The Truth About Hormones and Your Skin—A Top Endocrinologist and Dermatologist Explain

Breaking Beauty Podcast

In this episode of Breaking Beauty, twin sisters Dr. Florence Comite and Dr. Harriet Comite discuss the critical intersection of endocrinolo

Key takeaways

• Declining estrogen and testosterone levels can shift skin pH from acidic to alkaline, increasing vulnerability to irritation and moisture loss.
• Dr. Florence emphasizes that 'normal' lab results are often not 'optimal' and suggests tracking glucose via CGMs to manage healthspan.

Main topics

• Hormonal impact on skin health
• Perimenopause and menopause transitions

Notable quotes

Your genes are really a draft that you can actually change.

Conclusion

The episode serves as an empowering guide for women to take agency ove

Transcript preview

Speaker 4 (0:00) The following podcast is a Dear Media production. Speaker 6 (0:08) Welcome to Breaking Beauty, the podcast all about the breakthrough people, products, and moments in beauty. We're your hosts, Jill Dunn and Carlene Higgins. Speaker 6 (0:21) Welcome back to Breaking Beauty Podcast, everyone. I'm your co-host, Carlene Higgins, and I'm here with my work wife for life, Jill Dunn. Speaker 7 (0:29) Hey, everyone. And of course, we are two longtime magazine beauty editors turned beauty podcasters. We produce more than 450 episodes all about the breakthrough people, products, and moments in beauty. And Carlene, how long have we been waiting to do this episode today? Speaker 6 (0:45) Oh my gosh. It has been at least three years, I would say. And so the topic I'm just going to tell you right now is about hormones in your skin. And I very selfishly wanted to cover this topic as I got into perimenopause and my skin completely freaked out on me. It just started getting flare ups and I was complaining to all of you about it. And so we were trying to find the perfect. person, but I was having trouble finding a dermatologist who knew a lot about perimenopause and a hormone specialist who knew a lot about dermatology. So today we've... fix this problem. We Speaker 7 (1:27) have the perfect guests and they are two incredible twin sisters who represent the ultimate dream team in internal and external health. So we're welcoming Dr. Florence Comete. and Dr. Harriet Komate. Thank Speaker 6 (1:45) you for having us. Of course. Dr. Florence is a Manhattan-based Yale and NIH-trained endocrinologist and founder of the Center for Precision Medicine and Health, where she uses personalized genomic and metabolic data to optimize lifespan and healthspan from Speaker 7 (2:02) the inside out. And Dr. Florence is also the author of the New York Times bestselling book. Invincible, Defy Your Genetic Destiny to Live Better Longer. That's actually how you got on my radar because of your book. And this book is all about identifying your unique biomarkers to help develop a personalized framework to sort of decode your current and future health. We really need those lessons. I Speaker 6 (2:27) know I do. Speaker 7 (2:28) And we're thrilled to welcome Dr. Harriet Comete as well. Speaker 6 (2:32) She's a Yale-educated, board-certified dermatologist, fellow of the American Academy of Dermatology, and founder of the Advanced Skin Care Laser and Body Contouring Center in Pennsylvania. Dr. Harriet's early clinical research helped advance landmark acne treatments like isotretinoin and benzoyl peroxide. therapies. Very cool. Welcome, Dr. Harriot. Thank Speaker 7 (2:56) you. Power duo. So this episode is all about where endocrinology meets dermatology, like Carlene mentioned, and why looking at your hormones and your skin together is the real key to your healthiest skin ever. Just ahead, we're going to find Speaker 6 (3:09) out when it's actually time to get your hormones tested, why your skin suddenly acts up in your 30s or during perimenopause. or whether viral TikTok hacks like taking Pepsid and antihistamines for PMS actually has any scientific backing. And Speaker 7 (3:27) we're also answering a lot of questions about... hormonal acne, which I tend to get. And we're going to be talking about estrogen face creams, GLP-1s and longevity peptide injections, all these things that are really relevant to the cultural conversation today. So officially welcome. Right before we got on the mic, we were saying how impressive it is that both of you are incredibly accomplished MDs. And then you had a whole litany of your family tree and how accomplished they all are. Speaker 5 (3:57) Supposedly, becoming a doctor runs in the family along with criminals. Oh, wow. Speaker 7 (4:01) So Speaker 5 (4:01) not in our family. But once I was on a plane with folks from Australia who I guess were channeled to Australia years and years ago, and they said that you can inherit being a criminal and being a doctor. No way. That's true or not, Speaker 7 (4:13) I don't know. You need to put that to the test. I Speaker 5 (4:15) know. Speaker 7 (4:16) Hopefully not at the same time. Hopefully no criminals have shown Speaker 5 (4:18) up. Maybe minor crimes. But yes, so our brother's a dermatologist. You Speaker 4 (4:22) have