B (5:05)

I cannot believe I'm here, but thank you so much for having me.

A (5:09)

Well, I'm really glad you're here and there's two things I want to say before we ju number one, you know as you're listening or watching on YouTube, I just wanna tell you you have picked a winner and I can already tell because you have about 40 pages of notes in front of you. I know that we are in for something that is gonna be world class so thank you for really showing up in a way for me and for the person who's spending time with us today to make an impact. Second thing is when I posted on Social all about the fact that you were coming, just ask people for their questions. I don't know that we've ever gotten more questions on. And so we are gonna go deep. I'm so excited. Where I wanna start, Dr. Idris, is what is going to change about my life if I take everything to heart that you are about to teach us and I apply it.

B (6:02)

The biggest thing that's going to change when you take to heart everything we're gonna talk about here today is not just the knowledge in your skin or gaining a little bit more confidence in taking care of your skin, but the emotional impact it's going to have on your overall confidence moving forward. Because aging, 20% of it is genetics. If it was all purely genetics, habits wouldn't matter. And so 80% of how we age and show up in the world has to do with habits. And so if we can create the system so we can show up for ourselves every single day, but also have the confidence in our knowledge to, we can transform from a inside out perspective and really blossom into the butterflies that we are.

A (6:43)

You said that only 20% is determined by genetics, so I've never heard anybody say that.

B (6:48)

Yeah. So 80% has to do with cumulative sun exposure. Are we living a rockstar lifestyle? Are we consuming alcohol to no end? Are we not focusing on the overall aspects of our lifestyle and diet? Are we actually washing our faces? Are we using the things? And that, I think, is a reflection of everything else. When all of it comes together, your skincare is that reflection of how you view yourself and how you take care of yourself overall. So to be able to put a little bit of emphasis, a little change every single day will amount to bigger changes in the long run. And I think the most dramatic one is truly how you feel about yourself. And that's why I went into dermatology. I never liked convincing people that they had a problem. And so because they could see their problem, they're already more motivated to help themselves. But to be able to see somebody's confidence be restored after we've helped them go through whatever it is they're going through, there's no feeling that compares.

A (7:41)

Well, it's true. Most of us don't go to the dermatologist unless we hate something about the way we look or if there's something on our skin that's scaring us. And this is gonna sound really dumb to admit, but when I listen to what you're already saying, I realize that I've been so focused on the outside and what I'm putting on my skin that I haven't really considered all of the things that you're also gonna talk about that are part of your lifestyle that go from the inside out a thousand percent. Wow. Why is skin health so important for overall health? And what does the state of your skin reveal about what's going on inside your body?

B (8:24)

Your skin is your largest organ and it is one of the few places, right, where internal health shows up visibly on the outer surface of your skin. So that is one thing that isn't often taken into consideration. But your skin is a visible feedback system that is showing you what is going on on the inside, but also not just internally from a physiologic standpoint, but also on the inside up here, mentally, emotionally, from a stress perspective. And that is the first visual trigger that you have when you look at yourself. So I think one thing that is often so overlooked when it comes to skin health is that mental and emotional impact that comes with it. And that is something that shouldn't be overlooked. And skin is not just vanity, it's not just cosmetic, it's not just superficial, it's really a whole person issue. And I think once you start to shift that perspective, you realize, holy cow, this is my biggest organ. And yet I put it through the ringer. I and I don't even care for it. So it's really something that I find fascinating. Cuz it's so visible and yet it's an afterthought for so many.

A (9:31)

Let's say the person listening or watching here on YouTube is in a phase of their life where they're going through all kinds of hormonal changes and you hear that your skin is a reflection of what's going on on the inside. How do you want the person listening who feels now all of a sudden like, oh my God, the fact that my skin is in welts and it's acne all over the place and I hate how I look, or my skin is sagging or I sat out for decades in the sun and now I'm screwed. How do you want the person listening who's now starting to collapse a little, to listen to what you have to say about what's possible if you feel like your skin is reflecting not good health on the inside. You know what I mean?

B (10:16)

Yeah. So I would want you to know if you feel like your skin is Taking control of your life. And it is out of control. You are still in control. And it's a matter of first taking a step back and calming your skin down and really trying to first focus on calming everything down before focusing on treating the issue. And once we have that step in place and we will talk about it more today, you will gain control over your skin and you will see that the possibilities are really endless. And it's never too late to start, whether you are 20, 30, 40. I mean, I have patients, my oldest patient is 88 and she still cares. And that's what I love about her, that shows her will to keep going. And people, I think our society, they describe very negatively cosmetic work or vanity. And it's usually talked about under a negative light. But the truth is being vain to a healthy and certain extent is just a reflection that you still care. If we didn't care, I'd almost be more worried. Are we really at the bottom of our struggles here? And so you have to understand that it's not just vanity, it's a reflection of you caring that you still want to show up. It doesn't matter when you're starting, you can always start to take control and help yourself.

