MENOPAUSE AND YOUR SKIN 101

MENOPAUSE

Menopause can take a toll on us.  The hormonal shifts have both emotional and physical effects.  Some of it is out of our control, but a lot of it can be managed.

As our estrogen levels drop we notice changes such as hot flashes, changes in our skin and hair, difficulty sleeping, fatigue, irritability and decreased sex drive.  (to name just a few)  As an aesthetic nurse I am frequently asked what can be done to help with some of the skin changes.

Obviously, it goes without saying, that having a healthcare provider to help you manage the medical aspects of “the change” is in your best interest.  HRT (hormone replacement therapy) is a viable option for many of us, but not everyone.  Some individuals may have contraindications for HRT.  If it is an option, estrogen replacement can help alleviate many of the symptoms of menopause.  Each individual has to look at their own medical history and determine what is the best approach for them.

ESTROGEN AND OUR SKIN

As our ovarian function declines,  we lose estrogen production.  A side effect of this is the loss of collagen.  Estrogen helps the body with the production of Collagen I and III.  Additionally, estrogen supports oil gland activity, elastin and subcutaneous fat.  We notice this as we discover our skin thinning, new wrinkles, sagging, dry skin and less volume.  We can provide support to our skin as it experiences menopause related changes.  Here are a few ideas….

  • Eat a healthy diet full of antioxidants. (eat lots of colors!)
  • Try to incorporate soy into your diet.  The isoflavonoids in soy mimic estrogen.
  • Drink plenty of water/stay hydrated.
  • Try to sleep 8 hours a night.  (easier said than done, I know)
  • Wear sunscreen every day, rain or shine!  UV rays break down our collagen.
  • Use a topical antioxidant prior to your sunscreen every day.
  • Utilize a retinol/retinoid (Vit A) product topically at night.  Studies show this helps stimulate new collagen.
  • Utilize peptides in your skin care.  It is proven that various peptides help support the production of collagen and elastin.
  • Use a gentle non-stripping cleanser.
  • Exfoliate your skin.  A physical exfoliant or lighter chemical peel exfoliant.
  • Look for hyaluronic acid in your skin care.
  • Utilize fillers/fat transfers to replace lost volume.
  • If dryness is an issue, make sure your moisturizer is replacing enough moisture so your skin feels comfortable.

There are other issues I hear complaints of related to menopause.  Facial hair growth is a common complaint.  (as estrogen levels drop and our androgen hormones become more dominant)  If there is pigment in the facial hair, laser hair removal is a fantastic option.  If the hair is light or has no pigment, electrolysis is a better option.  There are  also prescription creams that can decrease facial hair growth.

Acne can be a problem that resurfaces at this point.  Again, due to the dominance of androgen hormones our skin can have thicker sebum production.  Retinoids/retinols can be helpful.  For more serious issues your health care provider can help you decide if Spironolactone (a prescription) is an option for you.  The Spironolactone helps suppress the androgen hormones, helping both with hair growth and acne.

Estrogen also helps control our melanocytes.  As we lose the estrogen, hyperpigmentation can become more of a problem.  So, this brings us back to sunscreen and topical antioxidants to protect from UVA/UVB.

For those wanting to go the extra steps to help with collagen production and repair prior damage, there are numerous laser modalities available that make a considerable improvement and difference.  I am currently a fan of  HALO™, IPL’s and Ultherapy®.

I read that we spend 1/3 of our lives in menopause based on the average life expectancy in the developed world.  We can make it feel good and look good ladies!

I’ll finish with a current list of favorites.

SUNSCREENS

The entire line of Elta MD® sunscreens are excellent sunscreen options.

c-e-ferulic

The Skinceuticals line has excellent antioxidants.  Both CE Ferulic® (for drier skin) and Phloretin CF® are great options.

alastin retinol

Alastin® Retinol at night is effective, yet gentle.

Alastin Restorative Skin

The Alastin® Restorative Skin Complex has numerous peptides and antioxidants.  This stimulates collagen and elastin.

Both SkinMedica® and SkinCeuticals offer hyaluronic acid products that effectively boost hyaluronic acid in the skin.

triple lipid restore

SkinCeuticals Triple Lipid Restore is an excellent hydrating cream for those with drier skin.

