Turkey Neck, Dry Skin, Random Acne: Hormones Might Be Running the Show

Summary

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

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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.

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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)

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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)

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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

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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.

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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.)

Transcript

[Emisha Gormley]

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[Molly Sims]

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LIPSTICK Hey, I'm Molly Sims.

[Emisha Gormley]

And I'm Emisha Gormley. We're two girls obsessed with one thing.

[Molly Sims]

Beauty. And by that we mean everything that.

[Emisha Gormley]

Makes you look and feel beautiful. We're calling on our favorite health experts, industry insiders and friends to answer all.

[Molly Sims]

Your beauty questions with a drink in hand.

[Emisha Gormley]

Definitely with a drink in hand.

[Molly Sims]

You're listening to Lipstick on the Rim with Molly Sims. I feel like this is a universal moment for all women. You know that moment you look in the mirror and think, wait, what the fuck happened? When did it all change?

[Emisha Gormley]

Oh, my God. Yep. I literally had that moment a week ago when I was looking in the mirror, and I just was like, I kind of want my skin that tight little.

[Molly Sims]

That little turkey neck.

[Emisha Gormley]

Just the neck.

[Dr. B (Dermatologist)]

All of it down the jawline.

[Emisha Gormley]

Just the jawline. What has happened to my jawline?

[Molly Sims]

So I was in my kitchen a couple of weeks ago, and Dr. B called me. She was like, does this bother you? Like these conversations we're all having? And anyway, one thing led to another. I merged Emisha in.

[Emisha Gormley]

I was in the bathtub.

[Molly Sims]

She was in the bathtub.

[Emisha Gormley]

Yeah. I was in the bathtub.

[Dr. B (Dermatologist)]

Yeah.

[Molly Sims]

But we were essentially discussing how women. How we all go through so many different changes. Most of them, as Dr. B will talk about, are driven by hormones. But what we're left with is little guidance and way too much information overload on social media. So what we wanted to do since our Victoria Joya aired, we kind of wanted to get questions from our audience, our listeners, and so we've gathered a bunch for Dr. B. Perimenopause, hormones. Agings, 30s, 40s, 50s, 60s. We all think, okay, our OB is on it. Right? Our OB is on it.

[Dr. B (Dermatologist)]

We should hope. We should hope. Yeah.

[Molly Sims]

But today we're gonna kind of do a little bit more of a deep dive into where do women go? Because a lot of the Internet is really great. You can get really good suggestions. You can get pills and supplements. But I think what's missing is, like, what. What do I. What does that roadmap look like?

[Emisha Gormley]

The pendulum swung from where we had zero information and zero access to the entire other side, where now it's.

[Molly Sims]

We're.

[Emisha Gormley]

I mean, I constantly hear the words perimenopause. And the one thing, though, that I really am excited to talk about here today is 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.

[Molly Sims]

You can't sleep.

[Emisha Gormley]

Perimenopause.

[Dr. B (Dermatologist)]

I think what you're referring to is the fact that we've finally come to a place where we realize how important hormones are in every body part. We have. It's not just a GYN thing. Here's the thing about hormones in general. I think we're beginning to appreciate how Influential they are. And you might have gotten a little glimpse of that while you were pregnant or right after you delivered with the hormones. Right. I think what's important to understand is that hormones influence everything. Your brain, your bones, your muscles, your body fat, your body composition, and the largest organ of our body, the skin.

[Emisha Gormley]

Yeah.

[Dr. B (Dermatologist)]

And I think that every physician of every field better know what's going on with those hormones. I don't think it's fair to leave it to just one specialist. I think all of us need to know how hormones affect that particular body part. For me, it's skin and hair, because that's what I do. I'm a dermatologist. So it's imperative that I understand how hormones influence skin and hair and when those hormones start to decline, what happens as a result and how can we help that steep pitch? So I, I, when you ask who should you go to, the answer is, is every doctor should have some knowledge of hormones and perimenopause.

[Molly Sims]

And I don't think every doctor does though.

