April 2, 2025 • 21 mins
Your skin tells the story of your life, especially during hormonal shifts like perimenopause. As estrogen declines, collagen loss accelerates, leading to crepiness and reduced elasticity far beyond the slow 1% decline seen in our 20s and 30s.
For post-cancer skincare, topical estrogen creams can help rebuild collagen without systemic absorption, offering a safe alternative to traditional hormone therapy. Meanwhile, targeted treatments for dark spots, rosacea, and sensitivity ensure better results than a one-size-fits-all approach.
Beyond skincare, nutrition plays a key role, prioritizing protein and whole foods that support skin regeneration from within. For those with sensitivity, a “less is more” approach allows for gradual healing before introducing actives like vitamin C and retinol.
Have you noticed changes in your skin during perimenopause?
Share your experience, we’re here to help!
• ABOUT THE GUEST •
Meet Melissa June, survivor, speaker, and founder of Live Anyway, a nonprofit dedicated to helping women reclaim their power after life-altering challenges. With unfiltered honesty and an unstoppable spirit, she creates transformative spaces through storytelling, retreats, and deep conversations.
Melissa’s mission is simple: to inspire women to heal, rise, and rewrite their stories on their own terms.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Listen to your Skin by Moon and Skin, the
podcast where science meetsnature to celebrate the story of
your skin.
Your skin is a living canvas,ever evolving, deeply personal
and uniquely yours.
Each week, we'll dive into thescience of healthy skin, share
empowering stories and uncovertransformative self-care rituals
.
We're here to help you embraceevery phase of your journey with
(00:22):
confidence and care.
Speaker 2 (00:23):
Hi, hi, thank you for having me.
I love it.
I have so many questions.
I am 41.
I am perimenopausal, reallybordering like menopausal.
I have so many questions aboutmy skin because it's just not
the same anymore.
What actually works?
What do I actually need toinvest in?
Speaker 1 (00:43):
Right, yeah, so I'd say between 35 and 55, it's a
really tricky time becauseeverybody's aging at a different
rate and it depends on what'sgoing on in your environment, in
your body, hormonally.
And I don't think we talkenough about hormones and I
understand you've gone throughsome things with your hormones
which have lowered your estrogendramatically, and what happens
(01:07):
is is when we're in our 20s to30s, we lose about one percent
of collagen per year and then aswe get perimenopausal which can
be 15 years our estrogen dropsdramatically and our collagen
drops dramatically.
And I often think of it as likea balloon.
You know when you have a partyand you have a balloon blown up
(01:28):
and you clean everything up butyou might have forgotten a
balloon in the corner and youcome back a couple weeks later
and you find the balloon andit's deflated, where you have
lots of little crinkles in there, like that crepiness of the
skin, and that's what lowestrogen looks like in the skin.
Speaker 2 (01:46):
Wow.
So as a cancer survivor, am Iallowed to use estrogen, or what
do you think is the best way tobattle that?
Speaker 1 (01:51):
Yeah, that's such a good question because when I was
a resident, the women's healthinitiative came out that
basically said that the hormonereplacement was bad for everyone
, and now we're finding a lot ofevidence to the contrary, where
we're finding that hormonalsupplementation can be very
beneficial for everything fromour bones to our skin, to our
(02:11):
brains and our cardiovascularhealth actually.
But when you have ahormone-positive,
receptor-positive breast cancer,we really are not on board with
adding estrogen therapy.
So we have seen intravaginaland topical estrogen cream be
very beneficial for those organs, for both the vaginal mucosa to
(02:34):
be plump and more moist and forthe skin to have improved
hydration and improved collagen.
So by adding topical estrogencream, which is compounded in a
pharmacy, some women are usingthe vaginal estrogen topically
on their skin and that thoseestrogen receptors are getting
hit to produce more collagentopically in the skin without
(02:57):
getting systemically absorbed inthe body.
We're not finding levels in theblood.
Speaker 2 (03:01):
Wow, okay, talk to me about dark spots, because I
first started struggling withdark spots when I was going
through my pregnancies and asI've gotten older, it just is
something that I'm having areally hard time like solving.
So what do I do about that?
Speaker 1 (03:15):
Yeah, so we'll talk about all dark spots.
But on the topic of estrogen,um, during pregnancy or with
birth control, having highestrogen levels can contribute
to something called melasma,which I personally struggle with
, and that's one type of darkspot.
So while I'm 53 and while Iwant to apply topical estrogen
(03:38):
to my skin, I often know I'mgoing overboard when I start
getting more of that melasmaback.
There's different types of darkspots, so all dark spots are
not created equal.
There's what we call static orstable dark spots, and then
there's dynamic or unstable darkspots.
So melasma is unstable Anythingthat's going to inflame it or
heat can make it worse.
And then stable is sunspots,like the age spots on the back
(04:01):
of your hands or the sunspots onyour face and those you could
just like ablate with a laserand they go away and it takes
years for them to come back.
But if you burn off, melasma orthe dark spot that you get
after a pimple or a cut goesaway, which we call
post-inflammatoryhyperpigmentation that can come
back tenfold immediately worse.
Speaker 2 (04:19):
Wow, Okay.
So what's the differencebetween dark spots and rosacea
and how do you treat them?
Do you treat them the same ordifferent?
Speaker 1 (04:26):
No, they're totally different.
So rosacea is, I would sayrosacea is most often confused
with sensitive skin.
So sensitive skin is abreakdown of the skin barrier.
