What actually works for healthy, vibrant skin—and what’s just hype? In this episode, we sit down with the brilliant and refreshingly honest Dr. Mary Alice Mina, Harvard-trained dermatologist and host of The Skin Real podcast. We dive deep into what midlife skin really needs, what treatments are worth the money, and how hormonal changes can shake up everything we thought we knew about our skincare routines.
Together, we unpack skin minimalism, sunscreen truths (spoiler: it really matters), and the difference between aging gracefully and chasing the next trending procedure. We also get personal—sharing our own frustrations about neck bands, droopy brows, and that “face falling” feeling—and ask Dr. Mina everything from estrogen creams to slugging and Botox.
Episode Highlights:
[0:02] - Welcoming Dr. Mary Alice Mina and diving into hormonal changes and midlife skin shifts.
[3:38] - Our own candid stories about "face falling" and dry, aging skin.
[5:00] - The psychological toll of aging and the importance of internal confidence.
[8:10] - What “skin minimalism” actually means—and why less really can be more.
[11:37] - Estrogen’s role in skin hydration and how perimenopause changes everything.
[13:53] - Sunscreen strategy: how often to reapply, the importance of hats, and Dr. Mina’s favorite brands.
[19:07] - Retinoids 101: how and when to use them for best results.
[20:26] - All about neck bands: what works (and what doesn’t).
[26:09] - Estrogen creams for the face: what Dr. Mina prescribes and how it works.
[28:58] - Why sleep is skin care and how sleep deprivation shows up on your face.
[30:58] - Sunscreen myths, TikTok fads, and Dr. Mina’s biggest dermatology pet peeves.
[33:59] - Genetics vs. skincare habits—what really makes the difference.
[40:16] - Starting or restarting retinoids without overwhelming your skin.
[40:39] - Why annual skin checks are essential and how to talk to your dermatologist.
[43:31] - How to connect with Dr. Mina and find your “skin style” through her quiz.
Resources:
- Dr. Mary Alice Mina’s Podcast: The Skin Real
- Find your skin style quiz: https://www.theskinreal.com/style
- Skincare Compounding: Skin Medicinals (estriol cream)
- Sunscreen favorites: EltaMD, La Roche-Posay, Neutrogena Stick
- Instagram: https://www.instagram.com/drminaskin
- Facebook: https://www.facebook.com/drminaskin
- YouTube: https://www.youtube.com/@drminaskin
- Titktok: https://www.tiktok.com/@drminaskin
- Medium: https://medium.com/@drminaskin
- LinkedIn: https://www.linkedin.com/in/drminaskin/
- Pinterest: https://www.pinterest.ph/06k6qtsxj4uvtpulz6w5ghdc8l2gwo/
Make sure to visit the “Resources” page on our website www.insightsfromthecouch.org to download the worksheet and take ways that accompany each episode. This is hugely important as we are now creating a download that is unique to each episode and working hard to create an email list to support our programming offerings moving forward.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Colette Fehr (00:02):
Hi everyone.
Welcome back to another episodeof insights from the couch. We
are talking skin today with afabulous Dermatologist, Dr Mary,
Alice Mina, and we're going tobe getting into everything you
need to know about sunscreen,holistic skin care, what
treatments to get? Whattreatments not to get? Does
(00:25):
putting estrogen on your facemake a difference, especially
for women at middle age? Youknow, what can we be doing to
take care of our skin? So you'regoing to want to stay tuned for
this one, because we're askingDr Mina all the questions, but
first, let me briefly introduceher. She's so impressive. Dr
Mina is a Harvard traineddermatologist, international
(00:47):
speaker, author and host of theskin reel, a podcast, ranked in
the top 2.5%globally. She's a co owner of
Balcombe and Mina DERM surgeryin Atlanta, Georgia, and a
leading expert in proceduraldermatology, skin health and
skin care. She has nearly twodecades of clinical experience
and is celebrated for herartistic, eye surgical precision
(01:09):
and ability to help patientsfeel radiant at every stage. Dr
Mina is also a sought afterspeaker, and she's been featured
in all kinds of media outlets,People Magazine, The Wall Street
Journal, glamor and HuffingtonPost to name a few. Welcome. Dr
Meena, we're so thrilled to haveyou today, so let's just jump
(01:31):
right in and start off with whatcan you tell us? Dr Amina, about
the hormonal changes that happenat this phase of life, and how
that affects the skin. Like,what are some of the most common
issues you see with women atmidlife? As a dermatologist,
Dr. Mary Alice Mina (01:50):
gosh, see and have experience, or am
experiencing, right? So lots ofthings happen. A common issue
is, I used to have great skin,or someone never even really
thought about their skin, andall of a sudden they look in the
mirror and they feel likethey've aged overnight, and
they're like, what is happening?
My skin is crepey. I have thesewrinkles I never had before, the
(02:12):
neck people. I feel like that'sone of the first areas people
notice it, and I can relate. Soyeah, the neck and yeah, they
are jowling that people feellike they're starting to get
jowl so they they feel like theword I hear a lot is my face is
falling, things are just movingsouth. And so that's a big one.
(02:35):
And then hair loss is a anotherbig one that I see during this
period, and this can happensooner than people realize. It
can happen in your late 30s,early 40s. You can start seeing
this even before you see thetraditional signs of menopause,
right, like the hot flashes andbrain fog and other things that
(02:56):
women will experience so in thissort of perimenopausal phase
where your hormones arefluctuating, you can start to
see these changes.
Colette Fehr (03:10):
Okay, you just hit the nail on the head. My neck
looks like ET like, it's likeall like banded. And I'm that
person who I feel like. I alwayshad great skin. My whole life. I
don't wash my face. I didn't doanything, and all of a sudden my
skin's getting really dry. Mywrinkles are more pronounced. I
(03:30):
have gels. The neck thing, it'sreally crazy. The Face falling
is, is the perfect you
Laura Bowman (03:38):
know, I feel like my brows like I feel like my, I
feel like my I'm gettingsquintier and squint, squint
here. I'm like, trying to openmy eyes.
Dr. Mary Alice Mina (03:48):
I also think we are our toughest
critics, right? Like we arelooking at ourselves, and then
it's like, the only thing we cansee our brows are so heavy, or
my neck, or the banding. And soI think we can also just, it can
almost paralyze us, becausewe're not used to seeing these
(04:08):
things. We're maybe used tobeing looking a certain way,
getting a certain attention, orlooks, or getting that sort of,
you know, you look good, and nowyou kind of reach the age where,
like, Oh, I'm not turning headslike I used to. I don't get the
first drink at the when I'm atthe bar anymore. The sad thing
is, I don't I'm I don't want tospeak for you all, but I still
(04:30):
feel like I'm 25 so then when Isee these changes, I'm like,
wait a minute, that's i i Don'tlook how I feel. And so that can
be sometimes disheartening too.
I think, yeah, it's jarring. Itis jarring. And then then we
have also seen examples of womenthat get like, hyper fixated on
not aging, yeah, and I'm sureyou've seen examples of people
(04:52):
who just go like, way too farwith injectables or Botox. I
mean, I see this in like, I've.
Laura Bowman (05:00):
Young clients that are spending so much money on,
like, blood facials, likethings, and I'm just like,
you're like, 30 something, andyou're, I don't know I am a skin
like minimalist, like some Iheard from one of my, like,
family friends when I was a kidthat she, like, was just gonna
use sunscreen in a bar of ivorysoap. And I was like, ding,
(05:21):
ding, ding, me too. So I'm like,on that weird end, but like, how
do we where is the sweet spotof, not of Me and my ivory soap?
And like, the woman that's nowlooks like her face is a pillow
because she's done so manyinjectables. Yeah,
Dr. Mary Alice Mina (05:39):
it is. It is so, so tricky. And I think as
dermatologists, we I have to becareful with this too, right?
Because I have access towhatever I want, I can do, and
it's a slippery slope that youdon't become so fixated on one
thing or one flaw, because thenyou fix that, and then you you
find another. You're neversatisfied. That's the thing, we
(06:00):
always will find something else.
So I think first and foremost,and this is where people like
you come in, it's we have tokind of do the work internally
like we need to make sure wehave confidence we feel good
about ourselves like that we dothe internal work of taking care
of our mind and body, because ifyou fixate like, this syringe is
(06:21):
going to fix my problems, thistreatment is going to you're
never, you're never going to behappy, right? And that's when
you go down the slippery slope.
So I think having a healthyattitude about aging, not
everything is amazing, right?
But what's the alternative?
Right? So I'd rather age thanthan die young, right? Or died
(06:43):
in my mid 40s. So it's importantto not fixate so much on the
negative, to have outlets thatdon't require you to stare at
yourself and look at yourself,and things that nourish your
mind and body. And then you cancome to me for the last 10 to
15% if you want to, if you needto. And my mom is like you,
(07:05):
Laura, she uses moisturizer andsunscreen. I've tried to get her
a tretinoin product, and I'veoffered my services to her, and
she wants nothing to do with it.
