Your skin tells a story about what's happening inside your body, long before you notice it on the outside. In this episode, Dr. Anna sits down with triple board certified dermatologist Dr. Mamina Turegano to unpack what actually drives collagen loss, which skincare ingredients are worth your money, and two conditions, rosacea and vulvar lichen sclerosus, that too many women live with undiagnosed for years.
Listen to the full episode here: YouTube | Apple Podcasts | Spotify
Table of Contents
- Key Timestamps
- Meet Dr. Mamina Turegano
- Why Your Skin Ages Faster Than You Think
- Sunscreen Truths, Chemical vs Mineral
- The Skincare Ingredients Worth Your Money
- In-Office Procedures That Actually Work
- Rosacea and the Gut Connection
- Vulvar Lichen Sclerosus, the Diagnosis Too Many Women Miss
- Rapid Fire with Dr. Mamina
- FAQ
Key Timestamps:
- 00:00 – Intro, today's topics
- 02:23 – Dr. Mamina's path into dermatology
- 08:04 – Why we lose collagen and what accelerates the breakdown
- 10:29 – Sun protection and sunscreen fears
- 19:51 – Retinoids: how often to use them and why
- 23:36 – Vitamin C, peptides, and topical hormones
- 29:06 – IPL for dark spots and redness
- 33:51 – Red light therapy: what to look for in an at-home mask
- 41:44 – Vulvar lichen sclerosus: why it's often missed
- 52:22 – Rapid-fire round
Meet Dr. Mamina Turegano
Dr. Mamina Turegano is a triple board-certified dermatologist, internist, and dermatopathologist based in New Orleans. She blends conventional dermatology with a root-cause, integrative lens, and shares dermatologist-backed skincare and wellness insights with over 2 million followers across social media. Her path began in a childhood shaped by her mother's preference for unconventional remedies over prescriptions, leading her through internal medicine, a fascination with autoimmune skin conditions, and eventually a dermatology residency where medicine, pathology, and skin health came together.
Why Your Skin Ages Faster Than You Think
Collagen loss starts earlier than most women expect. Dr. Mamina explains that we lose about one percent of our collagen a year starting in our twenties, and that rate speeds up during perimenopause and menopause as estrogen drops. Collagen sits in the dermis and gives skin its plumpness and lift, so as it breaks down, skin loses structure. UV exposure, a pro-inflammatory lifestyle (smoking, alcohol, sugar, chronic stress), and the natural aging process all contribute. Meanwhile, the epidermis thins, which is why crepiness and fine lines tend to show up first, while deeper wrinkles and sagging come later as fat and collagen continue to decline.
Sunscreen Truths, Chemical vs Mineral
Sunscreen is one of the most talked about, and most misunderstood, tools for supporting skin as it ages. Dr. Mamina breaks sunscreens into two categories.
Chemical (organic) sunscreens like avobenzone, octocrylene, and octisalate absorb UV rays.
Mineral (physical) sunscreens like zinc oxide and titanium dioxide absorb and partially reflect UV rays.
The controversy around chemical sunscreens traces back to animal studies using very high, unrealistic doses that showed systemic absorption and some endocrine disruption. Human evidence for harm at typical use levels isn't there yet, and oxybenzone specifically has largely been phased out of newer formulations. For anyone who wants to play it safest, Dr. Mamina recommends sticking with mineral sunscreens, especially on the face.
The Skincare Ingredients Worth Your Money
Dr. Mamina walks through the ingredients with real research behind them.
Retinoids (retinol, tretinoin) support collagen production and are most effective when used five to seven nights a week, followed by moisturizer.
Vitamin C is a well-studied antioxidant that supports collagen and helps even out skin tone. Best used in the morning, under sunscreen.
Topical peptides support the skin barrier and can help with pigmentation and tone over time.
Hyaluronic acid doesn't build collagen, but it's a strong humectant that pulls in moisture and plumps the skin's appearance. Safe for daily use.
Topical estrogen can help with crepiness in thin skin areas like around the eyes, though Dr. Mamina notes it doesn't work the same way for everyone.
In-Office Procedures That Actually Work
For anyone considering in-office treatments, Dr. Mamina shares her honest take.
