Verizon Announcer (1:21)

Of $45 for three month plan equivalent to $15 per month required. New customer offer speed slow after 35 GB. If network's busy, taxes and fees extra. See mint mobile.com.

Dory Shafrier (1:43)

Hello and welcome to Forever 35, a podcast about the things we do to take care of ourselves. I'm Dory Shafrier.

Elise Hu (1:50)

And I'm Elise Hu. And we're just two friends who like to talk a lot about serums.

Dory Shafrier (1:54)

And today we have a very special guest.

Elise Hu (1:56)

She's very special.

Dory Shafrier (1:58)

Very special to you, certainly.

Dr. Jenny Wong (2:00)

Yeah.

Dory Shafrier (2:02)

None other than Elise's dermatologist.

Elise Hu (2:05)

That's right. Dr. Jenny Wong. Dr. Jenny Wong is based here in Southern California and she treats me. She treats my eldest daughter Ava because Ava had some skin concerns as she was entering puberty. So, yeah, she's really lovely. And she's not a big person on the whole podcast guest circuit. She's just like a very knowledgeable, well educated dermatologist who is out there treating patients every day. And so we brought her some of Yalls skin questions because sometimes when we ask for makeup questions for Rachel Goodwin, they tip over into dermatologist or esthetician land. And so we brought those to Dr. Jenny Wong and she was great. She, like, handled all of them. We didn't prep her or anything.

Dory Shafrier (2:50)

Yeah, she was awesome. When we were, we were like, oh, we want to have a dermatologist on. And we reached out to some like, you know, social media famous dermatologist celebrity, right? And they didn't get back to us. And then Elise was like, actually, my dermatologist would probably be great. And I was like, okay. And then, yeah, she was great as advertised. So thank you, Elise.

Elise Hu (3:11)

And y' all will hear her for yourselves later on in the show. But we just want to remind folks, since it is December and it's gift giving season, that we are out now with our Forever 35 gift guide, holiday gift guide. That episode came out last year, last Monday as we were coming back from Thanksgiving break. And if you haven't heard it yet or seen the guide, you can find it on our Patreon.

Dory Shafrier (3:36)

Yes, and our Patreon is patreon.com/formal35. And in fact, we are running a promo right now on our Patreon. You can get 20% off for a limited time. It ends next Friday, December 19, right before midnight. So sign up. You get 20% off either a monthly membership or an annual membership. And the there is a code. And the code is serums in all caps.

Elise Hu (4:04)

Yeah, see? See you there. We just posted on our Patreon our pop culture. Our monthly pop culture episode. So if you become a member of our Patreon at one of the paid tiers, the Dory's Hotel lounge or Dory's Hotel Spa tiers, you get an extra episode per week because every Friday we have the casual chats where we just kind of chat. And then there are monthly pop culture episodes where we have recommendations in music and books and film and television and podcasts occasionally. And then we also have on Tuesdays, a special bonus questionnaire from our Monday guests. And you can hear about their favorite things and the books that they recommend to everybody and how they feel about the age 35, whether it's before them or after them. So it's a Good time. And for a limited time only, 20% off. Yeah.

Dory Shafrier (5:01)

Super fun. And we are doing a really fun live casual chat recording on December 10th at 7:30 Eastern, 4:30 Pacific p.m. we will be doing casual chat live with our Patreon supporters.

Dory Shafrier (5:20)

So join our Patreon and we will see you on December 10th. It's very exciting.

Elise Hu (5:26)

That's going to be really fun.

Verizon Announcer (5:27)

Yeah.

Elise Hu (5:27)

We haven't done a live chat like this for a minute, so yay.

Dr. Jenny Wong (5:31)

Okay.

Dory Shafrier (5:32)

Usually our casual chat is just us casually chatting, but we will be taking listener questions and just kind of hanging. So I'm excited for that.

Elise Hu (5:40)

Yeah. Good, good. Well, we are getting to catch up for a little bit because before we get to. Jenny, you are just back or recently back from your Thanksgiving trip to see family in New England. Somewhere in New England, because I don't know the geography. Like, somewhere up there.

Dory Shafrier (6:00)

Boston.

Elise Hu (6:01)

Now, it's just this running joke where I'm like, I don't know, somewhere on Eastern time.

Dory Shafrier (6:08)

They seem like New Hampshire. Is that a state?

Elise Hu (6:13)

If you ask me to, like, write, like, name them on a map, I probably could. But, like, Connecticut is very, very small.

Dory Shafrier (6:20)

So it's very small. But it also often, like when you're. It's. It's sort of a running joke among people who drive from New York to Boston. Like, Connecticut is just very. It feels very long, especially if you take 95. It's like very.

Elise Hu (6:35)

You're just stuck in Connecticut for a long time.

Dory Shafrier (6:41)

Anyway, I was in Boston and one of the things I did over Thanksgiving was I went to my 30th high school reunion.

Elise Hu (6:51)

Wow. Did you go to your 20th and your 10th?

Dory Shafrier (6:54)

I went to my.

Elise Hu (6:54)

Had you seen this evolution?

Dory Shafrier (6:56)

So I did go over the decade. I did go to my 10th, which was a very, like, informal affair. It was just, as I recall, it was just like at a bar, like, very hastily organized.

Dory Shafrier (7:11)

I mean, traditionally, I don't know if it's like this everywhere in the country, but, like, traditionally, the, I guess the Wednesday night before Thanksgiving was always like. Or the Friday night of Thanksgiving was the night that, like, people who had come back from college or, you know, being a young adult would go out.

Elise Hu (7:30)

Yeah.

Dory Shafrier (7:31)

And see people in high school. So it felt like sort of just an extension of that, as I recall. And I don't think that many people were there, but I have very hazy recollection of this reunion. I. I mean, it was a very long time ago. I did not go to my 20th. I don't even know if we had a 20th. Like my class was sort of like, I think notoriously, not like, apathetic, but like, we definitely were at that tail end of Gen X where it was sort of like slacker generation.

Elise Hu (8:00)

Yeah, Generation Crunch.

