Dr. Nancy Samolitis Breaks Down Types of Lasers, Growth Factors and Answers More of Your Questions

Summary

Gloss Angeles Episode Summary: Dr. Nancy Samolitis Breaks Down Types of Lasers, Growth Factors and Answers More of Your Questions

Release Date: March 28, 2025

In this enriching episode of Gloss Angeles, co-hosts Kirbie Johnson and Sara Tan welcome esteemed dermatologist Dr. Nancy Samolitis to discuss advanced skincare treatments, focusing on lasers, growth factors, rosacea management, and the nuanced use of fillers. Drawing from over two decades of dermatological expertise, Dr. Samolitis provides listeners with in-depth insights and practical advice for maintaining healthy, youthful skin.

---

1. Introduction to Dr. Nancy Samolitis

The episode kicks off with Kirbie and Sara introducing Dr. Samolitis, highlighting her extensive background in dermatology and her dedication to advancing skincare treatments.

Dr. Nancy Samolitis [00:39]: "Have we ever actually said her first name on this podcast? Dr. Nancy Samolitis."

2. Dr. Samolitis’s Dermatology Journey

Dr. Samolitis shares her path into dermatology, emphasizing how her initial indecision in med school led her to this specialized field. She recounts shadowing a pioneering dermatologist, Dr. Jeff Klein, whose work in the tumescent technique for liposuction inspired her commitment to dermatology.

Dr. Nancy Samolitis [10:14]: "It's a natural transition for me because I was a biology major, and I was like, what am I gonna do with this?"

3. Advanced Laser Treatments

A significant portion of the discussion centers around various laser technologies used in dermatology. Dr. Samolitis explains the functionality and applications of different lasers, particularly for treating rosacea and skin pigmentation.

Vascular Lasers: Derma V (KTP Laser)

• Uses: Treats red elements such as scars, rosacea, broken blood vessels, and sun damage.
• Efficacy: Provides noticeable improvement after one session, with maintenance treatments recommended every few months.

Sara Tan [14:53]: "Rosacea is something that you sort of... it's lurking. So it's something that you always have to pay attention to and continue to treat."

Avava Laser

• Function: Similar to Fraxel (1550 nm) targeting dermal remodeling for skin firming.
• Benefits: Facilitates collagen production for improved skin quality without the promise of surgical lifting.

Pico Lasers and Exosomes

• Pico Lasers: Offer faster pulse delivery, reducing tissue damage and targeting pigmentation more effectively.
• Exosomes: Discussed as a promising yet not fully understood treatment option, highlighting the need for more research and FDA approval.

Dr. Nancy Samolitis [24:43]: "We learned ways to safely use almost any kind of laser on darker skin types now."

4. Comprehensive Rosacea Management

Dr. Samolitis delves into the multifaceted approach required to manage rosacea, combining laser treatments with medical therapies to achieve optimal results.

Combination Therapies

• Medications: Ivermectin, metronidazole, and azelaic acid are staples in treating rosacea.
• Lifestyle Adjustments: Identifying and avoiding triggers such as heat, sun exposure, and certain foods.

Dr. Nancy Samolitis [29:02]: "Rosacea requires long-term maintenance... combination therapies are essential."

Innovative Treatments

• Vegas Cream: A compounded formulation used post-procedure to enhance healing and maintain skin health.

Dr. Nancy Samolitis [34:42]: "It's a melasma cream that we get compounded, and it really helps with post-procedure healing."

5. The Role of Fillers in Cosmetic Dermatology

The conversation shifts to the use of fillers, addressing common misconceptions and emphasizing the importance of professional administration to avoid complications.

Types of Fillers

• Hyaluronic Acid Fillers: Such as Restylane and Juvederm, used for adding volume and smoothing fine lines.
• Bio-Stimulators: Like Sculptra, which promote collagen growth for longer-lasting results.

Dr. Nancy Samolitis [35:05]: "Fillers are not inherently bad. The issue arises when they're administered by inexperienced providers."

Misconceptions and Best Practices

• Overuse and Complications: Highlighting the risks associated with non-medical providers and the importance of realistic expectations.
• Maintenance: Clarifying that fillers add volume rather than provide surgical lifting, advocating for a balanced approach in cosmetic treatments.

6. Controversial Treatments: Exosomes and Salmon Sperm Facials

Dr. Samolitis and the hosts discuss emerging but controversial treatments such as exosomes and salmon sperm facials, cautioning listeners about their efficacy and FDA approval status.

Sara Tan [47:24]: "Exosomes are only FDA approved for use in topical skincare, not for injections."

7. Effective Skincare Routines and Essential Ingredients

Emphasizing the fundamentals of skincare, Dr. Samolitis advises on key ingredients that provide tangible anti-aging benefits without overcomplicating routines.

Key Components

• Sun Protection: The most crucial step for preventing premature aging and skin damage.
• Retinoids: Essential for promoting cell turnover and maintaining youthful skin.
• Minimal Hydration: Encouraging personalized hydration practices without over-reliance on moisturizers.

Sara Tan [55:20]: "The most important steps are sun protection in the day and repair at night with retinoids."

8. Launch of Facile Skin Line on Sephora

The episode concludes with an exciting announcement about the launch of Facile Skin, Sara Tan's skincare line, now exclusively available on Sephora.com and in stores starting May 16. The hosts express their enthusiasm for the line's thoughtful formulation and trusted ingredients.

Sara Tan [05:14]: "Finally, we are exclusively available on sephora.com and will also be in stores on May 16th."

Dr. Nancy Samolitis [58:40]: "After listening to this episode, you can trust Dr. Sam. You can trust these products. The ingredients in them just work."

---

Conclusion

This episode of Gloss Angeles offers a comprehensive exploration of advanced dermatological treatments, guided by Dr. Nancy Samolitis's expertise. From the effective use of lasers and fillers to managing complex conditions like rosacea, listeners gain valuable knowledge to make informed decisions about their skincare routines. The launch of Facile Skin on Sephora further underscores the hosts' commitment to providing quality, trustworthy skincare solutions.

---

Where to Find Facile Skin:

• Website: facileskin.com
• Instagram: @DrSamilitis
• Sephora: Available exclusively on Sephora.com starting May 16th.

Transcript

[Verizon Ad]

Your old or broken phone can let you down when you need it most. But at Verizon, trade in any old phone from our top brands and get the most for it. Up to $2,000 in value for an amazing new iPhone 16 Pro with Apple intelligence and a new line on my plan and iPad and apple watch series 10. That's like a three for one. And you can get it on any plan. At Verizon, trade in your old phone for a brand new iPhone 16 Pro, iPad and Apple watch. The other guys won't give you that. Visit verizon.com today. Additional terms apply. Service plan required for Apple watch and iPad. Up to $2,000. Value based on iPhone, iPad and Apple Watch. G L A M Los Angeles.

[Kirby]

Hi, Kirby.

[Dr. Nancy Samolitis]

Hi, Sarah. Welcome to Los Angeles. It's Dr. Samilitis. Have we ever actually said her first name on this podcast? Dr. Nancy Samolitis.

[Kirby]

No one knows her first name. She doesn't have one.

[Sarah]

That's okay.

[Dr. Nancy Samolitis]

Her first name is Dr. And she worked very hard for that title.

[Sarah]

It's true.

[Kirby]

It's true.

[Dr. Nancy Samolitis]

How have you been?

