Insights from the Couch - Mental Health at Midlife

Ep.49: Glow Up at Midlife: What Works, What Doesn’t, and What’s Worth It With Dermatologist Dr. Mary Alice Mina

• Colette Fehr, Laura Bowman • Season 4 • Episode 49

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What actually works for healthy, vibrant skin—and what’s just hype? In this episode, we sit down with the brilliant and refreshingly honest Dr. Mary Alice Mina, Harvard-trained dermatologist and host of The Skin Real podcast. We dive deep into what midlife skin really needs, what treatments are worth the money, and how hormonal changes can shake up everything we thought we knew about our skincare routines.

Together, we unpack skin minimalism, sunscreen truths (spoiler: it really matters), and the difference between aging gracefully and chasing the next trending procedure. We also get personal—sharing our own frustrations about neck bands, droopy brows, and that “face falling” feeling—and ask Dr. Mina everything from estrogen creams to slugging and Botox. 

 

Episode Highlights:

[0:02] - Welcoming Dr. Mary Alice Mina and diving into hormonal changes and midlife skin shifts.
[3:38] - Our own candid stories about "face falling" and dry, aging skin.
[5:00] - The psychological toll of aging and the importance of internal confidence.
[8:10] - What “skin minimalism” actually means—and why less really can be more.
[11:37] - Estrogen’s role in skin hydration and how perimenopause changes everything.
[13:53] - Sunscreen strategy: how often to reapply, the importance of hats, and Dr. Mina’s favorite brands.
 [19:07] - Retinoids 101: how and when to use them for best results.
 [20:26] - All about neck bands: what works (and what doesn’t).
 [26:09] - Estrogen creams for the face: what Dr. Mina prescribes and how it works.
 [28:58] - Why sleep is skin care and how sleep deprivation shows up on your face.
 [30:58] - Sunscreen myths, TikTok fads, and Dr. Mina’s biggest dermatology pet peeves.
[33:59] - Genetics vs. skincare habits—what really makes the difference.
[40:16] - Starting or restarting retinoids without overwhelming your skin.
[40:39] - Why annual skin checks are essential and how to talk to your dermatologist.
[43:31] - How to connect with Dr. Mina and find your “skin style” through her quiz.

 

Resources:

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Colette Fehr:

Hi everyone. Welcome back to another episode of insights from the couch. We are talking skin today with a fabulous Dermatologist, Dr Mary, Alice Mina, and we're going to be getting into everything you need to know about sunscreen, holistic skin care, what treatments to get? What treatments not to get? Does putting estrogen on your face make a difference, especially for women at middle age? You know, what can we be doing to take care of our skin? So you're going to want to stay tuned for this one, because we're asking Dr Mina all the questions, but first, let me briefly introduce her. She's so impressive. Dr Mina is a Harvard trained dermatologist, international speaker, author and host of the skin reel, a podcast, ranked in the top 2.5% globally. She's a co owner of Balcombe and Mina DERM surgery in Atlanta, Georgia, and a leading expert in procedural dermatology, skin health and skin care. She has nearly two decades of clinical experience and is celebrated for her artistic, eye surgical precision and ability to help patients feel radiant at every stage. Dr Mina is also a sought after speaker, and she's been featured in all kinds of media outlets, People Magazine, The Wall Street Journal, glamor and Huffington Post to name a few. Welcome. Dr Meena, we're so thrilled to have you today, so let's just jump right in and start off with what can you tell us? Dr Amina, about the hormonal changes that happen at this phase of life, and how that affects the skin. Like, what are some of the most common issues you see with women at midlife? As a dermatologist,

Dr. Mary Alice Mina:

gosh, see and have experience, or am experiencing, right? So lots of things happen. A common issue is, I used to have great skin, or someone never even really thought about their skin, and all of a sudden they look in the mirror and they feel like they've aged overnight, and they're like, what is happening? My skin is crepey. I have these wrinkles I never had before, the neck people. I feel like that's one of the first areas people notice it, and I can relate. So yeah, the neck and yeah, they are jowling that people feel like they're starting to get jowl so they they feel like the word I hear a lot is my face is falling, things are just moving south. And so that's a big one. And then hair loss is a another big one that I see during this period, and this can happen sooner than people realize. It can happen in your late 30s, early 40s. You can start seeing this even before you see the traditional signs of menopause, right, like the hot flashes and brain fog and other things that women will experience so in this sort of perimenopausal phase where your hormones are fluctuating, you can start to see these changes.