A (11:29)

As a world renowned dermatologist, what is healthy vanity and what is unhealthy vanity when it comes to hydration?

B (11:37)

That is a great question and I don't think it has ever been truly defined. So I'm going to give you my subjective perspective. Unhealthy vanity, let's start with a negative is when it is constantly consuming your mental thoughts. Almost like an addiction where no matter what you do or no matter what you try for yourself, you're constantly speaking about it in a negative way and it's not good enough. And so you are chasing a never ending nothingness because it's just not something that's achievable, right? Whereas a healthy dose of vanity is like caring enough to show up and wear an ironed shirt instead of a wrinkled shirt. You know, caring enough to brush your hair, caring enough to show up in a way where it's still a positive reflection of who you are, but it's not consuming who you are. Your confidence is not dependent on how you look, but it's the cherry on top and it allows you to feel more confident. And so that, I think is the difference between unhealthy vanity and healthy vanity.

A (12:31)

What I kept thinking about as I was listening to the way that you were talking about self criticism and never being enough is that there's Also that relationship between unhealthy being, the constant pursuit of, of hoping other people think you look a certain way versus the ability to look in the mirror and care about how you feel about yourself.

B (12:55)

I mean, newsflash, you've always looked like you. So if you're always pursuing other people's approval of how you look, you're pursuing something that doesn't exist. And I've been in practice for over 10 years. I see nearly 100 patients a week and more often than not it's a much deeper rooted issue that you're trying to get to. And that's where it's such a vulnerable state where you have to find someone that you know you trust who's not going to feed off these insecurities or vulnerabilities or take advantage of. And I've seen it through every angle. And cosmetics is not just skin deep, it's deeper.

A (13:28)

I've never heard anybody explain it like that. And I can give you an example because I feel like I'm in the exam room with you right now and I have come in because I hate at the age of 57, I've got these jowls. And when you just said that, it's never really about the thing you're complaining about. You're right. For me, it's that I feel old when I see my skin sagging. And it scares me to think that I'm 57 and that that much of my life has just flown by and that somehow if I get rid of these things that are hang down like meat purses on my face that I will feel different about myself. But maybe there's something to do that we can and we'll talk about all that. But I love that we're also saying that it's really about how you feel and the deeper things that are going on.

B (14:29)

Yeah, 1,000%.

A (14:31)

Wow. Let's talk about how your lifestyle and habits impact your skin. What are the specific lifestyle habits that positively impact affect your skin?

B (14:43)

The most important habits that I think are underspoken of right number one. And I used to roll my eyes in my 20s and even in my 30s at this one. But it's true sleep. You cannot underestimate the value of sleep. And the reason beauty sleep exists is for a reason. But I think it's misunderstood. It's not because you slept eight hours last night that you look good today. Sleep is like compound interest. It's a long term investment. And it's that bank that you're feeding over time that gives you Your best results over time in the long run. So it's not just about having one good night's rest. It's about consistently showing up to let your skin and your body heal and regenerate and start over again. Number two is movement. And I'm not saying you have to go become triathletes and like, you know, bodybuilders, but simple movement, like just getting up, going for a walk, moving around, because that causes your lymphatic fluid to move. It keeps things going, it pumps the blood to your skin, it allows you to be better and show up better for yourself. It's very simple. But not many people move as much as they should. Number three, and this one is a little bit sensitive, but diet, okay, A healthy diet is going to be supportive and it's going to help to create the right environment for your skin. We are all in agreement, but when people are eating their retinol, AKA eating carrots to no end to try to get the benefits of a retinol that you're applying topically, it's not going to give you that same impact as a topical medication, prescription moisturizer cream. Food is meant to really be supportive, to make sure that you are creating the best environment for yourself to push forward. Skincare with the crappiest diet is not great. You're just putting a band aid. Right?

A (16:21)

Right.

B (16:21)

It's both working hand in hand. So I think you have to think of lifestyle as a piece of the puzzle, a very important piece of the puzzle. But it's not the whole puzzle. Because when you make it the whole puzzle, you think that you can be fully in control. But there are gonna be some things that happen that you're gonna have to learn. How do we roll with the punches? How do we ask for help? How do we have external things coming in to help us?

A (16:44)

Well, Dr. Idris, the good news is that you're here to educate us about what the actual options are. So one thing that I'd love to hear you help us with is that we are so marketed to and every time I go online, I see some 12 step skincare routine, red light masks, treatments, miracle products. How do you tune out the noise to figure out what your skin truly needs?

B (17:16)

This is a great question and I think this is the million dollar question. First of all, Nobody needs a 12 step skincare routine. Nobody, nobody needs to be spending thousands and countless of hours on products. It's not productive, it's not realistic. And as a mom of two who has not one, but two, some would argue Three businesses and a partner in my life, especially between the ages of 0 and 4, when my kids were really small, it was impossible to find time for myself. And so failing yourself by not showing up through a consistent skincare routine is the first point of failure. So if it's not something that you can be consistent with, it's not good enough. And a routine needs to be simple enough that you can be consistent with it so you can stick it through and actually see results. Right?