Dory Shafrier (8:02)

Not really. Like, it was not cool to show, like, school spirit, you know what I mean? Like, yeah, okay. Like, we didn't have homecoming or any. Like, we didn't. We didn't have, like, valedictorian. Like, we didn't have class rank or anything. Like, and we had a lot of sports. So all the, like, it was very dispersed. There was just not a lot. It didn't feel like there was sort of like a unifying principle of Brooklyn School, even though it's a very good school.

Dr. Jenny Wong (8:29)

Okay.

Dory Shafrier (8:31)

I don't know. People didn't feel that connected to it, I guess. So anyway, one of my really close friends from high school, we had texted like, months ago and she was like, we should go. And I was like, we should go. Like, we look great. And we're like, you know, it'll be fine. And then, like, as it was getting closer, she was like, are we making a mistake? I was like, no, it'll be fine.

Dory Shafrier (8:53)

I did get my hair done though, because I was.

Elise Hu (8:56)

It looked awesome.

Dory Shafrier (8:57)

Thank you.

Elise Hu (8:57)

You put it on your Instagram and I saw it. I was like, hair.

Dory Shafrier (9:02)

Well, I found this place, like, on the Internet. It seemed to have good reviews and was around the corner from the hotel that my brother and sister and I were staying at. So I was like, okay. And I walked in and like, it was Saturday afternoon. It was slammed. It was like every chair was taken. People were getting blowouts, color. The air was like thick with hairspray. Like, literally, like. Like I needed like a gas mask for all the hairspray. And I was like. At first I was like, ooh, is this too, like, done? And then I was like, no, I like, this looks good. I like it. Yeah. So I did get my hair done and I actually had a really good time. Like, I was afraid that I was just going to have these sort of like, small talky, superficial conversations with people. And I did have a couple of those where I was sort of like, okay, like, really nice to talk to you.

Elise Hu (9:52)

Yeah, yeah.

Dory Shafrier (9:55)

But I also had, like, I had a really nice catch up with a friend from elementary school who I hadn't seen in so long. And we just were sitting there, like, laughing. And I was like. I was like, oh, yeah. Like, she was so fun.

Dory Shafrier (10:08)

And we. Yeah, I was just like, that was really nice, like, to see those people, the people who Like, I'm Facebook friends with. I'm Facebook friends with most of them, so I feel like I sort of knew stuff about their lives, but I hadn't seen them in a really long time.

Elise Hu (10:23)

Yeah.

Dory Shafrier (10:25)

So it's really nice. I. I recommend going to, like, your 30th reunion, because I feel like 10 is too close, you know?

Elise Hu (10:33)

Right. You're. You've just seen each other. Yeah, probably.

Dory Shafrier (10:36)

But serious, I mean, people have really changed and like, the world has really changed.

Elise Hu (10:41)

I don't know if we're gonna have a 30th because we, we very strangely had to do a 25th due to being the graduating class of 2000. And so the year of our 20th reunion was Covid. So there was no way to do it. And so the 25th ended up. Which was this year ended up being kind of the makeup.

Dory Shafrier (11:03)

Yeah.

Elise Hu (11:04)

And so now I'm like, wait, are we gonna have to do the next one with only a five year interval? And who pays for these and who organizes it? Like, I have no idea who's behind it even, because they started an Instagram account for my 25th high school reunion, and I'm like, who's running this? And they were featuring like, who they were then and who they are now.

Dory Shafrier (11:22)

And I'm like, oh, what?

Elise Hu (11:24)

I still don't understand who pays for reunions. Like, are you supposed to donate to a fund or does the district pay? I have no idea.

Dory Shafrier (11:33)

We bought ticket. Like, they, we were charged money for it.

Elise Hu (11:37)

Okay. And then that's the case. That's got to be the case.

Dory Shafrier (11:39)

But there were definitely like a. There were, there was a committee of people who like, volunteered their time and organized it all, which I was not a part of by choice.

Elise Hu (11:49)

Sounds like the folks who were involved in high school and still in Dallas were the ones who were organizing all of that.

Dory Shafrier (11:57)

Makes sense, actually, the people who organize ours. The, the, like the lead organizer was in Connecticut, so not far. But then there were a couple people who were.

Dory Shafrier (12:07)

Remote. Yeah. Who were, who were remote. And you know, a lot of people do still live in the Boston area, but there were a few. There were a bunch of people who had like flown in from California. I don't think anyone came in international. I was glad I went. I was a little bit like, what's this going to be like? But I was glad I went.

Elise Hu (12:27)

Good.

Dory Shafrier (12:28)

So.

Dr. Jenny Wong (12:29)

Yeah.

Dory Shafrier (12:31)

Well, should we introduce Dr. Jenny?

Elise Hu (12:36)

Yes. Dr. Jenny Wong is the founder of SoCal Skin and Surgery, a highly regarded board certified dermatologist. She specializes in medical and cosmetic dermatology she graduated from the University of Chicago with a BA in Biology and then completed completed her dermatology residency at UC Davis. Her research focus is on psoriasis and other complex inflammatory skin conditions. We didn't ask her about psoriasis. It's her expertise.

Dory Shafrier (13:05)

Yeah.

Elise Hu (13:07)

She's a member of the American Academy of Dermatology and in her spare time enjoys spending quality moments with her family and dog. And she also is a snowboarder. And as we mentioned, she's my dermatologist. We met at a book club.

Dory Shafrier (13:22)

So cool.

Elise Hu (13:23)

True story.

Dory Shafrier (13:24)

We didn't ask her about snowboarding.

Elise Hu (13:27)

No. I could see her shredding. I could see her shredding out there.

Dory Shafrier (13:32)

Well, before we get to Dr. Jenny Wong, just a reminder that you can Visit our website forever35podcast.com. We have links there to everything we mentioned on the show. We are also on Instagram at february35podcast and our patreon, which again is on sale 20% off for a limited time. Coda Serums is at patreon.com forever35. You can shop our favorite products at Shopmy US forever35. We have a shelf with our gift guide recommendations so you can go check that out @shopmy us forever35. And our newsletter is now on Patreon also, so sign up for that@patreon.com Forever35 and call or text us at 781-591-0390 and email us at Forever35podcastmail.

Dory Shafrier (14:17)

And we will be right back with Dr. Jenny Wong.

Elise Hu (14:21)

We'll be right back.