Colette Fehr:

Okay, you just hit the nail on the head. My neck looks like ET like, it's like all like banded. And I'm that person who I feel like. I always had great skin. My whole life. I don't wash my face. I didn't do anything, and all of a sudden my skin's getting really dry. My wrinkles are more pronounced. I have gels. The neck thing, it's really crazy. The Face falling is, is the perfect you

Laura Bowman:

know, I feel like my brows like I feel like my, I feel like my I'm getting squintier and squint, squint here. I'm like, trying to open my eyes.

Dr. Mary Alice Mina:

I also think we are our toughest critics, right? Like we are looking at ourselves, and then it's like, the only thing we can see our brows are so heavy, or my neck, or the banding. And so I think we can also just, it can almost paralyze us, because we're not used to seeing these things. We're maybe used to being looking a certain way, getting a certain attention, or looks, or getting that sort of, you know, you look good, and now you kind of reach the age where, like, Oh, I'm not turning heads like I used to. I don't get the first drink at the when I'm at the bar anymore. The sad thing is, I don't I'm I don't want to speak for you all, but I still feel like I'm 25 so then when I see these changes, I'm like, wait a minute, that's i i Don't look how I feel. And so that can be sometimes disheartening too. I think, yeah, it's jarring. It is jarring. And then then we have also seen examples of women that get like, hyper fixated on not aging, yeah, and I'm sure you've seen examples of people who just go like, way too far with injectables or Botox. I mean, I see this in like, I've.

Laura Bowman:

Young clients that are spending so much money on, like, blood facials, like things, and I'm just like, you're like, 30 something, and you're, I don't know I am a skin like minimalist, like some I heard from one of my, like, family friends when I was a kid that she, like, was just gonna use sunscreen in a bar of ivory soap. And I was like, ding, ding, ding, me too. So I'm like, on that weird end, but like, how do we where is the sweet spot of, not of Me and my ivory soap? And like, the woman that's now looks like her face is a pillow because she's done so many injectables. Yeah,

Dr. Mary Alice Mina:

it is. It is so, so tricky. And I think as dermatologists, we I have to be careful with this too, right? Because I have access to whatever I want, I can do, and it's a slippery slope that you don't become so fixated on one thing or one flaw, because then you fix that, and then you you find another. You're never satisfied. That's the thing, we always will find something else. So I think first and foremost, and this is where people like you come in, it's we have to kind of do the work internally like we need to make sure we have confidence we feel good about ourselves like that we do the internal work of taking care of our mind and body, because if you fixate like, this syringe is going to fix my problems, this treatment is going to you're never, you're never going to be happy, right? And that's when you go down the slippery slope. So I think having a healthy attitude about aging, not everything is amazing, right? But what's the alternative? Right? So I'd rather age than than die young, right? Or died in my mid 40s. So it's important to not fixate so much on the negative, to have outlets that don't require you to stare at yourself and look at yourself, and things that nourish your mind and body. And then you can come to me for the last 10 to 15% if you want to, if you need to. And my mom is like you, Laura, she uses moisturizer and sunscreen. I've tried to get her a tretinoin product, and I've offered my services to her, and she wants nothing to do with it. And she's almost 70, and she looks great. You know, she looks 70, but she does look great, and her skin looks great. So then, you know, you have the other extreme, where people want to do everything, but it's a slippery slope, right? Because then you start not even looking like yourself. Oh yeah, and I'm in the middle, right, like I'm okay with doing tweet, you know, impactful things that will give me results or help me feel good, but I always want to look like myself, even if that means I do have some skin laxity or sagging or some wrinkles, I still want to be me and and that's okay at 50 or 60 to have some lines or some some looser skin or hacking 40s, right? But I think everyone's different, and everyone has to reach that point on their own. I can't tell someone. You have to figure it out so,

Colette Fehr:

and you are a big proponent of skin minimalism as well, right? And that less is more finding that sweet spot for you. So I'm not far beyond Laura, I use L trainer, but that's the only thing a couple times a week. And even that, it's hard for me to get myself to use it as often as consistently. What's an ideal skin care routine? I mean, obviously I know some degree it has to be customizable for the person and their issues, but yeah, what do you think is kind of that sweet spot for a woman

Dr. Mary Alice Mina:

