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Breaking Beauty Podcast
The Gift of Real Talk: Is Vitamin C Overrated? "Anec-data" and the Truth About $400 Luxury Serums With Dermatologist Dr. Aegean Chan
00:46:20
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A
The following podcast is a Dear media production.
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Welcome to Breaking Beauty the podcast.
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All about the breakthrough people, products and moments in beauty. We're your hosts, Jill Dunn and Carlene Higgins.
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B
Hello everyone. Welcome back to Breaking Beauty Podcast. I'm one of your co hosts, Jill Dunn and I'm here alongside Carlene Higgins. And happy holidays to everyone. Listening, listening. Hey Carlene.
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A
Hi. Happy holidays to everyone and spreading the love to all of you. And we're two longtime beauty editors turned beauty podcasters. I'm proud to say we've been in your feeds every single Wednesday. So fun to see the Spotify wrap ups that we've seen. And you know, we are 1% listeners are 2%. We love that we are sharing the breakthrough people, products and moments in beauty and this week is no different. That's right.
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B
And we love Apple podcast too. I don't know why they don't do Apple podcast wrapped like they really need to come out with something cool.
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A
It's true. You know, make it and they have all.
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B
And the thing is, most of our listeners listen on Apple podcasts. So we love you too. We're here for you. Yes, we said the software.
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A
We love our YouTubers too. We're growing on YouTube, everyone. So follow us on there and hit subscribe and you can watch us.
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B
Heck yeah. Because there's no weeks off around here and we love sharing content all about beauty and we even had a few bonus episodes this year. So there's lots in our archive for all to comb through if you're so inclined, either in your podcast app or YouTube. And this week we hope that you are enjoying holiday family time. But I've been there. You need to sometimes get out for the hot girl holiday walk or sometimes you just need to go for a drive by yourself and listen to a beauty podcast. We're here for you.
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A
That's right. And this week we're happy to welcome a derm that many of you may follow on social Media. And that's Dr. Adrian Chan.
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B
So Dr. Chan, she has a really unique skill set. She's a double board certified dermatologist and dermatopathologist. You heard me right. And as such, Dr. Chan is dedicated to bridging the gap between medical dermatology and everyday skin care.
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Dr. Chan's clinical expertise spans complex medical dermatology, skin cancer, acne and cutaneous infectious diseases. She's authored numerous peer reviewed publications on topics including including the skin barrier, congenital skin diseases and electron microscopy.
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B
Yeah, she's a skin nerd. Of all the skin nerds I would say. She also serves as the medical director of California Dermatology Group in Santa Barbara, California. And she's an adjunct professor in the department of dermatology at the Keck School of Medicine at the University of Southern California. So she's doing the most at all times. And she's a busy mom of three. She was just back from her maternity leave from her third baby when we sat down for this conversation, so we really appreciate her time.
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A
In this week's episode, we're getting a little nerdy with Dr. Chan. We're going to be chatting about her skin barrier research. She's also going to deliver a truth bomb about why she thinks vitamin C is overrated, which I have personally felt for a long time. I felt so seen.
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B
Yes, you did. You guys were bonding. It was pretty much I was sitting in the middle and I was like, there's going to be a high five here, you know, at a certain point. So she explained, explains all of that reasoning. Plus we get her input about some trending topics in aesthetics and dermatology, like what she makes of transdermal patches for skin care. I think we're going to be hearing more about that in the year ahead. And we also get her take on if we should be rethinking some of these trending in office procedures, like Morpheus 8 per the FDA guidelines.
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A
And stay tuned to the end where we play a fun round of De Influence Me dermatologist edition, where she debunks everything from $400 serums to spicules in your skincare.
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B
That's right. So welcome Dr. Adrian Chan. Welcome to breaking beauty podcast. Dr. Adrian Chan, it's wonderful that you're joining us. We have to ask you, first of all, you are a dual board certified dermatologist and dermatopathologist, which is a very unique position to be in and definitely a first for our show.
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C
I'm so honored.
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B
So first question for you. What exactly is a dermatopathologist and how does that influence the types of, you know, what exactly do you do? I need to know everything.
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C
All right, so. So have you ever been to a dermatologist where they've biopsied a lump or bump or maybe a rash?
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B
Not me personally. Not me.
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A
Probably me. I think so. I think I got a little something sliced off.