And she's almost 70, and shelooks great. You know, she looks
70, but she does look great, andher skin looks great. So then,
you know, you have the otherextreme, where people want to do
(07:26):
everything, but it's a slipperyslope, right? Because then you
start not even looking likeyourself. Oh yeah, and I'm in
the middle, right, like I'm okaywith doing tweet, you know,
impactful things that will giveme results or help me feel good,
but I always want to look likemyself, even if that means I do
have some skin laxity or saggingor some wrinkles, I still want
(07:49):
to be me and and that's okay at50 or 60 to have some lines or
some some looser skin or hacking40s, right? But I think
everyone's different, andeveryone has to reach that point
on their own. I can't tellsomeone. You have to figure it
out so,
Colette Fehr (08:10):
and you are a big proponent of skin minimalism as
well, right? And that less ismore finding that sweet spot for
you. So I'm not far beyondLaura, I use L trainer, but
that's the only thing a coupletimes a week. And even that,
it's hard for me to get myselfto use it as often as
consistently. What's an idealskin care routine? I mean,
(08:34):
obviously I know some degree ithas to be customizable for the
person and their issues, butyeah, what do you think is kind
of that sweet spot for a woman
Dr. Mary Alice Mina (08:43):
life. First of all, when I say I'm a skin
minimalist, sometimes peoplethink, Oh, you don't do any
cosmetics. I'm like, No, I docosmetics. But again, I do
selective ones that are thingsthat are beneficial for me, not
just what my best friend got orwhat some beautiful celebrity
got. And so making it work forme. And that's where I think
(09:05):
sometimes people, they justhear, Oh, the halo laser. I
should get the halo laser. Ishould get this. I should get
that. But skin minimalismdoesn't mean doing nothing or
aging completely natural, unlessyou want it to be. But what I
think it, we overdo it, we dotoo many things, and it's
important that you're just doingthe right things for you. So the
bare minimum would be have acleanser, a gentle cleanser you
(09:27):
like, have a moisturizer andhave a sunscreen. If you do
nothing else but Sun protect itwill get you so far. And I can't
believe we're still debatingthis with all the data and
science. And even if you don'tbelieve me, look at your if you
have some older friends orpeople, and look at the ones who
maybe spend more time indoors,and then look at the ones who
(09:50):
have been out in the sun. Andthere's a clear, clear
difference. Or look at yourstomach versus the skin on the
top of your arms, right? That's,that's sun damage over. The
years sun exposed versus Sunprotected. So if you truly want
to be a minimalist, you know,I'd say Laura, more power to you
just, you know, and make sureyou're sun protecting. And that
will take you so far. If youwant to be a little extra, like
(10:13):
I'm a little extra, I do atretinoin at night, which is a
retinoid, or you could do anover the counter retinol. I'm a
big fan of these. It's very costeffective and affordable. It
doesn't work like magicovernight, but if you stick with
it, if you're consistent, youwill see amazing results. It's
one of the most powerfulcollagen boosters that we have.
(10:35):
The problem is, if you guys haveever used it, it's irritating to
the skin, yeah, and it takes awhile, so I don't use it every
night. When I was younger, Icould use it every night without
a moisturizer, and now thethought of doing that is
terrifying. So now every night Iput a moisturizer on, and I
would say four to five nights aweek, I'll put on my tretinoin
(10:59):
with that, and that seems towork well for me. And if I
notice I'm a little extra dry inthe morning, I might skip that
area or skip it the next night.
So is
Colette Fehr (11:08):
that, like, the same as altrina, as altrina
version of that? So I don'tknow, el Trina. Oh, really.
Okay, it's, like, it's, I thinkit's a retinol, just it has a
little moisture in it,
Dr. Mary Alice Mina (11:21):
yeah, if it, I would just see if it's a
retinol, retinoid, and thatprobably is, yeah,
Colette Fehr (11:27):
okay, because it's supposed to have that little
moisture in it to help with theskin dryness. But even I find
that I my skin, and my skin issuddenly so much drier,
Dr. Mary Alice Mina (11:37):
totally my mine as well. And that's a big
thing as we lose estrogen,estrogen helps keep our skin
barrier intact, helps hold inmoisture, and so we start to
lose that. And yeah, your skinwill get drier. And if you have
dry skin to begin with, it canbe, you know, a lot more severe.
So, you know, thankfully, youall live in kind of humid, more
(11:59):
humid climates, right? But evenwhere I am, it can, it can get
somewhat cold, but you may wantto consider getting a humidifier
to help, and then just latheringup with a moisturizer. I find
sometimes throughout the day Ihave to put moisturizer on, and
that's okay, and just I will usea thicker one. You could, even
(12:20):
if you truly have very, very dryskin, use something like
Vaseline, Aquaphor, cerebehealing ointment, you know,
something like that you don'tlove, you don't have to put it
on your whole face at night. Forsome people who are really,
really dry, they may need to dothat. I think the kids call that
slugging. Nowadays,
Laura Bowman (12:39):
my kids are all over using Vaseline like, I
think once you have kids that Iwas telling Colette this and
have gone through like an acnejourney, like my kids are
obsessed with skincare, yeah, ina way that I am not, and my son
has a more elaborate skincareroutine than
Dr. Mary Alice Mina (12:55):
my son too.
Colette Fehr (12:58):
I'm like, what is that? So? Okay, so let me ask
you this about sun block andstuff, because I wish I had been
on this bandwagon earlier. Youknow, they say I think something
like you get most of your sundamage before a certain age when
you're out playing. I don't evenknow if that's true anymore, now
with our digital generations,but I used to be a kid who went
(13:22):
to the dermatology medicalmeetings and all the kids we'd
all be out with, like reflectorsand baby oil, and I'd have
bubbles. I mean, bad, so I'mlucky it's not worse. But now I
wear sunblock every day. I'mcurious though. I use the Elta
MD One. I love that. Yeah, I putit on every morning before I put
(13:43):
on my makeup. But what aboutreapplying during the day? Do
you do that because doesn'tsunblock wear off in like, 90
minutes or something? Or is thatnot true?
Dr. Mary Alice Mina (13:53):
Not not that fast, but we do say if you
are outside, you should reapplyit every two hours. If you're
sweating or swimming, like ifI'm at the beach, then I will
reapply. Here's the thing, Ieven dermatologists aren't great
at reapplying. It's tricky,right? And I don't reapply when
I am indoors all day. But as thesummer, you know, approaches,
(14:15):
the days get longer. If I leavemy office and I know I'm going
to go outside and take a walk orgo to the playground with my
kids or be outdoors, then I willreapply on areas that are
exposed. My other favoritething, because I don't love
wearing a lot of stuff on myskin, is I will have a hat with
me, and I just don't care if itlooks cool or not. I personally
(14:41):
think it looks cool, but I justhave a hat with me, because then
I don't have to worry about, didI reapply? Did I rub it all in?
Did it? Did it get my part? Youknow, people, I'm not going to
put sunscreen in my hair, right?
So, so I have a hat with me, andI also, I think they're really.
Cute sun protective clothing outthere. And one of my favorite is
(15:02):
there's like, a little shawlkind of thing I can get. And so
if I know I'm gonna be somewhereoutside and I've got a tank top
on, I will just like, throw it'ssuper easy to throw in your
purse, and I'll just kind oflike, drape it over my
shoulders, if I know I'm gonnabe exposed. So I personally love
using clothing to also helpprotect me from the sun, instead
(15:25):
of just relying on sunscreen.
But it is tricky. I hear this alot with women like, if you've
got your makeup done and youdon't necessarily want to mess
it all up, and I hear you, so Iwould just say, either, stay in
the shade, get a hat, yeah, butit, but if you're at the beach
(15:46):
or you're at a sporting event orsomething like that, it is
important to reapply. I thinkthat's where people that's where
people get burned becausethey're good in the beginning,
and then it just kind of forget,yes.
Laura Bowman (15:56):
So I love, I love how you said that there are
certain things that you do thatare impactful. And I want to
know, like, what are the things?
And, of course, I know it'sdifferent for everybody, but
like, what are the things thatreally move the needle in, like,
making you look younger, thatdone, you know, in a thoughtful
way, really, like, change thegame. Well,
Dr. Mary Alice Mina (16:21):
so talking about skin, because I really
think, and I know you're like,you're a dermatologist, we want
to focus on the skin stuff, buttaking care of your body makes
such a difference with yourskin. People forget your skin is
an organ, and it really isalmost like a reflection or a
mirror to what's going oninside. So if you are staying up
(16:43):
all night, you're not sleeping,you're drinking a lot, you're
smoking, you're stressed out allthe time, your skin is going to
reflect that. So we don't givethat enough attention. So
focusing on, I'll say skinhealth is whole body health. So
before rushing out to buy moreproducts, do more procedures,
right? Is take a look at youryour life and your your health
(17:06):
in general, I think, makes ahuge impact on your skin. But
what about like skin care andall that? I would say again, not
to be a broken record, but sunprotection. I had never done a
laser procedure on my face untilabout this year, and I just kind
of did it for fun at aconference. And I've done that,
(17:28):
and I've consistently used aretinoid since I was probably in
my late 20s. Wow. And, and justby doing that, which cost
comparatively nothing, and,well, and a little Botox, like I
started doing Botox in my mid30s, a little couple times a
year, a little bit of Botox thatthat to me, I think, has been
(17:50):
the most impactful. And then nowin my 40s, I'm starting. I've
done a few vials of Sculptra.
And I am a big fan of sculpture.
It builds your own collagen.
It's very natural looking. Iknow my collagen is going to
drop, you know, about 30% withinthe first five years after
menopause, and even after mid20s, your collagen is going
(18:10):
down. So I think it's a good wayto sort of collagen bank. Now,
not everyone needs this. Somepeople have naturally fuller
faces, and that may not be whatthey need. They may have more
scarring from acne when theywere a kid, and so I would say
for someone like that, somethingimpactful for them would be a
(18:32):
laser or something to try tohelp address that scarring and
make their complexion or thetexture more uniform for someone
who has a lot of pigmentaryissues, maybe a lot of sun spots
from being outdoors, or they geta lot of hyper pigmentation, so
their skin is not a nice uniformcolor. Addressing that would be
(18:52):
more impactful for them. So it'sit's going to vary for everyone,
but I think universally, if youjust Sun protect and use a
retinoid, then you're way aheadof the rest.
Laura Bowman (19:08):
And just for people who don't really know,
like, can you get that aretinoid over the counter, or
does it have to be prescribed
Dr. Mary Alice Mina (19:15):
so a Retinol is over the counter? And
those tend to be a littlegentler. They're a little bit
weaker. They're not as strong.
It's not standardized as youknow. Like the prescriptions,
where I know what strengthyou're getting, but you can
certainly start with that. Ilike the prescription strengths,
and you can get started thelowest and then work your way up
(19:35):
or stay at the lowest. And Ithink the key for women our age
is to use it with a moisturizerand to just use a tiny pea.
Yeah, people, I think peoplethink it's a like a lotion and,
and, and you don't need to rubit like that. And then my other
tip is, I wish I had done thissince I was in my 20s, is to
(19:56):
include your neck. When you'reputting it on, we sort of think
our skincare stops at ourjawline, right? So do your neck?
Do the tops of your hands?
That's an area
Colette Fehr (20:10):
that goes separated, yeah. Why am I not
doing my stuff on my neck whenmy neck is worse, okay? While
we're on that, can we talkabout, is there anything that
can be done for this awful likeI am so banded. Is there
anything for that?