IPL (intense pulsed light) is her go-to for dark spots and redness.
Fraxel and CO2 lasers work deeper on the collagen level and resurface the skin, generally worth considering starting in your forties or fifties.
Morpheus (RF microneedling) helps with textural lines and scars, but needs an experienced provider, since incorrect settings can affect the fat layer that gives skin its youthful plumpness.
Chemical peels are a longstanding option for pigmentation and melasma, with no upper age limit.
Red light therapy shows promising evidence for supporting cellular activity in skin, though look for FDA-cleared devices, especially for at-home masks.
Rosacea and the Gut Connection
Rosacea shows up as skin that reacts more readily than average, with dilating vessels and increased sensitivity. Dr. Mamina points to research connecting rosacea with gut issues like H. pylori and SIBO (small intestinal bacterial overgrowth), alongside a genetic component more common in people of Irish ancestry. Her approach starts with a gentle, fragrance-minimal skincare routine, and for redness and breakouts, a combination of azelaic acid, topical ivermectin, and topical metronidazole. Left unaddressed long term, rosacea can lead to permanent redness and enlarged pores, which is why she encourages catching it early and looking at gut health alongside topical care.
Vulvar Lichen Sclerosus, the Diagnosis Too Many Women Miss
This is one of the most under-recognized conditions in women's health. Dr. Anna and Dr. Mamina describe the telltale signs, a whitening or paling of the skin with a "cigarette paper" texture that tears easily, itching, and burning, often around the vulva and clitoris. It's frequently missed because it requires a careful visual exam, and it's too often mistaken for a yeast infection. Both doctors have observed cases rising since the pandemic, and note it shows up in a bimodal pattern: in postmenopausal women as hormones decline, and in prepubescent girls, suggesting a possible autoimmune or viral connection worth further research.
Left untreated, it can lead to permanent skin changes and carries a slightly increased risk of skin cancer in affected tissue, which is why an early, accurate diagnosis matters. Approaches discussed include high-potency topical steroids to calm inflammation, topical calcineurin inhibitors for maintenance, hormone support, gut healing and an anti-inflammatory diet, and emerging research into low dose naltrexone, JAK inhibitors, and biologics.
This is general education from the conversation, not a substitute for a personal exam or diagnosis. If you're noticing symptoms, bring them to a doctor who is comfortable with this condition.
Rapid Fire with Dr. Mamina
Most overrated trend: Beef tallow as a facial moisturizer.
Most underrated habit: Washing your face before bed, every night, no exceptions.
Best value for your money: Sunscreen and retinoids, including affordable over-the-counter options like adapalene.
What aging beautifully means to her: Feeling confident and comfortable in your own skin, inside and out.
FAQ
What causes collagen loss as we age?
Collagen naturally declines about one percent a year starting in our twenties, and that rate speeds up during perimenopause and menopause due to dropping estrogen. UV exposure, smoking, alcohol, sugar, and chronic stress can also accelerate collagen breakdown.
Are chemical sunscreens safe?
Current human research hasn't shown harm at typical use levels. Concerns come mainly from animal studies using very high doses. If you'd rather play it safe, mineral sunscreens with zinc oxide or titanium dioxide are a solid alternative.
What is vulvar lichen sclerosus?
It's a skin condition that causes whitening, thinning, and tearing of the vulvar skin, along with itching and burning. It's frequently underdiagnosed and mistaken for other conditions. An accurate diagnosis usually requires a visual exam by a provider familiar with the condition.
Is rosacea connected to gut health?
Research has found links between rosacea and gut issues like H. pylori and SIBO, alongside a genetic component. Addressing gut health alongside gentle topical care is part of a comprehensive approach.
What's the most affordable, evidence-backed anti-aging routine?
Sunscreen and a retinoid. Both have decades of research behind them and are available at accessible price points, including over-the-counter retinoid options.
Products Mentioned
Connect with Dr. Mamina Turegano
Co-Author, Holistic Psoriasis Management and Nutrition Guide
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Disclaimer: * The information provided is for educational purposes only and should not be construed as medical advice. Always consult with your healthcare professional before starting any supplement program.