Dory Shafrier (14:26)

I think one of the worst things about gift giving is when you find something truly perfect for everyone on your list. But you also love everything that you bought for everyone, which is kind of what happened with my quince order. Everything's so soft and well made. I'm seriously tempted to keep it all for myself because Quint's pretty much has your whole list covered. They have Mongolian cashmere sweaters for $50 when you'd normally pay $200 or more. Then there's the denim that goes with everything. Silk tops and skirts for when you need to look put together, cashmere beanies and scarves and down jackets that actually keep you warm. Those Italian wool coats that they have, they're absolutely at the top of my list. They look designer, feel luxurious and are made with premium materials. I did get myself the 100% cotton oversized cable cardigan which I am obsessed with. I wear it all the time. It's a staple for sure. And I am going to give one to my best friend this holiday. But like everything at Quint's, the price won't make you panic. We're talking way less than other brands charge. By working directly with trusted factories that maintain high standards for both craftsmanship and ethical practices, and by cutting out the middlemen and markups, Quince is able to pass those savings straight to you. Find gifts so good you'll want to keep them with Quince. Go to quince.comfore35 for free shipping on your order and 365 day returns. Now available in Canada too. That's quincee.comfore35 to get free shipping and 365 day returns. Quince.comfore35.

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Elise Hu (16:45)

Doctor Jenny Wong, welcome to the show.

Dr. Jenny Wong (16:48)

Yay. Thank you so much for having me. I'm very excited.

Elise Hu (16:51)

We are excited because we have lots of questions from listeners that have piled up for a dermatologist. So you are going to take these questions. They are above our level of expertise. But just so that folks can kind of get to know you first, we ask all of our guests what they do to take care of themselves. So what are you doing for self care lately or something that you would consider self care?

Dr. Jenny Wong (17:15)

Oof. That's a good question.

Dr. Jenny Wong (17:18)

I used to do a lot more lifting these days because I am six months pregnant. That's kind of of taken a bit of a hiatus. So I've been picking up more yoga just to kind of, you know, get my, my joints moving a little bit, deal with some lower back pain.

Elise Hu (17:41)

Can't stop working on the mobility and the strength as we get older. How did you get into it? Were you somebody, were you an athlete growing up or what made you start lifting in the first place?

Dr. Jenny Wong (17:52)

No, not really. I actually started lifting around med school. So in my early 20s and my husb actually and brother they were lifting and so it gave me more confidence to try it out because I had someone to show me how to, you know, pick up the weights in the gym. Otherwise, I think it would have been really intimidating to go at it by myself. And honestly, I kind of fell in love with it because I like how in lifting, it's. There's a finite goal that you're trying to achieve, and you can see that progress from a week to week basis. You can see yourself getting stronger. And I thought that was really exciting. Gratify. And, you know, I had kind of. I was more goal oriented. I've never been great at cardio, so that's something I've always struggled with. And I'm still trying to pick up a good cardio sport for myself. But lifting, you know, was just easy. And it's something I've kept for, I guess, now, well over a decade.

Elise Hu (18:52)

Yeah.

Dory Shafrier (18:52)

Wow. Well, Dr. Jenny, we got quite a few questions for you, so I'm going to jump right in.

Dory Shafrier (19:01)

This first question is about eczema. Our listener writes, I had eczema as a child, but it disappeared for decades. And now as I near 40, it seems to be coming back. I'd love any and all Rex for creams daytime and overnight. My skin is itchy, very sensitive to the sun, wind, and sensitive to most things. I've pivoted to a mostly cotton wardrobe, which helps. And Eucerin eczema cream is soothing, too, though it doesn't feel very fun or lavish. I've upped my vitamin D as it was very low C. Also living in a gray city and always covering up, which I'm hopeful will help, too, but open to other supplements that are known to be helpful. Thanks.

Dr. Jenny Wong (19:44)

Yes, yes. That's a really common question that I get. Eczema is very common, especially here in our side of California because it's very dry. And we do know that eczema is caused by certain triggers. Number one, it's very genetic. So some people just have more sensitive skin and they have a more weakened skin barrier. And what happens is when you get exposed to environmental exposures, sometimes sweat is a big one. So in the summertime, when you sweat, that's very irritating. And definitely nowadays just our skincare products. And it's kind of very. It's difficult to.

Dr. Jenny Wong (20:24)

Always eliminate these skincare exposures because a lot of these fragrances are found in all of our household products, whether it's detergents, just gentle lotion, moisturizers. And so sometimes it can be very challenging for my patients to find products that they are able to tolerate. And so I always Tell them, try thinking about a skincare diet and it sounds just as boring as a regular diet. You essentially eliminate all of your products. That includes all of your non essentials fragrances, if you have essential oils at home, if you have even special detergents, if you use special soaps, bath bombs, all of those things just, you have to pause them. Take a hiatus for now and slowly allow your skin barrier to recover. Sometimes you have to give it maybe two, four weeks and then slowly you can reintroduce one product at a time. And in general, for my eczema patients, I do say simple is key. And you might not be able to tolerate all of your anti aging serums, your toners, all the fun stuff. You have to stick to boring and bas like Eucerin is a great brand. Some of the other very basic boring brands I like are CeraVe, VanaCream. These are readily accessible at your local drugstore. They're not expensive and usually that's how I tell my patients to start.

Elise Hu (21:57)

Okay. Even though Eucerin isn't very lavish or.

Dr. Jenny Wong (22:01)

Very fun, no dermatologists recommend it. Exactly. Yeah, I recommend the most boring products and use it for myself. Yeah, use it for my, my daughter. Just super simple.

Elise Hu (22:13)

Okay. All right, next question. I was wondering if you have any requests for dealing with blackheads. I have otherwise very easygoing skin, but I sometimes feel like I can't reduce my blackheads to save my life and I'm cursed to walk around with black dots all over my face. Any recommendations to implement at any stage of the skincare process would help.

Dr. Jenny Wong (22:34)

Blackheads is so challenging because there's no easy answer. I always tell my patients, so your blackheads are basically, they're very normal. We also call them sebaceous filaments. So what's happening is the pores on your nose and pores are natural. We need the skin to breathe. It's how the hair follicle comes out of the skin. And we can't technically be poreless, we can't be poreless. And then we have now Instagram filters. It's just, I think it portrays this very false sense of beauty that is unattainable.