Dr. Mary Alice Mina (20:27):
Are you taught? Are your bands going
more horizontal or vertical? Ah,I
Colette Fehr (20:31):
think they're more horizontal, horizontal, yeah,
Dr. Mary Alice Mina (20:35):
the tech neck. So if they were vertical,
if they were vertical, those areyour platysmal bands, which is
the muscle of our neck, andthose can be addressed very
nicely with Botox or disportthings like that. The horizontal
ones, first of all, even kidshave this, right? I'll even look
at children and they have thesehorizontal neckline so don't
(20:56):
think you know, we can get ridof them totally. And we are
bending our necks a lot, right,looking at our phone, looking at
the computer keyboard and allthat, I would say, helpful
things. Again, nothing's a quickfix, necessarily. But using your
retinoid on your neck can behelpful. Putting in some filler
can be helpful in the neck.
Yeah, or hyaluronic acid fillerradius or sculpture, they can
(21:21):
those can work nicely. And thenI love lasers that can help
build your collagen. So doing alaser that is going a little bit
deeper to help stimulate thecollagen, some people have great
results with radio frequency,micro needling. People are
trying, right? And it's not likethere's a one, because, trust
me, if there was, I would havedone it. But it kind of just
(21:43):
depends what kind of, what kindof neck you have, if you need
more volume, and then reallythe, you know, a neck lift,
sometimes there's just a goodbit of skin. And if you were
like, I want this, and you keeppulling your neck bag.
Colette Fehr (22:00):
I'm gonna have to do this at some point, because
this is actually the thing thatbothers me the most, is that my
face has sunk a little likeright here. And like you said, I
do feel 25 inside, and then I'llcatch a glimpse of myself on
something. I'm like, Who's thatold lady?
Dr. Mary Alice Mina (22:21):
No, I know I'll see my mom, and I'm like,
Oh my gosh, I am turning into mymother. You know,
Laura Bowman (22:28):
my mom? I was telling Colette, my mom did a
neck lift and a bluff when shewas, like, 54 and it bought her,
like, 15 years facially, yeah,like she it just looked, I mean,
I wish I could post the pictureswith her without her wanting to
kill me. But they were justlike, it was so good, wow.
Dr. Mary Alice Mina (22:49):
Yeah. And I think sometimes people get real
nervous about surgery, yeah. Butsometimes that is, you could, I
feel like you, you can spin yourwheels and try all these things
and really just cut, cut theskin out if it really, really
bothers you. And I love a bufferof plastic. I think that that's
an eyelid lift and or tuck. It'sa great way to open the eyes. If
(23:12):
a lot of times, when I you knowpeople typically a little bit
older than us, 60s, 70s, theyhave to use their forehead to
hold their eyes, their eyelidsup, and so by the end of the
day, they just feel exhaustedand heavy. And really a fairly
simple procedure for someone whoknows what they're doing, it's
to just remove that skin so theydon't have to, you know, hold
(23:37):
their eyebrows up just to see.
Colette Fehr (23:40):
It's a great thing. I mean, my aunt did that
with the eyelids in her, maybemid to late 60s, I want to say.
And it made a huge difference.
And she looks her age, but shejust looks great for her age.
You know? She looks really vitaland alive, and not obviously
plastic surgery, right? So,okay, so what I'm getting so far
(24:00):
in this, this is comforting tohear again from you that really,
if we're doing a good cleansingour skin, wearing sunscreen and
maybe considering adding aretinoid to your routine, that
that is that can work really,really well. And you don't have
(24:21):
to go crazy, spending a fortune,necessarily, with a million
procedures, although a littleBotox can help, you know,
depending on why. I mean, I'vebeen doing Botox since my mid
30s, too, and my forehead, youknow, it's not working as well
in a way now, like I either feelso frozen that I look weird, or
it's hard to get your lines togo, Yeah, my brows sink. So it's
(24:46):
becoming more challenging. And Idon't know, I think there are
probably other women listeninglike me who wonder, Am I going
to be botoxing My forehead tillI'm 80? Like, is this. Yes, at
some point, am I giving up, oram I just gonna keep going? You
know, yeah, foreheads
Dr. Mary Alice Mina (25:06):
are tricky.
In fact, a lot of my more maturepatients, I don't treat their
forehead because, again, they'reusing their forehead to hold
their eyelids up, and sometimeswhat they really need is a brow
lift to just cut their browshave fallen. They just need
those placed a little bithigher. But a lot of times, you
can still treat the scowl linesthose elevens pretty much until
(25:27):
you're 100 or whatever, if youreally want. But I do start to
back off on the forehead alittle bit, because it does can
either lead to a heavy brow andcan make it hard to see. They
feel like their their eyes don'topen as well. So it does get
tricky, but I do think by doingit early, you have staved off
(25:48):
developing those etched in lineswhich will serve you well down
the road.
Laura Bowman (25:57):
Good to know. Good to know. What? What about
estrogen on the skin like we'vebeen hearing about that lately,
and I don't know what to make ofHave you seen that be impactful?
Dr. Mary Alice Mina (26:09):
Yes, and I, and I've been prescribing it a
lot more. So I didn't realizethis, but actually, estrogen was
in skincare back in the 40s,before the FDA and regulations.
Yes, and, and people loved it.
But then, once the FDA wasformed, and I don't know the
exact details why, but itstopped being put in there. And
I think for a while, women havebeen using their vaginal
(26:30):
estrogen cream on their face.
Kind of all label,
Colette Fehr (26:36):
yeah, they said that the menopause conference,
we said, put it on your part.
Yeah,
Dr. Mary Alice Mina (26:42):
yeah. So, so people have been, you know,
women have been kind of figuringthis out, like, Well, hey, if it
helps the skin there, which weknow, it's very helpful there,
it prevents UTIs, it helps withdryness and pain and and so
women knew that, oh well, let metry it on my face. I think the
issue was the formulation wasn'tnecessarily that desirable to
(27:06):
apply on the face. And also, Idon't know if people necessarily
wanted their, you know, vaginalcream sitting right on the
counter next to theirtoothbrush. I don't know. Maybe
they didn't care, but, but now Ithink with this new push to kind
of recognize menopause as awhole season in life, and not
just something to just ignoreand forget about, forget about
(27:29):
women. Now, companies haveformulated more elegant products
with estriol to apply on theskin, and I think we're going to
be seeing a lot more of this andmore studies showing the impact,
but we know it works for the thevaginal skin, so I think it's a
great option. And I'll tell mypatients, when I prescribe it to
them, to use it like amoisturizer, that they can use
(27:52):
it and it can help with dryness.
So that's that's something to
Colette Fehr (27:55):
try too. So you could use that with your
retinoid, yeah,
Laura Bowman (28:00):
like, instead of your moisturizer that you use,
Colette Fehr (28:04):
yeah. And so, what do you what do you like to
prescribe for an estriol? I'mlike, I'm getting some today.
Dr. Mary Alice Mina (28:11):
I just, I use a compounding company called
Skin medicinal, and it's, theyhave an estriol cream, and I got
it to try myself, and it feelsgreat. It's light. It does seem
like a moisturizer, so that'swhat I tell my patients, to use
that in place of theirmoisturizer.
Laura Bowman (28:29):
Oh, my God, I want some. Yes, let's get some right
Colette Fehr (28:33):
away. Yeah. But I also like that you're pointing
to how important it is to takecare of your whole body, and
that the skin is an organ, andit's not just about procedures
and creams, and it really isabout sleeping, hydrating,
eating. Well, how much doessleep affect the skin? I would
(28:56):
imagine, more than we think,right?
Dr. Mary Alice Mina (28:58):
Totally.
And you know, it's taken me 40years to figure this out. Where
I feel like our culture is,especially in medicine. It's
like, you know, sleeping for theweek, and you know, you need to
pride yourself on not sleeping.
And then I think I hit 40, and Iwas like, I need to sleep like,
I cannot stay up all night. Andnow that I have a I don't sleep.
(29:20):
You know, probably a sleepexpert would tell me, I need to
sleep more, which is fairenough, but I'm working on it,
but just getting a consistentschedule to get about six and a
half hours a night for me makesme feel amazing. Now, ideally, I
probably should be getting sevenand a half right. I recognize
that, but just being on aconsistent schedule has been
(29:41):
helpful, not just for my skin,but for everything. Yeah. I
mean, think about when you weremaybe in college, or we had
newborns, right? And you're upall night. Did you look good
when you looked in the mirror?
No, like you accentuated darkcircles under your eyes you
might have. More like puffinessand swelling, and then you don't
eat right when you're tired andyou're, you know, not going to
(30:05):
go exercise. So all these thingshave downstream effects. So
sleeping is important. It's atime for our body, including our
skin, to regenerate and to havegood blood flow and our skin
cells to turn over so it all.
It's so important. And I dothink it's great. I feel like
people are now even like bigCEOs and people are promoting
(30:29):
sleep and and letting lettingpeople know it's not a sign of
weakness. It's actuallycritical, right?
Colette Fehr (30:35):
I know I'm so glad to I've never been a good
sleeper, and I take it soseriously now. So I'm glad to
hear you say that, and also thatyou're speaking to these things
that really matter for the skin,and there are some things that
people believe that don'tmatter. Are there any myths that
you just giggle about as adermatologist or that you could
(30:56):
debunk for our listeners?
Dr. Mary Alice Mina (30:58):
Gosh, I feel like there's always
something. And I feel like withsocial media, it's almost like,
the more outrageous to get, themore views. And it's kind of
crazy. One that doesn't make megiggle, it actually really makes
me cry, is this whole thing ofsunscreen causes cancer and
that, you know, parents I hearwho don't put sunscreen on their
(31:20):
kids and their kids are burning.
I mean, that really breaks myheart. Yeah, because I see the
patients when they're older withthe skin cancers, and they all
tell me, I wish I had known Iwish I could go back so that
that to me. I wish we didn'thave that. I wish we didn't have
celebrities promoting that, orpeople with large platforms. I
think just following a lot ofthese Tiktok trends, you know,
(31:42):
it's always something new,right? Flaxseed oil, it can, can
work instead of Botox, or tapingyour face instead of Botox, or,
you know, beef tallow, or allthese, all these different
things. And it's like, you know,or a lot of the DIY stuff at
(32:02):
home, it's like, there, there'sstuff we know that works, that's
formulated just for your skin,and it's been tested and tried
and true. You know, you don'tneed to reinvent it and make it
in your own kitchen. That justbecause you made it in your
kitchen doesn't mean it'sbetter, right? I think that
concept that natural is alwaysbetter, but something made very
(32:26):
elegantly and cleanly andpulling out just the important
ingredients and actives in a labis not a bad thing. Just because
it was created in a lab, it'snot reasonable to think we're
gonna all just rub oranges onour face for vitamin C serum,
right? So I think just, I wishpeople would just trust the
(32:47):
experts with skin health and notjust follow whatever they see on
social media or someone tryingto get views or clicks or likes,
and just, also, it's hard to notbe persuaded like, oh, maybe I
need that product. Oh, I'venever heard of that. Maybe I do
need that. It's very tempting towant to stray from what you use
(33:10):
and find the next shiny object,but really, consistency is key.
