The ONLY 3 Skincare Steps You Need Over 50 (Derm Approved)

Is a 7-step skincare routine doing more harm than good for your midlife skin?

In this episode, I sit down with Dr. Angela Casey, a double board-certified dermatologist and skin cancer surgeon, to strip back the noise and bring you the science-backed truth about caring for your skin during perimenopause, menopause, and beyond.

We dive deep into what actually changes at the cellular level (yes, those hormonal shifts are real!), why your “holy grail” products suddenly start to betray you, and what a truly simple, effective routine looks like for radiant, resilient skin. From viral trends like salmon sperm and red light masks, to why your dermatologist should be your new BFF before booking lasers, nothing is off the table.

What You’ll Learn

1. The Real Reason Your Skin Changes in Midlife

How hormonal shifts, including declining estrogen and progesterone, make your skin more sensitive, reactive, and prone to irritation.

2. The 3 Non-Negotiable Steps for Healthier Skin Over 50

Why mineral-based sunscreen (with zinc or titanium dioxide), a retinoid or retinol, and an antioxidant serum (like vitamin C) are all you truly need.

3. Why Less Is More (And When Skincare Trends Backfire)

The science behind keeping your regimen simple, and how piling on products can break down your skin barrier and fuel inflammation.

4. Navigating Cosmetic Procedures Safely

The most important step before booking lasers, peels, or injectables and why starting with a dermatologist can save your skin and your health.

5. What’s Hype, What’s Helpful? Dr. Casey Breaks Down the Trends

Her honest take on viral ingredients like salmon sperm (PDRN), snail mucin, red light masks, and whether facial yoga actually helps or harms aging skin. 

Music:  

