The Food Medic - Hormones and Skin: What Your Skin Is Trying to Tell You | With Dr Thivi Maruthappu

Starting point is 00:00:00 When does fast grocery delivery through Instacart matter most? When your famous grainy mustard potato salad isn't so famous without the grainy mustard. When the barbecue's lit, but there's nothing to grill. When the in-laws decide that, actually, they will stay for dinner. Instacart has all your groceries covered this summer. So download the app and get delivery in as fast as 60 minutes. Plus enjoy $0 delivery fees on your first three orders. Service fees, exclusions,

Starting point is 00:00:25 and terms apply. Instacart, groceries that over-deliver. You're really lucky if you don't get some sort of a spot before your period. Dr. Vivi Marathapu, a consulting dermatologist with a rare blend of expertise in both medical dermatology and nutrition. She's back with us to explore how our skin shifts across the menstrual cycle. How real are the effects that we're seeing in the skin when it comes to the menstrual cycle? You cannot underestimate the role of hormones. Estrogen is that one that gives you the glow and it goes up when you're pregnant, for example, and skin really radiant and sometimes skin conditions like eczema and psoriasis can get a bit quieter

Starting point is 00:01:04 during pregnancy for that reason as well. radiant and sometimes skin conditions like eczema and psoriasis can get a bit quieter during pregnancy for that reason as well. What would you recommend for someone who's really struggling with like stubborn acne related to their PCOS or maybe hair growth if you're thinking okay we need to move to the next level? Hello everyone and welcome back to the Food Medic podcast. I'm Dr Hazel Wallace, a women's health nutritionist and former NHS doctor and I'm back for a special women's health series of the Food Medic podcast. In this mini-series we're diving Wallace, a women's health nutritionist and former NHS doctor, and I'm back for a special women's health series of the Food Medic podcast. In this mini-series, we're diving into all things women's health, from expert insights and myth-busting chats to mini Ask Dr. Hazel episodes, where I answer questions submitted by you. Expect accessible, evidence-backed tips to help you feel empowered, not held back by your menstrual cycle and more. On today's episode,

Starting point is 00:01:50 I'm joined by the brilliant Dr. Thivi Marathapu, a consultant dermatologist with a rare blend of expertise in both medical dermatology and nutrition. With training from Oxford, Imperial and Stanford and experience leading NHS services for eczema and psoriasis, Dr. Thivi takes a truly holistic evidence-based approach to skin health. Her research into nutrition and psoriasis, Dr. Tibby takes a truly holistic evidence-based approach to skin health. Her research into nutrition and psoriasis has made her a leading voice in this field. And today, she's back with us to explore the fascinating and often overlooked topic, how our skin shifts across the menstrual cycle. If you're enjoying these conversations and want to go beyond just understanding your hormones and your menstrual cycle and actually learn how to work with them, my latest book, Not Just a Period, is available to pre-order now. It's a practical, science-backed roadmap that helps you align your cycle in every area of your life, from nutrition and mood to

Starting point is 00:02:35 body image, skin, hair, and more. If you're ready to feel more in tune with your body and supported by your hormones rather than confused by them, I'd love for you to check it out. You might notice a QR code floating around if you're watching the video for each scan, or if you're listening to the audio version, you can find the link at the bottom of the episode shown out. Tibby, you've been on the podcast before and we talked all things skin and nutrition which i guess is your bread and butter but today we're going to talk about something a little bit different and that's skin and the menstrual cycle and skin and hormones which i'm super excited to dive into but shall we just bring it back to basics in terms of like how the sex hormones

Starting point is 00:03:20 estrogen progesterone and testosterone may impact the skin and start from there. So these are the three key hormones that we're dealing with in clinic all the time. And we're really thinking about when we're looking at someone and we're thinking about their skin and how it's changing throughout their life course, really, because we've got changes, obviously, teens, we've got adults and we've got around the perimenopause and menopause as well. So all of these phases, we're seeing changes in the the skin and a lot of that is down to what's happening with the hormones so if we start with estrogen estrogen is that one that gives you the glow and the great hair and it goes up when you're pregnant for example and that's why often you see hair really

