Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
Acne Problems? Not Just for Teenagers
Acne doesn't discriminate by age. From teenagers to menopausal women, breakouts can strike at any life stage—often when we least expect them. Speaking of Women's Health Podcast Host Dr. Holly Thacker dives deep into why some of us battle persistent acne while simultaneously fighting wrinkles and dry skin, revealing the surprising hormonal connections that dermatologists and patients often miss.
This comprehensive guide to skin health explores how our body's largest organ responds to everything from stress hormones to dietary choices. Dr. Thacker explains how the surge in adrenal hormones during perimenopause can trigger what feels like "reverse puberty" on your skin, and why some women see dramatic improvements with certain hormonal treatments while others don't. You'll discover why that midlife pimple appeared on your chin despite your careful skincare routine.
Whether you're dealing with teenage acne, adult hormonal breakouts, or trying to prevent future skin problems, this episode offers actionable advice for achieving healthier skin at any age. Plus, discover the decade-by-decade skincare essentials that address your changing skin needs as you move through life. Your skin deserves better than trial and error—tune in for evidence-based strategies that target the root causes of troublesome skin.
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...
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Welcome to the Speaking of Women's Health podcast. I'm your host, dr Holly Thacker, the Executive Director of Speaking of Women's Health, and I'm back in the Sunflower House for a new podcast for the summer podcast. For the summer, I'm going to talk all about the skinny on acne and skin care for all ages, as we're wearing somewhat lighter, skimpier clothes for the long-awaited summer. And while we're in the middle of summer, unfortunately acne can worsen because it can be so hot and humid. Your body perspires more and being exposed to the sun certainly has a drying effect, a potential aging effect, depending on how you're protecting yourself and what skin is being exposed. And when sweat mixes with oil and dead skin cells it can clog the pores and the sun's keratolytic effects, which is kind of breaking down the keratin in the skin. It can lead to clogged pores and, paradoxically with aging, the skin turnover sometimes is slower and it's not as efficient at shedding. And so a lot of people notice as they get older they get little milia, little bumps under the skin of keratin skin material. And even though acne is thought to be quintessential time of being a teenager, in fact, artemis, my oldest granddaughter of the three I have three granddaughters now with baby Vivian Vira Vive, as in long live. She was just born in 2023. Anyway, all three granddaughters have beautiful complexions, and when Artemis heard that acne is common in teenage years, she told me Mimi, I am not going to be a teenager, I'm going to skip that age. And so there could be a lot of things that people might want to skip about some of the awkwardness of you know, trying to grow into your body and find your own way and transition from childhood to adulthood can certainly be a challenging time, and having you know big red bumps and altered skin certainly can make it more challenging. But unfortunately acne is not just for teenagers. Almost every week I have some woman talk to me and say why am I getting acne now, while I'm getting wrinkles and dry skin? And so actually at midlife, when there is a surge in the stress hormones because of the lack of estrogen and the adrenal glands which put out, the adrenal stress hormones can actually increase acne because they're what we call more androgenic, and some people are just predisposed to acne their whole life. And it is frustrating to me at my stage in life when I wake up with a pimple on my face. It does happen, and some people don't get any acne at all, and so maybe you're one of those and thinking I can tune out for this one, but chances are there's someone in your circle of loved ones that may have to deal with this.
Speaker 1:And we will also talk about just good skincare. In fact, speaking of great skincare, I met our skincare estheticians at the Cleveland Clinic back when my three sons were in high school and having acne. And in males there's not as much many treatment options, because one of the big treatment options we offer for females is hormonal contraceptives, because they'll suppress the ovarian and the adrenal androgens and can many times beautifully clear up the skin. And we've got an upcoming podcast in the fall with Dana Leslie, our wonderful I call her the role model of all role models of women's health and nurse practitioners, and we're going to talk about how she counsels and selects different types of contraceptive agents in younger women in terms of looking at other medical conditions. So if you're genetically predisposed to acne or you've ever had acne, you could certainly have acne again and certain hormones can trigger it. Certain bacteria can play a role, certain underlying skin abnormalities, there's definitely a genetic component to it, and stress stress levels increase the stress hormones, which can be bad on the skin and certainly, like with everything, your lifestyle, your nutrition, your vitamin status can play a role, and there's definitely some people who believe that certain foods tend to trigger acne. Most people don't say that, but there are some people Now. Acne can occur on different parts of the body and I remember when I was, and I remember when I was getting towards the end of my medical school career and we got our test score results and we were thinking about what types of specialties to go into, and when I got my board scores, which were pretty high, I had a lot of my friends and co-medical students like grab my hand and say, wow, that's so great, you can apply to dermatology.
