When it comes to menopause and skincare, it’s very important to take a medical point of view into account as well. Founders of 23MD Clinic Dr Martin Galy and Dr Suha Kersh might be working on different floors of their Chelsea clinic (which they opened eight years ago), but their experiences and professional opinions compliment each other in the most organic way (they have also been married for over 25 years, a testament to their lasting partnership, in life and at work).
Dr Galy is considered to be one of the best specialists in Bio-identical Hormone Replacement Therapy, which offers individually tailored solutions for both the health of the skin and the body, while Dr Kersh is a trusted expert in cosmetic medicine. Having practised in different areas of traditional medicine, Dr Galy has also worked as a GP, where he always focussed on the individualised approach to his patients. His business partner and wife Dr Kersh is much respected and recognised for her work in aesthetics and skin health, where she combines an artistic eye with the holistic approach to ageing.
Dr Kersh believes in the 360 degree approach when it comes to both health and beauty and prefers to look beyond the obvious. Her laser focus is on the individuality of her patients, as well as on helping to solve skin problems, including wrinkles and loss of volume, and the general state of health that impacts how the patient looks and feels. By giving her patients the opportunity to take informed and fact-based decisions when it comes to individual treatments, Dr Kersh allows her patients to achieve a healthier and more youthful appearance, as well as the improvement in emotional state and confidence. When it comes to skincare choices, both in terms of products and treatments, it’s also very important to take into account that what works for one patient, according to Dr Kersh, might not work at all or cause a negative skin reaction in another. It might take up to six months to figure out a perfectly tailored individual treatment or course of action, as skin cells regenerate every four to six weeks. When you start using new skincare products, it’s important to allow the skin both time and opportunity to react – to the skincare product, hormones or injections.
Is is enough to just use the skincare in order for your skin to look healthier, plumper and glowing during the menopause? The answer to this question, according to Dr Kersh, depends on multiple factors – from genetics and individual speed of ageing within body, to daily lifestyle choices. Some of Dr Kersh’s patients are genetically blessed even in their 70s and skincare minimalism suits them perfectly, while some women in their 40s might already need a more complex approach. However cosmetic route might also not be for everyone and shouldn’t be forced on the patient. Having said that, both Dr Galy and Dr Kersh think that one will have to be very, very lucky to only need individualised skincare during the period of menopause in order to address all of the changes that the skin and body undergo during that intense period of time, lasting not months, but years. Correctly matched skincare to individual’s needs can certainly bring a visibly positive effect – both it terms of how you look and as a consequence, how you feel about yourself. But there is a significant ‘but’ here – the skincare needs to be chosen not by a random person, but by a genuine, knowledgable expert, who will understand your needs in the moment in time.
During our conversation Dr Galy stressed that even though they currently don’t carry the skincare specifically labelled ‘for menopausal skin’ at 23MD, both he and Dr Kersh recommend the following ingredients for the skin that is undergoing significant hormonal changes from within the body. Vitamin C (which helps extend the life-activity of cells, Retinol (improves the speed of skin regeneration), Stem Cell Growth Factors (help improve both the health and life expectancy of skin cells) and Hyaluronic acid ( which assists production of collagen). Dr Galy notes that hyaluronic acid doesn’t penetrate the skin well when it is an ingredient in the cream or serum and thus its efficacy in skincare, in his expert opinion, is somewhat limited – unless it is injected as part of the hydration solution or as the deep derma filler. Both Dr Galy and Dr Kersh also recommend a combination of Vitamin C and retinol during the menopause years. The next stage of effective treatment after that would have to be a more invasive – either an injectable therapy or one of the energy-based treatment, which will stimulate collage production and positively impact skin’s state of health.