Starting point is 00:04:00 thriving during that time and skin really radiant. And sometimes skin conditions like eczema and psoriasis can get a bit quieter during pregnancy for that reason as well. And then we have progesterone. And progesterone is obviously really in the second half of your cycle. We're really seeing more of the progesterone. And that can have a lot of different effects on the skin. It can be very good for the skin and collagen production. But on the other hand, it can act a little bit like an androgen, a little bit like a testosterone, and then it can increase oil production. And that can be in the skin, but it can also be in the hair as well. So

Starting point is 00:04:42 you might see those signs in the scalp where you might not see it in the skin and finally we have testosterone and as you've said many all of us have testosterone and we need it super important but when we have testosterone having too much of an effect on the skin either because you have more or you're sensitive to it then that can again increase oil production increase hair growth sometimes in places where you wouldn't normally expect hair growth and it can contribute to hair loss on the scalp as well so all of these hormones are doing their own thing and working in tandem yeah absolutely and i guess like you said it's it's about having that fine balance and i'm always cautious to use the the

Starting point is 00:05:22 term like balancing our hormones but like too much of one hormone can cause these unwanted effects like in the case of raised testosterone and PCOS for example in someone who doesn't have a health condition or a hormone condition how real are the effects that we're seeing in the skin when it comes to the menstrual cycle because you mentioned the ovulation glow and then like most women talk about breakouts before their period. Like, is this common? Is this truly happening?

Starting point is 00:05:50 Or is it something that, you know, what are you seeing in clinic essentially? You're really lucky if you don't get some sort of a spot before your period. You are really lucky. So that might be because maybe you're on treatment or maybe you just have someone, your skin doesn't really care

Starting point is 00:06:03 what your hormones are doing. There are people out there, hard to believe it, i'm not one of them but some people their skin just doesn't really care about the hormones doesn't matter what phase of their cycle they're in their skin's pretty much going to look the same and then there are lots of us who our skin notices and it feels the change and it may not even be that your hormones are out of the normal range the sort of if we did a blood test your hormones might be really perfectly within all the normal parameters all of your ratios between you know your different fsh lh everything could be perfectly aligned no excess androgen but your skin is very sensitive to those normal fluctuations that are happening and i would say that's the

Starting point is 00:06:42 biggest bucket of people i see actually so people whose hormone levels when we measure them are fine but their skin is sensitive and so you know in the week or even two weeks running up to their menstrual menstruation their period coming they're seeing increased oil production in their skin their skin just doesn't feel as glowy and healthy as it normally would be and then we see breakouts which typically like to happen sort of jawline is you know in adult females we're going to see mainly jawline acne but it can go all the way up the cheeks as well yeah and for people who maybe are experiencing that like cyclical flare-up in acne or breakouts what can they do to perhaps like get on top of that or maybe like preempt that their skin does change in

Starting point is 00:07:26 in that phase and and maybe what tweaks could their skincare could they make so i guess it depends how severe it is so some people it's really debilitating they can have acne all month you know and and then before the period that so they've got a baseline of acne and then before the period that goes up a notch and so we've got people who are experiencing that and there are people who are generally quite clear and then before the period they're getting breakouts and they're quite mild and if you're in the latter category then skincare is fine you can up your regime you can switch your cleanser if you know when that's going to hit then maybe a few days before you want to switch your cleanser to something with benzoyl peroxide

Starting point is 00:08:03 salicylic acid something that's a little bit decongesting and then you may even if you know that trigger area you might use a blemish control product on that area as a preventative sort of hack a retinol and azelaic acid as i said benzoyl peroxide salicylic acid those are really good to preemptively target an area where you know you're always going to get a spot. So for some people that might be around the nose, some people that might be around the chin, but you can target those places if you know and you're monitoring your cycle as well. It's a bit harder if your periods are irregular. Yeah, yeah. It's a bit tricky if you're in that situation. You might just want to keep your skincare very consistent throughout the month. Yeah, which I guess is the tricky thing with PCOS.

