At a certain point in midlife, many women start noticing something frustrating: the skincare routine that used to work suddenly… doesn’t.

You buy better products. Add more steps. Spend more money. Maybe even consider lasers or injectables. And yet your skin still feels duller, thinner, drier, more reactive, or somehow just not like you anymore.

So what’s actually happening?

In this episode of The Iconic Midlife, Roxy sits down with renowned board-certified dermatologist Dr. Jessica Weiser for a smart, nuanced conversation about what really happens to skin during perimenopause and menopause — and why pushing your skin harder may actually be the wrong approach.

They discuss:

• Why skincare routines plateau in midlife
• The hormonal shifts affecting collagen, hydration, elasticity, and recovery
• Why “more aggressive” skincare can backfire
• The overlooked middle ground between topical products and cosmetic procedures
• Why many women feel disconnected from their reflection during this stage
• The emotional side of skin changes and identity
• How practitioners are rethinking skin renewal and resilience
• The difference between “pushing” the skin and supporting its natural renewal process
• What Dr. Weiser would simplify immediately in most midlife routines
• The biggest myths women still believe about aging skin

If what we talked about resonates with you — the idea that your skin still has the ability to renew, it just needs the right support — DefenAge has put together a breakdown of exactly how this works and what makes their approach different.

✨ Visit: defenage.com/renewal

✨ Use code ROXY29 to get the DefenAge Fly Kit for just $29 (normally $98)-a special starter set designed to support midlife skin renewal.

Follow Dr. Jessica Weiser

Instagram: @weiserskinmd

Follow DefenAge

Instagram: @defenageskincare

Join the Inner Circle: https://the-iconic-midlife-with-roxy-manning.kit.com/3433416614

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Social media: @theiconicmidlife (show) | @redcarpetroxy (host)

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Exclusive Offer from DefenAge Skincare

Today’s episode is brought to you by DefenAge — advanced skincare powered by patented defensin technology designed to help rejuvenate the look of aging skin. ✨ Right now, listeners of The Iconic Midlife can get the DefenAge Fly Kit for just $29 (normally $98) at DefenAge.com/renewal using code ROXY29. If you’ve been curious about DefenAge’s breakthrough defensin technology, this is an incredible way to try it. Follow: @defenageskincare Shop here: www.DefenAge.com/renewal

Exclusive Offer from DefenAge Skincare

Today’s episode is brought to you by DefenAge — advanced skincare powered by patented defensin technology designed to help rejuvenate the look of aging skin. ✨ Right now, listeners of The Iconic Midlife can get the DefenAge Fly Kit for just $29 (normally $98) at DefenAge.com/renewal using code ROXY29. If you’ve been curious about DefenAge’s breakthrough defensin technology, this is an incredible way to try it. Follow: @defenageskincare Shop here: www.DefenAge.com/renewal

Patients come in and complain about their neck. This is such a common thing to complain about.

You come in, you just turned 50, and the thing that you look at is what happened here when you start to remove the hormonal influence on the skin, when you start to say, okay, now we don't have estrogen, that really changes the way that we should approach the skin. And it doesn't always.

And it feels like you're almost going through a second puberty when you're going.

Through perimenopause, backwards puberty.

Take me through like a regime, like a skin care regime that you would recommend.

A lot of people are catching on to this idea that as the skin changes, we need to modulate our behavior, we need to modulate our recommendations to those patients.

And I have met so many women that do not wash their face at night.

You don't need to wash off the makeup only. You need to wash off the pollution, you need to wash off the debris.

I would wake up looking like a pepperoni pizza the next day, day if I didn't wash my face at night.

What if the reason your skin care suddenly isn't working has less to do with the products and more to do with the fact that your skin itself has changed?

Because I think a lot of women hit this moment in midlife where they're doing all the same things, maybe even spending more money, adding more steps, trying harder, and still still feel like their skin just isn't responding the same way anymore.

So today we're getting into what's actually happening biologically during perimenopause and menopause, why aggressively pushing the skin can sometimes backfire, and why many dermatologists are starting to think differently about renewal, resilience and supporting the skin instead of fighting it. Joining me today is board certified dermatologist Dr. Jessica Weiser. And honestly, this conversation made so much sense to me.

This is Dr. Jessica Weiser on the Iconic Midlife. Welcome to the Iconic Midlife. Jessica, how are you today?

I am well, thank you, thank you for having me.

Oh, I'm so excited to chat with you. I mean, there are so many things to talk about, skin, midlife, all the things that go on, you know, during this time.

It's like you step into this period, you know, of, you know, the aging process and you don't know really what to expect effect. It's sort of like you're coming into this and, you know, things get thrown at you.

So I'm very grateful you're here to kind of decipher and talk about all of these skin issues that are coming up. I know for me personally, I mean, I don't know for you if you've kind of experienced some of the same issues as.

Well, I always say that I'm. I'm older than I look. I feel like that goes along with the dermatology realm. But, yes, I'm the mom of two teenage boys.

And I think that what you realize as you go through and you start the aging process and you hit perimenopause and you have, you know, friends and peers already in menopause, unfortunately, not quite in menopause yet, but certainly getting towards there is that there is so much skin, you know, new territory. And I think that's the hardest part is that you're used to your skin sort of living in a certain zone.