[Dr. B (Dermatologist)]

Well, unfortunately that's true. And I think that' a big fault of when you're training. There really is very little information given to us as medical students and residents on perimenopause and menopause. And you know, to quote a doctor that I love following and that has given me a wealth of knowledge, her name is Rachel Rubin. She says, you know, this is not niche medicine. Perimenopause and menopause is not niche medicine. There is half the population going through what we're going through. And it's not, not just one window in time. Perimenopause spans a 7 to 8 to 10 year period in a woman's life.

[Molly Sims]

We did learn from Victoria Joya, from parallel that the actual menopause is one day.

[Dr. B (Dermatologist)]

Yeah, right. Menopause is the one year after your last period. Perimenopause is that big chunk of time leading into that.

[Emisha Gormley]

Which by the way, I think I've heard numbers as early as 35 year in perimenopause. Right.

[Molly Sims]

Like you can't, I mean, one of our friends went through menopause at 41.

[Dr. B (Dermatologist)]

Well, listen, I think that if other factors aren't as at play, like surgical, you know, a hysterectomy or whatnot, or, you know, I think that when does.

[Molly Sims]

The average woman go through perimenopause?

[Dr. B (Dermatologist)]

The average woman goes through menopause at 52. So you're gonna think about seven to 10 years before that is fair game. And everyone's different. Some people are gonna Start earlier, and some people are gonna start later. I think 35 is very, you know, rare and low.

[Molly Sims]

But it can happen.

[Dr. B (Dermatologist)]

It can happen. It can happen.

[Molly Sims]

Everyone knows hot flashes, but what are some of the less obvious ways perimenopause shows up in the skin?

[Dr. B (Dermatologist)]

So I think to understand what happens in the skin, you kind of have to know what estrogen and progesterone and sometimes testosterone are doing for our skin in the good years. Okay? So estrogen is a stimulator. It binds to estrogen receptors. We have estrogen receptors all over our skin and on our face, on her scalp. It promotes hyaluronic acid barrier function. It stimulates collagen, elastin. It does all the things we love, right? So when it starts to decline, we see lower elasticity of the skin. That, you know, that pull when you pull the skin, and it kind of just stays there like a tent. And it doesn't snap back because it snap back. So that's elasticity. Collagen obviously plays a part in the firmness of our skin, our epidermal barrier, which Molly, you know a lot about because of wise, and you've kind of studied that, that epidermal barrier and how important it is to retain moisture barrier. Right. And to retain moisture. So by, you know, promoting that. That complex epidermal barrier where you're not losing water, you're not. That water is not leaking out because your barrier is intact. Estrogen plays a big role in that. I also think it's not just vanity. It also really does contribute to wound repair and wound healing.

[Emisha Gormley]

Here's a question I have for you, because I think that a lot of us women at this age get targeted by so many products. Barrier repair cream, collagen. Do you feel that products superficially added to the skin help, or is it the big kind of elephant in the room with a lot of women? Hormone replacement therapy? Is HRT actually the way to get that back that we're trying to supplement by buying 10 different face creams and serum.

[Dr. B (Dermatologist)]

There are topical estrogens. There's, you know, the estrogen cream that was really developed for vaginal Was a vaginal estrogen cream. It's estradiol. It's a bit more potent. And then there's these newer formulations that are more compounded with estriol, which is a bit weaker but more targeted, that are, you know, more for the face. And sometimes these compounding companies can mix in some hyaluronic acid or tretinoin. Now, I will say that these topical estrogen creams are really not in place of our skincare, our tried and true like retinoids and vitamin C and sunscreen, they are an adjunct. Do they help? I think there's more and more studies to show that we are seeing some results with the topical. Now, as far as your question with with hormone replacement therapy, I don't think that's a one size fits all answer. I do think that you need to kind of go through that with your physician. And to your point, it may not be easy to find a physician that's well versed in hormone replacement therapy. But I will say that what we're finding out is that hormone replacement therapy isn't the bad guy it was once thought to be. And that's I think why there's so much talk about HRT is because we're finally getting the green light in that it is safe, it is protective. And the conversations that we need to have is in that small population and it is a small population that may not be able to do hrt. What other things can be done?

[Molly Sims]

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[Emisha Gormley]

And I love that I don't have.

