Lipstick on the Rim

Episode: Turkey Neck, Dry Skin, Random Acne: Hormones Might Be Running the Show
Hosts: Molly Sims & Emisha Gormley
Guest: Dr. B (Dermatologist)
Release Date: January 20, 2026

Episode Overview

This episode takes a deep dive into the impact of hormones on women's beauty, especially as it relates to skin, hair, and overall aging. Hosts Molly Sims and Emisha Gormley welcome their friend and dermatologist, Dr. B, to tackle listener questions about perimenopause, hormone replacement therapy (HRT), collagen loss, skin care, hair thinning, and navigating the often confusing world of beauty treatments during life’s hormonal transitions. The tone is candid, supportive, and always practical, focusing on what actually works, what’s hype, and the realities every woman faces as their bodies change.

Key Discussion Points & Insights

Women, Hormones, and the “What the F*ck Happened” Moment

• Mirror Realizations:
  Molly and Emisha describe relatable moments of suddenly noticing significant changes in their skin and jawline, sparking the episode’s theme.

  "You know that moment you look in the mirror and think, wait, what the fuck happened? When did it all change?"
  — Molly Sims (02:21)

• Social Media Information Overload:
  There’s acknowledgment of today’s overwhelming and sometimes contradictory hormone-related skincare and wellness advice.

Hormones and Their Holistic Impact

• Hormones Affect Everything:
  Dr. B stresses that hormones influence not just gynecological health, but also the brain, bones, muscles, fat distribution, and especially the skin—the body's largest organ.

  "Hormones influence everything. Your brain, your bones, your muscles, your body fat, your body composition, and the largest organ of our body, the skin."
  — Dr. B (04:49)

• Perimenopause: Not Just a Buzzword:
  The hosts highlight how "perimenopause" is often diagnosed as the culprit behind almost every midlife symptom, sometimes causing confusion.

  "Everything is now chalked up to perimenopause. And I think that also becomes confusing. Oh, you have a frozen shoulder. Perimenopause. Your skin is dry. Perimenopause."
  — Emisha Gormley (04:30)

Perimenopause & Menopause Demystified

• Timeline & Variability:
  • Menopause happens, on average, at 52, and perimenopause can begin 7-10 years earlier, though starting as early as 35 is rare.
  • "Perimenopause spans a 7 to 8 to 10 year period in a woman's life."
    — Dr. B (06:34)
  • "Menopause is the one year after your last period. Perimenopause is that big chunk of time leading into that."
    — Dr. B (07:10)

Hormones’ Direct Relationship with Skin

• Estrogen’s Protective Role:
  • Estrogen stimulates collagen, elastin, hyaluronic acid production, and maintains the skin barrier, contributing to moisture retention and wound healing.
  • As estrogen declines, skin elasticity, firmness, and moisture decrease, which leads to dryness, sagging, and slower healing.
  • "Estrogen plays a big role...it also really does contribute to wound repair and wound healing."
    — Dr. B (09:02)
• What About HRT and Topical Estrogens?
  • Topical estrogens are prescribed for skin but do not replace tried-and-true skincare like retinoids and vitamin C; rather, they are adjuncts.
  • HRT is regaining acceptance due to new evidence of its benefits and safety for most women; decision must be individualized and physician-led.
  • "HRT isn't the bad guy it was once thought to be."
    — Dr. B (11:09)

Collagen: Why We Lose It and How to Help

• Collagen Loss Stats:
  • Women lose up to 30% of their collagen within the first five years after menopause, not during perimenopause.
  • Collagen naturally declines from the mid-twenties onward, but loss accelerates after menopause.
  • "You're not going to have that robust, you know, building of collagen."
    — Dr. B (17:15)
• Signs of Collagen Loss:
  • Laxity, dryness, sagging jawline, facial fat shifting, loss of under-eye volume.

At-Home & In-Clinic Approaches to Skin Aging

• At-Home Devices:
  • Devices like NuFACE and ZIIP may offer mild, short-term benefits but can’t match clinical microneedling or lasers for true collagen stimulation.
  • "A lot of the things that are really going to stimulate collagen are going to be a little more intense and you're not going to be able to get that result with an at home product."
    — Dr. B (19:11)
• Topical Must-Haves:
  Dr. B’s over-the-counter essentials (21:48):
  • Retinols (collagen stimulators)
  • AHAs, BHAs (cell turnover)
  • Vitamin C (antioxidant/repair)
  • Sunscreen (barrier/protection)

  "Those three products you can get over the counter and they're non-negotiable."
  — Dr. B (22:36)

• “Homework” Approach:
  • Combine in-office treatments (microneedling, lasers) with consistent at-home skincare for optimal, long-arc results.
  • Preventative treatments in your 30s and 40s pay off later.

