December 2024: Navigating Skin Changes

We are two doctors who are curious about aging. Our monthly newsletter embraces conversations about aging from many different perspectives—medical, psychological, societal and even personal.

You can read our November edition?here.?

This month's newsletter pays homage to the almighty wrinkle! Dr. Vogler and Dr. Baumgaertel approach their writing from different perspectives that blend nicely together.

Susan V:

Wrinkles: A visible tribute to a lifetime filled with laughter

From an early age, society bombards us with messages that equate youth with beauty and vitality. Media portrayals often emphasize smooth skin as the ideal, creating an implicit belief that aging is something to avoid. The cosmetic industry generates billions of dollars annually, primarily serving as a platform for smoothing skin, hiding blemishes, lifting cheeks, and brightening the eyes. This perspective fosters a negative view of aging skin and wrinkles, relegating them to symbols of decline and lack of beauty rather than markers of a life well-lived.

Menopause officially starts one year after the last menstrual cycle and can lead to changes in the hair and skin. As estrogen levels decrease, the skin loses collagen, becoming thinner, drier, and more sensitive. Many women experience increased facial hair while noticing reduced hair on their scalp. The decline in collagen happens rapidly during the first few years of the menopausal transition and continues at a slower rate. As the skin loses its firmness, it starts to sag, and skin changes become more visible. Permanent lines develop from the nose to the corners of the mouth, and the wrinkles that appeared only when smiling or frowning are now visible all the time.?

While wrinkles can represent the wisdom and happiness accumulated over the years, they also evoke complex feelings about aging. Many individuals grapple with the fear of losing their youthful appearance and the societal validation that comes with it. And, despite these negative connotations, there is a growing movement advocating for the acceptance of aging and the beauty of imperfections. Many are beginning to celebrate wrinkles as badges of honor—each line telling a story, and each crease a reminder of laughter shared, and challenges overcome. This shift encourages re-evaluating beauty standards, promoting a more inclusive understanding of what it means to age gracefully.

As mentioned in previous newsletters, the 'Wiser Than Me' podcast, hosted by Julia Louis-Dreyfus, is one of my favorites. I recently listened to the November 20, 2024 episode featuring Isabella Rossellini. In the 1980s, Ms. Rossellini served as the face of Lanc?me Cosmetics for over a decade until her contract was not renewed in her early 40s. Years later, the company reached out to her again when a new female CEO, who embraced beauty at every stage of life, took the helm. Ms. Rossellini was rehired to help launch a new product line for women in their 60s. If you haven't had a chance to listen, I highly recommend it!

Susan B:

Just because we have earned every wrinkle doesn’t mean we have to like them!

The list of skin and hair changes as we age seems expansive: acne, rosacea, pigment changes, thinning skin, dry skin, wrinkles, delayed wound healing, scaly lumps and bumps, hair loss, coarser hair, finer hair, and my personal favorite, hair where you don’t want it and no hair where you want it. Can these changes be attributed to aging or menopause or both? The answer is both. Menopause can throw a wrench into our daily skin care routine, but there are ways to combat this aging process and regain control.

Here are 10 tips for better skin at any age, especially in perimenopause:

1. Sun protection: You can’t wish away that horrible sunburn you had on spring break during college, but you can use sunscreen and sun-protective clothing now that you are aware of the importance of protecting your skin from UV light. Reducing lifetime sun exposure will reduce skin cancer risk, as well as reduce general skin damage. Be sure to take extra precautions around reflective light, such as water or snow.
2. Hydration: Topical hydration is important for skin to stay supple and reduce tiny cracks that can lead to damage and infection. When it comes to emollients, creams are better than lotions. Staying away from perfumed products is best for sensitive skin. Oral hydration is also key, although the myth that you have to drink eight glasses of water daily is just that—a myth. Aim for drinking as much water as you desire.
3. Smoking cessation: Beyond the myriad other problems that smoking causes, it also ages the skin and adds to increased wrinkles and skin damage. Healing of damaged and infected skin is also hampered.
4. Nutrition: Consuming healthy fats and oils is also good for the skin—think omega-3 fatty acids (black cod, salmon, tuna), avocados, flaxseed, soybeans, almonds, and the like. Note: Avocado oil has a high smoke point, so is also good for stir-frying and grilling.
5. Vitamins and minerals: Many fruits and veggies are full of antioxidants and vitamins A, E, C, and other vitamins and minerals that help break down free radicals and reduce cell damage. “Eat the rainbow” to reduce aging effects on skin!
6. Sleep: Restorative sleep is essential to good health in many ways, especially for skin healing and regeneration.
7. Alcohol moderation: Regular and/or heavy alcohol use is bad for skin integrity and appearance, especially over time. Microvascular damage can contribute to broken veins and other visually undesirable skin features. Easy bruising can also occur, along with delayed healing.
8. Exercise: Increased cardiovascular movement improved oxygenation of all body tissues, including skin. Maintaining integrity of surrounding muscle and tissue layers also supports optimal skin suppleness.
9. Stress management: It should almost go without saying that stress reduction and improved responses to stress will go a long way to improve so many bodily functions. Skin is the largest organ that we have, so we need to take good care of it so that, in return, it protects us and helps maintain healthy body systems.
10. Skin cancer screening: Seeing your physician or dermatologist annually is important for those with a personal or family history of skin cancer (especially melanoma), history of sunburn, hundreds of freckles, extremely fair skin, and—well, anyone with skin!

(The above is an excerpt from The Menopause Menu, chapter 12, Skin & Hair Changes)

??? Our January edition will focus on nutritious eating.

???? The 2 Susans would love to hear from you!

Let us know the aging topics YOU are curious about. Please also share this newsletter in your network and tag us—we are so grateful.

Susan B: [email protected]

LinkedIn, myMDadvocate, MenopauseMenu, The Menopause Menu book

Susan V: [email protected]

LinkedIn, Vogler Medical

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The 2 Susans newsletter is for informational purposes only. It does not represent medical advice and is not intended as a substitute for professional advice, diagnosis, or treatment. Always consult with your private physician.