Dr. Jenny Wong (23:10)

And unfortunately the pore size, I always tell patients, it's like your shoe size. How do you change your shoe size? You can't really, it's totally genetic. Some people are, unfortunately, they have more oily skin, they have larger pores, some people have drier skin, smaller pores. And so that pore size really dictates how prominent some of Those blackheads appear and blackheads. It's not really a skin problem. It's not a skin condition. It's totally natural. It's really your skin oils and the oxygen, when they oxidize together, it turns a little bit darker and you know it's going to keep coming up. We can do things to try to minimize the appearance of pores, of course, you know, making sure you're washing your face daily. Sometimes I recommend things like gentle exfoliants, maybe like a salicylic acid wash. Something gentle. There are a lot of products out there that are marketed towards removing blackheads. They can be very harsh, like an acid toner that's left on. If it's left on, sometimes it can just cause more irritation and you get more irritation. The skin wants to try to combat that irritation by maybe producing more oils. Maybe you're causing irritation. It can permanently disfigure those pore sizes and they become bigger. So even things like those strips, the blackhead strips, super popular. I think once in a while. Sure, I think. And that's very satisfying to take it off. And you see all the black dots.

Elise Hu (24:44)

Yeah, it's kind of fun just to even see.

Dr. Jenny Wong (24:46)

Yeah. So I'm like, it's kind of therapeutic. It's kind of fun. But you shouldn't be doing it regularly because you can really strip that skin barrier. And honestly, over the counter, retinols are great. Retinols are a way to help increase cell turnover so that you have less skin cell. Skin cell blockage. And a lot of times that's what. It's like a traffic jam. So we're trying to move along that traffic jam. You're shedding off dead skin and that really helps.

Elise Hu (25:12)

Well, that's a good analogy. Dr. Wang, we talked before, not on this show, but just offline about Differin. Differin gel. Is that a retinol?

Dr. Jenny Wong (25:24)

Yes. Okay, so differin, it's. The generic is called Dapalene. It used to be actually prescription, and over the last few years, it actually became approved to be over the. So it's actually a great. It's a great retinol that I recommend for my patients because it's a more. It's a little bit more gentle. So it's kind of like a cousin of a. Of like a tretinoin, which is a little bit stronger. I think adaptoline is better tolerated for some of my teenager patients or patients with more sensitive skin.

Elise Hu (25:57)

Okay, okay, this is great.

Dory Shafrier (26:00)

All right, next question. What do you do when your skin is revolting against you? I've been using the same products for several years and now all of a sudden, probably perimenopause's fault, my skin is reacting as if I'm allergic to them. They are hypoallergenic, fragrance free, everything. And I don't know what to do. Is there a line of products for the highly sensitive skin ladies out there?

Dr. Jenny Wong (26:26)

So this is something that I see a lot. Number one, you can absolutely develop a new sensitivity to a product you've been using for decades. I see it all the time. Number two companies, they will change their formulation. So just because it's the same product, you know, they have a rebranding and they will add something usually maybe to make it more luxurious or maybe change the scent a little bit. So that could be, that could be the case. And number three, over time as our hormones fluctuate, things happen to our skin. This is very common. We see it. You know, when you change things like, you know, maybe birth control, you go through pregnancy, postpartum, you're going through peri, being perimenopausal. All of this, all of these things will change the skin composition and something you have been using fine for decades, you can no longer tolerate. And in terms of products, once again, kind of like what I mentioned before, that idea of a skin elimination diet, you have to stop everything slowly, reintroduce one product at a time. You have to maybe think about taking out all of your non essential, you know, serums, toners, and then try to stick to the basics. Just start from square one. Your boring stuff, your, you know, I'm not a spokesperson for these brands but they're cheap and they're at your drugstore, you know, Cerave, Bana Cream, La Roche, Posay. You just have to start simple and start there and one at a time.

Elise Hu (28:06)

Yeah, yeah. And we should mention that you are not sponsored by any of these brands.

Dr. Jenny Wong (28:10)

That we're talking about. Yes.

Elise Hu (28:12)

So this is really just what you have exactly to be tried and true for both your patients and your loved ones.

Dory Shafrier (28:19)

So we're just going to take a short break and we will be right back.

Dory Shafrier (28:28)

Sometimes the holidays are the best time to get a steal of a deal on things you've been wanting all year. So if you've been thinking of trying Masterclass, I recommend trying it now. Especially if you're going to be traveling, change your commute or travel time into a classroom. You can learn wherever you are on your phone, laptop or even your tv. You can go audio only mode or watch the videos. You can even download classes to watch offline and make the most of your travel time. Masterclass goes with you and fits into your life. I love using Masterclass as a way to keep my doom strong in check also. And if I find myself reaching for my phone too often, I'll open Masterclass instead and take a look around. Suddenly I'm watching Amy Poehler teach me ways to apply the principles of improv to my life or atomic habits. Author James Clear teaching me to develop good repeatable habits. I guess that's why 88% of surveyed members feel that Masterclass has made a positive impact on their lives. Masterclass always has great offers during the holidays, sometimes up to as much as 50% off. Head over to masterclass.com forever35 for the current offer. That's up to 50% off at masterclass.com forever35 masterclass.com forever35.

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Elise Hu (30:19)

Additional terms applied. Okay, next question.

Elise Hu (30:29)

Our listener says quick question. I'll keep this short and sweet. How do we feel about exosomes and growth factors infiltrating our anti aging serums? They are everywhere right now. Scam, Magic bullet I've been looking for insight and expert consultation. Welcome.

Dr. Jenny Wong (30:48)

Yes, so exosomes are very sexy right now. They've been around for much longer outside of the U.S. like in Korea, there's a lot more robust data on it. So with exosomes it's very exciting. The idea of exosomes is that you have these extracellular cells and they carry signals that tell what's that tell the cell what to do, whether it's how to repair itself, how to maybe fight anti aging, promote collagen and we use it in a lot of different fields, not just in aesthetics.

Dr. Jenny Wong (31:26)

I think.

