Hormonal geekery...
... including whether pregnant women really need dedicated skincare ranges, and the REAL reason why peri/menopausal women are all so tired/angry/forgetful...
This week I’ve unintentionally ended up writing about pregnancy and menopause. Which I realise may sound really dull if you’re miles away from either, but I promise it isn’t. I’m delving into the truth about pregnancy skin care and its links to clean beauty, and looking at whether everything we’re attributing to peri/menopause, really is hormonal.
By the way, if you’re trying to look at previous issues of Beauty Geekery, you’ll find that they automatically paywall after two weeks, meaning only paying subscribers can read them. As with everything on Substack, I’m kind of feeling my way with this. But I always hoped that, as with all the other writing I do, Beauty Geekery would eventually pay its way, and this looks like a way to try to start down that path. However, for now, every newsletter will be free to read for a fortnight from the day it’s published. As ever, all feedback and thoughts welcome. Let’s get into it…
BTW: some of the links in this newsletter are affiliate links which means if you buy a product through them, I can earn a small amount of commission. This will never influence my opinion on something: I only rave about products I really rate. If you hate the idea of this, please let me know, as this is very much a work in progress and nothing is set in stone (and, for more on my thoughts on affiliate links, click here.)
Do you need pregnancy-safe skincare?*
Can we talk about the bollocks that is pregnancy-safe skincare? That was a rhetorical question because I am going to talk about the bollocks that is “pregnancy-safe” skincare. Because it’s making me absolutely furious. At first glance it seems innocuous enough but it’s really not. I have been pitched so many “pregnancy-safe” skincare brands in the last year and the argument is always that they’re doing a service to women, that they’re simplifying things, that the founder felt “so confused” during her own pregnancy about what she could use and what she couldn’t that she felt compelled to launch the range.
I’m sorry but this is just another version of the “I couldn’t find the product that I wanted so I made it myself” founder story that always makes me think that “you’re not looking hard enough.” But, I think this is ten times worse than that because it sends the message that most skincare that women are using isn’t “pregnancy-safe”, for me, “pregnancy-safe” skincare sits in the same bucket as “clean” and “non-toxic”. It’s marketing via scaremongering. It’s selling your product while denigrating someone else’s. And, of course, it’s largely pseudoscientific bollocks.
Because the reality is you can use almost everything on your skin when you’re pregnant. In fact pregnancy skincare is so not a thing that skin expert Caroline Hirons’ book on skincare devotes only a single page to it, and the only things she specifically talks about are vitamin A-based products:
“Avoid strong retinoids (vitamin A), but do not panic if you see vitamin A listed lower down on the ingredients list of products that you use regularly. It is frequently used at low doses in skincare as part of the formula and is perfectly safe. When talking about retinoids in pregnancy, we are specifically referring to anything that stipulates vitamin A/retinol etc on the front of the pack.”
— more on this later — and salicylic acid:
“despite old wives’ tales, low levels of salicylic acid are completely safe for pregnant women. Doctors recommend using no higher than a 2 per cent product to tackle pregnancy breakouts, and most OTC products are sold at levels lower than 2 per cent.”
I will concede that, because it’s not considered ethical to test on pregnant and breastfeeding women, entirely innocuous products will often be plastered with notices saying stuff like “consult your doctor if pregnant or breastfeeding”, which is basically arse-covering and which may work in the US if you have a private obstetrician, but really good luck to anyone who wants to get an NHS appointment to see their GP to discuss their pregnancy skincare regime. So I get that this might be where the confusion arises but…
But… I don’t know how many more times we have to tell people how difficult it is to get stuff across the skin barrier. Because this is what we’re worried about when we talk about topical skincare in pregnancy and avoiding things. We’re hypothetically worried about products going through your skin and into your bloodstream and then being fed to your baby. Now I have taken probably 100s of drugs in my life (I’m talking prescribed ones, obviously) and, ignoring those specifically designed to work on the skin — such as tretinoin, hydroquinone, antihistamine creams etc — of all those hundreds of drugs, one, just one — oestrogen if you’re interested — has been prescribed in a form that is to be rubbed on the skin. Almost everything that we want to have a systemic impact on the body is either swallowed or injected. That is how hard it is to get something into your bloodstream by just rubbing it on to your skin.