[Sarah]

I've been good. I'm so sad that I. The one AAD meeting that I have not attended, literally since my first year of Residency, which was 2002, you were.

[Dr. Nancy Samolitis]

There, and that's how I usually get so much interesting information from you. When I go and see her in office, she'll tell me about all the new incoming things, the things coming from Europe, the things that she learned about. I happened to go this year. This was my first ever aad. I've been to the World Dermatology Congress. I've been to various other skincare conferences. This is my first aad. Dr. Sam, nowhere in sight. Everyone's like, who's your derm? I'm like, well, she's not here, unfortunately. If she was, I'd be sure you.

[Kirby]

Had a good reason.

[Dr. Nancy Samolitis]

Time to get me some dysport. Little injection just busted out of your purse.

[Sarah]

I also heard for the first time there was a puppy booth in the exhibit hall.

[Dr. Nancy Samolitis]

Dr. Sam.

[Sarah]

There was a puppy booth, and that was inspired, I think, by ophthalmology or some other specialty I'm on, you know, a lot of groups online with different physicians and some other specialty. They're like, we always have puppies at our conferences. And, you know, it really drives the attendance and the interest.

[Dr. Nancy Samolitis]

No, everybody was talking about these puppies at a.

[Kirby]

Was it like a sponsored booth?

[Dr. Nancy Samolitis]

Yes. It was just. I can't remember what it was for because by the time we got over There, the puppies had gone away, which we were very sad about, but it was there.

[Sarah]

Apparently, they can't work too many hours. No, no.

[Dr. Nancy Samolitis]

It's like child labor laws, essentially. So we. But they had signs being like, puppies this way. So, like, on the floor, it was you. And everyone kept talking about the puppies, and I was so excited, but I was also working, so couldn't get over there fast enough. So they were off the clock by the time I got over there.

[Kirby]

Oh, my gosh. Sad.

[Sarah]

I know you were.

[Kirby]

What were you doing?

[Sarah]

Were you.

[Kirby]

You had so many clients launches happening.

[Sarah]

My. My schedule of meetings is kind of full this year, and I'm opting to go to a new one that I haven't attended before. In Capri. Oh, yeah.

[Dr. Nancy Samolitis]

Not Orlando. My favorite.

[Sarah]

Well, yeah, that was part of it too. But the Capri meeting is run by a derm who is Italian and also practices in the US and she lectures on hair. And so it's kind of a hair focused meeting along with anti aging. But all things anti aging. More like a holistic approach, not just, you know, lasers and Botox and stuff.

[Dr. Nancy Samolitis]

Wow. Yeah, I'm interested in that one.

[Sarah]

I hope I learned something.

[Kirby]

I'm sure you will.

[Dr. Nancy Samolitis]

Okay. Dr. Sam, you're back. Is this episode four?

[Kirby]

Yeah, I think so. We've had. She's the only guest who has come on more than twice.

[Dr. Nancy Samolitis]

Yes. Or maybe. Maybe this is fit. We got to figure it out. We got to go back. But we love her because she's our gutter. Yes. We adore her. So, Dr. Sam, what is on your face? What are you loving right now?

[Sarah]

All right, where should I start? Well, so, of course, Facile brighten serum, My kind of ride or die, since day one of developing our skincare line is the first thing I put on. And then I have barely there, which is our lightweight moisturizer. And. And for my sunscreen today, I did something kind of fun. I mixed the Eltamd, the new green sunscreen.

[Dr. Nancy Samolitis]

I love it.

[Sarah]

With a little bronzer.

[Dr. Nancy Samolitis]

Ooh, for a little glow. Yeah.

[Kirby]

Wait, why is it green?

[Sarah]

You know, it's supposed to balance out redness, and I just turn red really easily, so everything I can do to make myself look less red, I'm okay with. But it's also great for post procedure. I think that was one of the main reasons they developed it and for people with sensitive skin. Okay.

[Dr. Nancy Samolitis]

Yeah.

[Kirby]

What bronzer do you like to use?

[Sarah]

I have a few different ones. I. You know, I'm really not like a makeup expert. At all. But I have one from Sisley.

[Dr. Nancy Samolitis]

Yes.

[Sarah]

Okay. That was recommended by the amazing Robin Black.

[Kirby]

Yep.

[Sarah]

Yeah. So, like, whatever.

[Kirby]

Yeah, I know.

[Sarah]

My God. I'm buying it.

[Dr. Nancy Samolitis]

She's incredible.

[Sarah]

Yeah.

[Kirby]

Wait, you're Lip.

[Sarah]

Oh, of course. My lip is Facile Lip jelly. I love the nudes. And I have great news about the facile products, you guys.

[Dr. Nancy Samolitis]

What is it?

[Sarah]

Finally? We are exclusively available on sephora.com.

[Kirby]

That'S so exciting.

[Sarah]

Congratulations. We will be also in stores in May 16th.

[Dr. Nancy Samolitis]

That is amazing.

[Sarah]

I know.

[Dr. Nancy Samolitis]

I remember when you were first telling me about these conversations. This was maybe two years ago. It's been a while.

[Sarah]

It takes a while.

[Dr. Nancy Samolitis]

Now it's happening. That's so exciting. I'm glad that they are focusing more on, like, actual experts and bringing those brands into the Sephora stores. My favorite is De Stress.

[Kirby]

Okay.

[Dr. Nancy Samolitis]

That's my favorite serum.

[Kirby]

I love that serum too.

[Dr. Nancy Samolitis]

I love the phyto spinky scene.

[Sarah]

Yeah.

[Dr. Nancy Samolitis]

That's the.

[Sarah]

Never travel without that one.

[Dr. Nancy Samolitis]

Yes.

[Sarah]

Yeah.

[Dr. Nancy Samolitis]

Because it just calms the skin, really, if you have any type of flare up. I think that's why I gravitate towards it. I just know it's going to play well with everything else in my routine. And if I'm traveling and my skin gets too dry and starts to develop bumps or anything like that, I absolutely love it.

[Kirby]

Is that the one that's specific for, like, acne? No, you have a certain year.

[Dr. Nancy Samolitis]

Right.

[Kirby]

Okay.

[Sarah]

The De Stress is more of a calming barrier restoring, really. Anybody can use it. Yeah. But it's really good for people who have sensitive skin or rosacea. Or if you're traveling and your skin's in a dry climate. Yeah, yeah.

[Kirby]

Okay.

[Dr. Nancy Samolitis]

Yeah. And then clear is the one for acne.

[Kirby]

So that one I gave to my friend Mia, who's also a doctor, and she was going through some breakouts and she was like, this is the best serum I've ever used. And it totally cleared up her skin. And she was like an instant believer. And I was like, of course. Because it's Dr. Sam.

[Sarah]

Nothing better than real testimonials from people, for sure.

[Kirby]

Okay, so have we not talked about this?

[Dr. Nancy Samolitis]

We've never asked her this question.

[Kirby]

Brought her on and be like, answer our question. Yeah.

[Dr. Nancy Samolitis]

We literally just sit her down, tie her hands behind her back and say.

[Kirby]

This one's an easy one, though. Cause we haven't talked about your background and, like, why you got into dermatology. Like, is this always been something that you wanted to do? Have you always been in love with Skincare?

