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As estrogen declines through perimenopause and into menopause, women lose an estimated 30% of dermal collagen in the first five years after their final menstrual period, with continued loss of roughly 2% per year thereafter

Patients with severe acne would be contraindicated, as I would refer them to their board-certified dermatologist for skin check, as well as any patients with sores, open wounds, or propensity towards severe viral outbreaks, says Shafer

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For example, the ROS hydrogen peroxide, which reduced glutathione directly neutralizes, is a form of ROS that also causes significant inflammation in the body