And what we find as we age is that you sort of start to shift outside that zone. You're living on the periphery of that zone, and it's so hard to find where that new territory lies.

And so I think that is one of the biggest challenges of that sort of midlife moment, as particularly as a woman, because I think so many of us find ourselves in that limbo and not sure what direction to take. And so I think as a dermatologist, I am given that distinct advantage of saying, well, I know what's about to happen, right?

I know what the estrogen effects are going to look like on skin. And so how do you anticipate that?

Yeah, you know, definitely. I think that, you know, we kind of step into this time thinking, like, our old strategies are going to work, right?

Like, we kind of go in thinking, you know, we can use the same products, we can. You know, our skin is going to have the same sort of reaction to things.

And, you know, what we used to do will still work, which I find for myself, and I know for a lot of other women out there, that is not the case. So what is the biology behind what is going on in our skin, you know, during perimenopause and menopause?

Cause I think that, you know, obviously waning estrogen is our biggest trigger. And so when we start to see estrogen levels drop, so many different things happen. We're going to see accelerated collagen breakdown.

We're going to see loss of elastin, or elasticity in the skin. We're going to see increased dryness, the sensitivity of the skin changes.

And so so many of the things that you're doing in your 30s and 40s all of a sudden become not applicable and the harder you try, the more you fight against it.

And so what I find is that, you know, when you're, you know, 35 and your skin is not behaving, you add a new product, you increase the intensity of something. And what we find in sort of midlife and perimenopause menopausal years is that it's actually the exact opposite.

You actually want to take a step back, you want to avoid the irritating products, you want to sort of move away from things that are exfoliating and inflaming the skin, and you want to move towards things that are nurturing the skin in a different way. And so what we're looking at is we're looking more towards renewal and regeneration than we are towards really working aggressively on the skin.

And so I think that is probably the biggest trigger is understanding how to actually restrain yourself as opposed to trying harder. And I think that that's what most of us encounter as we reach that sort of midlife moment. And so I think there's lots of different options.

I'm happy to get into, you know, some of what that looks like. But that self restraint, that pulling back on the more aggressive skin care products is really where the key tends to lie.

Do you find that your patients, when they're coming in to see you, they're in there in midlife and they see their skin changing, you know, they don't know what to do.

Do you find that they blame themselves or that they really, you know, feel like maybe there's some sort of a failure or something they did wrong during this process?

Of course, I think that that's what we all do, right? When something goes wrong in your job, you immediately go, ooh, well, how could I have done this better? I think the same thing happens in aesthetics.

What could I have changed? How could I have avoided this? What could I have done, you know, differently?

And I think that we have to sort of take away that level of blame and sort of, you know, self deprecation almost, because you can't control it. And the process is unique from person to person. And so when you're seeing those waning sebum levels, that oil is going away.

What do you do you think, oh, I'm going to add a bunch of oils. Oh, but now you're going to get perimenopausal breakouts and you're going to trigger a whole different, you know, occlusive cycle.

Oh, well, if I'm all clogged now, I'm going to exfoliate more and you end up with this very evil cycle where what you're finding is that people are actually trying to add more and more and more products. And what you really need is just different products. The skin responds much better to hydration. It responds better to balance.

Sometimes it responds better to toning. And so there are different things that we can work on where we actually want to change the way the skin is responding.

And so one of those key principles to me is this concept of cell renewal. We don't necessarily want to increase turnover.

When you think about acne prone young the skin, you're like, great, turn it over faster, boost the collagen faster.

What we find as we age is that our fibroblasts, which are those cells that produce collagen, are sort of more tired and it's harder to get the same amount of, you know, output from those cells.

And so instead what we find is that we can actually trigger a different type of cell renewal where we can activate things like stem cells, where we can activate different, you know, moieties in the skin, where we're working on the skin or from a new angle. And we find that in the anti aging process that one of the molecules that we find most exciting in my practice is something called the defensin.

And defensins are essentially sort of little stimulating signals. They travel down the hair follicle and they activate the stem cell.

And that essentially is encouraging skin cell renewal as opposed to turnover or over producing cells or over exfoliating. What we're doing is we're activating the stem cells and we're making them make the new skin cells.

And so that creates a really beautiful sort of dewy or refreshed layer. And it's not hurting the skin. There isn't an irritation potential there. I always say that I'm very grateful.

I have a really broad range of patients in my practice, and I would say the vast majority fall between their 40s and their, you know, I would say late 60s, early 70s. And what that allows is what that you can sort of evolve with these patients.

So when they originally come in, you know, patients in their 30s, it's really easy. You know, all of these things that you see sort of trending in beauty magazines.

They're very specifically targeted at that sort of 30 something, maybe early 40 something demographic of patients who kind of have straightforward, okay, well, I have sensitive skin or I have dry skin, but it's not drastically different. When you start to remove the hormonal influence on the skin, when you start to say, okay, now we don't have estrogen.

That really changes the way that we should approach the skin. And it doesn't always. I think some people still really drive home, you have to have this in your skincare, you know, in your skincare regimen.

