In the News

Hi everyone, I’m Tatiana Beto, director of aesthetic content and we are here at AAD 2026 in Denver with four esteemed dermatologists, Dr. Mary Lupo, Dr. Doris Day, Dr. Heather Willery, sorry, Dr. Heather Willery Lloyd, and Dr. Heather Rogers. And today we are talking about menopause, which is such a big topic right now. It should have been a big topic for years, but now we’re talking about it so much more. And we wanted to get your input on what women should be doing right now to take care of their skin during this time and what are the best treatments to to undergo. So I’ll just start by saying what should women know about their overall health outside of their skin when they’re going through this phase?

Well, I think women need to realize that menopause is a time of your life where things are changing. And I think it’s important to realize that menopause, in my opinion, is very much interrelated with the concept of longevity and living well longer. I think that’s that’s what we all want to achieve. And when we have this menopause time in our life, I actually think there’s epigenomic changes that occur systemically in our body. And I think the single most important thing women do is be an advocate for themselves. Because if you leave the discussion of how to handle menopause to your doctor, it may get neglected.

And which doctor, right? Like who do you go to?

Good question. you know, when you first are seeing signs. What are your thoughts, Dr. Day?

Well, you go to many doctors and I think the problem is that the symptoms are so non-specific and often it’s us as a dermatologist that tells women that they’re in perimenopause be because they come in with the skin symptoms. Their hair is thinning. They say, “My face is falling apart. My skin is dry and itchy or I’m breaking out like a teenager like I never did before.” And then we ask them more questions. How’s your sleep been? How’s your mood? Are you thinking you’re more or are people more stupid? like you know and the people who really laugh at that kind of know that that’s like oh that’s a sign. So we put it together and we work with colleagues both in functional medicine and OB but I think ultimately all doctors should be able to mar manage perimenopause and menopause because it affects every organ system. So it doesn’t belong in one lane we all we all should be able to manage it.

Yeah. Yes. I totally agree. I think that there’s so especially in dermatology, we’re definitely in a field where the symptoms of perimenopause and menopause are so visible. There was a study that showed that a 100% of women who presented to a clinic that was focused on menopause had skin symptoms 100%. So there is no one specific doctor to deal with menopausal symptoms because the issues with hair, with the skin are so common in women in menopause.

Yeah.

And I think in addition to that, it’s about finding an advocate and a partner that we all have different symptoms. We all have different things that are bothering us. And so you have to decide how you’re going to address those concerns. Is it weightlifting? Is it, you know, taking hormone replacement? But it is something that all women are going to go through. We’re lucky to get to go through it. And so you just have to find a partner that will help you feel good about the choices that you’re making. to add to that. I think one of the biggest problems in managing perimenopause and menopause is that doctors are not trained in it. So finding a physician who understands menopause hormone therapy who doesn’t just tell women, “Oh, get over it. It’ll pass.” And just tells people to not do anything. I mean, I think you talk about how you’ve been doing hormone therapy for over 20 years. I’ve been doing it for almost 15. But most doctors in our field and in medicine will tell women hormone therapy is dangerous or you have to just do it for 5 years and then stop when in reality that’s completely wrong. So doctors need better education before we even get to patients.

You know it was over 20 years ago when I went through my time and I was fortunate because I knew that those studies that were used to tell women it was dangerous were extremely flawed studies. Yeah.

And so I knew better. I was always my own advocate, but I tell you I tell my patients to be angry if they’re not consulted. They’re not it’s not discussed because it is associated with morbidity, right? Urinary tract infections in otherwise healthy older women can cause sepsis and death. Bone density decreasing from lack of estrogen causes falls and death. Yeah. Not to mention heart disease and dementia. So there are more pluses than minuses, right?

And we talked a little bit about some of the symptoms already. What are the treatments that you are actually providing your patients right now?

Well, I would say starting with the basics, the most common complaint would be very dry skin and hair thinning. Those are the two things that and you know, I have to say there is another one, new onset of acne. That’s another one that that we sometimes don’t talk about as much, but um so when you start with those, that’s one of the more common things. And then there’s the anti-aging or, you know, rejuvenation concerns. So, it’s really good to make sure that the patients are on the appropriate skin care. They’re going to have to switch their moisturizer most likely because what you use when you’re 32 is not going to work when you’re 52 theoretically, right? Um and the other thing is addressing hair thinning which is a very common complaint for women and you can do that with neutrauticals and we have so many things in our office that we offer but those are probably the most common complaints that I s see starting with the basics.

Yeah.

