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A couple of weeks ago I received a press release I wanted to tell you about but didn’t, because there always seemed to be more important news. But the ponytail facelift is important news. I (reasonably and naively) assumed it was the effect you get when you pull your hair into a tight ponytail—and I was saddened to discover that it is not. It’s a surgical procedure, introduced in the press release this way:
A fully advanced facelift may be too much for someone who is 25 but still wants something done to make their face look tighter and lifted.
I can confidently say that a person who is 25 who wants something done “to make their face look tighter and lifted” is most likely a person who needs counseling. I am all for the you do you approach to aesthetic procedures—as long as you clearly understand your motivations. And there may well be a circumstance (such as enormous weight loss) in which a very young woman might benefit in some way from a tighter and lifted face, but normalizing such a procedure speaks to the destructive nature of our beauty culture. The marketers of this procedure (a few dermatologists and plastic surgeons) boast that one of its positives is that the scars are easy to hide. They’re referring to the physical scars, of course, not potential emotional ones.
“Ask Val” answers your urgent questions, Vol. 33
Yes, you, right here in the front covering your mouth with your hand. Could you please speak up?
Q: I'm 56 and am still having irregular menses; my body temperature and sleep habits have changed. Typical stuff. All of this for 10 years now but the trade-off, I figure, is that my skin and hair still look amazing. I'm not taking anything for these symptoms except turmeric, moringa, and Omega-3. I cook organic, fiber-filled meals for myself 99% of the time, drink lots of water, practice yoga, walk regularly, wash my face twice a day, moisturize, use foundation only maybe once a month, yada yada yada. But recently I've been getting acne on my chin. According to Chinese medicine, the chin is related to gynecological issues. So here's the question: Any tips for how to minimize or avoid this lower face acne? I've kicked up my usage of charcoal masks and I use benzoyl peroxide on the blemishes—but honestly, it can take a week or longer for them to resolve. They hurt and look awful. Help!
A: As my dear, departed, Democratic dad said (after losing a councilman election in our Republican town), “No good deed goes unpunished.” By which I do not mean that the superb care you seem to be giving yourself is in any way causing your breakouts—but how disappointing when in spite of our good intentions and disciplined behavior we get…pimples! You are correct to associate the chin and jawline with gynecological issues, as breakouts in those areas are usually due to fluctuating hormones.
If you’re not into supplementing your current treatments with allopathic medicine, you could just ride this out till your hormones stabilize. (I would understand that decision.) But if you want to get into the nitty-gritty of your hormone situation, you could follow the suggestion of dermatologist Mary Lupo. “I would get labs,” she says. (Meaning bloodwork.) What would she be looking for? “It’s most important to determine levels of estradiol, free and total testosterone, DHEA (hormones), and vitamin D.” Lupo further suggests that the natural remedies you’re currently using likely won’t solve your issues. In her practice, she says, she usually prescribes the anti-testosterone pill spironolactone with great success. In some women, hormonal acne is caused by a sensitivity to progesterone; spironolactone blocks the effects of progesterone and androgens on the skin.
HNTFUYF DermDiva Heidi Waldorf agrees about the spironolactone treatment. And she adds that acne can occur on the chin with or without gynecologic issues. But adult women—from child-bearing years through post-menopause—do tend to get more acne on the jawline and chin than teens. In menopause, reduced estrogen may cause a relative increase in androgen, which can lead to side effects like thinning scalp hair, increased facial hair, and acne. Just a friendly reminder that not all symptoms of menopause occur in everyone and that symptoms occur in varying degrees. (In other words, you might find a little thinning of your hair and/or a few more facial hairs, and see an occasional breakout. But there’s no need to expect the zombie apocalypse.) Waldorf has a few recommendations for dealing with recurrent acne cysts:
Don’t pick or pop them. That just spreads bacteria and skin debris deeper and can cause scarring.
Try an over-the-counter topical salicylic or benzoyl peroxide spot treatment and topical corticosteroid on the spot to help reduce the inflammation. Also helpful are acne patches, available in medicated (usually microscopic spikes with salicylic acid) or unmedicated (hydrogel) versions.
See your dermatologist for an injection of a few drops of dilute corticosteroid into a persistent cyst. With treatment, most cysts resolve in 48 hours and are less likely to recur.
