Podcast Summary: Better! with Dr. Stephanie

Episode: Skin Aging Explained: Collagen, Supplements & Medical Procedures with Amitay Eshel
Host: Dr. Stephanie Estima
Guest: Amitay Eshel, Founder & CEO, Young Goose
Date: October 13, 2025

Episode Overview

This episode dives deep into the science and strategies of skin aging, with a special focus on perimenopausal and menopausal women. Dr. Stephanie interviews Amitay Eshel, founder of the skin longevity brand Young Goose, to cut through myths and marketing (and the noise from big skincare influencers), exploring real, science-backed ways to protect and rejuvenate skin. The conversation covers hormones, nutrition, collagen, supplements, trending (and questionable) medical procedures, and how to create a sane, science-driven skincare routine for healthy aging.

Key Discussion Points & Insights

1. Hormones and Skin Aging

[05:26 - 11:23]

• Hormones like estrogen, progesterone, and testosterone affect the skin, but their actions on skin differ from other body tissues.
  • Estrogen critical for skin structure, hydration, and resilience.
  • Loss of estrogen during perimenopause/menopause leads to dehydration, reduced skin thickness, sensitivity, delayed wound healing, and diminished repair (angiogenesis/inflammation modulation).
  • "When we have less estrogen, we have less hyaluronic acid, which helps our cells retain moisture." — Amitay, [08:26]
• The skin barrier weakens with hormone decline, increasing water loss, sensitivity, and slower recovery (delayed wound healing, more scar tissue).

2. Collagen: Loss, Supplements, Myths

[11:23 - 19:56]

• The often-cited stat: post-menopause, women lose 30% of collagen in 5 years, mainly due to estrogen decline.
• Collagen is an outcome, not a direct fix:
  • Supplementing doesn’t funnel directly to skin. Proteins are broken down into amino acids during digestion; unless significantly deficient, adding more won’t translate to more skin collagen.
  • "The body doesn't work in eventualities. If I lost a toe, I can't eat a toe and grow a toe." — Amitay, [15:31]
  • Research: Some studies show benefit from supplementation if initially deficient, but mixed evidence overall.
• Clickbaity collagen claims: Topical collagen (e.g., masks) are unlikely to improve skin—molecule too big to penetrate, and without mechanisms to assure conversion, it’s more marketing than medicine.
• Scar tissue is also made of collagen, but it’s not youthful or volumizing—overstimulating collagen might worsen skin appearance.

3. Procedures and Treatments: Fact vs. Fiction

[26:48 - 35:50]

• Microneedling (without radiofrequency):
  • Minimal downtime, targeted micro-trauma, supports healthy repair and minimal scarring.
  • “Downtime is extremely low...your body knows what it means to have a scratch.” — Amitay, [28:10]
• Radiofrequency treatments (e.g., Morpheus8):
  • Use heat to target deep tissue (via radiofrequency needles), causing swelling and contracted tissue for a temporary “snatched” look, but resolves as scar tissue, leading to long-term negative effects (thin, brittle, clumpy tissue).
  • Risk: repeated sessions make future surgical correction more difficult; can worsen aging.
  • “That’s the result, my friend—that scar tissue is the result.” — Amitay, [33:58]
• If you’ve had damaging procedures:
  • Facial massage (gua sha), facial exercise (jawsizer), deep microneedling, and improving circulation may help.
  • "You are now a worse patient for plastic surgery, but you can mitigate some damage with gua sha, facial massage, microneedling..." — Amitay, [35:50]
  • Maintaining bone mass also matters—chewing (jaw exercisers) helps maxilla/mandible density.