life. First of all, when I say I'm a skin minimalist, sometimes people think, Oh, you don't do any cosmetics. I'm like, No, I do cosmetics. But again, I do selective ones that are things that are beneficial for me, not just what my best friend got or what some beautiful celebrity got. And so making it work for me. And that's where I think sometimes people, they just hear, Oh, the halo laser. I should get the halo laser. I should get this. I should get that. But skin minimalism doesn't mean doing nothing or aging completely natural, unless you want it to be. But what I think it, we overdo it, we do too many things, and it's important that you're just doing the right things for you. So the bare minimum would be have a cleanser, a gentle cleanser you like, have a moisturizer and have a sunscreen. If you do nothing else but Sun protect it will get you so far. And I can't believe we're still debating this with all the data and science. And even if you don't believe me, look at your if you have some older friends or people, and look at the ones who maybe spend more time indoors, and then look at the ones who have been out in the sun. And there's a clear, clear difference. Or look at your stomach versus the skin on the top of your arms, right? That's, that's sun damage over. The years sun exposed versus Sun protected. So if you truly want to be a minimalist, you know, I'd say Laura, more power to you just, you know, and make sure you're sun protecting. And that will take you so far. If you want to be a little extra, like I'm a little extra, I do a tretinoin at night, which is a retinoid, or you could do an over the counter retinol. I'm a big fan of these. It's very cost effective and affordable. It doesn't work like magic overnight, but if you stick with it, if you're consistent, you will see amazing results. It's one of the most powerful collagen boosters that we have. The problem is, if you guys have ever used it, it's irritating to the skin, yeah, and it takes a while, so I don't use it every night. When I was younger, I could use it every night without a moisturizer, and now the thought of doing that is terrifying. So now every night I put a moisturizer on, and I would say four to five nights a week, I'll put on my tretinoin with that, and that seems to work well for me. And if I notice I'm a little extra dry in the morning, I might skip that area or skip it the next night. So is

Colette Fehr:

that, like, the same as altrina, as altrina version of that? So I don't know, el Trina. Oh, really. Okay, it's, like, it's, I think it's a retinol, just it has a little moisture in it,

Dr. Mary Alice Mina:

yeah, if it, I would just see if it's a retinol, retinoid, and that probably is, yeah,

Colette Fehr:

okay, because it's supposed to have that little moisture in it to help with the skin dryness. But even I find that I my skin, and my skin is suddenly so much drier,

Dr. Mary Alice Mina:

totally my mine as well. And that's a big thing as we lose estrogen, estrogen helps keep our skin barrier intact, helps hold in moisture, and so we start to lose that. And yeah, your skin will get drier. And if you have dry skin to begin with, it can be, you know, a lot more severe. So, you know, thankfully, you all live in kind of humid, more humid climates, right? But even where I am, it can, it can get somewhat cold, but you may want to consider getting a humidifier to help, and then just lathering up with a moisturizer. I find sometimes throughout the day I have to put moisturizer on, and that's okay, and just I will use a thicker one. You could, even if you truly have very, very dry skin, use something like Vaseline, Aquaphor, cerebe healing ointment, you know, something like that you don't love, you don't have to put it on your whole face at night. For some people who are really, really dry, they may need to do that. I think the kids call that slugging. Nowadays,

Laura Bowman:

my kids are all over using Vaseline like, I think once you have kids that I was telling Colette this and have gone through like an acne journey, like my kids are obsessed with skincare, yeah, in a way that I am not, and my son has a more elaborate skincare routine than

Dr. Mary Alice Mina:

my son too.

Colette Fehr:

I'm like, what is that? So? Okay, so let me ask you this about sun block and stuff, because I wish I had been on this bandwagon earlier. You know, they say I think something like you get most of your sun damage before a certain age when you're out playing. I don't even know if that's true anymore, now with our digital generations, but I used to be a kid who went to the dermatology medical meetings and all the kids we'd all be out with, like reflectors and baby oil, and I'd have bubbles. I mean, bad, so I'm lucky it's not worse. But now I wear sunblock every day. I'm curious though. I use the Elta MD One. I love that. Yeah, I put it on every morning before I put on my makeup. But what about reapplying during the day? Do you do that because doesn't sunblock wear off in like, 90 minutes or something? Or is that not true?

Dr. Mary Alice Mina:

Not not that fast, but we do say if you are outside, you should reapply it every two hours. If you're sweating or swimming, like if I'm at the beach, then I will reapply. Here's the thing, I even dermatologists aren't great at reapplying. It's tricky, right? And I don't reapply when I am indoors all day. But as the summer, you know, approaches, the days get longer. If I leave my office and I know I'm going to go outside and take a walk or go to the playground with my kids or be outdoors, then I will reapply on areas that are exposed. My other favorite thing, because I don't love wearing a lot of stuff on my skin, is I will have a hat with me, and I just don't care if it looks cool or not. I personally think it looks cool, but I just have a hat with me, because then I don't have to worry about, did I reapply? Did I rub it all in? Did it? Did it get my part? You know, people, I'm not going to put sunscreen in my hair, right? So, so I have a hat with me, and I also, I think they're really. Cute sun protective clothing out there. And one of my favorite is there's like, a little shawl kind of thing I can get. And so if I know I'm gonna be somewhere outside and I've got a tank top on, I will just like, throw it's super easy to throw in your purse, and I'll just kind of like, drape it over my shoulders, if I know I'm gonna be exposed. So I personally love using clothing to also help protect me from the sun, instead of just relying on sunscreen. But it is tricky. I hear this a lot with women like, if you've got your makeup done and you don't necessarily want to mess it all up, and I hear you, so I would just say, either, stay in the shade, get a hat, yeah, but it, but if you're at the beach or you're at a sporting event or something like that, it is important to reapply. I think that's where people that's where people get burned because they're good in the beginning, and then it just kind of forget, yes.