[Sarah]

No. Well, I grew up in the 80s, and skincare was very simple, but also without, you know, social media and the Internet. It was kind of just like, go to the drugstore and grab stuff or what's in, you know, Cosmopolitan magazine. So, no, actually, I was always kind of interested in science, and my mom was a nurse. But I Honestly, when I started college, I didn't even know I was going to go to med school. So I don't have some interesting story where my whole life I've aspired to be a dermatologist. I didn't really even know much about what dermatologist did. Yeah, Even when I started med school, at the time, it was kind of much less. A little less glamorous, more like, you know, leprosy, syphilis, fungal infections, you know, warts, skin cancers. Obviously is kind of the bread and butter, really, of dermatologists. But I started med school. It was just kind of a natural transition for me because I was a biology major, and I was. I'm like, what am I gonna do with this? And so started med school. I like everything. I still. Internal medicine. I love surgery. I don't. I'm not crazy about pediatrics. Like, children scare me a little. But even, you know, er, I mean, psychiatry, like, I really liked everything. So it was kind of a hard decision. But I met a dermatologist during my second year. My roommate at the time, my sorority sister, was going to see him for lipo in the office, and I was like, huh, okay. So anyway, I went with her for moral support for the consultation. And he was all excited. He was like, oh, you're a med student, you should do derm. And I was like, eh, I don't know. And, you know, he removed one of my moles, whatever. And then I observed her lipo surgery, which I think a lot of people don't know that there was a dermatologist who pioneered something called the tumescent technique, which allowed liposuction to be done more safely in the office with smaller surgical tools. So less risk, less downtime, smaller incisions. His name's Jeff Klein. I actually did a training with him. He's in San Juan Capistrano. But anyway, so that dermatologist offered me to shadow with him for a couple weeks in the summer. So that was kind of my first intro into my school. My med school actually didn't have a dermatology program. Um, so after I spent two weeks with him, actually, by the way, the first time I saw a Mohs surgery where he was Taking out a skin cancer and doing the repair. I almost fainted, and I had to leave the room.

[Dr. Nancy Samolitis]

That is so funny, because you observed.

[Kirby]

The liposuction and that didn't scare you at all?

[Sarah]

No, no. Yeah. Anyway, I mean, it's kind of. Liposuction's more. It's like, so interesting, but you don't see all the, like, you know, the insides and the arteries and the ve and the muscles and all the. All the stuff when you peel the skin back. But anyway, then I had to kind of scramble because derm is very competitive, and I hadn't planned it out, so I didn't have any research projects or any kind of recommendations from dermatologists other than this guy who was not an academic. And so I had to do a bunch of rotations away from my school. And anyway, somehow I got in.

[Dr. Nancy Samolitis]

And look at you now.

[Sarah]

Sometimes I wonder how I got in still.

[Kirby]

But no. Do you feel like, like you said that your med school didn't offer dermatology? Do you think that's different now because dermatology is so popular, especially, I feel like, among, you know, up and coming med students.

[Sarah]

Yeah, I mean, that's a good point. But dermatologists are still kind of a. Amongst, like, all physicians. You know, we don't have as many residency positions. You know, we're still a little bit of, like, a minority of all physicians. There were only two residents in, like, my program every year. Oh, wow.

[Kirby]

So it's still super competitive.

[Sarah]

I mean, so, yeah, there are a lot of applicants for a pretty small number of spots.

[Dr. Nancy Samolitis]

One thing that I liked about dermatology that I actually was talking to several dermatologists about is that you kind of see a patient through their life. You. You could do, you know. You know, you're keeping them from getting melanoma to, like, as they get older, like, what are they experiencing? And you're. You're kind of going through the motions with them throughout their entire lifetime. So, like, sometimes I feel like people change their primary care providers frequently. I don't know. I feel like when people ask me who my PCP is, I'm like, I don't know. But my dermatologist is anesthesia. Totally.

[Kirby]

It's like almost like a dentist.

[Sarah]

Yeah.

[Kirby]

Like the ones that you keep, like, forever.

[Dr. Nancy Samolitis]

Yes.

[Kirby]

So important.

[Dr. Nancy Samolitis]

Totally.

[Sarah]

I mean, yeah, I have a lot of patients I've been seeing for. I mean, I've lived in California since 2008, and I still see patients one day a week in an office in Long Beach. That's right. I've been seeing patients there since 2008, so I have, like, whole families. I've seen kids grow up. They come in when they're in their 20s and they're like, remember, I was here when I was 12. And so, yeah, it is really nice to have that kind of ongoing relationship with patients.

[Dr. Nancy Samolitis]

Totally. Okay, we're going to get into the listener Q and A. I know the listeners are thrilled to hear about your background, but they now are like, answer my the question.

[Sarah]

Juicy stuff.

[Dr. Nancy Samolitis]

Yes. Okay. Lasers. Lots of questions about lasers.

[Sarah]

Great. I love lasers.

[Dr. Nancy Samolitis]

And I feel like there's so much conversation in general about lasers right now. So much because of the demonization of filler, which is weird. And also unrelated to laser, which we can get to. Yes, I know, but. Okay. Are there lasers best suited for rosacea or skin redness?

[Sarah]

Yeah, absolutely. We just got one at Facile called the Derma V. Okay, so type of laser called vascular laser. These have been around, actually. Some of the original devices were vascular lasers known as pulsed dye lasers. Back then, when those were new, they caused a lot of bruising. So when you try to target blood vessels using heat, if the blood vessel explodes because you heated it too much, you'll have a bruise, but the effect is usually very good because you basically, like murdered those blood vessels. So over the years, honestly, I mean, with this and all lasers, there haven't been that many new devices or new, like, types of lasers. We've just gotten better at safely using the same sort of devices, less downtime, able to use them on different skin types, more effective, etc. So the DERMAV is something called a KTP laser, and it's pretty versatile. It mostly treats red things. So lots of different types of red things from scars, surgical scars, acne scars, rosacea, redness just from sun damage, broken blood vessels, all that kind of stuff. But it also can treat pigment. It's not the best for pigment, so I usually will combine it or suggest doing that and then doing a different laser to address the pigment in the sun damage.

[Dr. Nancy Samolitis]

How often or how many of these sessions? Obviously it's dependent on the patient, but typically, would you recommend for someone if someone is coming in for, let's say, rosacea?

[Sarah]

So redness is one of the hardest things to treat because you can think that it's gone and then it comes right back. Yeah, so it's hard to control the blood vessels, really. Typically with these types of devices, you will see a noticeable improvement with one session. I tell people to maybe consider planning on doing three or four. Most people will do one or two, and then they'll be good for maybe three months or six months. And then when the red comes back, they do it again. So you don't necessarily have to do multiple treatments back to back. And rosacea, which is different than redness.

[Dr. Nancy Samolitis]

Yes.

[Sarah]

And flushing and redness from sun damage usually needs to be treated with some sort of medical therapy, topical and or oral, in addition to laser. And I actually did a research project on this at the end of my residency where we did laser treatments with a laser called the V beam, which was like the OG vascular laser and ipl. And we saw that the redness improved. But we looked at little tiny biopsies under the microscope before and after. And the disease process of the rosacea didn't change that much. So it kind of gave patients the cosmetic benefit, but they still would need to be on some sort of treatment for rosacea to make the disease process, the inflammation kind of keep it at bay.

[Dr. Nancy Samolitis]

Got it.

[Kirby]

Okay.

[Sarah]

Yeah.

[Dr. Nancy Samolitis]

Have you heard of the Avava laser?

[Sarah]

You know, I haven't, but I looked it up.

[Dr. Nancy Samolitis]

Yeah.

