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Menopause and How it Affects Your Skin · Create The Best Me

• 0:00
  Well, hello there and welcome to Create The Best Me, the show dedicated to empowering and inspiring you on your journey to a healthier and more vibrant self.
• 0:21
  I am your host, Carmen Hecox, and today's episode, we'll delve into a topic that resonates with many of us.
• 0:28
  Skin changes during premenopause, menopause, and postmenopause.
• 0:34
  We are incredibly fortunate to have with us Dr.
• 0:38
  Mary Alice Mina, a Harvard trained, double board certified dermatologist and dermatologic surgeon.
• 0:46
  Dr.
• 0:47
  Mina is not only a leading expert in skin and healthcare, but also a passionate advocate for holistic and preventative approach to skin aesthetics.
• 0:59
  With over 15 years of clinical experience, she co-owns Balcom and Mina Derma Surgery in Atlanta, Georgia, and the host of the Skin Real podcast, offering real skin guidance by a true skin expert.
• 1:17
  In our conversation today, Dr.
• 1:18
  Mina shares her profound insights on the intricate ways our face and skin changes during the stage of premenopause, menopause, and postmenopause.
• 1:30
  We'll explore the underlying causes of these changes and discuss practical, effective strategies for aging gracefully.
• 1:39
  Dr.
• 1:39
  Mina emphasizes the importance of tailored skincare and lifestyle choices that not only enhance our outer appearance, but also nurture our overall well-being.
• 1:51
  So whether you're approaching these life stages, currently experienced them, or simply interested in understanding the journey of skin health better, this episode is a treasure trove of wisdom and guidance.
• 2:05
  Now, let's dive into the enlightening conversation with Dr.
• 2:09
  Mary Alice Mina.
• 2:11
  Dr.
• 2:12
  Mary Alice Mina, welcome to Create The Best Me.
• 2:17
  Thank you so much.
• 2:17
  I'm thrilled to be here.
• 2:19
  So for some of the people that do not know who you are, could you please tell the viewers a little bit about yourself and your podcast?
• 2:29
  Yeah, absolutely.
• 2:31
  So I am a double board certified dermatologist, and I also am a dermatologic surgeon, which is a mouthful to say, but it means that I do a lot of surgery and procedures and one of the surgeries that I do a lot of is skin cancer removal with mohs surgery.
• 2:48
  And I've been in practice about a little over eleven years at this point and I love seeing patients.
• 2:55
  I love what I do.
• 2:56
  But what I realize is that there's a lot of confusion out there in regards to skin care and how to take care of your skin.
• 3:04
  And I'm also in my mid 40s.
• 3:06
  And so I'm noticing a lot of my friends as well as myself, we're noticing changes in our skin.
• 3:13
  And a lot of people are coming up to me saying, What's going on?
• 3:16
  Am I going crazy?
• 3:18
  Is this real?
• 3:19
  What's happening?
• 3:20
  And I just have really taken an interest in delving into what is going on with our skin.
• 3:27
  And I figured that if I've got questions, I know people have questions out there.
• 3:31
  So I created a podcast where I answer a lot of questions that my patients, my friends, that I have myself for a larger audience, because I realized my time in the clinic is limited and I can reach a much wider audience through my podcast.
• 3:48
  And thank you so much for doing that because I know that a lot of times I find cause my skin is changing like it seems every day.
• 3:56
  And I find that I'm searching through blog posts and stuff, trying to find answers, and you're going to get all kinds of answers, but I love that you're an expert.
• 4:06
  And so the information that you are providing is based on medical information.
• 4:12
  Yeah, absolutely.
• 4:14
  That's the whole point.
• 4:15
  So the podcast is called The Skin Real and I always laugh because people ask me how to spell real and it's just because this day and age right with so many reels, R E L, but it's real as in real information.
• 4:28
  R E A L.
• 4:29
  And that's really my goal.
• 4:31
  I really want to just put really good information out there.
• 4:34
  Like you have a dermatologist best friend who is telling you, hey, don't worry about that.
• 4:40
  That's a waste of money.
• 4:41
  You don't need this or try this or you should be doing that or this is helpful.
• 4:46
  This is bogus cause there's so much out there.
• 4:49
  It's overwhelming.
• 4:50
  It's hard to know what's true, what's not, what works, what doesn't.
• 4:54
  And you can really go down this rabbit hole.
• 4:57
  And I think you can also start to feel really bad about yourself when you're not getting the results.
• 5:03
  You spend a lot of money.
• 5:04
  It's frustrating and so hopefully my podcast just gives people some good solid information.
• 5:11
  And of course, it's not going to be a complete substitute for medical care, but I would encourage you to use it to help educate yourself.
• 5:19
  That way when you do go see someone or you are looking at a procedure or aesthetics or seeing a dermatologist, you have that background education.
• 5:29
  Great.
• 5:30
  Can you explain the typical skin changes that start to happen for women who are pre-menopause, menopause, and post-menopause?
• 5:39
  Yeah.
• 5:39
  So this is huge.
• 5:42
  And I love that we're finally talking about this.
• 5:44
  I don't think I had any education on this in my residency training.
• 5:49
  And I know even my friends who are OBGYNs, There's so much focus on, earlier in our lives, our reproductive lives.
• 5:57
  And then it's nothing afterwards.
• 5:59
  But I'm so glad to see that changing because as women in your mid forties, fifties, sixties, seventies, and beyond, we are going to be spending a lot of time in this perimenopausal and postmenopausal state.
• 6:14
  And so we need to understand our skin, what's going on.
• 6:17
  It's not good enough just to say, live with it.
• 6:20
  It's natural.
• 6:21
  It's nature.
• 6:22
  Just deal with it.
• 6:23
  I think we're finally saying, no, that's not acceptable.
• 6:26
  I'm not willing to live a third of my life, a fifth of my life suffering or having these symptoms.
• 6:32
  So a lot of things happen as some of your listeners might know firsthand during menopause and your skin is no exception, right?
• 6:41
  So your skin is going to see the effects of that estrogen depletion, that progesterone depletion, and there's also an imbalance between your testosterone and your estrogen.