There's no must, right? Each of us is going to respond differently. Each of us is going to need different active ingredients.

But I think that a lot of people are catching on to this idea that as the skin changes, we need to modulate our behavior, we need to modulate our recommendations to those patients in order to maximize the results that they're getting.

I think it's very difficult to achieve the same answer if you have a different sort of, you know, you're working on a different canvas, you're working on a different skin. And so those patients need new approaches in order to accomplish similar endpoints. We want to keep the skin youthful looking.

We want to keep that radiance. One of the hallmarks to me of youthful skin is that light reflex.

So when you look at somebody and you look at how the light sort of radiates off of a cheekbone, that's about the plumpness of the skin. If you over exfoliate and you over irritate the skin, you start to lose it, you start to develop a dullness.

And so this idea that we can get down and kind of renew the skin cells and build them up from the inside creates much more of that kind of dewy, hydrated radiance that people really perceive as youthful. And so it doesn't mean that the skin is young. It just means that it is enriching itself in a way that's very productive.

And so I do think as we get to that sort of midlife moment, we need to change our approach.

So are we saying not to exfoliate at this time, or is it just a different method that we should be having? I mean, what, what do we say?

You know, like, for example, a woman is coming into you, she's exfoliated, you know, her whole life because that's what she's been told and, and, or to use certain products and, and different, you know, different methods on how to clean her skin and try to keep it hydrated and dewy and youthful and all these good things. What do you say to her?

So it's not that you can't exfoliate, it's that you're going to maybe think about it in a different way.

And so while it's sort of a very natural part of most people's skincare, Routine to think about it as like, oh, every, you know, two or three days, I use an exfoliating product. It's going to be a little bit more sort of thoughtful, meaning we're not going to tell everyone to do it the same way.

And sometimes instead of using a chemical exfoliant, which can be useful in certain patients, sometimes we're going to use an enzyme or we're going to use a physical exfoliant.

So for example, if you're using something like an enzyme mask, it's going to sit on the skin in a, in a nice way where we're going to kind of get some of that nice skin cell turnover, you're going to get some of that change where you will get an exfoliating effect, but you're not going to strip the skin, you're not going to be pulling away, you know, oils. You know, for example, like if I'm using a salicylic acid or a beta hydroxy acid as they're sort of, you know, clinically known.

If you apply that to skin that's feeling sensitive and you strip some of the natural oils from the skin, you're going to get more inflammation, more redness, more dryness. People don't love the way that feels and the way that looks. But if we, if we sort of pare that down and we say, how about using an enzyme?

What if we change this approach and instead of using, you know, a beta hydroxy acid, now we're using an enzyme and we're talking about breaking it down in a gentler way, in a milder way. We still want to get that exfoliation. You might just want to do it, you know, kinder to the skin, less harsh to that skin surface.

So don't avoid things, just do them a little bit differently.

What do you say to women who feel sort of stuck in the middle, like when they're coming in to see you and they say, you know, my skin care isn't working. So I'm dealing with that on one side. But I'm not quite ready to do lasers and peels and things that may be a little more invasive.

What do you say to them? But they still want, of course, solutions to their skin problems.

I think that there's always going to be a group of people who feel not ready for procedures. We certainly don't force procedures, although that is sort of the mainstay of, you know, what I do in my practice.

I do a lot of energy based devices and procedures, but some people are just not there. Whether it's emotionally or physically. And so what we try to encourage them is we try and encourage them to try by shifting some of their products.

I don't tend to do sort of a complete jump right when someone comes in and they say, I love the way that my cleanser feels, or I'm really happy with this product that I've been using. What I often will do is start to transition their. Their evening skin care.

What I always explain to patients is that your morning is sort of your protective skin care. So sunscreen is going to be my number one ingredient every single morning. But what we find in the evening is that's your restorative skin care.

And if I can change my restorative evening routine a little bit, if I can add something, as I said, that's going to be a little bit more calming, a little bit more hydrating, a little bit gentler on the skin at night. What people tend to find is that they wake up in the morning and they notice some of those restorative effects a little bit faster.

If you change everything, they feel sort of unsettled.

And I think that the idea is to make it gradual, to make patients feel comfortable with what you're changing and that you're not taking away everything that they think that they like. Sometimes they do really like a product. And sometimes I will say, okay, we're not going to change everything you're doing.

We're going to change some of these products, and we're going to reassess in six weeks and see how much your skin has changed. A really common thing that I would say a great example of this kind of situation is patients come in and complain about their neck.

This is such a common thing to complain about. You come in, you just turned 50, and the thing that you look at is what happened here?

Please tell us what happens to our neck, because I have it, too. I'm like, what is going on?

Yes. You're like, I feel like I can maintain my face. I think I have a handle on that.

Somehow, you know, south of the jawline just feels like a different area altogether. And it is.

And that's the reason that you feel that way is because our facial skin has a lot more oil glands, a lot more sebum production, and so it maintains itself a little bit better. Also think about gravity. Think about how this skin sits. It is constantly being pulled on by gravity.

And so we have less oil glands, so we have less robust skin there. And so the skin doesn't heal as quickly. It gets crepier faster, because it doesn't have as much oil and as much sort of substance to it.