When I speak to Caroline Hirons about it, she is her usual unequivocal self. Talking about the sort of skincare you can buy over the counter, she says: “You can’t have it both ways — you can’t say something is only a topical product if you’re also saying that you shouldn’t use it when pregnant because it could have a systemic effect. Roaccutane (oral vitamin A) is different but Skin Rocks retinoids? I gave Ava [her daughter who is pregnant] one to use a few months back, do you think I’m going to endanger my unborn grandchild?”
She also said that most people who are on topical tretinoin for acne will — on the advice of their dermatologists — actually stick with it during pregnancy because the stress and upset caused by acne flares is considered to be more damaging than using tret.
But you don’t have to take our word for it. I found a couple of papers on the topic — one, admittedly from a few years ago, called Safety of skin care products during pregnancy, and another, more recent one called Skin Changes and Safety Profile of Topical Products During Pregnancy. Both of these papers go through the evidence available for each ingredient and look at the absorption. Perhaps unsurprisingly, they come to very similar conclusions to Caroline Hirons.
Broadly speaking, because of five case reports that “raised the suspicion that birth defects cannot be ruled out after topical use of tretinoin” most people suggest you stop using tret — unless your doctor says otherwise — while pregnant. BUT another couple of studies that looked in total at more than 200 women “reported neither congenital malformation nor evidence of retinoid embryopathy.” So if you’ve found out you’re pregnant and have been using tret, there is no need to panic or do anything drastic and, if you think acne is going to make your pregnancy miserable and your derm doesn’t have an issue with it, there’s no need to automatically come off it. Also bear in mind that these studies relate to the prescribed drug tretinoin — prescription-strength, most potent form of vitamin A, not retinol, retinal, retinyl palmitate or any other vitamin A derivative. So there is no evidence that you should quit all topical vitamin A derivatives while pregnant.
(Having said all that, I did. Because I think you need to do what makes you comfortable and what causes you the least stress. In my case, having taken a gazillion years to get pregnant, I never wanted to have a reason to reproach myself for anything if I miscarried (again) and so I decided that ditching anything topical that was vitamin A-related was the right choice for me. I also decided not to dye my hair until I was past 12 weeks, even though there is literally no evidence that dyeing your hair can harm your baby. What can I say? Women do mad things when they’re pregnant and even madder things when they’ve had miscarriages and tonnes of IVF. But, I reiterate, THIS IS STILL NOT A REASON FOR CREATING “PREGNANCY-SAFE SKINCARE.” In fact, it’s actually a reason not to — you know women are vulnerable, don’t be the dick that capitalises on that to your advantage.)
The other thing people worry about is salicylic acid, which is derived from the same plant that aspirin is derived from. High doses of aspirin in pregnancy can cause problems for the foetus. Using salicylic acid does not — hypothetically it might if you’re basting your entire body in it and then mummifying yourself, but using under 2%, which is the upper concentration of most skincare products available over the counter, on your face is not going to be an issue.
Hydroquinone — an ingredient used to tackle pigmentation, which is prescription-only in the UK is also flagged as being a hypothetical concern because it has a relatively (compared to other skincare ingredients) high absorption rate.
But that’s it. As I said above, the reality is that, when it comes to skincare that you can buy over the counter here in the UK, there is pretty much nothing that you can’t use on your skin when you’re pregnant. (I’ve even written before about the fact that the insect-repellant DEET is actually “pregnancy-safe” even though I’d assumed that it wasn’t.) Prescribed skincare might be different, oral skincare (prescribed or otherwise) might be different, but when it comes to going into a shop in the UK and buying stuff to put on your skin, if it’s safe to use on your skin at any other time in your adult life, it’s safe to use on your skin when you’re pregnant.