• 6:54
  And so you get skin changes like acne with that.
• 6:58
  So I would say the most common thing that women notice probably starting in their mid forties, fifties, and certainly once menopause hits you will notice a drastic drop in your collagen.
• 7:10
  And how this will make you feel is that you will wake up and think, my face is falling, I am melting.
• 7:17
  What happened?
• 7:18
  And you're not going crazy because it really can be that drastic.
• 7:22
  You can lose 30 percent of your collagen the first five years after menopause.
• 7:27
  So that's huge.
• 7:28
  And you're losing it incrementally before that as well.
• 7:33
  So collagen loss, that's a big one, right?
• 7:35
  You feel like your skin is sagging.
• 7:38
  It's really dry.
• 7:40
  It's no longer plump and vibrant.
• 7:43
  You don't have the light, reflecting off of it.
• 7:45
  It just seems dull.
• 7:47
  And that's because your skin is also dehydrated.
• 7:49
  It's hard to hold on to fluid.
• 7:52
  Your hyaluronic acid is not as plump and that's one of the big things that helps us hold on to moisture.
• 7:58
  So those are kind of the big things that people notice.
• 8:02
  You also have things like bone resorption.
• 8:04
  So our jaw actually starts to recede and so you may notice that you used to have a nice jaw line or a chin and now you don't.
• 8:13
  Now you have jowls.
• 8:15
  And, in dermatology, we talk about this sort of triangle of the face where when we're younger, and if you look at younger people, you'll see this, or kids, they're wider across their cheeks, and then it points down to their chin.
• 8:28
  However, as we age, that triangle gets reversed.
• 8:32
  So now we've got the wider part down at our chin and the point higher up.
• 8:37
  And so that's why we feel like we've got that heaviness around our lower face.
• 8:41
  So you're not crazy if you're feeling this, if you're seeing these changes, they're real and, it's happening.
• 8:48
  But the good news is there are things that can be done.
• 8:51
  And I think the first step is just acknowledging it and acknowledging that this is what happens.
• 8:57
  You're not alone.
• 8:57
  This is pretty universal.
• 9:00
  So tell me, what can we do to slow down the depletion of collagen?
• 9:05
  Yeah.
• 9:06
  So that's the question, right?
• 9:08
  And there's not necessarily like one thing you do this, you're never going to lose your collagen.
• 9:13
  Cause again, this is nature.
• 9:15
  It is natural.
• 9:16
  And I always joke, like it's hard to fight mother nature.
• 9:20
  She is incredibly powerful.
• 9:22
  But I would say we should try to reframe aging as not trying to fight it, not trying to completely necessarily reverse it.
• 9:30
  Although I guess that may be in the pike, right?
• 9:33
  But how can we be the healthiest we can be for as long as possible?
• 9:39
  So how can we keep our skin as healthy as possible?
• 9:42
  And I really think little things along the way are going to make the most impactful difference.
• 9:48
  So if you're listening and you're in your twenties, that is great, but not all is lost.
• 9:54
  If you're listening in your fifties and you're thinking, I haven't done any of these things, but I would say number one is to take care of your body.
• 10:02
  Make sure that you are eating a balanced diet.
• 10:06
  I find a lot of women really restrict their diet or they yo yo, with their weight and that can really cause havoc, not only with your skin tightness, but also your hair.
• 10:17
  So being healthy from within, and we can, do a whole episode on that.
• 10:21
  But I know you're probably like, give me some skin wrecks, right?
• 10:26
  One of my favorite, and I would say it's simple doesn't mean it's easy, but sun damage is such an accelerator of aging.
• 10:36
  I look at people or I look at, societies and countries where some protection is really valued.
• 10:43
  And if I see a patient from there, I noticed their skin is beautiful.
• 10:48
  They have protected it from the sun.
• 10:50
  It's just what their community does.
• 10:52
  It's not looked at as weird or obsessive or anything like that.
• 10:57
  They wear sunscreen, they use umbrellas, they seek shade and their skin shows, it really does.
• 11:03
  So sun protection I can't emphasize it enough.
• 11:08
  And I would say you can even see it on your own body.
• 11:11
  I can see the tops of my hands have not been as sun protected as my face.
• 11:16
  I can see that, my arms have not been as sun protected as my face.
• 11:21
  A lot of times people can see their stomach.
• 11:23
  How does the skin on your stomach look compared to the rest of your face?
• 11:27
  If it's, kind of wrinkle free and thicker than the rest of your skin.
• 11:31
  It's probably because it's been protected from the sun more than other parts of your body.
• 11:35
  So that's a huge one.
• 11:37
  And, smoking is another big one.
• 11:39
  So this is cigarettes, e-cigarettes, marijuana, all of that can really restrict your blood vessels and cause a lot of damage.
• 11:47
  It's really hard to have nice skin when you do smoke.
• 11:52
  So those are two big things that if you can just, knock those out and if that's all you do, you can have beautiful skin as you age.
• 12:01
  So those are two big ones.
• 12:03
  We can go through a whole different things on like topicals and devices and stuff like that.
• 12:08
  I don't know how far you want me to take it.
• 12:11
  I've always heard that, for example, you were talking about, consumption.
• 12:14
  I've also heard that alcohol can also impact your skin.
• 12:18
  Yes.
• 12:19
  So I think there is multifactorial.
• 12:21
  And again, if we look at aging as not something to be fought or reversed, we're not trying to remove every line possible.
• 12:29
  We're not trying to necessarily look like we did at 20.
• 12:32
  We're trying to take the best care of our body so that we, look, as good as we feel and that we feel good.
• 12:39
  So you are so right.
• 12:40
  Alcohol by drinking a lot excessively, it also impacts your sleep.
• 12:45
  And that's another big factor in people who actually they even showed studies like higher mortality and people who do more night shift jobs because it does wreak such havoc on your body when your sleep cycle is out of whack.
• 12:59
  And I know that's one of the unfortunately one of the problems.