Title: Relax by SyncLabMusic 

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Transcript

0:00

Can I ask you sort of a personal question? Has your skincare routine turned into a seven-step science experiment? And if so, what if that's exactly why your skin is freaking out? Today, I'm sitting down with Dr. Angela Casey, a double board-certified dermatologic, Mohs surgeon, and mom of three teens, tweens, girls who truly gets what's happening to our skin in midlife. We're talking about what changes at the cellular level in perimenopause and menopause. Why products that we use used to be our "holy grail" can suddenly irritate you, and the simple routine that actually works without launching a nuclear bomb on your face. And yes, I asked her about the viral stuff too, gua sha, salmon skincare, red light mask, and whether any of it is worth the money. Plus, the one thing you should do before you ever book a laser or cosmetic procedure. Alright, let's get into it. Dr. Angela Casey, welcome to Create The Best Me. This is an honor, a privilege. I'm so excited about having you on the show. Thank you so much for the invitation, Carmen. It is truly an honor to be here. So before we get into today's exciting must have conversation, could you please tell the listeners and viewers a little bit about, who Dr. Casey is, what she does, and what else she does. Absolutely. I am a double board-certified dermatologist and micrographic dermatologic surgeon based in Columbus, Ohio, where I've practiced for almost 20 years now. I'm also the mother of three teen and tween daughters and a wife. And it's really the intersection of those two worlds of practicing skin cancer surgery and being a mom of three teens and tweens. That was the inspiration behind Bright Girl, which is my other role as the founder of Bright Girl Skincare, which is dermatologist created clean, pH- balanced, and clinically proven skincare for teens and tweens. And most importantly, because I think you and I are real close, maybe around the same age in the fifties generation. When I grew up and I ran cross country in high school and in junior high. I was out in the sun. I grew up in California, central Valley. When school started up, I was darker than dark because I did not wear sunscreen. And no one wore sunscreen around that time, during that generation. Right. It's so true. Funny enough, I was also a cross-country runner in high school. We were actually state champions my senior year. I loved it. Much like you, Carmen, and I grew up in Kentucky where the sun is not quite as strong year-round as it is in California. But, the danger with where I grew up and any of your listeners who are in cooler climates is that our skin goes through this constant, doesn't see the sun for many months, and then it's kind of shocked when the sun comes out and it warms up in the spring and summer months. So, sometimes individuals in climate such as that are a little bit more prone to sunburns. Which is extremely damaging to the skin and more damaging compared to kind of a chronic, low-grade sun exposure. But much like you, I'm a child of the eighties and nineties, and we grew up in a generation where tanning beds were all the rage. The darker, the better, even for those of us with fair skin. And if any of your viewers are watching this on video, they'll see I have very fair skin, and it's not the type of skin that likes to tan, but I tried to tan it. You have beautiful skin that has a nice, a little bit more olive tone and beautiful skin that I'm sure tans beautifully, not like mine, that burns. But all of those mistakes that we made in our younger years because we simply didn't know any better. Mm-hmm. Very true. And actually my skin changed, I used to tan. I don't tan anymore. And I would say it probably happened during perimenopause. That's when I noticed a big difference in my skin. I burn, I blister. Can you as a double-board certified dermatologist explain what happens on the cellular level, what happens to our skin once we approach perimenopause and into menopause? Yeah, hormones have a tremendous impact on our skin. And it's one of the reasons that we see so many changes in our skin during the teen and tween years, adolescent years when individuals are going through puberty. As women, we see it again often during pregnancy, and it can really skew either way during those times. Some women, when they're pregnant, have beautiful, glowing, radiant skin. Others have very stressed, inflamed, acne-prone skin. And that happens again in menopause, just as those hormone balances are shifting and our estrogen and progesterone levels specifically in the perimenopause and menopause years continue to decline until we hit menopause. And then they take a sharper decline. And then our testosterone levels which are higher in us actually throughout our lives compared to estrogen and progesterone. But then that testosterone, estrogen balance becomes a little bit more skewed. So, the impact of that on our skin is that our skin is often more sensitive. It's more prone to irritation from external factors like ultraviolet radiation. And, in some cases, some of us might notice more inflammation. Some of us might have acne breakouts; all of that is tied into these changes as our skin is trying to catch up to these hormonal changes that are happening at a deeper level. And another thing I noticed is that products that I use like body wash, shampoo, makeup, or just, you know, just creams and stuff that I apply on my face or even sunscreen. My skin started reacting to all these different chemicals. When before, these were my staple products. We start to lose that buffer, so to speak, that we had for so many decades. And it happens not just on our skin level, but it happens within our metabolism, foods that we can tolerate. Even our mood, right? Things that used to not bother us and we kind of handled it and just went with the flow of things. We reached those perimenopause and menopause years and we realized we have a little bit of a shorter fuse, a little bit less tolerance for things that used to not bother us. We're probably noticing some different responses with certain dietary things or maybe more sensitive to foods we ingest. But likewise our skin, which may have previously been able to handle lots of different ingredients, maybe really was kind of immune to fragrances and certain ingredients, certain actives all of a sudden is saying, hold on a second, like, I'm not so sure I like this. This is bothering me a little bit more. Now I'm gonna get red and inflamed and sensitive, and then it kind of starts a cycle from there. So it's very much a physiologic response. It does not happen in everyone, much. Like hormones in