A (18:03)

Yeah.

B (18:03)

So that I think is really important that people understand because the Internet, social media, it's optimized for selling things and more doesn't mean better, especially not when it comes to your skin. And you really have to try to take a giant step back. And so this is what I tell patients. Like I'm going to tell you, you, like I tell my own family, literally take a giant step back from your mirror and not your magnifying mirror and look at the forest and not the tree. Understand what is the biggest issue that you see in your skin? Is it brown spots? Is it redness? Is it dehydration? Is it wrinkles? Is it, I don't know, whatever, crepiness, whatever it is that it is that you see, what is the one biggest issue that bothers you? And let's start just there.

A (18:47)

If you're overwhelmed, what are the three skincare products that you would say to somebody in your practice that they should add to their routine?

B (18:57)

If you're overwhelmed by all the products, forget the specific products themselves. There are three categories that you kind of want to incorporate into your routine to make sure, number one, that you're protecting your skin, you're supporting your skin barrier, number two, and number three, you are helping drive long term change. Before I start, I just want to preface this by saying I am not sponsored by any of these companies. None of this is paid for, this is not an advertisement. And I try to pick products that are within everyone's budget.

A (19:25)

Great.

B (19:25)

But also products you can find at your local drugstore. And I'm going to give you two examples for each because it's the way that, you know, make up your own mind what it is that you want to use. We're starting with a very gentle cleanser, one that is meant to clean and cleanse your skin without over stripping your skin. And this is one that you can find at any drugstore. It's called Vana Cream. It's a very simple one. It's nothing fancy, it can help clean your face. If you're somebody who has very Dry skin, you can get another kind of cleanser that is a little bit more hydrating. But the job of a cleanser is really to just set the foundation, clean the gunk off of your face. And it is the smallest act of kindness that you can do for yourself. After you've put your face out into the world, come home, get the day off your face, and just start afresh. It's your foundational step.

A (20:06)

Okay.

B (20:06)

Right. That's number one.

A (20:07)

How are you supposed to wash your face?

B (20:10)

So I recommend using a cleanser at night for the most part. Right. This is a general rule. And ideally just using water in the morning. Once you've gotten the day off at the end of the day and you've put on your moisturizer and you go to sleep in the morning, do you really need to use a cleanser to get all of the extra gunk off? Probably not. And just having water run on your face is gonna be enough.

A (20:33)

Wow. Like, even if your, like, spouse or dog is, like, breathing on you.

B (20:37)

Just a general rule of thumb. I don't know.

A (20:39)

Well, you know what? I'm older than you, so when I'm sweating like crazy because of menopause, I feel like I've woken up and run a marathon. So I'm like, I gotta clean all

B (20:48)

this stuff, but here's the thing.

A (20:48)

I could do with water.

B (20:49)

But even going through menopause. Right. Your skin is in a more dehydrated state. It is, yes. And so you're losing that ability to hold onto hydration, and that's why you feel a little creepier. If you are compounding. On top of that, overstripping your skin and getting rid of the oil that is on your skin. Oh, your skin is going to feel more out of sync, and it's going to be harder to make sure that you feel more. Now, there's a lot of. There's a huge subset who cannot not use a cleanser in the morning because they have a lot of acne, they're oily prone, et cetera. So this is not necessarily for everyone, but for the vast majority, it is enough. And so I think that's the first thing. The second thing to take into consideration before you go into the action of washing your face is the water temperature, which leads me back to the dehydration. No one talks about water temperature. And we usually probably use hot water because it's the morning and you want something warm on your face.

A (21:41)

Well, yeah.

B (21:42)

Yes. But think of your face like a greasy pan. Hot water gets rid of the grease. So if you're now over stripping your face with hot water and using a cleanser every morning, every morning and at night, you're probably double whammying the thing.

A (21:56)

But don't I want to get rid of the grease?

B (21:57)

Sometimes the grease is also protective. Like it's a balance. It's not all bad.

A (22:01)

It's cleansed at night.

B (22:02)

Exactly.

A (22:03)

Then the skin is doing what it's trying to do overnight to repair itself overnight.

B (22:08)

Exactly.

A (22:08)

And then I wake up and wash it all away with just hot water. Okay.

B (22:12)

Warm water.

A (22:13)

Warm water.

