Your Skin Can Bounce Back: Why Estrogen Loss Causes Wrinkles, Zits and Saggy Knees!

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Chapters

• 0:00 Welcome And Why Skin Changes
• 2:28 Estrogen’s Role In Skin Health
• 4:08 Collagen Loss And “Overnight” Aging
• 6:45 Body Skin, Knees, And Budget Finds
• 10:24 Texture Shifts And Barrier Repair
• 12:40 Collagen Supplements: Evidence And Benefits
• 16:15 Hormonal Acne Returns And Why
• 19:50 Dry Yet Oily Skin And Milia
• 23:18 Cleansers That Clean Without Stripping
• 26:45 Treating Perimenopause Acne Strategically
• 30:12 Drugstore Vs Cosmeceuticals: What Matters

Transcript

Val: 0:00

Welcome to The Pause, the menopause podcast with unfiltered conversations about the symptoms you hate, the changes you didn't see coming, and the hilarious moments midlife can bring. I'm your host, Val Lego, and I've been a dedicated health reporter for 25 years, and I wanted to normalize something that every woman goes through. Hey friends, welcome back to The Pause. You know, one of the biggest changes we've been noticed during curry menopause and menopause isn't just how we feel, it's how our skin looks and behaves. I have noticed when I look in the mirror, I'm seeing all of the teenage sundays on the beach coming to fruition to show me all the damage I did and why I should have been wearing sunscreen when my mom told me to wear sunscreen. I'm seeing the wrinkles, I'm seeing all the things that all of a sudden I just don't feel like I look like myself. And I know I'm not alone. I know this is happening to everyone. Um and, you know, maybe it's maybe it's just something simple like your face feels drier. I have drier skin anyways. And so if I put a serum on, like that's it. You know, it's gone in like two seconds. Uh and for others, it's about breakouts. I fortunately have been blessed because I never really had acne. Um, but I know I've got girlfriends that are now revisiting those teenage years with the acne coming back because you're going through all these hormone fluctuations, and that's one of the problems with you know your skin during menopause. So yeah, I'm really sorry for anybody who's going through that because that could be a hard thing to really deal with. So we want to delve into what's really happening beneath the surface when estrogen starts to dip, and more importantly, uh, what you can do about it. So we are talking with Dr. Diana Castan on Westgate. Now, I want to be transparent. I have known Deanna for ooh, I want to go towards like 15 years. That's probably very close. Probably very close. She is a wonderful dermatologist. I talk to her often about many things. So she's going to help us with navigating these hormonal shifts, uh, you know, with real skincare strategies. So we're diving into what's really going on with our skin during this session and how to bring back that healthy, confident glow because you can do it. So, Deanna, what happens to our skin as estrogen levels begin to decline in perimenopause and menopause?

Dr. Diana Castanon: 2:29

Well, estrogen is a skin superhero. Oh. So, first let's talk about what estrogen does. And then, wah, wah, wah, we'll go over the things that happen when estrogen declines. So, estrogen activates fibroblasts, which produces collagen and elastin. Those are the structural elements of the skin that really give it its structure, function, firmness, plumpness of the skin. It also produces hyaluronic acid or increases hyaluronic acid and it increases oil production or regulates oil production so that the skin has a nice balance. The repair mechanisms are in place, your skin is hydrated, the firmness is there, your skin is plump and toned. Um, and it also, a lot of people don't really understand this about estrogen, but has anti-inflammatory properties. Oh. So you talk about that sun damage that you picked up as a teenager. True, you should have been wearing sunscreen. But when estrogen starts to decline, your defenses are down. So sun damage and aging from photo damage accelerates. Oh, wow. Um, in addition, the skin doesn't have the same abilities to repair wounds. So wound healing is declined, all of that because estrogen starts to dip. So that kind of declining estrogen can create the sagging, the wrinkles, the dryness, and even sensitivity and irritancy of the skin as well as accelerated photo and environmental damage.

Val: 3:49

You know, Diana, I sometimes feel like this stuff is happening like overnight. Like I'll wake up in the mirror and be like, when did I get jowls? I swear they weren't there yesterday.