And I joke that I've used thesame cleanser. It's the dove
Beauty Bar. I've used it fordecades. There we go. And every
you know people, sometimes I'llgo to a conference or someone
like, I'm gonna try a foamingface wash or something. And I
(33:31):
always just go back to my dovebecause it's easy and it works.
And so why? Why do I need tocomplicate it with a separate
one for my face and body and allthat. So if it's working for
you, stay with it. Yeah.
Laura Bowman (33:47):
And another, another thing that, like Colette
and I were talking about, isthat, you know, how much of it,
how much of good skin is thesepreventable things and these
routines that we do, and howmuch of it is just the genetic
Dr. Mary Alice Mina (33:59):
lottery?
Well, genetics does play a role,for sure, but I would also say,
like, your epigenetics, right?
Like, what's actually turned onand we we can control a lot more
than we think. So, yes, if youare born with, you know, eczema
or certain conditions, then thatis going to be your skin's going
(34:22):
to be different than someone whodoesn't have those struggles.
Right? To me, it's more justyour overall like look and
appearance and bone structureand all that that I think, play
a role, but you can still do somuch. So you know, you may have
gotten your acne from your dador whatever, your baldness, but
there's still so much you cando, and so I don't think I would
(34:44):
just say, Oh, well, I throw myhands up. I can't do anything
about it.
Colette Fehr (34:48):
That's a great way to put it. So what kind of
sunblock Do you like to use? I'mjust curious, because you
obviously have very beautifulskin. Oh,
Dr. Mary Alice Mina (34:56):
well, thank you. I like L to MD. I. Think
it's a great it's a great pricepoint. It's, I like to put it on
my face. It's very elegant. Ilove the spray because it's,
it's a mineral spray, but it'sso, so light, and it works great
for, like, spraying on my kidsand rubbing them down real fast.
They really like the sticksunscreen. So I've got a 11 and
(35:20):
10 year old. So I thinkNeutrogena has a stick
sunscreen. They use that veryobligingly and and that's
another thing I would just say,for people who have kids
listening, you know, and maybeyour kids are older, but I would
say, just try to model thebehavior you want them to have.
My kids, don't fight me aboutwearing hats, because that's
(35:41):
just what we've been doing sincethey were babies. And they see
Mom puts her hat on, they puttheir hat on rash guards like
that's just what we do whenwe're outside, at the beach, in
the pool, we put our rash guardson. So I think that that's
helpful. But for sunscreen, I'lltell people, there's no magic
sunscreen. SPF, 30 or higher,broad spectrum, but the most
important thing is, you like theway it feels. I also like La
(36:03):
Roche Posay. I tend to have moreoily skin, and I don't like to
feel like I have something heavyor sticky on my face. So I like
the ones that you have to shake,and they're super light, yeah,
on my body. I'm less particular,but there's some, I mean, again,
I use sunscreen if it's notlgmd, it's from the drug store,
(36:23):
so that's what I do. Yeah,
Colette Fehr (36:26):
that's great. And how important do you think it is
that the sunscreen has titaniumor zinc in it? So
Dr. Mary Alice Mina (36:33):
if you are worried about chemical
sunscreens, then stick with amineral based sunscreen, like
zinc or titanium. There havebeen some studies that concern
people where they saw that thechemical sunscreens were
absorbed by the bloodstream, andso they were measured in the
bloodstream after use, which weknow things are absorbed through
(36:53):
our skin. So that's not reallysurprising. The study didn't say
there was any harm from that, orany negative side effects from
that, whatsoever. But if you areconcerned about that, then, then
sure, stick with the mineralbased sunscreen. That's totally
fine. The problem with thosesometimes is that they're not
quite as elegant. If you have adarker skin, sometimes they can
(37:15):
leave more of a white, chalkycast. So don't be scared of
chemical sunscreens. Theythere's a no study showing human
harm and all that. But again,also, don't think of sun
protection as stopping at yoursunscreen, right? Throw on a
hat. Wear sunglasses, throw onsomething to cover your the tops
of your arms, if you're on aboat or paddle boarding, so
(37:37):
you're not just like roastinglike a rotisserie chicken. Yeah,
Colette Fehr (37:42):
yeah. I mean, Florida really has made me I
mean, what you said is so true.
You can see the difference incolder climates versus people
who live here and the sun isjust so strong and relentless
all the time. Yeah. And, youknow, as we get older, and you
just, I just don't, I don't evenfeel good when the sun's beaming
on me, unless I feel like I havesomething.
Dr. Mary Alice Mina (38:05):
So yeah, I am, I am right there, yes, yeah,
even just
Laura Bowman (38:10):
the side of your face from the driving in the
car, the one side of my face is,it's a little darker,
Dr. Mary Alice Mina (38:18):
yeah, the left side, and I the hat, the
baseball cap, like I willfrequently see in guys there,
the this part of their face,sort of the mid part of their
face, will be nice, and not alot of sun damage, but all the
sides have a lot of sun damagefrom I can, I can see, like,
where the baseball cap shadedit. So, yeah, just think if you
(38:40):
had just shaded all of it,right,
Colette Fehr (38:43):
right? And you're right, it's such a great point.
Look at your stomach, or, youknow, my kind of lower back,
where the skin has had so muchless exposure over unless you're
somebody who works outside everyday in a bathing suit, it's
dramatically different,
Dr. Mary Alice Mina (38:58):
right? Or or even the top, like your arms,
like the top of your arm, flipit, if they're different colors,
then,
Colette Fehr (39:09):
yeah, and I have, I do have a lot of melasma now,
it's really, it's a bummer,
Dr. Mary Alice Mina (39:16):
yeah, well, that that's one thing I should
say, Colette some, Some peopleone thing to think about with
the estriol cream is there havebeen some anecdotal reports that
it could worsen melasma. Sothat's just one thing to keep in
mind. I think it's still worthtrying it, or maybe trying an
area to see, but just for thelisteners to know about that,
Colette Fehr (39:38):
okay, that's great to know and good to know that
you don't have any opposition toputting the estrogen cream on
your face. Because I waswondering, is that even true? Is
that even good?
Dr. Mary Alice Mina (39:48):
No, no. And do your neck too? Neck, top of
your hands, upper chest. So yes,
Colette Fehr (39:54):
I'm going to put my red and we're going to take a
bath. Yes, but it's greatadvice. To use a small amount,
because I'll get the dryness,particularly like here, you
know, in the creases, especiallywhere it peels. And, yeah, it's
so many the faces dry, but youdon't want wrinkles. So there's
so many things to think about,yeah,
Dr. Mary Alice Mina (40:16):
and I would say anyone trying, don't give
up. Play around with it. And Ithink of it, I like to treat to
a little bit of peeling, just asmidge, because then I'm like,
Okay, it's doing what it'ssupposed to Yeah,
Colette Fehr (40:28):
yeah. And anything you recommend to our listeners
to ask their dermatologist, orgo into their dermatologist
specifically saying that theymight not think of I think if
Dr. Mary Alice Mina (40:39):
you've had a lot of sun damage, and you're
in your 40s plus, and you havenever had or really, if you
never had a skin check, get inand have a skin check, because
it no matter what color you are.
Or really, if you think you'vehad a lot of sun or not, right,
if you are in your 40s, you'veseen some sun, let them look you
over head to toe, scalp tobottoms of your feet. And they
(41:01):
can help you know what to lookfor. I think a lot of people
know what to look for withmelanomas, which are the dark
spots, but they don't know aboutthe much more common basal cell
carcinomas and squamous cellcarcinomas, which can happen
starting in this phase of life.
And then they can also helpguide you on what skincare
(41:24):
regimen you should be doing, andany potential treatments or
lasers or devices that you mightbe interested in. They can kind
of go over all that with you,but I would say if you never had
a skin check, that would be agreat opportunity to go and
sometimes people think thesebrown spots on their skin are
sunspot or, you know, like abrown spot for a laser, and it
(41:45):
could be a melanoma. So again,just getting an expert's eyes on
your skin first, can, I think,be really helpful, and
Colette Fehr (41:53):
for the average person, once a year, like an all
over body mold check kind ofthing? Okay, yeah, I
Dr. Mary Alice Mina (41:59):
would say once a year, but they'll let you
know. If you're someone who'shad a lot of sun damage, maybe
have a lot of moles, maybe afamily history of melanoma, they
may want to see
Colette Fehr (42:07):
you twice a year.
Yeah, yeah. I'm definitelygetting to the point where I
know so many people who arehaving to have something removed
or have a skin cancer, and Ithink maybe especially being on
Florida, it's just seems so I'llnever forget the first
dermatology appointment I wentto here, the entire waiting
room, and that doctor that Iused to see was a Mohs surgeon.
I mean, the entire waiting room,it looked like, you know,
(42:30):
Purgatory, because everybody wasjust an old and had, like, the
bandages on their nose.
Dr. Mary Alice Mina (42:40):
Yeah, I tell my younger patients like,
you're going you're gonna sit inmy waiting room and think I
don't belong here. One of thesethings is not like the other.
That was me
Colette Fehr (42:49):
and my 20s, but it's you know what think about
that for our listeners who areyounger, I mean, wear the
sunscreen every day. If I couldgo back in time, that is the one
thing I would do, and a hat.
Yeah, protect yourself when youdon't think you need to, because
you'll be really glad later.
Dr. Mary Alice Mina (43:07):
Yeah, they say, if you want beautiful skin
in your 50s, wear wear sunscreenor some protecting your 20s.
Colette Fehr (43:13):
Yeah, I'm going to tell my daughters this. My
daughters are both in their 20s.