So we have this beautiful skinbarrier that protects us from
the outside world and when it'sbroken down, the worst case is
(04:47):
like in a burn victim, when theskin barrier is completely
destroyed.
Burn victims die from infectionand dehydration.
So if you think about all ofour bodies 60% water and it's
being held in by our skin andwe're not losing it and it's
protecting us from environmentaltoxins and microbes and
pathogens and all sorts of germs, basically.
So sensitive skin is whenthere's a compromise of the skin
(05:08):
barrier and it could be.
Typically it's from overuse ofsoap or using too many chemicals
on the skin that the skin can'tprotect itself anymore.
Rosacea looks like sensitiveskin and it does have a
sensitive skin component, but italso has something called
vasomotor instability, orbasically the blood vessels are
not stable.
So there's three forms ofrosacea.
(05:31):
There's a really long wordcalled erythematalangetatic form
, which is basically flushing,when people get really red and
they flush up and down.
The second form ispapulopustular and that looks
like pimples and the pimples aretypically on the central part
of the face and they're redjuicy pimples or they're
whitehead pimples.
You never see blackheads andwhiteheads.
So someone 20s, 30s and 40s canget that type.
(05:54):
And then the third form is likethe WC Fields nose.
So rosacea is more aboutunstable blood vessels.
So we want to get the bloodvessels stable again and we do
that with some of the strategiesthat we use for sensitive skin,
as well as other strategiesthat we do internally.
Speaker 2 (06:09):
Wow, that's amazing.
So much.
I have so many more questions.
So tell me about chocolate andbreaking out, because one thing
that I've noticed is I lovechocolate so much, but sometimes
it makes me break out.
Is it something like aningredient in the chocolate?
Is it sugar?
Is it what?
Speaker 1 (06:27):
kind of chocolate are you?
Speaker 2 (06:27):
having.
Um, I mean, I like dark chart,like dark chocolate, like cacao.
But does that break you?
Speaker 1 (06:33):
out.
Yeah, really Okay.
There's a couple of interestingthings about chocolate, because
I always felt like it was morethe sugar in the chocolate,
because the quicker your bloodsugar jumps up, the more likely
you're going to have highinsulin and then inflammation
and that leads to acne.
Some chocolate is also high incadmium, which is a heavy metal
(06:54):
found in the earth.
It tends to pull it up, butthat hasn't really been linked
to acne.
I suspect it's more the sugargoing on, because cocoa itself
really we haven't found a reallygood link to acne.
It's more the sugar.
But because cocoa itself reallywe haven't found a really good
link to acne, it's more thesugar.
But I mean, I always say listento your body, listen to your
skin, and if your body's tellingyou something, you have to
listen to it.
I've heard all sorts of thingsover the years and I just want
(07:17):
people to listen to their ownbody.
That's so fair, okay.
Speaker 2 (07:19):
So one last question.
I feel like there are so manyproducts out there, I so one
last question.
I feel like there are so manyproducts out there.
I mean it's so hard to narrowdown.
Do I need 15 different productsthat are going to do all of the
things for my skin, or what isa good like go-to, you know
process for my skin?
Speaker 1 (07:36):
That's a really good question.
So it depends on where you'restarting, right.
So I think simple is better,because we do have science for
individual products.
We don't have great science forhow these products interact
with each other.
So when we're layering five,six, seven, eight layers
together, what's going on there?
You look at sodium and sodiummixes with chloride and makes
(07:57):
salt, no problem.
You take sodium and you mix itwith water and it makes an
explosion.
So just because fiveingredients are good, I don't
know how they're going to betogether.
So I like to keep it simple.
With a good cleanser that's notgoing to strip your skin barrier
and cause sensitive skin.
Then a vitamin C product in themorning, something that's
stable.
So ascorbic acid is the activeform of vitamin C and it's
(08:20):
unstable.
So as soon as it hits light,heat or oxygen, it doesn't work
any longer and it becomesunstable.
So there's other forms like THDascorbate and sodium ascorbyl
phosphate that convert intoascorbic acid in the skin and I
prefer those forms becausethey're more stable on the shelf
.
Right, because we're not in thelab, we're in our bodies.
(08:41):
So we want things to work inour bodies and we want things to
work in our bodies.
And then if someone's dealingwith pigmentation or acne, I'll
have them use a targeted serumat that point and then
moisturize their sunscreen inthe morning.
That's the most anyone needs.
Now, if someone, I tend to be alittle oily.
I don't use a moisturizer inthe morning, I only use it at
night.
So at night I like cleansing,get the makeup and the dirt and
(09:04):
debris off your face and thenput a retinol on your skin,
something that's not going to beirritating Less is more.
It works through cell signaling.
So Having heavy coverage with aretinol is going to irritate
the skin more.
We don't need a lot.
We have to trust the sciencebecause it signals through the
nucleus of the cell and we don'tneed a lot of coverage.
(09:26):
We have to just trust that themolecule will get where it needs
to be to enhance cell renewaland then let that dry and put a
really good moisturizer on.
I love finding moisturizers thatcan be used as eye creams and
neck creams, so you don't haveto have multiple products.
And then I like people tochange with every season.
So our skin takes about six to12 weeks, depending on how old
(09:46):
we are, to turn over and we wantto look with the changes of the
seasons, like are we going toadd something to exfoliate the
brown spots off in the fall?
That's a great time.
Are we going to add moremoisturizer in the winter?
So I do like people to modifythings.