During my conversation with Dr Galy and Dr Kersh, a member of their team at 23MD, a medicinal aesthetician Juta Esite, who also does different types of facials at the clinic, as well as mesotherapy, also contributed her thoughts and experience. She mentioned wild yam, a cosmetic ingredient, which contains a chemical substance called diosgenin, which can be used in the laboratory and transformed into different types of steroids, such as oestrogen and the collagen mimetic peptide DGEA . But in order to get such a cream one would certainly need a prescription. At 23MD clinic such creams can be made to order, taking into account individual patient parameters, as well as skin and body’s needs during different stages of the menopause. Such creams can also contain prescribed doses of oestrogen, progesterone and even testosterone – with regular use they help stimulate the skin, in which levels of collagen are diminishing, thus there is noticeable loss of plumpness and elasticity, which we take completely for granted when we are young. The answer to the question for how long and how effectively the use of such creams during menopause would be was as thorough, as it was thoughtful. When it comes to such matters, every person is as individual as their DNA and among other things depends on the speed with which oestrogen is decreasing within individual’s body.
At the moment there are still few studies which can answer the question why some women go through the menopause at the increased speed, while others have the opposite experience. At the end of the day this process determines how quickly a woman moves from peri-menopause stage into menopause, as well as how it will affect individual appearance & skin health. According to Dr Galy, oestrogen is both a powerful and an important hormone for one’s health and even in small doses it helps to optimise body’s hormone functions and helps skincare to work more effectively. If you get an optimal dose for your body, then, according to Dr Kersh, coupled with the individualised skincare selection and its synergy with oestrogen, you will be able to achieve more visible and lasting results that will also positively impact your sense of wellbeing. It’s also important to take into account that with all the benefits of retinol, not everyone can tolerate it. Juta recommends to start using retinol both slowly and carefully, in encapsulated form, which will guarantee its slower release into skin layers and make its effect on the skin more gentle, allowing the skin to adapt accordingly.
Another good tip from her is to apply vitamin C, in combination with ceramides, in the morning and thus achieve more effective collagen synthesis. Its also helpful to keep in mind that individual selection of ingredients and skin care products will allow you to better address your individual needs in the moment in time. I was also tactfully reminded by the team of professionals with years of experience that there are no magic ingredients or skincare products, which can turn back the time and stop the effect of menopause on individual’s appearance and daily functioning of the body. If you don’t yet have symptoms of the menopause, its’ quite likely that irrespective of age there are still plenty of hormones circulating in your body – and our hormones are in constant movement and flux, even when we sleep or rest. What is more important is the diagnosis of menopause at an earlier stage – not only from the point of view of the looks alone, but in terms of general health, especially when it comes to heart and bones, which are both significantly impacted by the decreasing levels of oestrogen in the body.
While I was researching and writing the original article, that later became the series “Menopause and Skincare” that focussed on the ageing process beyond the 40s, I got to listen & learn from top industry professionals within the beauty industry (including retailers, facialists and dermatologists). Thanks to all those insightful conversations I realised that with the gradual change in the level of comfort when it comes to discussions about menopause, we are experiencing and observing the evolution of the whole segment of the beauty industry. The more women feel personally uncomfortable with the topic of age related to “anti-ageing” – if we pause and consider for a moment the fact the ageing and our longer life expectancy is a privilege, rather than an impediment – the quicker the segment marketed to us as ‘anti-age’ will disappear into oblivion and in its place will come the more logical, holistic and targeted ‘perimenopause’, ‘menopause’ and ‘mature skin’. The most important thing to do, when it comes to skincare and treatment choices, is to find solutions that target and address your individual skin and body needs, which in turn will significantly impact how you feel and look.
Menopause is indeed one of the most promising and interesting, but not yet fully realised commercial opportunities of the last decade. It’s not at all surprising that more and more beauty brands and startups realise the potential of helping women during this long period of transition. As I typed this post, the words of the prima ballerina and extraordinary graceful beauty Maya Plisetskaya came to mind: “Of course there are no creams that will make wrinkles disappear, but female face is like a garden – it can be old and neglected, or it can be old, but beautifully groomed”.
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