Latest / The Science of Skin / Skincare Through the Ages - Episode 5: The impact of menopause on skin health

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Skincare Through the Ages - Episode 5: The impact of menopause on skin health · The Science of Skin

• 0:00
  SPEAKER_00: The Skin Care Through the Ages series is sponsored by Neutrogena.
• 0:03
  SPEAKER_00: To learn more about the products mentioned in the episodes, please visit the link in the description.
• 0:14
  SPEAKER_03: Hi, I'm Dr.
• 0:15
  SPEAKER_03: Patty Ferris.
• 0:16
  SPEAKER_03: I'm a board certified dermatologist, and I am your host for this episode of the Science of Skin podcast, formerly known as Skincare Confidential.
• 0:25
  SPEAKER_03: I'm really excited today to be joined by two of my girlfriends, but also two very well-respected dermatologists.
• 0:34
  SPEAKER_03: I'm going to read both of their bios and I'm going to start with Dr.
• 0:36
  SPEAKER_03: Mona Gahara.
• 0:37
  SPEAKER_03: She completed her residency in dermatology training at Yale, served as chief resident, and is now a clinical professor and associate director of community engagement and practices in New Haven, Connecticut.
• 0:49
  SPEAKER_03: She's a leading advocate for skin health, education, diversity, equity, and inclusion in dermatology.
• 0:55
  SPEAKER_03: Yes, she is.
• 0:56
  SPEAKER_03: She lectures nationally and internationally, writes for the mainstream media, and partners with professional societies and industry to advance the representation in the field.
• 1:05
  SPEAKER_03: She served as president of the Women's Durham Society.
• 1:08
  SPEAKER_03: She's widely published.
• 1:10
  SPEAKER_03: And I did not know you sat on the editorial advisory board for all these publications.
• 1:14
  SPEAKER_03: Very cool.
• 1:15
  SPEAKER_03: L, Woman's Health, Shape Prevention, and Good Housekeeping.
• 1:18
  SPEAKER_03: Outside of medicine, she and her husband have a lovely home in Connecticut and two teenage sons, which I know keep you busy.
• 1:26
  SPEAKER_03: Both of you guys have boys.
• 1:28
  SPEAKER_03: I know you're boy moms.
• 1:32
  SPEAKER_03: I love that.
• 1:32
  SPEAKER_03: I always wish I was a boy mom.
• 1:34
  SPEAKER_03: I had three girls, but I'm such a town boy.
• 1:36
  SPEAKER_03: I'm like, what a waste.
• 1:37
  SPEAKER_03: All right.
• 1:38
  SPEAKER_03: So for Kavita Marwalla, she's double board certified in dermatology as well as she's a cutaneous oncologist.
• 1:46
  SPEAKER_03: She's a Moe surgeon.
• 1:48
  SPEAKER_03: She did her undergraduate and medical school and residency and fellowship training at Yale.
• 1:53
  SPEAKER_03: Is that where you two met?
• 1:54
  SPEAKER_02: Yes.
• 1:55
  SPEAKER_03: Wow, the plot thickens here.
• 1:58
  SPEAKER_03: After leaving New Haven, she served on the faculty at Columbia as director of cutaneous oncology and then at Stony Brook University.
• 2:06
  SPEAKER_03: In 2011, she founded her private practice, Marwalla, dermatology on Long Island.
• 2:12
  SPEAKER_03: She's widely published in the medical literature and is the author of several books and book chapters.
• 2:18
  SPEAKER_03: She's the founder of the series 21 to 21, which focuses on teaching Durham residents.
• 2:22
  SPEAKER_03: And I know everybody knows you so well for that.
• 2:26
  SPEAKER_03: She's also currently serving as president-elect at EASDS and has three sons that are baseball loving.
• 2:33
  SPEAKER_03: I love that.
• 2:34
  SPEAKER_03: So, guys, welcome to the Science of Skin podcast.
• 2:38
  SPEAKER_03: And we have such a great subject.
• 2:40
  SPEAKER_03: I've been so excited for this because what is having a bigger moment in medicine than menopause?
• 2:46
  SPEAKER_03: Nothing.
• 2:47
  SPEAKER_03: It is so big right now.
• 2:48
  SPEAKER_03: It's big on social media, it's big in medical circles.
• 2:52
  SPEAKER_03: And we really want to talk on this episode about skin care and how it relates to the perimenopausal and the menopausal patients.
• 2:59
  SPEAKER_03: So maybe starting with you, Cavita, what are you seeing in your practice?
• 3:03
  SPEAKER_03: Are more women coming in with, you know, in this age range and this time of life looking for advice from you?
• 3:10
  SPEAKER_03: And like what things are they complaining about?
• 3:14
  SPEAKER_02: I think for me, you know, this menopausal topic is one that hits home because when you start going through it, there's no mistaking that something is off, right?
• 3:26
  SPEAKER_02: Forget just the night sweats.
• 3:28
  SPEAKER_02: It's like the brain fog, your stomach isn't quite the way it used to be.