Starting point is 00:08:45 So obviously one of the kind of main symptoms in PCOS for most women is irregular cycles. And then you also have the oily skin because of the raised testosterone. So for women in that situation who have a diagnosis of PCOS, and they not only have their skin effects, but they also have the hair effects. And actually it was my dermatologist who said to me I think you should maybe look at getting some blood tests to see if you have PCOS because of the symptoms I was experiencing so what are the main skin and hair manifestations in PCOS and what can you do because for some women when that I speak to they're the most challenging symptoms to even like the impact on your body image, the impact on your self-esteem to like to get a handle on. Absolutely, it's the visible

Starting point is 00:09:31 nature and that's why skin often brings people to the clinic and then they get diagnosed exactly as you've experienced because sometimes if your period's a little bit irregular you might not notice it but if you've got acne that's really recurring most most of the time you'll want to get that addressed you'll be you know it'll affect you enough that you'll go and see someone about it and then it's our job to have a look and say well there's not just acne there when i'm looking i can see some increased hair growth for example around the chin and we all have a little bit of fuzz around the chin but it'll be those darker hairs coming in the chin area and they can even be down on the neck which is hard for you to see so when we're examining we're always looking underneath because you might not pick up that you've got some hair growth under here for example

Starting point is 00:10:12 and that can extend down on the neck as well and we'll also be looking at the scalp to see if there's a loss of density and that typically occurs over the temples but also in the middle of the scalp so the frontal area and sometimes it can go over the crown as well so what we might see is normal thickness of hair at the base and around but then we'll see a thinning sort of along the temples and over the top of the scalp as well so we're looking for a particular pattern and and then i might ask you know these sometimes these are quite personal questions but do you have more hair growth for example around your nipple um in the middle of your chest?

Starting point is 00:10:46 Sometimes people have longer hairs in those areas, and that can be a clue. And also going from your belly button down to the pubic area. So those are the places we normally want to look to see if there is a different type of hair growth in that area. And you don't need to have all of these things. You know, even if someone is coming with acne, I think if they're noticing that cyclical variation, so getting worse at times of the month,

Starting point is 00:11:09 I do usually want to do the blood test to see if there's anything hormonally going on there because it helps to navigate our way through treatment. Yeah. And what's driving these signs and symptoms in PCOS? So in PCOS, it tends to be due to androgens, so testosterone. And we know that there's high insulin as well. And that insulin can trigger the production of more testosterone and androgens. And insulin, insulin-like growth factor, all of those things together can stimulate testosterone. And that testosterone then has an effect on lots of different body sites but in the skin what you may notice is increased hair growth and increased oil production and

Starting point is 00:11:51 breakouts it can be a couple of things that you you notice and it might be quite subtle so i often see people come with acne and then when i have a closer look i can see the hair under the chin and that's when we think okay well there might be something else going on there yeah absolutely and i think you know focusing on measures to like lifestyle measures and nutrition and things like that can help improve those symptoms to a degree but i think what i'm seeing anecdotally is that lifestyle can massively improve cycle length and and symptoms in related to the menstrual cycle but when it comes to skin and hair sometimes they're the last symptoms to change or the hardest symptoms to change and we're really looking at maybe topicals or some medication um what would you recommend for

Starting point is 00:12:35 someone who's really struggling with like stubborn acne related to the pcos or maybe hair growth um in areas that they they just can't get on top of so you go, it depends on the severity and how much it's bothering you. So how much it's affecting you really matters in terms with how we'll go with treatment. And you could start topically. So you could do topical hair removal. You could do topical prescription strength retinol combined with topical antibiotics or a prescription strength azelaic acid. That's quite a good topical regimen and if that

Starting point is 00:13:06 works it's great but if you're thinking okay we need to move to the next level and we need to think about what the hormones are doing we have the option of certain contraceptive pills and some of those can be skin friendly skin and hair friendly the commonest one that is used is yasmin although there is a limit on how long you can use that for and that's because the progesterone that's in yasmin actually has an anti-androgenic effect so not only do you have the estrogen but you've also got the progesterone which is helpful so it's helping to combat some of those effects of the androgens so that's one option um if you think okay i'm not sure if I