Please share with your pregnant friends who are agonising about this and wondering if they have to throw everything out and start again with a new “pregnancy-safe” skincare brand, they really don’t. Skincare when pregnant is a bit like exercise when you’re pregnant, keep doing what you were doing and you’re probably going to be fine. Caroline Hirons recommends not going wild with any new actives, not because they’re dangerous, but if you f**k up your skin (my words not hers) your prescription cream options for treating it are more limited because you’re pregnant.
My skin was fairly well-behaved when I was pregnant. (But I know not everyone is as lucky as me, which is why they shouldn’t be scared of using something like salicylic acid if they’ve got hormonal acne.) I used prescription 20% Azelaic Acid nightly instead of my usual tret — and when the skin on my neck had a minor freak out and went red and itchy and sore, on the advice of Dr Beibei Du Harpur, I slathered on Avene Cicalfate twice daily and that made it behave. But I did go through inordinate amounts of body oil and moisturiser in a bid to avoid stretchmarks (although the data suggests that sometimes you can try everything and there’s a hereditary aspect which means that they’re inevitable.) As with so many things, I think finding one that you’ll use is more important than any specific one.
I used the now discontinued Caudalie Divine Oil, whose smell I adored, Elizabeth Arden Eight Hour All Over Miracle Oil, which I really like from a practical perspective as it’s a spray and comes in a plastic bottle so you don’t worry about smashing it in the shower. (I leave all my body oils in the shower because I like putting them on wet skin — and I know I won’t do it if I have to get out the shower and apply.) And I was really surprised to find that I used a load of the Morrocanoil Dry Body Oil and Body Soufflé — again something about the fragrance, but really use whatever you’ll use.
Anyway. That’s all you need to know about pregnancy skincare and whether you need it or not.
*I’m sure I’ve talked before about that long running joke / trope in newspapers about how if you see a headline in a newspaper that asks a question, the answer is invariably “No.” So “Could this be the REAL reason Prince Andrew hasn’t been seen in public for ten years?” “Will this £10 hack change your life?” “Does this ancient buried scroll hold the key to civilisation?” They’re all Questions To Which The Answer Is No (QTWTAIN) — and so, obviously, is “Do you need pregnancy skincare?” Although I feel like most newspapers string out the answer for a bit by not referring to the subject as “bollocks” in the opening line.
The Peri/Menopause Blame Game
I ummed and aaahed about whether to write about this in a newsletter that is devoted to Beauty Geekery as opposed to Health Geekery or Wellbeing Geekery, but it increasingly feels as if those lines are blurring far more than they ever have before.
Last week I was part of a panel at SXSW London talking about Skin as Data: What Your Face is Revealing About Burnout, Beauty Lies and Digital Damage and quite how they thought we were going to get all that into a 35 minute panel discussion I’m not really sure, but we did cover a LOT, and one of the things we got into was how I feel that they beauty industry has shifted over the last few decades and what we’re seeing now is a genuinely holistic approach, it’s the wellbeingification of beauty, the self-carification of beauty.
And something that popped up from a brand on my social media feed this week really confirmed that. (I’m actually NOT going to link to it because I’m fairly sure that the post is entirely created by AI. That doesn’t mean that the data it references isn’t necessarily valid (it is, I checked it, of course I did) but I’m kind of loath to give the oxygen of publicity to a company that is using AI to create content and not even bothering to make it not look like AI slop.) It was talking about the fact that the pace of growth in the wellness industry is faster than that in beauty, and it highlighted that a face serum isn’t just competing against another skincare product, it might also be competing against a sleep tracker or supplement. Let that sink in. As I might write, if I were AI, which I’m not.