I also think that in addition to the dryness, your skin just becomes incredibly more sensitive. Like there’s less, not only is there less collagen, but there’s less sebum production, there’s more vascular sort of um inflammation, people are having hot flashes, so people are getting rosacea in addition to the acne. So, not only do you need a moisturizer that’s more formulated like your natural moisturizing factor that has more squaline in it, for example, less petroleum based ingredients, you also just need less activives in general. So regular vitamin C may not work for you. You might need the lipid soluble form of vitamin C, THD. You might have to go from prescription tinino and down to retinol. And that doesn’t mean that these ingredients are less effective for you. It means that you’re absorbing a lot of them, so a little bit goes a long ways. And so I think so often as we’re aging, we’re like, “Oh, we need more.” But aging skin needs more but really tolerates less. And so you have to be selective about giving it fewer, higher quality options to work with.

And I think one thing is that this is something that’s done over time because as your estrogen declines, your estrogen receptors go down, but your brain estrogen receptors increase because your brain is trying to grab any circulating estrogen it can get. So your skin is always sacrificing for your body and your brain especially to stay healthy. And you can lose up to 50% of your collagen in the first five years post menopause. So what we do as dermatologists is we’re focusing on the cellular level. what’s going to support the fibiberblast, those cells that bu build collagen. What’s going to help drive the skin thickness? And it’s usually stacking therapy. So, one is great skincare as they’ve been talking about. Then it’s devices that stimulate collagen gently lowering the energy many times because you don’t need the higher energy and the skin can’t tolerate it. And then one thing I do for every patient after treatment is I use local hyperbaric oxygen therapy in the form of a caroxy mask and that also drives the the improvement. So it’s stacking treatments differently in our older patients and in our younger patients.

You know, another thing I think is significant is the decrease in healing times and our skin is more fragile and I think we all need to start thinking upstream with the problem of aging. You know, the hot flashes are a symptom of your estrogen being low. Don’t get me started on the hot flashes. I think I might be having one right now. But but the wrinkle is really a symptom. The fragility of the skin is the symptom. It’s upstream and it’s the aging of the fibroblast and their ability to even respond to the things that we’re trying to get it to respond to.

So it’s so fascinating when is a good time to just go in and start birth. We we spend so much time talking about puberty, right? And but we’re in menopause for more than a decade and we spend so little time educating women about it. So it’s just very you know I’m so glad we’re at the place we are at now where we can have this conversation and where more people are talking about it and it is at the forefront and and I do the studies that came out 30 years ago were incredibly detrimental to this progress. But now with additional conversations and education, I really try to get um my motivated female patients to start thinking about what they can do proactively. How do we go into perimenopause with as much hair as possible with as thick collagen as possible? And when you are perimenopause, you can do an aggressive resurfacing laser at strong settings, but then as you age, you really have to pull back and do multiple treatments at lower energy. So I do sort of like let’s build everything we can until the estrogen starts to wayne and then we want to continue but you just have to be more respectful and gingerely in that process.

One of the things is really having that holistic approach. So it’s helping women understand you mentioned it a little bit earlier but talking about resistance training the importance of protein in their diet. Even the order in which they eat their food makes a difference. Starting more with the proteins and having the sweets later to blunt those glucose spikes. Many of these patients go on GLP-1. So talking about um maintaining their weight and not getting too thin and managing the weight changes. So there’s so much that we do, but as dermatologists, we treat whole people, whole bodies, whole patients, mind and body. And we that gives us great power. So we can help our patients stay healthy over time. And I always tell my patients, these are the best years of your life. You’re going to be your most beautiful, your healthiest. It’s work, but it’s worth it. And they appreciate it.

And then what is one thing everyone should be doing right now in this in this during this phase?

Oh no, no, no. It is it is so multitasking, right? It’s never one thing. So, you know, so I I’m a All right, I’m glad you went first. Okay, I’m not going to say. All right.

Look, I think if a woman is not doing one simple thing you can add to your routine that I think is hugely important is jump training, squat lifts with weights. Now, be careful if you have bad knees, but the sooner you start this, you’re building muscle. You’re increasing your metabolic rate. I think that that is so important because I’m a big believer in the less people have to do exogenously, the better off they are. And I think we are uh so we’re talking about creatine and we’re talking about taking protein but if you’re not stressing those muscles which not only help you in general but they help build bones. So that you know that’s what I think is the one thing is get in the weights but don’t just lift the weights jump while you’re lifting.

Wow. You’re gonna have me jumping in the gym Dr. Loop in the gym.