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C
So they're taking that little piece of skin, they're putting it in a bottle, and it goes to the quote unquote lab. So when it gets to the lab, it actually gets embedded in a little piece of wax. So you get a little block of wax and that actually gets sliced almost like a piece of bread. And one of those really thin little slices gets mounted on a slide and it gets stained. And then that slide gets put on my desk, and that's where I come in. So I put that slide under the microscope, and that's when I can see on a microscopic level what's happening in the skin. So if it's a mole, whether those cells look happy and benign, or if it's cancerous, make a diagnosis, write it in a report. And that would go to the dermatologist and that would help inform, you know, next steps for treatment. What's really interesting about it is that it is kind of like an art. So especially when we're dealing with rashes, so we're looking at the types of cells there are, what level of the skin they're at, and that can help us put the picture together for your dermatologist.
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A
Okay, well, since you have this very unique dual perspective, what do you think is one of the sneakiest things on a cellular level that accelerates our skin aging?
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C
I feel like that's kind of a tricky question for me to answer because, I mean, I am a bread and butter dermatologist and I feel like with all the social media and I think dermatology gets misrepresented. There's no big secret. We're not gatekeeping.
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B
Right?
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C
There's no big secret. Most of it is really knowledge that we know and common sense. So, I mean, I would say UV damage is still, in my mind, the number one driver of skin aging, particularly of esthetic concerns. But I will say, coming from the dermatopathology lens, I know what sun damaged skin looks like. So under the microscope, you have the top layer of the skin, the epidermis. We're going into a little science lesson. And then the deeper layers, the dermis. So that's where the blood vessels are. That's where all the collagen, elastic fibers, all of the hyaluronic acid that our body produces, it lives there. Over time, chronic sun exposure actually makes that collagen and those elastic fibers degrade. So you get this change that we call solar elastosis. That's sort of, I call it mushy collagen. And it's just this amorphous purple stuff. And so when you're thinking about products and thinking about claims, I always have that image in my mind. I'm like, could this cream actually alter this chronic change from UV damage over 50 years?
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A
Yeah.
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C
And so that's Sort of my.
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A
Yeah. And the answer is probably not. Yeah.
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B
A little too good to be true.
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A
Maybe past the point of no return, I suppose.
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B
Well, I think you can always like, not reverse sun damage, but you can prevent future. Right.
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C
Well, prevention is much more effective.
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B
Yeah, yeah. Reverse, definitely. Definitely.
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A
Let's talk about barrier repair and skin barrier. These have become buzzwords at this point in the beauty industry, but you've actually published research on the skin barrier. So what's the nerdiest or coolest thing that you've learned about the skin barrier that perhaps only someone looking at it through a microscope might know?
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C
The skin barrier is amazing. It is this really dynamic organ. And I actually, in my research did electron microscopy, so really getting to this actual. The cell of looking at the skin and the epidermis. And I think that before skin barrier health became a trend, which I love. Yeah. Especially in like the 2000s, it was like you got to scrub your skin to get it to look nice. You know, you do the proactive, you do the St. Ives.
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A
Yeah.
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C
And it's sort of based on this idea that the top layer of your skin is inert. It's like a kitchen counter. You just got to scrub it clean and you'll have clear skin. But I think what people still probably don't understand is really how complex on a microscopic, microscopic level the skin barrier is. So when we talk about the skin barrier, usually we're talking about the outermost layer, the stratum corneum. So that is made up of stacked up dead skin cells, so dead keratinocytes. But between those keratinocytes is what we call the lipid bilayer. So that's where, you know, your ceramides, your cholesterols come in. And then within that there's all these little proteins like filagrin, and they signal to each other and they're really good at repairing themselves. You know, I feel like the discourse around beauty is that you have to do these things to get your skin to look a certain way. And I always like to say, give your skin credit. It's evolved over millennia to really function pretty well on its own.
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B
Yeah.
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C
And so I just. I think that the dynamic nature of the skin barrier, I think is underappreciated.
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A
It's.
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C
Yeah, it's very cool.
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A
Yeah, yeah.
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B
I love how a lot of people think about their skin barrier only from the neck up and they're just like. And then they moisturize their body.
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A
Guilty as charged.
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B
It's like it's an. Yeah, it's an Organ guys make sure it's all hydrated.
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A
Yeah.
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B
And as consumers, like, I feel like there's just so many products out there and we often are looking for products that target a specific perceived problem. Acne, wrinkles, dark spots. So why is maintaining a healthy skin barrier as important to target from your perspective? Like, if you're out there shopping and you're like, I only care about acne, why should you also care about skin barrier?
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C
So the skin barrier, that's like the foundation of your house, you want that to be healthy and sturdy and robust. Because all the treatments for these particular concerns, acne, hyperpigmentation, etc, they typically can be irritating to the skin. So if you can't tolerate those treatments. Yeah, often you're affecting your skin barrier when you're putting those treatments on. So if you want to be able to maximize how much medication you can get on your skin, you want to have that healthy skin barrier first. And so particularly with acne, people are disrupting their skin barrier left and right.