And then it also has this chronic pull on it.

You know, anything that is under that constant sort of gravitational pull, it's really hard to keep it up there if it just feels like it always wants to be drifting down. And so things that we want to do on the neck are a little bit different.

And I always say this is a classic place where if you go really aggressive on your neck, it gets red and irritated. It's so miserable. Patients get so miserable, the harder they try on their neck, the worse it gets.

And so finding a neck product that's going to give you a little bit of antioxidant, a little bit of hydration, a little bit of renewal, stem cell renewal, there's a great defense and mediated neck product. And the idea behind that is that those are new skin cells again.

And so finding these products that are going to give us newer skin cells, that are going to give us more hydration, more plumpness, those are things that really make a difference in the neck skin. Is it going to give you a lift? Not necessarily.

But if we can find a way to encourage those cells to turn over faster, we can find that we're going to get them plumper and more hydrated looking. And it starts to take away some of that creepiness and some of that, you know, people look at it and they go, it feels like tissue paper.

You know, my face doesn't feel like tissue paper. Why does my neck feel that way? Because it needs more tlc. It's a different kind of surface.

And we have to, you know, we have to be nicer to it, kinder to it. And so we do like a thicker, more hydrating, more enriching product on the neck to target that differently than the face.

Yeah, I feel like I also don't break out really on my neck.

Totally. And so what we find is that you can use a lighter product on your face and you can essentially, almost like just below the jawline, the skin changes.

And so we see that that skin tends to be less prone to hormonal breakouts.

Another thing that I always joke, you turn 45 and all of a sudden you're like little cystic pimples and things like that, because as you balance out your hormones, all of a sudden your estrogen is gone and you have this relative excess of testosterone. You almost never see a patient get a hormonal breakout on their neck. And so we can treat it a little bit differently.

We find that it's Going to respond a little bit different, better to those thicker, heavier, more hydrating, more plumping products.

Interesting. So the, the, the, the balance, since the balance is off and the estrogen is low, the testosterone is really getting those breakouts going.

No, it totally makes sense. It's the way our body perceives those hormones. They're different.

They're different. And it feels like you're almost going through a second puberty when you're going through perimenopause.

You know, it's backwards. Backwards puberty.

Yes. Yes, it is. It is. I know. And it shows so much on our skin.

I mean, I feel like that's sort of the place where I see, you know, however I'm feeling inside is immediately reflecting on how I look outside.

Totally. Right.

During this period, we also say that, you know, estrogen is so protective against so many things, and so it protects you against all these things. And then we take away that protection and all of a sudden you have to deal with, wait a second, what's under there?

What other hormones am I dealing with? What other issues are happening?

And so I always say it's this idea that you get like the straight chin hair, that you're like, oh, I really want to pluck that chin hair. You pluck the chin hair, it makes a huge pimple, and you're like, wait a second, this seems so unfortunate.

It's just in this really uncomfortable place where you're not sure how to treat it.

And again, if you go after those really aggressive acne products, you're going to dry the skin, you're going to strip the natural barrier, and the skin doesn't like that either. And so we're in a very tenuous place as we go through hormonal midlife shifts that you have to understand both perspective.

Do you believe also in bringing some of those products down to the backs of the hands to kind of, you know, take care of the, the skin on the backs of the hands. Because I do see, you know, as I get older, more sun damage and things like that seem to pop out for sure.

One of the most common places that we see neglected, actually, is the backs of the hands. Right. We all sort of think about, you know, face and neck.

What we actually say is that face, neck, and decolletage should be considered one unit, and your backs or your hands should be the extension of that unit. And so we actually would love for everything that you're using on your face and neck to be also used on your chest and then to be used on the hands.

What we find is that people start to treat their hands and the next thing they start to notice is that their upper arms feel creepy. And there's a body product that goes along with that.

And so while we can stick to things like moisturizer, simple body lotions from the drugstore when we're really young, because our body allows for that, as we get older, we need more nourishing on the body as well. And so hands need to be treated differently, arms need to be treated differently.

I even encourage my patients to actually treat their legs differently because if you maintain these things.

So if I'm using a, you know, a good quality product on my arms and I'm starting to work against, you know, that sort of dried up, more sort of shriveled, you know, cells that tend to feel tissue papery. If I have a product that works on my arms, why am I not taking it down to my legs?

Why am I not using it on my shins and my thighs and on my knees to help enrich and nourish that skin in the same kind of way?

And so I do think that again, you can get back into those defense and mediated products and you can find that there's a place to use them on the full body.

There's a special hand cream that is a body and hand cream that works really beautifully for, you know, these off, you know, off face areas, as we say, because each of these surfaces is a little bit different. But yes, pigmentation on the hands is so common. Creepiness on the hands. It's one of those things that you look down and that's what we see. Right.

You don't need a mirror to see your hands. You can just look down and see them and you're like, oh, just constant reminder.

Yes. In the skin. The skin seems thin too much thinner as I've gotten older, you know, it's really.

It's almost like looking at your mother or your grandmother's hands.

Absolutely, absolutely.