• 3:33
  SPEAKER_02: You feel like some days you feel totally fine, like yourself.
• 3:37
  SPEAKER_02: And some days it's just crankastic, Vil.
• 3:40
  SPEAKER_02: And it's real, you know, like it really makes you feel like what's going on in the world.
• 3:45
  SPEAKER_02: And then you feel like someday you just wake up and you're old.
• 3:49
  SPEAKER_02: And that's what my patients say.
• 3:50
  SPEAKER_02: Like, I don't know what's happening to me, but suddenly I just feel like I'm old.
• 3:54
  SPEAKER_02: And they all do this grasping motion of their face like that.
• 3:57
  SPEAKER_02: Like you just feel like everything has fallen and it's not going the right way.
• 4:02
  SPEAKER_02: And there's hair loss.
• 4:03
  SPEAKER_02: So I think a lot of us end up putting everything in the bucket of perimenopause and menopause, but at the same time, it's like we don't put enough in the bucket of perimenopause and menopause because we blame it for things, yet patients don't know what to do to try to combat it, which is why I'm so excited to be on this podcast with two of my favorite women ever.
• 4:25
  SPEAKER_02: So I see it a lot.
• 4:26
  SPEAKER_02: People come in complaining a lot of the symptoms and asking, what can I do?
• 4:31
  SPEAKER_03: Of course.
• 4:32
  SPEAKER_03: Go ahead, Mona.
• 4:34
  SPEAKER_01: Yeah.
• 4:34
  SPEAKER_01: So, first of all, thank you so much for having me, Patty.
• 4:36
  SPEAKER_01: This is a good one.
• 4:39
  SPEAKER_01: Um, so I definitely see women coming in every single day who are my age.
• 4:44
  SPEAKER_01: I just turned 50, so I'm kind of going through it with them.
• 4:46
  SPEAKER_01: That makes it better.
• 4:48
  SPEAKER_01: Um, common concerns, but I don't know if it makes it better, but at least we understand each other.
• 4:52
  SPEAKER_01: But, you know, common concerns include dryness, dullness, sensitivity, loss of firmness.
• 4:58
  SPEAKER_01: Many also are experiencing breakouts.
• 5:00
  SPEAKER_01: They're like, what the heck is going on?
• 5:01
  SPEAKER_01: I'm my teen my teenagers having breakouts.
• 5:03
  SPEAKER_01: Why am I here breakouts?
• 5:05
  SPEAKER_01: Hyperpigmentation is huge, especially with the whole advent of um hormone replacement therapy.
• 5:11
  SPEAKER_01: There's a lot of hyperpigmentation.
• 5:13
  SPEAKER_01: So to me, it becomes parimenopause and menopause really has become a time of skin recalibration for my patients.
• 5:20
  SPEAKER_01: They kind of have to figure it all out again.
• 5:23
  SPEAKER_03: Oh, I love that.
• 5:24
  SPEAKER_03: Skin recalibration.
• 5:25
  SPEAKER_03: Let's talk about skin care because this is part of our Neutrogena takeover.
• 5:29
  SPEAKER_03: And of course, they've really trailblazed through this uh with all the research they've done.
• 5:34
  SPEAKER_03: What do you do when these patients come in?
• 5:36
  SPEAKER_03: What types of things are you recommending?
• 5:39
  SPEAKER_02: For me in my practice, you know, I like to go back to a lot of basics.
• 5:43
  SPEAKER_02: I think that we don't, as much as everybody wants to be on a retinol, like they're not on a retinol really in their 30s and 40s.
• 5:52
  SPEAKER_02: They sort of start to figure it out as they see the changes.
• 5:56
  SPEAKER_02: For some, by the time you see changes, it's like you're playing a game of catch-up.
• 6:00
  SPEAKER_02: Um, so I like to make sure that they're using sunscreen.
• 6:04
  SPEAKER_02: I like to make sure that they are using something that's a retinol or a retinoid.
• 6:08
  SPEAKER_02: I have a like my sort of sleeper secret in the drugstore is neutrogen or rapid wrinkle repair.
• 6:14
  SPEAKER_02: I make no secret of that.
• 6:15
  SPEAKER_02: I love it.
• 6:17
  SPEAKER_02: But the reason I love it is because when you get to know how it's formulated, it's incredible that it's at that price point and in the drugstore.
• 6:26
  SPEAKER_02: You know, retinols, Patty, I don't need to tell it to you, but you know, they're very unstable in formulation.
• 6:32
  SPEAKER_02: And by the time a jar is on the shelf, you don't really know is it, was it sitting there, you know, did it just get delivered two months ago, or is that the product that in your particular store has been sitting there for four months?
• 6:43
  SPEAKER_02: And it's really important that that retinol is stable, that when you apply it, it actually disperses into the skin and doesn't just sit on the surface to cause all the irritation and none of the advantage.
• 6:56
  SPEAKER_02: And one of the things about rapid wrinkle repair is the way that Neutrogenus stabilizes their retinol through the entire production process.
