor what we do.
So one of the things I really love that is not a filler, although some people call it a filler, it’s a biostimulant. And what I like about it is that it uses this medicine called PLLA, poly-l-lactic acid, dissolved in water and it’s injected, but it stimulates your own collagen. So I find that that is a really kind of natural way to boost your collagen directly in the skin. It’s not like wondering is the collagen I’m drinking gonna end up in my skin, but it actually stimulates the collagen in your face or your neck, your hands, wherever you want it. So I think that’s a great option. It’s kind of playing the long game. It’s not a quick fix again, because your body has to make its own collagen, but I do find that that is a really impactful procedure. And I would consider it natural because it’s your own collagen.
Beyond that, there are lasers like Fraxel or fractionated lasers that help resurface the skin, help tighten the skin. There are devices that can actually remove little cores of tissue and then kind of shrink wrap it and tighten it up. There are microneedling procedures that when combined with radio frequency can help tighten the skin. And so it really just depends on how advanced you are or not. So some procedures like microneedling are a great kind of preventative measure for people who don’t really have a lot to reverse. And then I would say the microcoring or even surgery is reserved more for someone with a lot of skin laxity or tightening that needs to go on.
And I would just say, these things are expensive. They’re expensive. There are a lot of people who have these lasers and they’re offering them, but they’re not necessarily experts at these procedures. And so I really think if you are going to invest your time and your money to see someone really trained in this, like a board-certified dermatologist or plastic surgeon, because I think you’ll get the best input from them. They’re not just going to say, well, I have this laser, so I’m going to use it on everyone. They’re going to really help walk you through what are the different options out there. Not every laser is safe on every skin type. So that’s something to be aware of. If you have darker skin, you want to be really careful because you can get hyperpigmentation or whitening of the skin if the wrong settings are. If the wrong settings are used.
So there are tons of options out there, but I do find that it can be overwhelming for people. And a lot of times people are just trying to sell you something and it may not really address what you need. And I think it’s important to have realistic expectations, right? If you think that this one treatment is going to tighten your skin like surgery, you’re gonna be disappointed. And so just make sure you’re aware of what realistically this procedure can do and what it can’t do. Because a lot of times they are expensive.
So I think your best bet though, see someone who really is an expert at this, who has a lot of experience with it. If someone tells you no, thank them because they’re giving you an honest opinion. They’re not just willing to do any procedure to make some money off of you. That’s really not the right option. So again, that’s where I think the experts in this are dermatologists and plastic surgeons.
Katie: I so much appreciate you being the voice of reason and moderation in that, even though I know that you have some of these procedures available, speaking to not everyone needs all of these and don’t waste your money. Because I think, like you said, they can be very expensive. I know a random tip that I have that I don’t think it has like an extreme skin benefit, but a little bit of one is in the morning to actually dunk your face in a bowl of ice water. And I actually do this primarily for cortisol and hormones, not actually for skin. But I noticed it does like brighten up my skin, probably because the blood flow of cold water hitting your face. Yeah. But this is really cool for helping your cortisol patterns, especially if you’re getting light in the morning and getting the right circadian rhythm going. And that one’s basically free at home. So I always suggest that one. I also love that you touched on. Oh, go ahead.
Dr. Mina: Oh, well, and you know, the cold, the cold ice baths, right? Like people are loving that. I have lots of friends who own one. I just can’t handle the cold like that. But yeah, I mean, cold water splashing on your face, putting some ice or a spoon in the fridge and rolling it under your eyes. I mean, these are quick little hacks that can, that can totally help. And yeah, they’re free. So even better.
Katie: I also love that you brought up when we take collagen and just sort of like hope it’s going to get to our skin, because I don’t have the experience on the skincare side, but from working with pro athletes, I know when we’re trying to get collagen into their joints and tissues for recovery, collagen alone doesn’t do it. It actually depends on a whole host of other things like your micronutrient levels and trace amounts of silica and magnesium. So I love that you spoke to like, just taking collagen is not a fix all there’s other things you can do as well.
And I’m also curious about at-home devices because it seems like some of these have gotten popular lately. I’m curious which ones you think are evidence-based and are worth trying for someone who wants to take a gentle approach, whether it’s things like red light, or I think micro-electrical stimulation or whatever it’s called has gotten popular or those little needle rollers. Are there any benefits to these at-home devices that people might try?
Dr. Mina: Yeah, no, at-home devices are definitely all the rage on TikTok or at-home do-it-yourself stuff. I would say a word of caution, right? There are some that I like. So I do like the LED mask. The issue with the LED mask, they are very, very expensive. We don’t have a lot of good data to tell us what is the strength, what is the energy that we need for these lights and the wavelength and how much power do they need to emit to really be effective. So the data, the research is lacking there. However, we do know red-light can be quite helpful, especially the in-office versions of red-light out there. But there are some LED masks out there that the red-light ones that can be helpful, but the issue is you have to do it every day or very consistently for about 10 minutes to make it work. So don’t invest in this if you don’t think you can commit to putting it on and using it on a regular basis. So I am not someone who would be able to do that. So I don’t do it. But if that’s something you’re willing to commit to, then I have no problem doing that. Just know that they are a lot of money, and the data is not totally out there on which is the best one, which is the most powerful one and all that.