• 13:03
  with menopause is that it's hard to get a good night's sleep It's hard to get a lot of rest, but If you can limit your alcohol now there's mediterranean diet that I actually think is a great diet.
• 13:15
  They do recommend a glass of red wine a night is actually not harmful.
• 13:20
  So I think again, in moderation, if you enjoy a glass of wine, have a glass of wine, but don't have three, don't have five, and don't do that consistently because, it is going to affect your skin.
• 13:33
  It's going to affect your sleep and it's going to affect more than your skin, right?
• 13:37
  It's going to affect your whole body.
• 13:38
  So that's a great point.
• 13:39
  What can we, other than consumption and practicing being healthy, exercising and stuff like that.
• 13:46
  What type of topicals can we use to, just slowly get older.
• 13:51
  Yeah, no, absolutely.
• 13:52
  I'm right there with you.
• 13:54
  I think universally loved is a vitamin A cream called Tretinoin is the prescription.
• 14:00
  Or, retinoid.
• 14:02
  I was going to say retinal.
• 14:03
  A retinol or a retinoid.
• 14:05
  Retinoid is the prescription strength one so it's a stronger vitamin A cream.
• 14:09
  A retinol are the over the counter products.
• 14:12
  If you can start this and you can start it early, it will be, I say it's the biggest bang for your buck because it's relatively affordable.
• 14:21
  You don't need a lot of it.
• 14:23
  If you start putting that on your skin, your neck, top of your hands, if you start doing that consistently, especially early on or before even menopause, if you can, you are going to see those changes.
• 14:35
  It is such a powerful collagen booster.
• 14:39
  The problem is it's slow to work and it's slow to see the benefits and it can be irritating.
• 14:45
  It can be drying.
• 14:47
  So a lot of times people will quit before they really see the benefits.
• 14:51
  So, starting on one of those is a great way to really boost your collagen.
• 14:56
  You will see the difference, but I say it's like weight loss you have to do it consistently.
• 15:01
  And you're not going to notice the results overnight.
• 15:04
  It's going to take about six months before you see those changes.
• 15:07
  But I think getting on board with one of those is a great way to boost your collagen.
• 15:13
  I think doing a vitamin C serum in the morning is a great way to also brighten your skin to fight some of the, free radicals from sun damage.
• 15:23
  So that's in my regimen as well.
• 15:26
  Along with sunscreen and a moisturizer, because I am noticing as I'm in my forties now, my skin is drier.
• 15:33
  I used to have very oily skin and I kind of joke.
• 15:36
  I had the what is it glazed donut skin before it was popular.
• 15:40
  And I just called it acne.
• 15:42
  But, doing those, the vitamin C serum, sunscreen and a moisturizer, and then at night doing your vitamin A cream that really can be, it if you want.
• 15:53
  And that's actually my routine exactly, but those are super powerful, but it's playing the long game.
• 16:00
  It's slow changes, but you will see the benefits.
• 16:03
  Do you find that as women get older that we need to change our moisturizer because our moisturizer is just not doing it anymore?
• 16:11
  Yep, absolutely.
• 16:13
  So as you hit menopause and beyond, your skin does not retain moisture as well.
• 16:18
  You may also find that you're just dehydrated more in general.
• 16:22
  So making sure you're getting about two liters of water even a day is really recommended, especially more if you're sweating, exercising a lot.
• 16:30
  But staying hydrated, and then you probably are going to need to adjust your moisturizer.
• 16:36
  So just like you might in the winter months when it's colder, you might get a thicker, heavier moisturizer.
• 16:42
  You will want to do that as well if your skin is drier.
• 16:45
  So instead of a thin lotion, you may, want to look for something that's a little thicker, a little creamier, that will hold on to the moisture that you do have.
• 16:55
  What about, I know you say that, put sunscreen on, and I know I always put sunscreen on before I put my makeup on, but then there's sometimes where I'm like, oh, I'm, the sunscreen said that it was only good for two hours.
• 17:07
  I need to reapply, but I have makeup on.
• 17:09
  Yeah.
• 17:09
  What do you do in that situation?
• 17:11
  Cause I have seen some of my girlfriends have this powder.
• 17:13
  It's almost like a translucent powder type of sunscreen.
• 17:17
  Well, unfortunately that I think is okay on top of sunscreen, but yes, this is a quandary for people.
• 17:25
  And what I would say is my goal as a dermatologist would be to get your skin looking amazing so that you don't have to wear foundation.
• 17:32
  But I know for a lot of people, they're like, I want it.
• 17:35
  I like it.
• 17:36
  But I have that same issue too, right?
• 17:37
  I wear my sunscreen in the morning, I'm in an office, I'm not by windows, and then in the summertime I go home and it's still sunny out and I may go outside for a little bit.
• 17:46
  So, you really do need to reapply if you're going to be outside.
• 17:49
  I will put it on my arms, my hands.
• 17:52
  I love a hat because I'm like you, I don't necessarily want to smear my face with makeup or smear it with sunscreen, at the end of a day or if I'm sweaty and hot.
• 18:02
  And so I think if you really don't want to do that, get a hat.
• 18:05
  And I love hats.
• 18:07
  I don't care what I look like in it because it works so well.
• 18:11
  I don't have to put sunscreen on top of my makeup.
• 18:15
  I don't have to worry about not rubbing it in certain locations.
• 18:18
  So if you do know you're going to be outside, you're going on a walk, you're at a game, whatever.
• 18:23
  Wear a hat, otherwise you do have to reapply because the powder unfortunately is not enough.
• 18:28
  I know that sometimes, for example, we go to Hawaii a lot.
• 18:31
  We go to Hawaii like maybe four times a year, and I am under this monster umbrella, and I am under a monster hat, and I go back into my room, and my face is burned, and my husband makes fun of me.
• 18:43
  He's you put sunscreen on, you were under all this, and you're still burning.
• 18:47
  Why?
• 18:47
  Well, I would make sure your hat is totally opaque nothing is coming through.
• 18:53
  Make sure it's a hat that has like a UPF, which is the sunscreen rating for clothing.