I joke that my mother, the only thing that has ever bothered her, and she's the loveliest, the only esthetic thing that really bothers her is she comes in and she'll be like, I have to do something about the brown spots on my hands. It's an area that gets a lot of sun. You don't even really think about it. Right.

If you wear, you know, a long sleeve shirt in the summertime or you're wearing something thin, we often think, oh, we should sun protect our arms or we should put a little sunscreen there.

But you're very seldom remember to bring it down to the backs of your hands, or you're wearing a long sleeve and your hands are exposed, they're sitting up on the steering wheel. When you drive, what's one of the most common effects of UV radiation? Collagen breakdown.

And so if you just sit with your hands up there, I always say you can't get a sunburn through the window because the UVB rays don't come through the window. But the UVA radiation goes right through the car glass, and it continues to break down collagen and it continues to trigger pigmentation.

And so sitting by a window of any sort, you're getting damage through the window. And everyone goes, well, I can't get a sunburn. I said, doesn't matter.

You're going to get wrinkles, you're going to get sunspots, and you're going to age the skin. And you want to be able to slow those things down.

And you really want to pay attention to those areas in particular, because all those classic studies, I don't know if you've seen the photographs. There's a very classic photograph of an older truck driver, and it's literally as if his face was split down the middle and the side.

And the driver's side window is aged tenfold of what the side that's sort of more protective on the interior of the truck. And so we have to start to think about these things as exposures. And you sort of. Don't you think, oh, I'm in the car, I should be fine.

Sunscreen in the car is so important. You know, skin renewal, skin care in the car is so important. You always want to be working on that regenerative process.

Oh, my gosh. You know, I went even so far as to buy those driving gloves I ordered. I was so I have them, too. You have them too. Okay, good, good.

I had them for years.

And I don't only wear them in the car, which is mortifying to people when they see me, but I actually wear UPF gloves that cover everything but my fingertips pretty much anytime I'm spending any length of time outside. I wear them hiking. I wear them when I'm out with my kids on their, you know, for their sports team games.

I don't want to be sitting outside and completely exposed. Those hands age really quickly.

And so I think, again, those products that you can use at night to restore and rejuvenate and refresh that skin is so important.

You know, I think you brought up an interesting point about the cell renewal process. The skin renewal process.

And as we get older, it's not necessarily that we need the stronger products, but again, it's like more that your skin, you're losing the signal of how to tell the skin to renew. So can you go into a little bit more detail about that?

Because I think that that is a definite, you know, just saying, okay, let's try something stronger or something more intense.

Absolutely.

I think that what we start to realize is that when we talk about the skin as we age, that we have to start to think about how are we going to renew or regenerate the skin in a different way. And I think that this concept of regeneration finally is very buzzy. Right.

People are finally starting to think about, instead of making a totally different person, instead of changing the way we look, we're so much more interested in maintaining a natural aesthetic. And what that requires is it requires for the body to work a little bit harder.

And the best way for us to control the way that the body works is through these signaling cascades.

And so if we have the ability to topically apply a signaling molecule like a defensin, just to go back to that, what we're able to do with those defensin molecules is we're able to get into the skin and we're able to stimulate a regenerative process. So it's not only about more collagen. More collagen? Yes.

Of course, at the end of the day, if we can get it, get back to a place where we have more collagen, that's wonderful. But it's harder and harder to produce collagen as we age.

And so this idea of regenerative, where we're stimulating new skin cell production, where we're actually finding a product that goes onto the skin, that penetrates into that skin without causing irritation, without causing dryness or redness or inflammation or other side effects, and we're able to make new regenerated skin cells. What we're going to find is that the skin is going to feel thicker, it's going to feel more plump, it's going to feel better, taken care of.

And so that's a very different approach than the idea of, you know, purely antioxidants, purely, you know, more aggressive exfoliants. I think that there is a way to approach it that isn't classic.

And this is sort of a new age way of looking at it, where we can stimulate those cells through those new sort of more scientific signaling pathways.

It seems like almost longevity for the skin in a way. You know, we talk about longevity you know, inside the body quite a bit. And it almost seems like skin longevity.

They absolutely go hand in hand. There's no way around saying, I want my body to, you know, last longer. You don't just want it to last longer.

So I always say that this concept of longevity is really interesting because for a long time we were talking about lifespan, just how long you lived. And I think that we've really shifted that conversation in such a productive direction, where we're now talking about this concept of health span.

How long are you living? Well, how long are you living in a high functional state? And the skin is exactly the same. Your skin is going to last. But how is it going to last?

Is it going to last in a way that feels elastic and vibrant and, you know, supple, or is it going to be withered and cranky and, you know, less? How do we get back there? And again, that's the stimulation idea.

If we can get into skin and we can stimulate a healing or renewal cascade, what we're doing is we're essentially extending the positive, more youthful feeling, longevity of the skin.

We want to keep our skin feeling as good for as long as possible, for sure. So take me through like a regime, like a skincare regime that you would recommend.

Sure. I'm going to go back. As I said, we've really been talking about this idea of stimulus, stimulation.

And one of the product lines that I think is so important and so interesting is this company, Definage. And Definage is working exclusively. It's the only line that I know of that is using this defense and mediated skin care.