Laura Bowman:

So I love, I love how you said that there are certain things that you do that are impactful. And I want to know, like, what are the things? And, of course, I know it's different for everybody, but like, what are the things that really move the needle in, like, making you look younger, that done, you know, in a thoughtful way, really, like, change the game. Well,

Dr. Mary Alice Mina:

so talking about skin, because I really think, and I know you're like, you're a dermatologist, we want to focus on the skin stuff, but taking care of your body makes such a difference with your skin. People forget your skin is an organ, and it really is almost like a reflection or a mirror to what's going on inside. So if you are staying up all night, you're not sleeping, you're drinking a lot, you're smoking, you're stressed out all the time, your skin is going to reflect that. So we don't give that enough attention. So focusing on, I'll say skin health is whole body health. So before rushing out to buy more products, do more procedures, right? Is take a look at your your life and your your health in general, I think, makes a huge impact on your skin. But what about like skin care and all that? I would say again, not to be a broken record, but sun protection. I had never done a laser procedure on my face until about this year, and I just kind of did it for fun at a conference. And I've done that, and I've consistently used a retinoid since I was probably in my late 20s. Wow. And, and just by doing that, which cost comparatively nothing, and, well, and a little Botox, like I started doing Botox in my mid 30s, a little couple times a year, a little bit of Botox that that to me, I think, has been the most impactful. And then now in my 40s, I'm starting. I've done a few vials of Sculptra. And I am a big fan of sculpture. It builds your own collagen. It's very natural looking. I know my collagen is going to drop, you know, about 30% within the first five years after menopause, and even after mid 20s, your collagen is going down. So I think it's a good way to sort of collagen bank. Now, not everyone needs this. Some people have naturally fuller faces, and that may not be what they need. They may have more scarring from acne when they were a kid, and so I would say for someone like that, something impactful for them would be a laser or something to try to help address that scarring and make their complexion or the texture more uniform for someone who has a lot of pigmentary issues, maybe a lot of sun spots from being outdoors, or they get a lot of hyper pigmentation, so their skin is not a nice uniform color. Addressing that would be more impactful for them. So it's it's going to vary for everyone, but I think universally, if you just Sun protect and use a retinoid, then you're way ahead of the rest.

Laura Bowman:

And just for people who don't really know, like, can you get that a retinoid over the counter, or does it have to be prescribed

Dr. Mary Alice Mina:

so a Retinol is over the counter? And those tend to be a little gentler. They're a little bit weaker. They're not as strong. It's not standardized as you know. Like the prescriptions, where I know what strength you're getting, but you can certainly start with that. I like the prescription strengths, and you can get started the lowest and then work your way up or stay at the lowest. And I think the key for women our age is to use it with a moisturizer and to just use a tiny pea. Yeah, people, I think people think it's a like a lotion and, and, and you don't need to rub it like that. And then my other tip is, I wish I had done this since I was in my 20s, is to include your neck. When you're putting it on, we sort of think our skincare stops at our jawline, right? So do your neck? Do the tops of your hands? That's an area

Colette Fehr:

that goes separated, yeah. Why am I not doing my stuff on my neck when my neck is worse, okay? While we're on that, can we talk about, is there anything that can be done for this awful like I am so banded. Is there anything for that?

Dr. Mary Alice Mina:

Are you taught? Are your bands going more horizontal or vertical? Ah, I

Colette Fehr:

think they're more horizontal, horizontal, yeah,

Dr. Mary Alice Mina:

the tech neck. So if they were vertical, if they were vertical, those are your platysmal bands, which is the muscle of our neck, and those can be addressed very nicely with Botox or disport things like that. The horizontal ones, first of all, even kids have this, right? I'll even look at children and they have these horizontal neckline so don't think you know, we can get rid of them totally. And we are bending our necks a lot, right, looking at our phone, looking at the computer keyboard and all that, I would say, helpful things. Again, nothing's a quick fix, necessarily. But using your retinoid on your neck can be helpful. Putting in some filler can be helpful in the neck. Yeah, or hyaluronic acid filler radius or sculpture, they can those can work nicely. And then I love lasers that can help build your collagen. So doing a laser that is going a little bit deeper to help stimulate the collagen, some people have great results with radio frequency, micro needling. People are trying, right? And it's not like there's a one, because, trust me, if there was, I would have done it. But it kind of just depends what kind of, what kind of neck you have, if you need more volume, and then really the, you know, a neck lift, sometimes there's just a good bit of skin. And if you were like, I want this, and you keep pulling your neck bag.