For the stamping and the rollers, I am not a big fan of those. I think anytime you’re doing something where you’re breaking the skin barrier and introducing something into the skin, there’s a risk of infection. There’s a risk of scarring. And also it’s going to hurt. And you’re not going to really go deep enough, I think, to get the real benefit because again, you’re doing it at home. So I think those procedures are risky. I’ve seen infections and scarring from them. I would not recommend those at home. I would say just go see a professional if you are interested in microneedling. I have friends who are doing like facial exercises and things like that. I don’t love those. I think you’re not going to really see improvements unless you’re really doing it consistently all the time. And I think that’s kind of unrealistic. But I would say my favorite would be the LED red-light at-home mask if you are looking to do something.
Katie: And then what would be, I know you touched on several of them, what would be your recommendation, especially for like a woman in menopause or postmenopause, if she did want to have an in-office procedure, where would you give her as a starting point and which ones would you tell her maybe avoid or these don’t have as much clinical benefit and have more risk?
Dr. Mina: Well, I think it all just really depends on what she needs, right? And what her goals are. So if she feels like her eyelid skin is hanging down, then actually removing that in a procedure called a blepharoplasty would be most helpful. But what I find most people who come in, they’re sort of just overall discouraged and maybe disappointed, and they don’t even really know where to start. And one of my favorite things to do is just even out the complexion. I find if you can get your skin complexion more uniform and more kind of vibrant and glowing, it makes everything look better, right? You no longer are as you don’t notice the puffiness or the bags under your eyes or the jowling, things like that.
So that’s usually my first step is let’s get the canvas, right? Let’s get your facial canvas glowing and beautiful. Because to me, that’s that’s so critical because if you do a neck lift or fillers and all this other stuff, but your skin texture and complexion is not even in uniform, it never looks as good. And I think people are always a little bit disappointed. So that’s really my first thing, especially if someone doesn’t have one particular thing they’re bothered by is like, let’s get your skin complexion more even. Let’s sort of remove some of that sun damage or you know, crepiness and things like that. Let’s tighten it up. So that’s kind of my favorite. And that can be done with lasers, things like the halo laser, or I love a chemical peel. I’m a big fan of chemical peels. And sometimes I’ll pair that with a little microneedling too for some extra collagen boosting, but I find just doing that, and a lot of times with a chemical peel, you do it once and as long as you maintain some protection and a good skincare routine, you don’t, this isn’t something you’re doing every year. And that’s kind of my favorite is just getting the complexion more uniform, more radiant and glowing. And that seems to just make everything else look better.
Katie: Yeah, I love your sort of foundation first approach to that. Because I say the same thing on the like nutrition and physical health side from the inside out is like, yes, there are biohacks that can be helpful. Yes, there are supplements that can be helpful. It’s very individual, like you spoke to. And get those foundational things in place first, the free ones, the inexpensive ones, because then anything else you do is going to be more effective anyway. So get your sleep dialed in, your nutrients dialed in, your movement, and your light exposure, and then build from there versus thinking some really expensive biohack is going to fix things when you haven’t built the foundation for it too. So I love that you take that approach in the skincare world too.
Dr. Mina: Yeah, absolutely. It’s all about that. And I think that’s where the confusion comes in, and I liken it kind of like shopping or your wardrobe, right? We buy these things, but we don’t really know how it all goes together. And we don’t really have that foundation set. And if you don’t have that foundation set, you are going to be frustrated. You’re going to feel like you’re wasting time and money. So getting that foundation locked in first is so key for what you do and for what I do, right?
Katie: Exactly. And I know you have some resources available for people to kind of dial in that personalized aspect and figure out what’s going to work for them. Where do people find you online to learn from you?
Dr. Mina: Yeah, so I have a podcast called The Skin Real where I try to just break down questions I’m asked from my patients, my friends, the latest that’s coming out, try to make it just really sort of holistic skin health. And so that’s theskinreal.com. You can find it there. You can find it on Apple, Spotify. And my social media handle is @drminaskin.
Katie: Perfect. Well, I will make sure those links are included in the show notes but thank you so much for your time. I haven’t gone deep on skincare on this podcast yet, and I love your realistic and balanced approach and you being the voice of build the foundation, nourish your body from the inside out, do the other things once you’ve done those things, but don’t waste your money either. I feel like you have such a good perspective, and I’m so grateful for your time.
Dr. Mina: Oh, Katie, thank you so much. And thanks for all you’re doing on your wonderful podcast.
Katie: Well, thank you. And thanks as always to all of you for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did. And I hope that you will join me again on the next episode of the Wellness Mama podcast.
If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.
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