Dr. Jenny Wong (31:28)

The issue with exosomes right now is that it's still very new and it's not as tightly regulated right now. And the concern with that is there are all of these competing exosome companies that are trying to sell their product. And we don't necessarily know where are these exosomes being harvested from. Are they coming from humans? Are they coming from animals, plants? How pure are these exosomes? Are we sure that it's just exosomes? How do we know there aren't additional proteins that are being attached to the sample? And right now, the companies, they're less transparent about how they source these exosomes. And so it's hard to really compare then how effective one single product is. And then the other issue with exosomes right now is we usually in offices, we will pair it with other procedures. So what that means is you pair it with something like microneedling rf, because exosomes, if you just layer it on top of the skin, it really doesn't penetrate.

Dr. Jenny Wong (32:38)

You need an opening in the skin barrier for the exosome to penetrate deeper into the skin. So you need something to disrupt that skin barrier with more of an invasive procedure like microneedling. Some people do. Other, other practices are doing ultrasound to create little channels. And so, you know, how do we know is it that actual technology that's doing more work? Is it the exosomes? It's hard to say, but it is very exciting. I think we just need a lot more data. We need to kind of, we need to see the longevity of this technology.

Elise Hu (33:12)

How are exosomes primarily delivered?

Dr. Jenny Wong (33:14)

Right now, it's basically, it's applied topically, but it doesn't really work. If you just apply it like a lotion or serum, it really needs to penetrate deeper. So that's where those other procedures help. Because things like microneedling, you're creating channels, you're creating open wounds on the skin. Right? And then the exosome will be layered on top and it can penetrate deeper to deliver.

Elise Hu (33:38)

Yeah.

Dr. Jenny Wong (33:38)

The messages it needs to deliver.

Dory Shafrier (33:40)

Okay, this is a question from me, but I think it's something that, like, a lot of our listeners are curious about for people who are, you know, want to explore, like in office treatments. In your opinion, what treatments give you, like, the best bang for your buck?

Dr. Jenny Wong (34:01)

Oh, yeah, that's really good. So when I start, when I see a patient for the first time and they tell me, hey, I just, I just want to look maybe a little bit more refreshed, a little bit younger.

Dr. Jenny Wong (34:15)

The first thing I ask is, how are you with sun protection? Sun protection is the cheapest way to fight anti aging. That and tobacco sun exposure and tobacco smoking are the quickest way to accelerate aging. So, number one, I ask, how are we with that, because it's not always something that. That's so natural. For patients. Sun protection means daily sunscreen, physical sun protection, seeking shade, hats, clothing protection. Because a lot of the things that they're seeing, whether it's pigment problems, they're seeing brown spots, they're seeing just a breakdown on their collagen. All of that, fine lines and wrinkles, all of that can be slow. We can't stop it. We can't stop aging, but we can slow it down. So you really want to give yourself the best advantage possible. So sun protection is key, cheapest thing to do. And then also sometimes, you know, they do want to start with some type of skincare routine. So I do like the idea of retinol. So retinols is over the counter. Retinoids is prescription. It's basically, it's a vitamin A medication. Increases cell turnover, but it also stimulates collagen production. That's a very. And there are actually relatively inexpensive retinols on the market as well. That, plus a sunscreen, I think will take you 80% of the way just with your home skincare without having to do a procedure. Now, if you're starting to think about, okay, what are some other things I want to splurge on to kind of get me that, you know, less. Yeah, that. Like, sort of like, what if I.

Elise Hu (35:51)

Came into some money?

Dr. Jenny Wong (35:52)

Right. Yes, Just money. Just, can I throw money on my face?

Dr. Jenny Wong (35:57)

What? Yeah, what. What's the best? So usually I find that the. Probably the best bang for your buck is probably a toxin. So toxin is what you think of as Botox. It's botulinum toxin. And what that does is it relaxes muscles, because a lot of the signs of aging that we see are due to fine lines and wrinkles. It's just from the same dynamic expressions being performed over and over again, whether you're raising your forehead, furrowing your brows, your crow's feet, your smile lines. And what a toxin will do is it helps soften those lines because it stops muscle activity. And over time, when you can do that, you can prevent those lines from being more etched in at rest. So what that means is sometimes as we get older, we will have those lines, even if we're not making that expression. Sure. So the idea of relaxing muscles helps with that aspect. If the lines are already etched in, we can't do too much to erase them completely at rest, but we can certainly prevent them from getting deeper.

Dr. Jenny Wong (37:08)

That's one thing I like to talk about. And then also improving the skin quality because that's also something that we notice. We will notice pigment issues, we will notice texture irregularities. And so things that will help improve the skin texture that can be done through different things. Whether it's people like peels, microneedling, laser treatments, all of those things target to improve the skin texture and quality. So usually those. Those are things I like to start bringing up for patients.

Elise Hu (37:43)

Yeah, I feel like a friend of mine was a big proponent of some of the laser treatments out there. Are there certain ones that you have found to be very popular with your patients?

Dr. Jenny Wong (37:55)

Yeah. So I. For me, it depends on kind of what they're looking for. So a lot of times when they're dealing with pigment problems or, once again, fine lines, wrinkles, I do like to talk to them about a resurfacing technology. The idea of resurfacing is, what we're doing is we're creating micro injuries to the skin in a very controlled way. So it sounds kind of scary. Yeah. But it's kind of like when you. If. I don't know if you guys are runners, I'm not a runner, but I'll use the analogy. Yeah. You mentioned you didn't do much cardio, but talk about it. Okay, but. But the idea is that. So when you have. When you do high impact sports, you're creating micro traumas to your bones. And when those bones heal, it actually strengthens the bones and increases bone density, which is why things like running, even weightlifting, can help fight things like osteoporosis for some of our older women. And the same thing is true for things like laser resurfacing. So if you injure too much, then that's really bad because then the skin really can't recover. Just like if you have a really bad fracture, things like that, the recovery is gonna be really bad. So the idea is we're creating micro injuries to the skin, and then it's able to repair itself very quickly. And each time it does that, it basically promotes more collagen, better skin integrity, and actually it can improve overall skin health. So there's a lot of exciting new data out saying that a lot of these resurfacing technologies on the skin, not just cosmetic, it can actually minimize risks, risks of skin cancer, which is huge. You're actually just reversing aging on the face.

Elise Hu (39:49)

Okay, thank you for this explanation.