• 18:58
  So a UPF of 50 or higher will block out 99 percent of the rays, water reflects back.
• 19:05
  So if you're on a raft or kayaking or whatever, the water is going to reflect it back.
• 19:10
  Make sure you reapply.
• 19:11
  And I don't know if you really are burned.
• 19:13
  You say you are, or maybe you're red or flushed.
• 19:16
  It's hard to say, but if you are using like a SPF 30 or higher, you're reapplying every two hours and you have a UPF hat on or, a umbrella with a shade that we know has a UPF factor, then you shouldn't be burning.
• 19:29
  But I would wonder, maybe is that shade not really blocking that much?
• 19:34
  Is it really, protecting you from the sun?
• 19:37
  Because clothing will do a little bit, but it's not a hundred percent unless it has that like UPF rating.
• 19:44
  I always tell my husband, I'm like, I don't know, maybe it's because I'm past menopause.
• 19:47
  And my skin is getting thinner.
• 19:49
  So I'm like a baby I'm like sensitive to light.
• 19:52
  So I'm catching glares from everywhere.
• 19:55
  Yeah, your skin is getting thinner, but I don't know if that's the reason, but I would say maybe just try to reapply, maybe use a zinc or, mineral based sunscreen.
• 20:05
  Cause you might be getting more UVA rays than you realize and regular sunscreen, I shouldn't say regular chemical sunscreens do a great job blocking UVB, but not always the longer wavelength, which can go through windows and it penetrates further.
• 20:21
  So maybe switch it up and use like a physical blocker, like zinc or titanium.
• 20:26
  And you talked about using like a Retin-A type of product, which I'm assuming is something that you would get at the drugstore.
• 20:34
  Yeah, so a retinol is the one you get at a drugstore yeah.
• 20:37
  Is there a particular one that might be better than the other?
• 20:40
  So the one I really love is the one you get from your doctor's office.
• 20:44
  I think they're also like online pharmacies that do it just because I feel like if you're going to do it, just do it.
• 20:50
  And get the prescription strength.
• 20:52
  You can start low, you can start slow.
• 20:54
  But if you really can't tolerate it or you have really sensitive skin, then try an over the counter one.
• 21:00
  It's not going to be as strong, but, most of the popular, dermatology companies, Neutrogena, Roc, I think La Roche Posay, they all have some variant of a retinol and I don't think one is necessarily better than the other.
• 21:14
  But I would say if you can get the strong one, get the prescription strength for the maximum benefit.
• 21:20
  And when you start using it, cause I know I have used the over the counter one and it says to use it, I think it's every other day.
• 21:28
  And when I've tried it, I noticed that like here, I start to see these ugly patches where, I'm dry.
• 21:35
  How do you get over that?
• 21:36
  Yeah.
• 21:37
  So I like to reframe it as, oh, it's working.
• 21:40
  It's working.
• 21:42
  But, joking aside, I still get dry too.
• 21:45
  I get dry more around my mouth, around the eyes that eyelid skin is really delicate.
• 21:50
  So there are a couple of ways to get around that.
• 21:52
  If you know you are getting dry there, first of all, just know that it's working.
• 21:56
  It's normal.
• 21:57
  Think of it like an exfoliation.
• 21:59
  What I would do is just skip the next time you're going to use it, whether it's the next day, take a night off or skip two nights.
• 22:06
  The other thing you can do is put a really thick moisturizer on the areas, you get dry.
• 22:11
  So you could put a little Vaseline or Aquaphor around your eyes or a very thick moisturizer.
• 22:18
  You can also dilute your retinol with a moisturizer.
• 22:21
  So some people, I think on TikTok, they call it the sandwich technique.
• 22:25
  You put your moisturizer on, then you put your retinol, then you follow up with more moisturizer.
• 22:30
  So that's a way to, still get the benefit, but dilute it a little bit.
• 22:35
  And I actually like that technique a lot for the neck because the neck also has very thin skin and it's definitely going to peel and get dry.
• 22:44
  But I tolerate a little bit of that because I'm like, you know what?
• 22:47
  It's working Cause I keep telling myself, cause I've tried it a couple of times.
• 22:51
  And when you and I first met a couple of weeks ago, I thought, you know what, I'm going to try it again.
• 22:55
  and I had to wear Aquaphor on my face day and night for several days to try to recover.
• 23:01
  In fact, my face still looks dry in certain areas because, and that was the over the counter.
• 23:06
  Wow.
• 23:06
  Make sure you're using just a tiny pea, like very tiny.
• 23:11
  I think sometimes people use too much as well.
• 23:13
  So just a tiny bit, even if you can only do it one night a week.
• 23:17
  Wintertime can be hard cause the weather's already a little more dry, but I would just encourage you to stick with it.
• 23:23
  Because your body will get used to it and you will see the benefits.
• 23:26
  But yeah, that's the biggest hurdle for people is the dryness.
• 23:30
  It's annoying, but, I would just encourage you to stick with it, maximize your moisturizer and use a tiny bit.
• 23:37
  What about microneedling?
• 23:38
  I've heard that microneedling can help promote collagen.
• 23:42
  Yep.
• 23:43
  So a lot of devices can stimulate collagen.
• 23:47
  And the thought is that by creating micro injuries in the skin that don't lead to scarring, it actually stimulates growth factors, wound healing, and collagen formation.
• 23:57
  So microneedling is one of those that can do it.
• 24:01
  Sometimes people will layer on PRP on top of that to really boost it.
• 24:06
  Devices like lasers, so whether you're doing, IPL is not a laser, but that can, or things like a fractionated laser that's going deeper into the skin can stimulate collagen.
• 24:17
  So, really all of them are great options.
• 24:20
  I like microneedling for people with more, for more preventative or very early signs of, sun damage or aging.
• 24:28
  And then more of a fractionated device, something a little more intense or a chemical peel for someone with a more mature, lady or person who has more maybe sun damage, more wrinkles, more laxity.
• 24:41
  So those are great options and I'll say one of my favorite and I'm not sponsored, but I just love this is Sculptra, or Radiesse.