Dr. Diana Castanon: 4:00

That is an unfortunate thing, right? So I usually tell people that 80 to 90% of the signs of sun damage or signs of visible aging come from the sun. And that's true. But um, when estrogen declines, there is kind of this upregulation of aging that happens that really is not in line with chronological aging and is not in line with the degree of sun damage that you're achieving during those years post-menopause, because you can actually lose up to 30% of your collagen in the first five years after the onset of menopause. Oh my God. And so that is where the sagging comes in. And so people do think that it happened seriously overnight. They're like, oh, okay, I thought I was doing okay. And, you know, I was using my products, the same old products that I've been using for years, and now all of a sudden my skin just feels and looks different.

Val: 4:45

I know we're concentrating a little bit on the face, but I swear my knees are saggy.

Dr. Diana Castanon: 4:50

You know, it's so true. And I have patients come in often and they're like, what can I do for my body? Because all these cosmosceuticals that I want to use for my face are so expensive that I don't have things that I can use for the body. But the good news is there are a couple of products now that are available to address just that because you're right, skin is everywhere, collagen is everywhere. So people get that little bit of sagging under their arms, a little bit of sagging by their elbows, a little bit of sagging over the top of their knees, and no one likes it. And so there are some products over the counter now. There's one from C to Phil that's like pretty inexpensive, probably in the $20 range that has some like AHA BHA in it that's actually appropriate for firming and hydrating the skin could be great for postmenopausal and perimenopausal patients.

Val: 5:31

So you think those products have something to it? Because a lot of times feel people feel like drugstore products, I don't know if it's gonna work.

Dr. Diana Castanon: 5:37

You know, um, that product actually, I mean, it's a pretty decent product. Would a whole body retinoid be a better option? There are some of those available that are from like the cosmeceutical brands that are probably better regulated and studied. But when you're talking about putting something over your whole body, good ingredients can go a long way, even if they don't have necessarily all the data behind them for areas that are secondary, not your primary focus, places like knees and elbows and those types of areas where you're getting like forearm wrinkling, um, you know, and purpura, those little bruises that people get on their forearm when their skin gets thin. So those over-the-counter products are really great for targeting those less important, less vital to self-esteem areas, but still things that bother people.

Val: 6:20

All right. I'm gonna go down the aisle and look for that. Um, texture of your skin also changes, I think, a little bit too. Yeah. You can notice it a lot when you start trying to put on your same old um foundation or your powders. All of a sudden things are settling into creases that you didn't realize you had. Um, yeah, it's just a whole change up.

Dr. Diana Castanon: 6:41

Absolutely. When the collagen and elastin decline, the skin doesn't have that firmness support anymore. So the wrinkles deepen and the creping starts, where you're like, okay, I knew I had smile lines, I knew I had forehead lines, but now why am I getting all this like just subtle wrinkling where I'm seeing if I put my powder on that it's like all settled in those subtle wrinkles? That's just the loss of that structure as well as the loss of hydration. So the skin really does need that water balance and it needs to be maintained in the skin. And you also lose that kind of oil sheen, that kind of dewy appearance that everybody is going for. You lose that because the estrogen isn't there to support that. And when that oil barrier is lost, the repair mechanisms and the barrier can increase transepidermal water loss, and that leads to more and more wrinkles.

Val: 7:30

You're a really, really big um fan of collagen powder supplements.

Dr. Diana Castanon: 7:35

Yeah, I do. I actually, so it's interesting. When I was in medical school, we were actually taught that there was no evidence that collagen supplementation was beneficial at all. They're like, it's too big of a molecule. If you take it internally, it's not going to do anything for you. There's no way that you'll systemically absorb it. I mean, here we are, yeah. I mean, medical school was a long time ago for me. Um, but here we are a couple decades later. And what we're finding is that the meta-analyses actually do support collagen supplementation. And good, well-sourced collagen can be really effective at improving our body's innate and endogenous collagen production and really help to prevent some of that sagging and wrinkling that we're seeing on the skin, but also really good for joints, blood vessels, other structures that rely on collagen for their structure and function.