All of the mentioned products are available at TOC Medical Spa.

We have a sale this month too!

10% off one product

15% off two products

20% off three products

Hope this is a little informative 🙂

 

 

 

 

DECADES

aging face

Our skin care needs change as we age and it is easy to be overwhelmed by all of the choices out there.  This is a quick guide through the decades.

THE 20’s

In our twenties we are generally enjoying the glow of our youth.  This is a time when we frequently take for granted our smooth and plump skin.  This can be a time when we do a lot of the damage we regret years later.  This is a good time to be committed to a supportive skin care regime.

  • Sunscreen is a no brainer.  Ideally with zinc or titanium to assure long lasting, broad spectrum protection.
  • A topical antioxidant to ward off additional UV and free radical damage. (Vitamin C for example)
  • A retinol or low dose retinoid to keep those skin cells turning over and to help manage occasional breakouts.
  • This is the time to introduce an eye cream.  Remember, an ounce of prevention is worth a pound of cure.  You will thank yourself later in life.
  • For spot treatment of blemishes a product with salicylic acid or benzoyl peroxide can be applied.  More is not better because you may replace your blemish with a dried scab which can then hyper pigment.
  • By now you have probably made the correlation with diet and skin and are aware that a healthy, well balanced diet helps all of your organs, including your skin. (in addition to not smoking!)

THE 30’s

Throughout our thirties we start to see subtle changes from exposure and repetitive muscle movement.  In addition to a supportive skin care regime we might consider extra steps to help during this decade.  We are producing less collagen and elastin by now and are starting to notice.

  • Botox® can be introduced to manage lines from repetitive movement. (frown lines, crow’s feet, etc)
  • Chemical peels can help to lift the outer layers of the skin diminishing pigmentation and fine lines and wrinkles. Collagen is stimulated in this process.
  • IPL’s can minimize pigmentation and redness in the skin.
  • Some patients opt to introduce small amounts of filler in their thirties where they are seeing changes related to volume loss.

THE 40’s

As we begin to experience shifts hormonally and as our estrogen levels drop we lose even more collagen, elastin and facial fat.  Our bones are also shrinking under all of that creating more changes we may not love.  Our sebaceous glands are producing less sebum and dry skin may become more of a concern.

  • Continuing with a skin care regime involving sunscreen, antioxidants and a retinol/retinoid is a must.  You may opt to increase the strength of the retinol/retinoid.
  • Additional moisture is frequently needed.  Look for products with ceramides, for instance.
  • Facial volume loss can be managed with an expanding menu of dermal fillers.
  • Botox® can be used to help “lift” when your injector relaxes the muscles pulling down (depressor muscles) allowing the elevator muscles to lift unopposed.
  • IPL’s and more aggressive lasers (fractionated erbium and CO2 for example) can be utilized to manage skin discoloration and texture changes.  Collagen stimulating treatments, like Ultherapy®, can be used to help combat the loss of collagen.
  • Neck, chest and hands can benefit from all of the above!

THE 50’s , 60’s, 70’s and 80’s (and beyond)

In our fifties  we are likely approaching menopause and are continuing to see age related changes.  As we continue in to our sixties and beyond this becomes more of an issue as post-menopausal skin experiences more age related changes without the support of estrogen.   We probably need to boost our moisture as our skin becomes drier.

  • Continue with the three pillars in skin care: sunscreen, antioxidants and retinol/retinoid.
  • Some find it helpful to cut back on the % of their retinol/retinoid to combat  dryness.
  • Increase moisture as needed.
  • Continue to see your provider to determine if Botox®, filler and various laser modalities can help obtain your aesthetic goals.
  • If surgery is appropriate, find a surgeon you trust and have vetted.

 

 

 

 

NOT JUST YOUR FACE

We make a considerable effort to protect and care for the skin on our faces but can neglect the skin on our neck, décolleté and hands.  As we officially enter in to these summer months, I wanted to remind everyone to also pay attention to other commonly exposed areas.

Sun screen and antioxidants are the best defense.  Avoiding the high sun hours between 10-2 or even 10-4 is helpful. (although tough to accomplish if you love the outdoors!)

But what if there already is damage?  What can be done?