general affect all of us differently. Some people have a very strong sensitivity and maybe their whole life they've struggled with their cycles and really feeling different. Others kind of just take it all in stride. Menopause is the same way. Some of us might just sail through it and others really, really, it's a very bumpy road. But, with our skin health, we definitely see those same variations: where some individuals just kind of gradually travel through that journey and really don't have issues, whereas others really start to know some significant changes in their skin. Mm. Mm-hmm. I am a strong believer. I didn't believe in this before, but I would say menopause kind of changed my way of thinking. I strongly believe, and you can tell me whether this is true or not, that just like we have our GP, just like we have our OB-GYN, we should all have a dermatologist. And we should all get seen by a dermatologist before we do anything. Laser, injections, whatnot. That's what I believe. Tell me if that's right or wrong. Dermatologists are definitely the leading expert in those procedures that you mentioned. And we are the ones who have four to five years of clinical training before we're going out into the world and practicing those procedures. And then we're continuing to learn through continuing medical education. Individuals that might work in a medi spa or another general clinic; not to say that they can't be good. Because anybody can, if they have the proper training and put in enough time and investment in learning it. But dermatologists are really the specialists that have paved the way in those fields. They are typically the ones performing the large majority of research and clinical trials as new products and new procedures come to the forefront and come out into clinical practice. And I can tell you from my own perspective as a dermatologist who does all of those procedures, I'm the one who sees complications from patients that initially seek treatment elsewhere. So if nothing else, I strongly recommend for your audience: if you're thinking about having a skin treatment procedure, at least go and see a dermatologist to talk through things, get a baseline idea. And also most importantly, to make sure that your skin is healthy to start, that you don't have the start of a pre-cancer or skin cancer, or some other condition before you go get a laser, which can then exacerbate it or hide it, or worsen symptoms. Mm-hmm. I know something that's very common for, at least I noticed it in myself, so I say it's common in women and midlife is that we start to get like spots on our face. And if we were someone who had flawless skin and all of a sudden we have these, sunspots or melasma, whatever. Our first thing is, I want my skin back and so we might try vitamin C or other type of products that's not working, so then we want laser to erase it. I absolutely hear what you're saying. It's a couple of important points that you just brought up. Sun damage is cumulative throughout our lives. So it starts from the time we're children and we're out playing outdoors, and we're at the pool, and we're playing sports with our friends, through our teen years where we're doing those same things. We're going on vacations, et cetera. We may not notice the ramifications of that sun damage in our twenties and thirties, even though it's happening. It's happening at the cellular level, it's happening at the level of the DNA. That damage is continuing to occur. To a certain extent, our skin has an innate ability to repair that damage, which is quite remarkable. It can have a sunburn, it can have an injury, and the DNA can kind of fix itself to a certain extent. Not a hundred percent, but maybe 98– 99%. As we get older, that ability to repair the skin, damage the DNA damage lessens over time. And that's one of the reasons why we start to see that damage from years ago coming up. But then also any new sun exposures, or skin irritations, or skin damage, our skin does not bounce back quite as easily. So it often seems to us like, oh, we've been going along fine, then all of a sudden we're noticing this mottled pigmentation. There's a dullness to our skin. Our skin's looking more lax. Hormones are also playing a big role, there because again, getting back to that idea that I mentioned earlier; they kind of offer a buffer for all of this. And the estrogen and progesterone help feed our collagen, and elastic fibers, and our skin health in general. So they're keeping everything kind of healthy and active until they're not there to provide that support. In situations like that when individuals are noticing those changes, lasers, chemical peels, that can be a great option for a reset in the setting when skincare products alone aren't doing the trick. But it is important to pair that with a consistent skincare regimen. One that's tailor-made and we can talk a little bit more about what that looks like. But I kind of view those procedures as giving you that like, kind of big boost to get you hopefully closer to goal, and then you're implementing your skincare to maintain after that. Personally, I've spoken to a dermatologist before who said I had a patient come in, she was going to have laser work. She was coming in for something else. It was, I think it was her annual like visit. And she says, "Oh, by the way, see this thing right here, I'm gonna go have that laser." And It turned out to be cancer. She said, had the appointments been off, to where the laser would've come before the dermatology visit, no one would've ever known that the cancer was there. It is a very, very, poignant story that you just shared. Because it happens all too often and it really does underscore the importance of having an expert who is trained to survey for skin cancers, and scan the skin and really evaluate it before you're going to those cosmetic procedures. Because at baseline, first and foremost, you wanna make sure that your skin is healthy. That you don't have something that's starting to brew, that can be very problematic. And likewise that you don't have a skin condition of some sort that could actually be made much worse by laser. So, certain autoimmune diseases, certain pigmentary disorders like melasma is a good example. Certain lasers can really worsen and trigger melasma, sometimes almost irreversibly. So very important that you are getting proper guidance about where your skin is at baseline. And, then if you are given the go ahead to proceed with those certain procedures that you know exactly which ones and which direction, and what's safe for your skin and what's gonna help you achieve the goals that you're seeking. And, what type of products should women in perimenopause or