• 7:06
  SPEAKER_02: And that's incredible to me.
• 7:08
  SPEAKER_02: So what's in the jar is really high quality ingredient that's stable and does not cause a lot of irritation.
• 7:14
  SPEAKER_02: It's really hard to make that at that price point.
• 7:17
  SPEAKER_02: So I love that as a basic beginner.
• 7:19
  SPEAKER_02: I tell my patients to make sure they're using some kind of antioxidant.
• 7:23
  SPEAKER_02: And then I'm a big fan of peptides.
• 7:25
  SPEAKER_02: You kind of have to do that one-two combination when you're going through this perimenopause, menopausal state.
• 7:31
  SPEAKER_02: And I know we'll get into it.
• 7:32
  SPEAKER_02: We'll talk about these topical estrogens, whether we believe them, whether they're doing the things, but you know, really collagen production decreases so much at this age that we really need to try to, you know, supplement it.
• 7:45
  SPEAKER_03: Yeah, I think that's so true.
• 7:46
  SPEAKER_03: And you make a good point about the formulations.
• 7:49
  SPEAKER_03: One of the things I love about Neutrogena rapid wrinkle repair is they have the concentration of retinol on the bottle.
• 7:56
  SPEAKER_03: Very few products actually have that.
• 7:58
  SPEAKER_03: They also have multiple formulations you can use, the creams, you can use the oils.
• 8:03
  SPEAKER_03: I mean, there's very there's different formulas of it too.
• 8:06
  SPEAKER_03: And you make a good point about the stabilization of that's so important.
• 8:10
  SPEAKER_03: We all know that.
• 8:11
  SPEAKER_03: And I think retinols, so but maybe a question for you, Mona, is retinol is still the gold standard.
• 8:16
  SPEAKER_03: I mean, yes, we have peptides, we have growth factors, we have secretone products, we have exosomes, we've got ingredients galore, but retinoids in the eyes of the dermatologists are still the gold standard.
• 8:26
  SPEAKER_03: And why do you think that is?
• 8:28
  SPEAKER_01: I think it's very simple.
• 8:30
  SPEAKER_01: I think it's because they're backed by decades of science.
• 8:32
  SPEAKER_01: I mean, they're not one-hit wonders, right?
• 8:35
  SPEAKER_01: They're not, they are, they are bad, they they they withstand, they have withstood the test of time.
• 8:40
  SPEAKER_01: They increase skin cell turnover, they boost collagen, they even add skin tone.
• 8:45
  SPEAKER_01: I mean, I always joke around with my patients.
• 8:47
  SPEAKER_01: If my house was burning down, I'd grab my husband, my kids, my dogs, and my retinoid, and I'd go.
• 8:51
  SPEAKER_01: Right.
• 8:52
  SPEAKER_01: Um, you know, because and nothing else checks all those boxes.
• 8:56
  SPEAKER_01: Not I mean, you know, I would love to hear from you two, esteemed dermatologists, if you can think of one ingredient that checks all those boxes and is backed by so much science.
• 9:06
  SPEAKER_01: And I just love the fact that now it's evolved.
• 9:08
  SPEAKER_01: You know, it's kind of like the iPhone, like it's evolved so much that you can find it, you know, specifically like you all have talked about in different formulations, in different concentrations.
• 9:18
  SPEAKER_01: And I love that you can find it here at with Neutrogena, different price points that's accessible to everybody.
• 9:23
  SPEAKER_01: Um, so for me, the simple answer is it's science.
• 9:26
  SPEAKER_01: It has the science and it's it withstood the test of time.
• 9:30
  SPEAKER_03: I agree a hundred percent.
• 9:32
  SPEAKER_03: I'm gonna hit one study, and this really speaks to the commitment that Neutrogena has to retinols.
• 9:38
  SPEAKER_03: We published in 2024 an integrated analysis of six studies.
• 9:43
  SPEAKER_03: And this integrated analysis looked at various parameters of photoaging, including wrinkles and crow's feet, and uneven pigmentation and overall photo damage as well.
• 9:53
  SPEAKER_03: The patients were 30 years old and over.
• 9:56
  SPEAKER_03: They had to have mild to moderate photo aging.
• 9:59
  SPEAKER_03: And they combined all six of these studies.
• 10:02
  SPEAKER_03: There was over 350 patients.
• 10:04
  SPEAKER_03: Many of the studies were split-faced.
• 10:06
  SPEAKER_03: So it ends up that, you know, there were 234 subjects in the vehicle and 237 in the retinal group.
• 10:13
  SPEAKER_03: Of course, some of them serve as their own control in a vehicle controlled study.
• 10:17
  SPEAKER_03: But basically, what they found was as early as four weeks using Neutrogena, 0.1% stabilized retinol, patients started seeing statistically significant improvement over the vehicle control.
• 10:29
  SPEAKER_03: And that's four weeks.
• 10:30
  SPEAKER_03: And then, of course, it got better over time.