[Sarah]

Because I've heard the name kind of thrown around and I'm kind of. I feel like the website was a little bit vague as far as I had a hard time figuring out kind of exactly how this device is a little bit different other than the way the pulse is delivered. And this is the way a lot of lasers are made to be safer and with less downtime, is that the heat is delivered more slowly or more spread out instead of a very rapid pulse that sometimes can cause more damage. So even though the technology and the type of laser is the same, the pulse is different. That seems to be the case with the Avava. It looks like something similar to the original Fraxel, which was a wavelength of 1550 nanometers. So that targets the dermal tissue for like, remodeling and like firming and tightening.

[Dr. Nancy Samolitis]

Okay, got it. So this would be like a kind of like a lift firming laser that you would look into if you were looking into something like that.

[Sarah]

I don't like to use the word lift.

[Dr. Nancy Samolitis]

Okay.

[Kirby]

When we're talking about lasers, what is the target goal with a laser?

[Sarah]

I feel like the words lifting and tightening sort of conjure unrealistic expectations because it's like, do we want all this skin to come up? Like, you know, I wish that a laser would do that or radio frequency or ultrasound, which are technically not laser, but there are other heat based devices. I just don't think it's possible to achieve true lifting of skin laxity and tightening without surgery. And I think this is where a lot of cosmetic stuff has gone wrong because we're trying too hard to achieve surgical results with non surgical things. We're really. Those treatments should all go hand in hand surgery and non surgical. Right. But when we say the laser is targeting dermal remodeling, it's for improving the skin quality. So I guess the word firming is maybe more appropriate.

[Dr. Nancy Samolitis]

Okay. Yeah.

[Kirby]

Okay. I like that.

[Dr. Nancy Samolitis]

Yeah, same.

[Kirby]

It's funny, though, because I was telling Kirby, my sister asked me. She sends me questions that her friends always ask her, and she's like, in her early 50s. And she was like, how do you get rid of a double chin? I was like, surgery.

[Sarah]

Surgery.

[Kirby]

She was like, what? Really? There's no pro. I was like, no. Like, I don't know. Like, there's just too many.

[Sarah]

Like you said, we've tried, we've tried, and the non surgical treatments are not great. And you probably end up spending more. And then, like, not much happens. And then you just have the LIPO that takes 30 minutes. Exactly.

[Dr. Nancy Samolitis]

I mean, if Kybella was really that effective, nobody would be getting liposuction on their chin. You know what I mean? I mean, everyone would opt for those. But I talked to people. I actually know a lot of people that have tried Kybella, and I would say 90% of them are not happy with their end result. There's only been one person that I have met who literally, I think, only needed two sessions of Kybella, and she's the most snatched jaw I've ever seen.

[Sarah]

Yeah, I actually did the clinical trial for Kybella, and when we were doing the clinical trial, I also was doing liposuction at the time. And so every patient in the trial came in every month, and they had six months of treatments back to back to no matter what their results were looking like, that's how many they had. And we were allowed to gauge how much Kybella we use based on how much fat they had. But basically at the end of the treatment series, they had a lot of treatments. And every time you do it, there's swelling and discomfort, and then the fat gets kind of hard and lumpy, and it takes a while to recover from that. And in my head, while I was doing the trial, I'd be like, why wouldn't these people just do lipo? And honestly, it may even end up costing the same or more. And then you go through all that unpleasantness. And I think when they first launched it, a lot of People were like, oh, well, maybe I'll be the lucky one who gets a good result with two treatments, because some people do. Some people seem to be good responders, but it's just the. I think the risk kind of outweighed the benefit, and people realized over time that it wasn't magical.

[Dr. Nancy Samolitis]

Yeah, I'd love to know what about the special people, like what I make.

[Kirby]

Up that makes that.

[Sarah]

Yeah, they probably have only superficial fat, because you can have some fat under the muscle. That's not really addressed with Kybella. And also, the skin tightening is an issue, so probably has to do with the age of the patient and the quality of their skin, their genetics, their bone structure. Because if somebody. There are a. Of other things that are happening in the neck that causes a double chin. It's not just the fat. Right, right, right, right.

[Dr. Nancy Samolitis]

Is there. Are there any other options outside of lipo for this area there?

[Sarah]

I mean, there is a type of procedure called a platysmaplasty that addresses the muscle. It may be done in combination with lipo. Now, we're getting outside of my scope of expertise here, but I'm familiar with a lot of these procedures, but I don't do them. But the platysmaplasties, where they tighten up the muscle also surgically, so they have to make an incision. But it's a pretty minimally invasive surgery. But if you have too much extra skin, unfortunately, you just have to pull it up and cut the extra skin off and. Yeah, you know, reattach it.

[Kirby]

Okay. This is a question we get a lot, too, regarding lasers. Which lasers do you recommend for women of color?

[Sarah]

Yeah, so usually we think about first, like, what are we treating in women with skin of color? And it's usually not so much sun damage as it is, like, discoloration, uneven skin, skin tone, and acne scars, I think, are kind of the main things, because usually when you have more melanin in your skin, the sun damage, the appearance is not so much like, the creepiness and. And like all the. The dullness and things that you see in people with, like, what we call, like, type one through three skin, so with less melanin. So I have a few favorite lasers. And actually, if you talk to a lot of the laser experts who've developed the devices, I mean, we have learned ways to safely use almost any kind of la laser on darker skin types now. And this is why it's so important to see somebody who knows what they're doing with their laser, because it's all about Tweaking the settings. Like, I can use my. Sometimes we'll see people with darker skin and they have some redness and broken blood vessels and rosacea. Typically, a vascular laser would be more dangerous on darker skin because the heat is also attracted to melanin as much as it is to hemoglobin in blood. So you can accidentally dump too much heat into the skin, kind of similar to hair removal where the heat can't tell the difference. But if we can adjust things like the cooling and the type of pulse that we are delivering the heat with, we can get a safer result. And really all skin types. But the resurfacing lasers for acne you can use, you know, when I'm at meetings, we can't say, like the brands of, of lasers. And so I'm like, you know, a 1927 nanometer laser. You guys probably don't. Yeah, but like a clear and brilliant or a very like, low density fraxel or some kind of device like that, a non ablative, fractional resurfacing type of laser is usually very safe to use on darker skin. If somebody does have melasma or a tendency to get hyperpigmentation, their skin should always be prepped with some sort of brightening product to kind of get the skin less able to overproduce pigment as a consequence of the treatment. And so usually if you prep the skin and then after you're healed, and maybe we modify the aftercare as well and then get them back on the brightening product, you're gonna have better luck with treating things like uneven pigmentation without as much risk.

[Kirby]

I've been seeing a lot of people talk about Pico lasers on my Instagram. Are you a fan?

[Sarah]

Well, you know, I don't have a Pico laser.

[Kirby]

Okay.

[Sarah]

And that says, well, I mean, I can't afford to buy like every laser that's in existence. Like, it's just not real.

[Dr. Nancy Samolitis]

There's not enough space.

[Sarah]

I mean, some people do have a lot of devices. And I wonder, I'm like, how much debt do you have?

[Dr. Nancy Samolitis]

And that's why they're overcharging for these.