So you may have 10 or 15products, but you're not using
them all at the same time.
You're kind of rotating themand cycling them in and out and
(10:08):
going back to topical estrogen.
You would add that either asyour moisturizer, depending on
how it's compounded, or as yourstep after the retinol, before
your moisturizer at night andthen after your vitamin C in the
morning, before yourmoisturizer and sunscreen in the
morning.
So we can incorporate things tomake a more bespoke plan,
depending on what someone's skinneeds are.
Speaker 2 (10:30):
That makes sense?
Okay, one more, one more.
Last, last question.
Speaker 1 (10:32):
I love it.
Speaker 2 (10:33):
Big pores.
Is there really a solution tothe pores situation?
Speaker 1 (10:38):
Yeah, so there is a laser.
There's a laser that canactually help reduce pore size,
believe it or not.
I'm not even going to give thewavelength.
I think it's a 13, 20 nanometerwavelength, but don't, don't
hold me to that, because I don't.
Yeah, so there's differentlasers for different things.
And the cool thing about lasersis lasers are basically
attracted to certainchromophores or targets in the
(11:00):
skin.
So, like I said, with theliposomal technology of the
retinol, it can bypass theepidermis.
Lasers can bypass damaging thetop layers to target hemoglobin
in a blood vessel to helpcollapse the blood vessel, or
bypass the epidermis to attachto the sebaceous gland or the
oil gland and do things likethat.
Or be attracted to pigment,whether it's deep pigment at a
(11:22):
hair follicle for hair removal,or more superficial well,
depending on the depth of thetattoo, like different levels
for tattoo removal or for eachspots or brown spots.
So lasers basically targetcertain things.
So I I like lasers.
What was I even talking about?
Pores, pores, yeah, so for poresin general, for most people
(11:44):
that aren't going to spendthousands of dollars on a laser
for reducing their pore size.
Really, what you want to do isjust clean out your pores.
So I like products containingsalicylic acid because it's a
keratolytic, which means itbreaks down keratin or the dead
skin cells, but it's attractedto oil.
So glycolic acid just kind ofloosens up the dead skin cells,
(12:05):
but salicylic acid goes to theoil glands to remove the skin
cells.
So if you have a big pore and abig opening and it's filled
with something, it's going tolook larger.
So if you can clean out thedebris and the dead skin cells
and the dirt and the oxygen andeverything inside there, it will
appear smaller, even thoughit's not actually smaller.
And what really matters is howit appears at the end of the day
(12:28):
.
And that's basically it.
Speaker 2 (12:30):
Speaking of the time of day, are there certain masks
that you should use at differenttimes of day?
You know like, should I docharcoal in the morning and a
moisturizing mask at night, ordoes it matter?
Speaker 1 (12:39):
Yeah, I don't think it really matters.
I don't think there's a lot ofscience with the circadian clock
for masks.
I'm not like the hugest maskperson.
I'm more about the compoundeffect, like little things over
time, how it makes a differenceIf you're dealing with, if you
want to do a detox or something,you could do a charcoal mask
every once in a while.
Or if you need hyperinfusion ofhydration, then you could do a
(13:02):
hydrating mask overnight, Likeovernight you want to do more
hydration because that'stypically when we're losing the
most water with our circadianclock.
Speaker 2 (13:10):
I've been getting way more disciplined about my diet
and how I'm eating because I'mstarting to become so much more
conscious of how I feel in mybody with the food, which is
amazing.
But are there certain foodsthat are best to avoid, or maybe
even certain foods that arebest to digest?
That will help my skin.
Speaker 1 (13:28):
Yeah.
So you know it's interesting.
I heard a quote from MotherTeresa years ago talk about
somebody said are you going togo fight against that war?
And she goes no, they go.
So you want war?
And she said, no, she goes Idon't.
I will fight for peace, but I'mnot going to fight against
something.
So I often look at diet thatway too.
(13:49):
It's so easy to say don't dothis and don't do that.
And yes, I don't find benefitsof sugar.
Sugar has no nutritionalbenefit for your body or for
your skin, maybe your tongue,but that's about it, right.
So I like to focus on what toadd in right, and if we add the
right things in, then we'regoing to naturally eliminate the
things that we don't wantwithout beating ourselves up.
Speaker 2 (14:11):
I love that that's so much less constrictive and
restrictive, you know.
Speaker 1 (14:16):
Yeah, I mean, I do that to to myself.
So the last thing I want to dois like, have that done to other
people, but like, if we focuson for women in particular, we
really want to focus on gettingenough protein, and in the form
of high quality protein, and soyis not the one that I want
people to get.
So, whether it's you peaprotein or hemp protein, or I
(14:39):
choose high qualityregeneratively farmed meat and
getting about one pound perideal body weight.
So you know, if you'reoverweight and you're aiming for
130, then go for 130 grams perday.
So getting high quality proteinin your ideal body weight in
grams of protein per day, havingas many vegetables as you want.
(15:02):
This is an unpopular opinion,but I don't believe fruit is
meant to be eaten in the winter.
Fruit is there for thesummertime, to make us a little
chubby, so we could survive awinter.
We don't live in that kind ofworld anymore, so I don't really
eat fruit, except for thesummertime and maybe into the
fall, like we would naturallyharvest, harvest it.
But if you do have a sweettooth and you want some berries
(15:23):
or some mango, they're.
They're definitely beneficialand there's studies showing that
some mango up to I can'tremember how many grams, but a
certain number of grams per dayactually helped improve the
appearance of the skin.