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B
Yeah.
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C
And I tell my patients that come in there, they're doing 10 things, you know, they're scrubbing their skin and I say, just stop all of that. Don't worry about your acne, Just do a week of essentially a detox, Just do gentle skin care, give it some tlc, do a hydrating cleanser, moisturize, and a lot of times they'll come back and say, that actually got rid of a lot of my acne. Because you can get reactive acne if you're drying your skin out too much. You get that excess oil production that can lead to more acne breakouts. So I find that if you think about your barrier, first, get it healthy, you feel like your skin is, you know, supple, not feeling too tight, not too dry, then you can start slowly introducing those active ingredients in pH.
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B
Let's talk about that. Because I think that is often what happens as well during skin barrier upheaval. So, like, what in your research, what is this PH count for that much like, are we being misled or what?
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C
So I, yes, PH is a factor in that skin barrier balance. I do think it's become something that people become overly concerned about. Okay, so I think, yes, I think biologically it is relevant, but in terms of it being clinically relevant, I don't necessarily think that the everyday consumer necessarily needs to, you know, do a weekend course on skin and how to manage it. I do think that, you know, well formulated products, they do take into account the PH and aren't disrupting the Skin barrier with that. Okay, so. Except for vitamin C. Except for vitamin.
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A
C. Honestly, I cannot. And I think it's, like, from my understanding, it's alloscorbic acid, specifically that one. But that one, I feel like, just throws my ph so far out of whack, and my skin is, like, irritated for a week after.
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C
Oh, yeah.
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A
So I don't use it. And every germ will say, vitamin C essential in your routine.
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C
Do you want my thoughts on that?
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A
Yes, I do. I do.
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B
You're the woman.
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C
And I think, you know, what you said was really great because I think, you know, you're thinking about ph, but it's really just about how your skin feels. And so that's, you know, where I sort of focus my education on is really helping people feel confident. In assessing your own skin. You don't need someone to tell you what's good for your skin, because if you actually just stop and sort of ignore what's. What's being fed to you in your feeds, you have a pretty good sense, an intuitive sense of what works for your skin, what does it, what makes your skin feel good. And. And look at the best. You know, it's so individual. And so I think it can get really stressful and confusing for people if they're trying to incorporate too much.
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A
Right.
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C
And then, you know, in terms of vitamin C, I honestly think it's overrated. I. For me, as a dermatologist and as, like, a regular person and a mom, we're all busy. We all have, you know, so much going on in our days. So for me, vitamin C is sort of a second tier.
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A
Okay, you heard it here.
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C
My jaw's on the floor, I think, you know, and I think a lot of people, yes, are scared. I think a lot of dermatologists are sort of scared to say that. But focus on your skin barrier. So make sure you have a really good, consistent routine with your cleanser, your moisturizer, your sunscreen. If you have got that, you're like, okay, I can do this with my eyes closed or hungover, you know, great. And then add on your retinoid. And if you have that and you don't have to think about it, and it's really rote, and your skin is tolerating well.
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A
Great.
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C
I always tell people I love. Aha. I feel like that gives you the best bang for your buck. Yeah, I think it really addresses a lot of esthetic concerns. You know, acne, hyperpigmentation, texture.
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B
So, you know, something like lactic acid or glycolic.
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C
You Know, get that in your routine. And then if you have that dialed in and you're feeling good and you're feeling confident, then you maybe add in a vitamin C. But I think a lot of people, because of all the hype around vitamin C, they're like, that's the one thing that I should be using when I think the other sort of more tried and true old school, not as glamorous ingredients don't get incorporated into people's routines. And I think that's a missed opportunity.
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A
Yeah.
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B
I do feel as though we're hearing about it less than vitamins like three years ago.
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A
Well, it popped off, I think, and then it sort of tapered off.
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B
Yeah, for sure.
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A
But dermatologists will still.
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B
Sure.
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A
Aside from. From you, maybe that, you know, it's about sunscreen, retinoid and vitamin C and a moisturizer, obviously, but like, period. That's. That's it.
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C
I mean, I don't. I'm currently not using a vitamin C. Yeah, me neither. It's just one of those things that falls off because I don't see that immediate benefit. Yes. I think there's a lot of great research. I think it is a great antioxidant. So if you're maybe living in an urban place where there's a lot of pollution, you're in the sun, a lot of, I think over time it probably has some cumulative benefits. But I think we're all people that want to put our efforts into things where you can see visible results. And so often I tell people, great, if you want to try this XYZ product, try, try one bottle, you know, and if by the end of it, you notice no difference in your skin.