[Sarah]

I mean, in a perfect world, you know, the, the salespeople come in and they're like, oh, if you do this many treatments a week, you'll pay for it in like, this many weeks. And sometimes it's hard when you buy a new device to get that many treatments. So Pico originally was developed for tattoo removal. And, you know, Pico second technology is kind of like what I was talking about before. The type of laser that a pico is is the same type of laser that's been around for tattoo removal for a long time. Usually it's either alexandrite or ND yag, so it targets pigment. But they sped up. So picosecond is a smaller duration of time than a millisecond, which is what most lasers are traditionally kind of measured in their pulse delivery time. And so they learned that when you deliver the pulse faster, you get less tissue, bulk heating, and less damage, but very specific activity on your target, which is. And so when the pico laser first came out, people were like, great, but I don't want to do tattoo removal. So, like, what else does this machine do? So, technically, you could target any kind of pigment, like freckles and sunspots or melasma. And then you can do something called picotoning, which is something we also do with the Derma V, where it's sort of like a whole face, sort of warm everything up, and it just basically, like, stimulates the circulation, and it's sort of tricking the collagen into thinking there's an injury happening because everything's warm, warmer than a normal temperature. And so therefore, the, like, healing activity should be sort of switched on. So the pico, it's an interesting device. I just don't. Because I don't have one. I'm, you know, it's not something I know that much about.

[Kirby]

Okay. Okay.

[Dr. Nancy Samolitis]

I feel like tattoo removal should be something people are gunning for because everyone wants to get rid of a tattoo. Like, there's so many people that do. It's like an extra income stream.

[Sarah]

I used to do tattoo removal, and it's not that fun. I mean, for the person doing it.

[Dr. Nancy Samolitis]

Right.

[Sarah]

I feel like I've paid my dues. I did a. Yeah, basically a fellowship with a laser expert. His name's Mark Taylor. He's in Salt Lake City. And speaking of people who have every laser, I mean, he has, like a 40,000 square foot office with all these devices that are things. It's like a laser museum in there. Wow. So I really got to learn a lot about, like, which devices I like and what I thought that I really needed in my practice. Cause I got to sort of, like, play with all of them.

[Dr. Nancy Samolitis]

That's so cool.

[Sarah]

But we did do tattoo removal in that practice. And you paid your dues?

[Kirby]

Yeah, yeah.

[Dr. Nancy Samolitis]

Like, I've been there and I've done that.

[Sarah]

And unfortunately, tattoos are really hard to remove. Like, unfortunately, they usually take a lot of treatments and and you do the treatment, you're like, wow, that looks really bad. No way is the tattoo gonna survive this. And then it looks kind of the same the next time you see it.

[Dr. Nancy Samolitis]

It's still hanging on. It's still hanging on. That pizza on your butt. Still hanging on.

[Sarah]

My husband has the Adidas symbol on his ankle that he hates. No, I cannot tell you how many times I've lasered it. And it looks basically the same.

[Dr. Nancy Samolitis]

It's a cockroach. So it keeps coming back.

[Sarah]

I don't know exactly.

[Kirby]

Word to the wise.

[Sarah]

He loves when I talk about it.

[Dr. Nancy Samolitis]

I'm sure he's thrilled.

[Kirby]

I can't wait to look at his ankle next time.

[Dr. Nancy Samolitis]

Yeah, I'll be like, show me your ankle immediately. Okay. Rosacea treatments in general. You actually were talking to us a little bit before the pot. We started this about a topical that you use. Right. But could you walk through what are options for people? They have rosacea. They're really looking to help take it down and see some results.

[Sarah]

Yeah. So usually I love treating rosacea, by the way. It's something that I get excited about because I feel like we can usually get it under control. It's really, unfortunately, just about the long term maintenance that I think it's important for the physician or provider to make sure the patient understands that this is like a long term, like treatment. Because rosacea is something that you sort of. All of a sudden you have it. And there's probably some genetic component and there's some sort of environmental triggers that come in. And then once you have it, it's. It's lurking. So sometimes it flares up and sometimes it gets better, but it's kind of always with you. So it's something that you always have to pay attention to and continue to treat. Most people will figure out, you know, kind of the first thing you can do, lifestyle wise, is what kind of things trigger my rosacea. So usually it's heat and sun and exercise. And so if you love to do hot yoga, it's going to be harder to treat your rosacea because your skin's always like turning red and flushing because you're heating it up. For some people, it's certain foods, usually alcohol and spicy foods are sort of the classic ones. But some people come to me and they're like, oh, for me, it's when I eat cheese or, you know, something else. And so maybe they have a specific sensitivity to that food. There's a lot of theories, I mean, in general, in all of medicine, about like, what's the role of the gut.

[Dr. Nancy Samolitis]

Yes.

[Sarah]

And, you know, we just don't know enough right now. But there probably is a connection with, like, gut inflammation and skin inflammation. And rosacea is one of these specific things that, you know, seems to definitely be correlated with some, like, food intolerances and things like that. So we just haven't figured it out enough yet to be able to make that a treatment, like, take this, this, you know, supplement, or this probiotic, or eat this thing, and your rosacea will get better. Totally. For a while, it was thought that H. Pylori, which is a bacteria that lives in the stomach that's also responsible for causing certain types of ulcers, that that was more significant in people who had rosacea. So they saw this correlation and they're like, maybe if we treat the H. Pylori bacteria, their rosacea will get better. But. But it never really panned out. So the other thing that is kind of a hot topic these days is that rosacea has some correlation with the number of mites that live in our skin. The little mites called Demodex, they have, like, long tails and little, like, short arms. And when we scrape the skin and we find them under the microscope, they're sort of like, swimming around.

[Kirby]

Don't dogs have Demodex?

[Sarah]

Yes, there are different species of mites, and dogs have. A certain one I think is different than the kind that we have. Okay. But it's, like, part of our normal flora. But in people with rosacea, there seems to be sort of this overpopulation of the mites. And then when we use ivermectin, which is also kind of a hot topic ever since COVID nobody knew what ivermectin was before. But interestingly, ivermectin seems to help with rosacea both topically and orally.

[Dr. Nancy Samolitis]

Oh, wow.

[Sarah]

We usually don't have to use it orally. I actually just prescribed it recently to somebody because she was not responding to all the other typical therapies for rosacea. And the pharmacy kind of gave me some trouble about it. I won't say what pharmacy, you know, one of the big pharmacies. And they wouldn't give her the medication, I think because of this whole, like, sort of ivermectin fiasco about, like, people are hoarding it. Wow. So anyway, we found a pharmacy that was happy to prescribe it to her, and she's doing better. Oh, good for her. Finally, usually we treat rosacea with sort of combination therapy, just like we do with acne, because there seems to be A combination of factors that are, you know, causal. So we usually do the ivermectin. Metronidazole has long been kind of a staple in treating rosacea. We don't really understand the mechanism of that. It's just. It's like that works. And then azelaic acid is another one that helps with both the redness and the inflammation. So we in derm, we love to do compounding, where instead of me sending a bunch of prescriptions and you layering them all on, we have a pharmacy that will mix a combination of the things that work the best for rosacea.

[Dr. Nancy Samolitis]

Hence why the Vegas cream exists. If she was allowed RIP Vegas Sephora, the Vegas cream would be there because the Vegas cream is the best name for cream.

[Sarah]

I know.

[Dr. Nancy Samolitis]

That's the. If you guys are new listeners, that's the melasma cream that Dr. Sam gets compounded. And at first, we had to send it to our. We. You had to send it to a Vegas compounding pharmacy? Yeah, it's the only place that would do it.

[Sarah]

Yeah.

[Dr. Nancy Samolitis]

And then now you can, I guess, get it here.