Then once you got past acertain threshold, it reduced
the appearance of the skin.
Then, once you got past acertain threshold, it reduced
the appearance of the skin.
And I think that what happenswith a small amount of mango it
(15:45):
was boosting the polyphenols,the healthy colorful nutrients
that are in the fruit, in yourskin, but too much boosted the
sugar.
So there's a sweet spot where alittle bit will help your skin,
but then too much the sugaroutweighs's a sweet spot where a
little bit will help your skin,but then too much the sugar
outweighs the benefits of thepolyphenols.
So that's with fruit.
And then I try to avoidprocessed carbohydrates like
(16:09):
anything that's really in apackage, if we can right, and
instead we just want to focus onwhole, real food.
So I'm not a big fan ofmeasuring the amount of olive
oil you use or worrying abouteating the whole avocado
Anything that's a real food thathas one ingredient.
Go for it and I doubt you'llever be overweight and you'll
have enough ability to maintainmuscle mass and all the building
(16:31):
blocks for your skin if youhave a whole food diet.
Speaker 2 (16:35):
Wow, that's really great.
Are there any ingredients Ishould be looking for in my
products?
Skincare I know there's a lotto avoid, so just to keep it
simple, kind of what we weretalking about with the food like
what food are we looking for?
What ingredients are?
Like yes, that's what I shouldhave in my products.
Speaker 1 (16:55):
Yeah, so it depends.
Product selection depends on alot of factors.
So it depends on what age youare, what season of life you're
in, because what you're going touse as a teenager is going to
be different from when you're 40, and also where you live.
So somewhere like Arizona,you're going to need more
hydrating products than if youlive somewhere like Hawaii, for
(17:15):
instance, right, so all of thosevariables taken into effect, I
mean you want to find a cleanserthat's going to remove
effectively remove dirt from theskin without stripping your
skin of its skin barrier,because that's going to
compromise you and make you moreprone to environmental toxins
and breakdown of your collagenall the things we're trying to
avoid.
And then, in the morning, Ireally like people to use a
(17:37):
vitamin C.
It's one of the most tried andtrue things.
The biggest thing with vitaminC is looking for a staple form
of vitamin C with either sodiumor ascorbyl phosphate,
especially for anyone that isprone to acne.
If they're prone to acne orrosacea, they want to look for a
form with sodium ascorbylphosphate, because a lot of
people break out with vitamin C,so that form is less likely to
(18:00):
break out with or THD ascorbateis another form.
And then sunscreen.
And with sunscreen I don't likethe chemicals.
I've never liked the chemicalssince I was 30 using sunscreen.
I've always recommendedsunscreen with zinc oxide.
And one of the things I noticedjust from looking at tens of
thousands of patients over theyears when people put sunscreen
on, they go center to out and Isee most skin cancers right on
(18:24):
the periphery of the face and,for men, behind the ear.
So as we blend it out, itbecomes thinner and not even
applied peripherally.
So I like people to applysunscreen from outward to inward
because we're always going tocover our nose and see that in
front of us and that way we'llbe less likely to get skin
cancers and brown spots on theperiphery of the face.
(18:46):
Where I see them day in and dayout, especially on the left side
of the face from driving,because the UVA comes through
the windows, so at night, what Ilike people to use is a retinol
.
So retinol is it's not thehottest thing.
It's been around since the1970s, since Dr Kligman
discovered retinol, and it worksin so many ways.
It helps lift off pigmentation.
(19:07):
Retinol helps remove the deadlayers of the skin because this
slows down with age.
Over time it also sends signalsto produce collagen, so it
really works in so many ways toreverse sun damage, to help
improve the appearance of skinand fine lines and wrinkles.
The problem with retinol isthat it could be really
(19:28):
irritating to the skin.
So I want people to start slowand go slow, just starting three
times a week for two to threeweeks and then increasing one
night every two weeks until theycould tolerate it every night.
But retinol is definitelysomething that should be a
staple in everyone's plan,unless you're pregnant.
Speaker 2 (19:45):
Amazing.
Yeah, I think the hardest orthe most confusing part for me
was going through breast cancerand becoming extra sensitive in
my skin to pretty much everyproduct.
So I think, just a littleclarity on how do I help my skin
heal.
So I think, just a littleclarity on how do I help my skin
heal, you know, if it's dry orif it's just feeling like I
don't really know what to dowith it or for it.
(20:06):
I think just knowing you knowhow to heal it.
Speaker 1 (20:11):
Yeah, so less is more .
If you're dealing withsensitive skin, the more things
you apply, the more irritatingthey're going to be.
Something that you couldtolerate when your skin barrier
is not broken down you can'ttolerate when it is.
So if someone is dealing withsensitive or irritated skin or
going through what you've beenthrough, I would definitely
recommend very, very gentlecleanser twice a day, no toner
at all.
(20:31):
Definitely skip a toner, andI'd probably avoid vitamin C and
retinol at the time and use ahigh quality moisturizer,
something that containshyaluronic acid or niacinamide
Niacinamide is very calming andsoothing and just keep the
hydration simple until your skinbarrier is maintained, and then
you could slowly startintroducing something.
(20:53):
When your skin barrier ismaintained and you're not
sensitive anymore, you introduceone new thing every two to
three weeks.
Speaker 2 (21:01):
That's what I was just going to ask.
Do you recommend a certain way,like a certain ingredient, to
start with?