Speaker 1:And back then I thought, oh, I don't want to take care of acne and eczema and warts, and so I thought no, no, no, dermatology is not for me, because I kind of dismissed it as maybe not those conditions as not as serious conditions as a lot of internal medicine diseases, and I was very, of course, interested in the differences between the two sexes and the manifestations of disease and that really had not been very well explored even after my medical school training and residency, and so it was nice to be able to have a career where I was a trailblazer in this field. And when I think about how kind of dismissive I was of skin problems, it kind of showed a little bit of a lack of maturity, because the skin is the largest organ in the body and it's something that you know, you see at least most parts, at least, of people's faces and hands and arms, and in the summer sometimes a lot more skin and it's a very important organ and there's a lot of different things that can happen to it. And acne is not just a cosmetic problem. In fact, one of the first patients that I took care of when I was a resident at the Cleveland Clinic and at that time I joined the clinic I was planning to specialize in cardiology and I didn't want to move my husband, you know, to two different cities for both residency and fellowship. So I thought I'll pick the place I want to do the fellowship and, with the clinic being number one in heart, I thought that'll be good. I'll do my both sets of training there and one of the first cases I took care of was a gentleman who had endocarditis, which is infection of the heart valve.
Speaker 1:Gentleman who had endocarditis, which is infection of the heart valve, and it was from acne propionic bacteria, which is a type of bacteria that is involved in the pathogenesis of acne, and his acne was so significant and he was in his forties, so he was not a teenager that the infection from his skin seeded his heart valve and he, despite our best efforts, actually succumbed and died from the disease. So that's obviously a pretty dramatic example of what can happen with acne example of what can happen with acne. But that really did stick in my mind for my whole career about how the skin is a very important barrier and anything that can irritate it or cause an infection can be life-threatening, and infections that occur specifically in this area of the body that drains directly into the brain can lead to serious brain infections. So when there's something wrong with your skin, even if you just think it's acne or eczema or a wart that you're picking, at many times it is important to get medical attention and to understand that, even though we don't routinely see people die of bacterial infections like we did in the pre-antibiotic era, it still does happen.
Speaker 1:So the parts of your body that are more likely to get acne are where you have more sebaceous oil glands and they're tiny little oil-producing glands that are definitely affected by hormones. So in children before puberty we don't see acne and you have the most sebaceous cyst on your face, your upper back, the chest, the neck and the upper arms. So there's three classifications of acne mild, moderate and severe. And we discussed the causes being related to your genetics. So if your parents have acne, you're more likely to have acne. Hormonal fluctuations, any condition that can increase oil production from these sebaceous glands, any inflammatory state and certainly if you eat a highly inflammatory diet, you're going to have a lot more skin problems, that is for sure.
Speaker 1:Sometimes the hair follicles are hyperkeratinized and that can clog up the pores and then certain bacterial colonization on the skin can play a role in the pathogenesis of acne. If you have abnormal shedding of the skin, of the sebaceous glands and the upper section of the little hair follicles near the opening of the pores, and these skin cells can clog the pore and form what's called medically a microcomodone, so like a little miniature whitehead or blackhead. Propionide bacterium acnes, or what's called P acnes, is a bacterium that is normally found on the skin, but in people with acne it can grow abnormally to pretty good levels and this leads to inflammation and skin changes and follicular hyperkeratinization and alteration of the sebum, the oil in the skin, and alteration of the sebum, the oil in the skin. So, as we said, hormones do play an important role and that's why a lot of times acne is referred to as hormonal acne and generally when you go through puberty and you go through adrenarche, where your adrenal glands produce higher levels of sex hormones, and then menarche, when the ovaries start to kick in and ovulate. But in both sexes the sex hormone levels increase and regardless of gender you can get acne. Now women can get later.