[Sarah]

Yeah. So I found, you know, that was a great pharmacy recommended to me by one of my colleagues who lives in Vegas. And, you know, somehow their formulation, even though a lot of people will do compounding with those ingredients, I found that their formulation seemed to be kind of magical. So, sadly, that pharmacy shut down. And so we have found another pharmacy that makes a nice formulation.

[Dr. Nancy Samolitis]

So we're going to keep calling it the Vegas cream, though.

[Sarah]

I think that's fine.

[Kirby]

It's a great name.

[Sarah]

I think that's fine.

[Dr. Nancy Samolitis]

It is.

[Kirby]

Oh, okay.

[Sarah]

Okay.

[Kirby]

So we have to talk about filler, which Kirby was mentioning. I feel like there's been this demonization of filler, and then people are trying to find all of these different alternatives to it. And you're like, well, filler is not that bad. But tell us.

[Sarah]

Yeah, tell us.

[Kirby]

What are we still learning about filler?

[Sarah]

Well, you know, just like I was mentioning with lasers, you know, we've had the same types of lasers around. There haven't been that many new ones. We've just just modify the ones we have. Kind of the same thing goes with fillers. We've had hyaluronic acid fillers since, like, the early 2000s. I don't remember so long ago. I don't remember what year it was. This was during my residency. And so I was like, ooh, I want to learn how to use this stuff. And we had Restylane, and we had Juvederm. We're the only ones. And we had collagen. And collagen, sadly, because its duration was so short compared to the hyaluronic acids, they took it off the market. But it was a nice filler. It was very smooth and thin and you could do a lot of things with it. More superficial type of filler. So that went away. And then we had Radiesse and Sculptra, which both became available also kind of around like 2005ish. I don't remember the exact release dates, but all of these fillers have been around for a while. And now the hyaluronic acid fillers have sort of expanded their family. Where there are certain ones that are thicker and have a. What's called a higher G prime, that means that they can resist force better. And so those are ones that we use on top of bone, like cheeks and jawline. And then we have thinner fillers. Some. Some of the ones are similar to old collagen, where you can sort of just like smooth things out, where there's fine lines and it doesn't create any volume. So we have a lot more types of fillers, and they're meant to be injected all kind of with different techniques. And so unfortunately, I think the number of injectors has increased so much. And the requirements for being an injector in some states, you don't even have to be a medical provider to be allowed to do this. And so I think that's what's really kind of gone wrong. It's not that that fillers are bad or that they always have to be dissolved or that they stretch your skin out and then it never goes back to normal. Or maybe like some people say, oh, they never go away. But, you know, I think in a way that's not a bad thing. And if we need them to go away, they're kind of easy to dissolve. And so I've been injecting fillers for like, 20 years, and I rarely have to dissolve. I'm not going to say never. I'm not going to say I've never had to dissolve a filler that I did, but it's pretty rare. And if it wasn't rare, I wouldn't want to do it anymore. Like, I stopped doing a lot of procedures where I'm like, God, I just see a lot of complications from this and stresses me out and I don't want to do it anymore. So. But I don't feel that way about fillers. I feel like it's. In my experience, it's been mostly all good things, including under eye filler, which.

[Dr. Nancy Samolitis]

Oh, really? Okay.

[Sarah]

Yeah. I do a ton of under eye filler and it's usually great. It's all about picking the right candidate and using the right product and not using too much. Like, I think that's really. Yeah. All there is to it.

[Kirby]

Do you feel like you have less patients coming in asking for filler, or do you feel like it's been the.

[Sarah]

Same, maybe a little bit less? Like sometimes when I see new people who've never had it, they. They're like, oh, I'm scared to filler. Is there something else? And I'm kind of like, well, really not for volume. If you need volume, filler's kind of it. Or if you have like a wrinkle, a sort of etched in line, you don't need a fat transfer for that. You can't really always get the results you want with laser or microneedling or PRP injections like filler. It works. And if it's not great, it is easier to correct than surgery or fat. And not that that those things don't have their place as well. But I think what a lot of people who are saying like I should have more surgery and less filler don't understand is that I do procedures on people with facelifts all the time. Like every day the patients with facelifts are doing their maintenance and it's filler and toxins and laser and so 100%.

[Dr. Nancy Samolitis]

I think that's such a crucial point because I think some people think I'm gonna get a facelift and that's it. Yeah, I don't have to worry about anything else. But even, even plastic surgeons that I've interviewed have said no, they still have to go in and they're still getting, you know, dysport, Botox, whatever, or some type of filler to help with that residual volume loss as we age, because we do age and we do use lose volume. I also think a big part of this too is how frequently you are getting injected. It's not just that there are these inexperienced, unskilled providers injecting you. But then also, I remember when I first started learning more about injectables in general for neuromodulator, it was come in every three months. Like that was kind of like hammered into my brain, not from you, but like the public perception. It's like you go in every three months for Botox or dysport or whatever, and then filler maybe every four to six. And I've gotten filler with you in the past. I can't remember the last time I've even done filler.

[Sarah]

Yeah, it's been a minute.

[Dr. Nancy Samolitis]

Yeah, it's been like several years. And even when I was. I was not coming to see you consistently for every three, four, five months. It was maybe once or twice, if that a year.

[Sarah]

I think that mentality of, like, do your Botox and your filler, just, like, make your next appointment and we'll just do all the same stuff, kind of came from the collagen days, because collagen lasted, like, about three months. And so I think as the fillers got better, a lot of patients, and I see patients like this still, they come in and they're like, I want filler. And I'm like, where you don't need it? And I send them away or I say, do microneedling or do, you know, a cool peel or a laser or, you know, something else to make your skin better. But, yeah, filler, you just. I'm not gonna put it in your face if you don't need it.

[Dr. Nancy Samolitis]

This is a question. This is like an actual verbatim question. It says, recommendations for older skin. I tried Sculptra. It didn't do anything. I've done IPL seems to help with texture. I have loose skin along my jawline. It runs in my jeans. I just want to look as fresh as I can without using fillers.

[Sarah]

Oh, no. Well, you know, fillers don't help with loose skin necessarily. Just like I was saying with devices, heat based devices, I wish they would tighten that skin, the jowl or whatever you want to call it. And you can't do it with filler either. And I think a lot of people are trying to. They're like, oh, if we put a bunch of filler up here, it'll lift everything up. And to some degree, if somebody has a lot of volume loss and they have, like, loss of bone and fat, and when you replace that, it supports the skin a bit. But I think where some people get in trouble is they're trying too hard with filler to lift the skin. And, you know, Sculptra is also a great product. It is a bio stimulator. So we inject it into the deeper compartment kind of under the skin, and it stimulates growth of new tissue. But it also. It's a little bit unpredictable. So some people seem to be good responders, and some people seem to need a lot more Sculptra to get the same outcome. But at the end of the day, it still creates volume more than it actually creates lift. Okay. So with Sculptra, I definitely think that usually when people are disappointed, they have. They just haven't had enough or maybe what they're trying to achieve is not the right thing. So the person who's doing the procedure should be counseling you about what is a realistic expectation for this procedure so that you're not bummed. IPL is for discoloration, so redness, brown spots. It's not for skin tightening. It can improve the skin quality. There have been a lot of studies that show that just, like, heating the skin up with that, like, laser toning or whatever you want to call it, Laser Genesis. When you do an ipl, there can be some, like, improvement of the skin quality, but it's not going to, like, lift true skin laxity.