Speaker 1 (21:06):
I'd probably start with the vitamin C in the
morning and then wait two tothree weeks, make sure you're
not having any issues and thatyou're tolerating it well, and
then you're starting to get alittle bit of a brightening
effect from the vitamin C, whichis great, and then the retinol
is going to be the next thingyou're going to want to add,
because that's always thesensitivity trigger, but it also
(21:26):
gives us the most benefits.
So you know no pain, no gain,but we don't want the pain.
There's ways to do it withoutpain.
Speaker 2 (21:31):
Yeah, amazing.
Thank you so much.
I appreciate all the help andsupport my pleasure.
Welcome to Listen to your Skin by Moon and Skin, the
podcast where science meetsnature to celebrate the story of
your skin.
Your skin is a living canvas,ever evolving, deeply personal
and uniquely yours.
Each week, we'll dive into thescience of healthy skin, share
empowering stories and uncovertransformative self-care rituals
.
We're here to help you embraceevery phase of your journey with
(00:22):
confidence and care.
Speaker 2 (00:23):
Hi, hi, thank you for having me.
I love it.
I have so many questions.
I am 41.
I am perimenopausal, reallybordering like menopausal.
I have so many questions aboutmy skin because it's just not
the same anymore.
What actually works?
What do I actually need toinvest in?
Speaker 1 (00:43):
Right, yeah, so I'd say between 35 and 55, it's a
really tricky time becauseeverybody's aging at a different
rate and it depends on what'sgoing on in your environment, in
your body, hormonally.
And I don't think we talkenough about hormones and I
understand you've gone throughsome things with your hormones
which have lowered your estrogendramatically, and what happens
(01:07):
is is when we're in our 20s to30s, we lose about one percent
of collagen per year and then aswe get perimenopausal which can
be 15 years our estrogen dropsdramatically and our collagen
drops dramatically.
And I often think of it as likea balloon.
You know when you have a partyand you have a balloon blown up
(01:28):
and you clean everything up butyou might have forgotten a
balloon in the corner and youcome back a couple weeks later
and you find the balloon andit's deflated, where you have
lots of little crinkles in there, like that crepiness of the
skin, and that's what lowestrogen looks like in the skin.
Speaker 2 (01:46):
Wow.
So as a cancer survivor, am Iallowed to use estrogen, or what
do you think is the best way tobattle that?
Speaker 1 (01:51):
Yeah, that's such a good question because when I was
a resident, the women's healthinitiative came out that
basically said that the hormonereplacement was bad for everyone
, and now we're finding a lot ofevidence to the contrary, where
we're finding that hormonalsupplementation can be very
beneficial for everything fromour bones to our skin, to our
(02:11):
brains and our cardiovascularhealth actually.
But when you have ahormone-positive,
receptor-positive breast cancer,we really are not on board with
adding estrogen therapy.
So we have seen intravaginaland topical estrogen cream be
very beneficial for those organs, for both the vaginal mucosa to
(02:34):
be plump and more moist and forthe skin to have improved
hydration and improved collagen.
So by adding topical estrogencream, which is compounded in a
pharmacy, some women are usingthe vaginal estrogen topically
on their skin and that thoseestrogen receptors are getting
hit to produce more collagentopically in the skin without
(02:57):
getting systemically absorbed inthe body.
We're not finding levels in theblood.
Speaker 2 (03:01):
Wow, okay, talk to me about dark spots, because I
first started struggling withdark spots when I was going
through my pregnancies and asI've gotten older, it just is
something that I'm having areally hard time like solving.
So what do I do about that?
Speaker 1 (03:15):
Yeah, so we'll talk about all dark spots.
But on the topic of estrogen,um, during pregnancy or with
birth control, having highestrogen levels can contribute
to something called melasma,which I personally struggle with
, and that's one type of darkspot.
So while I'm 53 and while Iwant to apply topical estrogen
(03:38):
to my skin, I often know I'mgoing overboard when I start
getting more of that melasmaback.
There's different types of darkspots, so all dark spots are
not created equal.
There's what we call static orstable dark spots, and then
there's dynamic or unstable darkspots.
So melasma is unstable Anythingthat's going to inflame it or
heat can make it worse.
And then stable is sunspots,like the age spots on the back
(04:01):
of your hands or the sunspots onyour face and those you could
just like ablate with a laserand they go away and it takes
years for them to come back.
But if you burn off, melasma orthe dark spot that you get
after a pimple or a cut goesaway, which we call
post-inflammatoryhyperpigmentation that can come
back tenfold immediately worse.
Speaker 2 (04:19):
Wow, Okay.
So what's the differencebetween dark spots and rosacea
and how do you treat them?
Do you treat them the same ordifferent?
Speaker 1 (04:26):
No, they're totally different.
So rosacea is, I would sayrosacea is most often confused
with sensitive skin.
So sensitive skin is abreakdown of the skin barrier.
So we have this beautiful skinbarrier that protects us from
the outside world and when it'sbroken down, the worst case is
(04:47):
like in a burn victim, when theskin barrier is completely
destroyed.
Burn victims die from infectionand dehydration.
So if you think about all ofour bodies 60% water and it's
being held in by our skin andwe're not losing it and it's
protecting us from environmentaltoxins and microbes and
pathogens and all sorts of germs, basically.
So sensitive skin is whenthere's a compromise of the skin
(05:08):
barrier and it could be.
Typically it's from overuse ofsoap or using too many chemicals
on the skin that the skin can'tprotect itself anymore.