Speaker 1:Acne related to hormonal fluctuations from pregnancy can get later. Acne related to hormonal fluctuations from pregnancy, perimenopause and some forms of hormonal contraceptives are what we call more androgenic and worse on the skin, where others are much less androgenic and very favorable to the skin, especially if they lower androgen levels. It's not uncommon for me to get consults from my dermatology colleagues because they're sending me women who have hormonal causes of skin and hair problems from hormonal imbalance. So we talked about inflammation from the diet playing a role. Some people have classically argued that the diet is less significant, but I think over time our diet has gotten more inflammatory and I think we have more bad things in our food supply. Last fall, if you didn't hear my podcast on banned foods in other countries that are available in America, that's really one to listen to. Now.
Speaker 1:Some medications can increase acne and some occupational chemical exposures, but these types of acne are different than the common acne vulgaris. Vulgar means common and of course, a lot of us who have acne think it's rude that we have it. It's rude of our body to allow us to have acne. So, moving on to treatment, adult acne can be treated with medication, lifestyle changes and, of course, changes in your diet. So let's start with what's the best diet for acne.
Speaker 1:What are some good foods to eat? Maybe foods you should avoid, and are there any supplements that you might want to consider? So, in general, when talking about skin health, when we talk about foods to avoid, in general foods that have a high glycemic index, and that's a measure of how fast or how slow you break down food, how fast it spikes your blood sugar. So foods that have a very high glycemic index can cause dramatic ups and downs in blood sugar and that can make acne worse. Some people can feel shaky and have reactive hypoglycemia, and so some of these foods are like teenage favorites, like soda and candy and sugary cereals and ice cream and candy cereals and ice cream and candy. So a little bit of ice cream or candy, you know, for a certain holiday may be fine, but in general, people of all ages should avoid excessive sugar and sweets.
Speaker 1:As I've said, there's no such thing as an essential carbohydrate. We have essential amino acid proteins and two essential fats. So other things to avoid would be highly processed foods Again chips, fast food, microwavable meals Again, those can be popular amongst young people amongst young people, and limiting these sweets and sugars and candies and cakes and sports drinks and energy drinks and cookies are certainly a good idea. Some people find that dairy and or whey protein irritates their skin and joints, so dairy products like milk and cheese and yogurt do promote insulin secretion and the production of some hormones, and then some people can contribute to acne. Being an osteoporosis doctor, I'm very fond of the dairy foods because they're great for your bones, and if you haven't caught my column and podcast on everything about cheese and why cheese can be good for you, that is certainly one to go back and listen to, and a lot of young people use whey protein supplements as meal substitutions or in part of their pre-workout, because whey protein is great for tendons and muscles. It's good for tendon repair. So I think doing a dietary survey in patients is a good thing to do and sometimes that can lead to some things that we can do differently.
Speaker 1:You have been listening to the Speaking of Women's Health podcast. I'm your host, dr Holly Thacker, back in the Sunflower House this summer for a podcast on everything acne and skin health. So what are some good foods to eat? Well, obviously your vegetables broccoli, spinach, kale, peppers, carrots Both peppers and carrots are rich in vitamin A. Vitamin A kind of gives a nice little glow to the skin and vitamin A actually can be very helpful if a child has measles. There's been studies looking at giving vitamin A. So that directly helps the skin, just like vitamin C helps and a lot of skin conditions. There's excessive skin turnover and there may be higher requirements for vitamin C helps and a lot of skin conditions. There's excessive skin turnover and there may be higher requirements for vitamin C. So vitamin C foods like berries and oranges and apples and bananas, cherries and grapefruit good old cherries we talked about in the gout podcast it's one of the fruits that do really help lower uric acid levels.