I'm going to be telling themthis again after this recording.
Well, Dr, Mina, thank you somuch. Can you share with our
listeners how they can find youand anything else you'd like to
promote in particular? Yeah,
Dr. Mary Alice Mina (43:32):
well, this was a lot of fun, ladies. I'm so
glad we got to chat today. Iactually have a podcast called
the skin real, R, E, A, l, so ifyou are curious about certain
skin things, procedures,devices, I really just kind of
cover topics that I get askedabout all the time. And I'm at
at Dr Mina skin on all thesocial media platforms, YouTube,
(43:55):
all that good stuff. Andactually, if you this is a fun
quiz. If you want to know, whereyou know, are you more of a
Laura, are you more of a colead, or me? You can take a fun
quiz to find your skin style atthe skin real.com forward slash
style. Great.
Colette Fehr (44:11):
And we'll put all that in the show notes. I'm
going to take the quiz. I wantto find out.
Laura Bowman (44:16):
I think I know it's end of the spectrum I'm on,
but
Colette Fehr (44:19):
I love, I love that kind of stuff. That's
great. So, and your podcast isgreat, so I think our listeners
would really enjoy that as well.
Dr. Mary Alice Mina (44:28):
Well. Thank you.
Laura Bowman (44:30):
Thank you so much for listening today. We hope you
got some insights from ourcouch. If you like what you
heard, and we hope that you did,don't forget to subscribe and
share with a friend and write areview. Thanks for listening,
guys. We'll see you next timesee you, next time you.
Hi everyone.
Welcome back to another episodeof insights from the couch. We
are talking skin today with afabulous Dermatologist, Dr Mary,
Alice Mina, and we're going tobe getting into everything you
need to know about sunscreen,holistic skin care, what
treatments to get? Whattreatments not to get? Does
(00:25):
putting estrogen on your facemake a difference, especially
for women at middle age? Youknow, what can we be doing to
take care of our skin? So you'regoing to want to stay tuned for
this one, because we're askingDr Mina all the questions, but
first, let me briefly introduceher. She's so impressive. Dr
Mina is a Harvard traineddermatologist, international
(00:47):
speaker, author and host of theskin reel, a podcast, ranked in
the top 2.5%globally. She's a co owner of
Balcombe and Mina DERM surgeryin Atlanta, Georgia, and a
leading expert in proceduraldermatology, skin health and
skin care. She has nearly twodecades of clinical experience
and is celebrated for herartistic, eye surgical precision
(01:09):
and ability to help patientsfeel radiant at every stage. Dr
Mina is also a sought afterspeaker, and she's been featured
in all kinds of media outlets,People Magazine, The Wall Street
Journal, glamor and HuffingtonPost to name a few. Welcome. Dr
Meena, we're so thrilled to haveyou today, so let's just jump
(01:31):
right in and start off with whatcan you tell us? Dr Amina, about
the hormonal changes that happenat this phase of life, and how
that affects the skin. Like,what are some of the most common
issues you see with women atmidlife? As a dermatologist,
Dr. Mary Alice Mina (01:50):
gosh, see and have experience, or am
experiencing, right? So lots ofthings happen. A common issue
is, I used to have great skin,or someone never even really
thought about their skin, andall of a sudden they look in the
mirror and they feel likethey've aged overnight, and
they're like, what is happening?
My skin is crepey. I have thesewrinkles I never had before, the
(02:12):
neck people. I feel like that'sone of the first areas people
notice it, and I can relate. Soyeah, the neck and yeah, they
are jowling that people feellike they're starting to get
jowl so they they feel like theword I hear a lot is my face is
falling, things are just movingsouth. And so that's a big one.
(02:35):
And then hair loss is a anotherbig one that I see during this
period, and this can happensooner than people realize. It
can happen in your late 30s,early 40s. You can start seeing
this even before you see thetraditional signs of menopause,
right, like the hot flashes andbrain fog and other things that
(02:56):
women will experience so in thissort of perimenopausal phase
where your hormones arefluctuating, you can start to
see these changes.
Colette Fehr (03:10):
Okay, you just hit the nail on the head. My neck
looks like ET like, it's likeall like banded. And I'm that
person who I feel like. I alwayshad great skin. My whole life. I
don't wash my face. I didn't doanything, and all of a sudden my
skin's getting really dry. Mywrinkles are more pronounced. I
(03:30):
have gels. The neck thing, it'sreally crazy. The Face falling
is, is the perfect you
Laura Bowman (03:38):
know, I feel like my brows like I feel like my, I
feel like my I'm gettingsquintier and squint, squint
here. I'm like, trying to openmy eyes.
Dr. Mary Alice Mina (03:48):
I also think we are our toughest
critics, right? Like we arelooking at ourselves, and then
it's like, the only thing we cansee our brows are so heavy, or
my neck, or the banding. And soI think we can also just, it can
almost paralyze us, becausewe're not used to seeing these
(04:08):
things. We're maybe used tobeing looking a certain way,
getting a certain attention, orlooks, or getting that sort of,
you know, you look good, and nowyou kind of reach the age where,
like, Oh, I'm not turning headslike I used to. I don't get the
first drink at the when I'm atthe bar anymore. The sad thing
is, I don't I'm I don't want tospeak for you all, but I still
(04:30):
feel like I'm 25 so then when Isee these changes, I'm like,
wait a minute, that's i i Don'tlook how I feel. And so that can
be sometimes disheartening too.
I think, yeah, it's jarring. Itis jarring. And then then we
have also seen examples of womenthat get like, hyper fixated on
not aging, yeah, and I'm sureyou've seen examples of people
(04:52):
who just go like, way too farwith injectables or Botox. I
mean, I see this in like, I've.
Laura Bowman (05:00):
Young clients that are spending so much money on,
like, blood facials, likethings, and I'm just like,
you're like, 30 something, andyou're, I don't know I am a skin
like minimalist, like some Iheard from one of my, like,
family friends when I was a kidthat she, like, was just gonna
use sunscreen in a bar of ivorysoap. And I was like, ding,
(05:21):
ding, ding, me too. So I'm like,on that weird end, but like, how
do we where is the sweet spotof, not of Me and my ivory soap?
And like, the woman that's nowlooks like her face is a pillow
because she's done so manyinjectables. Yeah,
Dr. Mary Alice Mina (05:39):
it is. It is so, so tricky. And I think as
dermatologists, we I have to becareful with this too, right?
Because I have access towhatever I want, I can do, and
it's a slippery slope that youdon't become so fixated on one
thing or one flaw, because thenyou fix that, and then you you
find another. You're neversatisfied. That's the thing, we
(06:00):
always will find something else.
So I think first and foremost,and this is where people like
you come in, it's we have tokind of do the work internally
like we need to make sure wehave confidence we feel good
about ourselves like that we dothe internal work of taking care
of our mind and body, because ifyou fixate like, this syringe is
(06:21):
going to fix my problems, thistreatment is going to you're
never, you're never going to behappy, right? And that's when
you go down the slippery slope.
So I think having a healthyattitude about aging, not
everything is amazing, right?
But what's the alternative?
Right? So I'd rather age thanthan die young, right? Or died
(06:43):
in my mid 40s. So it's importantto not fixate so much on the
negative, to have outlets thatdon't require you to stare at
yourself and look at yourself,and things that nourish your
mind and body. And then you cancome to me for the last 10 to
15% if you want to, if you needto. And my mom is like you,
(07:05):
Laura, she uses moisturizer andsunscreen. I've tried to get her
a tretinoin product, and I'veoffered my services to her, and
she wants nothing to do with it.
And she's almost 70, and shelooks great. You know, she looks
70, but she does look great, andher skin looks great. So then,
you know, you have the otherextreme, where people want to do
(07:26):
everything, but it's a slipperyslope, right? Because then you
start not even looking likeyourself. Oh yeah, and I'm in
the middle, right, like I'm okaywith doing tweet, you know,
impactful things that will giveme results or help me feel good,
but I always want to look likemyself, even if that means I do
have some skin laxity or saggingor some wrinkles, I still want
(07:49):
to be me and and that's okay at50 or 60 to have some lines or
some some looser skin or hacking40s, right? But I think
everyone's different, andeveryone has to reach that point
on their own. I can't tellsomeone. You have to figure it
out so,
Colette Fehr (08:10):
and you are a big proponent of skin minimalism as
well, right? And that less ismore finding that sweet spot for
you. So I'm not far beyondLaura, I use L trainer, but
that's the only thing a coupletimes a week. And even that,
it's hard for me to get myselfto use it as often as
consistently. What's an idealskin care routine? I mean,
(08:34):
obviously I know some degree ithas to be customizable for the
person and their issues, butyeah, what do you think is kind
of that sweet spot for a woman
Dr. Mary Alice Mina (08:43):
life. First of all, when I say I'm a skin
minimalist, sometimes peoplethink, Oh, you don't do any
cosmetics. I'm like, No, I docosmetics. But again, I do
selective ones that are thingsthat are beneficial for me, not
just what my best friend got orwhat some beautiful celebrity
got. And so making it work forme. And that's where I think
(09:05):
sometimes people, they justhear, Oh, the halo laser. I
should get the halo laser. Ishould get this. I should get
that. But skin minimalismdoesn't mean doing nothing or
aging completely natural, unlessyou want it to be. But what I
think it, we overdo it, we dotoo many things, and it's
important that you're just doingthe right things for you. So the
bare minimum would be have acleanser, a gentle cleanser you
(09:27):
like, have a moisturizer andhave a sunscreen. If you do
nothing else but Sun protect itwill get you so far. And I can't
believe we're still debatingthis with all the data and
science. And even if you don'tbelieve me, look at your if you
have some older friends orpeople, and look at the ones who
maybe spend more time indoors,and then look at the ones who
(09:50):
have been out in the sun. Andthere's a clear, clear
difference. Or look at yourstomach versus the skin on the
top of your arms, right? That's,that's sun damage over. The
years sun exposed versus Sunprotected. So if you truly want
to be a minimalist, you know,I'd say Laura, more power to you
just, you know, and make sureyou're sun protecting. And that
will take you so far. If youwant to be a little extra, like
(10:13):
I'm a little extra, I do atretinoin at night, which is a
retinoid, or you could do anover the counter retinol. I'm a
big fan of these. It's very costeffective and affordable. It
doesn't work like magicovernight, but if you stick with
it, if you're consistent, youwill see amazing results. It's
one of the most powerfulcollagen boosters that we have.