Pretty much anything that can be done to the face can also be done off face.

hands

chest # 1

IPL (Intense Pulsed Light) is very effective at removing sun spots (hyperpigmentation).  The hands and chest are commonly treated with this modality.  The pigment will return if the area is not protected from the sun though, so invest in a sunscreen with zinc!  Additionally, consider protective clothing if your will be out during hours of the day when the sun is intense.

For those fellas out there (or even women with very thin hair) make sure to protect your scalp as well.  Since I am adding to the list, let me also include ears!  This is not only about hyperpigmentation, skin cancer commonly occurs in all of these areas!

Enjoy these warm summer days!  Safely!

 

SKIN CANCER AWARENESS MONTH

SUNSCREENSMay is Skin Cancer awareness month, so I thought I would do a quick blog on sun protection and skin care in regards to sun exposure.

Approximately 1 in 5 Americans will have some type of skin cancer in their lifetime.  Skin cancers are the most common type of cancer in the United States of America.  Protection from damaging UVA/UVB rays can help improve ones odds significantly.

Some basic tips include avoiding sun exposure between 10-4, wearing broad spectrum sunscreen, wearing protective sunglasses, wearing broad rimmed hats and seeking shade whenever possible.  But when you find yourself in the sun, your choice of sunscreen protection is important.

When purchasing sunscreen look for broad spectrum, meaning, protects against UVA and UVB radiation.   Broadly, UVB rays burn our skin and UVA rays go deeper and damage the skins structure. Both increase cancer risk.  Both contribute to premature aging of the skin.

In the sunscreen market there are chemical sunscreens that are referred to as absorbers.  They absorb the UV rays and convert them to heat.  There are a long list of these chemical agents and some cover either UVA, UVB and some absorb  both.  There are approximately 20 FDA approved agents.  These chemical agents have a maximum amount of absorption and then loose their effectiveness unless reapplied.  Physical agents, such as zinc dioxide and titanium dioxide, reflect the UVA/UVB rays.  I always discourage patients from focusing too much on the SPF factor because an SPF of 15 filters 93% of the UV rays while SPF of 30 filters 97%.  Going to an SPF of 50, 70, 80 or 100 does not significantly improve your protection factor.  Reapplying, however, does.

I am a big fan of physical agents as they are the least likely to cause irritation, work immediately upon application and offer broad spectrum UVA/UVB protection.  When applying make sure not to miss the eye area, ears, backs of legs, feet, lips, and if you are bald or have thinning hair, the scalp.  Sunscreens with zinc and titanium are not the thick greasy kind we remember from our childhood.  They are now micronized and have a cosmetically elegant feel.  Do not under utilize your sunscreen.  When applying to your whole body you should use several tablespoons of sunscreen.

There are increasingly sunscreen garments that can add protection.  Rash guards are increasingly popular and fashionable.  When purchasing sun protection wear make sure it has a UVP rating on the label.  Do not rely solely on this as a means to protect your skin.

Finally, I wanted to review protecting eyes.  Repeated and cumulative UVB/UVA exposure to the eyes can contribute to cataracts and macular degeneration.  Eyelids (upper and lower) are one of the most common sites for non melanoma skin cancers.  The lower lids are more effected than the upper lids.  Sunscreen and sunglasses with UVA/UVB protection are vital.  Skin cancers on the eyelids do not always present the same way as elsewhere on the face.  These types of cancers tend to infiltrate and can effect ocular structures, thus putting site at risk.  Those with light colored eyes and skin are more at risk.   Ideally your eyelid skin is evaluated by your dermatologist yearly.

That brings me to the importance of yearly skin checks.   A yearly skin check should be part of your routine medical evaluation.  Depending on your risk factors a physician may determine if this should be done more or less frequently.  There are also physicians who will skin map you if you are at higher risk.  (take photos to reference back to,  helping to  evaluate changes over time)  I had mine mapped as I am a fair red head who spent part of her childhood in the South Pacific with year round sun exposure and am covered in acquired nevus (brown skin lesions/freckles).   If you feel you have too many spots to keep track of skin mapping may be a good option.

I am a huge fan of the Elta MD® line of sunscreens (thus the photo) and encourage everyone to find their favorite sunscreen.  If you love it you will use it!