[Kirby]

Okay. So don't trust anyone. I was trying to sell you a laser to lift and sculpt, which I.

[Dr. Nancy Samolitis]

Feel like also the filler facelifts. Yeah, filler facelifts. We need to put that to bed because I just feel like you end up looking like a alien.

[Sarah]

Too much filler.

[Dr. Nancy Samolitis]

It's just.

[Kirby]

Yeah, it's like puffy. You don't want to look like that top.

[Dr. Nancy Samolitis]

Heavy. Like really weird. Big up here. I don't know. It's just getting bigger. Yeah, I just feel like this part of your face just like he's like, getting bigger. It's weird. It's just weird.

[Sarah]

No, it's a. It's a shame. I. It's. Yeah.

[Kirby]

No, but I'm glad that you said that because I feel like we needed to hear it. Like, everyone just needed to be reminded. Okay, here's another question from a listener. What are some common treatment upsells that aren't worth it dollar for dollar, and are pushed by less ethical, greedy providers? I'm thinking, for example, about PRP and wondering if the add on almost doubling the cost of microneedling really doubles the treatment efficacy.

[Sarah]

Okay, so that's a great question. And I talk. We. We do PRP in my office. And I really like prp. I do think so. Basically, the concept of what PRP is doing is we're taking your blood and we are harnessing the. The platelets into sort of a concentrate, and then we are using that in comb with your procedure. So we're creating some sort of injury, whether it's with microneedle or laser. And then the healing process requires growth factors to sort of amplify the outcome. If you just put PRP on your skin topically, it's probably not going to do that much. But I think when you make some sort of injury, including just an injection, when you do an injection, there's sort of like a stretching out of the skin. And so there's, there's some still a trigger of a wound healing sort of reaction happening. And then the PRP amplifies it. I usually, if somebody has acne scars or deeper wrinkles or they really have kind of a difficult sort of under eye with like crepey skin, really thin skin, maybe they don't need filler or they had filler and it didn't do everything they wanted for their under eye. Cause the under eye is like everybody's most hated part of their face. Everybody. I'm just like, nobody ever says my under eyes. My best feature. Oh my God.

[Dr. Nancy Samolitis]

If there is, please reach out to us.

[Sarah]

We want to meet you. So anyway, so I usually suggest PRP in certain instances, but I definitely, I have a lot of people who come in and they want to do something just for maintenance, skin rejuvenation. And their skin's good and it's fine. And I say do micro needling, but you don't need the prp. Like, so I do think it's beneficial if you kind of need a little more help than what just microneedling can do. But definitely for people who it's not in their budget. And if they ask me, should I do one microneedle PRP or should I do three microneedlings which maybe cost about the same, I would definitely say three microneedlings and just skip the prp. But there are also a lot of these sort of upsells that are things that are not FDA approved. And I think everybody's excited. They want to be the first one doing this or that. Like, salmon sperm is on my list, exosomes. And we just don't have enough information about those things. And even though exosomes seem really promising, there's a lot of, it's like, where are they coming from? How are they harvested? What kind of tissue? What is the. What kind of exosomes are they? Like, there's just, just to say, oh, I have some stuff with exosomes and I'm going to put it, inject it into your skin or give it to you to put on. You know, after microneedling, we just don't know enough about what's the right way to do it or which companies are making legitimate ones to really be able to, you know, say that that's effective and worth the money.

[Kirby]

So it is not FDA approved Exosomes.

[Sarah]

Exosomes are only FDA approved for use in topical skin care. Not for, like, injections or I guess, you know, micro needling. Where you're applying something topically is sort of that gray zone where it's like, it is topical. It's not really an injection, but you're, you know, really trying to needle it into the skin. But it's interesting because I've purchased some exosomes from a company that is. Is fd. They have an FDA approved clinical trial. So I'm like, oh, I'm gonna try it for myself with, you know, post laser to see if it heals faster. Looks better to try to, like, make some hair grow. Whatever I can do. And, you know, they're really expensive and they need to be frozen and they can't be, you know, they. Once you thaw them, they have to be used right away. And so I kind of don't understand how ones that aren't like, that could be as legitimate as the ones that are. Because it's kind of like we harvest this from living tissue. So how can it sit on a shelf and still be as potent? Yeah, you know, I don't know. We just don't know enough.

[Kirby]

And then same with salmon sperm facials. So I think that I've been seeing a lot of people. Well, you know, in Korea, for example, you can get it injected and they might offer that here in the States. But that is not FDA approved.

[Sarah]

So that is not FDA approved. It is FDA approved. Use it topically. The poly deoxyribonucleotase. Not like, oh, my God, PDRN or.

[Kirby]

Yeah, but like you said, it's the gray area where it's like micro needling.

[Sarah]

Right, Right. I just think we don't have enough data. Okay. To be like, oh, yeah, this is a great treatment. So as soon as there is, I want to offer it. Yeah.

[Kirby]

I will not do anything until Dr. Sam.

[Dr. Nancy Samolitis]

Is that what we're running? PBRN?

[Kirby]

Yeah.

[Sarah]

So they have like a skincare line with that. But, you know, we. I don't know if we know, like, just again, just putting it on your skin without there being some sort of, like, trigger for your skin to heal. You don't always get that same effect.

[Dr. Nancy Samolitis]

Okay, interesting. Because I bodiced Roger. Oh, you did Office dialvana. It just came in and I'm like, I truly was trying to figure out what the hell this was and how to use it.

[Kirby]

Yeah.

[Dr. Nancy Samolitis]

Because the instructions are just like. It talks about putting it on your Skin.

[Sarah]

Is it in a syringe?

[Dr. Nancy Samolitis]

It is.

[Kirby]

That's the thing. Like, do you feel like it's even, like, efficacious at all? If it is like, in a bomb, It's a moisturizer on the shelf.

[Sarah]

Yeah. I don't know.

[Dr. Nancy Samolitis]

It's a moisturizer.

[Sarah]

And I think most of the data that I've seen are for, like, wound healing.

[Dr. Nancy Samolitis]

Yes.

[Sarah]

So, you know, I guess just like, with growth factors and other things that are in skincare, it's like, what are they really doing? If you're just putting them on your skin, is it really getting to where it needs to go if there's not a wound or you're not like, post procedure? Is it real? What is it doing?

[Dr. Nancy Samolitis]

That's what Fariha was talking about. So we had a nail artist on the show and she was talking about going to Korea and she has rejuran. She brought back the physical actual creams. It was because she had done procedures. And this is for post. It's essentially for post procedure. So basically I have to come in and do cool peel, and then I can start using it and maybe see the back benefits of it.

[Sarah]

Let me know, I'll keep you posted.

[Dr. Nancy Samolitis]

I did make sure that it was the actual product and not some kind of bootleg. Weird stuff.

[Sarah]

Yeah. So, yeah, no, I hope it's great.

[Dr. Nancy Samolitis]

Same.

[Sarah]

I've heard that the injections. So with that and other things that are in Europe, like the skin boosters. The thing is, when you do these injections, you have to inject, like, little drops all over and it's kind of unpleasant to have it done, and then you might be bruised. And so there's. There's, like, some recovery involved. And so I guess the question is, do you really want to, like, keep doing that? I feel like the most successful procedures, in my opinion, are things that people don't mind doing, like, oh, cool peel. Oh, it's easy. It took five minutes. The healing wasn't that bad. I didn't look that bad. I saw a difference. I want to keep doing it. And then you do it for maintenance. When something's, like, really painful and the downtime's kind of unpleasant, you're sort of like, I think I like it. I think I want to keep trying. But there's never. I don't want to go through that again.