Speaker 1:And whole grains, sweet potato, also rich in vitamin a, brown rice, quinoa, butternut squash. And then you want heart healthy fats. They're also good for the skin, like whole eggs and olive oil and avocado, coconut oil, and various healthy nuts and seeds, omega-3s, which so many people don't get enough of. They're in fish and certain nuts and seeds, like chia seeds and walnuts, and almonds and flax flax oil. The omega-3s are very important. Whenever I have a woman complaining of dry skin, dry eyes, worsening eczema, skin that just doesn't glow as much as it did before joint aches, mood changes, brain fog I frequently will find that the omega-6 to omega-3 ratios are off, and if you haven't read my column on omega-3 or listened to the podcast on that, it's a good one to go back to Now.
Speaker 1:Some plant-based dairy alternatives can include almond milk and coconut milk, soy milk, cashew milk. And high quality protein is always important for the skin, the bones, the muscle, the metabolism, the brain. So high quality proteins like salmon, eggs, shellfish, chicken, turkey eggs, tofu they're all excellent sources of protein. Some have more purine content than others, some have more omega-3 content than others, but in general they pack a good punch for the calories to the nutritional ratios Legumes like black beans and chickpeas and lentils, and there's a lot of herbs that are anti-inflammatory, like cinnamon, black pepper, turmeric very anti-inflammatory garlic, ginger, parsley. So eating a nutrient-dense, anti-inflammatory diet can certainly help treat and prevent many conditions or at least help moderate them, things like acne. It's important to drink unsweetened drinks like uh, like lots of water, green tea, hibiscus tea, um, lemon water and hibiscus tea and lemon water uh are good at also helping to lower uric acid, which is inflammatory.
Speaker 1:Supplements for acne vitamin D. Research has shown that low vitamin D levels can worsen acne and over half of people with acne have low vitamin D. So if you live in a Northern climate, like we live here in Cleveland, ohio, especially in people over 40, because the skin doesn't make it as well, plus, a lot of people that are adults are inside working. They're not running around outside playing sports and swimming and getting to enjoy all the outdoor activities during the sunlight. Interestingly, green tea extract there was a study of women with moderate to severe acne and those that boosted their green tea intake or took a green tea extract. For four was a study of women with moderate to severe acne and those that boosted their green tea intake or took a green tea extract for four weeks did have an improvement in their skin. I try to drink green tea several times a week.
Speaker 1:Fish oil or omega-rich fishes such as fish rather, such as mackerel, salmon, sardines, anchovy, caviar, herring, trout, to name a few of my favorites. If you're not a fish fan, sometimes your physician may recommend certain types of fish oil supplements. The results are somewhat mixed. Some people can actually have worsening symptoms. So you really want to do this under the guise with your healthcare team. B vitamins Supplementing with B vitamins may benefit people with acne, but interestingly, high dose injections of B12 may induce acne in some people, interestingly. And there's people who don't have B12 deficiency who just go to these health spas or go to their physician to say give me a B12 shot, kind of like a placebo, basically. So again, if you don't need it, it's not good just to take it to take it. Zinc Oral zinc supplements can improve some acne severity and zinc does play a crucial role in helping the immune system, the mood and fighting off viruses and maintaining skin health, and increasingly I've been doing more zinc levels and finding a lot of women that I thought previously were unhealthy diets have some low levels.
Speaker 1:Vitex Vitex agnus castus is also known as chaseberry, and sometimes herbalists and other integrative doctors may recommend chaseberry to reduce acne before menstruation because it might lower some of the sex hormones. But I really think more research is needed. If something's not a food or it's not a drug, it isn't regulated, so it is. Buyer, beware Barberry Berberis vulgaris. Barberry has anti-inflammatory and antibacterial properties, and so some people recommend supplementing with barberry extract based on some studies. But again, I think you should do this under the recommendation of either integrative medicine or functional medicine physician or an herbalist, or at least talk with your dermatologist or family medicine physician about this. Probiotics and prebiotics there is some research that shows that the bacteria in your gut may reduce skin inflammation and therefore reduce acne. So many things are linked to our gut microbiome and really the research in this area is rapidly exploding.
