What Estrogen Does to Your Skin (And What Actually Works)

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Tony Youn, a board certified plastic surgeon nationally recognized as one of the top plastic surgeons in the United States, bestselling author of Younger for Life, and the most followed plastic surgeon on social media with more than five million YouTube subscribers and eight million TikTok followers. In part one of this two part conversation, they take on a question that sits at the intersection of hormones and skin health that most doctors have never connected for their patients: what estrogen is actually doing to the skin, and what women can do about it.

Dr. Youn opens with a statistic that women lose 30% of the thickness of their collagen in the first five years after menopause, and then continue losing collagen at twice the rate of men for every year that follows. He explains exactly why this happens, how estrogen interacts with the fibroblasts that produce collagen and elastin, what declining estrogen does to hyaluronic acid and skin hydration, and why women are not imagining it when their skincare suddenly stops working.

From there the conversation becomes a practical guide. Dr. Youn walks through his morning and evening skincare framework, covering vitamin C serums and why stabilization matters, retinoids and tretinoin and how to choose between them based on skin type, peptides, growth factors, exfoliation, and where women are spending money on products that do nothing. He also addresses sunscreen, the debate between mineral and chemical formulas, and why the FDA has not approved a new sunscreen filter since the 1990s.

The episode then moves into procedures, with Dr. Youn covering neurotoxins including Botox, Dysport, and Daxxify, what they do, when to start, and what baby Botox actually means. He explains hyaluronic acid fillers, how much is too much, which areas carry the most risk, and why he only recommends fillers that can be dissolved. He also covers fat transfer, what makes it appealing and what makes it unpredictable, and how to vet whoever is doing your injections.

Dr. Youn also addresses the data on hormone replacement therapy and skin, including the evidence for systemic estrogen improving collagen thickness, what the studies do and do not show, and where topical estrogen fits into the conversation.

Guest links:

• Anthony Youn, MD
  
• Tony Youn, MD (Instagram)
  
• Doctor Youn (TikTok)
  
• Dr. Anthony Youn (Facebook)
  
• Doctor Youn (YouTube)
  
• The Doctor Youn Show (Apple Podcasts)

Books:

• “Younger for Life: Unlocking the Secrets of Longevity, Nutrition and Self-Care for a Youthful Life,” by Anthony Youn
• “Playing God,” by Anthony Youn
  
• “The Age Fix,” by Anthony Youn
  
• “In Stitches,” by Anthony Youn
• “The New Perimenopause,” by Dr. Mary Claire Haver
  
• “The New Menopause,"⁠ by Dr. Mary Claire Haver

Articles:

• Managing Menopausal Skin Changes: A Narrative Review of Skin Quality Changes, Their Aesthetic Impact, and the Actual Role of Hormone Replacement Therapy in Improvement (Journal of Cosmetic Dermatology)
  
• Overview of Aging, Skin Health, Estrogen, Menopause and HRT (Life)
  
• Menopause, skin and common dermatoses. Part 2: skin disorders (Clinical and Experimental Dermatology)
  
• Topical estrogen therapy for aging skin: Current evidence and clinical considerations (JAAD)
  
• Use of Retinoids in Topical Antiaging Treatments: A Focused Review of Clinical Evidence for Conventional and Nanoformulations (Advances in Therapy)
  
• Prospective, randomized, double-blind assessment of topical bakuchiol and retinol for facial photoageing (British Journal of Dermatology)
  
• Antioxidants to Defend Healthy and Youthful Skin—Current Trends and Future Directions in Cosmetology (Applied Sciences)
  
• Urinary concentrations of benzophenone-3 and reproductive outcomes among women undergoing infertility treatment with assisted reproductive technologies (Science of the Total Environment)
  
• Comparison between endocrine activity assessed using ToxCast/Tox21 database and human plasma concentration of sunscreen active ingredients/UV filters (Toxicological Sciences)
  
• Polynucleotides in Aesthetic Medicine: A Review of Current Practices and Perceived Effectiveness (International Journal of Molecular Sciences)
  
• Fatal phenol peel by an unlicensed social media practitioner: A forensic medical analysis (JAAD Online)
  
• Reverse skin aging signs by red light photobiomodulation (Skin Research and Technology)
  
• Mortality is Written on the Face (The Journals of Gerontology)
  
• Perceived age as clinically useful biomarker of ageing: cohort study (BMJ)
  
• Adipose-Derived Stem Cells for Facial Rejuvenation (Journal of Personalized Medicine)
  
• Adipose Tissue, Regeneration, and Skin Health: The Next Regenerative Frontier (Aesthetic Surgery Journal Open Forum)
  
• Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis (International Journal of Dermatology)
  
• Ingestion of a collagen peptide containing high concentrations of prolyl-hydroxyproline and hydroxyprolyl-glycine reduces advanced glycation end products levels in the skin and subcutaneous blood vessel walls: a randomized, double-blind, placebo-controlled study (Bioscience, Biotechnology, and Biochemistry)
• Retinoids for prevention and treatment of actinic keratosis (Anais Brasileiros de Dermatologia)

Other Resources:

• SkinCeuticals C E Ferulic® with 15% L-Ascorbic Acid
  
• Jeuveau
• The Menopause Empowerment Guide 
• What Does it Mean if My Antioxidant Serum is Gold or Amber in Color?