Dr. Doris Day on Menopause, Collagen, and Rebuilding Skin from Within

Dr. Doris Day, a board-certified dermatologist and NYU clinical associate professor, frames the skin as the body's largest contiguous organ and one of its most telling. As estrogen falls in perimenopause and menopause, estrogen receptors in the skin decline while the brain competes for whatever estrogen remains, so skin changes often appear before brain fog. She explains that UVA rays reach the layer where collagen lives and drive enzymes that break it down, and that skin can lose roughly 30% of its collagen in the first five years post-menopause, then about 2% per year.

Rather than chasing the fullness of youth, Day argues for balance and 'a different beautiful,' shaped by changing bone and fat structure. Her at-home levers are unglamorous but consistent: high-quality protein, strength training that also builds facial and skeletal support, hydration inside and out, and a simple routine of vitamin C and sunscreen by day, a retinoid and moisturizer by night.

She dives into the mTOR pathway, describing how TORC1 can get stuck 'on' at menopause and how selectively calming it helped exhausted 56-year-old fibroblasts behave like 23-year-old ones in her research. On hormones, she is a vocal advocate for menopause hormone therapy and is studying topical estradiol. Her closing rapid-fire is refreshingly plain: hydration first, retinoids, sleep quality, sun protection above all, and consistency over perfection.

• 1

  Build from the inside out 21:00

  Prioritize high-quality protein and strength training; building muscle supports both the skeleton and collagen in the skin.

• 2

  Practice a 'new neutral' in the mirror 24:30

  Use a magnifying mirror to find and hold a relaxed, non-drooping resting expression and to lift from the ears rather than the forehead.

• 3

  Treat sugar and alcohol as occasional 37:30

  Skin is highly sensitive to inflammation from sugar and alcohol, and recovery margin shrinks with age; make sweets a controlled treat rather than a daily habit.

• 4

  Keep skincare simple 53:30

  A few morning steps (rinse, vitamin C, sunscreen) and a few night steps (cleanse, retinoid, moisturizer) beat a 10-step routine; sun protection is number one.

• 5

  Prioritize quality sleep 54:30

  Aim for 7.5-8 hours with enough deep and REM sleep; poor sleep shows in the face because tired muscles let it drag.

• 6

  Consistency beats perfection 55:10

  The women who age most powerfully exercise, eat, and sleep well most of the time. Nobody has to be perfect, just good most of the time.

• 7

  Consider ingestible collagen as building blocks 52:30

  Hydrolyzed collagen is digested down to building blocks that can put your own collagen synthesis a few steps ahead, and Day reports seeing a difference in patients.