Dr. Jenny Wong (39:52)

Yeah, of course.

Elise Hu (39:55)

Okay, the next question from a listener says, I am 55 and I'm looking for a good hydrating serum that does not contain hyaluronic acid. My skin does not love it for some reason and it makes me drier. Even when I use a face mist before I apply, every hydrating serum seems to contain this ingredient.

Dr. Jenny Wong (40:15)

Please help.

Elise Hu (40:16)

It's getting cold here and my skin is getting drier by the moment.

Dr. Jenny Wong (40:20)

Yeah. So hyaluronic acid is very popular, I think, I think it's very popular because it feels very nice. It feels very lubricating and soft and really it is just meant to be a moisturizer. So if we're looking for good moisturizers, you can certainly go for a, a thick water based moisturizer like a cream. So in general, creams are going to be thicker than lotions. Even a big tub of a. Yeah, something like, like a eustorine or cerave cream. And they sell them in large bulks. You could probably get them at Costco as well. That, and sometimes if that's not enough, you can almost do. It's like a slugging effect where you take Vaseline, which is petroleum jelly, which is very occlusive and you can thicken your moisturizer by doing that. And the key with all these moisturizers is that you have to, you should do it when your face is slightly damp. So after you clean your face, pat the face down dry, put the moisturizer on. So it really occludes the moisture that's already on your face. Because if your skin is super dry and you put it on, it's not going to really trap that moisture. And that's what we're really trying to do. So I don't think you have to necessarily go try all these expensive serums. You can certainly try with something basic like this and you can really get the same effect. Sometimes if I have a dry patch, even from overuse of a retinoid, I'll just put a bunch of Vaseline on my face and the next day it actually looks much better.

Elise Hu (41:56)

How do you feel about face oils?

Dr. Jenny Wong (42:00)

So in general, when a patient comes to me and they, and they bring their products and they tell me, go over my skincare routine, tell me what I need to change. And I ask them, do you like your skincare routine? Is it working for you? Because if it is, there's no need to change it. I think skincare is so personal and it's very therapeutic. So some of my patients do have a 10 step skincare routine and, and they love it. And I say don't, don't change it. So if you find that you like your skin oil, you like the way it feels on your skin, go for It. But if you're coming to me because you're having issues.

Dr. Jenny Wong (42:34)

Then I'll maybe change course a little bit. So these oils, I can see issues. Lot of my patients that have oilier skin at baseline, acne prone skin. The reason is our faces naturally produce oils. And when we introduce more oils to the face, it starts becoming almost like a, it's like a buffet for the organisms that are already present on your face. So this sounds super gross and patients always get freaked out when I tell them this, but you have, have low levels, just normal levels of mites on your face. It's called Demodex. You have fungus on your face, you have bacteria on your face. This is super normal. It's just everywhere. When you introduce more oils, it's literally, it's just a food source for them. And these things can thrive. And I sometimes will see certain skin problems that will get a lot worse with the use of essential. With oil face oils, it can sometimes make acne a little bit worse. I see really bad dandruff. It's called seborrheic dermatitis where you just get these yellow flaky patches. Perioral dermatitis is super common with my patients. They get this, this red rash around their mouth, sometimes around the eyes. Yeah, super common. And, and sometimes overgrowth of Demodex, which is those mites, and you get these little yellow pustules on the face. They get really itchy. So I always tell them, yeah, you got to take away the, those, the, the oil based toners, the oil based cleansers, the face oils. Yeah, you just really gotta start basic sometimes. Just less is more. Less is more.

Elise Hu (44:15)

Yeah, yeah. It's a good reminder.

Dory Shafrier (44:18)

I have a question about fillers because I feel like in the last, I don't know, six to 12 months, there's been a lot of conversation on social media about how fillers are like the devil and they stay in your face forever or they migrate.

Elise Hu (44:37)

Funny migrate.

Dory Shafrier (44:38)

And it feels like there's been this real shift in terms of like how people are thinking about fillers. So my question to you is how much of this is real? And have you seen this shift also, like in your own patients? Are people kind of moving away from fillers?

Dr. Jenny Wong (44:56)

This is such a timely topic because you're absolutely right. There has been a huge shift and it's something that is actually brought up a lot with at conferences. I mean, I think, I think the definitely, I think the companies that sell fillers are definitely. They're noticing this because they can track they can track how much product is being pushed.

Dory Shafrier (45:16)

Right.

Dr. Jenny Wong (45:17)

And it's definitely gone down significantly. And yeah, so it's a very real phenomenon, just even financially. And I do think that a lot of it is due to what we see on social media and what we see when, with maybe our celebrities and pop culture. What we see are examples of, unfortunately, bad filler. So whether it's too much, usually it's too much filler. So when we think of the stereotypical overfilled face, you cannot achieve that with one session. One session is not gonna do that. That's usually someone who has gone to get fillers multiple times. And at some point, you know, it's just, you get. You get something called perception drift, which means you see yourself in the mirror and that's your normal. You put some filler in there. Now you look at yourself in the mirror, that is your new normal. And each time that new normal shifts a little bit, and at some point you lose sight of what you're supposed to look like in the beginning.

Dr. Jenny Wong (46:26)

And I do think as, you know, as physicians, as practitioners, we do have a responsibility to, to tell our patients maybe when is too much too much. But sometimes, I mean, that's not always the case. And they do end up getting more and more and more. Or they might see different. They might see different physicians or different offices, and they don't know what they've had done. And they say, you're just walking into my office for the first time. Of course I want to give you good experience. I'll deliver what you asked for. And so I think there's just a lot of bad examples of filler out there. But what people don't realize is you. No one talks about the examples of good filler because it's imperceptible. It's imperceptible. Yeah. Where. Where a lot of, you know, non celebrities or just people walking out, you know, in society, you know, you can't really tell. They just. They just kind of keep looking pretty good, and that's usually what we're trying to achieve. And, and of course, you know, every, every physician has their own philosophy, but for me, definitely, I like a more natural look. I'm not trying to change the way anyone looks. I'm just trying to help make someone feel their best selves. And so in regards to, you know, does it migrate if you put too much of filler in one space? It will absolutely migrate because there's just not enough space for that filler to be held. So that goes for your Lips, for instance, your cheeks. When a filler is properly placed in the right plane, because there's different planes on the face, that filler usually will stay there. We do see very low examples of migration when properly placed in the right amounts. But unfortunately we do just have bad examples out there. And I do think it's led to this fear of filler where, which I don't think is. I mean, I think it's very important for people to realize, you know, what can happen when these procedures go wrong.