menopause, they're losing collagen, they're losing, their elasticity in their skin. What kind of products should they be using to sort of slow that down and age naturally or gracefully? It's the very basic, I always say skincare doesn't have to be complicated, but it does have to be consistent. Any dermatologist will tell you, you don't need a six or seven step regimen to achieve outstanding results. If I have to pick just one product, if a patient comes to me and says, Dr. Casey, you get one, you can pick one thing for me to apply to my skin every day. It's going to be a mineral-based sunscreen without a doubt. Prevention is everything when it comes to skin health. And we can throw all the other fancy creams and lotions and potions at your skin. We can spend thousands of dollars if you don't have that mineral-based sunscreen on every day you're fighting an uphill battle and you're never gonna achieve the results that you're seeking. So a mineral-based sunscreen, you want at least an SPF 30. Sunscreens that are mineral should clearly denote that they are mineral sunscreens. But the active ingredients that you're listeners are looking for are a zinc oxide or titanium dioxide is the active ingredient. Our Bright Girl Sunscreens are all mineral sunscreens, so we have a tinted version. We have a sheer version. If they don't know where else to go, you can go to bright girl.com. And know that you're getting quality sunscreens. That's the sunscreen I use every day. And a countless my patients use it as well. So that's number one. The second most important skincare product for any of us, really even before the perimenopause year, starting in our twenties and thirties; which is when we start to lose collagen, we start to lose collagen around age 19 is a topical retinol or retinoid. And the reason for that is that retinoids, which are the prescription strength retinols are over the counter; are the most clinically proven topical product to apply to the skin to help build and maintain collagen. So sunscreen is gonna prevent that collagen breakdown, prevent the elastic fiber breakdown, the retinoids and retinols are going to help maintain and maybe even boost that collagen level a bit with consistent use over many years. So that's number two and any dermatologist that you speak to is probably using a retinoid on their skin. And then the third pillar, I would say of a good skincare regimen is a good antioxidant serum. You alluded to that earlier. So that is, something like a vitamin C or a vitamin E serum. Vitamin C tends to be kind of the mainstay and one of the most clinically proven. Sometimes the vitamin C is combined with other ingredients like, caffeine and green tea and et cetera in certain products. But that antioxidant is going to be that extra coat of armor on your skin, kind of protecting against environmental insult. So protecting against environmental pollutants, other stressors that come in from the external environment into contact with our skin. And think of that antioxidant as kind of neutralizing that damage. So it's kind of the damage hits our skin and that, that antioxidant just kind of diffuses it and puts the fire out, so to speak. And when that occurs, it's preventing inflammation in our skin. And inflammation is really what's at the root of pretty much all skin damage. Whether that's inflammation being caused by ultraviolet damage, that the sunscreen's blocking. If it's inflammation being caused by environmental factors that, that antioxidant is helping to combat. Or, if it's inflammation from foods and other stressors in our world that are factoring into our skin. I've also heard you're supposed to pair, and I don't do this, but I've always wanted to know, like some kind of acid galactic acid with the vitamin C. Uh, so alpha hydroxy acids perhaps is probably. So glycolic acid is an alpha hydroxy acid. Those products help with increasing skin cell turnover. They're typically light exfoliants, so they're helping to exfoliate the skin. I don't necessarily agree with that thinking. What you've probably heard or what that individual is getting at is that the alpha hydroxy acids can help with the penetration and activity of an antioxidant serum or even a retinol. The danger with that is that sometimes you can get too much of a good thing and you start to tip the scales from support of your skin and boosting your skin to, breaking down the skin barrier, getting irritation, which then leads to inflammation. And as I said earlier, inflammation is at the root of all skin damage. That is what we absolutely want to avoid. So it's a delicate balance among all of these things. Once you pile too many things onto the skin, and this is the problem with those six and seven step skincare regimens, you're adding in more potential for allergies to any of the ingredients. You're certainly, layering more, irritants onto the skin. So the more things you pile on, the more likely, the skin is to get irritated. That then leads to skin barrier breakdown, and that starts the cycle of inflammation and damage. And that's going to lead to breakdown of the collagen, dullness of the skin, redness, sensitivity, all the things that we wanna avoid. Oh, so applying way too many concoctions; it's like it's a mixed drink or, it's almost like you're creating a nuclear bomb or something on your face. Exactly. I mean, we, we see the same thing in individuals who take too many medications. If they're on 10 medications, what's the chance that, one is gonna cause a side effect that another is then going to worsen and they're gonna get sicker because of that. So our skin is the same way. It's very much a less is more, keep it simple, but make sure that the ingredients that you are selecting have a specific role and that they had that clinical proof of efficacy. Because we can otherwise spend a lot of money on these magic potions, quote unquote, that are designed to fix everything, but really don't have the proof that they're gonna accomplish that. What are your thoughts about, this is very hot Korean skincare? Where they have it's either salmon, salmon, sperm or something, or it's what's the other one? Collagen. Uh, they, I think it's snail mucin was another one I've seen. Yeah, so there's, again, when you go back to the clinical studies and as a physician, I always fall back to science and data. It's fun to have these anecdotal stories. It's fun to have these like new sexy ingredients. Show me the study that salmon sperm is more clinically efficacious than using a topical retinoid or a more established mortality. Let's compare it.'Cause I would say those are two different things, the salmon sperm is often administered in a physician's office as part of a procedure.