Val: 8:21

Yeah, I think people are surprised when they realize how many different ways collagen is good for you. It's not just a skin, hair, and nail thing. But I will say, when I took it religiously for a year, I've fallen off the wagon and I'm upset with myself about doing it, but life happens, right? Um, when I did do it for a year, I found that my everything was better. My nails, um, my skin had a better complexion. I didn't have that popping in my knees when I'd go up and down the stairs anymore. Like I was amazed that it really worked.

Dr. Diana Castanon: 8:49

It I think there's really something to it. There was a giant meta meta-analysis that actually showed that there was some significant benefit to collagen supplementation.

Val: 8:57

Yeah. So something to consider, ladies, if you are like, what else can I do? They say from the inside out, right? Drinking your water and putting the water on your face in forms of products that have good water retention.

Dr. Diana Castanon: 9:09

Absolutely. It's about what you supplement, but it's also about what you eat and it's about how you take care of yourself too. Sleep makes a big difference. All the things kind of come together.

Val: 9:19

You know, for some women, it's not about necessarily the wrinkles, it's about the acne, and the acne comes back. And sometimes, you know, women return to their cystic acne, which can be so painful and scarring and terrible. You know, let's talk a little bit about what's causing that and what we can do for those.

Dr. Diana Castanon: 9:36

So acne is a big part of my practice. I see a lot of younger folks, adolescents with tons of acne, but I see tons of adult females who come in and they say, Oh my gosh, what is the going on? Either I have never had acne before, or I was expecting to grow out of this. It never went away. Um, and the acne does kind of resurge and they're like, I'm too old for this. Why am I getting breakouts? Um, but the reality is that hormones are lifelong and hormones play a role in every single type of acne. Obviously, we see a big surge in adolescence because of pubertal hormones. But when those hormones die down, specifically for men, they kind of stabilize, but for women, there is this fluctuation of hormones that still happens later.

Val: 10:17

All right. I'm just gonna say, Diana, like, how many more like bad apples can we get? The men get it so easy. They get to stabilize and we get to fluctuate.

Dr. Diana Castanon: 10:27

I know, I know. It's it's definitely um troublesome because men, when I see adult men with um with acne, it's usually because they're doing testosterone supplementation and they're getting a little too much testosterone and that's like triggering the acne. But when I see hormonal acne in women, women are like, I'm not doing anything different. Why is this happening to me? And it's again, it's that estrogen falling, the androgens becoming dominant, stimulating those oil glands, and kind of starting that cycle for acne production again.

Val: 10:56

Someone will say though that their skin feels really dry, but they're still getting their acne.

Dr. Diana Castanon: 11:00

Yes, that happens also because remember, estrogen does a lot of things: water balance, anti-inflammatory properties, and it also helps with oil regulation. So some people actually get dysregulated with oil. They can get oily in some areas, dry in other areas, and they're like, what do I do? I'm like shiny on my forehead and my T zone again, like I'm a teenager, but I'm super dry around my eyes and around my mouth. Um, and that's where I'm getting my acne, is around my mouth. Why is that? Some of that has to do with skin turnover as well, because estrogen can kind of improve skin turnover and and support the keratinocytes, the cells as they're kind of regulating themselves and turning over the skin to make it new. Um, and when skin turnover is impaired, pores get clogged and what oil is made gets trapped. Um, so it's the beginning of acne all again in a very dysregulated system.

Val: 11:53

You know what I've been noticing on myself that I've been getting a little bit more of are the um the really hard there, you know, you have the black heads where you see the blackheads, but mine are like the white, really hard, whatever they are under the sun.

Dr. Diana Castanon: 12:05

They're called milia. And we obviously see those as well. Um, there's lots of things that can contribute to milia. Sun damage can contribute to it, a natural kind of tendency toward getting them. Some people get more than others. But one of the things I see in women who are kind of in the peri- and postmenopausal age group that tell me they're starting to get millium is they're probably using products to try to combat some of these estrogen-related, hormone-related changes that are actually clogging their pores in such a way to create these little small superficial cystic lesions. The number one thing that I see is people are trying to do a heavier hydration because their skin is so dry and the heavy hydration traps things. And so they're kind of using the wrong moisturizers or using oil-based products, and that can lead to mylium. So there is usually some education that happens there. How do we pick the right moisturizer so that I can actually target the dry skin, get my skin hydrated, but not occlude the skin to end up with these little white bumps.