Elise Hu (48:31)

Yeah, there are side effects.

Dr. Jenny Wong (48:32)

Sometimes there are side effects, yes. There are some dangerous side effects for filler placement. And so I think it's very important to know who's injecting you. I think here your training really matters, your expertise really matters. You could pretty much get Botox filler just, you know, just around the corner anywhere.

Elise Hu (48:54)

Yeah.

Dr. Jenny Wong (48:54)

These days. Yeah.

Elise Hu (48:57)

There's Groupons.

Dr. Jenny Wong (48:58)

There's Groupons. And also there's products out here that are not, you know, they're not really FDA approved filler products. So there's like off, you know, you have different label brands. Off brands. Exactly. So who knows how long those products can last for.

Dr. Jenny Wong (49:17)

So I think it's a little bit of a wild, wild west out there. But I do tell my patients, you know, I definitely, you know, tell them, hey, if you have a fear, you know, we can talk about it. What are your concerns? I can try to help you understand them. But at the end of the day, you know, some people don't want to go for fillers and I think that's totally, totally fair. It's a cosmetic treatment at the end of the day.

Elise Hu (49:40)

Yeah, right. Yeah.

Dory Shafrier (49:41)

I have another sort of social media influenced question for you, which is I've seen a bunch of, of plastic surgeons on TikTok saying if you are, if you think you might get a facelift at some point, don't do Morpheus and don't do RF micro needling because it will like melt your skin or something. I, I don't like totally understand.

Dory Shafrier (50:09)

But I'm wondering like what you think of that. And then I have another follow up after that about like dermatology treatments versus plastic surgery treatments.

Dr. Jenny Wong (50:19)

Yeah, yeah. I actually haven't heard the one about don't do, don't do microneedling or Morpheus with, with facelifts. But I have heard don't do Sculptra with facelifts. But just the, just the idea that, you know, don't, don't do X procedure because you're going to think about doing, you Know xyz.

Dr. Jenny Wong (50:43)

And actually, I have spoken to different plastic surgeons specifically regarding Sculptra. So what Sculptra is, it's a bio stimulator. It's injected like a filler. So it carries some of the similar risks that a filler will carry as well. But the idea is that it boosts collagen and so you don't receive the results till a few months down the road, sometimes up to a year.

Dory Shafrier (51:05)

Oh, interesting.

Dr. Jenny Wong (51:06)

Okay. But some of the side effects of that is because we're actually promoting collagen production, sometimes you can get fibrosis. So basically a little bit of thickening underneath the skin. And so the idea is that when you're doing a facelift, it's harder to actually get to the correct plane and safely lift the skin off to move it.

Elise Hu (51:28)

Yeah.

Dr. Jenny Wong (51:29)

And so I have been hearing a little bit of that concern with those two procedures. But plastic surgeons that actually do both, they're totally, they're like, that's not a problem at all.

Dory Shafrier (51:39)

Oh, interesting.

Dr. Jenny Wong (51:40)

It actually makes the procedures not necessarily easier. You wanna know that they have a history of that, so you know what you're getting yourself into. But actually it improves the skin integrity. So rather than transposing, you know, like a flimsy piece of skin, you have, you have, you know, a little bit more to work with, a little bit more integrity to work with.

Elise Hu (52:01)

Okay.

Dr. Jenny Wong (52:01)

So I think it really depends on, you know, what, what services do these plastic surgeons offer? Is there a conflict of interest? Are they just trying to sell more things?

Elise Hu (52:13)

Yes, exactly.

Dory Shafrier (52:14)

This is my question.

Dr. Jenny Wong (52:15)

Yeah, like, not, not everyone is going to go for a facelift. And also, it's not like you can get a facelift every decade. You. Yeah, like you can get at most maybe like two facelifts. I'm not a plastic surgeon, so I don't actually know that, but I, but each time you have a facelift, you do have more scar tissue. You, you, you can't do it an infinite amount of times.

Elise Hu (52:38)

Right, Right.

Dr. Jenny Wong (52:39)

So if you're trying to delay that facelift, are you just not going to do anything in the meantime? There are safe, non invasive things to try to help delay that first facelift, even.

Dory Shafrier (52:49)

Wow.

Elise Hu (52:51)

I feel like we could talk to you for a long time and we should probably, we have a makeup artist who comes on kind of quarterly, so we should probably have you check in at least twice a year or something because it's been so enlightening and educational to catch up with you. It seems like skincare and the medicine behind it is constantly changing and innovating and improving. So learning a lot from you, Dr. Wong. Thank you so much for coming on. And where can folks find you online or what would. Where should we point folks who are interested in learning about you and your practice?

Dr. Jenny Wong (53:24)

So, yes, we are on social media. I'm not great at updating it, but our Instagram handle is ocal skinsurge, and we were a practice based in Playa Vista and West la, and we've been open for about a year and a half now. And I would love to see. Yeah, I would love to see patients in person.

Dr. Jenny Wong (53:48)

So that's. That's what I do with my time.

Elise Hu (53:50)

Okay, fantastic. Thank you for coming on. It was so fun.

Dr. Jenny Wong (53:53)

Yeah, of course.

Dory Shafrier (53:54)

It was really fun.

Dr. Jenny Wong (53:55)

Thank you so much.

Dory Shafrier (54:00)

Well, Elise, I. I am very loyal to my dermatologist, but I feel like if anything were to happen to him.

Dory Shafrier (54:10)

I would know where I could go, though.

Elise Hu (54:12)

Yes, you. You know exactly.

Dory Shafrier (54:14)

I know exactly, though.

Elise Hu (54:15)

It is on the other side of the 405 from you, so I don't know. This is basically like. It'd be like a bicoastal trip.

Dory Shafrier (54:20)

Yeah. I mean, my current.

Elise Hu (54:22)

Let's hope nothing happens to your dermatologist.