Starting point is 00:13:45 want to go on the pill or if the pill is not effective on its own, we can think about other tablet treatments. And the one that we most commonly use is spironolactone. And spironolactone is a drug we've used for many years. It wasn't ever invented for the skin, but it was found that it happened to help with lots of skin-related issues. So it can help with acne, hair growth in unwanted places, and also scalp hair loss. And it is a drug that has its own, you know, little set of side effects that you really need to think about before you start it. Certainly not something you could get pregnant on. But it can be really effective in people who've got PCOS and excess androgen. to think about before you start it. Certainly not something you could get pregnant on,

Starting point is 00:14:29 but it can be really effective in people who've got PCOS and excess androgen. So we discussed how acne can flare up premenstrually, but we also see it with other conditions like psoriasis and rosacea. For those people, what can they do if they're seeing that or they're experiencing it? Because I imagine it's not all people in that situation. Yes. So it's tricky, actually, because some people, their eczema, psoriasis, rosacea is the same all month. And some people, it's varying due to other factors, stress, you know, there are lots of things that can affect those conditions. Rosacea can be exacerbated by estrogen. So when estrogen is high, and the reason is that estrogen you know it really helps those blood vessels increases blood supply to the skin that glow but if it's too much blood supply to the skin that manifests as redness and so we can see so i go back to pregnancy because that's

Starting point is 00:15:17 the time where we see so many changes that we learn a lot from that and when your estrogen levels are very high for example in, in pregnancy, we can see rosacea manifesting for the first time. With eczema, eczema is a condition that we see a lot of changes actually. So I see a lot of women around the perimenopause and menopause who get eczema for the first time. And it can be on the face, it can be on the eyelids, for example. And that's because estrogen is so important for the skin barrier and how the skin barrier is functioning and so when estrogen levels are low the skin barrier can be compromised and the eczema can flare and i've had quite a few patients who have eczema and they notice it flares before their period and it's really frustrating and that week before they notice

Starting point is 00:16:01 that when those estrogen levels are down the skin is more itchy, it's dry, it could be affecting their sleep as well. How do we address that? Well, there isn't enough evidence to support a pill or going on the contraceptive pill, for example, to sort of even out your hormones, let's say. We normally would treat the condition as we would conventionally treat it. We would want to get you to a really nice, stable maintenance phase. Now, you mentioned how we can use certain forms of contraception to improve things like skin and hair in the case of PCOS. But that's not the case for all forms of contraception. And some forms, which I learned the hard way, can actually exacerbate things like acne. And that would be progesterone based methods can you chat

Starting point is 00:16:46 a little bit about that it's really hard so um the because you know these are really good contraceptives and people may have a family history of breast cancer and may not be able to have something with estrogen so maybe that's the favored choice for them um but marina coil for example um progesterone implants we have definitely seen you know acne flaring particularly on the chin greasy hair and hair loss so the greasy hair tends to come first and then the hair shedding can happen after so the the increased oil production and scalp can be a precursor for the hair to fall so that is something we have absolutely seen we can still treat it because if you've gone to the effort of having that coil put in or and it's it's a painful

Starting point is 00:17:30 procedure lots of people not keen to have it taken out and if your acne is relatively mild we can try and manage it topically sometimes we'll use oral treatments to get it under control we still use even in pcos or hormonally driven we would still use sort of antibiotics and things like that it's still a useful treatment um so we would try and manage that um but some people do end up wanting to have that coil taken out yeah that implant taken out yeah yeah something to be aware but i guess yes like you said it's not happening to everyone so if you are someone with a coil and your skin's fine don't't change anything. Absolutely. And also if you've got some mild acne and it's manageable, you might still want to stay on it. It may be a really good form of contraceptive for you. And now,