The Filler & Surgery Spectrum: Moderation Is Key

• On Filler Trends:
  • Overfilled faces were a trend, but now the swing is back to moderation—some volume replenishment is important to avoid the need for more dramatic surgical lift later.
  • "You need to be somewhere in the middle. When you don't replenish some of the volume that we lose...you lose that volume and there's really nothing else you can do other than go under the knife later on."
    — Dr. B (24:40)
• Access Matters & Aging Gracefully:
  • A luxe facelift isn’t accessible to everyone; small, regular steps with trusted providers allow most women to age beautifully on their terms.

Hair Thinning & Loss: Hormonal Drivers and Real Solutions

• Estrogen’s Role in Hair:
  • Estrogen promotes hair growth. Lower estrogen shortens the growth phase, increasing shedding.
  • Perimenopause can cause erratic swings, triggering noticeable loss.

  "Estrogen is a promoter of growth...so as our estrogen starts to lower, that antigen phase becomes shorter, and we start to get more of those hairs in that shedding."
  — Dr. B (33:33)

• Androgens & Pattern Baldness:
  • With declining estrogen/progesterone, testosterone acts more strongly, sometimes leading to “female pattern baldness.”
  • Treatment includes anti-androgens (like spironolactone) and minoxidil (Rogaine).
• Medications & Therapies for Hair Loss:
  • Spironolactone: Blocks androgen effects (prescription, can have side effects).
  • Minoxidil: Topical and oral versions increase blood flow and growth phase; oral use can cause body hair growth.
  • Dutasteride/Finasteride: Off-label for women for severe cases.
  • PRP & Red Light Therapy: Can be adjuncts, best if started early.

  "Don't wait until you're super thin and you can see the scalp because it's harder to get that hair back."
  — Dr. B (38:54)

Advocacy & Self-Education

• Proactive Health:
  • Don’t be afraid to bring up perimenopausal symptoms with your dermatologist. Make lists and track your changes.
  • Dryness, eczema, and skin sensitivity often intensify with hormonal changes; update your routine accordingly.

Product & Treatment Recommendations (Lightning Round)

• Cleanser: Glycolic acid cleanser—“Glytone Mild Gel Wash” (39:43)
• SPF: The best is the one you’ll use; avoid fragranced products for sensitive/aging skin (40:01)
• In-office must: Microneedling for scars, texture, pigmentation, and anti-aging (40:13)

Memorable Quotes

• “Perimenopause and menopause is not niche medicine. There is half the population going through what we're going through.”
  — Dr. B (06:25)
• “Everything is now chalked up to perimenopause. And I think that also becomes confusing.”
  — Emisha Gormley (04:30)
• “If a beauty routine takes longer than five minutes, it's probably not happening.”
  — Molly Sims (11:39)
• “Don’t wait until you're super thin and you can see the scalp because it's harder to get that hair back.”
  — Dr. B (38:54)
• “Make your list. Okay. I'm feeling anxiety. My skin is really dry...And my eczema is back.”
  — Molly Sims (39:09)
• “Microneedling for sure. I love it for so many different reasons: acne scars, texture, anti-aging, pigment.”
  — Dr. B (40:13)

Notable Segments & Timestamps

• Opening: The “WTF” Aging Moment | 02:21
• What Hormones Do for Skin | 05:30–09:02
• Topical Estrogens, HRT, and Skincare Adjuncts | 09:58–11:39
• Collagen, Prevention, and Early Intervention | 16:39–21:08
• At-Home Devices vs. Office Procedures | 18:38–21:48
• Filler Trends and Facelifts | 24:25–27:36
• Hair Loss, Hormones, and Treatments | 32:06–39:02
• Dr. B’s Skincare Top Shelf & Product Recommendations | 39:36–40:25

The Bottom Line

The episode champions an informed, moderate, and proactive approach to aging and beauty:

• Understand how hormonal changes drive not just internal but highly visible external changes (skin, hair, body composition).
• Get comfortable discussing hormones with all your medical providers, not just OBs.
• Prioritize proven topical ingredients, responsible in-office treatments, and individualized decisions about HRT or prescriptions.
• Maintain a routine: prevention and consistency in your 30s/40s set you up for a softer landing through menopause and beyond.
• Beauty routines and interventions aren’t “all or nothing”—moderation, personalization, and professional advice are key.

To connect with Dr. B and discover more skincare advice, check out Dr. B Dermatology on Instagram.

(For a lighter moment, don’t miss Rachel Zoe’s cameo and her COVID glam routine at 31:11.)