B (22:14)

And then this is, I think, where it gets complicated, the double cleanse makeup removal, where people get confused. So a lot of people don't realize that they can use their cleanser twice. Now, if they are heavy makeup wearers who have waterproof makeup, of course, or really heavy makeup, use an oil based cleanser first or micellar water and follow it with a gentle gel based cleanser. That's not a problem. But what I think is the most important part is having a washcloth for your face by your sink and utilizing that washcloth to help yourself work into the nooks and crannies of your face to get everything off. And it's funny because people rolled their eyes and I had so many comments, but if you have seven little washcloths, each one a different color. Right. And you keep it in your mirror by your sink every day, you're guaranteeing to use a different one. And it's a fresh pair of underwear for your face. Are we going to reuse a dirty pair of underwear? No. And so having a clean washcloth is such a very simple solution. And making sure that you have seven of them takes away the brain work from it so you don't have to actively think of it. And once you're done washing your face, you toss it in the hamper.

A (23:21)

Got it.

B (23:21)

So then number two is a very simple moisturizer. I'm not talking about moisturizer with actives. Right now we are setting the foundation and we're trying to understand how to moisturize our skin. And one thing we do not often talk about is not just your skin type or your age, but the environment that you're in. Are we living somewhere really dry? Is it winter? Or are we somewhere very humid? But very simple moisturizers like this one, it's a tried and true, everything great was once new. Not everything new is great. We go for the tried and true.

A (23:49)

Grandma used that.

B (23:50)

This is one. It's a nice thicker cream. This is more of a gel moisturizer

A (23:54)

that's a l' Oreal collagen gel.

B (23:56)

And the reason I bring this up is to make sure that this is a very nice hydrating moisturizer. But the word collagen on this moisturizer makes people think that it's going to help them replenish their collagen. But it's a hydrating moisturizer. It's not going to replenish your collagen. Okay. And so I just think you have to understand that nuance and understand what you're buying and what you're trying to get out of it. And then number three, what everybody should be using a daily sunscreen. And so there are several sunscreens that you can find at any local drugstore. One thing that most people don't realize about sunscreen, it can double up as your moisturizer. It can, yeah, for sure. So you don't necessarily need a moisturizer. Let's say you're really oily and you live somewhere really humid, like you're in Florida. Do you need to add extra moisture to your skin? Absolutely not. So you can just find yourself a sunscreen that works for your skin type. Like, this is a sheer, light sunscreen. If you're somewhere very dry and you want extra moisture, even though you've moisturized, like, you can get a moisturizing, thicker, richer sunscreen that can help with barrier repair.

A (24:53)

Got it. And would it say moisturizer on it? Because you've got one from Neutrogena, one from La Roche Posay.

B (24:59)

So they don't always say moisturizer. This one does say. And I think it's a nice example, just because if somebody doesn't know and they're going to a drugstore, they can see it. But it's really about understanding that texture. If it's really rich and really creamy and nice, and you feel like your skin stays hydrated after the fact, it's hydrating your skin.

A (25:15)

So is it more about the feel of what it feels like?

B (25:18)

Absolutely, I think. And that's the secret about sunscreen. It's that finding a sunscreen that you actually like how it feels on your skin. And I think the biggest reason why most people don't adhere to wearing sunscreen is because I don't like how it feels. And so I think people haven't found the right frog, and they've kissed many frogs, but they haven't found the right one.

A (25:35)

What SPF should you wear every day?

B (25:39)

It's a great question. SPF is more than just a number. So SPF stands for sun protection factor, but it measures basically how well your skin is protected.

A (25:50)

Okay.

B (25:50)

So when we're looking for an spf, we need to make sure that our SPF has broad spectrum on it.

A (25:55)

Broad spectrum. Okay.

B (25:56)

So that it's protecting against both UVA and uvb, because both contribute to skin cancer. One causes more burn, like uvb, One contributes more to the breakdown of your collagen, like uva. But if you're just getting a simple sunscreen. Spf, not broad spectrum. You're not protecting against uva. Oh, so broad spectrum is not a nice to have. It's a need to have.

A (26:17)

Okay.

B (26:18)

Okay. That's number one. The second thing, SPF 30. People don't really know. It's just a number.

A (26:24)

Should I guess what I think it is?

B (26:25)

Yeah.

A (26:26)

I kind of believed that, like, the 15 is only going so deep in terms of the barrier. The 30s may be going a little deep in terms of the. It's like, you know, kind of the

B (26:37)

thickness of the cream or the invisible

A (26:39)

shield of the invisible shield. And is it actually about the number of minutes that it's helping? Yes, it is.

B (26:47)

It's minutes. So it's not 15 minutes or 30 minutes, but it roughly means how much longer you can stay out of the sun without burning compared to no sunscreen.

A (26:57)

So let's say this is a lot of Math.

B (26:59)

It takes 10 minutes for you to burn. With an SPF of 30. It should technically take you 300 minutes. So that's what SPF stands for. And so it's something that most people don't even know.

A (27:11)

Dr. Idris, what's the biggest myth about getting a safe tan?