Rosacea looks like sensitiveskin and it does have a
sensitive skin component, but italso has something called
vasomotor instability, orbasically the blood vessels are
not stable.
So there's three forms ofrosacea.
(05:31):
There's a really long wordcalled erythematalangetatic form
, which is basically flushing,when people get really red and
they flush up and down.
The second form ispapulopustular and that looks
like pimples and the pimples aretypically on the central part
of the face and they're redjuicy pimples or they're
whitehead pimples.
You never see blackheads andwhiteheads.
So someone 20s, 30s and 40s canget that type.
(05:54):
And then the third form is likethe WC Fields nose.
So rosacea is more aboutunstable blood vessels.
So we want to get the bloodvessels stable again and we do
that with some of the strategiesthat we use for sensitive skin,
as well as other strategiesthat we do internally.
Speaker 2 (06:09):
Wow, that's amazing.
So much.
I have so many more questions.
So tell me about chocolate andbreaking out, because one thing
that I've noticed is I lovechocolate so much, but sometimes
it makes me break out.
Is it something like aningredient in the chocolate?
Is it sugar?
Is it what?
Speaker 1 (06:27):
kind of chocolate are you?
Speaker 2 (06:27):
having.
Um, I mean, I like dark chart,like dark chocolate, like cacao.
But does that break you?
Speaker 1 (06:33):
out.
Yeah, really Okay.
There's a couple of interestingthings about chocolate, because
I always felt like it was morethe sugar in the chocolate,
because the quicker your bloodsugar jumps up, the more likely
you're going to have highinsulin and then inflammation
and that leads to acne.
Some chocolate is also high incadmium, which is a heavy metal
(06:54):
found in the earth.
It tends to pull it up, butthat hasn't really been linked
to acne.
I suspect it's more the sugargoing on, because cocoa itself
really we haven't found a reallygood link to acne.
It's more the sugar.
But because cocoa itself reallywe haven't found a really good
link to acne, it's more thesugar.
But I mean, I always say listento your body, listen to your
skin, and if your body's tellingyou something, you have to
listen to it.
I've heard all sorts of thingsover the years and I just want
(07:17):
people to listen to their ownbody.
That's so fair, okay.
Speaker 2 (07:19):
So one last question.
I feel like there are so manyproducts out there, I so one
last question.
I feel like there are so manyproducts out there.
I mean it's so hard to narrowdown.
Do I need 15 different productsthat are going to do all of the
things for my skin, or what isa good like go-to, you know
process for my skin?
Speaker 1 (07:36):
That's a really good question.
So it depends on where you'restarting, right.
So I think simple is better,because we do have science for
individual products.
We don't have great science forhow these products interact
with each other.
So when we're layering five,six, seven, eight layers
together, what's going on there?
You look at sodium and sodiummixes with chloride and makes
(07:57):
salt, no problem.
You take sodium and you mix itwith water and it makes an
explosion.
So just because fiveingredients are good, I don't
know how they're going to betogether.
So I like to keep it simple.
With a good cleanser that's notgoing to strip your skin barrier
and cause sensitive skin.
Then a vitamin C product in themorning, something that's
stable.
So ascorbic acid is the activeform of vitamin C and it's
(08:20):
unstable.
So as soon as it hits light,heat or oxygen, it doesn't work
any longer and it becomesunstable.
So there's other forms like THDascorbate and sodium ascorbyl
phosphate that convert intoascorbic acid in the skin and I
prefer those forms becausethey're more stable on the shelf
.
Right, because we're not in thelab, we're in our bodies.
(08:41):
So we want things to work inour bodies and we want things to
work in our bodies.
And then if someone's dealingwith pigmentation or acne, I'll
have them use a targeted serumat that point and then
moisturize their sunscreen inthe morning.
That's the most anyone needs.
Now, if someone, I tend to be alittle oily.
I don't use a moisturizer inthe morning, I only use it at
night.
So at night I like cleansing,get the makeup and the dirt and
(09:04):
debris off your face and thenput a retinol on your skin,
something that's not going to beirritating Less is more.
It works through cell signaling.
So Having heavy coverage with aretinol is going to irritate
the skin more.
We don't need a lot.
We have to trust the sciencebecause it signals through the
nucleus of the cell and we don'tneed a lot of coverage.
(09:26):
We have to just trust that themolecule will get where it needs
to be to enhance cell renewaland then let that dry and put a
really good moisturizer on.
I love finding moisturizers thatcan be used as eye creams and
neck creams, so you don't haveto have multiple products.
And then I like people tochange with every season.
So our skin takes about six to12 weeks, depending on how old
(09:46):
we are, to turn over and we wantto look with the changes of the
seasons, like are we going toadd something to exfoliate the
brown spots off in the fall?
That's a great time.
Are we going to add moremoisturizer in the winter?
So I do like people to modifythings.
So you may have 10 or 15products, but you're not using
them all at the same time.
You're kind of rotating themand cycling them in and out and
(10:08):
going back to topical estrogen.
You would add that either asyour moisturizer, depending on
how it's compounded, or as yourstep after the retinol, before
your moisturizer at night andthen after your vitamin C in the
morning, before yourmoisturizer and sunscreen in the
morning.
So we can incorporate things tomake a more bespoke plan,
depending on what someone's skinneeds are.
Speaker 2 (10:30):
That makes sense?
Okay, one more, one more.
Last, last question.
Speaker 1 (10:32):
I love it.