Colette Fehr:

I'm gonna have to do this at some point, because this is actually the thing that bothers me the most, is that my face has sunk a little like right here. And like you said, I do feel 25 inside, and then I'll catch a glimpse of myself on something. I'm like, Who's that old lady?

Dr. Mary Alice Mina:

No, I know I'll see my mom, and I'm like, Oh my gosh, I am turning into my mother. You know,

Laura Bowman:

my mom? I was telling Colette, my mom did a neck lift and a bluff when she was, like, 54 and it bought her, like, 15 years facially, yeah, like she it just looked, I mean, I wish I could post the pictures with her without her wanting to kill me. But they were just like, it was so good, wow.

Dr. Mary Alice Mina:

Yeah. And I think sometimes people get real nervous about surgery, yeah. But sometimes that is, you could, I feel like you, you can spin your wheels and try all these things and really just cut, cut the skin out if it really, really bothers you. And I love a buffer of plastic. I think that that's an eyelid lift and or tuck. It's a great way to open the eyes. If a lot of times, when I you know people typically a little bit older than us, 60s, 70s, they have to use their forehead to hold their eyes, their eyelids up, and so by the end of the day, they just feel exhausted and heavy. And really a fairly simple procedure for someone who knows what they're doing, it's to just remove that skin so they don't have to, you know, hold their eyebrows up just to see.

Colette Fehr:

It's a great thing. I mean, my aunt did that with the eyelids in her, maybe mid to late 60s, I want to say. And it made a huge difference. And she looks her age, but she just looks great for her age. You know? She looks really vital and alive, and not obviously plastic surgery, right? So, okay, so what I'm getting so far in this, this is comforting to hear again from you that really, if we're doing a good cleansing our skin, wearing sunscreen and maybe considering adding a retinoid to your routine, that that is that can work really, really well. And you don't have to go crazy, spending a fortune, necessarily, with a million procedures, although a little Botox can help, you know, depending on why. I mean, I've been doing Botox since my mid 30s, too, and my forehead, you know, it's not working as well in a way now, like I either feel so frozen that I look weird, or it's hard to get your lines to go, Yeah, my brows sink. So it's becoming more challenging. And I don't know, I think there are probably other women listening like me who wonder, Am I going to be botoxing My forehead till I'm 80? Like, is this. Yes, at some point, am I giving up, or am I just gonna keep going? You know, yeah, foreheads

Dr. Mary Alice Mina:

are tricky. In fact, a lot of my more mature patients, I don't treat their forehead because, again, they're using their forehead to hold their eyelids up, and sometimes what they really need is a brow lift to just cut their brows have fallen. They just need those placed a little bit higher. But a lot of times, you can still treat the scowl lines those elevens pretty much until you're 100 or whatever, if you really want. But I do start to back off on the forehead a little bit, because it does can either lead to a heavy brow and can make it hard to see. They feel like their their eyes don't open as well. So it does get tricky, but I do think by doing it early, you have staved off developing those etched in lines which will serve you well down the road.

Laura Bowman:

Good to know. Good to know. What? What about estrogen on the skin like we've been hearing about that lately, and I don't know what to make of Have you seen that be impactful?

Dr. Mary Alice Mina:

Yes, and I, and I've been prescribing it a lot more. So I didn't realize this, but actually, estrogen was in skincare back in the 40s, before the FDA and regulations. Yes, and, and people loved it. But then, once the FDA was formed, and I don't know the exact details why, but it stopped being put in there. And I think for a while, women have been using their vaginal estrogen cream on their face. Kind of all label,

Colette Fehr:

yeah, they said that the menopause conference, we said, put it on your part. Yeah,

Dr. Mary Alice Mina:

yeah. So, so people have been, you know, women have been kind of figuring this out, like, Well, hey, if it helps the skin there, which we know, it's very helpful there, it prevents UTIs, it helps with dryness and pain and and so women knew that, oh well, let me try it on my face. I think the issue was the formulation wasn't necessarily that desirable to apply on the face. And also, I don't know if people necessarily wanted their, you know, vaginal cream sitting right on the counter next to their toothbrush. I don't know. Maybe they didn't care, but, but now I think with this new push to kind of recognize menopause as a whole season in life, and not just something to just ignore and forget about, forget about women. Now, companies have formulated more elegant products with estriol to apply on the skin, and I think we're going to be seeing a lot more of this and more studies showing the impact, but we know it works for the the vaginal skin, so I think it's a great option. And I'll tell my patients, when I prescribe it to them, to use it like a moisturizer, that they can use it and it can help with dryness. So that's that's something to

Colette Fehr:

try too. So you could use that with your retinoid, yeah,

Laura Bowman:

like, instead of your moisturizer that you use,

Colette Fehr:

yeah. And so, what do you what do you like to prescribe for an estriol? I'm like, I'm getting some today.