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A
Yeah.
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C
And you feel like you want to put your efforts towards other things, then, you know, I think that's information. I think that's okay.
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A
Yeah.
- [17:08]
B
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- [19:18]
D
Have you ever looked in the mirror and not recognized yourself?
- [19:22]
B
Me too.
- [19:24]
D
Hi, I'm Caroline Baudino from Instagram Shop with Caroline and host of Coming In Hot. This tough New Yorker who swore she would never depend on a man, lives to wear all her jewels and look fabulous. Let everyone else's expectations of being a mom, a wife, a daughter to Cuban parents take priority. I finally put my oxygen mask on first and took the biggest bet of my life. Join me every Monday on Coming In Hot to Deep dive on finding your own happy tools and living your best life too. Yes we can.
- [20:05]
B
I also wanted to ask you, while on the skin barrier topic, about just the microbiome and like how that played into your research, if it did at all on the skin barrier.
- [20:14]
C
Yes I did. Look at that. I think the microbiome again, I think there's still so much we don't know. It's really complex and I think it's still hard to say, you know, how alterations in the skin microbiome can necessarily lead to actionable treatment. So we know it's there. We know it plays a big role in skin health. But I think when it's being marketed, when Things are being marketed towards improving your skin microbiome. I think it's hard to say whether or not those things necessarily are musts.
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A
Yeah.
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C
So again, I always say go back to basics, like get your routine down, get those tried and true ingredients down. And then maybe you add in some things and maybe that's the thing for you that helps you with your breakouts. You know, again, I'm not against anecdote.
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B
Sure.
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A
But I think anecdata.
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C
Anecdote.
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A
What's that?
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C
It's really when people use anecdotes as data.
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A
Okay, got it.
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C
So it's that, oh, my friend used this and she said it was amazing. Which I think is like all of TikTok.
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A
Right, of course.
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C
And so I call that anecdote. And I think, you know, it's not what I would use. Like I wouldn't use that in a patient setting to be like, I recommend this, this and this for you. But you know, if your friend said, oh, this is a great product, I really loved it, that's great, try it for yourself. And I would say like a lot of the time people say it did nothing for me, you know, because everybody's. It's so different. And I don't think it's just statistically significant enough for me. That's why I don't really talk about products on my platform.
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B
Yes.
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C
Because I just sort of want to keep it more open ended.
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A
Yeah, yeah.
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B
And you got to make your own decision. I do think that whole microbiome conversation is really just a spin off because of the wellness trend of talking about gut health and gut microbiome. And that is, we know is so powerful to our overall health. And I think you're exactly right. We know that the microbiome is powerful on our skin, but we just don't know enough yet.
- [22:15]
C
And it's sort of like treating it. You said supplement. Yeah, Discussion. Right. Like we don't necessarily have enough data to say that these are things that are for sure beneficial for you.
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A
Okay. Well this is really, I think, think what gets at the heart of so many, so many skincare products is there's this idea that what's good for us internally, if we apply it topically, it must be good too. And we've seen that take off in so many different types of products, whether it's turmeric or there's honey, like there's a gazillion products that have come out like that. But it really comes down to. And I think you're the perfect person to talk to about this is how much it's penetrating the skin barrier and actually doing anything. And I think this is also partially what's confounding about the skincare industry in general is that you'll hear experts, some experts who will say, well, molecules in general are too large to penetrate the skin, so, for example, it won't enter the bloodstream. But then we heard that for years. But then there was sunscreen information that came out that said, well, actually it does. Like nanoparticles do enter the bloodstream, but they don't. We don't know that it causes it. There's no data that says it causes harm. And you can correct me if I'm wrong. So I find that confusing is that sometimes the story is that it's these tiny molecules are penetrating and doing something, and sometimes they're not. Don't worry about it. It's only working on the surface level of your skin.
- [23:54]
C
So it's really dependent on the molecule itself. And so, you know, again, going back to the microscopic molecular level, the skin, it really is like, I like to use the analogy of a brick wall. When the skin barrier is intact, its primary function is to keep things out of the body and to keep things inside the body, inside that, you know, all your water content does not evaporate out. And it generally does that. So, you know, when you see those things where they sort of compare skin to mesh, you know, where whatever you put on the skin automatically goes into your bloodstream, that is not the case. But again, with. Depending on the size, you know, there is that selective permeation. And that's where those organic filters have been found in the bloodstream is just through that process. You know, things can either go through, go around the skin cells or pass through the skin cells. And depends on its, you know, chemical properties and its size as well. And so it's really hard to say. And I really like to look to data.