• 10:33
  SPEAKER_03: The studies were all 12-week studies, except one, I think was an eight-week study.
• 10:38
  SPEAKER_03: But the nice thing about doing this integrated analysis is we have what is really the largest cohort of patients ever to be examined and ever to be, I think, published, at least it was when we published it in 2024, that used eretinol.
• 10:52
  SPEAKER_03: You know, we have tons of research on tretino, as you guys know.
• 10:55
  SPEAKER_03: That was more my era than yours.
• 10:58
  SPEAKER_03: But they were publishing in the 90s tons of studies, big studies and good studies, because it was prescription, right?
• 11:04
  SPEAKER_03: But they made a huge commitment here with these six studies, all vehicle controlled, all double-blinded.
• 11:10
  SPEAKER_03: And actually, they were done by the same investigator over a period of time.
• 11:14
  SPEAKER_03: So there's a lot of consistency here.
• 11:16
  SPEAKER_03: Obviously, integrated analyses can have some weaknesses because you are putting different studies together.
• 11:22
  SPEAKER_03: But these were all very similar studies.
• 11:24
  SPEAKER_03: And, you know, the data's just so strong here.
• 11:26
  SPEAKER_03: And this was looking at wrinkles on the forehead, looking at periorbital wrinkles, looking at cheek wrinkles, uneven pigmentation, brown spots, and overall photo aging.
• 11:36
  SPEAKER_03: So such a great study.
• 11:37
  SPEAKER_03: I loved when they published this.
• 11:39
  SPEAKER_03: It was a labor of love because it was a lot of work to get it published.
• 11:42
  SPEAKER_03: But it really, I think, adds significantly to the literature.
• 11:46
  SPEAKER_02: And Patty, to your point, like it's incredible that an over-the-counter brand would foray into a double blind scientific paper, right?
• 11:56
  SPEAKER_02: And the thing that I loved about that work is that it was done over 12 weeks because so much of what we'll see in these sort of white papers or offshoots that are not actually through peer-reviewed journals.
• 12:08
  SPEAKER_02: So this is peer-reviewed, it got into the literature, is these like four-week studies, six-week studies.
• 12:13
  SPEAKER_02: Well, in four and six weeks, what are you really seeing?
• 12:16
  SPEAKER_02: You're seeing a little bit of just moisturization, you know, like the benefits of using something, the benefits of having a routine.
• 12:23
  SPEAKER_02: So 12 weeks is really where, you know, the truth comes out.
• 12:26
  SPEAKER_02: And I love that study because it felt like there was such good data that we don't see over-the-counter companies really engaging in.
• 12:35
  SPEAKER_01: Right.
• 12:36
  SPEAKER_01: And I think to me too, it it really speaks to their commitment to accessibility, right?
• 12:42
  SPEAKER_01: Like wanting consumers and our patients to have access to scientifically backed and efficacious products that are, you know, accessible to everybody.
• 12:53
  SPEAKER_01: And I I appreciate that.
• 12:55
  SPEAKER_03: I agree.
• 12:55
  SPEAKER_03: I love that democratization, as we call it.
• 12:58
  SPEAKER_02: Yeah, the democratization is so important.
• 13:01
  SPEAKER_02: Um, I was at a dinner a year ago, and uh, you know, it was a government uh program funding thing for the women's health initiative.
• 13:09
  SPEAKER_02: And the line that always stuck with me is that half of the world is gonna go through menopause.
• 13:15
  SPEAKER_02: And yet, like here we are.
• 13:17
  SPEAKER_02: How do we not have more programs, like more education about this?
• 13:23
  SPEAKER_02: And to be able to actually tell women, look, let's start here.
• 13:26
  SPEAKER_02: This is the first thing to put in the bucket for your skincare and these skin concerns.
• 13:31
  SPEAKER_02: You can get it at the drugstore.
• 13:33
  SPEAKER_02: To me, it's such a win.
• 13:40
  SPEAKER_00: The Skin Care Through the Ages series is sponsored by Neutrogena.
• 13:44
  SPEAKER_00: For over 90 years, Neutrogena has advanced skin health for all skin types with formulation expertise that combines scientifically proven ingredients and innovative technologies to deliver maximum efficacy and an unparalleled aesthetics experience.
• 14:00
  SPEAKER_00: That's beauty to a science.
• 14:02
  SPEAKER_00: To learn more about the products mentioned in the episodes, please visit the link in the description.
• 14:12
  SPEAKER_03: I'm curious from you guys, because I know you see a lot of patients with skin of color.
• 14:18
  SPEAKER_03: How do you deal with retinoids in patients with skin of color?
• 14:21
  SPEAKER_03: Do you feel comfortable with the Neutrogena rapid wrinkle repair in this population?
• 14:27
  SPEAKER_01: Oh, absolutely.
• 14:28
  SPEAKER_01: Yeah.
• 14:29
  SPEAKER_01: I mean, I certainly feel it very comfortable.
• 14:31
  SPEAKER_01: I think everybody's individual, everybody has different skin types and skin nuances and routines, etc.