Speaker 2 (10:33):
Big pores.
Is there really a solution tothe pores situation?
Speaker 1 (10:38):
Yeah, so there is a laser.
There's a laser that canactually help reduce pore size,
believe it or not.
I'm not even going to give thewavelength.
I think it's a 13, 20 nanometerwavelength, but don't, don't
hold me to that, because I don't.
Yeah, so there's differentlasers for different things.
And the cool thing about lasersis lasers are basically
attracted to certainchromophores or targets in the
(11:00):
skin.
So, like I said, with theliposomal technology of the
retinol, it can bypass theepidermis.
Lasers can bypass damaging thetop layers to target hemoglobin
in a blood vessel to helpcollapse the blood vessel, or
bypass the epidermis to attachto the sebaceous gland or the
oil gland and do things likethat.
Or be attracted to pigment,whether it's deep pigment at a
(11:22):
hair follicle for hair removal,or more superficial well,
depending on the depth of thetattoo, like different levels
for tattoo removal or for eachspots or brown spots.
So lasers basically targetcertain things.
So I I like lasers.
What was I even talking about?
Pores, pores, yeah, so for poresin general, for most people
(11:44):
that aren't going to spendthousands of dollars on a laser
for reducing their pore size.
Really, what you want to do isjust clean out your pores.
So I like products containingsalicylic acid because it's a
keratolytic, which means itbreaks down keratin or the dead
skin cells, but it's attractedto oil.
So glycolic acid just kind ofloosens up the dead skin cells,
(12:05):
but salicylic acid goes to theoil glands to remove the skin
cells.
So if you have a big pore and abig opening and it's filled
with something, it's going tolook larger.
So if you can clean out thedebris and the dead skin cells
and the dirt and the oxygen andeverything inside there, it will
appear smaller, even thoughit's not actually smaller.
And what really matters is howit appears at the end of the day
(12:28):
.
And that's basically it.
Speaker 2 (12:30):
Speaking of the time of day, are there certain masks
that you should use at differenttimes of day?
You know like, should I docharcoal in the morning and a
moisturizing mask at night, ordoes it matter?
Speaker 1 (12:39):
Yeah, I don't think it really matters.
I don't think there's a lot ofscience with the circadian clock
for masks.
I'm not like the hugest maskperson.
I'm more about the compoundeffect, like little things over
time, how it makes a differenceIf you're dealing with, if you
want to do a detox or something,you could do a charcoal mask
every once in a while.
Or if you need hyperinfusion ofhydration, then you could do a
(13:02):
hydrating mask overnight, Likeovernight you want to do more
hydration because that'stypically when we're losing the
most water with our circadianclock.
Speaker 2 (13:10):
I've been getting way more disciplined about my diet
and how I'm eating because I'mstarting to become so much more
conscious of how I feel in mybody with the food, which is
amazing.
But are there certain foodsthat are best to avoid, or maybe
even certain foods that arebest to digest?
That will help my skin.
Speaker 1 (13:28):
Yeah.
So you know it's interesting.
I heard a quote from MotherTeresa years ago talk about
somebody said are you going togo fight against that war?
And she goes no, they go.
So you want war?
And she said, no, she goes Idon't.
I will fight for peace, but I'mnot going to fight against
something.
So I often look at diet thatway too.
(13:49):
It's so easy to say don't dothis and don't do that.
And yes, I don't find benefitsof sugar.
Sugar has no nutritionalbenefit for your body or for
your skin, maybe your tongue,but that's about it, right.
So I like to focus on what toadd in right, and if we add the
right things in, then we'regoing to naturally eliminate the
things that we don't wantwithout beating ourselves up.
Speaker 2 (14:11):
I love that that's so much less constrictive and
restrictive, you know.
Speaker 1 (14:16):
Yeah, I mean, I do that to to myself.
So the last thing I want to dois like, have that done to other
people, but like, if we focuson for women in particular, we
really want to focus on gettingenough protein, and in the form
of high quality protein, and soyis not the one that I want
people to get.
So, whether it's you peaprotein or hemp protein, or I
(14:39):
choose high qualityregeneratively farmed meat and
getting about one pound perideal body weight.
So you know, if you'reoverweight and you're aiming for
130, then go for 130 grams perday.
So getting high quality proteinin your ideal body weight in
grams of protein per day, havingas many vegetables as you want.
(15:02):
This is an unpopular opinion,but I don't believe fruit is
meant to be eaten in the winter.
Fruit is there for thesummertime, to make us a little
chubby, so we could survive awinter.
We don't live in that kind ofworld anymore, so I don't really
eat fruit, except for thesummertime and maybe into the
fall, like we would naturallyharvest, harvest it.
But if you do have a sweettooth and you want some berries
(15:23):
or some mango, they're.
They're definitely beneficialand there's studies showing that
some mango up to I can'tremember how many grams, but a
certain number of grams per dayactually helped improve the
appearance of the skin.
Then once you got past acertain threshold, it reduced
the appearance of the skin.
Then, once you got past acertain threshold, it reduced
the appearance of the skin.
And I think that what happenswith a small amount of mango it
(15:45):
was boosting the polyphenols,the healthy colorful nutrients
that are in the fruit, in yourskin, but too much boosted the
sugar.
So there's a sweet spot where alittle bit will help your skin,
but then too much the sugaroutweighs's a sweet spot where a
little bit will help your skin,but then too much the sugar
outweighs the benefits of thepolyphenols.
So that's with fruit.