[Molly Sims]

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[Emisha Gormley]

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[Molly Sims]

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[Emisha Gormley]

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[Molly Sims]

How does that.

[Emisha Gormley]

It's not something that you just go to Sephora and say, hey, estriol.

[Dr. B (Dermatologist)]

No, no, it is a prescription. It's a compounded prescription. So you can get it. A physician like a dermatologist like myself, if they are kind of in this realm. And we're hoping to see more and more physicians kind of take this on and, you know, learn about perimenopause and hrt. But there are companies now that are physician drived that you're able to kind of consult with, and some of them are virtual hers.

[Molly Sims]

I mean, I was so impressed by both platforms.

[Dr. B (Dermatologist)]

Well, there are platforms, like you said, where you can consult with someone who, who is, you know, trained to know who. The nuances, all of the nuances of hrt, if you're ready for it. In what form? You know, there's estrogen patches, there's progesterone pills. Do you need progesterone? What your doses are? It's definitely something that needs to be monitored. And it is not a one size fits all. The important thing is we need to be asking for it and searching for it. It's not that thing that, oh, we're not going to do that because it's not good for us. It is very beneficial to sure that those hormones stick around as long as they can safely because they are protective.

[Emisha Gormley]

So we. I specifically have an obsession with collagen. I literally like, I'm always searching for collagen serum. But it's, I mean, here our notes say we've read that women can lose up to 30% of their collagen within the five years of perimenopause. But I also heard. But it's menopause.

[Dr. B (Dermatologist)]

Menopause, yes. So five years.

[Molly Sims]

Five years of menopause or we sit down perimenopause.

[Dr. B (Dermatologist)]

No, no. Once you hit menopause, you start in that first five. After menopause, you get a 30% decline.

[Emisha Gormley]

I remember reading somewhere, I even know.

[Molly Sims]

Who told me this.

[Emisha Gormley]

I, that maybe I thought I was a dermatologist, but that at the age of about 25, 26 is when we start to lose our collagen.

[Dr. B (Dermatologist)]

Well, sure. I mean, you are our skin cells and our cells are aging from the minute we're born. Right. We're getting older and older and older eggs. Exactly. And when that happens, yes. You're not going to have that robust, you know, building of collagen. Now, I don't think you notice it as much when you're in your 20s, but it starts to play a role.

[Emisha Gormley]

And then, so what do you know, what is that? If you're. What. What are the first signs of your collagen really kind of having started to drop?

[Molly Sims]

Sagging.

[Emisha Gormley]

Sagging. Right.

[Dr. B (Dermatologist)]

You're gonna see a little bit laxicity in your skin. You're gonna see dryness, you're gonna see, you know, you're also. That epidermal function is gonna be starting to decline. So you might need. Your skin feels more thirsty. You just can't quench it. The other thing about it is that as all of this is happening with our hormones, we're also accumulating photo aging. You know, we're also, you know, our bone structure. There's invite, there's intrinsic and extrinsic. So there's so much happening and it's all kind of together. You're getting the result of laxity, that jawline. You're starting to see your facial structures going to alter a little bit where your fat gets repositioned. You know, you don't have that kind of high cheek. It's starting to separate a little bit. You're going to get a little bit of loss of volume under your eyes.

[Emisha Gormley]

So the collagen thing is, is, is very common and we see it. And now you're also assaulted by all these at home tools. What are your thoughts on that? Because there is, there's. What is it? There's the zip, there's the, the new face. There's all these things that really are like, yes, in that moment, you use it. I see a difference. What's your professional opinion on them?

[Dr. B (Dermatologist)]

So my professional opinion is I really like to combine in office treatments with a good at home skincare product. So we call it homework. You do your stuff in the office and then you got your homework. I do think it's important to understand that 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. So a really good example of that is microneedling. So when we do microneedling in my office, we're going deep. You are getting bloody. Okay. It's not like the derma rollers that you have at home. You're getting in there deep and you're stimulating collagen. By really relying on that wound repair mechanism of the skin. And then what you're doing at home is also really important because you're gonna maintain that collagen stimulation with a good retinoid. You're going to maintain that cell and wound repair with a good antioxidant, like a vitamin C, and then, of course, your protection with a good sunscreen. So I think at home, products, you know, if they don't harm, great. You know, if they're not causing harm, But I don't know that they're doing that much that you can get done you a little bit more intense.