So yes, I feel like even within the context of Beauty Geekery, I’m OK to talk about a load of stuff that might be considered beauty adjacent. And today I want to talk about whether we’re confusing “life” with “peri/menopause” and, to be honest, a whole load of other things.
This thought was sparked by a conversation between me and some friends in the industry. One — late 40s — was talking about how she was being targeted on social media with ads for products to remedy vaginal dryness (which wasn’t an issue for her); another responded that this was mad because she was 15 years older, on HRT and didn’t have that problem either. And then, without sounding too Carrie Bradshaw, we got to talking about the fact that a load of our 40-something friends outside the industry are all talking about perimenopause and menopausal symptoms. They know what they should be looking out for, and so they’re super-sensitive to them, or even the suggestion of them. Are we the first generation to properly understand perimenopause, or are we just being seduced by the power of suggestion?
I should know, I’ve been there. Irregular periods before the birth of my second child were a fairly good indicator that I was probably perimenopausal, but in the years before and after, I also had a series of annoying episodes of tendonitis — a frozen shoulder, tennis elbow, golfer’s elbow, inflammation of a tendon in my foot, another shoulder thing (the other one, just for balance) — and having checked with my GP that I didn’t have any raised inflammation markers that might suggest some sort of arthritis, I decided “screw it, this is probably a hormonal peri/meno thing, might as well go on HRT.”
(Here is not the place to debate the merits or otherwise of HRT, although if you are interested in hearing more on this, let me know as my friend Alice Smellie literally wrote the book on this stuff and I’d happily drag her in for a guest slot here. Suffice it to say that I am utterly convinced that, for the majority of women, if HRT is prescribed as per NICE guidelines, there are not only no negative health implications, but actual benefits that extend far beyond quality of life — which itself should obviously not be underestimated.)
The thing is, when I was looking at other symptoms of the menopause, and talking to my GP about them, I could easily have said yes to many of them. While I didn’t have hot flushes and night sweats, I could definitely tick the boxes when it came to sleep problems, mood changes, poor memory and brain fog. But then I also have two small children, a full-time job and a busy home life that — like so many people — I’m trying to juggle.
As a friend said to me the other day, when I was complaining about words going clean out of my brain (last week I couldn’t remember, in no particular order, New Orleans, alpacas, or the name of one of my antenatal group friends) “I know we’re meant to blame it on menopause but isn’t it just, er, life?” And I thought she might actually be right.
Do you know how much information we’re expected to process on a daily basis compared to how much our predecessors were subjected to? I tried to find out an up to date figure but the best estimation I got dates back almost 10 years and reckoned that the average person living in 2017 processed as much as 74 GB of information a day (that is as much as watching 16 movies), through TV, computers, mobile phones, tablets, billboards, etc etc. and that cited another study that estimated that each year that figure of 74 GB increased by around 5% — if that were true, now in 2026, we’d be hovering around the 115 GB mark. According to the source, back in the 1500s, 74 GB of information would be what a highly educated person consumed in a lifetime. So we are processing more than a lifetime’s amount of information every single day. And yes, of course, our brains are plastic and adaptable and can do amazing things and yet, and yet, and yet… we don’t ask them to do a lot of the things that we used to that might encourage that plasticity and adaptability.
How many numbers did you know off by heart before you had a mobile compared to how many you know now? How often do you let your brain actually relax? Daydream? Do nothing? How often do you write a reminder note to yourself in actual pen as opposed to either tapping it into your Notes app or asking Alexa to add it to the shopping list?
(There is a massive difference — I found this recent paper on the subject fascinating in its conclusions:
“Handwriting activates a broader network of brain regions involved in motor, sensory, and cognitive processing. Typing engages fewer neural circuits, resulting in more passive cognitive engagement. Despite the advantages of typing in terms of speed and convenience, handwriting remains an important tool for learning and memory retention, particularly in educational contexts.”)
