TODAY'S AJENDA #72

Thin. Crackly. Crinkled. Papery. As we get older, almost all women start dealing with crepey skin. So how come no one warned us or told us what to actually do about it? 

For too long, crepey skin has been brushed off as “part of getting older.” (*eye roll*) But crepey skin isn’t something you have to accept. There are clear reasons why it shows up, and more importantly, science-backed ways to improve it. 

What Causes Crepey Skin

The primary causes of crepey skin are: 

• Sun Damage: The most common cause. UV rays break down collagen and elastin fibers that keep skin tight and wrinkle-free. (This is why you should be wearing sunscreen every day!) 

• Natural Aging: Starting in your mid-20s, collagen production decreases by about 1% per year. By the time we reach our 50s and 60s, our collagen levels have dropped significantly. For women, menopause accelerates this process. When estrogen plummets, so does collagen production. 

These are the two main culprits, but there are secondary contributing factors: hormonal changes during menopause, lifestyle factors (smoking, drinking, stress, pollution), rapid weight loss or gain, and genetics. 

How Not To Fix Crepey Skin

I've watched too many smart women (myself included) throw cash at miracle creams and gadgets that don’t do anything. Here’s what you can skip: 

• Basic Body Lotions: It doesn’t matter how expensive it is (or how nice it smells). If it doesn’t include proven active ingredients, you’re basically pouring lotion on a cracked driveway. It might feel good, but it won’t repair the damage underneath. 

• Heavy Exfoliation. Scrubbing too hard can thin already fragile skin! While gentle exfoliation can help, it’s not a full fix. 

• Hydration. Hydration is important, but you can’t “drink your way” to firmer skin. Topical hydration and barrier support matter here.

Also, any product that promises “overnight” results is almost certainly a marketing myth. Crepey skin takes time and consistency to improve. 

What Can Help With Crepey Skin? 

The good news is that you can improve crepey skin with: 

1. Protein and Strength Training

Treating crepey skin isn't just about what you put on your skin. If you're over 50, aim for 90+ grams of protein daily (about 50% more than younger adults need) and add some resistance training. Muscle props up your skin from the inside, reducing that saggy and loose appearance. 

For me, there was a major reduction in the crepey skin situation when I actually gained 5 pounds of muscle during my Wellness Experiment! 

2. Professional Treatments

For stubborn crepey skin on larger areas like your arms or thighs, professional treatments can help. Microneedling, radiofrequency, and fractional lasers all work by creating controlled micro-damage that forces your skin to ramp up collagen production and smooth out that tissue-paper texture.

3. SPF. Every. Single. Day. 

I cannot stress this enough. UV exposure is one of the biggest contributors to crepey skin. Slather sunscreen on your neck, chest, and arms every day, rain or shine. 

I’m also a fan of SPF tights when doing activities outside (like golf!). They’re not necessarily fashionable, but hey, they feel good and they do good. 

4. Topical Estrogen 

Here’s what most doctors won’t tell you about crepey skin: for perimenopausal and post-menopausal women, estrogen cream is great at improving elasticity and boosting collagen. 

But you’ll be hard-pressed to get it prescribed. Most doctors are unfamiliar with prescribing estriol cream for the face especially, leaving patients with responses like, “Sorry, I don’t prescribe that” or “That’s not an option.” 

This is where Alloy comes in.* They’re a smart, woman-owned company that’s solving this exact problem. They were the first to put prescription-strength estriol at the center of skincare for women dealing with hormonal skin changes! 

Alloy first launched with prescription hormone therapy, and in 2023 introduced their M4 Face Cream Rx — a topical estriol cream in a base specifically formulated for the face. Since then, they’ve expanded their skincare line to include new products featuring peptides, hyaluronic acid, and other powerful ingredients that target crepey, aging skin at the dermal level. In a 2024 clinical study, the M4 Face Cream Rx showed: 

• 88% improvement in skin elasticity 

• 70% in hydration 

• 68% in overall skin health 

It’s no wonder the M4 Face Cream Rx quickly became a bestseller. Now, Alloy is expanding their skincare offering with the M4 Lift & Renew Rx Eye Cream and M4 Face Serum, both available on Alloy's website via prescription from a menopause specialist. Each product features estriol plus peptides to enhance the firming and smoothing effects, which is exactly what crepey skin needs. 

Just as I'd never recommend something to you that I haven't tested myself, Alloy operates the same way. They only offer solutions that they've used themselves, that they stand behind, and that the science supports. 

The symptoms were subtle. My hair was falling out. Not in clumps, but definitely more than ever before.  I blamed the hair loss on all the high-lights and rough professional styling  I’d had during my 18 years  on network television. But deep down, I knew something was off. 

So I decided to do a heavy metal blood test since I eat a lot of fish and have protein smoothies a few times a week. I’d recently learned that some protein powders were linked to high levels of heavy metals like lead, cadmium, arsenic, and mercury. 

And when those results came back? Let’s just say they explained a lot. 

The Case For Testing Mercury

The “normal” upper limit for mercury levels is 10. My labs came back at a level of 32! While it wasn’t high enough to be toxic, it was definitely a reality check, as high mercury exposure can affect multiple systems in your body.