• 24:49
  If people have heard of those are things called biostimulants.
• 24:53
  And what I love about Sculptra is these PLLA particles get dissolved in water.
• 24:59
  We inject it into the skin and it stimulates your own collagen.
• 25:04
  So it gives a really natural result.
• 25:07
  And if you can even start this before you've had a lot of that volume loss, you really can stave it off and never feel like you're having that drop or you're making that big plummet of your 30 percent collagen.
• 25:21
  It's lessened because you've been stimulating your own collagen all along.
• 25:25
  And I find it gives a really natural result.
• 25:28
  I think a lot of people are leery of fillers because we've overblown people over the last five, ten years.
• 25:36
  People look really unnatural.
• 25:38
  They look really fake.
• 25:39
  And sculpture is nice because it's your own collagen.
• 25:42
  So I'm a big fan of that and even, of course, you can do it whenever, but even starting it early as sort of maintenance can be very helpful as well.
• 25:52
  So make it look like, Sandra Bullock or, who's the other, What's her name?
• 25:56
  Jennifer Aniston Or like Madonna.
• 25:58
  I don't know about Madonna nowadays.
• 25:59
  I don't know.
• 26:00
  Oh, I thought you were talking about, yeah, the filler where you're overdone.
• 26:03
  But no, it helped.
• 26:03
  I just saw a picture of Jennifer Aniston.
• 26:05
  I don't know how old it was, but comparing her now to when she was in her twenties and she looks great.
• 26:09
  She looks so natural.
• 26:10
  You can tell she's older, but she looks beautiful.
• 26:13
  And that's really the goal.
• 26:14
  I'm not trying to necessarily erase every line, erase everything, but I think if we can give people even complexion, if their skin can radiate, it's okay to have a few lines or a little bit of loose skin, right?
• 26:28
  So I thought that comparison was great, but yeah, you don't want to look done.
• 26:32
  You just want to look, radiant.
• 26:34
  You want to look good, but you don't want to look done.
• 26:36
  So that's why I love Sculptra.
• 26:37
  And, I know a lot of people are really into collagen supplements.
• 26:40
  So I don't know if you have questions on that.
• 26:43
  But what I like about the Sculptra is that there's debate on whether they actually work for the skin and not.
• 26:49
  And some studies show that there is some improvement in hydration and wrinkles, fine lines.
• 26:54
  But what I like about the Sculpture is I know where I'm giving you the collagen because I'm placing it actually in the skin where I know it needs to go.
• 27:03
  So that's why I like the Sculptra or the Radiesse cause I'm actually stimulating the collagen directly into the skin where I know it needs to be.
• 27:13
  So, I'm not totally against collagen supplements.
• 27:16
  I think, more studies need to come out.
• 27:18
  They're expensive.
• 27:19
  We don't really know the dose that people should be taking.
• 27:23
  And, we've got some data saying that it can be helpful, but, I wouldn't hang your hat on, I'm just going to take collagen supplements and I'll be good.
• 27:31
  Yeah I've been taking collagen supplements for oh my goodness I want to say about three or four years.
• 27:36
  And I look at my legs or my arms I'm like, okay, this stuff is supposed to not only restore collagen, but it's also supposed to make your skin look healthy.
• 27:45
  And I'm like, I'm still dry.
• 27:47
  So is this stuff working?
• 27:48
  Yeah.
• 27:49
  I know, right?
• 27:50
  It's, I don't know if we can, it's not like we can target it.
• 27:53
  Okay, I want you to go to my elbow.
• 27:55
  I want you to go to my face.
• 27:56
  But, we actually even do, Sculpture off the face and other parts of the body like elbows, forearms, hands, neck, knees, areas where you can get that creeping skin just to it's like a balloon that's starting to deflate.
• 28:10
  Just fill it back up with that healthy collagen.
• 28:13
  And if it's your own collagen, even better.
• 28:16
  I've also heard that, stress and lifestyle factors can have a significant impact on your skin.
• 28:24
  Absolutely.
• 28:25
  So yeah, if you can just eliminate all the stress, you'll have amazing skin.
• 28:29
  It's that simple.
• 28:31
  I'm just kidding.
• 28:32
  But yes, stress and lifestyle for sure.
• 28:34
  I haven't actually read the book or watch the Netflix show about the Blue Zones, but I think that sort of shows that longevity, a lot of things affect longevity more than just going to the gym or working out.
• 28:49
  Well, it's sort of like a culmination of all of these things.
• 28:53
  Having a purpose in life, managing your stress.
• 28:56
  All of those things impact aging.
• 28:59
  And if you are not taking care of your body, you're not eating well, you're eating processed foods.
• 29:06
  That's another thing I didn't mention, but actually eating processed foods, refined sugars, they actually bind to your collagen and make your collagen more brittle, friable.
• 29:16
  And so again, trying to eat whole foods, fruits and vegetables.
• 29:21
  I like sweets, so I can't say I can't eliminate sweets, but having them in moderation, can really be impactful.
• 29:28
  And yes, stress, when we're stressed out, our cortisol levels go up.
• 29:32
  We have inflammation, which that raises inflammation in our bodies.
• 29:37
  And when our bodies are inflamed and cortisol levels are high, it's hard for us to fight infections.
• 29:43
  And it's hard for our body is in this fight or flight state.
• 29:47
  And so it's not a good place to be in, perpetually for years and years, right?
• 29:52
  It's something just for emergencies.
• 29:55
  And then, learning how to manage that stress, manage your mind.
• 29:58
  That's something that I've really kind of diving deep into now in my forties.
• 30:04
  It so much is mindset and mental.
• 30:06
  And I'm not saying these changes that we're seeing are all in your head, they're not.
• 30:11
  But how you reframe it.
• 30:13
  How you look at aging, all of that is going to change how you feel about yourself in your life.
• 30:20
  So that's super critical.
• 30:21
  Absolutely.
• 30:22
  I think another thing is like being happy, being grateful, being happy.
• 30:27
  Because sometimes I look at certain people, I've watched TV and they show this person, they say, oh, this person's 70 or 80 years old.