Dr. Mary Alice Mina:

I just, I use a compounding company called Skin medicinal, and it's, they have an estriol cream, and I got it to try myself, and it feels great. It's light. It does seem like a moisturizer, so that's what I tell my patients, to use that in place of their moisturizer.

Laura Bowman:

Oh, my God, I want some. Yes, let's get some right

Colette Fehr:

away. Yeah. But I also like that you're pointing to how important it is to take care of your whole body, and that the skin is an organ, and it's not just about procedures and creams, and it really is about sleeping, hydrating, eating. Well, how much does sleep affect the skin? I would imagine, more than we think, right?

Dr. Mary Alice Mina:

Totally. And you know, it's taken me 40 years to figure this out. Where I feel like our culture is, especially in medicine. It's like, you know, sleeping for the week, and you know, you need to pride yourself on not sleeping. And then I think I hit 40, and I was like, I need to sleep like, I cannot stay up all night. And now that I have a I don't sleep. You know, probably a sleep expert would tell me, I need to sleep more, which is fair enough, but I'm working on it, but just getting a consistent schedule to get about six and a half hours a night for me makes me feel amazing. Now, ideally, I probably should be getting seven and a half right. I recognize that, but just being on a consistent schedule has been helpful, not just for my skin, but for everything. Yeah. I mean, think about when you were maybe in college, or we had newborns, right? And you're up all night. Did you look good when you looked in the mirror? No, like you accentuated dark circles under your eyes you might have. More like puffiness and swelling, and then you don't eat right when you're tired and you're, you know, not going to go exercise. So all these things have downstream effects. So sleeping is important. It's a time for our body, including our skin, to regenerate and to have good blood flow and our skin cells to turn over so it all. It's so important. And I do think it's great. I feel like people are now even like big CEOs and people are promoting sleep and and letting letting people know it's not a sign of weakness. It's actually critical, right?

Colette Fehr:

I know I'm so glad to I've never been a good sleeper, and I take it so seriously now. So I'm glad to hear you say that, and also that you're speaking to these things that really matter for the skin, and there are some things that people believe that don't matter. Are there any myths that you just giggle about as a dermatologist or that you could debunk for our listeners?

Dr. Mary Alice Mina:

Gosh, I feel like there's always something. And I feel like with social media, it's almost like, the more outrageous to get, the more views. And it's kind of crazy. One that doesn't make me giggle, it actually really makes me cry, is this whole thing of sunscreen causes cancer and that, you know, parents I hear who don't put sunscreen on their kids and their kids are burning. I mean, that really breaks my heart. Yeah, because I see the patients when they're older with the skin cancers, and they all tell me, I wish I had known I wish I could go back so that that to me. I wish we didn't have that. I wish we didn't have celebrities promoting that, or people with large platforms. I think just following a lot of these Tiktok trends, you know, it's always something new, right? Flaxseed oil, it can, can work instead of Botox, or taping your face instead of Botox, or, you know, beef tallow, or all these, all these different things. And it's like, you know, or a lot of the DIY stuff at home, it's like, there, there's stuff we know that works, that's formulated just for your skin, and it's been tested and tried and true. You know, you don't need to reinvent it and make it in your own kitchen. That just because you made it in your kitchen doesn't mean it's better, right? I think that concept that natural is always better, but something made very elegantly and cleanly and pulling out just the important ingredients and actives in a lab is not a bad thing. Just because it was created in a lab, it's not reasonable to think we're gonna all just rub oranges on our face for vitamin C serum, right? So I think just, I wish people would just trust the experts with skin health and not just follow whatever they see on social media or someone trying to get views or clicks or likes, and just, also, it's hard to not be persuaded like, oh, maybe I need that product. Oh, I've never heard of that. Maybe I do need that. It's very tempting to want to stray from what you use and find the next shiny object, but really, consistency is key. And I joke that I've used the same cleanser. It's the dove Beauty Bar. I've used it for decades. There we go. And every you know people, sometimes I'll go to a conference or someone like, I'm gonna try a foaming face wash or something. And I always just go back to my dove because it's easy and it works. And so why? Why do I need to complicate it with a separate one for my face and body and all that. So if it's working for you, stay with it. Yeah.