But it's not better than PRP: 22:54

Platelet Rich Plasma, which has been around for decades. But it's not as hot of a topic to talk about, right? PRP has been around forever. It's like kind of old news. The salmon sperm, like that sounds like exciting and kind of daring. Yeah, other things with like certain venoms that were used to swell the lips years ago. You remember like the bee venom and it's gonna make your lips plumper. And then yeah, the snail mucin. What I will say is that all of those ingredients do have some clinical data behind them. So it's not just that the media is putting out these shocking statements designed to create like excitement and hype. So there is some clinical data. Is it enough that they are better than what's been tried and true for decades? The answer is no. Not, not as of yet. Not to say that something's not around the corner that we're gonna discover at some point, but as of yet, none of those are outweighing what we've been doing for decades. And you know, I remember this back in the late eighties and nineties, I used to pull my eyelid down to get my eyeliner in there and my mom used to yell at me and say, don't do that. You're stretching your skin. Even though I was rather young. So I look at these Instagram and TikTok videos where you have people that are doing facial yoga and they're like stretchy their face, or they have the gua sha thing and they're doing that. Tell me, Dr. Casey, should you be doing that to your face? If you're a woman in midlife Um, who's loosing your elasticity? There's like, there's a happy medium there. So there is a lot of evidence that facial massage, lymphatic massage, not necessarily stretching the skin, but I'm referring to more of like a lighter massage that you might get during a facial, during a traditional massage that that does help stimulate circulation, in the face. On a temporary level, it can also cause a little bit of recontouring in a favorable manner where you might be removing swelling in one area and putting a little bit more plumpness. But is that a permanent change? No. And same with gua sha. The danger with something like gua sha is that it's often done at home without the expertise and supervision and really without that understanding of the facial anatomy and where things are and how things should work. So I'm really cautious not to, I don't say never, but cautious about the at home procedures, whether it's at, at home gua sha, which is relatively benign in the grand scheme of things. But at home microneedling, at home lasers, there's just not enough of the control and antisepsis and, expertise to really be able to use those in an efficacious way. And again, it comes back to individuals often spending money on something that not gonna be incredibly powerful or transformative. Getting back to what you were mentioning about the facial massage and all the stretching of the skin; what we do know is that the more our collagen is stretched and stressed the more likely it is to break down. And a good example of this that we see is with women or men who are very expressive and they start to get deeper lines from a combination of that repetitive movement of the muscles under the skin. For example, if you're frowning all the time and you get those elevens between your brows, that continued motion with the combination of sun exposure that breaks down the collagen and then the hormone changes, it's gonna leave those little elevens between the brows. Individuals who Botox their whole life and therefore, kind of paralyze and settle those muscles, they're never really making that strong motion. So a lot of clinical studies demonstrating that the less wear and tear that you have on your skin, on your collagen, on those elastic fibers, the smoother and plumper and more robust your skin, is going to be. I think we still have yet to see what the ramifications are of all of this stretching and these kind of extreme movements and behavior patterns that we're seeing on social media. Because they're still relatively new in the grand scheme of things. We don't have 20 or 30 years of data on them yet. And my thinking with many of these at home procedures is, you know, I, I'm not gonna be implementing them with understanding what I know on a physiologic level of what's happening within our skin. But because like we don't know if that's gonna cause a whole lot of damage 10 years from now. We used to think that tanning beds were healthy for us and then look at where that landed us. Yeah. What about, 'cause I wear a red, light helmet for my hair.'Cause I lost my hair. I started to lose my hair and it's, it's proven to help my hair grow back. You lost your hair? You have the thickest, most beautiful hair I have ever seen Carmen, you've got gorgeous hair; so I wanna know what red light you're using. It's iRESTORE. It's not the black helmet, it's the white helmet. And, I've been using it for, I wanna say over a year and a half. But I also take Minoxidil pills, a half a pill. And this is not all of my hair yet. It used to be bigger. So it's coming back. Impressive. I think it's working. Yeah, it is working. But now people have started using the red light mask. What are your thoughts regarding that? So, again, a lot of variation with the red light devices.