• 30:34
  And I look and I'm like, they don't look that age.
• 30:36
  And they're showcasing them because they're happy or because they're doing something that is engaging or they're giving back.
• 30:44
  And I just noticed that they've just seen younger looking.
• 30:48
  Right, yeah, focusing externally, not so much on yourself.
• 30:52
  Cause if you are constantly focus on yourself, picking yourself apart.
• 30:56
  You're going to be really miserable.
• 30:57
  We can all find a hundred flaws, like we could list them off right now without missing a beat.
• 31:04
  But can you list off all your good qualities and can you focus on the positive?
• 31:08
  Because, that's going to lead to a more rewarding life.
• 31:11
  If you're always thinking about your flaws and the negative, you're going to be pretty miserable.
• 31:15
  And, you're never going to be happy with even the most amazing things that I can offer you is never going to reach your expectations that you want.
• 31:24
  And so there's going to be that mismatch and you're constantly going to be on the search for the next thing.
• 31:29
  The next thing that's going to fix your life.
• 31:31
  And these things that we can do as dermatologists these procedures these topicals and things like that they can augment it, but they can't totally fix it, right?
• 31:41
  That work has to come from within and I'm just making it look pretty on the outside.
• 31:46
  So tell me cause I know that, there's a lot of spas that, provide, laser therapy, microneedling, even Botox.
• 31:54
  But I also know that dermatologists as yourself, some of them do provide these services in their facilities.
• 32:01
  What's the difference about getting them done through a doctor like yourself versus someone who was trained a couple of hours to do this?
• 32:10
  Right, well you have to think about this.
• 32:12
  This is a completely elective or if you're getting a cosmetic procedure, right?
• 32:15
  This is completely elective.
• 32:17
  You don't have to do it.
• 32:18
  It's not necessary.
• 32:19
  There are risks with everything that we do in life, medical procedures, right?
• 32:24
  Why are you going to take that risk for something totally elective?
• 32:27
  And a lot of times your face or how you look.
• 32:30
  And unfortunately, there's not a lot of regulations, every state is different.
• 32:36
  So there are some states like Texas where you can have absolutely zero medical knowledge and you can go watch a YouTube video and do injections.
• 32:45
  And the scary thing is, everyone can have complications, even the best person.
• 32:50
  The best, most skilled dermatologist, plastic surgeon can have complications.
• 32:54
  But the question is, do you know how to manage that complication?
• 32:57
  And I frequently in my office and throughout my training, we would see the complications because the people at these med spas and these other places, they don't know what to do when it's not cookie cutter.
• 33:10
  And there is an issue.
• 33:12
  And you can scar yourself.
• 33:14
  There are people who have gone blind with filler.
• 33:16
  There are people who just have to deal with a droopy eyebrow and eyelid for three months, which is not particularly fun or a crooked smile.
• 33:24
  So it can range.
• 33:25
  And I'm not saying those bad complications are going to happen if you go to those places.
• 33:30
  But it always baffles me why we search reviews on Amazon for the best towel or the best vacuum cleaner, but yet we won't necessarily do that due diligence for an elective cosmetic procedure on ourselves that could really alter the way we look and have long term side effects.
• 33:51
  So I think if you want the best results, you should seek the person who has the best training in that area, whatever you're looking for.
• 34:00
  And I know Botox sounds, so simple, right?
• 34:03
  Like how hard a monkey could do it.
• 34:05
  You just, follow the pattern that they teach you at this weekend course.
• 34:08
  But there are nuances to it.
• 34:10
  And, I just think you should go to someone who is really trained and also knows how to handle the complications.
• 34:16
  The other reason, I think, to see a dermatologist for your skin care needs is that this is what we do.
• 34:22
  We train not just on the skin, but your hair.
• 34:24
  We didn't even talk about how hair thins during menopause and beyond as well as your nails.
• 34:31
  And I find when you see a dermatologist, I don't make my money by selling products or things like that.
• 34:37
  Like I'm going to tell you, here's how I think you can have really healthy skin, or here's what you should be doing.
• 34:44
  This is going to be the most impactful.
• 34:46
  And I think that can save you a lot of trial and error.
• 34:49
  It can save you a lot of money buying stuff you don't need.
• 34:53
  Buying expensive things just because it looks pretty or your friend got it.
• 34:57
  And another thing is at this age, in life for a lot of people, skin cancers pop up.
• 35:03
  And so you might think that brown spot on your face is a sunspot that needs to be lasered off.
• 35:10
  But I have seen a woman on this middle of her face had a melanoma lasered for multiple times.
• 35:18
  which just allowed it to grow under the skin.
• 35:21
  And I just wish if she had come to see a dermatologist, we would have biopsied it and diagnosed her a lot sooner.
• 35:28
  So, getting in to have your skin scan, make sure you don't have anything worrisome for a skin cancer is also important as we hit our fifties or sixties, seventies and beyond.
• 35:39
  So I do think training matters.
• 35:41
  You are going to get the best results.
• 35:43
  And I think if you're going to research the heck out of that, Roomba vacuum cleaner, you should also research the heck out of the person who's going to be doing something to alter the way you look.
• 35:54
  I've been getting Botox for almost 20 years because I had suffered chronic migraines.
• 35:59
  I've always gone to a neurologist and they give me my Botox.
• 36:02
  And I remember joking with my neurologist once and I said, hey, if you have a little extra, feel free to shoot the eyes.
• 36:09
  And he looked at me and he says, Carmen, I don't know if you've ever looked at yourself this close, but you have a lot of little veins near your eyes.
• 36:17
  I'm a doctor, I'm a neurologist, I'm a surgeon.
• 36:20
  And he says, and I don't feel comfortable even getting near that area because I could blind you.
• 36:25
  And when he said that, that just scared me.
• 36:27
  And I thought about all these people that go to these spas that maybe they're being injected by a RN or maybe they're being injected by an esthetician or whatever, someone who took a YouTube course.
• 36:41
  Yeah.
• 36:41
  And there's not to say there's not a role for estheticians and facials or things like that make you feel good.