• 14:37
  SPEAKER_01: But in terms of the science and in terms of the, so it's like, for me, it's like efficacy and elegance, you know, cosmetic elegance.
• 14:45
  SPEAKER_01: Is it efficacious?
• 14:46
  SPEAKER_01: And if those two things, um, and and the other E for me is everybody, right?
• 14:51
  SPEAKER_01: Can everybody use it?
• 14:52
  SPEAKER_01: And if I can check all those boxes, then it's a product I recommend to my patients.
• 14:56
  SPEAKER_01: And this one does.
• 14:57
  SPEAKER_01: I have zero um issue recommending this to patients of all skin types and tones.
• 15:02
  SPEAKER_02: I'm somebody who's pretty intolerant of retinoids.
• 15:05
  SPEAKER_02: And whenever I say that, you know, people be like, oh, have you tried this?
• 15:08
  SPEAKER_02: Have you tried that?
• 15:09
  SPEAKER_02: I'm like, okay, guys, like I am a dermatologist, I know I use a retinoid, but my skin just, you know, it's it gets very irritated.
• 15:16
  SPEAKER_02: The Neutrogena rapid wrinkle, I have no problem with.
• 15:19
  SPEAKER_02: And for those who are worried about it, actually, Neutrogena has gone back and done some really interesting work on this idea of whether a moisturizer is going to impact your efficacy of your retinol.
• 15:33
  SPEAKER_02: And it turns out they did it with their Hydro Boost line, which I also love very much.
• 15:39
  SPEAKER_02: Um, and speaking of boy moms, I've got my boys using it and they love it very much.
• 15:43
  SPEAKER_02: But um, if you do something we call kind of an open-faced sandwich, so on social media, people say, oh, you can put a moisturizer, you put your retinol, then you do another moisturizer.
• 15:54
  SPEAKER_02: We don't want people doing that anymore.
• 15:55
  SPEAKER_02: We really want them to decide which way is their sandwich going to go.
• 15:59
  SPEAKER_02: You get one piece of bread, and that bread is hydroboost water cream or water gel, and then you've got your retinol.
• 16:05
  SPEAKER_02: So you can do the moisturizer first and then the retinol or the retinol and then a moisturizer, but we're not layering it in between.
• 16:12
  SPEAKER_02: And it turns out that it does not change the efficacy of the retinol.
• 16:16
  SPEAKER_02: And for those who might even be sensitive with the rapid wrinkle, it will still allow you to use it without any uh issue with tolerability.
• 16:24
  SPEAKER_02: And for those who are listening, you know, remember in brown skin, anything that makes it turn red will be darker brown afterwards.
• 16:32
  SPEAKER_02: So it's really important for us to make sure everything is really just very calming and soothing rather than irritating.
• 16:40
  SPEAKER_03: That's such a great point.
• 16:41
  SPEAKER_03: Because you touched on HRT earlier.
• 16:49
  SPEAKER_03: So many women are on hormones now.
• 16:51
  SPEAKER_03: We've got a whole resurgence of that and and acceptance of it again.
• 16:56
  SPEAKER_03: Thank goodness for the studies that came out.
• 17:00
  SPEAKER_03: But you you did mention that hyperpigmentation is a huge problem in these patients, and sometimes you do see it in patients with HRT.
• 17:07
  SPEAKER_03: So, how do you approach those patients?
• 17:09
  SPEAKER_01: I mean, for me, daily diligent SPF, indoors and outdoors is absolutely everything.
• 17:15
  SPEAKER_01: And we know that um that's a hard concept to grasp.
• 17:18
  SPEAKER_01: I mean, like behind me, it's freezing outside.
• 17:20
  SPEAKER_01: It's it's you know, it's cold, it's gloomy.
• 17:23
  SPEAKER_01: People are like, what in the H E double hockey sticks are you talking about?
• 17:27
  SPEAKER_01: Tell me I need to wear sunscreen.
• 17:28
  SPEAKER_01: What are you telling us?
• 17:29
  SPEAKER_01: But we need to kind of like, you know, shift the paradigm to think about it as light screen.
• 17:34
  SPEAKER_01: For me, it needs to be light screen.
• 17:35
  SPEAKER_01: So if there's light, you need to wear it.
• 17:37
  SPEAKER_01: It's not just about the sun.
• 17:38
  SPEAKER_01: And so kind of shifting that paradigm to really educate our patients around the fact that sunscreen and SPF is actually um, you know, a medical, uh it's a treatment.
• 17:50
  SPEAKER_01: It's not just protection, it's actually a treatment um to help with hyperpigmentation.
• 17:55
  SPEAKER_01: And I really like products that are um you brought up, Patty, um that don't leave that white awful cast, especially in brown skin.
• 18:05
  SPEAKER_01: So the ultra sheer mineral face liquid SPF from Neutrogena is awesome because it's sheer.
• 18:10
  SPEAKER_01: It goes on.