[Emisha Gormley]

How much collagen can you expect to rebuild? Like, what does that look like? I go to your office, I do the microneedling, I do the things.

[Molly Sims]

It's gonna feel tighter, you're gonna feel. It's like blood, that blood pumping out it. Like, I don't know how to explain.

[Emisha Gormley]

It, but does it actually rebuild the collagen?

[Dr. B (Dermatologist)]

Well, I think that there has been studies where we've, you know, kind of done before biopsies to show that collagen, and then after a few treatments, and they have shown that it is stimulatory, that those collagen fibers or elastin fibers are more bundled. I do think it's really important for our listeners to understand that preventing and doing things a little along the way is so much more beneficial than waiting until it's gone to start to stimulate it to come back.

[Emisha Gormley]

So what does that look like?

[Dr. B (Dermatologist)]

That looks like when you're in your 30s and 40s, protect yourself from the sun, do little minor treatments like regular microneedling, use a tretinoin, stimulate collagen. You want to be as tanked up as possible when your gas tank starts to dwindle. You've got a full tank, you want a full tank. You don't want to already be on empty when things are starting to dwindle.

[Emisha Gormley]

Do you have a few products before we move on? Like, like within the collagen and like, barrier repair area that you like, that's over the counter that you don't have to get a prescription for?

[Dr. B (Dermatologist)]

Yeah, well, any of the retinols, any of the glycolic acids, you know, AHAs and BHAs, all of those promote cell turnover. And, you know, retinols is kind. The retinol family is kind of the lower strength of the tretinoins, which are prescription. And they're a really good, you know, collagen booster and promoter. I also think that, you know, to rely on that wound repair or cell repair is really important as well. You want to make sure that your cell is repairing any kind of oxidative damage. So that's where vitamin C comes in. And then of course the protector, which is our sunscreen. So those three products you can get over the counter and they're non negotiable.

[Molly Sims]

So let's talk CO2 because, you know, so many women, 10 years ago, you get put to sleep, you're doing the CO2, they go deep. It's like microdermabrasion on crack. And now you're starting to hear less and less. Because I was very pretty much adamant. I'm like, don't do that big CO2. But now everybody's doing the baby.

[Emisha Gormley]

I did a baby CO2 under my eyes.

[Molly Sims]

Yeah, talk to us a little bit about that. I'm very intrigued. I kind of want to do it with Dr. Dorfman. Can I do it? Is it worth it? And what does it do?

[Dr. B (Dermatologist)]

So you're talking about an ablative laser. So you are getting rid of some of that surface damage, right? And you're getting rid of quite a bit of it. It's definitely more intense than what you could get done with, for example, a chemical peel. So that's why it's a little bit more of an intense procedure. And there's different levels. Like you said, there's the baby CO2, there's full ablative where you're under anesthesia. And I think there's certain skin types that definitely respond better to a laser like that. Fairer skin types, you know, blonde hair, light eyes. That type of skin type is going to respond well to that. And listen, we have to understand that a lot of these things, especially with social media, they. There's these ebbs and flows of trends, you know, there's these trends and sometimes when they take off, it's just like everyone wants to get on that bandwagon. I feel like, like as a board certified dermatologist, I'm a lot more conservative. I have patients come to me and say, well, what about, you know, for example, threads? Or what about, you know, and I like to see the science. I'm, I'm a nerd, a scientist nerd. At the end of the day I want to see the data and sometimes it takes a few years to be able to see the data or the damage or the benefits.

[Molly Sims]

Which were saying about, you know, radio frequency with microneedling, you know, it was all the. But I would always say go low, go low, do it a few times, as opposed to just Doing one major. I don't know, I always get scared.