I agree. And also you’re in a time of collagen decline so protecting it. So what we we obvious we we take sunscreen and sun protection for granted but this is a time where that’s even more important because you want to protect the collagen you have but resistance training also improves collagen in the skin. So there’s everybody should be doing resistance training and the younger you start the better. But there was just a study that showed that when you start in your 40s and 50s you get more benefits then for the brain for dementia even for the skin than you do starting in your younger years. So if you’re there and you didn’t start yet now’s the time to start.

Never too late. Never too late. And see your dermatologist. If you do one thing, see your dermatologist and do whatever they say. Yes.

So, I totally agree with both of you because I really believe lifestyle is so important when it comes to addressing all of these things that occur during pre menopause and menopause. And just to add on to the resistance training is to train to failure because the goal is to build muscle. And the way you build muscle is by training to failure. So sometimes you might be thinking, “Oh, I’m doing great.” Yeah. But you really need to train to failure. So that’s huge. see your dermatologist. That’s another one because I think that sometimes women feel so alone and isolated. And of all of the specialties, I do think dermatologists are honed in on this and more aware and more likely to kind of address someone’s concerns.

So, I would say also see a derm.

And I think um support yourself with rituals. Get routines and stick with your routines. And it’s your skinincare, it’s your exercise, it’s your sleep. And if you’re not really taking care of all of those little steps, one thing isn’t going to work. Like it, this is exactly what Mary said. Like it is about creating a routine that supports you. So you’re putting on your sunscreen, you’re using your night turnover product, you’re exercising, you’re sleeping, and you’re eating well. And that does make it a really powerful time of your life where you’re really in control.

I think the very last one I would say is having a good group of girlfriends. I think women, we need our girlfriends and grandchildren. Oh my goodness. Grandchildren. Yeah. Yeah. Just Yeah. It’s the best thing. But that social circle is really really important and and you reminded me of that by talking about um the support, but it is about having a good social circle on top of it.

And then we’re talking about this huge shift, right, where we’re, you know, discussing this more. How have you seen this shift presented even here at the dermatology meeting this week?

I think the very fact that we’re talking about it, Darus and I talked about it recently on uh her serious doctor show. Uh I I was speaking about this at the U Dallas cosmetic meeting. Everyone is beginning, you know, it’s like we have been the forefront and then there’s a lot of people behind us who are getting on the wave to write and that’s a good thing. That’s a good thing. the more that the more we have engagement of all of the specialties that women are no longer dismissed and they’re heard. It’s good for all women and we’re women. Yeah.

You know, I think you’re right. I think it’s hit that tipping point where in the beginning my colleagues would argue with me and tell me that this is ridiculous. It’s not our lane. Why are you talking about this? And now they’re talking about it too. And now companies are coming on board and having ad boards. I was just in Paris and Galerma did a whole ad board with beauty editors talking only about menopause and about bio stimulate. They they have an agenda but they have products to sell but they are telling the story and they’re helping us reach our patients in meaningful ways. So I think we’ve hit that tipping point where you’re a younger generation of of women the the kids the residents starting now in med school and in residency are really going to learn about menopause and it’s going to be normal to talk about menopause and to treat it. Right.

Yes, I agree. And the other thing that I’ve been seeing a lot of is at this meeting is longevity. Yeah. And that, you know, I we just were at a session where that was a hot topic. And I think that in general, we want to live longer, but we want to live longer in a healthy way to have a great health span. And we also want our skin to be healthy. We want our hair to be healthy as healthy as it can be in general. One of the reasons why I think menopause is getting its moment right now is because we’re living longer. And I love that you said someone said we’re lucky to be able to go through it. You said we’re lucky to be able to go through menopause. I always say every day is a good day. This is we’re fortunate. And so longevity is a big piece. So living as healthy and as um in a positive way for as long as possible physically, but also for your skin and hair.

I agree. It’s um it’s just part of the journey and I think it’s wonderful that it’s getting the attention it deserves and I do think that at least for me there’s a lot of noise in beauty in general and um it is our job to sort of help people identify what of those things are worth doing, what they’re worth spending their time and money on because a lot of it is common sense. It’s what we already talked about and it’s such a wonderful time in our lives, right? Because you’ve worked so hard. we’re accomplished women and all of these concerns can sometimes bring you down a little bit. So, it’s wonderful to be talking about this with all of you and getting your insights and knowing that there are options out there that can help us through this time. So, thank you all for your insights and for coming and joining New Beauty and always being great resources for us. So, thank you so much.

Thank you. Thank you.