That's where again, at home use: 28:51

how far is it from your skin? So we have everything from the red light masks, to the wands, to the panels that you sit in front of. There's just tremendous variability. There are a number of clinical studies that demonstrate that red light in and of itself can help with promoting some of that collagen production. That can help with settling and stopping inflammation in our skin. So helping to mitigate that inflammation, which again, is at the root of so much skin damage. That's gonna help with the increasing circulation, which is beneficial to our skin. So we do have, objective data that demonstrates that. Do we have any data that demonstrates that red light is more efficacious than the skincare regimen that I discussed with you earlier? With the sunscreen, the retinoid, and the vitamin C? No. No studies comparing that head to head. And when you inter view dermatologists, I think a lot of us will kind of side on the camp of we have decades worth of clinical data on skincare regimens and how efficacious that is for skin health and skin appearance. And not a lot of data on these red light devices, which are so across the board variable. Also, it's important to remember that that red light is a form of radiation. And I don't say that to fear monger or to scare anybody, but again, it comes down to; are we gonna find something, some side effect that is going to occur 20 or 30 years from now from individuals that used red light on a regular basis? And will that be different if they used it in their scalp for the purpose of hair growth or if they used it on their face for the purpose of skin rejuvenation? We just don't know. It's not, of course, red light is not nearly as powerful as ultraviolet light. It's a whole different portion of the spectrum. And no company is gonna make an at-home device that could potentially cause a lot of damage. The energy levels of those are toned down significantly compared to what might be offered in office. So the jury's still out on that. There are a number of dermatologists that do recommend the red light devices on a regular basis. My take on it, do I have a red light device? No. Could I get one for free from a company if I wanted? Yes. And I've chosen not to do that. The evidence is just not convincing enough. But I also don't discount or ever discourage a patient who's really recognizing some benefit from it because we do not have any data to date that demonstrates that it's harmful. So who am I to say that it is harmful? I just throw out that word of caution. We don't have a lot of long-term data on it just yet. And I think one of the struggle that people have when they use, ' cause I use Tretinoin and I'll use it one night and this is how I use it. I will put like a moisturizer, a, a light moisturizer on my face before I apply the tiny pea size, Tretinoin all over my face. And then I'll put Aquaphor on my face. And the reason I do that is because sometimes I get crackling, along the edges of my mouth and along my nose. Yeah, so what you described is what we call in dermatology, a very non-technical term, the sandwich technique. Where we're essentially sandwiching that retinoid in between a gentle moisturizer and then another product. Some people double the moisturizer and put that in place of where you're using the Aquaphor, but kind of buffering that retinoid. Which is I don't wanna say a powerful product, I don't wanna scare your listeners, but it is potent and it has a lot of efficacy. I myself use Tretinoin and I use the strongest form, the 0.1% Tretinoin; and I've used it for decades. Yep, you're saying me too. Yep. And I don't get much irritation from it, so I'm not putting on that layer of Aquaphor afterwards, but I do put on my moisturizer first. I use The Day And Bright; Bright Girl moisturizer. And then put the tretinoin on top of that. So that sandwich technique can kind of, again, act as a buffer with that Tretinoin, In individuals who may not tolerate it so well otherwise. And as we were talking about earlier, as we get older and our skin goes through changes of perimenopause and menopause, many times we find we have less of a buffer. We just don't have, our skin, doesn't have the ability to tolerate some of those stronger medications. But I think that's a very good modality. I tend to maybe slather my tretinoin on a little bit more heavily. So you said you use the tiniest pea sized amount, I probably use about five times what you use and I put it all over my face. And including a little bit on my eyelids and then I put it down through my neck and chest area. And it is, using retinols very sparingly on the eyelids is proven safe. You don't wanna get it into your eye. I tend to use it more on my lower eyelids where there's a little bit more tissue compared to the upper eyelid skin. But it is much more efficacious than a lot of the eye creams that are on the market because again, tretinoin is gonna help build collagen and elastic fibers in our skin. And at the root of many issues with eyelids sagging or getting dark circles under your eyes. Or getting that laxity is the loss of collagen. So what can we do to support that? Sunscreen. And always, always a mineral sunscreen around your eyes. You do not wanna put a chemical sunscreen around your eyes, or it will sting and burn, and you'll never wanna use sunscreen on your eyelids again. So making sure you've got a sunscreen and then, the tretinoin is safe. And it is important to address that skin on your neck and chest. Too often, we miss those areas. And the skin of our neck and chest is much more delicate than the skin on our face. It does not handle damage nearly as well. So that is where we will often start to see the first signs of aging in individuals. I know my dermatologist told me when she first wrote my prescription for Tretinoin,'cause I was using, I think, the 0.5, I think, and then she bumped me up. She's like, you're complaining about some of these spots. They're okay. These spots are not cancerous. Let's bump you up to this. And she said, with time, keep using it, with time, your skin will become, she said, thicker in a sense to where it will become more tolerable to the Tretinoin. And I did what you said; ah well not as much. I did like two peas, maybe two and a half peas, and I had to like lather my face in aquaphor for a couple of days. Well, that sometimes does happen, and then also depending on our external environment. So if we're somewhere where it's very cold and it's winter; the air does not hold as much humidity, so our skin's gonna be more susceptible to irritation and dryness. I mean, I do go through periods where like I might have like a dry patch, or a little bit increased which is more from the