Menopause Skin Changes and the Science of Skincare

Erica Kelly (0:00)

All these women in their 40s and 50s come in that were like, my skin just suddenly changed overnight. Sudden dryness, sensitivity, loss of elasticity, and sagging, and it's all happening at once. Losing the 30% collagen in those first five years after menopause, it happens to everyone. You know, I see just as many men. I like to explain it to my patients, your face has gotten too small for your skin.

Mary Claire Haver (0:22)

You lose fat where you want it, you gain it where you don't want it. What does the research actually show about hormone therapy and skin aging?

Erica Kelly (0:30)

If I have a woman who is in their 70s, 80s, 90s, her skin looks really good for her age, I always ask and usually discover that she was placed on hormones.

Mary Claire Haver (0:39)

Is it ever too late to start protecting your skin?

Erica Kelly (0:42)

Um, hmm.

Mary Claire Haver (0:52)

The views and opinions expressed on unPAUSED are those of the talent and guests alone, and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis or treatment.

My guest today is someone that is both my friend and my colleague at the University of Texas Medical Branch, and she's a big part of the reason I understand my own skin. Dr. Erica Kelly was the first physician who ever told me about what was happening to my skin in midlife. The thinning, the loss of that bounce, was tied to losing estrogen and the collagen that goes with it. No one had connected those dots for me before. That conversation changed how I saw everything. Dr. Kelly is a board certified dermatologist and the founder and director of UTMB's Cosmetic Dermatology Division, which she built from the ground up. She sees thousands of women a year and trains the dermatologist who come after her. Texas Monthly Magazine has named her a super doctor five years running, and through all of it, her philosophy has stayed the same. Natural results built around what each individual woman actually wants.

Today, Erica and I are going to dig into what's real and what's nonsense when it comes to your skin in midlife. The science no one to explain and the treatments and products worth your time. From a doctor who sees this every single day. I'm Dr. Mary Claire Haver, a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics and gynecology at the University of Texas Medical Branch. Welcome to unPAUSED, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life. Because there were so much to cover with Dr. Erica Kelly, we have broken this episode into two parts. This is part one and we will publish part two later this week.

So Dr. Erica Kelly, welcome to unPAUSED.

Erica Kelly (2:59)

Thank you. I'm so happy to be here.

Mary Claire Haver (3:01)

So you were, I remember this conversation we had. You were talking about papers, something you've been to a conference and talking about the 30% loss of collagen in our skin in the first five years of menopause. And that there was some reasonable data looking at putting topical estrogen on skin and maybe it could slow down some of that loss. But like I had never heard that in my life, you know, and me being the menopause expert.

How did you really understand this connection between hormones and skin, was this new or was that taught to you through your training?

Erica Kelly (3:33)

So honestly, I think that I really learned that from my patients. You know, we talked a lot about the hormone skin connection in training. But mostly through the lens of acne and, you know, melasma and androgenetic alopecia.

And you know, that paper that came out, that came out in 2012 So that really wasn't known yet when I was in training. But I kept having all these women in their 40s and 50s come in that were like, my skin just suddenly changed overnight. So I feel like I mostly started to learn that from my patients.

Mary Claire Haver (4:05)

So what were those patients typically complaining of when they come in?

Erica Kelly (4:09)

You know, not what, not just, oh, wrinkles, but their sudden, the sudden dryness and sensitivity and loss of elasticity and sagging, maybe, you know, acne, and it's all happening at once.

Mary Claire Haver (4:22)

So how did you counsel them?

Erica Kelly (4:24)

Well, you know, in general, most people don't make that connection, you know, at that age. You're not really thinking necessarily about menopause yet when you're 40 And to be clear, there, you know, cutaneous aging is multifactorial. I mean, you know, there's— That's skin aging to the lay population. Skin aging and many factors. So basically, there's chronologic, just how long you've been alive. We have hormonal factors, which I'm sure we'll get into extensively. There are genetic factors, which probably the most important of which would be skin tone and the amount of melanin you have. And then there's environmental factors. And honestly, I have to say, what I notice the most all day, every day, and, you know, on skin checks and exams with patients is much more the power of the sun. When you look at the difference between sun-exposed skin and non-sun-exposed skin, like my patients will come in and say, you know, gosh, I'm getting so old and they pointed their forearms. And one of my favorite things to do is to place their forearm next to the abdomen skin and say, they're the same age because it is shocking how different it looks. And that always is quite eye-opening for them.