When it comes to skincare, most of us think in terms of lotions, serums, and the latest viral routine. But Dr. Teo Soleymani, a fellowship-trained dermatologist and skin cancer surgeon, wants us to zoom out.
Skin isn’t just a surface issue. It’s tied to our hormones, our diet, our lifestyle, and even the way we think about aging itself. In this conversation, he pulls back the curtain on what really works, what’s overhyped, and how to protect your skin for both beauty and long-term health.
Glass Skin and the Rise of Multi-Step Routines
If you’ve spent time on Instagram or TikTok, you’ve probably seen the term glass skin — that poreless, glowing, nearly reflective look that’s become a benchmark of Korean beauty. South Korea’s cultural preference for flawless, porcelain skin is rooted in centuries of history, and today it drives an entire industry of innovative products, treatments, and sunscreens that aren’t even available in the United States.
But Soleymani points out something important: while it’s possible to achieve skin that looks just as radiant here, the path is often less complicated than what social media suggests. The more steps you add to your routine, the more chances you have for irritation, clogged pores, or breakouts. In other words, the nine-step regimen might be more about marketing than actual skin health.
Behind the curtain, many people with seemingly perfect complexions are also using prescription medications like Accutane, oral antibiotics, or hormone-modulating drugs, which are things you won’t see in a 30-second reel.
The truth is, less is often more, so long as what you’re using is effective.
Makeup, Mites, and Misconceptions
Makeup itself isn’t the villain it’s often made out to be. Used reasonably, it doesn’t accelerate aging or cause irreversible damage. The bigger issue comes from habits like sleeping in it, which prevents your skin from turning over and feeds organisms like Demodex, a tiny mite linked to rosacea flare-ups.
Many women who battle unexplained redness and breakouts in their 30s and 40s are shocked to discover that this little parasite may be the culprit. The fix? Often as simple as washing your face before bed and keeping brushes clean.
Soleymani also has mixed feelings about watchdog groups like the Environmental Working Group. While they raise awareness about potentially harmful ingredients, they tend to oversimplify complex science into “good” and “bad” lists.
Most preservatives and so-called “toxic” ingredients appear in concentrations far below dangerous levels. Still, he acknowledges there’s room for caution: long-term, low-level exposure is difficult to study, and no one truly knows whether cumulative effects matter.
This is an often overlooked point about toxicology research. We are exposed to many chemicals simultaneously, not just one at a time. Regulatory tests typically don’t measure what happens when these compounds interact, nor do they fully account for the fact that chemicals can act differently at low doses than they do at high ones. In fact, modern toxicology has repeatedly shown that even tiny exposures, far below current safety limits, can have measurable effects on health.
Hormones on Your Face: The Testosterone–Estrogen Divide
One of the most fascinating and overlooked aspects of skin health is the role hormones play in shaping how our faces age. Testosterone and estrogen, in particular, leave very different fingerprints on the skin.
Testosterone, which is making a comeback in medicine after years of being stigmatized, can be a double-edged sword. On one hand, it supports muscle mass, energy, and metabolic health. On the other, it thickens sebaceous glands, increases oil production, and often fuels acne. For some, even therapeutic doses trigger breakouts and leave scars more visible.
Too much testosterone can also give the skin a ruddy, flushed appearance, since it stimulates higher blood production. That’s why people using testosterone, whether medically or otherwise, often notice that their skin looks oilier, redder, and harder to manage.
Estrogen tells an entirely different story. Research shows that estrogen is one of the most important hormones for maintaining youthful, resilient skin. After menopause, when estrogen levels drop, women often notice their skin becoming thinner, drier, and less elastic.
This goes beyond cosmetics. Estrogen deficiency reduces collagen, weakens the skin barrier, and slows wound healing. Postmenopausal skin is more vulnerable to oxidative stress, pigmentation changes, and even impaired immune defense. In other words, estrogen is not only about smoothness and glow; it is central to skin’s structure and function.
Both systemic and topical estrogen therapies have been shown to improve collagen content, increase skin thickness, and enhance hydration. Studies measuring biochemical markers like hydroxyproline and procollagen peptides confirm that estrogen literally rebuilds the scaffolding of the skin. Topical 17β-estradiol, for instance, increases collagen and elastin production while reducing enzymes that break them down. It also boosts hyaluronic acid, which is the molecule that gives skin its plump, hydrated feel.
A meta-analysis of 15 clinical trials reported that menopausal hormone therapy consistently led to better skin elasticity, greater thickness, and fewer wrinkles in women on treatment compared to those on placebo.
The nuance, of course, is safety. Hormone therapy is not for everyone, especially women with a history of hormone-sensitive cancers. But for the right candidate, restoring estrogen levels can delay or even reverse many of the visible and functional changes of skin aging. This is why some dermatologists now view estrogen less as an “optional extra” and more as a fundamental pillar of skin health in midlife and beyond.
Sun, Cancer, and the Culture of Fear
As a skin cancer surgeon, Soleymani knows better than anyone the dangers of excess sun exposure. But he also resists the fear-based messaging that’s dominated dermatology for decades. You don’t have to avoid the sun entirely, you just have to be sun-smart.