B (27:15)

There is no safe tan. A tan and any form of pigment that gets produced because of the sun, even a freckle, is a sign of DNA damage. And so anybody who says, oh, but I get a base tan, is just telling me that their skin is already reacting to the UV rays that it got, and it has internally damaged the DNA of their cells. Whoa. So there is no safe tan.

A (27:44)

Okay. So for somebody like me, who really blew this child of the late 70s and the 80s who would lather up with bandesole tanning oil, and then I would lay on my driveway with my.

B (28:01)

Did you have the foil?

A (28:03)

Of course I had the foil. Of course I was going for that copper tan. Pull the bikini down. I have so much skin damage, but I got the tan line. Can you reverse that damage? What do I like?

B (28:16)

It's never too late to help yourself. Number one. I think if you are somebody who's done that, make sure you go in for a yearly skin exam because, yes, it's already DNA damage and you don't want to get skin cancer and you may develop skin cancer. But the good news with skin cancer is it's highly treatable when caught early. So don't let fear get in the way of you getting checked and just go in for a yearly skin exam the same way you go in for dental cleaning. Get your skin checked. But you can of course, help yourself, at least from a cosmetic standpoint, because how does that damage usually show up? First? It shows up in the form of brown spots, sunspots, hyperpigmentation, discoloration. And so understanding how to use skincare over the counter as a baseline routine married to prescription is going to give you a very solid way to help your skin to look fresher and better.

A (29:06)

I'm starting to understand the marketing language now because I am constantly seeing where it says reverses sun damage, but what it's actually saying is reverses the signs of sun damage because you can't get rid of the damage done to the DNA. You can just maybe lighten the brown spot that's starting to appear. Am I catching on?

B (29:29)

Exactly. Exactly.

A (29:30)

You're making us smarter, doctor.

B (29:32)

Exactly.

A (29:33)

So those are the three categories of products that you need. You need a gentle cleanser, you need a moisturizer, and you need sunscreen.

B (29:40)

Yes.

A (29:41)

I have so many more questions to ask you about this, but I need you to just hold on for a second because I need to take a quick break so we can hear a word from our sponsors. And while we do, this is the perfect moment for you to share this episode with somebody that you love who's struggling with their skin or whose bathroom is overflowing with products, or who's overwhelmed and just needs this kind of reassuring, kind, clear, life changing information that Dr. Idris is giving us today. So while you listen to the sponsors, I want you to hit send, text this link to somebody. I already know exactly who I'm sending this to. And don't go anywhere because when we come back, Dr. Idris is answering more of the most asked questions in her practice. We'll be right back. As a parent, you give endlessly to everyone around you. Your kids, your spouse, your neighbors. So it's okay to do something that helps you take a little time back for yourself, like delivery through doordash. Doordash shows up when you need it most. You can get everyday essentials delivered like medicines, diapers, groceries, and supplies. And if the idea of cooking dinner after the day you just had feels like too much, you can still open DoorDash and get your family's favorite restaurant meals delivered too. There to help when you need a little breather. You know, we were in the studio yesterday taping an episode and we realized, holy cow, we need some marbles. We need lunch. We need something else for a different podcast. So what do we do? We didn't send anybody else. We doordashed lunch. We doordashed the marbles we needed. Trust me, you're going to love it. It's for a little visual experiment we're doing on an upcoming podcast. It's incredible. Whenever I use DoorDash, whether it's dinner, it's essentials here at work, it's essentials that I need, like hair products, toiletries. It just shows up right at your door, whether that's home, your hotel or work. Order DoorDash right now to get a little bit of order delivered.

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A (32:05)

Let's talk about routines. You might have one for your morning for your workouts. What about your bathroom? It's time to upgrade your bathroom routine with the Cottonelle Cleaning duo. Cottonelle Toilet Paper and Flower Flushable Wipes have cleaning ripples that will leave you feeling cleaner and fresher than standard toilet paper alone. Continental gives you the kind of clean that will make you want to come clean about everything. Like the fact that you sometimes get excited when plans get canceled. And that On My Way doesn't actually mean you're on your way. Come clean with Cottonelle. Welcome back. It's your friend, Mel. Today you and I are getting to spend time with the incredible Dr. Sherene Idris. She's a board certified dermatologist and one of the most trusted voices on skin health in the country. And she's reminding you and me that your skin is not a problem to solve. It's a relationship to build. And today, she's breaking down what to eat, what to do what not to do. If you want healthier skin that not only looks better, but that you feel good into. All right, Dr. Idris, now let's talk about the things that you should skip because they are a waste of money.

B (33:23)

And to just think of this conceptually, anything that is promising instant results, it's probably not going to be for the best of your long term benefit. Anything that is breaking your skin barrier, it's not going to be for the best of your long term benefit. And anything that is irritating or inflaming your skin similar to breaking your skin barrier, it's not going to be for the best of your long term benefit. So, number one, all right, it's not sheet masks as a whole category, but when the format doesn't match what the product is trying to give you, it's a red flag.