Dory Shafrier (54:24)

Yeah, he's in Century City, so it's not like, super close, but it's also, like, manageable. Other side of the 405. That might be pushing it.

Dory Shafrier (54:34)

All right. Well, Elise, you were going to exercise three to five times week.

Elise Hu (54:39)

I am very proud to say I have done it. I have been, like, lifting weights. Wow. I feel buff. I had. I played a little tennis this morning with some moms, two of them who I'd never met, and one of them brought, like, dead balls. And I was very annoyed because, like. Because then you have some balls that are really bouncy, the ones that I brought, and then some balls that are not. And then I'm. I'm like, like, you have to kind of hit them differently based on whether, of course, there's air in them. And so that was kind of annoying. But I have exercised, and I think you had a similar intention if I did.

Dory Shafrier (55:19)

And I even brought some stuff to work out in. In Boston, and I just didn't do it.

Dory Shafrier (55:26)

I was so, like. I don't know. My sleep was so off with the jet, with the time.

Elise Hu (55:30)

Yeah. Travel takes a lot. Yeah.

Dory Shafrier (55:32)

And then with Henry, and it's just, like, didn't happen.

Dory Shafrier (55:37)

And I don't know, I really, like. I would really like to get back to group fitness classes. That would be fun.

Elise Hu (55:45)

Yeah.

Dory Shafrier (55:46)

So I don't know. Maybe I'll look into that. Because I need to do something. I need to do some sort of weight situation. You know, My parents go to the gym together, like, every day.

Elise Hu (55:57)

I took Rob to Mega former Pilates on Sunday, and it was so fun.

Dr. Jenny Wong (56:00)

Wow.

Elise Hu (56:01)

Yeah. Cause he, like, had no idea what was going on. It's really fun to watch. Does.

Dory Shafrier (56:07)

Does Rob. Does Rob play tennis?

Elise Hu (56:09)

Yeah, he can play tennis, too.

Dory Shafrier (56:10)

That's fun.

Elise Hu (56:11)

Yeah, but he does. I mean, he's, like, not great at it, but he. He can. My main thing with him is that I don't like to just go to the gym with him. He likes to go to the gym and just, like, lift weights, and I find that kind of boring. So if I could get him to go to a group exercise class and just watch him futz around and, like, not quite understand, it cracks me up.

Dory Shafrier (56:33)

That's funny.

Elise Hu (56:34)

So what are you gonna do for this week? What's your new intention?

Dory Shafrier (56:36)

You know, Elise, I think my new intention is an old intention, which is I need to declutter my office.

Dory Shafrier (56:45)

I was in, like, a. I was in a good, like, decluttering rhythm for a little while, and then, I don't know, I guess the travel and just all the other stuff, I feel like I fell off the wagon, so. So I need to get back into that.

Elise Hu (57:01)

Mine is sort of the opposite. I'm going to clutter my house. I'm going to put up my Christmas decor.

Dory Shafrier (57:07)

Oh, my gosh.

Elise Hu (57:08)

We have some lights up outside, but not complete. And then I still have pumpkins on the porch. I gotta switch out. It's time to switch things out. And, you know, Rob is with us, so we have Chris Macaw, we have Hanukkah and Christmas going on in here, so. So it's gonna be. It's gonna be a bit of a production.

Dory Shafrier (57:28)

We also need to put up our Christmas stuff, so that's a good reminder. Thank you.

Elise Hu (57:33)

Rob did buy guilt already. We do have guilt. Okay, I'm ready. Yeah.

Dory Shafrier (57:38)

Nice.

Dory Shafrier (57:40)

All right, listeners, this is the episode where we thank everyone who supports us at the $10 level and above. We are so grateful to you. This is just one of the many ways that we want to say thank you. If I could thank you every day, I would.

Elise Hu (57:55)

The folks we want to thank are Sarah liska, Fiona Castro Labrun, Felicia Justice Biro, Jasmine DeJesus, Christy Heather Whaley, Caitlin H. Katie Ashley Taylor, Theresa Anderson, Michelle Nicole Gass, Maya Barbara C. Amy, Amy Schnitzer, Megan Shelley Lee, Kim Beechler, Sarah Boozy, Allison Cohen, Susan Berseth, Fran Kelsey, Wolf Denay, Laura Eddy, Jadelle Apte, Valerie Bruno, Julie Daniel E. Jackson, Katherine Burke Burke, Amy Maseko, Liz Rain, jdk, Hannah M, Julia P, Matty o', Day, Marissa Sarah Bell, Maria Diana, Coco Bean, Laura Hadden, Josie H, Nikki Bossert, Juliana Duff, Chelsea Torres, Tiffany G, Emily McIntyre, Stephanie Germana, Olivia Fahey, Elizabeth A, Christine Bassis, Jessica Gale, Zulima Lundy, Carolyn Rodriguez, Carrie Golds and T. Katherine Ellingson, Kara Brugman, Sarah H, Sarah Egan, Jess Combin, Jennifer Olson, Jennifer hs, Eliza Gibson, Jillian Bowman, Brianne Macy, Elizabeth Holland, Karen Perelman, Katie Jordan, Sarah M, Kate M. Josie Alquist, Tara Todd, Elizabeth Cleary and Monica. Thank you all so much. And thank you to everybody in our community that listens every week.

Dory Shafrier (59:13)

Yeah, we're so thankful. And just a reminder that Forever 35 is hosted and produced by me, Dori Shafriar and Elise Hu and produced and edited by Sam Junio. Sammy Reed is our project manager and our network partner is Acast. Thanks everyone.

Elise Hu (59:29)

Talk to you next time. Bye.

Dr. Jenny Wong (59:33)

Guys.

Mrs. Claus's Sister (59:33)

Thanks for helping me carry my Christmas tree.

Elf Drew Ski (59:35)

Zoe. This thing weighs a ton.

Dr. Jenny Wong (59:37)

Drew Ski, live with your legs man. Santa. Santa, did you get my letter?

Elf Drew Ski (59:40)

He's talking to you, Bridges.

Elise Hu (59:42)

I'm not.

Mrs. Claus's Sister (59:43)

Of course he did.

Dr. Jenny Wong (59:44)

Right Santa?

Elise Hu (59:45)

You know my elf Drew Ski here.

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He handles the nice list.

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