Speaker 1:In addition to eating a healthy diet and seeing your health care team bringing in any supplements that you may take, just because they're not prescription doesn't mean you don't need to bring them in. Certainly, quit smoking if you smoke. Smoking ages the skin. It's full of toxins, it increases wrinkling around your mouth Lots of places. It's socially unacceptable, it's expensive. It's highly addictive and if you do smoke and you want to stop smoking, we have some great smoking cessation resources on our website, as well as a podcast on smoking cessation. It's also a good idea to limit your alcohol intake and get plenty of sleep. If you're sleep deprived, like so many Americans, your stress hormones are up, and if you're having trouble sleeping, go back and listen to some of our great podcasts on sleep wonderful sleep tips and I promise you the podcast won't put you to sleep, but we'll help you sleep later. Obviously, learning how to manage stress and understanding what proper skincare is and even though I'm a woman, I'm a physician. I really learned a lot when I was interviewing Lori Skarsgård, our head skincare esthetician, as well as Amanda, who is not currently an esthetician at the Cleveland Clinic, but she was a wonderful interview on skincare and if you didn't listen to that or you just need a refresher, I always learn something when I listen to them. It's a good one to go back to.
Speaker 1:So, moving on to your facial skincare, for acne prone skin, it's very important to have a cleanser specifically formulated for acne. They usually contain salicylic acid, which helps get rid of the extra keratin in the skin, or benzoyl peroxide, which can inhibit the bacteria on the skin. You want to clean your face gently, because if you are traumatizing your skin trying to exfoliate too roughly, that can actually worsen acne outbreaks and cause scarring, and that's one of the reasons why, even if someone's not bothered by cosmesis, they're not bothered by their acne. It's important to treat it because scarring can be permanent and skin infections can take root that occasionally can lead to serious consequences like sepsis. I've seen people get bone infections from skin infections where they have to get home IV antibiotics for six weeks or longer or a new heart valve. So it is important to care for your skin because it's a barrier between our internal organs and the parts of our body that aren't supposed to have any bacteria in them. You want to somewhat minimize your use of facial moisturizers and if you do need a facial moisturizer which, of course, a lot of us women need as we're getting older you want a light, non-comedogenic moisturizer which doesn't aggravate acne, and it's best, if you're going to use a foundation, to use an oil-free one and avoid heavy makeups or cosmetic products that can block the pores. Now, beta-hydroxy acid or salicylic acid does help improve acne and even if you don't have acne. It can be very nice for kind of clarifying the skin and the color and the texture. It does penetrate oil-laden hair follicles and as such helps reduce acne formation. There's a lot of different products over the counter and some do require a physician's prescription.
Speaker 1:Now hormonal therapy for acne In theory, most any estrogen-containing hormonal contraceptive should help if it's used for three to six months. But there's only some that are FDA approved. Orthotricycline was the first one. It has athenolestrogile with differing doses of norgestimate, yaz, yasmin Biaz, safral. They have athenol, estradiol and drosperinone, which is like spironolactone. Those have specific FDA approval for acne. Now, when I first started on hormonal contraceptives in medical school, I was on a levonorgestrel brand and I still had the same amount of acne. And then, finally, when I got to my endocrine rotation and I learned more about the different types of progestins, which are actually C21, more androgens, but they function to protect the uterus, I realized I was on the wrong hormonal contraceptive and so I got on a non-androgenic one and, oh my, did my skin significantly clear up and I really had wished I would have done that sooner.
Speaker 1:Now, body acne, back, knee. That is a really tough problem and it's not as cosmetically affecting, except it is in the summer, of course. But when it happens on the back, arms, shoulders and neck it can be particularly difficult to treat. It doesn't seem to be as amenable to Accutane, which is a very potent treatment. One of my sons and my nephew and niece had severe enough acne that they needed to go on Accutane and there can be really dramatic effects. But it has to be very closely monitored. There can be some significant side effects, so it's not something to just jump into loosely and whoever you see has to be able to prescribe it and monitor it. Whoever you see has to be able to prescribe it and monitor it.