And what they have thought about is that the skin is a little bit different on the face, a little bit different on the neck and chest, and a little bit different on the body. But at the same time, all of those areas need renewal.

And so to me, the idea of having, you know, a lightweight moisturizer that's not occlusive, that's not going to trigger those hormonal, you know, menopausal acne breakouts, is the first layer.

You don't necessarily want to sort of put on a layer that's really heavy, that's really clogging to the skin, because you're going to set off the skin in a different direction. So this lightweight moisturizer, it has brightening elements, it has nourishing elements, and it really lasts on the skin.

It penetrates into the skin, so it doesn't just sit up on the top. I would then follow it with the 8 in 1 myo serum, which, as it says, is 8 in 1.

It is so multifunctional, we're getting antioxidants out of it, but not these super aggressive, you know, high dose of vitamin C that can be irritating or stripping or aggravating.

It's a thoughtful antioxidant that's going to brighten, that's going to prevent collagen breakdown without being overly intense on the skin in terms of tolerability. And it also contains hydrating elements.

It contains those active defenses that get down into the hair follicle and reactivate your stem cells to get that really wonderful skin renewal. And not alone on the face. Morning and evening, with an excellent sunscreen in the morning for a lot of patients is enough.

A lot of my patients come in and say to me, well, you know, what do you think? What should I transition? And the first thing, as I said, is always the nighttime routine.

When they love it at night, often they will switch and start to use it during the day as well. I've been a loyal, definite user for probably five to six years. It totally changed the way my skin has aged. People always say to me, what do you do?

What do you do? What do you do? I joke that, like, you know, it's not something that I had, you know, been paid to do or anything of that sort.

It's something that I sort of fell in love with and really noticed that my skin changed. And similarly, the neck products, I think that if you bring your face products down to your neck, you're doing a good job.

If you can find something that's even more sophisticated, that's going to target the slightly more sensitive, slightly drier, less oily skin on the neck, you're doing an even better job.

I recently also started using Definage. And I will say within, I would say even within the week that I started using it, I noticed that the texture on my face face had improved. It just.

It really. It really stood by it, what it says it does.

You know, I felt a difference already, and I think, you know, as busy women like, you know, we want things to work.

I think that that is usually the plumping element. I think the idea behind these products is that you immediately start to see this sort of plumpness.

And after a few weeks of using it, you start to see that the skin actually seals almost thicker. But in a great way, it starts to relieve some of that early little creepiness.

It starts to make the skin feel really supple where you sort of feel like that sort of youthful bounciness comes back and I think again, it's because you're taking away some of the more harsh products and approaching it in a more nurturing way.

And I tell a lot of patients that, you know, the reason that I love Definage and one of the reasons I've supported the company, me, is because it's so scientifically driven. And I joke with patients every single day. I am a science nerd.

If you can explain to me from like a molecular perspective why this should work and it does, nothing makes me happier.

And so dealing with, you know, the scientists on a daily, you know, on a basis, if I need to reach out to them, their scientific team is someone who will respond to me immediately.

And the idea that someone is going to explain to me the mechanism of action and get really deep into that nitty gritty of why their products are going to be better for me or for my patients, you really understand that it's approaching something from such a different direction. There are so many Me Too products on the market and this is finally unique.

And so the idea that you can come up with a unique approach to skin and a unique way to get back to that healthy, radiant, fresher skin without overdoing it, I think is so important.

Do you find that your patients are looking for more of kind of a refreshed version of themselves versus like, let's say, you know, full blown anti aging? I want to look 25, you know, if they're 50, is it more of that where they just want to look like themselves but more just refreshed?

I think that there's a big element of that.

So I'm New York City based and I think that there are a lot of women who have, you know, important careers and they have, you know, daily places to be and downtime is really hard for them. And so this idea that they can have sort of the best version of themselves and they can really work on that as an at home maintenance is crucial.

I think that, you know, saying to somebody like, I could only do this for you if you have a week to heal is impossible these days.

And I'm so grateful that we have finally moved away from that over enhanced phase into this really beautiful version of it's okay to age, but how do we do it gracefully? How do we maintain the skin beautifully through that process? Because there's something very confidence boosting about beautiful skin.

And it doesn't mean that you have to have a thousand procedures that you have to do all these other things. Sometimes that's really satisfying and Very rewarding for some patients. Some patients don't want to go down a more aggressive road.

So we do a lot of at home skincare routine planning and consultation with patients so that they go home feeling like they're in control and they have the ability to help execute some of that change on their own.

You know, I just went to a practitioner actually about two weeks ago and she was telling me, she goes, of course, it's wonderful that you come into the office and we can do things here. But she goes, the most important step is what you are doing at home. I mean, she just, and I just, I hadn't really thought about it in that way.

I was thinking more, okay, well, I'm coming into the office, I'm doing something. But she's right, it's, it's the daily maintenance that you're doing.

Absolutely. I always say this is a partnership. Right. I'm the doctor and I'm going to, you know, help you with certain things that you can't do yourself.

But if you're not doing your part, it's a losing battle. Right. If I have a patient who's not taking care of their skin at home, there's only so much I can do for them in the office.