• 18:10
  SPEAKER_01: It's an and you don't have to have your patients compromise.
• 18:13
  SPEAKER_01: Again, the word I keep using is efficacy for elegance, so they feel comfortable using it.
• 18:18
  SPEAKER_01: Um, I always joke around with my patients that you have to have like an anti-tinder approach to sunscreen.
• 18:24
  SPEAKER_01: You can't just grab the first sunscreen that looks good or smells good, you like, or else the relationship ain't gonna last.
• 18:31
  SPEAKER_01: You need to have a tinder that is like you're gonna, you know, have a long-term relationship with.
• 18:36
  SPEAKER_01: So, so get to know it.
• 18:37
  SPEAKER_01: And um, and this is one that's great.
• 18:39
  SPEAKER_03: Oh my gosh, that's so funny.
• 18:41
  SPEAKER_03: I love it.
• 18:42
  SPEAKER_02: I also tell people, I mean, yes, the Tinder, yeah, the Tinder sunscreen or the Tinder light screen, I think is definitely has to be the motto.
• 18:50
  SPEAKER_02: But um, I tell people the same thing.
• 18:52
  SPEAKER_02: I'm like, if you can see and it's daylight, you need to have sunscreen on.
• 18:56
  SPEAKER_02: But the thing that a lot of people get confused about is that they think of as sunscreen having to be something different than moisturizer.
• 19:05
  SPEAKER_02: So they'll say, Oh, my moisturizer's got sunscreen in it.
• 19:08
  SPEAKER_02: And I always say, Why don't we think of it the other way?
• 19:10
  SPEAKER_02: Your sunscreen has moisturizer in it.
• 19:12
  SPEAKER_02: So use the sunscreen instead of doing extra steps.
• 19:16
  SPEAKER_02: Because the other thing about perimenopause and menopause, right, is that by the time you get into it, you're a busy person at that point in your life.
• 19:23
  SPEAKER_02: And you don't need other things taking extra time.
• 19:28
  SPEAKER_02: Like I'm sitting here chatting with you guys in a car parked while my son's doing a school interview.
• 19:33
  SPEAKER_02: Like, how many things can you do at once?
• 19:34
  SPEAKER_02: So you don't need extra.
• 19:36
  SPEAKER_02: I love sunscreen as a moisturizer.
• 19:39
  SPEAKER_02: There's nothing to say that sunscreen can't be your moisturizer.
• 19:42
  SPEAKER_02: Yeah.
• 19:42
  SPEAKER_02: So skip a step and you know, do the treatment.
• 19:46
  SPEAKER_03: That's such a good point.
• 19:47
  SPEAKER_03: Such a great point.
• 19:48
  SPEAKER_03: Uh, we've touched a little bit on Hydro Boost, and I want to mention another thing that I think Neutrogena did, which again sets them apart a little bit from the rest of the consumer companies.
• 19:59
  SPEAKER_03: We all know, like the dispensing companies, the doctor brands, are testing their products all the time with procedures.
• 20:06
  SPEAKER_03: But Neutrogena actually did a study, and actually, Ted Lane, who you guys know is podcast and my partner at the summit.
• 20:15
  SPEAKER_03: Yeah, no, I think he's doing then skincare, okay, where he belongs.
• 20:20
  SPEAKER_03: Listen, he's like my baby brother.
• 20:22
  SPEAKER_03: He's amazing.
• 20:23
  SPEAKER_03: I love him.
• 20:24
  SPEAKER_03: But he actually tested a little hydro boost regimen in patients who were getting not a blade of laser resurfacing.
• 20:30
  SPEAKER_03: And I love this because, again, we talked about democratization, not having to go buy some uber expensive moisturizer and cleanser to use after you have your little in-office procedure.
• 20:41
  SPEAKER_03: And he looked at the hydroboost gel uh cleanser, which is fragrance-free, and they use that twice a day.
• 20:47
  SPEAKER_03: And then he looked at the hydroboost water cream, which you mentioned, and that's a really nice moisturizing hydroboost product.
• 20:54
  SPEAKER_03: And they also used the Ultra Shear Mineral Face Liquid Sunscreen.
• 20:58
  SPEAKER_03: And what they did, and it was a small study, but what they wanted to do really just assess tolerability and see if the patients liked it.
• 21:04
  SPEAKER_03: These were patients who had had procedures before.
• 21:07
  SPEAKER_03: And basically at the end, the takeaway was it was very well tolerated.
• 21:10
  SPEAKER_03: They used it immediately post-procedure and for two weeks after.
• 21:13
  SPEAKER_03: And that the patients really felt they had less erythema, they had less downtime, they had less stinging and burning, and they had a great post-procedure experience.
• 21:22
  SPEAKER_03: So, this again is a really nice on-the-shelf option for us to look and turn to, you know, because these procedures aren't inexpensive, as we know.
• 21:31
  SPEAKER_03: So it's nice to be able to have something OTC that we can recommend that's actually been looked at with procedures.
• 21:38
  SPEAKER_03: Yeah, I think that's a good idea.