Laura Bowman:

And another, another thing that, like Colette and I were talking about, is that, you know, how much of it, how much of good skin is these preventable things and these routines that we do, and how much of it is just the genetic

Dr. Mary Alice Mina:

lottery? Well, genetics does play a role, for sure, but I would also say, like, your epigenetics, right? Like, what's actually turned on and we we can control a lot more than we think. So, yes, if you are born with, you know, eczema or certain conditions, then that is going to be your skin's going to be different than someone who doesn't have those struggles. Right? To me, it's more just your overall like look and appearance and bone structure and all that that I think, play a role, but you can still do so much. So you know, you may have gotten your acne from your dad or whatever, your baldness, but there's still so much you can do, and so I don't think I would just say, Oh, well, I throw my hands up. I can't do anything about it.

Colette Fehr:

That's a great way to put it. So what kind of sunblock Do you like to use? I'm just curious, because you obviously have very beautiful skin. Oh,

Dr. Mary Alice Mina:

well, thank you. I like L to MD. I. Think it's a great it's a great price point. It's, I like to put it on my face. It's very elegant. I love the spray because it's, it's a mineral spray, but it's so, so light, and it works great for, like, spraying on my kids and rubbing them down real fast. They really like the stick sunscreen. So I've got a 11 and 10 year old. So I think Neutrogena has a stick sunscreen. They use that very obligingly and and that's another thing I would just say, for people who have kids listening, you know, and maybe your kids are older, but I would say, just try to model the behavior you want them to have. My kids, don't fight me about wearing hats, because that's just what we've been doing since they were babies. And they see Mom puts her hat on, they put their hat on rash guards like that's just what we do when we're outside, at the beach, in the pool, we put our rash guards on. So I think that that's helpful. But for sunscreen, I'll tell people, there's no magic sunscreen. SPF, 30 or higher, broad spectrum, but the most important thing is, you like the way it feels. I also like La Roche Posay. I tend to have more oily skin, and I don't like to feel like I have something heavy or sticky on my face. So I like the ones that you have to shake, and they're super light, yeah, on my body. I'm less particular, but there's some, I mean, again, I use sunscreen if it's not lgmd, it's from the drug store, so that's what I do. Yeah,

Colette Fehr:

that's great. And how important do you think it is that the sunscreen has titanium or zinc in it? So

Dr. Mary Alice Mina:

if you are worried about chemical sunscreens, then stick with a mineral based sunscreen, like zinc or titanium. There have been some studies that concern people where they saw that the chemical sunscreens were absorbed by the bloodstream, and so they were measured in the bloodstream after use, which we know things are absorbed through our skin. So that's not really surprising. The study didn't say there was any harm from that, or any negative side effects from that, whatsoever. But if you are concerned about that, then, then sure, stick with the mineral based sunscreen. That's totally fine. The problem with those sometimes is that they're not quite as elegant. If you have a darker skin, sometimes they can leave more of a white, chalky cast. So don't be scared of chemical sunscreens. They there's a no study showing human harm and all that. But again, also, don't think of sun protection as stopping at your sunscreen, right? Throw on a hat. Wear sunglasses, throw on something to cover your the tops of your arms, if you're on a boat or paddle boarding, so you're not just like roasting like a rotisserie chicken. Yeah,

Colette Fehr:

yeah. I mean, Florida really has made me I mean, what you said is so true. You can see the difference in colder climates versus people who live here and the sun is just so strong and relentless all the time. Yeah. And, you know, as we get older, and you just, I just don't, I don't even feel good when the sun's beaming on me, unless I feel like I have something.

Dr. Mary Alice Mina:

So yeah, I am, I am right there, yes, yeah, even just

Laura Bowman:

the side of your face from the driving in the car, the one side of my face is, it's a little darker,

Dr. Mary Alice Mina:

yeah, the left side, and I the hat, the baseball cap, like I will frequently see in guys there, the this part of their face, sort of the mid part of their face, will be nice, and not a lot of sun damage, but all the sides have a lot of sun damage from I can, I can see, like, where the baseball cap shaded it. So, yeah, just think if you had just shaded all of it, right,

Colette Fehr:

right? And you're right, it's such a great point. Look at your stomach, or, you know, my kind of lower back, where the skin has had so much less exposure over unless you're somebody who works outside every day in a bathing suit, it's dramatically different,

Dr. Mary Alice Mina:

right? Or or even the top, like your arms, like the top of your arm, flip it, if they're different colors, then,

Colette Fehr:

yeah, and I have, I do have a lot of melasma now, it's really, it's a bummer,

Dr. Mary Alice Mina:

yeah, well, that that's one thing I should say, Colette some, Some people one thing to think about with the estriol cream is there have been some anecdotal reports that it could worsen melasma. So that's just one thing to keep in mind. I think it's still worth trying it, or maybe trying an area to see, but just for the listeners to know about that,

Colette Fehr:

okay, that's great to know and good to know that you don't have any opposition to putting the estrogen cream on your face. Because I was wondering, is that even true? Is that even good?