Getting counterfeit Botox or getting the real medication injected by an untrained unlicensed injector can have grave consequences. Buying anything on the internet when you’re not a physician, or even if you’re a physician looking for a bargain is a bad idea, and it is actually illegal. Just type in cheap Botox on TikTok and you’ll have a plethora of choices. I can promise you it is not legitimate product and you run the risk of having true catastrophe. You will end up in the hospital on a respirator or potentially dead. The Louisiana Health Department says in September 2 people were hospitalized for severe illnesses, one, after buying fake medication, the other after getting injected. In a non-medical setting by a person with unknown credentials. Too much of the medication in your blood causes paralysis of your diaphragm. The muscle used to breathe. This is a medical procedure. It needs to be done in the proper setting by a proper doctor, preferably someone who’s board-certified in an aesthetic specialty like dermatology, plastic surgery, ENT. Ophthalmology Warning signs are blurry or double vision. Drooping eyelids, difficulty swallowing, slurred speech, difficulty breathing, muscle weakness. Dermatologist Dr. Mary Lupo has also seen the unsightly cosmetic consequences of Botox injected in the wrong muscles, causing a scowl look, or Dr. Spock eyebrows. Dr. Chris Haas at the LSU Health Dermatology Clinic sees it too. Botox party. That is the most common source of that particular instance. Um, alternatively, we see a lot of people going to medical spas where they’re injecting tons of patients with Botox. Some medical spas have MDs in them, and some don’t. Were the ones who had trouble, ones that went to a medical spa and weren’t under the care of an MD or, um, an np. Yes, that is the case. And there’s no medication to reverse the droopy eyelids or crooked smiles. You just have to wait a few months for it to wear off. Meg Ferris, WWL, Louisiana, and Botulinum Toxin is one of the most poisonous biological substances known. So stick to the brain for safety to make the procedure more affordable. Ask the doctor if they can be on an appointment plan or just get one area injected at a time.

When it comes to sun and damage and aging, sun damage and aging, the eyes are the 1st place where you’ll usually see things changing.

Don’t I know it, right?

Yeah,

That’s. Not right. I will not agree with you, your eyes look amazing.

Don’t put me in.

Thank you, but the skin around your eyes, it’s really thin

Yes, it is

It’s 10 times thinner than the rest of your face. And, as meg Farris shows us on wrinkle, free Friday, the FDA just approved a new procedure to tighten that delicate skin without surgery, after a clinical trial right here by a local doctor.

Oh good. How do I look? Do I look fabulous?

It only took moments with this dermatology patient to notice her spunky and confident personality. Bb as we were asked to call her by her initials had the best answer of anyone when asked for some personal background to better tell a story about anti-aging in the skin.

Yeah, I’m of age. Huh. I’m definitely of age

Bb is a dermatologist Doctor Mary Lupo’s patient. She admits to loving the skin and damaging the sun over the years. She joined a clinical trial to test using an injectable filler under the eyes. What is important about this is this is the first study that was done in order to get FDA approval for use in the tear troughs area.

Juvéderm Volbella XC is a hyaluronic acid filler. It’s been injected for years in small lines, lips, cheeks, the jaw. Hyaluronic acid is naturally in your skin and joints. It gives the skin plumpness, elasticity, and it attracts moisture. What’s new is its now FDA approved for under the eyes. Can be used to help shadows and contours as we age, we get indentations, we get ptosis, which means drooping our orbital area gets bigger as we get older and our eyes start sinking back in our heads. Doctor Lupo says it’s important for doctors to pick the right patient for best results. If someone who still has some firmness to their skin? They don’t have a lot of laxity around the skin and they don’t, they do not have the herniated fat pad.

And it’s important that the doctor is trained in facial anatomy and injecting technique the company provides, there’s potential for problems around the eyes.

If you get a hyaluronic acid filler or any gel filler in a blood vessel, and it includes the blood vessel, it can cause circulation compromise to that area. Doctor Lupo uses a tiny cannula instead of a needle to help avoid that the filler is not permanent, it gradually absorbs in a year.

Perfect.

And when I looked in a mirror at 16, I didn’t see anything but once I. Hit that particular mark, I started seeing everything in my face, you know, as I guess a lot of women we do. Although we probably shouldn’t put that kind of pressure on ourselves, but, you know, we do that.

I see the difference. Yeah, I see the difference.

Bb did notice the difference. It was a little bit more plumped there, the indentation subsided a little. It probably enhanced, fabulousness, and just a little bit more, you know?

And that’s coming from a natural woman who doesn’t even like to wear concealer or any makeup for wrinkle free Friday. I’m meg Farris.

Well, I think she looks great before and after, but dark circles under the eyes can also be caused by allergies, congested blood vessels, and even rubbing your eyes too much. And all of those things can stimulate more dark pigments.