Happy Memorial Day weekend!  Protect yourself while having fun out there  🙂

DO YOU STRUGGLE WITH REDNESS?

flushing

Redness, or flushing, is a common skin complaint.  The two skin tone issues that I hear the most complaints about are hyperpigmentation (dark spots) and redness.

Redness is the result of superficial blood vessels dilating.  It can be a minor problem that remits and exacerbates, or it can become more and more of an issue over time.  Over time the small vessels can dilate and appear larger and more numerous.  The cheeks, nasal area and chin are common sites of this redness, although it can occur anywhere.

Culprits that contribute to redness include sun exposure, temperature extremes (cold and hot), consumption of alcohol and/or spicy foods.  Of course, there is a genetic component to facial flushing as well.

What to do to prevent or improve it?  For starters, use a good sunscreen, preferably with zinc (7-10%). Adding a quality sunscreen to your routine every day will protect your skin, and the blood vessels in it, from UVA/UVB rays   A topical antioxidant, along with the sunscreen will give you further UVA/UVB protection as well as strengthen the capillary walls.  Find a  product with niacinamide, as this has been proven to help.  Other ingredients that may help include licorice, chamomile and feverfew.

Products I frequently recommend include:

  • SkinCeuticals® Metacell Renewal B3 (niacinamide)
  • Alastin Skin Nectar™
  • Sunscreen, such as Elta MD® SPF 46 (has 5% niacinamide!)
  • Antioxidants such as SkinCeuticals CE Ferulic® or Phloretin CF®
  • ALL of these products are available at TOC Medical Spa

anti-redness-products

Obviously avoiding triggers such as hot/cold temperature fluctuations, spicy foods and alcohol can help.

If the vessels are broken, or noticeably enlarged, you need to remove them.   Lasers are your best option.  Pulse dyed lasers, such as the V-Beam, are meant for this specific purpose.  Yag and IPL devices are also helpful.  Your skin care provider can help you choose your most appropriate treatment plan.

There is a condition called Rosacea that can make your skin red and angry appearing and seeking the expert care of a dermatologist is recommended.  Rosacea can be treated with a combination of topical and oral medications.

HAPPY NEW YEAR

NYE

This is the time of year when we tend to consider new beginnings and come up with resolutions for the upcoming year.   If you’re feeling like you look tired and could use a pick-me-up, consider revisiting your skin care routine, and consider aesthetic treatments to compliment your appearance.

Here are a few suggestions to consider:

  • Make sure you are using a sunscreen with zinc or titanium EVERY DAY.  (Love Elta MD® SPF 40 Daily for normal/dry skin and Elta MD® SPF 36 Clear for normal/dry skin: both contain 9% zinc)
  • Incorporate an antioxidant on a daily basis as there is unequivocal  evidence that our skin benefits from this. (SkinCeuticals® CE Ferulic® is great for normal/dry skin, while SkinCeuticals Phloretin CF® is a good choice for normal/oily skin)
  • Add a Retinol or Retinoid to your routine because, again, there is unequivocal  evidence that it benefits our skin. (love Neocutis® Nouvelle+ which also contains a skin brightening complex)
  • If you are really noticing the effects of aging on your skin add a growth factor and use if for a full 3 months before you decide if you love it or hate it.  I recommend Neocutis Bioserum® or SkinMedica TNS Essential Serum®.
  • Drink plenty of water or uncaffeinated beverages every day as our skin thrives with hydration.  (try for an 8 oz serving every hour or every other hour)
  • Consider renewing your skin and thinning the stratum corneum (the non-living layer of cells on the surface)  which will brighten your complexion and fade hyperpigmentation.  (a series of peels such as the VI Peel®)

Most of us (at least based on my informal survey of those I know) have resolutions regarding our weight and diet  (year after year after year).  Be encouraged that eating well and incorporating the “good fats” and omegas in to our diet also has skin benefits.  Food is medicine, and our skin usually gives away whether we are feeding it with a healthy diet as opposed to a lot of junk food which increases inflammation and can ultimately break down collagen and elastin.

I hope 2016 is everything you want it to be and that you are successful with your resolutions!  Cheers!  Celebrate safely!

As always, the mentioned products are available at TOC Medical Spa 🙂