• 21:38
  SPEAKER_03: So I know you guys are.
• 22:00
  SPEAKER_01: in the public public eye.
• 22:01
  SPEAKER_01: And so a cosmetically elegant option that is good for your skin anyway, and um is is has these potentially reparative benefits to me is a is a win-win.
• 22:13
  SPEAKER_01: Agree.
• 22:14
  SPEAKER_02: I couldn't agree more.
• 22:15
  SPEAKER_02: And especially, you know, not just post-procedure, but like sometimes post-procedure, what happens is people are such good rule followers that they give themselves milia or clog pores or acne with the emollients that they're using to heal their skin.
• 22:31
  SPEAKER_02: So you go from one thing that you're trying to fix to now having to undo what you did in the healing phase.
• 22:37
  SPEAKER_02: And I have found that the hydro boost doesn't do that.
• 22:40
  SPEAKER_02: And it's also great for long-term aftercare.
• 22:43
  SPEAKER_02: So you know that the patient's not going to break out in acne or if they have acneic skin, they need something that's gentle that's going to get them through that little, you know, flare.
• 22:52
  SPEAKER_02: And so I use it as a go-to moisturizer all the time, not just post-procedure, but I have confidence in it that after whatever we're doing, it's not going to mess up the results, which is the key thing.
• 23:03
  SPEAKER_02: Right.
• 23:04
  SPEAKER_01: And it's like you can't if you can go home and mess it up.
• 23:06
  SPEAKER_01: Actually it in some ways may enhance the results a little bit.
• 23:10
  SPEAKER_01: That would be a nice kind of next step to this is it not just is it not just you know helping post procedure, but is it actually enhancing post procedure?
• 23:18
  SPEAKER_02: So I'm so glad you brought that up Mona because we use it a lot after intense pulse light, which again, normally you don't think of post procedure care after something that's not breaking the skin, right?
• 23:29
  SPEAKER_02: So intense pulse light, we pass it over the face, you do it a lot for red, for brown, it doesn't interfere with the skin barrier, but we know that erythema or that redness can be brought on by just simple skin irritation at the microscopic level.
• 23:45
  SPEAKER_02: So we have people use hydro boost for a solid month after intense pulse light.
• 23:50
  SPEAKER_02: And we are finding that recovery is better and they really are able to extend how long they need in between treatments.
• 23:58
  SPEAKER_02: Like they actually look a bit better after one treatment than if they had just gone to whatever skincare routine they were using before.
• 24:05
  SPEAKER_02: So anecdotally I can tell you that at least even in procedures that you wouldn't associate with needing post-care, it's a really good additive.
• 24:14
  SPEAKER_03: That makes total sense.
• 24:16
  SPEAKER_03: So we we have to talk a little bit about hormones and this whole estrogen skin cream phase craze.
• 24:22
  SPEAKER_03: Yeah.
• 24:23
  SPEAKER_02: Gotta talk about it.
• 24:24
  SPEAKER_03: Gotta talk about it.
• 24:26
  SPEAKER_03: I, you know, I'll throw it to you all to maybe tease it out a little bit.
• 24:30
  SPEAKER_03: What do you think about this?
• 24:32
  SPEAKER_03: Do we have enough studies to report or to suggest it to our patients to support the use of topical I'm not there yet.
• 24:40
  SPEAKER_01: I'm just gonna be honest.
• 24:40
  SPEAKER_01: I'm not at this I'm not at the I mean I know that we have you know there's a lot of lot of data about topical estrogens down there.
• 24:48
  SPEAKER_01: I don't know what term to use you know on on your podcast Patty but you know what I'm saying you know there's it's plumping it's firming it's rejuvenating but I just don't think that we're there yet on the face or would would we induce melasma for example what are we you know what what are the side effects um I'm sure there's benefit I'm sure there's some type of benefit there's no equivocation in my mind about that I just don't think we've peeled the onion enough to figure out how exactly to use it what's the right context um I think we just need more.
• 25:18
  SPEAKER_02: Yeah I think the thing that made it feel exciting is we know that when estrogen dips, you know you're hosed on the collagen aspect, right?
• 25:28
  SPEAKER_02: Like you do need estrogen to have collagen building blocks.
• 25:32
  SPEAKER_02: So what did the community do?
• 25:33
  SPEAKER_02: They tried to reverse engineer it.
• 25:35
  SPEAKER_02: So like okay you're not producing it anymore in your body can we apply it topically and sort of trick your skin into thinking it's still there that's the basis of a lot of these topical creams.
• 25:46
  SPEAKER_02: We do know in breast cancer populations, I'm a breast cancer survivor, I was thrown into menopause in six weeks that was a good time.
• 25:54
  SPEAKER_02: And you know you start to realize that like what else is out there for me.
• 26:00
  SPEAKER_02: So there's been a lot of work done on estriol E S T R I O L they claim now that it is safe to use in on the lady parts um it won't make your breast cancer return and it can be helpful.