(10:35):
The problem is, if you guys haveever used it, it's irritating to
the skin, yeah, and it takes awhile, so I don't use it every
night. When I was younger, Icould use it every night without
a moisturizer, and now thethought of doing that is
terrifying. So now every night Iput a moisturizer on, and I
would say four to five nights aweek, I'll put on my tretinoin
(10:59):
with that, and that seems towork well for me. And if I
notice I'm a little extra dry inthe morning, I might skip that
area or skip it the next night.
So is
Colette Fehr (11:08):
that, like, the same as altrina, as altrina
version of that? So I don'tknow, el Trina. Oh, really.
Okay, it's, like, it's, I thinkit's a retinol, just it has a
little moisture in it,
Dr. Mary Alice Mina (11:21):
yeah, if it, I would just see if it's a
retinol, retinoid, and thatprobably is, yeah,
Colette Fehr (11:27):
okay, because it's supposed to have that little
moisture in it to help with theskin dryness. But even I find
that I my skin, and my skin issuddenly so much drier,
Dr. Mary Alice Mina (11:37):
totally my mine as well. And that's a big
thing as we lose estrogen,estrogen helps keep our skin
barrier intact, helps hold inmoisture, and so we start to
lose that. And yeah, your skinwill get drier. And if you have
dry skin to begin with, it canbe, you know, a lot more severe.
So, you know, thankfully, youall live in kind of humid, more
(11:59):
humid climates, right? But evenwhere I am, it can, it can get
somewhat cold, but you may wantto consider getting a humidifier
to help, and then just latheringup with a moisturizer. I find
sometimes throughout the day Ihave to put moisturizer on, and
that's okay, and just I will usea thicker one. You could, even
(12:20):
if you truly have very, very dryskin, use something like
Vaseline, Aquaphor, cerebehealing ointment, you know,
something like that you don'tlove, you don't have to put it
on your whole face at night. Forsome people who are really,
really dry, they may need to dothat. I think the kids call that
slugging. Nowadays,
Laura Bowman (12:39):
my kids are all over using Vaseline like, I
think once you have kids that Iwas telling Colette this and
have gone through like an acnejourney, like my kids are
obsessed with skincare, yeah, ina way that I am not, and my son
has a more elaborate skincareroutine than
Dr. Mary Alice Mina (12:55):
my son too.
Colette Fehr (12:58):
I'm like, what is that? So? Okay, so let me ask
you this about sun block andstuff, because I wish I had been
on this bandwagon earlier. Youknow, they say I think something
like you get most of your sundamage before a certain age when
you're out playing. I don't evenknow if that's true anymore, now
with our digital generations,but I used to be a kid who went
(13:22):
to the dermatology medicalmeetings and all the kids we'd
all be out with, like reflectorsand baby oil, and I'd have
bubbles. I mean, bad, so I'mlucky it's not worse. But now I
wear sunblock every day. I'mcurious though. I use the Elta
MD One. I love that. Yeah, I putit on every morning before I put
(13:43):
on my makeup. But what aboutreapplying during the day? Do
you do that because doesn'tsunblock wear off in like, 90
minutes or something? Or is thatnot true?
Dr. Mary Alice Mina (13:53):
Not not that fast, but we do say if you
are outside, you should reapplyit every two hours. If you're
sweating or swimming, like ifI'm at the beach, then I will
reapply. Here's the thing, Ieven dermatologists aren't great
at reapplying. It's tricky,right? And I don't reapply when
I am indoors all day. But as thesummer, you know, approaches,
(14:15):
the days get longer. If I leavemy office and I know I'm going
to go outside and take a walk orgo to the playground with my
kids or be outdoors, then I willreapply on areas that are
exposed. My other favoritething, because I don't love
wearing a lot of stuff on myskin, is I will have a hat with
me, and I just don't care if itlooks cool or not. I personally
(14:41):
think it looks cool, but I justhave a hat with me, because then
I don't have to worry about, didI reapply? Did I rub it all in?
Did it? Did it get my part? Youknow, people, I'm not going to
put sunscreen in my hair, right?
So, so I have a hat with me, andI also, I think they're really.
Cute sun protective clothing outthere. And one of my favorite is
(15:02):
there's like, a little shawlkind of thing I can get. And so
if I know I'm gonna be somewhereoutside and I've got a tank top
on, I will just like, throw it'ssuper easy to throw in your
purse, and I'll just kind oflike, drape it over my
shoulders, if I know I'm gonnabe exposed. So I personally love
using clothing to also helpprotect me from the sun, instead
(15:25):
of just relying on sunscreen.
But it is tricky. I hear this alot with women like, if you've
got your makeup done and youdon't necessarily want to mess
it all up, and I hear you, so Iwould just say, either, stay in
the shade, get a hat, yeah, butit, but if you're at the beach
(15:46):
or you're at a sporting event orsomething like that, it is
important to reapply. I thinkthat's where people that's where
people get burned becausethey're good in the beginning,
and then it just kind of forget,yes.
Laura Bowman (15:56):
So I love, I love how you said that there are
certain things that you do thatare impactful. And I want to
know, like, what are the things?
And, of course, I know it'sdifferent for everybody, but
like, what are the things thatreally move the needle in, like,
making you look younger, thatdone, you know, in a thoughtful
way, really, like, change thegame. Well,
Dr. Mary Alice Mina (16:21):
so talking about skin, because I really
think, and I know you're like,you're a dermatologist, we want
to focus on the skin stuff, buttaking care of your body makes
such a difference with yourskin. People forget your skin is
an organ, and it really isalmost like a reflection or a
mirror to what's going oninside. So if you are staying up
(16:43):
all night, you're not sleeping,you're drinking a lot, you're
smoking, you're stressed out allthe time, your skin is going to
reflect that. So we don't givethat enough attention. So
focusing on, I'll say skinhealth is whole body health. So
before rushing out to buy moreproducts, do more procedures,
right? Is take a look at youryour life and your your health
(17:06):
in general, I think, makes ahuge impact on your skin. But
what about like skin care andall that? I would say again, not
to be a broken record, but sunprotection. I had never done a
laser procedure on my face untilabout this year, and I just kind
of did it for fun at aconference. And I've done that,
(17:28):
and I've consistently used aretinoid since I was probably in
my late 20s. Wow. And, and justby doing that, which cost
comparatively nothing, and,well, and a little Botox, like I
started doing Botox in my mid30s, a little couple times a
year, a little bit of Botox thatthat to me, I think, has been
(17:50):
the most impactful. And then nowin my 40s, I'm starting. I've
done a few vials of Sculptra.
And I am a big fan of sculpture.
It builds your own collagen.
It's very natural looking. Iknow my collagen is going to
drop, you know, about 30% withinthe first five years after
menopause, and even after mid20s, your collagen is going
(18:10):
down. So I think it's a good wayto sort of collagen bank. Now,
not everyone needs this. Somepeople have naturally fuller
faces, and that may not be whatthey need. They may have more
scarring from acne when theywere a kid, and so I would say
for someone like that, somethingimpactful for them would be a
(18:32):
laser or something to try tohelp address that scarring and
make their complexion or thetexture more uniform for someone
who has a lot of pigmentaryissues, maybe a lot of sun spots
from being outdoors, or they geta lot of hyper pigmentation, so
their skin is not a nice uniformcolor. Addressing that would be
(18:52):
more impactful for them. So it'sit's going to vary for everyone,
but I think universally, if youjust Sun protect and use a
retinoid, then you're way aheadof the rest.
Laura Bowman (19:08):
And just for people who don't really know,
like, can you get that aretinoid over the counter, or
does it have to be prescribed
Dr. Mary Alice Mina (19:15):
so a Retinol is over the counter? And
those tend to be a littlegentler. They're a little bit
weaker. They're not as strong.
It's not standardized as youknow. Like the prescriptions,
where I know what strengthyou're getting, but you can
certainly start with that. Ilike the prescription strengths,
and you can get started thelowest and then work your way up
(19:35):
or stay at the lowest. And Ithink the key for women our age
is to use it with a moisturizerand to just use a tiny pea.
Yeah, people, I think peoplethink it's a like a lotion and,
and, and you don't need to rubit like that. And then my other
tip is, I wish I had done thissince I was in my 20s, is to
(19:56):
include your neck. When you'reputting it on, we sort of think
our skincare stops at ourjawline, right? So do your neck?
Do the tops of your hands?
That's an area
Colette Fehr (20:10):
that goes separated, yeah. Why am I not
doing my stuff on my neck whenmy neck is worse, okay? While
we're on that, can we talkabout, is there anything that
can be done for this awful likeI am so banded. Is there
anything for that?
Dr. Mary Alice Mina (20:27):
Are you taught? Are your bands going
more horizontal or vertical? Ah,I
Colette Fehr (20:31):
think they're more horizontal, horizontal, yeah,
Dr. Mary Alice Mina (20:35):
the tech neck. So if they were vertical,
if they were vertical, those areyour platysmal bands, which is
the muscle of our neck, andthose can be addressed very
nicely with Botox or disportthings like that. The horizontal
ones, first of all, even kidshave this, right? I'll even look
at children and they have thesehorizontal neckline so don't
(20:56):
think you know, we can get ridof them totally. And we are
bending our necks a lot, right,looking at our phone, looking at
the computer keyboard and allthat, I would say, helpful
things. Again, nothing's a quickfix, necessarily. But using your
retinoid on your neck can behelpful. Putting in some filler
can be helpful in the neck.
Yeah, or hyaluronic acid fillerradius or sculpture, they can
(21:21):
those can work nicely. And thenI love lasers that can help
build your collagen. So doing alaser that is going a little bit
deeper to help stimulate thecollagen, some people have great
results with radio frequency,micro needling. People are
trying, right? And it's not likethere's a one, because, trust
me, if there was, I would havedone it. But it kind of just
(21:43):
depends what kind of, what kindof neck you have, if you need
more volume, and then reallythe, you know, a neck lift,
sometimes there's just a goodbit of skin. And if you were
like, I want this, and you keeppulling your neck bag.
Colette Fehr (22:00):
I'm gonna have to do this at some point, because
this is actually the thing thatbothers me the most, is that my
face has sunk a little likeright here. And like you said, I
do feel 25 inside, and then I'llcatch a glimpse of myself on
something. I'm like, Who's thatold lady?