- [25:00]
B
Yeah. Is there any particular ingredient you wouldn't use because it does enter the bloodstream?
- [25:06]
C
I don't. Because I do think that there's a lot of public health data. There's a lot of, you know, there aren't any signals. We've had these filters, the organic filters, for decades, and there are no human safety signals that have come up.
- [25:22]
A
I think she means are there any ingredients that you would avoid on a label, period, because you'd be concerned that it might enter the bloodstream?
- [25:30]
C
No, but this does come up. And you've probably seen since I become a mother, I think the question of using Things during pregnancy and breastfeeding, that's a pretty fraught time, I think. You know, obviously you want to prioritize the safety of your, of your fetus or your infant, but I do think there's a lot of incorrect information out there that actually or deprives women of things that could potentially help boost their mood and help themselves feel better. So I've done a lot of sort of myth busting around the idea of using retinoids during breastfeeding. So I think that there are a lot of articles that sort of just take the recommendations from pregnancy and put that into breastfeeding. But as we know, they're two different, totally different biologic states.
- [26:18]
B
Right.
- [26:19]
C
So retinoids can, they do get absorbed into the system, albeit in really small amounts, especially if you're just putting it on your face. Trace amounts can get absorbed into the milk. But they've done studies where they've tested the milk and then also looked at, you know, outcomes from the infants and found that there really is no harm that's been documented to infants. So, you know, even though it is getting to the milk, it's vitamin A, it's not gonna cause harm to a fully developed infant. But during pregnancy we worry about retinoids because it can affect fetal development.
- [26:50]
A
Right.
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C
So it's sort, it's so nuanced and it really depends on, you know, the molecule and sort of your state of your health.
- [26:58]
A
Yeah. The public's confidence in sun protection has taken a hit over the past year. And you know, this is because there's, it's been in headlines that some SPFs are not living up to their claim on the label when they're being retested or retested again. So what's your take on what's been going on and how are you kind of putting your patients at ease? Because this could be a moment where some people are throwing their hands up and being like, see, I told you. What's the, what's even the point?
- [27:26]
C
Yes. So I do think it is unfortunate for sunscreen, but I actually think it's giving a platform to other forms of sun protection. So I'm a big proponent of having just sunscreen is your last form of protection. So I think it's really all the other stuff, those sun safe habits that are more important. Not going out in midday sun and doing your activities, wearing those wide brim hats, hanging out in the shade. I think all of those, you know, help as much, if not even more than your sunscreen application. I think obviously sunscreen is A critical part of that protection, but it's so user dependent. I think it really does not get applied the way that it should for its maximum efficacy. We won't get into that. But I think, you know, again, it's that one layer of protection. Michelle Wong has this Swiss cheese analogy where it's all of them add up to, you know, really doing a good job at protecting your skin rather than just relying on sunscreen. But I will say that in general, I think think that larger companies tend to have more resources to be able to test their sunscreen. So if it's a confidence issue, you're worried about that. I think going with a larger conglomerate, a sunscreen from one of those brands, you may have more reassurance with the stated spf.
- [28:53]
A
Yeah.
- [28:54]
C
And again, you know, if you're putting it on and you're, you're putting on enough and you're noticing you're getting burnt, then that, that's a red flag. And again, that goes back to that. Listen to your skin. Yeah, yeah. And I do think most of the sunscreens on the market, you know, are good.
- [29:11]
A
Yeah.
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C
Are effective.
- [29:12]
A
Yeah, I agree.
- [29:13]
B
Do you have a favorite? What do you personally like?
- [29:15]
C
You know, I've been on the Korean sunscreen kick, the Beauty of Joseon. Their Aqua Relief is my favorite. So I just buy it by the dozen and have it shipped to me and I looking forward to more sunscreens that are just filters that have better finishes. I mean Ulta MD UV Clear is my tried and true. I think that has a wonderful finish but I've tried a lot out there that I just, you know, viral ones, others that people love and I'm just really.
- [29:47]
A
Yeah.
- [29:48]
C
Picky.
- [29:48]
A
Have you tried the, the new US version of the Beauty of Joe Sohn?
- [29:54]
C
I have. I think it's still okay.
- [29:58]
A
Yeah. I don't like it as much.
- [30:00]
C
I don't like it as much. That's why I still order from. Yes.
- [30:04]
A
When you said I order it by the box I was like, I had a feeling you were talking about that. So the new beauty of Joseon is Day dew sunscreen. Lightweight SPF 50. And I've been using it but I do find it's greasier. I think it might sting my eyes a bit.
- [30:20]
C
Yeah, it has the greasier but I still think it is better than. Yeah, majority.