A (33:59)

So you're holding these masks that I see at every checkout now that have all the, like my daughters wear these like crazy. I typically will put one on on a plane, but I don't know what I'm buying.

B (34:10)

This is where you have to understand what an active is. Okay, so the point of a sheet mask is to calm your skin down, to hold onto that hydration, to keep that gunk in. Right.

A (34:20)

Okay.

B (34:20)

When you find a sheet mask with an active, like a retinol, this is a red flag because the format of the product doesn't match the ingredient. The last thing I would want to do is put a retinol under occlusion in a sensitive area. It's like a recipe for chaos and disaster. So understanding what you're purchasing is very important for you. That's why I think it's important to have a basic understanding of what are ingredients, what are we trying to achieve with them, and then what are the different formats that exist that I can layer into my skincare once I have my foundation in place?

A (34:54)

You know, if you were to buy a mask, what are you looking for?

B (34:56)

Just like cooling, moisturizing, honestly, really, just hydrating, moisturizing. Because I'm looking for that instant kind of plumping glow and then I'm done. I'm not looking for long term gains with it.

A (35:06)

Okay, what is the next product we should not waste money on?

B (35:09)

All right, here goes. Ready? Uh. Oh. It's a little controversial, but like a loofah. Okay.

A (35:13)

Why should I not have a loofah?

B (35:14)

Number one, what worries me a bit about loofahs is people use this on their face. And I've seen this time and time again. If it's not a loofah that looks like this. Like a synthetic one. The traditional natural loofahs. Yeah, those sponges. People have used them on their faces, and I've seen this in my practice. It is a physical exfoliant that's getting rid of dead skin cells physically.

A (35:34)

Right.

B (35:34)

But the skin of your face is much thinner, and it can be extremely irritating and aggressive. Not to mention the fact that many people don't clean this. And bacteria can build up, water can be stuck in there. It can get moldy, gross, and just not necessarily the best thing. Number three. Now, this is not the complete devil. There are moments when it can be useful, but this is not something I recommend every day makeup remover.

A (35:58)

The makeup wipes everybody.

B (36:00)

But I prefaced it not every day. Not every most days, definitely. Maybe once a week. It's like this is reserved as your SOS by your bedside. If you had a night out and you're too tired to wash your face, at least you're guaranteeing that you're trying to show up for yourself and get that makeup off your face.

A (36:17)

What is the downside to basically scru. I literally scrub my makeup off with one of those things. Like, I am trying to get bits off a pan that is burnt to it.

B (36:32)

Think of it this way. Look at. Imagine an orange, right? And it has all these tiny little pits that are your pores. Okay, now let's cover that orange with foundation. It's nothing at all.

A (36:41)

Yep.

B (36:42)

Whatever. Tone foundation orange. Okay, you take a makeup wipe and you clean that orange. What are you doing?

A (36:49)

You're ramming it into the pores.

B (36:52)

And what's happened is that when you look at this orange, it might have shades of orange come through, but you've really just kept the stuff in the pores. So you haven't gotten rid of anything. You've just smeared it across the board.

A (37:04)

Well, and you feel like you've gotten rid of it because it's all right on the thing. But the truth is, you're right. I wake up in the morning, and

B (37:11)

there's probably a little residue on that on the pillow.

A (37:13)

And my eye makeup is smeared underneath my eyes. You're right.

B (37:17)

And it's funny. I mean, I've been guilty of this, right? There are nights when I haven't washed my face. No one's perfect. But in your 20s and 30s, it's not that big a deal. Once you turn 40, if you fall asleep with makeup, you look like the Crypt Keeper overnight. The next day, it's like your skin quality goes to Crap. You can't bounce back as fast. It just. You see the impact immediately. And so I think being in the habit of actually washing your face is huge. And makeup wipes again, there's a certain subset of the population who turns to makeup wipes. Maybe they have a disability. Something is better than nothing. And that's why I sit there on the floor.

A (37:53)

Or you're on a plane, fantastic. Or it's a late night, fantastic.

B (37:56)

But if it's your main way of washing your face. No. That's why I had to preface the makeup wipes. Now this is also another one. If you're a child of the 90s. No strips the pores. Now, this is going to give you temporary results, but it's not going to give you long term change. And it's very visually appealing because you feel like you got something out.

A (38:15)

Yes.

B (38:16)

But the problem with nose strips is that visual instant gratification does not equal long term results. And I'm just gonna hyperfocus on that sentence because we like the fact that we take out the most superficial layer of our pores, but it's an extremely aggressive movement. And over time, if you keep doing it, you're gonna stretch your pores and you're probably gonna buy yourself a bigger problem over time. In terms of your texture and how

A (38:38)

your pores show up, what kind of problem can it lead to?