a Speaker 5 (4:22) brother, right? Dr. Stephen Comente. He's actually in Manhattan. He used to be our younger brother, but now we made a deal when we were younger that he'd become our older brother when we got older, and he's fine with it. Oh, Speaker 4 (4:32) okay, Speaker 5 (4:32) great. Oh, wow. I know, I know. I love how that works. And my son's a facial plastic surgeon. Harriet has a daughter who's a dermatologist, and we have a cousin, Aviva Preminger, who is a body plastic surgeon. Speaker 7 (4:44) Oh, my God. In New York, too. So you literally have everybody you'd ever need on speed dial. They have to pick up your call. And the fact that you two are twins, I'm just so curious what your dinner table conversations are like. We do get a lot of things. Speaker 5 (4:57) But it did contribute to my book in a big way and my thinking many years ago, because I always realized that we were different, even though we have identical genes and that your genes are really a draft. that you can actually change and have influence over by changing the way you live life, by supplements, medication, creams. And that's what led me down this path of figuring out what's uniquely important for each of us to own our future health destiny, skin and body, mind and body. Speaker 7 (5:24) Dr. Harriet, where do you think the biggest overlap is between dermatology and endocrinology? Well, hormones Speaker 4 (5:31) drive the skin. There's hormone, there's estrogen receptors in every part of the skin. And so when we see any fluctuations in hormones, we're going to see changes in the skin. And we see that especially at the peak times of puberty, pregnancy, perimenopause and menopause, because all those things change and they impact the skin. I see it in my practice. I remember years ago, one of my patients said to me, you know, everything was working perfectly. And all of a sudden, none of the products seem to be dry. I'm irritated. And I said, I think you just need a change in the base of your products. Same medicine, different base. Because as you get older, you get drier. And then we change the. base of the medicine. So the medicine is the same, but it's maybe an ointment instead of a lotion. Okay. Speaker 7 (6:17) Fascinating. Speaker 4 (6:18) Generally during puberty is when you first start to make oil. And until you make oil, you can't make a pimple because the oil is what gets blocked and it can rupture deep down. And you'll see it in early teens, comedonal acne, whiteheads, blackheads. And then depending on their genetics, it can lead to regular acne. Generally, actually, women get more acne in their 20s than as a teenager. And it's not just a teenage thing that you go through. It's a disease that needs to be treated. It can lead to lifelong problems and scarring if it's not addressed when it should be. Speaker 7 (6:54) Yeah. Not to mention the psychological. Speaker 4 (6:56) Oh, yeah. Speaker 6 (7:04) Today's episode is brought to you in part by Nutrafol. Sometimes upgrading your routine doesn't mean changing everything. It's just about finding one thing you can do a little bit better. If hair health is something you've been meaning to pay more attention to, now is a great time to make it part of your routine. And that's where Nutrafol comes in. 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This is Don't Think, a break for your brain. Speaker 7 (9:34) So for the average listener, when is it time to get your hormones checked? And how do you know if you should speak to your family doctor, derm, OBGYN, endocrinologist? So the doctors that most people see Speaker 5 (9:47) in the States are your gynecologists. And then perhaps they even deliver you. In Canada, it may be a little different. It was certainly different in the UK. And in general, that kind of training, whether it's hormones or menopause or perimenopause, is not. present at all. So what we're hearing now when women are going into women's health is they're just beginning to emerge to think about it. Now, I did it a long time ago because I trained in every field of endocrinology, adult, which is diabetes, thyroid, lipids, bone, children, growth development, gynecology, and reproductive, as well as andrology in men. And so at Yale, I had a triple appointment, a little bit of an overachiever. And I did research across all that span. So I understood intimately how hormones changed every decade of life, starting from in utero Speaker 4 (10:37) beyond. And in women, we start losing eggs just as we are born. And every month we lose eggs. And around perimenopause, it's when ovulation becomes more Speaker 5 (10:47) erratic. And perimenopause can happen in your 30s and it can happen in your 50s. So there's a pretty wide range. The average woman goes through menopause at 50. When your body changes, it's a good time to establish what's going on hormonally. Speaker 6 (11:03) I started out with a functional medicine doctor. And so they, you know, I did a bunch of. blood work and they recommended certain supplements. I didn't take any of them. And then I don't know. I think I'm just not good at that stuff. Sometimes you'll say, Speaker 