- [30:26]
A
I prefer the Alta MD though.
- [30:28]
C
Elta M. Yes, that's good.
- [30:29]
A
Yeah, yeah, it's good.
- [30:31]
B
And I told you guys I've tell, I tell it every episode but Aveeno and Neutrogena I swear I've never burned on with either of those Neutrogena people.
- [30:39]
C
Really like the hydro boost. Yes, it's good, actually. The Trader Joe's daily facial sunscreen, the super goop.
- [30:46]
B
I've heard this is a dupe.
- [30:48]
C
It's a dupe.
- [30:49]
A
It's.
- [30:49]
C
I think it's $9. It's in the yellow box.
- [30:52]
A
Okay.
- [30:52]
C
And for husbands and for tweens.
- [30:55]
A
Okay.
- [30:56]
C
It's a really good option because it has that primer.
- [30:58]
A
Oh, nice feel.
- [30:59]
C
So it's got that, you know, clear silicone primer finish. And so a lot of my friends. Husbands.
- [31:07]
A
Yeah.
- [31:07]
C
That won't use sunscreen. They'll use that one.
- [31:09]
A
Okay.
- [31:09]
B
And then.
- [31:10]
A
Yeah, probably also because it's called Trader Joe's and it's not.
- [31:15]
B
Yeah, yeah, much.
- [31:22]
A
Sa. Today's episode is brought to you in part by Seed. Okay, beauty besties, let's talk about body changes. We talk about skin and hair, all the external stuff around here, but there are a lot of internal shifts happening, especially as we age. And I know I'm not alone in this. As I've navigated perimenopause, one of the most frustrating changes for me has been dealing with irregularity. It's crazy. It's like one week I'm fine and then the next I just feel so uncomfortable. There's this heaviness. My clothing might not fit. I don't feel great after a meal. It can even affect my mood. That's why I'm so grateful to have been introduced to seeds. Dso1 daily symbiotic. I recommend it to so many people. And since making it a consistent part of my morning routine, I've noticed a real difference in supporting healthy regularity. So what is it? The DSO1? It's not just some random probiotic. It's formulated with 24 clinically and scientifically studied strains to support benefits across your whole body, like gut health, skin health. I take two capsules a day, and it includes strains that are scientifically validated to support bloat ease and alleviate occasional constipation after just two weeks. So for me, it's that daily sense of regularity that I just appreciate so much and helps me feel more comfortable in my own skin. Seeds approach is science backed, and it fits really seamlessly into my routine. Like I said, two capsules every morning with water. And it's just like a part of my lifestyle if I'm gonna go walk the dog or exercise. And it's kind of a no brainer, which I really like as well. So if you're ready to feel the difference, get ahead of the new year with a routine that helps you now by going to see.com beauty and use code beauty. Get 20 off your first month. That's 20 off your first month of seeds DS01 daily symbiotic@seed.com beauty code beauty. Now, you also have done a lot of work in highlighting disparities in treating patients with skin of color. And you know, I think it's, it's come up in discourse this idea that there's been a lack of diversity in clinical trials. We know that what is one surprising or lesser known medical detail about diagnosing or treating common conditions like acne or hyperpigmentation in skin of color that you would like consumers to know?
- [34:04]
C
You know, I think the biggest thing is that skin disease, one diagnosis can look 20 different ways. And that's particularly true if you have skin with more pigment in it. It just looks different. And I think that, you know, whoever you're going to see, their experience is predicated on where they train. Did they see skin of color when they were learning dermatology? And I think geographically that can be tough. You know, if you're training in an area where there, there isn't much, you know, type 4, 5, 6 skin, you're not gonna be exposed to those disease states in darker skin. And that can lead to, you know, misdiagnosis as well as not optimizing treatment in these populations. And there's also certain diseases that are more prevalent in skin of color. One example is hidradenitis suppurativa. So this is sort of recurrent boils in the armpits and in the groin. And I find that, you know, dermatologists that train in areas that don't see this as much, and this is true across the board in medicine, you just don't feel as comfortable treating, you know, these types of diseases. But I've seen a shift. You know, the major textbooks have been really trying to collect a lot more photos to put into textbooks. So even if you are training in a area that's predominantly skin type 1 and 2, you're still seeing in the textbooks. Exactly. You have some reference of, okay, active acne looks like this in dark skin or psoriasis looks like this in dark skin, which can look very different than how, how it looks in lighter skin.
- [35:48]
A
Yeah. Okay.
- [35:50]
B
Now in the way of professional treatments, because a lot of people love to get these, myself included. Recently the FDA issued a safety warning about serious complications from radio Frequency and some microneedling treatments they I believe called out specifically Morpheus 8. What did you make of this as a practitioner?