And so for some patients, they want nothing in the office and for some patients, they want a combination of the two. And this idea that the maintenance at home is helping, anything I could possibly do for them in the office, work better go further.

That's a really important sort of, you know, two way street where I can give it to you. But if you don't do it, you're not ending up with the outcomes that you're really looking for.

Exactly. And because you want this to work, you should, you should do everything you can to be successful, you know?

Absolutely, absolutely. You need a motivated patient. I always say, I'm motivated. I want everyone to have the best. They come into my practice. I would love that.

You know, beautiful skin is sort of a walking advertisement for, you know, what we can offer you. But at the end of the day, they have to be motivated, they have to be doing their part and they have to be putting in the effort.

Because I always say the patients who come in like, I don't wash my face at night. And I was like, listen, we're going to add a couple cleanser and a moisturizer and it's going to change your world.

And it is really amazing how much that is true. It's really fantastic to see patients come back.

As I said, even a couple Months in on a new routine and say to me, oh, my God, I was, you know, had no idea that this is something I could have accomplished just by changing up my skincare. And so exciting to see.

It's so exciting.

You know, it's so funny that you're saying about not washing the vase at night, because recently I've been talking to women in midlife, and I have met so many women that do not wash their face at night. And I'm like, that would be the kiss of death for my skin.

Like, I would wake up looking like a pepperoni pizza the next day if I didn't wash my face at night.

I totally get it. I feel exactly the same. I'm very acne prone.

But I also think, I mean, particularly for me, I always say to people, I live in New York City, even if I'm not wearing any makeup. And honestly, like I joke, I've worked so hard to get my skin to a place where I don't like to wear skin makeup.

I really don't put anything on my skin on a daily basis. But you don't need to wash off the makeup only. You need to wash off the pollution. You need to wash off the debris. You need to wash off the sunscreen.

You don't want to go to sleep with those things on your skin. As I said, those nighttime hours are so important for renewal and for restoration of the skin. That's when our skin heals itself.

When you sleep, if you go to sleep with a dirty face, you're leaving. You're leaving oxidative, free, radical. And those are breaking down. They're literally eating through the quality of your skin as you sleep.

They have to come off before you go to bed.

If you're acne prone, you have to take off the day because that occlusion, that leading, that layer, that film on the skin, all it's doing is making your acne worse. If you're irritated, all of those things are making your inflammation and your dryness worse.

The stuff that's on your skin all day has to come off before you go to bed. I always say skin at bedtime is sacred. It has to be clean. It has to be washed and with.

A clean pillowcase, right? Clean?

Yes, please.

Yes, yes, yes.

And ideally, you know, hair products off of your face. You know, the skin has to be really kept. It's. It's hard to do. It's actually really a lot of work to do it well.

But it doesn't have to be complicated, meaning you have to just be Diligent.

I say if you have five minutes in the morning and five minutes in the evening, and you can do it consistently, reliably, every single day, you will notice a difference in your skin. And so it's, as I said, it's not complicated. It doesn't have to take a long time and it doesn't have to be 20 products.

Actually, it should never be 20 products, but it makes a huge difference. And as I said, I think that, you know, fresh skin is so confidence building. I think that skin is one of those things that inhibits people.

And the idea that we can take a couple of steps, a cleanser, a cream, serum, and call it a day and find that the skin is a completely different organ at the end of a few weeks. So wonderful, you know, what an accomplishment.

Absolutely, absolutely.

So for the woman at home that's listening or the woman that's coming in to see you, let's say she comes in, her skin care products are not working as she has used them in the past. Her skin's plateaued, but she doesn't want to kind of jump into, you know, the lasers and things like that. What would you recommend?

What's like, a good first step for her?

So, as I said, the first thing I like to change is the bedtime routine. I think that when you withdraw too many things at the same time, patients get intimidated or they sort of get defensive almost.

Well, they say, like, well, you know, I really like that. And so when you change their restorative nighttime routine, you change everything. As I said, my favorite things to do or to scale back.

Instead of adding ingredient upon ingredient and trying to fight harder, we actually find that sort of stepping back and doing things a little bit simpler actually accomplishes so much more.

And so usually my first step, you know, is to encourage them to use something like the combination of the definite 247 barrier cream, which is wonderful because establishing a healthy skin barrier is so, so important. Important.

And then adding in a serum that's going to help them be brighter, more hydrated, and give them that sort of overall cell renewal that's going to start to just work on the skin from the inside out. Sometimes I find that two simple steps at bedtime can change everything. And from there we start to work with them. Are you getting any breakouts?

No, usually not. If you're getting a little breakout, how do we balance that is more little bacterias or a little hormonal influence.

These are all things that you can edit. And so step by step is usually the best way to do It I like to check in with patients frequently.

I find that patients need to be checked in with, you know, on a six or eight week basis. If you send them away for six months, by the time they come back, they've sort of lost their path. And so I like to say I'm here to support you.

This is your journey and I am literally going to coach you through the whole thing and we're going to find you the routine that actually supports what your skin needs right now. Not what it needed six months ago and not what it needed five years ago, but what it needs today.