7 (11:22) I don't like taking a lot of pills. Speaker 6 (11:24) It's a lot. And then you go through them so fast, then you have to reorder. I don't remember what I ordered. Like it's not like at the pharmacist where I can just go back. Anyway, so I just kind of went off the rails and then I went to my GP. And I said, so I told her about this as I was piecing together the picture for myself. And she said, I don't understand how she was able to assign you certain supplements based on that hormone test because your hormones change every day and every week. So she's like how we would prescribe, you know, estrogen, progesterone, let's say, would be based on your symptoms. Speaker 6 (12:09) In part, Speaker 5 (12:10) she's not wrong. Hormones do change. In fact, they change even more radically than that. They change every hour. They change. So if you get bloods drawn first thing in the morning, let's say eight o'clock, your cortisol is one as a stress hormone can be much higher than if you get it drawn later because there are patterns. Speaker 4 (12:25) But Speaker 5 (12:25) if you understand the relationship of hormones to your menstrual cycle and the symptoms, it's far more precise. And so there's absolute patterns where I can see hormones in a woman and just find out what her cycle is. And particularly when the next cycle happens after the blood draw, and I can see where she is. I can tell you if she's ovulatory or not. I can tell you where she should be and why. And that makes a huge difference because each one of us is unique. So I hear that a lot. I hear that, you know, doctors saying, you know, we can't tell anything. We'll just give you hormones. And in fact, a lot of advice comes from hearing symptoms. And I see those patients subsequently and they're not doing well because they sometimes increase and increase the hormones or take them away. And symptoms are so variable across the scale of women. It's just not possible to simply tell. After a while, a woman herself might know. She knows what's happening because there are fluxes. The very first patient I remember seeing at the National Institutes of Health where I trained in clinical investigation and research and people was a young woman who was telling me her patterns of pain during her cycle. And I went into the noon conference, which was all men except me. And at that point, I was like nine months pregnant almost. came in, got a chair from my mentor because all the chairs were taken. And I reported on her and all the mail said, how does she know what's going on? I said, she lives in her own body. So hearing what you're experiencing, what I think of as the health story makes a difference. That's how we piece together almost like a detective what's going on. We Speaker 4 (13:57) need to turn your book into an app Speaker 5 (13:59) where Speaker 6 (14:00) we can just start, you know. logging information on all these biomarkers. Jill would hate this idea because she'd be convinced that the data would be sold to some Speaker 7 (14:10) big company and start Speaker 6 (14:12) putting some ads as you're driving down the highway. Actually, Speaker 5 (14:18) that's so funny because I was on CBS Mornings and a few weeks ago when the book came out, like April 25th, I think it was, and Gayle King was... asking me about the four words I say are the most dangerous. Your labs are within normal, which is scary because most labs are based on not well people, people that aren't well, done in thousands of people, and they're not really accurate. They're not optimal. And now I've seen two or three substacks taking that and using it as the basis of what they're saying. We had never seen it before. Right. So it's kind of interesting how fast things may not be wrong. Speaker 7 (14:54) Yeah, yeah, no, absolutely. Things take on a life of their own, especially on social media. Yeah, absolutely. They're all listening. That is such a good point about like, you know, just, you know, what are you comparing it to? You're comparing it to a baseline of people who are already not. Right. Right. Just your cohort. So just the same Speaker 4 (15:11) age Speaker 5 (15:12) and the same cohort. And Speaker 4 (15:13) that is Speaker 5 (15:13) so meaningless because there are people at 35 who are more like a 55-year-old and there are people at 55 who's more like a 25-year-old. Right. Like comorbidities and all that. Exactly. Yeah. Exactly. Speaker 7 (15:25) Yeah. Yeah. So Dr. Harriet, you mentioned at the beginning the three P's, which are puberty, perimenopause and pregnancy. And we get asked quite a bit about. what skincare is, quote unquote, safe during pregnancy, because it is kind of a wildcard time. What's your in-clinic experience with skin during that P, the pregnancy P? So Speaker 4 (15:47) that's true. During pregnancy, your hormones change, of course. And there are some women who have the best skin of their life. They're glowing. They're happy. They have a sheen to their skin because they may produce a little bit more oil and they don't get. any acne and their skin looks beautiful. But during pregnancy, your melanocyte stimulating hormone