- [36:09]
C
So I think it's an effective treatment. I know people that have had really good results from it. I think with any of these devices, so lasers, these types of in office devices, the company is incentivized to sell more machines.
- [36:25]
B
Okay.
- [36:25]
C
And so that, that means selling machines to maybe people that aren't as qualified. That's sort of what came to my mind when I saw this release. Because if you know, a experienced board certified dermatologist is using this machine, they have the expertise to sort of know, okay, we're not going to go down that aggressive setting. We're going to go more gentle in this certain type of skin type. We're going to space out the treatments. You know, they're going to have that clinical background with which to safely treat a patient and try to minimize those adverse effects. I wonder if they've gotten a lot of complaints and I'm wondering if where those complaints are coming from. Are they coming from med spas, maybe devices that are being operated by people that don't have as much clinical background?
- [37:13]
A
Yeah.
- [37:14]
C
So that, that's my thought. I don't think the device is inherently dangerous.
- [37:18]
A
Operator error.
- [37:21]
B
Yeah.
- [37:21]
A
I want to ask you about transdermal patches because I think that you're, you again, you have a unique expertise. We've heard of nicotine patches. I'm wearing a estrogen patch right now. So what do you make of this new direction? How do you think this technology could potentially be applied to the world of skin health?
- [37:45]
C
I think it's, I think it's great that sort of dermatology is getting the benefit of advanced technology. I think for the longest time we're just stuck to creams. So I think a different delivery system for whatever molecule that you know is the target I think is great. But it really depends on the molecule. So I would have to see the data. Right. For that specific molecule. Like obviously we know transdermal patches work, but what are you actually trying to get. Get through the skin?
- [38:16]
A
Yeah.
- [38:16]
C
And is that molecule. Yes. If it's going to the circulation, is it actually getting into the dermis and making a clinically significant difference in the dermis? So again, could you compare that to a topical retinoid if they're, you know, sort of claiming anti aging claims? Yeah, I'd love to see a six month head to head between somebody that, that's using a topical retinoid versus just the patch because I think that to me is my gold standard on whether something is actually worth recommending to people.
- [38:52]
A
Right, right, right.
- [38:53]
B
Okay. I think this particular brand that with the vitamin patches, it's called the what's Up Co? And very much the patches are marketed almost like a star face. They're like very cool, young, very colorful and fun.
- [39:09]
C
What are the vitamins meant to do?
- [39:10]
B
It's exactly. There's 15 energy vitamin patches. These are different types. Chill is one, detox is another. Looks good on you. Fifteen beauty vitamin patches. Now, again, this is something I read about from Sally Hughes, who I have a lot of respect for, and that's what made me want to ask you about it. And they also have. They're like scratch and stuff. Sniff. Oh. They're like aroma as well. Well, which is wild. But I find it fascinating.
- [39:43]
A
Yeah.
- [39:43]
C
And that's sort of, you know, I always like to tell people, like a cosmetic, you know, a cream that you can buy at the store that's not designated as a drug, it's considered a cosmetic.
- [39:54]
B
Yeah.
- [39:55]
C
And legally you're not supposed to change the structure of the skin or alter the biology of the body in any significant way. So.
- [40:03]
B
Yeah.
- [40:04]
C
So when there's claims that sort of skirt that.
- [40:06]
A
Yeah.
- [40:07]
C
I sort of wonder.
- [40:09]
B
I was actually kind of surprised that they were available in the US at all. I thought it was just initially in the uk, but you can buy them. So it. I think we're going to hear more about this.
- [40:17]
C
Report back and see if I'm worried.
- [40:21]
A
Here goes my curious mind again. But I, I often do wonder with micro needling and spicules and stuff like that, I sometimes wonder if this is like a gray area because when you think about the FDA and what has been passed for skin care, you typically it's for just topicals, period. So when you are enhancing penetration to the degree that you're using micro needling or whatnot, do you think there's ever a concern there?
- [40:51]
C
So are you talking about in home.
- [40:53]
A
Microneedling devices, professional or professional micro needling?
- [40:58]
C
Yeah. So I mean that. That you're creating an entry point into the skin.
- [41:01]
A
Yeah.
- [41:02]
C
So at home devices, they don't go as.
- [41:05]
B
No.
- [41:05]
C
As an office devices. So when I'm doing microneedling in the office, I want to see blood. That to me is that that's a good treatment.
- [41:13]
A
That's a good depth.