[Dr. Nancy Samolitis]

Never a good time to want to go through it.

[Kirby]

I've seen the photos of the salmon sperm facials via injection, and sometimes it takes a while for it to, like, it looks bumpy. It looks bumpy in your skin. And I'm like, really? Time for that?

[Sarah]

Yeah, I don't have time for that.

[Dr. Nancy Samolitis]

Yeah, like that.

[Kirby]

Yeah, no, it's like also, like, gives me like my.

[Sarah]

Yeah, yeah.

[Dr. Nancy Samolitis]

Okay, so there's exosomes and then there's this question, which is what exactly are growth factors and what should we look at when evaluating different. Different formulas with them? I'm curious about this because in our line of work, we are always pitched lines with growth factors in them. Growth factors from apples. Growth, like, literally, like, it's like. And then they do the apple demonstration where it's like, this is with, you know, this growth factor and this is without. And then it's like, no, the apple.

[Sarah]

Is literally just on the one apple's all brown and dried up and the other apple looks great.

[Dr. Nancy Samolitis]

No, this is just the apple going through its life cycle. Like, what are we doing? So what are growth factors? And if we are going to look for growth factors or are we trying to be sold growth factors in a skincare product, is there a way to evaluate what's good and what's not?

[Sarah]

Yeah. So this is kind of something that's been around for a long time and has always been a little bit controversial amongst dermatologists because growth factors are things that are secreted by cells, normally during growth. So like in a fetus or, you know, in children. And then after, like, there's a wound, obviously growth factors are needed to grow back the tissue. Right. And so it's just like a natural process to be like, oh, well, this must be good, because we want to grow collagen and all the youthful things. But I know one of the original growth factor products that has been on the market for a really long time is the one called tns.

[Dr. Nancy Samolitis]

Yes.

[Sarah]

Hundreds of dollars patients, you know, some people swear by it. I've kind of looked at the data here and there, and I think that the data is like, okay, but just like I was talking about with exosomes and things like that, we don't know. These are ingredients that need to be derived from human tissue. And so whether or not they're preserved properly, you know, if somebody did a test, you know, would there really be the growth factors in the product? You know, are you really sure what you're using? So I feel like, you know, I don't use anything with growth factors. I've never been convinced that I need that in my life. I always say there's a pretty short list of ingredients that are things that are actually effective for anti aging like it's really short. Okay, so sunscreen, great. Or sun protection, I should say, cuz I, I love sun protective clothing too for obviously the body retinols or you know, the whole spectrum of retinoids, I guess exfoliants. So like especially alpha and beta hydroxy acid. I think that's about all. Oh, antioxidants. Eh, a little, I think not as amazing for truly stimulating cell turnover. Like what retinoids do and niacinamide. So the antioxidants and the niacinamides I think are good sort of co factors, like they should be in your skin care. But the really, if somebody's like, give me the absolute simplest routine, I'm going to say wash your face with something, put sunscreen on in the morning and put a retinoid on at night and that's it.

[Kirby]

What about like hydration?

[Sarah]

Well, that's a personal thing. You know, I spent some time with a dermatologist a long time ago who's very well known for their skincare products. And I remember he used to tell patients all the time that women are oversold on moisturizer. And he was always like, why don't men need moisturizer? And you know, some of them probably do. But it was kind of a good point. You know, it's sort of a personal preference. Like I think some of those things are like, you like the way it feels, you like the way that your skin looks dewy, but do we really like need it? So I tell every patient, you know, when I choose a routine for them that I say, I think you need. And obviously if somebody has a skin problem, they might need other ingredients. But I say, what? You know, use a moisturizer. Does it have to be in the morning or night? I'm like, whatever feels good. It's just the most important to get the sun protection in the day and then the repair at night.

[Kirby]

That's why Matt loves going to Dr. Sam because he hates using moisturizers.

[Dr. Nancy Samolitis]

She's like, don't use them, don't need them, period. No, but I love getting to talk to you because I feel like every time I do see you, you teach me something new. And one of the conversations that I loved that we had recently was, was why are we freezing our faces and thinking that makes us look younger. And we brought this up on our episode with Jumi Song. And she said this. I'm like, my dermatologist literally was talking to me about this a few months ago because it's so true. And I do think that we're gonna see a big swing in not creaseless, lineless faces or even lift it. I think we're gonna see people wanting the most bright, even skin that they can possibly have in order to feel like they look more youthful.

[Sarah]

Yeah, I've always been saying this.

[Dr. Nancy Samolitis]

Yes, you have.

[Sarah]

You know, because I see people who. They try to just do injectables, and all of a sudden they're, you know, 50, and they're like, oh, my Botox just doesn't work anymore, and I'm just not getting the results I'm looking for. And I'm like, that's. Cause you never did anything for your skin. You never did a laser microneedling or use good skin care or the active ingredients. And so you. You can only get away with so much when you're in your 20s. It's probably fine if you want your forehead smooth, like, who cares? But it is, by definition, unnatural. Right. To relax all our facial muscles. And we've kind of created a. It's sort of like now a cultural norm that we have reduced facial expressions. So I don't know.

[Dr. Nancy Samolitis]

I think you look more youthful when you're smiling and laughing. Yes.

[Sarah]

Yeah.

[Dr. Nancy Samolitis]

Guys, I had a guy hit on me at a restaurant and said I had a great smile. You do have a great smile.

[Kirby]

I said, great.

[Sarah]

I look 25.

[Dr. Nancy Samolitis]

Thank you. He was 25. Okay. Amazing. All right, Dr. Sam, we are so thrilled for you and for Seal in Sephora in May, but on sephora.com already right now.

[Sarah]

Yep. Go check it out.

[Dr. Nancy Samolitis]

And it's so beautiful. It's bright. It's not like a lot of these other derm brands that are kind of.

[Kirby]

It's very stylish, blase.

[Dr. Nancy Samolitis]

It's very stylish and very cute. You're gonna want to use it because it just makes you happy. Picking up.

[Kirby]

And it's just like, after listening to this episode, obviously, you know, you can trust Dr. Sam. You can trust these products. The ingredients in them. They just work.

[Dr. Nancy Samolitis]

They really do.

[Sarah]

Thank you.

[Dr. Nancy Samolitis]

Where can everybody find you? Or Facile, if you prefer.

[Sarah]

Don't DM me medical questions.

[Kirby]

Don't DM her any weird pictures of your skin.

[Dr. Nancy Samolitis]

Yeah.

[Sarah]

Cut it out. So you can find Facile at facile skin. And facileskin.com is our website. And then my Instagram is DrSamilitis. Good luck spelling it.

[Dr. Nancy Samolitis]

We will link it. They should know how to spell it at this point. They know at this point.

[Verizon Ad]

Your old or broken phone can let you down when you need it most perfect. But at Verizon. Trade in any old phone from our top brands and get the most for it. Up to $2,000 in value for an amazing new iPhone 16 Pro with Apple Intelligence and a new line on my plan and iPad and Apple Watch Series 10. That's like a three for one. And you can get it on any plan at Verizon. Trade in your old phone for a brand new iPhone 16 Pro, iPad and Apple Watch. The other guys won't get give you that. Visit verizon. Com today. Additional terms apply. Service plan required for Apple Watch and iPad up to $2,000 value based on iPhone, iPad and Apple Watch.