Transitions, transitions! It sometimes helps me to remember that one of the most poignant experiences of, well, being awake, is that you notice everything changes and absolutely nothing stays the same. The happiness of growing older (alive! still!) increasingly aligns with the sadness of growing older (alive? still?). Those bittersweet feelings are worth celebrating, don’t you think?
Book Club News
I'm happy to share I'm partnering with Chirp to organize an audiobook club of biographies and memoirs called “Unfiltered Women.” Two things: It’s free to subscribe and Chirp offers great deals. Plus, you obviously get to keep the book to listen to at your leisure.
Here’s how it works. Every other month I’ll announce a new book club pick that we’ll listen to together. You’ll have a chance to share your thoughts on the book a few weeks later and hear what other readers thought, too. My second pick is the memoir H Is for Hawk by Helen Macdonald. I’ve now listened to this book twice and I’m sure I could listen to it again and still get fresh insights into the author and find new poetry in her language. This is a story about how a woman deals with the sudden death of her beloved father by retreating into herself, keeping only one relationship alive: with Mabel, a goshawk she trains. Goshawks are notoriously difficult and Macdonald struggles to domesticate her. Mealtimes are especially grisly, but Macdonald seems immune to the blood and guts she often holds in her bare hands or stuffs into a pocket. She describes in minute detail the primeval, prehistoric beauty of the bird and her intelligence. The fear of abandonment is strong and Macdonald’s grief seems bottomless till she understands viscerally the healing power of human connection. Like me, you’ve probably never considered becoming a falconer—and you’ll be glad you didn’t when you’ve finished this book! But you’ll get inside the head of someone very different from you, and it’s a fascinating place to be.
To get started, go to chirpbooks.com/val and press FOLLOW to join my club. (Again, it’s free and there is NO commitment.) There, for a limited time, you can buy H Is for Hawk for only $2.99 (normally $19.95), including a 50% discount with code VAL50 if it's your first Chirp purchase.
Val Asks You
Don’t be shy! What’s your most vexing or intractable appearance issue? Send your beauty-related questions to valeriemonroe@substack.com. If I don’t have a good answer, I’ll find someone who does.
HNTFUYF, a Payola-Free Zone
Readers, a few of you have wondered aloud to me if I get a cut from sales when I mention a beauty product. I do not. I only mention products I’d like to buy myself, and therefore think you might like, too. I share this so you know my recommendations are offered without obligation. All posts and the archive are free; there’s no paywall. I rely on readers for financial support, so please consider becoming a paying subscriber if you can.
Dear Val, your Ponytail Facelift post sent me time traveling to a weekend visit with a dear friend I’d known since high school. We were both in our 50s at the time.
As I was preparing to return to the city, she emerged from her bedroom to produce two clip-on ponytails that she had purchased on a whim. One matched her hair color and one matched mine. We pulled back our hair, clipped in the fake ponies, looked in the bathroom mirror and voilà! Suddenly, we were 16 years old again!
We started screaming with laughter and began to dance around her bathroom like, well, two teenagers. The ponytails may not have lifted our faces, but they lifted our spirits. The moment was a reminder of when our friendship had first started and, amidst life’s inevitable ups and downs, all the fun we’d had along the way.
My friend has since crossed over to the Other Side, but remembering our dance in ponytail heaven always makes me smile. Another example of “the happiness of growing older” increasingly aligning “with the sadness of growing older” (losing loved ones whose spirits will always be with us). And as you wisely point out, worth celebrating!
Thank you, Val! I really appreciate you researching this issue for me. I wasn't familiar with the drug recommended so I read a bunch of reviews that were helpful. Ultimately, it got me to DHEA as hormone support and I think I'll try that before considering a prescription. In particular, a DHEA blend that includes Vit B6 and Black Cohosh may help with a variety of menopausal symptoms. (fatigue and hot flashes) I'm glad to know this is common and I'm not the only one having problems. Again, thanks so much for the research and answers!
btw, face lift at 25? That's just sad. But a ponytail at any age always makes you look younger! I don't put my hair in one that often but I always love the swing of it when I do. I even did pigtails a few weeks back - lol! Why not? You're only as old as you feel!