Starting point is 00:18:13 you know, we know the Mirena can last a lot longer than we originally thought. It's just a very safe form of contraceptive. Yeah, absolutely. So something that's really popular right now is like tweaking your skincare to your cycle um i have some thoughts on this but i'd love to hear your thoughts and perhaps maybe some pros and cons to that so i think a consistent skincare routine is super important i think you need to do a good cleanse good spf and use your actives all. You may want to step it up a notch if you know that certain things are coming your way. And I think it's really good to be cognizant of that. But for a lot of people, that's just quite a lot to think about. And, you know, there's some people

Starting point is 00:18:57 who love their skincare routine. It's really important and they're happy to modify it. But there are lots of people who just want it done, you know, and they just want to have their simple skincare routine, effective ingredients, and don't want to over conceptualize it too much. So I think it depends what category of person you fall into. Yeah. And how sensitive your skin is to these changes. I find in that first week, my skin is a lot more dry and sensitive than it normally is. And so i'll be using like my stronger creams and more moisturizing barrier creams during that time um and as someone who is prone to acne maybe being more careful around that pre-menstrual phase with certain types of

Starting point is 00:19:37 you know the heavy creams and heavy moisturizers the oils that maybe will exacerbate what i'm what i'm feeling but i do agree with you, like sometimes if you're not experiencing big changes, you don't need to get too worried about it, keep doing the basics really right. But for those people who do notice those fluctuations, those little tweaks can make a difference. They can, yeah. And especially just bringing those right actives in. And sometimes actually those actives are good all month. So if you think about retinol, not only is it helping to prevent the breakouts, and you need to be using it for a good few weeks before it's going to do that,

Starting point is 00:20:13 it can really help with the marks that the breakouts leave behind and help them to go a bit more quickly. And in the long term, a really nice retinol will be working on diminishing oil production and helping with those sebaceous glands that are a little bit overactive, as well as improving skin quality and texture. So if you're using retinol, I'd want that all month. I wouldn't adjust that too much. But actives like benzoyl peroxide or salicylic acid, you can dip in and out of those. Yeah, absolutely.

Starting point is 00:20:40 One of the things that I came across when researching for the book, which I found really interesting, was the impact of estrogen on pigment production. And again, going back to the pregnancy situation, we often see that in pregnancy where we get melasma and hyperpigmentation. And there is some research around how around ovulation with that surge in estrogen that women who are maybe sensitive to that can get increased pigmentation um is that something that you've come across or i have heard of that but i haven't actually seen it myself yeah if you're melasma prone often it's how much uv you're getting that seems to be the most important factor but we know that melasma can be triggered if you're on a combined contraceptive bill, as you said, pregnancy as well. Those are well-known triggers for it. But sometimes even if you come off the contraceptive pill or even when you're not

Starting point is 00:21:35 pregnant, the melasma can still hang around. So it seems like once it's triggered, sometimes it can be quite happy in your skin and we have to work quite hard topically to get it under control. And the best thing from a prevention point of view there is your SPF. Really good SPF. And sometimes you may need some pigment reducing topicals as well. One thing I didn't mention earlier is that estrogen cream is becoming quite popular. Oh. Yes. So that's how important these hormones are for our skin. So it's used a lot in the States. It's used a lot in the States. It's used a lot as an anti-aging. And one of the side effects is actually rosacea. So funny that we were talking about that. So you have to be quite careful. So it's not for everyone. If you're

Starting point is 00:22:14 rosacea prone, oestrogen cream wouldn't be recommended. It's not widely available here in the UK. I think it will start to become available. But just interesting how topically applied hormones are now becoming, you know, part of skincare routines. So we talked about skin, but let's talk about hair. Well, we briefly talked about hair, but how is the cycle potentially impacting hair, if at all? So hair is more of a long game. So it can be affected by your cycle. You can become a bit more greasy during the second half of your cycle when your estrogen levels are a little bit lower. Progesterone is higher for the same reasons, because those sort of androgenic effects of progesterone as well as testosterone. And that can result in some dandruff, what we call seborrheic

Starting point is 00:23:02 dermatitis. So you may see oil production, you may see a bit of dandruff what we call seborrheic dermatitis so you may see oil production you may see a bit of dandruff during that time as well but there are some women for example pcos affect females that will notice actually they have more greasy hair and dandruff all through the months and that can be associated with hair shedding as well and that can be a clue that we need to do some further blood tests and investigations. Okay. And, I mean, we've talked mostly around women of reproductive age who have a menstrual cycle or are on contraception. But obviously, going through the perimenopause, we see those really big erratic shifts in hormones.