exfoliation that the Tretinoin is causing. So Tretinoin, we've talked a lot about how it benefits our collagen and elastic fibers, but what we didn't talk about is how Tretinoin also increases skin cell turnover. So it's helping to exfoliate, those dead damaged kind of cells that are just sitting on our skin and not really serving much function or purpose. Like they've kind of done their time, they're just hanging out there, let's get those guys outta there. So helping with that skin cell turnover. And then Tretinoin also helps with regulating pigment production in our skin. And you just alluded to that, you said your dermatologist bumped you up 'cause you had some brown spots that were still bothering you. So Tretinoin is gonna help with dispersing that pigment. So if you are somebody who's freckly or maybe has some melasma or hyperpigmentation, the Tretinoin is gonna help speed up the process of dispersing that as well. So those are really the three main benefits. And then one other to mention is if you have, very fine lines or wrinkles because the Tretinoin is helping with the collagen and elastic production and helping to support that; many individuals will notice that those fine lines and wrinkles start to fade a bit. Or there's a little mitigation of those from the Tretinoin. How long would you say, 'cause I noticed you said you shocked me when you said I almost fell outta my chair. You said you put it around your eye or around your eyes. How long does it take for the recovery from placing it there? For me; I didn't have too much of an issue. I have some patients; the biggest thing is because of that increased skin cell turnover. What a lot of people will describe as my skin got really flaky and irritated. That is those dead skin cells being shed. And it manifests as that flakiness, because your skin is literally shedding. You were describing, you noticed some of that around the nostrils is a very common location. The corners of the mouth is a common location. And it really varies in, every individual it has to do with your skin type at baseline. Are you a dryer skin type? Are you a combination? Are you oily skin type? How mature is your skin? How much damage does your skin have? And then, have you done any other procedures? So, if you're starting from absolute scratch and you've never done anything on your skin and maybe you're 60 years old and you throw that much Tretinoin as I was describing, you're probably gonna have some irritation and sensitivity. And that can often be the root of many individuals not proceeding and continuing with treatment. What we do find, and I'm a firm believer, is that there is a retinoid, a Tretinoin, or a cousin in the prescription level or a retinol in the over the counter version for everybody.'Cause there are literally hundreds of different formulations out there. So any patient who tells me I can't do retinols at all, that irritate my skin. I often, I hear them and I say, well, how about let's try a different one. Let's try a completely different formulation and then let's implement some of those other supportive measures. And we go through what other skincare products are they using. The cleanser that you're using can be a big factor in how much irritation your skin gets when you're starting these skincare regimens, because if you're using Dial soap to wash your face that's not gonna work out well. So we really need, I mean, we can talk a little bit more about that, a pH balance, gentle cleanser that really is supporting that skin barrier. And it is working with your skin and not against it. What are your thoughts about oil cleansers as opposed to, like, oh, I don't wanna say detergent, but as far like a. Yeah, like a, so like I would say oil versus like a gel cleanser would be kind of the opposite of that. I'm a, big fan of oil cleansers, especially for individuals who wear a good amount of makeup because makeup particles are typically oil-based or they have an oil component to them. So if you are just using oil-free products to wash your skin, you're likely not going to pick up all those makeup particles as effectively. So using an oil-based cleanser is a great way to remove makeup and excess oil that's on your skin. And also that oil is gonna help with replenishing your skin too. So it's not gonna be drying as some of the more alkaline; so like the more soap based cleansers that are out there. When we talk about skin pH; our skin pH sits on the more acidic side. So with seven being neutral on the pH scale, right? We can all remember back to high school chemistry. And 14 is very alkaline. And two is very acidic. Many soaps are on that alkaline end of the spectrum. And so a lot of the bar soaps that we use sometimes hand soaps are very alkaline. And our skin does not like that, and that may be why many of us see irritation and sensitivity when we use soaps like that. Not all of us, it's not across the board. Some people may notice that. So a pH balanced cleanser is really gonna work with your skin. So if you're using an oil-based cleanser, you just wanna make sure it's pH balance. And if you don't know what the pH is or if the product doesn't specify that then you'll know by how your skin feels. So if you use the cleanser and your skin feels stripped and dry and tight and red, probably not working with your skin so well. And if your skin feels clean and refreshed and nourished and soft, that's where you want to be. Some individuals like to do a double cleanse, and in that case I usually recommend starting with the oil-based cleanser to get off all the makeup, dirt, sweat, et cetera. And then doing that second cleanse with the gentler pH balance cleanser. I use The Bright Girl cleanser daily. I know that it's pH balanced on the label on the box, it calls out that it's pH balanced and tells you exactly where the pH is. But I know that works for my skin. And it has avocado oil that helps replenish the skin. It has aloe in it that's gonna soothe inflammation in the skin. And then it also has allantoin, which helps to very gently exfoliate and help promote that skin cell turnover. So not in a harsh or, aggressive way, but just enough to get off all the debris that our skin doesn't need. Oh, that's good because I use an oil-based cleanser and I started using it even though I don't have makeup on. It just, I feel like it's kind of exfoliating my face even though there's no exfoliant in it. And when I I'm drying my face, patting it; it just feels refreshed, like you said. As oppose to some stuff was tight. You know you're on the right track. Yeah. So, when I created and I'll, I'm gonna talk a little bit more specifically to Bright Girl Skincare. When I formulated this line, which I formulated from scratch with cosmetic