B (38:40)

I mean textural changes, it makes your pores more apparent. Your pores can start filling up faster again because it's just getting rid of that superficial part.

A (38:48)

Now I'm having to use it again to get it out as you're effect. This sounds terrible.

B (38:51)

And this is where like a salicylic acid cleanser can be helpful to help to minimize that buildup. Instead of something that's giving you an instant gratification, like cheap dopamine. Hip.

A (39:01)

You use the word actives. So let's talk more about them. Things like vitamin C, retinol niacinamide, if you even say it that way, hyalidronic acid. You know, who should use this stuff and who should not.

B (39:17)

Okay. So actives are very important to help to support your skin overall, depending on what your goals are.

A (39:22)

Right.

B (39:23)

But I just want to preface one thing again. It doesn't mean that they are miracle ingredients. So understanding what each one does is very important for you to know if you want it in your routine. But let's start with vitamin C. I think vitamin C has a lot of marketing around it. The food industry often trickles into the beauty industry. Okay.

A (39:42)

But I don't know what it does.

B (39:43)

No, exactly. And I think vitamin C. I actually

A (39:45)

put it on my face and I don't know what it does.

B (39:47)

Okay, Vitamin C. Most people. A lot of people can benefit from it.

A (39:51)

Okay, what does it do?

B (39:52)

It's going to help with your overall tone of your skin. Meaning it'll make it firmer skin color. It's a great, great question. And it's funny because I used to even be confused by what tone meant. It means your skin color.

A (40:04)

Well, can I ask a question about that? So if you're like a pale zombie like me who turns red all the

B (40:08)

time, it might not necessarily be the best thing for you. Okay, we'll talk about the types of vitamin C. But vitamin C helps with brown spots. It does discoloration. Yes.

A (40:17)

Okay.

B (40:17)

It also helps with collagen production. You need vitamin C to produce collagen, but it also has antioxidant protection. So it's going to help to protect your skin from, like, the environmental stressors that can cause free radicals that cause your collagen to break down early. So it is a very powerful ingredient that has a huge track record and it's a great one to have in your routine. But vitamin C is a category. There's the active form of vitamin C known as ascorbic acid, and then there's a whole inactive side to vitamin C. Oh, my God.

A (40:49)

So we may be buying something that says vitamin C that has. That's not active.

B (40:53)

Yes.

A (40:53)

Thinking it's active.

B (40:54)

Yes.

A (40:55)

How do we know?

B (40:55)

You have to under. This is where I think, again, understanding who you're buying from, understanding the education that the brand puts out, understanding the different forms and just educating yourself not to gain a PhD, but to know enough to be dangerous to understand. Can I use this to help myself?

A (41:10)

So you use vitamin C active. Vitamin C for tone, for brown skin.

B (41:16)

You can use both. Both of them help with all of these issues.

A (41:18)

Okay.

B (41:19)

But if you're someone who thinks you have sensitive skin and your skin's very reactive, I probably wouldn't tell you to use the active form.

A (41:25)

Okay.

B (41:25)

Because it's much more pungent or whatever the word is. Like, it has a stronger punch.

A (41:29)

Okay.

B (41:30)

And so I'd probably tell you, go for the inactive form of vitamin C. Okay.

A (41:33)

What about retinol? Everybody's talking about retinol. I see, you know, teenagers buying products with retinol in it. What is retinol?

B (41:40)

Retinol is the crown jewel of active ingredients. It is a vitamin A derivative.

A (41:44)

Okay.

B (41:45)

And as a prescription it is known as tretinoin, a retinoid. Over the counter, it's called a retinol. Now like vitamin C has an inactive form, retinol is the inactive form and the prescription is the active form. But this category of vitamin A is meant to help to build thicker skin, to promote collagen production, to help regulate how your cells turn over. So teenager would use it originally for acne, like blackheads and whiteheads, to minimize how it sticks. And then we realize it has long term longevity benefits. So it became a staple for the anti aging world and it has a huge track record of clinical data to support it. But one thing that I think people get wrong about retinols and retinoids is that stronger is better.

A (42:31)

I burnt my face doing this.

B (42:32)

That is wrong because you are going to just. It's better to be consistent over time than to go wrong and strong. And I say with retinol I'm a

A (42:41)

wrong and strong gal. Dr. Idris, I got it. The tretinoa thing or whatever it's called. I looked like a lizard that had red skin within a week because I probably over applied and then I just stopped doing it altogether.

B (42:57)

Exactly. You got dissuaded.

A (42:58)

Yes.

B (42:59)

So it's about consistency over intensity. I would rather you pick the inactive form at its lightest concentration over the counter and use it five nights a week and maybe use the prescription once and have a healthy, happy skin state. Because that inflammation that you're gonna cause, let's say you're doing this every week, long term, it's not gonna benefit you as you age. And let's say you just did it once, you got zero benefit out of that. You've just been traumatized completely. And so I don't believe in trying to push for a higher concentration. It's about what are you using most nights of the week and you're able to hold onto without inflaming your skin.