4. Skin as an Evolutionary Organ

[40:21 - 49:51]

• Past reproductive prime, the skin prioritizes protection—not signaling youth and fertility.
• Skin packs more dead cells, gets less hydrated, blood supply drops—barrier function is favored over “radiance.”
• Skin aging = dwindling resources (like NAD) and unrepaired damage.
• "Aging is really the accumulation of unrepaired damage." — Amitay, [47:00]

5. NAD+ and Cellular Energy in Skin Aging

[49:51 - 55:07]

• NAD+ is the "currency of repair" in the body (involved in 400–600 repair processes); dramatically declines with age.
• Current science: Without enough NAD, skin can’t repair, recycle, or restore itself properly, no matter what actives are applied.
• Young Goose products aim first and foremost to restore skin NAD+ with topical NMN/NR (precursors), using liposomal/micronized delivery for absorption.
  • "We need to first double the available NAD in the skin...nothing will work if you don't have enough NAD." — Amitay, [49:51, 105:07]
• Giving direct NAD to skin or body doesn't work—need precursors (NR, NMN), micronized and well-formulated for absorption.
• "You're not paying for the NAD; you're paying for years of stability, absorption, and bioavailability research." — Amitay, [62:38]

6. DNA Repair, Light, and Mitochondria

[64:40 - 69:53]

• DNA accumulates damage (UV, blue light, pollution); only recently have we found topicals that can activate DNA repair enzymes.
• Young Goose’s LADR Serum uses light-activated enzymes to repair DNA lesions (best with red or near-IR light—avoid UV).
• Supports both energy (NAD) and repair (DNA, mitochondria).

7. Sun Exposure, Pollution, and Environmental Aging

[71:17 - 79:09]

• Sun causes both aging and skin cancer—causes DNA and oxidative damage—but is needed (morning/late afternoon, limited, with torso exposure) for vitamin D.
• Pollution contributes to 60% of skin aging in cities: (“sticky skin”, heavy metals, EMF, blue light).
• Defense strategies:
  • Marine/brown algae cleansers to reduce skin “stickiness.”
  • Antioxidants (ergothioneine, resveratrol, fat-soluble vitamin C—THDA [tetrahexyldecyl ascorbate]).
  • Spermidine (autophagy/“recycling” booster).
  • Liposomal, micronized NMN for topical NAD delivery.

8. Debunking Popular Skincare Ingredients & Protocols

[80:11 - 85:22]

• Vitamin C (ascorbic acid):
  • Most L-ascorbic acid serums oxidize and degrade before use (turn yellow/orange), becoming pro-oxidant (aging!).
  • "The problem with ascorbic acid is that it is a synthetic version of vitamin C that doesn't follow the rules of nature...Any exposure to air, any exposure to oxygen, any exposure to other things in the formula are immediately going to turn it harmful, pro-oxidative instead of antioxidant." — Amitay, [82:14]
  • Prefer THDA (tetrahexyldecyl ascorbate): fat-soluble, stable, efficient.
• Retinoids (retinol, tretinoin):
  • Retinoids speed cell renewal but damage the barrier during transit; prescription versions (tretinoin) are harsh, require recovery, and more often recommended for provider profit/subscription.
  • Best case: find a formulation (like liposomal/bioretinol) you can use daily without irritation.
  • "We want to create the most renewal with the least damage." — Amitay, [85:22]
  • Future: Peptides that mimic retinoid signaling without Vitamin A/irritation.
• Peptides:
  • Many new “peptide” products may not deliver results; research and stability are crucial.
  • "I would not necessarily make a decision on what product I would use according to just companies waving the word peptide around. I would want to see some research." — Amitay, [104:22]

9. Building a Science-Based AM/PM Skincare Routine

[93:53 - 97:46]

• AM (Protection):
  • Gentle cleanser (marine/algae extract)
  • Antioxidant-rich serum (ergothioneine, resveratrol, THDA vitamin C), NAD+ precursors
  • Zinc oxide sunscreen (better for broad spectrum; especially if tinted)
  • Shield against blue light, pollution (ectoin, LPC6, etc.)
• PM (Repair):
  • After cleansing, apply NAD+ precursor-rich serums, bioretinol or liposomal retinol, mitochondrial activators (e.g., hyperbaric mask)
  • Higher-concentration peptides/repair molecules (spermidine, ergothioneine, resveratrol, copper peptide etc.)
  • Hyperbaric mask last to “lock in” actives and stimulate mitochondrial repair.
  • "Morning is protection, evening is repair." — Amitay, [93:53]