Speaker 1:So you want to avoid tight, constrictive clothing or rubbing up against the skin with a purse or a backpack. You always want to stay hydrated. You don't want to pick at or pop pimples. I know a lot of these YouTube videos with Dr Pimple Popper are very popular, but do not do this. You could really get a serious infection or scarring.
Speaker 1:Some of the treatments for acne on the back some have suggested tea tree oil, which has some antifungal effects. Warm compresses apple cider vinegar can be applied. Diluted three parts water to one part apple cider vinegar. Oatmeal baths can calm the skin. Topical benzoyl peroxide, salicylic acid and topical adapalene different, and that 0.1% and 0.3% are now over-the-counter or off-the-shelf without a prescription are now over the counter or off the shelf without a prescription. Many times a dermatologist may need to prescribe stronger topical creams, topical retinoids, prescription strength benzoyl peroxide or even anti-inflammatory antibiotics like doxycycline. If you're pregnant or breastfeeding, though, you cannot take doxycycline. It's a tetracycline. It can permanently stay in the teeth of the forming baby or child.
Speaker 1:So since we're in the middle of a lot of sunshine, I do want to also talk about skin care the must-haves for the decade, and they're also good tips for anyone who has acne of any age or anyone who just wants to have good skin. So we tend to be a little bit more in tune with the changes in our body as we age. But just like the rest of our body changes with age, so does the skin and sometimes the skincare routine needs to be changed. So in the teen years, acne and fluctuating hormones can be a big issue, and if you're a female and you're a candidate for hormonal contraceptives even if you don't need contraception but you just want to have a potent treatment for acne, it would be good to see your physician. In fact, females generally who are going on Accutane, since it can cause such teratogenic effects in a forming baby, are required to be on hormonal contraceptives even if they're not sexually active, just because of that risk.
Speaker 1:Salicylic acid can be very helpful in teens. It's over the counter in lots of cleansers, lotions or some facial washes. Benzoyl peroxide works on sebum production and actually can kill that P acnes bacteria, and again it's in lots of over-the-counter products. But there are higher strengths available by prescription. Isotretinoin, known as Accutane, is kind of one of our last resorts. It can be very effective. It may permanently dry your skin, though for the rest of your life. My one son says that his skin is just drier and a lot more sensitive. But if you might become pregnant or you're planning to become pregnant, it's a big fat no-no and there's a maximum dose that you can take over your lifetime. So you need to know how much you've taken, because if you ever go for a second course of treatment down the road, which sometimes is needed, it has to be limited and you have to know the amount that you've taken. And we need to teach our teens how not to pick at their face and to get them early treatment so they don't feel compelled to do that.
Speaker 1:As you move into your 20s, hit your stride. You still may have acne, but if you've graduated from that, you still need to prevent it and you might want to use a good SPF. If you're in sunny Florida and you want to use a daily moisturizer, if you're planning a Caribbean spring break, use your SPF during the day and bring a wide brim hat, because really protecting yourself from the direct sunlight, particularly when it's at its strongest, is the best. But if you're avoiding sun exposure, then your vitamin D levels may not be good. So season one, podcast three, was everything about vitamin D, and I can't emphasize the number of conditions that can be improved, reduced or prevented from adequate vitamin D.
Speaker 1:Now in your 20s, you may want to reach for a retinoid agent. Some are in over-the-counter creams or cleansers. In low doses they do stimulate collagen production or anti-aging, and it's not just for the face. You can apply it to the neck as well, because the neck tends to get thinner first and a lot of women take really good care of their skin and they kind of ignore their neck and their décollet area, which is this area. Here, once you hit your 30s, hopefully, you've got your life together and you already know how to take care of your skin, but now you're busy with work and a family, maybe, and planning for your future. So sometimes we see some significant changes in the 30s and the skin turnover tends to slow down, and this might be when people start noticing some of their first signs of aging.