Val: 13:06

For me, too, it's it's about a good cleanser when it's not gonna dry out. And I think we've all thought growing up, oh, if my skin is dry and tight, it's clean. Um, and it's getting used to finding a good moisturizer when you're done that your skin feels really soft and understanding that that also can be clean.

Dr. Diana Castanon: 13:25

Yes. So I, so as a dermatologist in general, the tight skin means clean skin thing just grates at my soul. Um, because I see so much like dry skin eczema because of that philosophy, and I see a lot of like dryness in the skin, dysregulation and irritancy. Um, it is really important to be careful with like things that are soap-based as opposed to cleansers. There's um there's a nuance there. Soap is going to trap oil and dirt in the little bubbles essentially and pull it off the skin, which is why the skin feels tight. It took all your moisture with it. Whereas cleansers are going to remove dirt and impurities, but they're not going to strip the skin's essential oils. So the skin doesn't feel tight, but it is clean. So that clean sensation or the clean, the truth of clean and the sensation of clean, the way that we understand it as being kind of like tight and stripped is actually just a falsehood. So it's really important to kind of retrain your mind into thinking my oils are good for me. The oil on my skin and that balance in our skin is actually really important.

Val: 14:34

What should you be looking for in a good cleanser?

Dr. Diana Castanon: 14:36

So I tell people to stick with something gentle. I even tell this, so there's a small subset of patients where you have to use something that has actives in it, ingredients like AHAs or BHAs in order to kind of strip through some oil. Those patients that have really truly, you know, oily, oily skin, those are kind of fewer and far between. Um, usually most people just need a gentle cleanser. Something that doesn't have any dyes, any fragrances in it, um, something that's made with glycerin can be really helpful to kind of clean the skin gently, but also not strip all of your moisture. I avoid soaps. People are people always like their like beauty bars or you know, bar soap. I tell people to avoid that. Definitely use a cleanser. And as you age, the type of cleanser that you need is different. So there's lots of different cleansers that are available. Teenagers who tend to be more oily might want to use like a foaming face wash, whereas someone who has drier skin or kind of in the peri postmenopausal area might want to use a hydrating or hydrating a foam cleanser depending on how oily they are.

Val: 15:40

Now, I think that that is such an essential part of like getting that skin clean so that you can get everything like really, really soaked in. Um, but I think people with acne maybe worry a little bit about like, okay, what am I using when I'm using a cleanser? Am I using one, you know, that's going to irritate my skin or what have you? I do want to get back to that conversation a little bit about what how do you treat people with with acne that are going through postmenopause or perimenopause?

Dr. Diana Castanon: 16:11

So that can be a little bit tricky because um there is a component where the oil is dysregulated. There is a component where where skin is not turning over the way it's supposed to, so you need to unroof that. And a lot of times that requires acidic containing products that can be drying. So it it's about finding the right balance, using a gentle cleanser rather than anything with active ingredients. If you have to use something acidic to exfoliate, if patients are are needing an exfoliation, using gentler acidic compounds like mandolic acid, lactic acid, or azoleic as opposed to like glycolics or salicylics. Um, that can be helpful. And then also targeting the hormonal component. So the hormonal component is can be targeted in one of two ways. You can either do it if it's more kind of superficial acne with a topical. There's a topical now that is a hormone receptor blocker called Win Levee that's available. It is a little difficult to get covered because it's a name-brand medication and there are no generic equivalents for it, but it's a very effective medication at reducing kind of more minor acne outbreaks. But for the majority of people who have moderate to severe hormonal acne with cystic lesions or nodules, those kind of undercovers under the skin, they need something from the inside out that blocks those receptors. And the best medicine that I have found works well for patients in this age group is spirnolactone. So spiranolactone is also a hormone receptor blocker, works at the level of the skin and at the level of the kidney. Um, it does work as a diuretic in the kidney, so it can drop blood pressure slightly. But most women, as they age, blood pressures start to kind of creep up just a little. So sometimes you kill two birds with one stone. There is a magic dose of that medicine, and it's usually between 50 and 150. So we usually start low and kind of increase the dose as we need to until we hit the sweet spot. When you hit the sweet spot for hormonal acne with an agent like spiranolactone, the topical medicines become kind of this supplemental to try to help with skin repair, decreased redness, and scar remodeling. But really, the acne disappears when you're under magic dose.