• 26:13
  SPEAKER_02: But I just want to take a second to talk about the science of it in skin care.
• 26:17
  SPEAKER_02: Estrial of the three different types of estrogens is the weakest.
• 26:21
  SPEAKER_02: So it is the weakest signal to your body to help you upregulate or produce more collagen.
• 26:28
  SPEAKER_02: And to me you're putting something on a decent sized surface area maybe you're using it on the chest, on the neck, on the face are you getting systemic absorption?
• 26:38
  SPEAKER_02: I'm not sure that I know that data it's one thing to do it on a smaller mucosal surface but now you do it there.
• 26:46
  SPEAKER_02: Now you're doing it on your face you're doing it on your decollet you're doing it on your neck.
• 26:50
  SPEAKER_02: Now I start to get a little bit fuzzy about that.
• 26:53
  SPEAKER_02: But if you're gonna choose an ingredient, am I gonna first go for estrial versus a retinoid?
• 27:01
  SPEAKER_02: Never no right we already know that there's a tried and true our you know our husband is out there always guiding our back right that's your retinoid the the estriol is like something cute to look at if you want to try it you can but there's been a lot of hype about it on the topical skincare that I just am not sure it's as good as what we already know.
• 27:24
  SPEAKER_02: Now some people are combining the two they're like okay we're gonna add estriol to a retinoid or a retinol so it's gonna be even better.
• 27:32
  SPEAKER_02: It's just not that strong.
• 27:33
  SPEAKER_02: It's the weakest of the three.
• 27:35
  SPEAKER_02: And so I think that you have to think about it like why are they choosing the weakest one?
• 27:40
  SPEAKER_02: And it's because the other two potentially do have systemic absorption so you can't risk that so I'm with I'm with Dr.
• 27:46
  SPEAKER_02: Gohara I'm not there yet.
• 27:48
  SPEAKER_03: Yeah I I think the thing that we said earlier to kind of touch back to retinol retinol does so many things.
• 27:57
  SPEAKER_03: Yeah epidermal effects skin life it's your life partner it's it's it is your life partner and the thing about retinol is it takes good care of photoage skin and you can't get all those benefits from an estrogen topical estrogen.
• 28:13
  SPEAKER_03: I mean it's not going to do all of those things it may give you some skin hydration it may help boost some collagen.
• 28:19
  SPEAKER_03: There was actually an interesting study done years ago in John Voorhey's lab who you guys know was like one of the preeminent researchers in at the time and he looked at topical estrogens in photoaged skin compared to what happened when he put them on sunprotected skin like the hip and what he found was that they didn't have near the benefits in photoage skin in terms of collagen production.
• 28:42
  SPEAKER_03: They did it really well in the intrinsically aged skin but they were less effective in photoaged skin it was a very interesting study.
• 28:50
  SPEAKER_03: They didn't really speculate as to why that was but to me that that's a study that I think is worth maybe revisiting because there's something inherently different about what happens in photoaged skin as we well know you have way more oxidative stress you have lots of different things going on.
• 29:06
  SPEAKER_03: So I still think that retinoids are a life partner for our faces.
• 29:10
  SPEAKER_03: Let's put it that way.
• 29:12
  SPEAKER_02: I agree and I think that you know in photoaged skin it's really photo damage, right?
• 29:17
  SPEAKER_02: So as like a cutaneous oncologist, I got to put that out there that you know the sun that you get in your 20s is going to show up in your 40s and 50s.
• 29:26
  SPEAKER_02: And so people get on the bandwagon a little bit late and really a retinoid or retinol versus an estrogen is going to help you reverse some of that.
• 29:35
  SPEAKER_02: And estrogen topically is never going to undo what's happened already.
• 29:41
  SPEAKER_02: And I think that's that's a key thing.
• 29:43
  SPEAKER_02: And for women who are going through menopause I mean the skin, the hair, the GI tract like there's so many organ systems that are affected by this that if like we can give you one solution it's just you know go grab a retinol use some sunscreen start there and then you know we're here with you on the journey.
• 30:02
  SPEAKER_03: I love it.
• 30:03
  SPEAKER_03: Thank you for giving me such an early morning time.
• 30:07
  SPEAKER_03: You guys are amazing.
• 30:08
  SPEAKER_03: You took really we you covered it so well and I think this is I hope this will be a great episode for everybody out there who's perimenopause or menopausal or even for those who are younger who at least want a little glimpse as to what's going to happen.
• 30:23
  SPEAKER_03: So thank you guys again for your expertise this is going to be amazing and I hope everybody has a great day.
• 30:28
  SPEAKER_00: Thank you for joining us at the Science of Skin Podcast The Skincare Through the Ages series is sponsored by Neutrogena for over 90 years Neutrogena has advanced skin health for all skin types with formulation expertise that combines scientifically proven ingredients and innovative technologies to deliver maximum efficacy and an unparalleled aesthetics experience.
• 30:57
  SPEAKER_00: That's beauty to a science to learn more about the products mentioned in the episodes please visit the link in the description