And that often requires a big change, but it should be done in steps. It's patients are so much more responsive and they feel so much more comfortable.

When you don't sort of overshoot, you want to start somewhere and you want to slowly work them through what their new routine is going to look like and how that's going to accomplish their skin goals. Patients who are consistent, patients who get some pleasure out of, you know, a little bit of self care, it only has to be a few minutes.

Most interesting thing to me is a number of women who are like, well, I have a really busy job. You have five minutes, everyone has five. Right.

I also think that probably you're going to sleep better if you take care of yourself a little bit better. Everything is a little bit easier. Right.

When you wake up in the morning and you don't need piles of makeup to, you know, try and cover the skin that you're not happy with.

When you take care of the skin, everything just becomes a little simpler, A little less, you know, to do in the morning, a little less to do at bedtime. Overall, just a nicer, sort of balanced day.

Yes.

I will say I feel so much better when my, I feel like my skin looks good and looks healthy and, you know, rested and dewy and all the things that we are looking for with skin.

Absolutely.

Well, this has been so informative. Jessica, thank you so much.

I mean, I feel like you gave so many great bits of knowledge and things that we can really use as, as midlife women, I mean, day to day to take care of our skin, to try to get the best skin we can get, you know.

Thank you. Thank you. No, it's my pleasure. I always say I love to educate people about skin. I think that's such an important aspect. Right.

We all talk about it, we all do it, but understanding why we do it is so important. So thank you for having me. I really appreciate it.

Yes, for sure. And Jessica, please tell Everybody where they can find you.

My name is Dr. Jessica Weiser. I'm a board certified dermatologist in Soho in New York City. And you can reach us on our website, ww.weiserskin.com and you're also opening up.

An office in Aspen, right?

Yes, I do have a. Yes, I have a small office in Aspen. We've just gotten off the ground. Mountain air and mountain sun are so different.

And it's so important to take care of your skin differently when you live at altitude.

And so we're really trying to go out there and really help people who are living in those conditions really work on their skin to keep it healthier for longer because it ages differently and it dries differently and it needs such different attention. And so we're really trying to help encourage people to take care of their skin specific to their lifestyle.

So wait, is it better for your skin to be sea level or mountain elevation? Which one's better?

Probably better for your skin to be sea level. When we talk about humidity and we talk about UV radiation, the more altitude you're at, the more UV radiation you're going to get.

And so when you live at altitude all the time, your risk of sun damage and skin cancer actually escalates to pretty fast.

We actually see the highest risk is for pilots, because if you think of who gets the most sun, just, you know, we were saying that UVA comes right through that glass. And so if you think of how aggressively intense the UVA is that comes through airplane windows, that is the worst kind of uva.

So mountains are going to be a close second where you're at, you know, really high altitude, 11,000, 12,000ft. It's going to be really damaging to the skin. And then as you get a little further away from the sun or that intensity, it's a little bit easier.

Obviously you can still burn, obviously there's still damage. But as you escalate your altitude and as you move further west in the country, it's more dry.

There's a combination of factors that can be really challenging to deal with. And so we're trying to really educate those patients about what works best in those climate conditions.

Oh, my gosh. I didn't even think about pilots, but that is a great point. They are right by the sun. They're the closest to the sun.

Fun. Absolutely. When we get on an airplane, the first thing I do is I always close my window.

Do you or you seem like really good about that.

You just immediately crazy.

Yeah, I love that. No, it's like all of it. That's why your skin looks so amazing. It's like.

Well, I always say it's such my truth. I live my truth. I'm never in the sun.

My children, as I said, two teenage boys, they crucify me for my like high neck, chest covered, long sleeve UV gloves. If it could see the sun, it will not on my, you know, on my body. So I really do try and live that truth.

Well, that's good. That's what we want from our dermatologists, right? To live their truth in that way.

Exactly. If you see a dermatologist with bad skin, go somewhere else.

Exactly. The skin is your calling card, right?

Absolutely. If you come in and you see someone who can't take care of themselves, how are they doing better for you? Exactly.

So I always say that, you know, for I have to be my first patient.

Yes, 100%. Well, if you're in New York or aspen, go see Dr. Weiser. She's amazing.

And obviously follow her on social media and listen to all of her great tips for sure.

Thank you so much, Dr. Weiser.

This was fascinating. I think so many women are going to hear this conversation and finally understand that their skin didn't fail them, it evolved.

And if what we just talked about about resonates with you, the idea that your skin still has the ability to renew, it just needs the right support. Definage has put together a breakdown of exactly how this works and what makes the approach different.

You can find [email protected] renewal and if you enjoyed this episode, make sure you're following the iconic midlife on Apple Podcasts, Spotify, YouTube or or wherever you listen. Leave a rating and review if the show is resonating with you. It genuinely helps more women discover these conversations.

You can also follow along at the Iconic Midlife and redcarpetroxy for clips, behind the scenes moments and more midlife conversations we're definitely not having quietly and come back on Thursday for our game episode with Dr. Wise. We're playing Skin Truth or Total Myth. And let's just say a few skincare myths are about to die.

Until next time, stay curious, stay evolving and stay iconic.