Val: 18:22

Wow. That is very promising for those who are going through it and wondering exactly what they need to do. Of course, you need to go to a qualified dermatologist to start this process, I would imagine.

Dr. Diana Castanon: 18:33

Yes. And there are some nutritional things too that I usually talk people through. Decreasing dairy can be helpful, decreasing simple sugars, and um also decreasing whey protein.

Val: 18:44

So I we've talked about a lot, and it can be so overwhelming to say, okay, I'm gonna go down the drugstore aisle and I'm going to get my my skin back in shape. But oh my goodness, there's so much to look through and and to see. And there's different point price points. Someone can can afford a little bit more than the drugstore, but some can't some can't. And you say, you know, drugstore can be just as good.

Dr. Diana Castanon: 19:04

Well, in some aspects, yes, and in some aspects, no. So what I usually tell patients are the products that I typically recommend. Um, I try to recommend products that have scientific data to support their claims. Most of the stuff over the counter is just surveyed in terms of trying to support their claim. You know, 80% of women said that they like it, that their skin looks better, that their wrinkles are improved. Whereas in scientific studies and like white papers for for cosmosceuticals that are studied, there has to be meaningful scientific change that can be evaluated by an expert in order for them to be able to make the claim. So typically when I recommend products, if I'm gonna tell people you should buy this, it's gotta have a white paper in my mind. But not everyone can afford those products. So what I tell patients is that if you can't afford the best of the best, that's really okay. You should at least have an understanding of what ingredients are going to help you. There may be an over-the-counter product that is sort of a dupe of one of these really expensive products that will actually do the job. We just can't guarantee it. I mean, there's so many products. Like you said, it's overwhelming when you go to the drugstore. It's overwhelming for you, but it's also overwhelming for your friendly area dermatologist because patients come in regularly with a bag full of products and say, should I keep using these? And I'm like, I've never heard of these. You know, and I've I've kind of seen the gamut of products. There's just so many SKUs available. And a lot of times patients will bring me their products, but they won't bring me the boxes, and all of the ingredients are listed on the box. So I'm like, I can't even tell you if this has the ingredients that will do the job for what you're you're asking for. So um, that's another little tip. So if you are gonna take your products to the dermatologist, take the boxes with you. Keep them because then at least we can tell you if the ingredients are good ones.

Val: 20:52

So if you were to go down like a checklist for like, okay, I'm gonna go and I'm going to get get to the store, what are some of the things you want? You want a good cleanser, you want a good moisturizer? Like, what are the some of the things that you want women to hit?

Dr. Diana Castanon: 21:04

Yeah, great. So when people come in and say, Doc, I need a skincare regimen, what do I need to do? Where do I start? And then they go through a laundry list of things about their skin that bothers them. I usually say, hold the phone just a minute. What are you currently doing? And if people are doing not much of anything or way too much, then we need to find a way to hone in. So then I start talking about the difference between foundational skincare and supplemental skincare. Foundational skincare is something that everyone should be doing. And um, those are things, like you said, I usually recommend the big five. So a cleanser, a vitamin C, um, a sunscreen, a moisturizer, and a retinoid. Those are the five things that really people should be doing every single day to try to keep their skin healthy and looking its best.

Val: 21:50

Those are pretty simple to remember. Um because I feel like we do talk about those a lot. So, like those are kind of the the non-negotiables. Do you have anything if you wanted to go beyond that that you would recommend?

Dr. Diana Castanon: 22:02

Yeah, so once you've done the big five, because you're out of your vitamin C, you're gonna get better photoprotection, you're gonna get a little bit of pigment lightening, you're gonna get some fine liner wrinkle reduction.