[Dr. B (Dermatologist)]

Yeah, well, listen, I think that you need to go to a trusted doctor who has experience, who you know is gonna guide you and not let you do something that isn't necessary. That's really important too. We're seeing a huge wave with filler and rejuvenation. Right. That pendulum is also swinging where there was this huge, you know, everybody is over volumized and the cheeks and the chin and the lips and everything is big. And now the pendulum is squigging the other way. And the other way isn't good either. Not doing any of that is also not good. You need to be somewhere in the middle. When you don't replenish some of the volume that we lose in little, you know, beautifully done, nicely placed, small aliquots of filler, you lose that volume and there's really nothing else you can do other than go under the knife later on. So I also believe that doing little bit along the way, and that includes filler, is really important. And we're seeing that trend now take off where you're seeing these people say, oh, filler is bad. And you know, we, we shouldn't do that. So now the pendulum is swinging. Moderation, you know, you gotta stay in the middle. You can't jump on every bandwagon. And when you have a trusted person, and I think a lot of people look to you all too, you guys look for who you want on this podcast. Who is going to have the knowledge and the education so that you can. Can steer the ship the right way?

[Molly Sims]

Well, we're hoping, you know, to give some type of, you know, pathway for women to know even what's available. What should they do, when should they do it, how should they do it? Because again, I mean, we have access, as you do, to everyone. And it's still hard, right?

[Dr. B (Dermatologist)]

You know, of course it is.

[Molly Sims]

And it's.

[Emisha Gormley]

I also, I mean, I'm curious what your thoughts are, but you just said if you can do baby, you know, beautifully placed filler throughout, do you think that that then can have you get to a place where you may not need a facelift?

[Molly Sims]

Possibly.

[Emisha Gormley]

Because I think that's something that, like, you know, I. Having gone through what I just went through, it was really easy. And I'm not trying to like, glamorize or simplify any form of surgery. You're under general anesthesia. But I will say it made me go oof. I don't know that I could actually do a facelift. Like the drains in the face. And all of that, like, freaked me out when I talk to him about it.

[Dr. B (Dermatologist)]

I can.

[Emisha Gormley]

But I think it's also. Listen, I think that there's a very small percentage of the population in this country that can afford a real good facelift.

[Molly Sims]

Right.

[Emisha Gormley]

So I think that's always really important to kind of just bookmark there, because I want women to feel, you know, that if you don't have the access that we do. Right, but you can still maintain and find a doctor that does those baby steps, and you can still age beautifully and just accept your age at 70 be like, you know what? I might not look like I'm 45, but I'm okay looking 60 at 70. Does that make sense?

[Dr. B (Dermatologist)]

100%. I agree with you, 100%. And it's also, again, every face is different. Every neck is different. Some people are lucky with genetics. Some people are lucky with natural fullness. You know, surgery really is more of a removing that excess skin, which you cannot volumize enough to fill that.

[Molly Sims]

And we're seeing more now with the GLP1s. People are losing a lot of elasticity in their face, their skin.

[Dr. B (Dermatologist)]

That's their body. That's right. We're seeing a lot of that. So the face is changing. The way we're aging is changing. And, you know, you have to kind of taking those little baby steps along the way with filler and neurotoxin, I think, are very important. I don't think it should be a negative thing. And yes, surgery isn't for everyone. That's absolutely true. There are other ways. And being protective and, and, and really kind of protecting your skin is so important. I think that also will help you age a lot more gracefully.

[Molly Sims]

Hey, guys. Late January has a way of sneaking up on you. One minute you're fine, and the next. The winter blues are very real. I feel it most in the mornings when it's freezing outside and getting out of bed feels almost impossible. But if you listen to our episode with Dream Murphy, you know, she's big on creating morning routines and rituals that not only make you feel good, but are realistic things you're actually going to stick with. One thing that completely changed my mornings is the new hotel collection Turkish bathrobe I got from Macy's, you guys. It's plush, it's soft, and it instantly makes me feel cozy the second I step out of bed. I also picked up a Jo Malone London diffuser from Macy's, you guys. It's so good. I'm obsessed. My bathroom honestly now feels Like a spa. These little upgrades from Macy's have made my mornings feel calmer, cozier, and more intentional, which is kind of what I want 2026 to be. Instead of dreading my alarm, I actually enjoy getting up, making a warm drink, easing into the day, and feeling good in the process. Sometimes it's the small rituals to help you beat the winter slice, and Macy's makes it easy to find them all in one place.