I’m not passing judgement, I’m just like you. I am NEVER not doing at least two things at once, and that’s not a boast. It’s pretty shameful. I am so proud of myself for putting a stop to my late-night bed-scrolling habit. That Brick device that I bought sits on my fridge and every night before I go upstairs I tap in so that the only things available on my phone are calls and text messages. (Angsting about elderly parents means I couldn’t quite ban my phone from the bedroom overnight.) It doesn’t get unBricked until I go downstairs the next morning. But that doesn’t mean I ever let my brain wander. While once I would scroll Insta while brushing my teeth, now I take my Kindle with me. Theoretically, and from an intellectual snobbery perspective, it’s “better” but isn’t it mad that I literally can’t do a two-minute tooth brush without simultaneously doing something else?
And then I wonder why I forget things, drop a ball, and get frustrated.
One of the things that we talked about during the Skin is Data chat at SXSW last week was the fact that actually the stuff that works for skin is quite boring, quite repetitive, quite long-haul. There aren’t quick fixes, it’s about what you do every day, day in, day out. There isn’t a magic pill. There’s just doing the hard yards. And really, that’s true of so many things.
But when I kept getting episodes of tendonitis, I wanted a magic pill. I wanted perimenopause to be the reason that bits of my body kept hurting. I didn’t want it to be the more prosaic, “you’re not doing enough exercise, or stretching and you’re constantly hefting two increasingly less small people around in a way that doesn’t take your biomechanics into consideration.” And I wanted HRT to fix it.
Has it? Who knows? In the last six months I’ve also started strength training with heavy weights, eating more protein, and trying to be more considered when hefting children around. And I can’t say that I really had any other massive issues where I’ve noticed incredible changes. I’m not tired all the time, but I’m tired a lot of the time. Sometimes it’s because I haven’t slept well, but I also suspect a lot of the time it’s because my body is trying to fend off some low level infection or virus.
But also because life right now, whoever you are, wherever you are is A LOT. And that constant low-level anxiety — whether you choose to engage with the news or not — about whether or not we might be on the brink of an energy crisis / third world war / prolonged recession / loss of autonomy to AI — literally pick your poison — is EXHAUSTING.
As for the mood swings, the misery, the anger, the fury that other friends cite as symptoms of peri/menopause. Well, see the paragraph above. If you’re not angry or depressed about the state of things, I either need the number of your therapist or the details of your drug regime, because I’m nowhere near that zen.
And please don’t get me wrong, I’m not saying that peri/menopause isn’t a thing. What I am saying is that it might not be every thing for everyone. It is entirely possible for two things to be true at the same time: that we are both the first generation of women to be alert to what the menopause and perimenopause actually entail and also that we are blaming a tonne of things on peri/menopause that are just life.
And some of the reason we might be doing the latter is because we’re being incentivised to do so, partly, as one delightfully caustic friend pointed out, “because some women like to make menopause their entire personality, it makes them feel part of a gang”, but also because there are a load of companies out there selling us solutions and, as explored above, who doesn’t want a quick fix? Cheryl Wischhover’s newsletter Good For Your Age is excellent on all this — the two linked below are particularly relevant in this context…
Anyway, I have no quick fixes for peri/menopause or life, but I just thought, after various conversations I’ve had this week, that this was worth exploring. Let me know your thoughts in the comments.
Phew this was longer than I intended so I think that’s all for this week. Until next time…
Thank you for this, Claire. There are so many things I’d like to attribute to perimenopause: PCOS symptoms intensified, exhaustion, supersonic scent recognition, etc. It turns out that a lot of those symptoms are the same for neurodivergence… so I need to stop shaming myself for needing rest, quiet, and scheduled time where I don’t have hands on my body.
Claire, thank you for sharing my posts! I agree with everything you’re saying here. It’s not always perimenopause. But it’s such a convenient thing to blame, and most importantly, an easy thing to sell stuff for since the symptoms can be so nebulous/bothersome