Val: 22:11

Because I heard that vitamin C actually helps sunscreen work better.

Dr. Diana Castanon: 22:15

Yes, it does. Eight or nine times better. Wow. In fact, if you just use a vitamin C every day on your skin and you forgot your sunscreen, you're two times less likely to burn just with your vitamin C alone. So that pack's a power punch. I recommend it not only to patients who are looking for anti-aging, I recommend it to patients who've had a history of skin cancers and precancers because it helps fight oxidative damage and it helps to photoprotect.

Val: 22:38

Wow. Okay. So if you're not using a vitamin C, if that alone should make you want to run out and get one.

Dr. Diana Castanon: 22:43

Yeah. Now, before people run out and get one, though, I do have to say there's a word of warning. The word of warning is that the type of vitamin C that you get matters for your skin. So for example, I am a big fan of skin suiticals products. Skin suitals have been making vitamin C for, you know, um teen years. Um, and they make a flagship product that everyone talks about. CE ferulic is kind of their cult classic, but CE ferrulic contains vitamin C and vitamin E, which is oil-based. And some patients, especially patients who are acne prone, can actually make their acne worse if they're using an E. So someone goes out, they're like, I've heard that vitamin C is important, and everybody talks about C. ferulic. I'm gonna go spend my $200 on this vial, and then all of a sudden their acne is worse. So I always tell people, um, just make sure the vitamin C that you're getting is a good one for your skin. And for those who can't, like, so I would just kind of ask your dermatologist, but for those who can't spend $200 on a vitamin C, again, knowing your ingredients and knowing your sourcing can be helpful. So I don't know if people, other people know this, but the company that makes La Roche Posey is the same company that owns skin physicals. It's L'Oreal. So they actually source their vitamin C from the same source. So La Roche Posey is over-the-counter vitamin C, which is pure C. There's nothing else in it. So it's not like C and E, like C ferulic. It's not like the fluoritin CF, which has fluoritin and ferrulic acid and other things in it. Those are kind of true cosmeceuticals that are kind of boosting the number of antioxidants to try to improve results. This one is just pure C, but it's good C and it's only 40 bucks. So you can get it at CVS. So I always tell patients, listen, just because you can't spend $200 on a serum doesn't mean you don't need a vitamin C. If you can spend 40 bucks on a serum, that serum can last you two to three months, and it's really not that big of an ask.

Val: 24:39

I love that. This has been great learning, especially for me. I I had heard the sunscreen thing, but not all of the details that you gave us, which was really outstanding. Um is there anything else that you would have them add um, you know, outside of the big five?

Dr. Diana Castanon: 24:56

So um sometimes patients will notice that perimenopausal skin ages quicker in the sun, and so they'll get more redness and more pigmentation. That's me. I get lots more redness. So so we see a lot of that. And that's where I would say the next thing I would add, you can think of a couple of things. You can either think of like phytoestrogens, like using actually a topical estriole, um, can be helpful to kind of improve skin and balance out some of those hormonal changes.

Val: 25:23

Okay. That's the big thing that I had heard from um some of the women who work in skincare where they said they've started using their vaginal estrogen under their eyes to sort of be the thought is that you know, vaginal estrogen, you know, works on those thinning walls that you have. So why wouldn't it increase skin that's thinning under your eyes? Thoughts on that.

Dr. Diana Castanon: 25:48

Thoughts on that. I would actually advocate for keeping things that are formulated for a specific area in that area. So you can get formulated for skin, like facial skin, um, a compounded estriol that is not super expensive, usually kind of in the $40, $50 range. Um, and that actually is going to have um a base that is more appropriate for skin so that it will absorb nicely into the skin and it will feel elegant using it. And you don't have to worry about cross-contamination or anything of that sort. So I wouldn't necessarily be an advocate of putting a product that you're putting in the nether regions up by your eyes, but um I do think that there's some promise to using some topical estrogen.

Val: 26:30

Yeah. My I I feel like that's gonna be the next big thing that we're gonna start seeing in skincare.