10. Lifestyle Integration & Supplements for Skin Longevity

[97:59 - 102:11]

• Sleep: Most potent repair tool; monitor quality and address (airways, blue light at night, consistency).
• Strength training/weightlifting: Supports blood flow, muscle, bone density, hormone regulation, autophagy.
• Mindfulness & gratitude: Reduces stress aging; measurable impact on skin health.
• Good oral supplements:
  • Oral NAD+ precursors (NMN/NR)
  • AKG (alpha-ketoglutarate)
  • Berberine/dihydroberberine (manage glycation/AGEs)
  • Beef organ complex (good multinutrient content)
  • "Hop Box" supplement pack (Amy Killen's product)
• Peptides (advanced):
  • GHK-Cu (copper peptide, ideally injectable for best effects)
  • CJC/Ipamorelin for skin health

Notable Quotes & Memorable Moments

• On Collagen Supplements:
  • "The body doesn't work in eventualities. If I lost a toe, I can't eat a toe and grow a toe." — Amitay, [15:31]
  • "Collagen is an outcome." — Amitay, [14:31]
• On Scar Tissue Post-Procedure:
  • "People think the results went away, but that's the result—my friend, that's the result. You've now ended up with the result of that process, and that's scar tissue." — Amitay, [33:58]
• On NAD’s Centrality:
  • "Nothing will work if you don't have enough NAD." — Amitay, [105:07]
• On Skincare Myths and Influencers:
  • "I know of three dermatologists who get $50,000 per post to mention Neutrogena. It's just not possible to summarize NAD in a 10-second Instagram clip, so most never mention it." — Amitay, [106:13]
• On Simplifying Aging:
  • "Aging is really just the accumulation of unrepaired damage." — Amitay, [47:00]
• On Science vs. Marketing:
  • “We want to do just enough to stimulate collagen production… the more downtime, the more recovery, the less you should be doing it.” — Amitay, [26:55]
  • “If it’s not stable, it’s not good—expiration matters. In nature, nothing just sits for years.” — Amitay, [63:44]
• On Takeaways and Skincare Philosophy:
  • "I just want the best in class in my skincare cabinet, not 400 impulse TikTok purchases." — Dr. Stephanie, [after party, ~108:00]

Actionable Takeaways

PROTECT & REPAIR:

• Start with skin health, not youth optics: Optimize NAD+ and cell energy first.
• Question procedures: Low-downtime, gradual stimulations trump “big” medical devices with collateral damage.
• Select actives for bioavailability, not trends (e.g., micronized, liposomal forms).
• Sunscreen is crucial (zinc oxide/tinted), but so is protecting against blue light and pollution (ectoin, LPC6).
• AM: focus on antioxidants and skin defense.
  PM: focus on mitochondrial & DNA repair, gentle renewal, and peptides.
• Good sleep, resistance training, stress reduction, and balanced nutrition have profoundly visible skin impacts.

Timestamps for Key Segments

• Hormones & Skin Aging: [05:26] – [11:23]
• Collagen, Myths & Supplements: [11:23] – [19:56]
• Procedures: Safe vs. Harmful: [26:48] – [35:50]
• Evolutionary Role of Skin: [40:21] – [49:51]
• NAD+ Basics and NAD Precursors: [49:51] – [55:07]
• DNA Repair, Light Activation: [64:40] – [69:53]
• Sunscreen, Sun, Environmental Pollution: [71:17] – [79:09]
• Active Ingredients: Vitamin C, Retinols, Peptides: [80:11] – [104:22]
• Building a Routine & Lifestyle: [93:53] – [102:11]
• Supplements & Advanced Tools: [97:59] – [102:11]
• Dr. Stephanie’s Reflections (“After Party”): [107:29]–End

Final Take

This episode is a master class in skin longevity—grounded in actionable science, not industry-sponsored soundbites. Prioritize cell energy (NAD+), use interventions with minimal collateral damage, don’t chase trends, and remember that sleep, strength, and resilience are your best “anti-aging” tools.