• 36:47
  But I think when we're going into the realm of injectables, devices with heat that can lead to scarring then training really does matter and another you brought up a great point.
• 36:59
  Don't be afraid to go to someone who tells you no.
• 37:03
  And a lot of these places they're out to sell you things.
• 37:06
  They're not going to tell you no but, you actually should thank someone who says, no, I'm not going to do that to you.
• 37:12
  You don't need that.
• 37:13
  That's not going to look right.
• 37:14
  That's someone who actually has your best interest at heart because they know I'm not the right person or you're not the right candidate for this.
• 37:21
  And, so actually if someone does tell, you might be disappointed at first, but really, I think you should thank them because they are looking out for your best interest and not just trying to sell you something.
• 37:33
  I feel comfortable going to see you because you're pretty and you look natural.
• 37:37
  So I think that if I came and I saw you, if you did any work to me, I'm probably going to come out looking like you, natural.
• 37:44
  Yeah, and that's another great point.
• 37:46
  I would say find someone you jive with, right?
• 37:48
  Not every dermatologist is into cosmetics either.
• 37:51
  And there's some that are more into surgery or into lasers and everything.
• 37:56
  So everyone's got their sort of area of expertise.
• 37:59
  But I would say, look at the person injecting you if they look overdone, they are probably also do that look to you.
• 38:07
  And so you want to go to someone who matches and maybe that's the look you're going for, right?
• 38:12
  I mean, depending on where you live and all that, there's different looks that people go for.
• 38:16
  But, if you're going for a very natural look, then I would seek out someone who can provide that.
• 38:23
  And if they look natural, chances are they're going to have that same mentality.
• 38:28
  And I also inject myself, I do all the things, you know, people will say, you don't look like you've had filler or Botox.
• 38:34
  And I was like, absolutely.
• 38:36
  But that's the point.
• 38:36
  I don't want to look like I've had it done.
• 38:38
  I just want to look refreshed.
• 38:40
  And a lot of times they feel, they're shocked like you just did, right?
• 38:43
  But they feel relieved, oh, okay, if you did that to you and you still look normal, then I feel better about doing it.
• 38:50
  But that's a great point.
• 38:51
  Yeah, if the person treating you doesn't have the aesthetic look you're going for, you may want to think twice about that.
• 38:58
  And I heard, one, dermatologist on YouTube say that steer away from microneedling that has radiofrequency when you're older because it will melt away the fat in your face and in essence, you're going to look older.
• 39:13
  Is that correct?
• 39:14
  Yeah.
• 39:15
  I've heard mixed things about that, too, and I don't really know what the right answer is.
• 39:19
  I find with some of these tightening devices, it is very user dependent.
• 39:24
  And so there are people who will get it done and they notice no changes whatsoever.
• 39:29
  And then there are people who rave about it and love it.
• 39:32
  So I think it depends on who is doing your treatment, how again, they're training, how many have they done?
• 39:37
  What's their experience level?
• 39:39
  But I have heard reports that when you are heating the skin, like the radio frequency microneedling, if you do it all the time and then have a facelift or a neck lift, that the heat has caused a lot more scarring and fibrosis under the skin, making it a more difficult procedure for the surgeon.
• 39:59
  So, that's what I've heard.
• 40:01
  I haven't actually seen a lot of literature or data on it, but I think because they're not totally new, but I think in the next five - ten years, we'll probably be learning a lot more about the long term effects of these.
• 40:13
  So again, I wouldn't be doing these devices all the time.
• 40:16
  Save them to when you really need them, because we don't really know what the long term side effects are going to be for heating up that skin consistently over time.
• 40:26
  But yeah, I have heard those and I've just heard it's makes it more difficult for, you get more scarring, harder to do surgical procedures later.
• 40:33
  I had this esthetician once tell me that getting injectables, fillers causes scarring under the skin layer, making it difficult if you later decide to get, a facelift, there's a lot of scar tissue under there.
• 40:47
  And so you're not going to have a successful facelift.
• 40:50
  No, not with fillers.
• 40:52
  I, do lower neck or necklace and lower facelifts.
• 40:55
  And, sometimes, or also even when I'm doing my mohs surgery, we can sometimes see the filler.
• 41:00
  But regular filler, no, I now maybe threads that people put under the skin could do that because you're actually leaving material in the skin.
• 41:09
  But, I've had patients get necklaces and they've had one in the past and so they've got scarring so it's not impossible.
• 41:16
  It does make it a little bit more difficult surgically to break up that scar tissue.
• 41:21
  But fillers, no, I don't think you need to worry about forming scar tissue with fillers.
• 41:26
  The main issue with fillers is that as you age too, sometimes the filler gets displaced or it can sometimes, bulge up a little bit under the eye by blocking some of your lymphatics there, and it just can leave sometimes a more stiff, unnatural look if you use too many.
• 41:45
  Which is why I'm really, I think the pendulum is swinging from being so overfilled, that Miss Piggy look to a more natural look.
• 41:53
  And that's why I really love these things like biostimulants that can just, very naturally restore your collagen without actually filling you with hyaluronic acid.
• 42:04
  How difficult is it to get an appointment to see a dermatologist such as yourself?
• 42:09
  Because I do know that you guys are far and few.
• 42:12
  Yeah, and unfortunately, there's not a lot of us and the number of training spots is limited And so they're I think they're about twelve thousand dermatologists in the U.
• 42:22
  S.
• 42:23
  So I know it's hard to see a dermatologist I know it's hard to get in.
• 42:26
  What I would advise you or listeners is just try to establish an appointment with the dermatologist even before you need one.
• 42:34
  Because once you're in it's a lot easier.
• 42:38
  It's much harder to get a new patient visit than to do a follow up.
• 42:42
  At least in my practice, we do everything we can to see our patients in a timely manner.
• 42:48
  Sometimes our schedules are pretty busy and it can be a full day.
• 42:52
  But I would say try to establish a relationship with a dermatologist before you think you even need one, just to have that relationship.
• 43:00
  Make sure you jive with them.
• 43:02
  What are your goals?