Starting point is 00:23:50 And then after the menopause, we lose all of that estrogen, which you've really clarified is very important for how good our skin looks and how healthy our skin barrier is what other symptoms are we seeing during that perimenopause that women might be experiencing and then again after the menopause that and what could we potentially do to help offset some of those impacts so around perimenopause very dry skin very dry skin so i often get women coming in saying it doesn't matter how much moisturizer i use dry skin, very dry skin. So I often get women coming in saying, it doesn't matter how much moisturizer I use, my skin feels really dry. And that's estrogen and the impact on collagen as well. So dry skin, more sensitive to skincare products as well. So things that you could have used quite happily, suddenly becoming more problematic. I also get another category, which is women who've had no acne since they were teens, and suddenly they're getting breakouts, really annoyed about it, you know, and that's because of that relative loss of estrogen compared to progesterone during that

Starting point is 00:24:34 time and other androgens. And we will see that on the chin. And, you know, I get women around that phase coming in saying, I'm having to use my daughter, my son's acne treatment. I don't want to use that. That's not designed for my skin. And then we have to come up with a skincare routine that is appropriate for skin during that phase because you can't really use those same products. You know, you're not dealing with necessarily very oily skin. You've got dry and sensitive skin that happens to also have breakouts it's a whole different ball game yeah so what products would you recommend seen in a woman's skincare routine at the very basic level going through that perimenopause transition so i i find that the benzoyl peroxide can be drying during that time so i wouldn't be moving towards that i really love

Starting point is 00:25:23 azelaic acid and retinol during that time because you can combine them with quite rich emollients and so they can be tolerated really nicely and you can use them locally to the areas that are affected. So I tend to move away from the sort of acne products I might use in a young woman who has female adult acne or teenage acne. And I will be wanting to focus more on anti-inflammatory skincare. Yeah. And diet, obviously, to think about as well, because sometimes we would want to add in some omega-3 supplements, for example, encourage oily fish intake. And that can help with that skin

Starting point is 00:26:01 hydration and that skin barrier function during those years when you might not be feeling that your skin is behaving the same way. Yeah, absolutely. I feel there's a lot of kind of marketing towards collagen supplements and collagen protein for women who are maybe going through that phase. What are your thoughts on that as a dermatologist? So I was super skeptical about collagen supplements until I had to give a talk to all my colleagues on, you know, big group of colleagues on aging and nutrition and things like that. And so I did a deep dive into the literature. I read every paper, all the reviews, all the meta-analysis, and we ended up having a slide and it starts with, you know,

Starting point is 00:26:43 is it even getting absorbed what is the peptide so these collagen fragments are broken down into tiny little peptides do they get absorbed yes so we have some data that you can actually eat these collagen peptides and they are absorbed into the bloodstream from the bloodstream do they get to the skin yes there's data to show that they can go from the blood to the skin and then when when they get to the skin, are they changing the biology of the skin? Are they improving skin function? And there is some data that connects all of those parts. So in theory, the data is there that they work, but we don't fully understand how they work.