Dr. Mary Alice Mina (22:21):
No, I know I'll see my mom, and I'm like,
Oh my gosh, I am turning into mymother. You know,
Laura Bowman (22:28):
my mom? I was telling Colette, my mom did a
neck lift and a bluff when shewas, like, 54 and it bought her,
like, 15 years facially, yeah,like she it just looked, I mean,
I wish I could post the pictureswith her without her wanting to
kill me. But they were justlike, it was so good, wow.
Dr. Mary Alice Mina (22:49):
Yeah. And I think sometimes people get real
nervous about surgery, yeah. Butsometimes that is, you could, I
feel like you, you can spin yourwheels and try all these things
and really just cut, cut theskin out if it really, really
bothers you. And I love a bufferof plastic. I think that that's
an eyelid lift and or tuck. It'sa great way to open the eyes. If
(23:12):
a lot of times, when I you knowpeople typically a little bit
older than us, 60s, 70s, theyhave to use their forehead to
hold their eyes, their eyelidsup, and so by the end of the
day, they just feel exhaustedand heavy. And really a fairly
simple procedure for someone whoknows what they're doing, it's
to just remove that skin so theydon't have to, you know, hold
(23:37):
their eyebrows up just to see.
Colette Fehr (23:40):
It's a great thing. I mean, my aunt did that
with the eyelids in her, maybemid to late 60s, I want to say.
And it made a huge difference.
And she looks her age, but shejust looks great for her age.
You know? She looks really vitaland alive, and not obviously
plastic surgery, right? So,okay, so what I'm getting so far
(24:00):
in this, this is comforting tohear again from you that really,
if we're doing a good cleansingour skin, wearing sunscreen and
maybe considering adding aretinoid to your routine, that
that is that can work really,really well. And you don't have
(24:21):
to go crazy, spending a fortune,necessarily, with a million
procedures, although a littleBotox can help, you know,
depending on why. I mean, I'vebeen doing Botox since my mid
30s, too, and my forehead, youknow, it's not working as well
in a way now, like I either feelso frozen that I look weird, or
it's hard to get your lines togo, Yeah, my brows sink. So it's
(24:46):
becoming more challenging. And Idon't know, I think there are
probably other women listeninglike me who wonder, Am I going
to be botoxing My forehead tillI'm 80? Like, is this. Yes, at
some point, am I giving up, oram I just gonna keep going? You
know, yeah, foreheads
Dr. Mary Alice Mina (25:06):
are tricky.
In fact, a lot of my more maturepatients, I don't treat their
forehead because, again, they'reusing their forehead to hold
their eyelids up, and sometimeswhat they really need is a brow
lift to just cut their browshave fallen. They just need
those placed a little bithigher. But a lot of times, you
can still treat the scowl linesthose elevens pretty much until
(25:27):
you're 100 or whatever, if youreally want. But I do start to
back off on the forehead alittle bit, because it does can
either lead to a heavy brow andcan make it hard to see. They
feel like their their eyes don'topen as well. So it does get
tricky, but I do think by doingit early, you have staved off
(25:48):
developing those etched in lineswhich will serve you well down
the road.
Laura Bowman (25:57):
Good to know. Good to know. What? What about
estrogen on the skin like we'vebeen hearing about that lately,
and I don't know what to make ofHave you seen that be impactful?
Dr. Mary Alice Mina (26:09):
Yes, and I, and I've been prescribing it a
lot more. So I didn't realizethis, but actually, estrogen was
in skincare back in the 40s,before the FDA and regulations.
Yes, and, and people loved it.
But then, once the FDA wasformed, and I don't know the
exact details why, but itstopped being put in there. And
I think for a while, women havebeen using their vaginal
(26:30):
estrogen cream on their face.
Kind of all label,
Colette Fehr (26:36):
yeah, they said that the menopause conference,
we said, put it on your part.
Yeah,
Dr. Mary Alice Mina (26:42):
yeah. So, so people have been, you know,
women have been kind of figuringthis out, like, Well, hey, if it
helps the skin there, which weknow, it's very helpful there,
it prevents UTIs, it helps withdryness and pain and and so
women knew that, oh well, let metry it on my face. I think the
issue was the formulation wasn'tnecessarily that desirable to
(27:06):
apply on the face. And also, Idon't know if people necessarily
wanted their, you know, vaginalcream sitting right on the
counter next to theirtoothbrush. I don't know. Maybe
they didn't care, but, but now Ithink with this new push to kind
of recognize menopause as awhole season in life, and not
just something to just ignoreand forget about, forget about
(27:29):
women. Now, companies haveformulated more elegant products
with estriol to apply on theskin, and I think we're going to
be seeing a lot more of this andmore studies showing the impact,
but we know it works for the thevaginal skin, so I think it's a
great option. And I'll tell mypatients, when I prescribe it to
them, to use it like amoisturizer, that they can use
(27:52):
it and it can help with dryness.
So that's that's something to
Colette Fehr (27:55):
try too. So you could use that with your
retinoid, yeah,
Laura Bowman (28:00):
like, instead of your moisturizer that you use,
Colette Fehr (28:04):
yeah. And so, what do you what do you like to
prescribe for an estriol? I'mlike, I'm getting some today.
Dr. Mary Alice Mina (28:11):
I just, I use a compounding company called
Skin medicinal, and it's, theyhave an estriol cream, and I got
it to try myself, and it feelsgreat. It's light. It does seem
like a moisturizer, so that'swhat I tell my patients, to use
that in place of theirmoisturizer.
Laura Bowman (28:29):
Oh, my God, I want some. Yes, let's get some right
Colette Fehr (28:33):
away. Yeah. But I also like that you're pointing
to how important it is to takecare of your whole body, and
that the skin is an organ, andit's not just about procedures
and creams, and it really isabout sleeping, hydrating,
eating. Well, how much doessleep affect the skin? I would
(28:56):
imagine, more than we think,right?
Dr. Mary Alice Mina (28:58):
Totally.
And you know, it's taken me 40years to figure this out. Where
I feel like our culture is,especially in medicine. It's
like, you know, sleeping for theweek, and you know, you need to
pride yourself on not sleeping.
And then I think I hit 40, and Iwas like, I need to sleep like,
I cannot stay up all night. Andnow that I have a I don't sleep.
(29:20):
You know, probably a sleepexpert would tell me, I need to
sleep more, which is fairenough, but I'm working on it,
but just getting a consistentschedule to get about six and a
half hours a night for me makesme feel amazing. Now, ideally, I
probably should be getting sevenand a half right. I recognize
that, but just being on aconsistent schedule has been
(29:41):
helpful, not just for my skin,but for everything. Yeah. I
mean, think about when you weremaybe in college, or we had
newborns, right? And you're upall night. Did you look good
when you looked in the mirror?
No, like you accentuated darkcircles under your eyes you
might have. More like puffinessand swelling, and then you don't
eat right when you're tired andyou're, you know, not going to
(30:05):
go exercise. So all these thingshave downstream effects. So
sleeping is important. It's atime for our body, including our
skin, to regenerate and to havegood blood flow and our skin
cells to turn over so it all.
It's so important. And I dothink it's great. I feel like
people are now even like bigCEOs and people are promoting
(30:29):
sleep and and letting lettingpeople know it's not a sign of
weakness. It's actuallycritical, right?
Colette Fehr (30:35):
I know I'm so glad to I've never been a good
sleeper, and I take it soseriously now. So I'm glad to
hear you say that, and also thatyou're speaking to these things
that really matter for the skin,and there are some things that
people believe that don'tmatter. Are there any myths that
you just giggle about as adermatologist or that you could
(30:56):
debunk for our listeners?
Dr. Mary Alice Mina (30:58):
Gosh, I feel like there's always
something. And I feel like withsocial media, it's almost like,
the more outrageous to get, themore views. And it's kind of
crazy. One that doesn't make megiggle, it actually really makes
me cry, is this whole thing ofsunscreen causes cancer and
that, you know, parents I hearwho don't put sunscreen on their
(31:20):
kids and their kids are burning.
I mean, that really breaks myheart. Yeah, because I see the
patients when they're older withthe skin cancers, and they all
tell me, I wish I had known Iwish I could go back so that
that to me. I wish we didn'thave that. I wish we didn't have
celebrities promoting that, orpeople with large platforms. I
think just following a lot ofthese Tiktok trends, you know,
(31:42):
it's always something new,right? Flaxseed oil, it can, can
work instead of Botox, or tapingyour face instead of Botox, or,
you know, beef tallow, or allthese, all these different
things. And it's like, you know,or a lot of the DIY stuff at
(32:02):
home, it's like, there, there'sstuff we know that works, that's
formulated just for your skin,and it's been tested and tried
and true. You know, you don'tneed to reinvent it and make it
in your own kitchen. That justbecause you made it in your
kitchen doesn't mean it'sbetter, right? I think that
concept that natural is alwaysbetter, but something made very
(32:26):
elegantly and cleanly andpulling out just the important
ingredients and actives in a labis not a bad thing. Just because
it was created in a lab, it'snot reasonable to think we're
gonna all just rub oranges onour face for vitamin C serum,
right? So I think just, I wishpeople would just trust the
(32:47):
experts with skin health and notjust follow whatever they see on
social media or someone tryingto get views or clicks or likes,
and just, also, it's hard to notbe persuaded like, oh, maybe I
need that product. Oh, I'venever heard of that. Maybe I do
need that. It's very tempting towant to stray from what you use
(33:10):
and find the next shiny object,but really, consistency is key.
And I joke that I've used thesame cleanser. It's the dove
Beauty Bar. I've used it fordecades. There we go. And every
you know people, sometimes I'llgo to a conference or someone
like, I'm gonna try a foamingface wash or something. And I
(33:31):
always just go back to my dovebecause it's easy and it works.
And so why? Why do I need tocomplicate it with a separate
one for my face and body and allthat. So if it's working for
you, stay with it. Yeah.
Laura Bowman (33:47):
And another, another thing that, like Colette
and I were talking about, isthat, you know, how much of it,
how much of good skin is thesepreventable things and these
routines that we do, and howmuch of it is just the genetic
Dr. Mary Alice Mina (33:59):
lottery?
Well, genetics does play a role,for sure, but I would also say,
like, your epigenetics, right?