• 43:02
  Maybe you just want someone to do your skin checks?
• 43:05
  Or maybe you have psoriasis and you just need someone to help manage that.
• 43:09
  Or maybe you are wanting to think about aesthetics and pro aging or, what you can be doing now.
• 43:16
  Well, I can say also, if you want to find a board certified dermatologist, because there are a lot of people who imply that they're dermatologists who are not really dermatologists, but the American Academy of Dermatology has a website it's A A D dot org.
• 43:29
  I believe it's forward slash find hyphen, A hyphen DERM.
• 43:34
  You can just go to the A A D website and typing your zip code and you can find dermatologists in your area.
• 43:41
  But, I know it's hard.
• 43:43
  And again, that's why I'm doing this podcast because I know it's hard to get this kind of information.
• 43:48
  At least now, hopefully it's given people some information that, they don't necessarily have to go see the dermatologist to, to hear all that exactly, or it helps guide them on what they need or what they don't need.
• 43:59
  But, it can be hard, but, stick with it.
• 44:02
  Try to find someone you connect with, who understands your goals and what you're looking for.
• 44:07
  And, I think if you can have a relationship with your dermatologist, like your hairdresser or whoever, your massage therapist, whoever you go to, your manicurist, it will, I think just really save you in the long run, a lot of trial and error, headaches, frustration and kind of wasted time and money.
• 44:25
  And, we women, we get mammograms at, age 40.
• 44:29
  When should we start considering seeing a dermatologist to check our skin?
• 44:33
  Yeah, so that's a great question.
• 44:35
  There's not a set age like there is for breast cancer or colon screenings right at 45.
• 44:41
  What I would say is if you have a lot of moles, a ton of those, moles all over your body or a family history of melanoma, or a lot of sunburns, the earlier, the better.
• 44:53
  So even in your thirties, it's probably a good idea to see a dermatologist.
• 44:58
  Sometimes I'll see people and I'll say, you're good.
• 45:01
  I don't need to see you for another two to five years, unless something comes up.
• 45:06
  By the time you're in your forties, unless you've been very good about sun protection, probably a good idea to just go in, get a once over.
• 45:14
  If you don't have anything worrisome, a lot of times we'll say you're good for a couple of years.
• 45:20
  But, that's a great way to also establish that rapport, establish that relationship, help, develop some healthy skin habits.
• 45:28
  And, then if something does pop up, you can call them up and say, hey, this concerning spot just appeared, when can you fit me in?
• 45:35
  So, it really just depends on several factors, but I think by age 40, if you've never seen a dermatologist, it's probably a good time to go in and see one.
• 45:43
  Because I know a lot of women, they say, oh, it's just an age spot.
• 45:46
  I have age spots.
• 45:47
  I'm getting age spots.
• 45:48
  And so I would want to make sure that, you don't ignore it.
• 45:51
  Or get a second opinion, let an expert look at it.
• 45:53
  Yeah, absolutely.
• 45:54
  I'd much rather reassure you that, hey, that's totally normal.
• 45:58
  But actually what oftentimes happens is the spot that someone comes in concerned about is nothing, but we find something else.
• 46:05
  And even if the spot you're worried about is nothing, I usually will look you over anyways, cause you're there.
• 46:11
  And, I don't want to say all the time, but it's not uncommon to then, identify something that you hadn't even noticed that's concerning.
• 46:19
  So that's another reason to get seen.
• 46:21
  Don't worry about, what if it's nothing?
• 46:23
  I'm going to feel stupid.
• 46:25
  We would much rather reassure you.
• 46:26
  Those are great appointments when we can tell you everything's great and I'll see you in a couple of years.
• 46:31
  So when does your podcast air so that people know, hey, this is where I'm going to get my information.
• 46:37
  Yeah, so the Skin Reel airs every Monday.
• 46:40
  It's a weekly, recording that comes out and I do a mix of solo episodes and then I also have a lot of my dermatology colleagues on which is a lot of fun to, chat with them about different topics.
• 46:52
  And, you can go to my website The Skin Real dot.
• 46:55
  com, where you can find my blog, the podcast.
• 46:58
  And of course it's on things like Apple and Spotify and all of that.
• 47:01
  And, I'm also on social media at Dr.
• 47:03
  Mina Skin, TikTok, Instagram, YouTube, all of those.
• 47:08
  Great.
• 47:08
  Dr.
• 47:09
  Mina, thank you so much for coming on and sharing your insights, your expertise, and educating the women on what they can do now to just, age gracefully.
• 47:20
  Yeah, absolutely.
• 47:21
  Don't be afraid of it.
• 47:23
  And, I love it.
• 47:24
  I love your podcast and it's been a pleasure being on here, Carmen thank you.
• 47:27
  Alright, thank you.
• 47:28
  And that brings us to the end of another enriching episode of Create the Best Me.
• 47:34
  A heartfelt thank you to Dr.
• 47:36
  Mary Alice Mina for joining us today and sharing her invaluable expertise on skin care changes.
• 47:43
  during premenopause, menopause, and postmenopause.
• 47:48
  Her insights and advice are truly a guide for all of us looking to embrace this phase of life with confidence and grace.
• 47:57
  To our listeners, we hope this conversation has illuminated the path to understanding and caring for your skin better during these transformative years.
• 48:07
  Remember, aging is a natural process and embracing it with the right skincare and attitude can make all the difference.
• 48:17
  If you enjoyed today's episode and found it helpful, please share it with friends and family members.
• 48:22
  Don't forget to subscribe.
• 48:24
  Dr.
• 48:25
  Mina's information and along with today's transcript can be found at createthebestme.com.
• 48:31
  I am Carmen Hecox and it has been a pleasure to guide you on this journey.
• 48:36
  Stay tuned for our next episode, where we'll continue to explore new ways to create the best version of ourselves.
• 48:44
  Until then, keep dreaming big, take care of yourself, and remember, you are beautiful, strong, and capable of creating the best version of yourself.
• 48:54
  Thank you for watching.
• 48:56
  Catch you next week.
• 48:57
  Bye for now.