Starting point is 00:27:20 What I will say is I don't think it's Lego. I don't think these little bits of collagen peptide find each other on the other side and make a big collagen molecule. We've known for a very long time that peptides are used in skincare because they stimulate collagen production. So it might be these little fragments of collagen when they do make their way to the skin, make your skin think that it needs to make more collagen. So they're triggering collagen production

Starting point is 00:27:45 so if they're working that is probably how they're working i don't think they work for everybody i think some people take them and it just does nothing and i think there's some people who take them and it actually really does make a difference they notice their nails are growing better their hair is growing better so things that you can actually objectively monitor those things are probably the easiest so hair growth how quickly is your for example your hair color growing out or if you're doing your nails do you need to get them done more often it's good to take if you're going to try them take it and see if you see a difference and if you don't there's no point taking them

Starting point is 00:28:19 yeah yeah absolutely that's a really interesting take on it. And kind of as a second question, because I know that people will be thinking this as you're talking, hair and skin and nail supplements are also really popular now. There's multiple different formulations that you can get in multiple different ways and gummies and powders and whatnot. What are your thoughts on them? So when you look at that list of ingredients, the same things are coming up time and time again you'll see selenium you'll see biotin you'll see zinc very few of us are deficient in any of those and there is very little evidence that if you are supplementing more than what you actually need in a day that that has additional benefits so more isn't always better yeah and so um for example zinc supplements that

Starting point is 00:29:07 there isn't good data that if you're if you have normal zinc levels having more zinc there isn't data to show that you're going to grow more hair or your nails grow longer so when you read the packet it will always say supports normal growth so it's not saying we'll give you tons of hair you're not going to be rapunzel um it's just going to So it's not saying we'll give you tons of hair. You're not going to be Rapunzel. It's just going to say it's going to support your normal skin function. There have been incidences on selenium toxicity where people have taken too much selenium and they actually shed hair. Nobody wants that. So I think you just have to be mindful. If you're missing something through your diet, then you need to think about supplementing.

Starting point is 00:29:46 For example, people might be removing certain foods, restricting things. I think sensibly, with the help of a nutritionist or a dietitian, you may want to supplement certain areas of your diet. But I don't think sort of blanket hair gummies are the answer to most people's problems. Also, why is your hair falling in the first place yeah why is your hair not growing that is the key if it's if there's a cause there that we need to treat it doesn't matter what you're taking you're not going to get the results you want yeah and i guess like thinking about women who are having you know cycles especially those

Starting point is 00:30:19 who have heavy periods yes um iron deficiencies yes and hair loss people often don't link them obviously you do but in day-to-day we often don't link hair loss with iron deficiency and i have a friend who her hair was falling out for a really long time and it took a while for the doctors to link that and you know an iron infusion changed everything for her so i think like you said if your hair is falling out if your hair is starting to thin before you jump and buy the gummies maybe go and see a doctor about getting some blood tests seeing what deficiencies or what else might be happening because as we know it's not just nutrition that can cause that or is there something wrong in the scalp have you got something completely different that's nothing to do with your period your diet any of those things you have you got an autoimmune condition in the scalp and that

Starting point is 00:31:08 needs completely different treatment i actually had a patient who was you know she poor lady was told you know your hair loss is because of perimenopause and she came to the clinic and she had an autoimmune condition called lupus i know know you know all about this, in her scalp. That was responsible entirely for her hair loss and it was nothing to do with perimenopause. So I think it's sometimes easy to say, oh, it's just because of this, but actually it's important to have it checked properly and make sure that you know exactly why your hair's falling. Yeah, absolutely. So important. For someone dealing with breakups or flare-ups and general skin frustration around their cycle, what would be your top tips for

Starting point is 00:31:52 navigating that? So importantly, how much is it affecting you? Because if it's really affecting you, if you know, some people don't want to leave the house. If they've got a bad skin day, bad hair day, they don't want to go out. They don't want to have go house if they've got a bad skin day bad hair day they don't want to go out they don't want to have go into the office that day so self-conscious don't want to see friends i mean that's quite a big impact on your life then you need to get see you need to see your gp maybe you need to see a dermatologist and you need to start a proper treatment protocol you may need prescription things because once it impacts your mental health you know that means it's a sign that it really needs to be addressed quickly if you've got quite mild acne um for example then you know a really nice holistic approach as you talk about so much in the book