Dr. Diana Castanon: 26:36

Well, I actually think now, certainly I think that there's a role for that. And I have patients who love it and have already asked for it and are using it, but I think the next big push is everybody's really interested in kind of holistic health. And there is a lot about gut health, plant-based eating, all the different things that that we're kind of looking more at, kind of doing things more all natural. There is an arm of the cosceutical industry that is looking at plant adaptogens. And plant adaptogens help the body to defend against stressors. And so there are things that are being formulated into creams that we would sometimes think that you would make a tea out of. Things like chamomile or turmeric or cocoa that are all being put into topicals and being studied to see what that does for skin. And so there are some products that are using plant-based ingredients like that to help with fine lines and wrinkles, skin tone, skin texture. And I actually swear by one. There's one front that I've been using for quite some time from Skin Better Science that's called Maestro. And Maestro is a product that I find that if I didn't like get enough sleep or I was under a lot of stress, I would be like, oh, my skin just looks terrible. I can like see the stress on my face or I can see the lack of sleep on my skin. But I would use Maestro and it seemed to like get my skin back into balance. Wow. And um, so it's a one of those products that I kind of swear by and use regularly. Well, they actually just upped the anid on it, and I don't even think it's released yet. They made a new product called Maestro Revive, which is actually targeting um perimenopausal skin changes specifically. And I just got my hands on one, and I'll tell you it feels nice, but I haven't used it long enough to really make a claim on it. But I will say, I think it gets released later this month. It contains a lot of the hydrators that we recommend in moisturizers for aging skin. So things like hyaluronic acid. It contains a little bit of urea, which is a gentle exfoliant. It contains all of those plant-based adaptogens, and it's supposed to be something big for perimetopausal skincare.

Val: 28:44

Wow. Oh my goodness, I can't wait for that to come out. And and you make a good point. You have to use these skincare products for a little bit of time before you see the difference.

Dr. Diana Castanon: 28:57

Well, patients always ask me, when can I expect to see a difference? And I do say good products should make a difference quickly. So if you say I've been using this product for a year and no one said, What are you doing? It's probably not a great product. But if you've been using something for three or four months and you don't see a difference, you know, that you should see a difference with good skincare in three or four months. Um, so that's usually kind of the target that I tell people to kind of set for themselves. Um, so I do think it's important. However, three or four months to make a change, it won't sustain if you stop there. So you have to just kind of keep going. When patients ask me what what skin really needs to be revived, it's really not a miracle, it's a commitment.

Val: 29:39

One more thing red light therapy, your thoughts on that for improving your skin and your collagen. Val, do you remember we actually did a segment on red light therapy way back when? And I have like kind of become obsessed with it ever since.

Dr. Diana Castanon: 29:54

So honestly, so way back when we did that segment um about red light therapy, and I was like, you know. The science is compelling. We're gonna have to see where this goes. There seems to be in the past 10 years that this has been um, you know, out and about that there's really no deleterious effects from red light. And there are some benefits. There are benefits in wound healing, there are benefits in collagen elastin and skin support. There are benefits in pain. I mean, people are using it for joints, people are using it for skin. There's tons of things that red light seems to be able to do without a lot of the harmful long-term side effects um coming coming out as red flags. So I don't know. I I still give it a thumbs up. I said back then that I thought it was promising. I still think it's promising and I think it's um a good thing to try.

Val: 30:42

So if somebody wants to put one of those face masks on their Christmas list.

Dr. Diana Castanon: 30:46

Oh, do it for sure. Oh my gosh, my colleagues in dermatology, several of them, will post pictures of themselves using their red light face masks. I haven't quite gotten into that myself, um, but I but I do think it's promising science and a lot of people swear by it. Love it.

Val: 31:00

This has been a great conversation, Deanna. I really appreciate you stopping by, talking all the things, perimenopause and postmenopausal skin. Um, lots of women struggling. You just want to look your best as you're going through these transition years. You know, you don't you can't chase 20 years old anymore, but you do want to be able to look really good when you're going through all of this. So I appreciate the advice.

Dr. Diana Castanon: 31:22

Well, it's my pleasure.

Val: 31:24

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