And then I try to avoidprocessed carbohydrates like
(16:09):
anything that's really in apackage, if we can right, and
instead we just want to focus onwhole, real food.
So I'm not a big fan ofmeasuring the amount of olive
oil you use or worrying abouteating the whole avocado
Anything that's a real food thathas one ingredient.
Go for it and I doubt you'llever be overweight and you'll
have enough ability to maintainmuscle mass and all the building
(16:31):
blocks for your skin if youhave a whole food diet.
Speaker 2 (16:35):
Wow, that's really great.
Are there any ingredients Ishould be looking for in my
products?
Skincare I know there's a lotto avoid, so just to keep it
simple, kind of what we weretalking about with the food like
what food are we looking for?
What ingredients are?
Like yes, that's what I shouldhave in my products.
Speaker 1 (16:55):
Yeah, so it depends.
Product selection depends on alot of factors.
So it depends on what age youare, what season of life you're
in, because what you're going touse as a teenager is going to
be different from when you're 40, and also where you live.
So somewhere like Arizona,you're going to need more
hydrating products than if youlive somewhere like Hawaii, for
(17:15):
instance, right, so all of thosevariables taken into effect, I
mean you want to find a cleanserthat's going to remove
effectively remove dirt from theskin without stripping your
skin of its skin barrier,because that's going to
compromise you and make you moreprone to environmental toxins
and breakdown of your collagenall the things we're trying to
avoid.
And then, in the morning, Ireally like people to use a
(17:37):
vitamin C.
It's one of the most tried andtrue things.
The biggest thing with vitaminC is looking for a staple form
of vitamin C with either sodiumor ascorbyl phosphate,
especially for anyone that isprone to acne.
If they're prone to acne orrosacea, they want to look for a
form with sodium ascorbylphosphate, because a lot of
people break out with vitamin C,so that form is less likely to
(18:00):
break out with or THD ascorbateis another form.
And then sunscreen.
And with sunscreen I don't likethe chemicals.
I've never liked the chemicalssince I was 30 using sunscreen.
I've always recommendedsunscreen with zinc oxide.
And one of the things I noticedjust from looking at tens of
thousands of patients over theyears when people put sunscreen
on, they go center to out and Isee most skin cancers right on
(18:24):
the periphery of the face and,for men, behind the ear.
So as we blend it out, itbecomes thinner and not even
applied peripherally.
So I like people to applysunscreen from outward to inward
because we're always going tocover our nose and see that in
front of us and that way we'llbe less likely to get skin
cancers and brown spots on theperiphery of the face.
(18:46):
Where I see them day in and dayout, especially on the left side
of the face from driving,because the UVA comes through
the windows, so at night, what Ilike people to use is a retinol
.
So retinol is it's not thehottest thing.
It's been around since the1970s, since Dr Kligman
discovered retinol, and it worksin so many ways.
It helps lift off pigmentation.
(19:07):
Retinol helps remove the deadlayers of the skin because this
slows down with age.
Over time it also sends signalsto produce collagen, so it
really works in so many ways toreverse sun damage, to help
improve the appearance of skinand fine lines and wrinkles.
The problem with retinol isthat it could be really
(19:28):
irritating to the skin.
So I want people to start slowand go slow, just starting three
times a week for two to threeweeks and then increasing one
night every two weeks until theycould tolerate it every night.
But retinol is definitelysomething that should be a
staple in everyone's plan,unless you're pregnant.
Speaker 2 (19:45):
Amazing.
Yeah, I think the hardest orthe most confusing part for me
was going through breast cancerand becoming extra sensitive in
my skin to pretty much everyproduct.
So I think, just a littleclarity on how do I help my skin
heal.
So I think, just a littleclarity on how do I help my skin
heal, you know, if it's dry orif it's just feeling like I
don't really know what to dowith it or for it.
(20:06):
I think just knowing you knowhow to heal it.
Speaker 1 (20:11):
Yeah, so less is more .
If you're dealing withsensitive skin, the more things
you apply, the more irritatingthey're going to be.
Something that you couldtolerate when your skin barrier
is not broken down you can'ttolerate when it is.
So if someone is dealing withsensitive or irritated skin or
going through what you've beenthrough, I would definitely
recommend very, very gentlecleanser twice a day, no toner
at all.
(20:31):
Definitely skip a toner, andI'd probably avoid vitamin C and
retinol at the time and use ahigh quality moisturizer,
something that containshyaluronic acid or niacinamide
Niacinamide is very calming andsoothing and just keep the
hydration simple until your skinbarrier is maintained, and then
you could slowly startintroducing something.
(20:53):
When your skin barrier ismaintained and you're not
sensitive anymore, you introduceone new thing every two to
three weeks.
Speaker 2 (21:01):
That's what I was just going to ask.
Do you recommend a certain way,like a certain ingredient, to
start with?
Speaker 1 (21:06):
I'd probably start with the vitamin C in the
morning and then wait two tothree weeks, make sure you're
not having any issues and thatyou're tolerating it well, and
then you're starting to get alittle bit of a brightening
effect from the vitamin C, whichis great, and then the retinol
is going to be the next thingyou're going to want to add,
because that's always thesensitivity trigger, but it also
(21:26):
gives us the most benefits.
So you know no pain, no gain,but we don't want the pain.
There's ways to do it withoutpain.
Speaker 2 (21:31):
Yeah, amazing.
Thank you so much.
I appreciate all the help andsupport my pleasure.
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