[Emisha Gormley]

So I have to tell you about my latest obsession, because I feel like we're all in the same boat right now. We want our homes to feel beautiful, functional, and honestly, easy. And that's literally what cozy does. Cozy furniture is designed to make your home comfortable, modern, and practical. What I love is that everything is totally customized by you. From sofas and shelves to rugs, tables, dining sets. Everything is modular and designed to fit your space, your taste, and your life. Cozy is practical by design and personalized by you. Your home is a reflection of you, and cozy lets you build a setup that feels unmistakably you. And the functional stuff is, honestly, a dream. The removable and washable covers mean you can swap colors and layouts without replacing the whole entire thing. And their free design consultants help you get the most out of your space. It's easy to order, easy to ship, easy to put together, and easy to maintain. Cozy makes furnishing your home so easy. Transform your living space today with cozy. Visit cozy.com spelled C O Z E Y the home of possibilities made easy. This week on Lipstick on the Rim, we sat down with the one and only Rachel Zoe. And wow. This episode is a ride. We talked about everything. Motherhood, divorce, finding herself again, joining Real Housewives literally overnight. And then she said this.

[Rachel Zoe]

Can I tell you a true story in Covid? In the darkness of COVID I had a cat eye every single day where nobody saw me. Not one soul. And when I had Covid, not even my ex husband saw me or my children. And you know what I did? I went into my bathroom, I did a black liquid liner, put on lashes, black liner in the waterline, a full lip, did my hair and sat in my bed. And that is what I did. And I looked at myself and I said, you are not a well person. I said, are you okay? You have 104 fever.

[Dr. B (Dermatologist)]

You are like.

[Rachel Zoe]

You are like contagion right now.

[Emisha Gormley]

If you love fashion, beauty, or bravo, this Rachel Zoe episode is a must. It's out now.

[Molly Sims]

Let's switch gears.

[Dr. B (Dermatologist)]

Hair, hair, hair.

[Emisha Gormley]

Hair loss. I mean, look at your hair.

[Molly Sims]

Is that all your hair, Dr. B.

[Dr. B (Dermatologist)]

Yes, it is.

[Molly Sims]

I mean, you have amazing.

[Emisha Gormley]

You have beautiful hair.

[Molly Sims]

A lot of women come to you now not only for skin, but for hair. They feel it. They've just had a baby, they've lost all their hair. They're in perimenopause. It's thinning. It's not what it used to be. Is what all them of, of our friends, including me, talk about.

[Dr. B (Dermatologist)]

Right.

[Molly Sims]

Well, what can we do?

[Dr. B (Dermatologist)]

So first, let's talk about what's happening. What's happening with the hair as we age. So it's not just, oh, you're getting older, you don't have full hair. Like, that's not. You know, the real true thing is, again, hormones do influence our hair. Some of us have experienced that when we get pregnant and we get that, you know, intense shedding after, you know, we give birth. It's called a telogen effluvium. And what happens is, is, you know, estrogen receptors and progest receptors on the scalp play a role in terms of, you know, the anagen phase. There are three phases to hair growth. There's anagen, which is the growth phase, and then there's the catagen phase and the telogen phase. And telogen phase means it's going to rest and then go to shedding and all.

[Molly Sims]

I don't like that phase.

[Dr. B (Dermatologist)]

Yeah, we. None of us like that phase. But all of our hair at some point or another is in one of those three stages, and they're not all in the same stage. Otherwise we're. We'd shed all at the same time, and we don't do that.

[Molly Sims]

Now.

[Dr. B (Dermatologist)]

What happens is estrogen is a promoter of growth. It's a promoter of that antigen phase. So as our estrogen starts to lower, that antigen phase becomes shorter, and we start to get more of those hairs in that shedding or telogen phase, which is why we see that shedding and thinning and that erratic behavior of perimenopause means that sometimes you'll have high levels of estrogen and things will look. And then you'll have. One day you wake up the low and you really see that intense shedding that puts you in a panic.