Starting point is 00:32:37 you know your diet is an important role stress management really matters um pre-empting those flares with good skincare routine keeping it simple not experimenting too much with products you know there are things like um red red and blue light treatment some people find those helpful there's lots that you can do so something that happens to women going through egg freezing is also breakouts and obviously when you go through egg freezing um which i have you have when you go through egg freezing which I have you have to take a whole load of hormones in a very short succession of time and so it's a lot for someone to go through is that something that you're witnessing do we know why

Starting point is 00:33:15 what can women expect when they're going through that process so when I have a patient who's going through egg freezing we have to be really careful firstly what skincare we're using so I would treat that patient as if they were someone who was pregnant actually i would be really careful with topical skincare i wouldn't want you on a retinol during that time i'd probably just want you on something like azelaic acid which is really well tolerated and oral treatments as well for example some antibiotics that would all have been needed to taken into consideration and stop well in advance of that egg freezing from happening so we go from before yeah and then during that

Starting point is 00:33:51 period sometimes you're quite good during the egg freezing itself because of the estrogen but when your levels drop that's when we see people come they can be quite tearful i think those hormones really you know yes, you've obviously experienced it. So that calm down can be huge. And so people can be really tearful. And on top of that, if they're starting to break out, that can be difficult as well. So I think there's the before egg freezing prep for it. So being really mindful on the skincare, on treatment that you're using during egg freezing.

Starting point is 00:34:21 And then afterwards, then we can start to introduce all of our skincare back again any oral treatments we need to get it back under control it's so helpful and so so good that you're mentioning that because i feel like when i went into egg freezing there was no advice regarding that and even regards to nutrition we know that that's hugely important for egg quality in the egg freezing process as well um and now i think a few years later that conversation's happening and we see like really great health professionals having those conversations so i think it's good to tie in the skincare element because that was definitely not front of mind until someone spoke to me about it as well even as someone who's medically trained

Starting point is 00:35:01 yes so it's amazing isn't? There's so many different effects. Did you take inositol at the time? I was taking inositol. It's quite a good supplement. And there's lots of data behind it now for egg quality. And the data for skin isn't quite there yet to say that it can help skin on its own. But I think it's worth trying. I think it's definitely worth,

Starting point is 00:35:23 but making sure you get that ratio right to get 40 to 1. Yes. Because I think it's worth trying. I think it's definitely worth, but making sure you get that ratio right to get 40 to 1. Yes. Because I think it's very easy to just pick up an inositol supplement off the shelf, but you need to get that ratio because that's what's been used in all the studies, of course. Yes, yes, absolutely. There's so many inositols on the market now that just aren't in that exact formulation. But I do see more and more coming out in that 40 to 1 ratio, especially for women with PCOS, it's so beneficial.

Starting point is 00:35:47 I'd love to finish with one question, which is what's one myth when it comes to women's health or hormones that you would love to bust? I mean, I think you've written it all in your book. I think that you cannot underestimate the role of hormones. And now when I see people in clinic clinic even if they're coming with you know psoriasis or eczema conditions that people never really asked about periods before i always want to know what their cycle's doing and um you know are they planning to conceive that matters too and for example are they um undergoing egg freezing all of these things that women experience we need to take into consideration because

Starting point is 00:36:25 your hormones are so busy and they're having such a huge impact on you in all different ways. And we really need to be mindful of that when we're thinking about the skin and the hair. I love that. What a great note to finish on. Thank you so much. Thank you, Hazel. Before we leave each other, I would love if you could just take a moment to rate the podcast, leave a review, or share it with a friend or a loved one that you think would learn a lot from this episode.

Starting point is 00:36:51 If today's conversation resonated, my book, Not Just a Period, is available to pre-order now, and it's packed with practical advice to help you understand your hormones, manage tricky periods, and work with your cycle for better energy, mood, and overall health.

Starting point is 00:37:05 You can grab a copy now through the link in the show notes or via the qr code on your screen i hope you all have a great week and thank you so much for listening

The Food Medic - Hormones and Skin: What Your Skin Is Trying to Tell You | With Dr Thivi Maruthappu

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