Yes, blistering burns are dangerous, and yes, cumulative UV exposure raises your risk of basal and squamous cell carcinoma. But genetics and family history also play an enormous role. Not everyone with wrinkles or skin cancer is simply guilty of “too much sun.” Soleymani finds it unhelpful to shame patients for conditions that are often beyond their control.
Skin aging is basically the result of two things: intrinsic and extrinsic factors. Intrinsic factors are the inevitable physiological processes that come with aging and are due in large part to genetics, while extrinsic factors are environmental exposures like air pollution and sunlight (technically called photodamage).
Using sunscreen on your face is an easy way to minimize the impact of chronic sun exposure on skin health, but it is not the only form of protection. Shade, clothing, and simply knowing your own tolerance matter just as much.
However, if you do use sunscreens, opt for non-nano mineral options, zinc oxide being the most popular. It will leave that characteristic white tint on your skin, but your long-term health will thank you. Ingredients like oxybenzone, octinoxate, and homosalate have all been shown in lab and animal studies to interfere with hormone signaling and fertility.
Human studies confirm that when applied to the skin, these chemicals are absorbed into the bloodstream at levels above established safety thresholds, sometimes persisting in the body for weeks.
It wasn’t until 2019 that the FDA even required thorough safety data on sunscreen ingredients, despite decades of widespread use. Of the 16 active ingredients currently on the market, 12 still lack sufficient safety data, and two have already been deemed unsafe.
Diet, Protein, and Collagen
When patients ask what they can do beyond creams and lasers, Soleymani always comes back to diet. Food is medicine, especially for the skin. Protein is key, since collagen — the structural backbone of youthful skin — is built from amino acids found most abundantly in animal sources. People who chronically undereat protein, or avoid it altogether, often show accelerated signs of aging.
Collagen supplements themselves are a mixed bag. While skeptics once dismissed them, research now suggests they provide meaningful benefits. A meta-analysis of 23 randomized controlled trials found benefits from collagen supplementation for skin hydration, elasticity, and wrinkling, even when looking only at studies judged to be of high-quality and those not funded by industry.
The improvements aren’t dramatic, but patients often report brighter, more hydrated skin after a few months. Vitamin C, which is required to assemble collagen, enhances this effect. It’s not a miracle, but for some, it’s an easy win.
Carotenoids are another easy win. These molecules are deposited into your skin barrier and function as defenders against environmental damages, including sunlight. For example, eating 40 grams of tomato paste (16 mg lycopene) led to 40% greater protection against UV damage than those eating the placebo after 10 weeks.
One meta-analysis of seven studies looking at how β-carotene supplementation affected the risk of sunburning found that there was a significant reduction in the degree of sunburn from supplementing with 15–180 mg of β-carotene per day. In fact, the authors estimated that β-carotene provided equivalent protection as an SPF-4 sunscreen, except that the effects are systemic and relatively permanent.
The Real Game-Changers: Retinoids, Lasers, and Smart Supplementation
If you strip away the noise, Soleymani boils anti-aging and skin protection down to three core strategies:
- Topicals that actually work. Retinoids are the gold standard. Unlike trendy serums, they’re proven to stimulate new collagen, smooth fine lines, and prevent pre-cancers. Pair them with a mineral sunscreen and, if tolerated, vitamin C for antioxidant defense.
- Resurfacing procedures. Devices like Fraxel lasers stimulate collagen production, reduce sun damage, and even lower skin cancer risk. They’re not about erasing every wrinkle overnight, but about slowing the slope of aging.
- Internal protection. This is the frontier most people don’t know about. Supplements like collagen, astaxanthin and other carotenoids, and polypodium leucotomos (a fern extract that provides strong UV protection) can protect skin from the inside out.
Beyond Vanity: Skin Health as Whole-Body Health
What makes Soleymani’s perspective refreshing is how he refuses to reduce skincare to vanity alone. Yes, we all want smoother skin and fewer wrinkles. But the deeper goal is health — protecting the body’s barrier, lowering cancer risk, and using appearance as a clue to internal balance. Skin changes are often the first sign of hormonal shifts, dietary gaps, or systemic illness. Treating them in isolation misses the bigger picture.
Action Checklist
- Simplify your skincare routine: fewer products, but higher quality.
- Never sleep in your makeup — it clogs pores and feeds organisms like Demodex.
- If you’re on hormones, pay attention to how your skin responds. Testosterone and estrogen act very differently on the skin.
- Don’t fear the sun, but know your dose. Protect yourself with shade, clothing, and mineral sunscreen.
- Prioritize protein in your diet, and consider collagen plus vitamin C.
- Use proven topicals: retinoids nightly, sunscreen daily, and vitamin C as an add-on.
- Consider professional resurfacing treatments like Fraxel for long-term collagen support.
- Explore supplements like nicotinamide, astaxanthin, and polypodium leucotomos to strengthen your skin from within.