- [41:14]
C
That's a good depth. As if you have like the Kim Kardashian like blood on your face. And I do think it can help, you know, even the. At home microneedlers there's, there was a study looking at androgenetic alopecia using the at home microneedling device to increase delivery of both tretinoin and topical minoxidil. I definitely think that can improve absorption.
- [41:38]
A
Yeah, yeah. So it improves absorption. But there you wouldn't ever be worried that it's, that it's making it too act. Any ingredient too active because you're enhancing the penetration so much?
- [41:49]
C
Well, it's dependent on the person.
- [41:51]
B
Okay.
- [41:52]
C
So if you're, if. So part of your routine is like doing your home microneedle and then putting your retinoid and you're like, my face is on fire. Right. Skin is coming off, my barrier is so disrupted. This feels horrible. Then that's a sign that it's too much for you. Yeah, but for me, like I tend to tolerate more like I'm doing like the 20 glycolic acid.
- [42:14]
A
Wow.
- [42:14]
C
You know, I love it.
- [42:17]
A
She's got a rock hard barrier.
- [42:19]
C
Yeah, exactly. So if you could tolerate it then that's great. But again if you're, if you are incorporating it and you're noticing increased sensitivity, then it's probably not for you.
- [42:28]
B
Yeah. Right.
- [42:29]
A
Okay. Well, we want to play a fun round of rapid fire before we let you go.
- [42:34]
B
I love this game. This is D Influence me Dermatologist edition. Okay.
- [42:38]
A
Okay.
- [42:39]
B
So the most universally unnecessary product that you feel the beauty industry successfully tricked us all, all into buying.
- [42:48]
C
There's so many. My first thought was vitamin C and then my second was sheet masks.
- [42:56]
A
Ah, okay. 400 skin serums. Is there, is there one that could possibly be worth that in your mind?
- [43:06]
C
Save your money and go get Botox.
- [43:09]
A
Okay.
- [43:09]
B
I would say, I say it all the time. Olay and Botox de influence me eye creams.
- [43:18]
C
I think it's unnecessary. I think, you know, I think for the, the average person, your facial moisturizer, put it around your eyes. If it doesn't irritate you, that's great. I would say if you can't tolerate a retinoid around your eyes, then you can get a retinoid containing eye cream.
- [43:38]
B
Okay.
- [43:39]
C
For that area.
- [43:40]
A
Okay. How about at home red light devices?
- [43:46]
C
I think that it's really time consuming and some people, you know, if you're getting ones that are FDA cleared and maybe a little bit more robust and have, you know, some clinical data to go along with it, you may see an improvement, but you have to be consistent with it.
- [44:04]
B
Yeah.
- [44:04]
C
And I, I know very few patients that are consistent long term with their red light devices.
- [44:11]
B
Do you personally use one.
- [44:13]
C
No, that's.
- [44:14]
A
Well, there. There you have it.
- [44:16]
B
Fill in the blank. The most overrated skincare ingredient is.
- [44:21]
C
Can I say vitamin C again?
- [44:22]
B
Yeah, of course.
- [44:24]
A
I love it.
- [44:27]
C
I'm gonna get some comments. I don't know.
- [44:29]
A
Love a hot take. I will ask, though, is there a antioxidant that you prefer instead?
- [44:36]
C
No, I think vitamin C is a very good antioxidant.
- [44:39]
A
Okay.
- [44:39]
C
But like I said, it's sort of second tier. If you have the time and energy for it, it's wonderful. And it. It does a good job for what it does. Yeah. But it's not miraculous, Right?
- [44:49]
A
Okay. Thank you so much for being on our show.
- [44:51]
C
Thank you for having me.
- [44:53]
A
It was awesome.
- [44:54]
B
And everybody, you can watch this episode on YouTube at Breaking Beauty Podcast because we're. We're on camera here. So, yeah, tune in. Thank you so much.
- [45:04]
A
Thank you. Thanks for listening. You can find details on every product mentioned in today today's episode, along with our exclusive promo codes on our blog @breaking beauty podcast.com.
- [45:15]
B
While you're there, be sure to sign up for our newsletter. Every episode will be delivered directly to your inbox so you won't miss a.
- [45:22]
A
Single thing and get social with us. Let us know what you think of the episode. You can follow us on Instagram at Breaking Beauty Podcast.
- [45:29]
B
And did you know we also have a private Facebook group? Just search Breaking Beauty Podcast chat room.
- [45:34]
A
You can even leave us a voice at any time with questions or feedback at 1-844-227-0302.
- [45:41]
B
And don't forget to subscribe to us wherever you get your podcast fix. Spotify, Stitcher, Google Podcasts and Apple Podcasts where you can show us some love by writing a review.
- [45:52]
A
See you.
- [46:10]
C
Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.