Dr. Mary Alice Mina:

No, no. And do your neck too? Neck, top of your hands, upper chest. So yes,

Colette Fehr:

I'm going to put my red and we're going to take a bath. Yes, but it's great advice. To use a small amount, because I'll get the dryness, particularly like here, you know, in the creases, especially where it peels. And, yeah, it's so many the faces dry, but you don't want wrinkles. So there's so many things to think about, yeah,

Dr. Mary Alice Mina:

and I would say anyone trying, don't give up. Play around with it. And I think of it, I like to treat to a little bit of peeling, just a smidge, because then I'm like, Okay, it's doing what it's supposed to Yeah,

Colette Fehr:

yeah. And anything you recommend to our listeners to ask their dermatologist, or go into their dermatologist specifically saying that they might not think of I think if

Dr. Mary Alice Mina:

you've had a lot of sun damage, and you're in your 40s plus, and you have never had or really, if you never had a skin check, get in and have a skin check, because it no matter what color you are. Or really, if you think you've had a lot of sun or not, right, if you are in your 40s, you've seen some sun, let them look you over head to toe, scalp to bottoms of your feet. And they can help you know what to look for. I think a lot of people know what to look for with melanomas, which are the dark spots, but they don't know about the much more common basal cell carcinomas and squamous cell carcinomas, which can happen starting in this phase of life. And then they can also help guide you on what skincare regimen you should be doing, and any potential treatments or lasers or devices that you might be interested in. They can kind of go over all that with you, but I would say if you never had a skin check, that would be a great opportunity to go and sometimes people think these brown spots on their skin are sunspot or, you know, like a brown spot for a laser, and it could be a melanoma. So again, just getting an expert's eyes on your skin first, can, I think, be really helpful, and

Colette Fehr:

for the average person, once a year, like an all over body mold check kind of thing? Okay, yeah, I

Dr. Mary Alice Mina:

would say once a year, but they'll let you know. If you're someone who's had a lot of sun damage, maybe have a lot of moles, maybe a family history of melanoma, they may want to see

Colette Fehr:

you twice a year. Yeah, yeah. I'm definitely getting to the point where I know so many people who are having to have something removed or have a skin cancer, and I think maybe especially being on Florida, it's just seems so I'll never forget the first dermatology appointment I went to here, the entire waiting room, and that doctor that I used to see was a Mohs surgeon. I mean, the entire waiting room, it looked like, you know, Purgatory, because everybody was just an old and had, like, the bandages on their nose.

Dr. Mary Alice Mina:

Yeah, I tell my younger patients like, you're going you're gonna sit in my waiting room and think I don't belong here. One of these things is not like the other. That was me

Colette Fehr:

and my 20s, but it's you know what think about that for our listeners who are younger, I mean, wear the sunscreen every day. If I could go back in time, that is the one thing I would do, and a hat. Yeah, protect yourself when you don't think you need to, because you'll be really glad later.

Dr. Mary Alice Mina:

Yeah, they say, if you want beautiful skin in your 50s, wear wear sunscreen or some protecting your 20s.

Colette Fehr:

Yeah, I'm going to tell my daughters this. My daughters are both in their 20s. I'm going to be telling them this again after this recording. Well, Dr, Mina, thank you so much. Can you share with our listeners how they can find you and anything else you'd like to promote in particular? Yeah,

Dr. Mary Alice Mina:

well, this was a lot of fun, ladies. I'm so glad we got to chat today. I actually have a podcast called the skin real, R, E, A, l, so if you are curious about certain skin things, procedures, devices, I really just kind of cover topics that I get asked about all the time. And I'm at at Dr Mina skin on all the social media platforms, YouTube, all that good stuff. And actually, if you this is a fun quiz. If you want to know, where you know, are you more of a Laura, are you more of a co lead, or me? You can take a fun quiz to find your skin style at the skin real.com forward slash style. Great.

Colette Fehr:

And we'll put all that in the show notes. I'm going to take the quiz. I want to find out.

Laura Bowman:

I think I know it's end of the spectrum I'm on, but

Colette Fehr:

I love, I love that kind of stuff. That's great. So, and your podcast is great, so I think our listeners would really enjoy that as well.

Dr. Mary Alice Mina:

Well. Thank you.

Laura Bowman:

Thank you so much for listening today. We hope you got some insights from our couch. If you like what you heard, and we hope that you did, don't forget to subscribe and share with a friend and write a review. Thanks for listening, guys. We'll see you next time see you, next time you.