[Emisha Gormley]

Which also explains why when you're pregnant, a lot of women have so much more hair.

[Dr. B (Dermatologist)]

You have great hair.

[Molly Sims]

Oh, my God, you have great hair.

[Emisha Gormley]

So why can't they bottle that?

[Dr. B (Dermatologist)]

Well, it's called estrogen and it's called, you know, replacing that if you can and if it's safe for you to replace that, it is Important. Now, another really interesting way that perimenopause plays a role in hair thinning is that. Remember I told you estrogen and progesterone also play along with testosterone? Well, testosterone becomes a little more dominant in our perimenopause phase. In other words, when estrogen and progesterone aren't there to put it in check, it starts to, you know, kind of act on those follicles a little bit more intensely. And what you get is what we see kind of in the male population with miniaturization of the follicle. And you see that kind of. Of thinning in the frontal part area in the crown. It's called female pattern baldness. So that can happen because of that relative testosterone or androgen dominance. And that's where you kind of see the hair where we don't want, and the hair where we do want is kind of thinning away. So what can we do? Was your question. What can we do? Well, you know, other than, of course, consulting with your physician and knowing if hormone replacement is the right thing for you. There's also antiandrogen. So we're gonna kind of stop what testosterone is liking to do by using an antiandrogen, which is like spironolactone. Spironolactone is an androgen blocker. It looks kind of like testosterone. Spironolactone, testosterone. So it binds to that receptor and it kind of tricks it. So that testosterone. And that can help with your hair? Yes, I know.

[Molly Sims]

It can help with your skin.

[Dr. B (Dermatologist)]

It absolutely can help you with your hair.

[Emisha Gormley]

Are there side effects to that if you're on it?

[Molly Sims]

Diuretic?

[Dr. B (Dermatologist)]

There can be. It's a diuretic. It's got minimal blood pressure activity as well. So it has to be given. It's a prescription. It has to be given by the doctor. There are it. It is in the works to be in a topical form, but we also have topical minoxidil. What does minoxidil do? Remember, estrogen is a. It. It works on our cardiovascular and our v. In our, you know, vasculature. So it is providing blood flow to those hair follicles. As it gets lower, it's not providing as much blood flow. Minoxidil helps, helps to give that blood flow back to the hair follicle. And it also stimulates that antigen phase, that growth phase.

[Molly Sims]

So minoxidil, you can take it topically and orally.

[Dr. B (Dermatologist)]

You can apply it topically. A real common one out there is Rogaine. That was maybe the first to market, but there's a lot of other minoxidil, five percents. There's sometimes they're compounded.

[Molly Sims]

Would you ever take it orally and topically?

[Dr. B (Dermatologist)]

No, but you can take it orally now. It's become a lot more in vogue to take minoxidil orally. And that's how actually Rogaine was discovered. It was an oral medication where we saw these patients, you know, growing lots of hair. And it grows hair not just on the head. So when you take minoxidil orally, you will get also hair in other places. And let me tell you, when a female, when a woman is thinning, they'll take it, they'll take that extra hair and, you know, deal with it as they may, whether it's more waxing or, you know, more, you know, dermatology, laser or whatnot. So minoxidil is out there.

[Molly Sims]

What about dutasteride? You're hearing a little bit of about now.

[Dr. B (Dermatologist)]

Dutasteride is a, a close cousin of finasteride, which is propecia, which is of course very well known in the male pattern baldness arena if you are in menopause. Dutasteride is now given off label to women who have intense, you know, hair thinning. It's a 5 alpha reductase inhibitor. 5 alpha reductase is that enzyme that works on the testosterone receptors in our scalp to cause that follicular miniaturization and thinning. So, yeah, we've got some options.

[Emisha Gormley]

Something too, right?

[Dr. B (Dermatologist)]

Yes. PRP is platelet rich plasma. That's also, you know, I know a.

[Emisha Gormley]

Few of my friends that have done that.

[Dr. B (Dermatologist)]

Right, where stem cell prp, you're stimulating those, those stem cells.

[Molly Sims]

Do you think it works?