Speaker 1:So this might be the time you need to go from a lower potency retinoid to something just a little bit stronger, if you can tolerate it, and you might need this as a prescription from your physician or your APP. But it can be irritating to the skin, so you might want to start every other day or mixing it with a moisturizer. If your skin starts to flake or become more sensitive, then back down and you might want to add an acid-based serum to your routine. Vitamin C, of course, is most important to get it in your diet, but topical vitamin C can help even out skin tone, brighten the skin and target signs of aging. I received a gift of some skincare products that had vitamin C and also had topical ferric acid, which is iron, which apparently can sometimes help brighten the skin. Glycolic acid is similar to the retinoids and it boosts collagen formation and help fight, you know, those fine lines and wrinkles. Lactic acid is similar to glycolic acid, but less harsh and it's a little bit more gentle to the skin. I have used topical lachydrin, which is a pretty potent concentration of it, on my arms and legs, as a moisturizer. It's a little bit stinging, so it doesn't feel particularly pleasant, but it is very good for the skin.
Speaker 1:Chemical peels it's a procedure that aims to accelerate the skin exfoliation by using chemical substances that result in renewed, healthier looking skin and a more uniform complexion. With one of our skincare estheticians, I finally got up the courage to get that perfect peel, and I did that over Halloween. I thought, well, if my skin's peeling and I look weird, I can, it'll just fit with the season. And I was really hesitant to do it because I had done one um several years earlier and my skin was uncomfortable and I just felt so irritable and even though it tightens up the pores and kind of helped cleaned up some of my acne, I just didn't want to undergo it. But that perfect peel was not difficult and when you get that fresh new layer of skin, it was really very nice Skin caring your 40s Well, by then you would think everything would be in check.
Speaker 1:But that's when perimenopause can hit, and fluctuating hormones it's like reverse puberty. And then you have aging. Maybe you have hyperpigmentation from too much sun exposure, thinner skin, maybe loss of elasticity, dry skin so you may have to use more moisturizer. Dry skin, so you may have to use more moisturizer. Melasma, which we've talked about in other podcasts, the mask of pregnancy I developed that with my first son. I had a doctor look at my forehead, saying wipe that dirt off your forehead. Like I went in the mirror and it's like I didn't see any dirt. It was melasma. But luckily hydroquinone, which is a skin bleaching treatment, can be used along with topical retinoids and sometimes it's mixed with a little potent steroid that can only be used for a short period of time, called Triluma. There is hydroquinone over the counter, but higher potency ones need a prescription. And if you're having a lot of acne, even if you don't need contraception some women have had tubals or they don't need contraception, for whatever reason. Sometimes, if they're in good health, with good blood pressures and no history of DVT, we will prescribe hormonal contraceptives just to clear up their skin.
Speaker 1:Now skincare in your 50s and beyond. Usually by the 50s women have entered menopause. It's very unusual to go to the late 50s or even up to 60. That's very rare. So most people have hit menopause and certainly postmenopausal hormone therapy does help the skin. It's not one of the official reasons. Medically we prescribe it because we women would do anything for skin and hair. But many times when I see older women and I just look at their skin. I can tell who's been on hormone therapy and who has it. I can tell who's been on hormone therapy and who hasn't. There's a lot of these online places that prescribe hormones without really any direct supervision.
Speaker 1:Topical estriol on the skin. I don't recommend that. I recommend if you need estrogen, because you're low in estrogen and you understand the benefits and the risk that you take it systemically. Wrinkles and fine lines become more evident. The skin can sag a little more. There's firming creams and serums, and topical retinoids still play significant roles and I think it's important. I mean, a lot of women are really happy that they have their laugh lines and that they are maturing with grace.
Speaker 1:So when you're in your 50s and beyond, you don't need to look like you're 20. That's for sure. But this is the time you might want to start getting regular skin checks for cancer, because skin cancer and other skin conditions can increase. So thank you so much for listening to this episode. Don't miss a future episode. Hit, follow or subscribe on Apple Podcasts or Spotify. Tune in. We're also on YouTube and Rumble. If you've enjoyed this episode and you want to help or support, please share it with others, donate to our non-profit or leave a nice review. Thanks again and I'll see you next time in the sunflower house. Remember, be strong, be healthy and be in charge.