chemists, and it was three years of research and development. But my benchmarks, Carmen, were the very best of the best dermatology products that I had tried over the course of my career. And I was fortunate to have access to literally thousands of brands. So I could say, these are the best moisturizers that I've tried and, you know, across the board, perform so well. These are the best cleansers that I've tried. These are the best sunscreens. So, Dr. Casey, based on the conversation that we have had here today related to women and midlife, what advice would you give them so that they can begin to love their skin again? So remember, your skin is mighty and it has done a lot for you throughout your lifetime. So first and foremost is really appreciating and respecting our skin and all the functions it performs; in keeping our bodies protected and communicating between our internal and external world. And, I'm always in awe. I mean, I work with skin every day. I look at skin under the microscope every day. I remove damaged skin every day and every day I continue to marvel at how this wondrous structure works within our bodies. It, it's just tremendous. It's our largest organ, and I would argue one of our most impactful organs for keeping us healthy. But It is, I think, key to understand your skin, where it is here and now. And if there are goals that you wanna achieve or specific current concerns that you have, that's when the guidance of a dermatologist comes in to steer you in the right direction. The other thing I'll mention is just how empowered each of us can become with the daily habits that we perform in our skin. And every day that you care for your skin, every single day that you put on that sunscreen, you put on that retinoid, it's like a deposit in the bank of your skin health. So the more money you put in every time you do it the healthier your skin becomes lifelong. And my final thought is that it's never too late, 'cause today is the first day of the rest of your life. So even if maybe you weren't so good about skincare in your early years, it's not too late to start those habits. Yeah. And again, Tretinoin, retinoid, whatever the two, products are that you're using, those are used at night, not during the day. Correct. Yeah. Correct. Yeah, so there is, it's not as essential as we once thought, but there is a school of thinking that retinoids are somewhat inactivated by the sun, that's probably not as much of an issue. More so it's because overnight, our, so our skin has a circadian rhythm just like the rest of our body. And overnight is the rest and repair phase of our skin. It's when it's recovering from everything it's encountered during the day and replenishing and rebuilding. So when you have that retinoid on board at night as your skin is replenishing and repairing; it's going to do more good than if you have it in the morning and then your skin's kind of encountering all the factors that it runs into over the course of the day. Perfect. And just to wrap up, Bright Girls, not just for teens, from what I'm understanding. We have a lot of moms and sometimes grandmas that are stealing it from their teens bathrooms. So the the script has been flipped for decades, our daughters were coming into our bathrooms and stealing our skincare. Now it's the other way around and the products are that good. I love nothing more than when I have stories of my patients or sometimes our social media followers that it's a grandmother who bought the Bright Girl line, for her daughter, and her granddaughter, and they're all using it together and sharing the stories. That is beautiful. That is beautiful. Because I was wondering if you were gonna come up with the mature line, but I don't think you need to. It's already there. Not right now. We're all about prevention, Carmen, right. That is truly an ounce of prevention, is worth a pound of cure. And that's really our mission with Bright Girl is to help prevent those skin damage issues that occur down the line. And ultimately to have a significant impact on the skin cancer epidemic, which affects one in five Americans by age 70. And skin cancer is the number one cancer worldwide and actually amounts to all other cancers combined. So it is not only, I really view this through the lens of skin health, and not so much about beauty in appearance. It is a skin health and a healthcare issue. And this is a small way that we can implement a habit, that's not such a huge lift for any of us as individuals to walk towards that healthier skin throughout our life. Great. Dr. Casey, thank you so much for coming on the show. I will include links to your website because your website actually tells people where they can actually grab the product from local stores or order it directly from Bright Girl. Absolutely. And please follow us too on TikTok and Instagram, we're at Bright Girl Beauty, all one word. Great. Thank you very much. Thank you so much, Carmen. Alright. Okay, wasn't that such a refreshing conversation? Here's what I'm taking with me, and I hope you are too. First, if you remember the one thing, skincare doesn't have to be complicated, but it does have to be consistent. Dr. Casey said if she could pick only one daily product it's a mineral-based sunscreen, SPF 30 or higher with zinc oxide and titanium dioxide. Prevention really is everything. Second for midlife skin, when collagen and elasticity starts shifting, she broke it down into those simple pillars, mineral sunscreen, a retinoid or retinol, and an antioxidant like vitamin C. Not six layers, not a cocktail of acids and not random trending potions that will leave you irritated. Third, the seven step routine problem: more product doesn't automatically mean better skin. In fact, piling on too much can trigger barrier breakdown and inflammation, and that's the opposite of what we want. Keep it simple, choose products with real evidence and don't underestimate techniques like buffering Tretinoin if your skin gets a little cranky. And lastly, if you're thinking about laser or treatments, her advice was crystal

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get your skin checked first. You want to make sure you are not missing something serious and you are choosing the right procedure for your skin. If you wanna learn more about Dr. Angela Casey, Bright Girl Skincare and everything we talked about, head on over to createthebestme.com/ep156. And if this episode helped you share it with a friend. Come back next week for another amazing episode created just for you. Until then, keep dreaming big. Take care of yourself. And remember, you are beautiful, strong, and capable of creating the best version of yourself. Thank you for watching. Catch you next week. Bye for now.