[Dr. B (Dermatologist)]

I think that it's not across the board. In other words, it's not like a sure thing that you're going to get a big result. But I think it's a good adjunct to using some of those other things we talked about. So you can do it. In addition, what about red light therapy? Red light therapy is also. There are some studies that show that it's stimulatory as well. And there are some caps, you know, some red light caps that you can use. So there are a few things that can kind of help prevent that. I think it's also important to detect it early. Don't wait until you're super thin and you can see the scalp because it's harder to get that hair back. And it's better to know and you know, to do that as it's happening to kind of prevent that intense shedding because it could be real panic inducing when that happens.

[Emisha Gormley]

I think if I have a takeaway from this conversation, it's that don't be afraid to talk to your dermatologist about paramenopause.

[Molly Sims]

I think my question. Make your list. Okay. I'm feeling anxiety. My skin is really dry. I mean, she treats me. So I'm 52 and my eczema is back.

[Emisha Gormley]

I mean.

[Dr. B (Dermatologist)]

Yeah, well, you know, that skin sensitivity and that dryness is a part of losing some of those hormones. So you really do have to replenish and be a lot more proactive about hydrating and hydrating with the right moisturizers.

[Emisha Gormley]

Should we do our skincare top shelf?

[Molly Sims]

Let's do it. Okay. Cleanser you swear by?

[Dr. B (Dermatologist)]

I like a good glycolic acid cleanser.

[Emisha Gormley]

Is there one in specific?

[Dr. B (Dermatologist)]

Yeah, there's one that's made by Glytone. It's called mild gel wash. What's your favorite spf? If the best sunscreen is the one that you're going to wear. And I always tell my patients because they ask me, what's the best sunscreen? If you're not going to like the way it feels or goes underneath your makeup or the way it smells and you're not going to use it, it's not the best sunscreen.

[Emisha Gormley]

Do you think fragrance free is wiser as we get older?

[Dr. B (Dermatologist)]

I do. I think sometimes fragrance products definitely produce a little bit more sensitivity.

[Emisha Gormley]

Go to in office treatment. If you could only pick one, what would it be?

[Dr. B (Dermatologist)]

Micro needle microneedling for sure. I love it for so many different reasons. I love it for acne scars. I love it for texture. I love it for anti aging. I love it for pigment hyperpigmentation.

[Molly Sims]

If you don't already, make sure and follow Dr. B Dermatology on Instagram. You really do give an incredible advice, real results, insights. And again, if you're in Los Angeles, if you're in Beverly Hills, come and see me. Come and see. I want to see.

[Emisha Gormley]

She's so out there. I made your appointments before and they're unparalleled.

[Dr. B (Dermatologist)]

Thank you. Thank you. And I do virtual appointments too, sometimes. If. If people can't get to me, I have, you know, I mean, look at what you did with Carrie. All schools. I have literally teenage patients in every school across the nation. I'm very proud mom.

[Molly Sims]

You are a proud mom. And she specializes in anti aging and acne. I mean, really is your superpower.

[Dr. B (Dermatologist)]

Yes.

[Molly Sims]

You're the best we love you.

[Dr. B (Dermatologist)]

Thanks guys.

[Molly Sims]

Thanks for coming.

[Emisha Gormley]

Thank you for coming.

[Dr. B (Dermatologist)]

Thank you.

[Molly Sims]

Good luck in Miami.

[Dr. B (Dermatologist)]

Thank you.

[Molly Sims]

Thanks for listening to Lipstick on the Rim with Molly Sims and My Ride or Die. Emisha Gormley. We are so excited to bring you guys along on this journey with us. You can find us on Instagram and TikTok at Lipstick on the Rim and Molly B. Sims. Or you go to my blog where you can dive just a little bit deeper into my favorite products, trends and [e-mail] and don't forget to check out our video episodes on my YouTube channel. Molly Simon this podcast is production with Sony Music. I wanted to give a special thanks to my team, Rosie Cummings, Ken Orion, Sophie Kevorkian and everyone at Sony Music. Don't forget to listen and follow wherever you get your podcasts so you never miss out on the fun.