Like, what's actually turned onand we we can control a lot more
than we think. So, yes, if youare born with, you know, eczema
or certain conditions, then thatis going to be your skin's going
(34:22):
to be different than someone whodoesn't have those struggles.
Right? To me, it's more justyour overall like look and
appearance and bone structureand all that that I think, play
a role, but you can still do somuch. So you know, you may have
gotten your acne from your dador whatever, your baldness, but
there's still so much you cando, and so I don't think I would
(34:44):
just say, Oh, well, I throw myhands up. I can't do anything
about it.
Colette Fehr (34:48):
That's a great way to put it. So what kind of
sunblock Do you like to use? I'mjust curious, because you
obviously have very beautifulskin. Oh,
Dr. Mary Alice Mina (34:56):
well, thank you. I like L to MD. I. Think
it's a great it's a great pricepoint. It's, I like to put it on
my face. It's very elegant. Ilove the spray because it's,
it's a mineral spray, but it'sso, so light, and it works great
for, like, spraying on my kidsand rubbing them down real fast.
They really like the sticksunscreen. So I've got a 11 and
(35:20):
10 year old. So I thinkNeutrogena has a stick
sunscreen. They use that veryobligingly and and that's
another thing I would just say,for people who have kids
listening, you know, and maybeyour kids are older, but I would
say, just try to model thebehavior you want them to have.
My kids, don't fight me aboutwearing hats, because that's
(35:41):
just what we've been doing sincethey were babies. And they see
Mom puts her hat on, they puttheir hat on rash guards like
that's just what we do whenwe're outside, at the beach, in
the pool, we put our rash guardson. So I think that that's
helpful. But for sunscreen, I'lltell people, there's no magic
sunscreen. SPF, 30 or higher,broad spectrum, but the most
important thing is, you like theway it feels. I also like La
(36:03):
Roche Posay. I tend to have moreoily skin, and I don't like to
feel like I have something heavyor sticky on my face. So I like
the ones that you have to shake,and they're super light, yeah,
on my body. I'm less particular,but there's some, I mean, again,
I use sunscreen if it's notlgmd, it's from the drug store,
(36:23):
so that's what I do. Yeah,
Colette Fehr (36:26):
that's great. And how important do you think it is
that the sunscreen has titaniumor zinc in it? So
Dr. Mary Alice Mina (36:33):
if you are worried about chemical
sunscreens, then stick with amineral based sunscreen, like
zinc or titanium. There havebeen some studies that concern
people where they saw that thechemical sunscreens were
absorbed by the bloodstream, andso they were measured in the
bloodstream after use, which weknow things are absorbed through
(36:53):
our skin. So that's not reallysurprising. The study didn't say
there was any harm from that, orany negative side effects from
that, whatsoever. But if you areconcerned about that, then, then
sure, stick with the mineralbased sunscreen. That's totally
fine. The problem with thosesometimes is that they're not
quite as elegant. If you have adarker skin, sometimes they can
(37:15):
leave more of a white, chalkycast. So don't be scared of
chemical sunscreens. Theythere's a no study showing human
harm and all that. But again,also, don't think of sun
protection as stopping at yoursunscreen, right? Throw on a
hat. Wear sunglasses, throw onsomething to cover your the tops
of your arms, if you're on aboat or paddle boarding, so
(37:37):
you're not just like roastinglike a rotisserie chicken. Yeah,
Colette Fehr (37:42):
yeah. I mean, Florida really has made me I
mean, what you said is so true.
You can see the difference incolder climates versus people
who live here and the sun isjust so strong and relentless
all the time. Yeah. And, youknow, as we get older, and you
just, I just don't, I don't evenfeel good when the sun's beaming
on me, unless I feel like I havesomething.
Dr. Mary Alice Mina (38:05):
So yeah, I am, I am right there, yes, yeah,
even just
Laura Bowman (38:10):
the side of your face from the driving in the
car, the one side of my face is,it's a little darker,
Dr. Mary Alice Mina (38:18):
yeah, the left side, and I the hat, the
baseball cap, like I willfrequently see in guys there,
the this part of their face,sort of the mid part of their
face, will be nice, and not alot of sun damage, but all the
sides have a lot of sun damagefrom I can, I can see, like,
where the baseball cap shadedit. So, yeah, just think if you
(38:40):
had just shaded all of it,right,
Colette Fehr (38:43):
right? And you're right, it's such a great point.
Look at your stomach, or, youknow, my kind of lower back,
where the skin has had so muchless exposure over unless you're
somebody who works outside everyday in a bathing suit, it's
dramatically different,
Dr. Mary Alice Mina (38:58):
right? Or or even the top, like your arms,
like the top of your arm, flipit, if they're different colors,
then,
Colette Fehr (39:09):
yeah, and I have, I do have a lot of melasma now,
it's really, it's a bummer,
Dr. Mary Alice Mina (39:16):
yeah, well, that that's one thing I should
say, Colette some, Some peopleone thing to think about with
the estriol cream is there havebeen some anecdotal reports that
it could worsen melasma. Sothat's just one thing to keep in
mind. I think it's still worthtrying it, or maybe trying an
area to see, but just for thelisteners to know about that,
Colette Fehr (39:38):
okay, that's great to know and good to know that
you don't have any opposition toputting the estrogen cream on
your face. Because I waswondering, is that even true? Is
that even good?
Dr. Mary Alice Mina (39:48):
No, no. And do your neck too? Neck, top of
your hands, upper chest. So yes,
Colette Fehr (39:54):
I'm going to put my red and we're going to take a
bath. Yes, but it's greatadvice. To use a small amount,
because I'll get the dryness,particularly like here, you
know, in the creases, especiallywhere it peels. And, yeah, it's
so many the faces dry, but youdon't want wrinkles. So there's
so many things to think about,yeah,
Dr. Mary Alice Mina (40:16):
and I would say anyone trying, don't give
up. Play around with it. And Ithink of it, I like to treat to
a little bit of peeling, just asmidge, because then I'm like,
Okay, it's doing what it'ssupposed to Yeah,
Colette Fehr (40:28):
yeah. And anything you recommend to our listeners
to ask their dermatologist, orgo into their dermatologist
specifically saying that theymight not think of I think if
Dr. Mary Alice Mina (40:39):
you've had a lot of sun damage, and you're
in your 40s plus, and you havenever had or really, if you
never had a skin check, get inand have a skin check, because
it no matter what color you are.
Or really, if you think you'vehad a lot of sun or not, right,
if you are in your 40s, you'veseen some sun, let them look you
over head to toe, scalp tobottoms of your feet. And they
(41:01):
can help you know what to lookfor. I think a lot of people
know what to look for withmelanomas, which are the dark
spots, but they don't know aboutthe much more common basal cell
carcinomas and squamous cellcarcinomas, which can happen
starting in this phase of life.
And then they can also helpguide you on what skincare
(41:24):
regimen you should be doing, andany potential treatments or
lasers or devices that you mightbe interested in. They can kind
of go over all that with you,but I would say if you never had
a skin check, that would be agreat opportunity to go and
sometimes people think thesebrown spots on their skin are
sunspot or, you know, like abrown spot for a laser, and it
(41:45):
could be a melanoma. So again,just getting an expert's eyes on
your skin first, can, I think,be really helpful, and
Colette Fehr (41:53):
for the average person, once a year, like an all
over body mold check kind ofthing? Okay, yeah, I
Dr. Mary Alice Mina (41:59):
would say once a year, but they'll let you
know. If you're someone who'shad a lot of sun damage, maybe
have a lot of moles, maybe afamily history of melanoma, they
may want to see
Colette Fehr (42:07):
you twice a year.
Yeah, yeah. I'm definitelygetting to the point where I
know so many people who arehaving to have something removed
or have a skin cancer, and Ithink maybe especially being on
Florida, it's just seems so I'llnever forget the first
dermatology appointment I wentto here, the entire waiting
room, and that doctor that Iused to see was a Mohs surgeon.
I mean, the entire waiting room,it looked like, you know,
(42:30):
Purgatory, because everybody wasjust an old and had, like, the
bandages on their nose.
Dr. Mary Alice Mina (42:40):
Yeah, I tell my younger patients like,
you're going you're gonna sit inmy waiting room and think I
don't belong here. One of thesethings is not like the other.
That was me
Colette Fehr (42:49):
and my 20s, but it's you know what think about
that for our listeners who areyounger, I mean, wear the
sunscreen every day. If I couldgo back in time, that is the one
thing I would do, and a hat.
Yeah, protect yourself when youdon't think you need to, because
you'll be really glad later.
Dr. Mary Alice Mina (43:07):
Yeah, they say, if you want beautiful skin
in your 50s, wear wear sunscreenor some protecting your 20s.
Colette Fehr (43:13):
Yeah, I'm going to tell my daughters this. My
daughters are both in their 20s.
I'm going to be telling themthis again after this recording.
Well, Dr, Mina, thank you somuch. Can you share with our
listeners how they can find youand anything else you'd like to
promote in particular? Yeah,
Dr. Mary Alice Mina (43:32):
well, this was a lot of fun, ladies. I'm so
glad we got to chat today. Iactually have a podcast called
the skin real, R, E, A, l, so ifyou are curious about certain
skin things, procedures,devices, I really just kind of
cover topics that I get askedabout all the time. And I'm at
at Dr Mina skin on all thesocial media platforms, YouTube,
(43:55):
all that good stuff. Andactually, if you this is a fun
quiz. If you want to know, whereyou know, are you more of a
Laura, are you more of a colead, or me? You can take a fun
quiz to find your skin style atthe skin real.com forward slash
style. Great.
Colette Fehr (44:11):
And we'll put all that in the show notes. I'm
going to take the quiz. I wantto find out.
Laura Bowman (44:16):
I think I know it's end of the spectrum I'm on,
but
Colette Fehr (44:19):
I love, I love that kind of stuff. That's
great. So, and your podcast isgreat, so I think our listeners
would really enjoy that as well.
Dr. Mary Alice Mina (44:28):
Well. Thank you.
Laura Bowman (44:30):
Thank you so much for listening today. We hope you
got some insights from ourcouch. If you like what you
heard, and we hope that you did,don't forget to subscribe and
share with a friend and write areview. Thanks for listening,
guys. We'll see you next timesee you, next time you.
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