• Brain and Nervous System Damage: Mercury is a known neurotoxin. Symptoms of prolonged exposure can include irritability, fatigue, tremors, headaches, mood changes, and, in severe cases, coordination issues. 

• Heart and Blood Vessel Problems: Too much mercury can be your heart’s worst enemy. Risks include hypertension, coronary heart disease, carotid artery obstruction, and  more. 

• Reproductive Effects: Increased mercury levels could lead to fertility issues, pregnancy complications, and developmental problems in babies. 

What Causes High Mercury Levels? 

It’s important to understand that mercury isn’t a single chemical element. It comes in multiple forms. But the most dangerous one? The methylmercury found in fish. 

• Science Says: Unlike other types, methylmercury has the highest absorption rate, crosses the blood-brain barrier easily, and stays in your body for about 70 days. (If you’re a sushi lover, I apologize for delivering the bad news.) 

The answer to my high mercury levels was fish. Honestly, this caught me off guard. I knew from FDA guidelines that large, predatory species like swordfish and tuna carry the highest mercury concentrations, so I’d been playing it “safe” by opting for salmon and Chilean sea bass. But it turns out any fish can still contain concerning amounts! 

How I Fixed My Mercury Levels

After speaking to environmental medicine physician, Dr. Aly Cohen, author of Detoxify, I: 

1. Modified My Fish Intake: I stopped eating fish for 3 months to give my body a break from new mercury exposure. Otherwise, it’s like trying to empty a bathtub with the faucet still running. 

2. Focused on Detox Support: I ramped up my hydration (mercury is eliminated through urine) and increased fiber intake with chia and flax seeds. I also ate more cruciferous vegetables like broccoli, Brussels sprouts, and kale, which support phase II liver detoxification pathways.

3. Retested After 12 Weeks: Mercury has a half-life of about 70 days in the bloodstream. After 3 months of these changes, I retested, and my levels dropped from 32 to 12. Still above the "normal" range of 10, but a significant improvement. 

What I Learned 

Even the “healthy” choices we make can have consequences if we overdo it. So if you’re eating seafood regularly and feeling fatigued, and losing hair, it’s worth asking your doctor about a blood mercury test. 

It’s important to note that I’m not demonizing fish! It’s an incredibly rich source of omega-3s and protein and should be part of your diet. But instead of ordering five times a week like I was before, I’ll have it once or twice a week. 

(Moderation: Not just for tequila or shopping sprees.) 

Ciao from Italy! I’m writing to you from the Amalfi Coast, where I’m on vacation with friends and family. While I obsessed over the usual pre-trip questions (“What do I pack?” “Am I bringing enough flat sandals and sunscreen?”), I was also thinking: “How do I keep my fitness intact?” 

Because if you’ve been following me for a while, you know I worked my tail off last year to get in the best shape of my life. Now I’m on vacation surrounded by prosciutto, gelato, and Aperol spritzes. 

Most people’s advice goes something like, “Don’t. Just enjoy yourself.” Respectfully, I disagree with this all-or-nothing mindset. You shouldn't have to choose between the body you've worked for and the trip you've earned. 

Here’s how I’m making both work (so you can too): 

1. Hydrate Like It’s Your Job 

Between flights, sun, salt, and those “just one more” cocktails, dehydration creeps in fast. 

Personally, I’m not great with hydration when I travel. I think I get so excited about where I’m visiting that drinking water becomes an afterthought. So I set iPhone reminders to drink water throughout the day.

2. “Will Future Me Thank Me?” 

While we’re on a trip, we tend to default to the most indulgent option. We say yes to the third glass of wine, the midday nap, the chocolate ice cream because “we’re on vacation.” 

When I catch myself in this autopilot mode, I ask myself: Will future me thank me for this? It’s not about being militant but pausing long enough to notice whether you’re nourishing yourself or just numbing out. 

Having an Aperol spritz with friends at sunset? Future me is grateful for that memory. But ordering dessert even though I’m full? Future me won’t be on board. 

3. Incorporate Movement 

Walk everywhere. And no, you don’t have to speed-walk for this to be effective! Research has found that slower walking for longer periods can be more effective for weight loss than shorter, faster walks. 

• Pro Tip: Use your phone’s step counter to gamify your walking (I aim for 10,000 steps a day). There are even apps that pay you to walk. Not joking! 

If you want a more formal gym session, go to hotels with gyms or fitness centers. Many gyms abroad also offer day passes for tourists.  

4. Pack Your Wellness Non-Negotiables 

Decide on 2-3 health habits you’ll continue on vacation. Maybe it’s getting 50g of protein daily, 8 hours of sleep, or eating one colorful plate (read: veggies and fruit) a day. 

Bottom Line

A two-week vacation is just 3.8% of your year. The other 96.2% is what truly determines your progress (not just a few days of gnocchi or sauvignon blanc). 

And once you get home, don’t step on the scale right away. Travel can cause water retention, digestion issues, and bloat, so the scale might not give you the right number. 

Even if the scale does go up a few pounds? Don’t let it cancel out the joy of your trip. The wonderful food you ate and the memories you made are part of wellness, too. And hey, many people actually come home from Italy down a few pounds, thanks to all the walking, the fresh (not processed) pasta, and possibly because the food is so delicious that we end up eating less, not more.

Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial!

ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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