A (43:38)

Talk to me about hydro. Hyaluronic. I can never say this word. Hyaluronic acid.

B (43:44)

Hyaluronic acid. So this was all the rage, even like four or five years ago where you saw it on every beauty brand mass marketing campaign. And it's funny because when it comes to the beauty industry, the biggest barrier is marketing and education so that consumers hear ingredients and they think, oh, I need that. Yes, it is a humectant that attracts water. A humectant means an ingredient that likes water.

A (44:05)

Okay.

B (44:06)

And attract it. So what's going to happen? It's going to give you more of a hydrating Effect, a plumping effect. You're going to look a little bit bouncier. It's going to help with the fine lines.

A (44:14)

Is that a good thing, to look bouncier?

B (44:16)

Why not?

A (44:17)

Okay.

B (44:18)

I don't know. I don't want to look deflated.

A (44:20)

That's true. I don't either.

B (44:21)

I'd rather be bouncy. Okay. But it's not the end all, be all and best humectant on the market, number one. Number two, it is quite literally an eight out of 10 products that you're probably using.

A (44:34)

Oh, okay.

B (44:35)

So do you need to have it as a dedicated product in your roundup to complicate your life and to add more stress and to add more time to your routine? Probably not.

A (44:45)

I love how you're simplifying all this, Dr. Idris, because it just comes back to that three step routine and asking yourself, what am I not happy about? What is it that I'd like to see an improvement in? What is it that I want to address? And then educating yourself about the right thing to add. And I'm also hearing go low and slow, low and slow, low and slow on this. Like you don't want to step on the pedal and burn your skin like Mel Robbins did.

B (45:12)

But it's kind of like dieting, right? Do we go into a diet and say, I'm going to lose £80? No.

A (45:17)

Yes.

B (45:18)

And then you don't, but then you don't, and then you get, you know, dissuaded and you feel like it's not for me. So let's focus on small wins, baby steps, things that we know we're not going to fail ourselves by and really try to get the ball rolling in the right direction before we start to be too gung ho about the whole process.

A (45:37)

Dr. Idris, let's talk about sensitive skin. 70% of adults worldwide say they have sensitive skin redness, irritation, stinging often from skin care products. And they assume, okay, well, that's all that it is. What does sensitive skin really mean? And As a dermatologist, Dr. Idris, what could be driving the sensitivity in the skin?

B (46:01)

So 7 out of 10 people say they have sensitive skin, but the reality is people who have true sensitivities is much lower. At 1 out of 10 real. Wait, 1 out of 10 people have real sensitivities?

A (46:15)

Okay.

B (46:15)

So the perception of what sensitive skin is as a skin type is often misplaced because what they're describing is not a skin condition but a skin state. Their skin is very reactive. They have reactive skin, but sensitive, true Sensitivities is I cannot tolerate. I'm making it up a preservative. And when I have this preservative on my skin, I get a crazy rash that's itchy and I flare up and it lasts for days, and I have to go on medication to calm it down.

A (46:43)

So it's more like an allergy.

B (46:44)

It becomes kind of like an allergy.

A (46:46)

Oh, I love that. But you could have reactive skin for a number of reasons.

B (46:49)

You can have reactive skin. You can just be a reactive human. Most white people are reactive. You're gonna see redness come up on your skin. All right? Most white people have that reactivity in their skin. If I wash my face, I get redder, and then it calms down after a few minutes. That doesn't mean I'm sensitive.

A (47:03)

Why does it get redder?

B (47:04)

Because of the rubbing. Your blood flow, you see it more. Your melanin's low. It's more obvious. But that being said, most people don't actually have real sensitivities and it's that skin state. And so when you start seeing stinging redness and burning, especially from products that never bothered you before, it's the result of long term, probably chronic inflammation that hasn't been fully addressed, where then you develop a real sensitivity over time. So when you have this reactive kind of skin, very easy to flare up, the first goal that you should always have is to calm your skin down again. Going back to the basics, focus on some. A basic routine that you know your skin can tolerate that keeps your skin calm. And that, I think is probably the hardest thing to do, because when people get reactive, even it's for two, three days, they start compounding things and products, trying to fix it without letting their skin do its thing to calm down and heal. So step one, if your skin is very sensitive or reactive, is to stop everything. And this freaks people out. I'm like, you're not going to melt, okay? You're going to survive this for like a week or two. Everything from skincare to makeup, you're going to wash your face with water. And if you really need something, if you really need an occlusive of some sort, you can use Vaseline, but you have to calm the skin before you can correct it. And then step two is very boring and very slow, but you rebuild your barrier slowly. So you first incorporate then a moisturizer, and you let that work for you for a few days, and you make sure that you're not reacting to that for a few days. Once you have that green check mark and green light. Then you incorporate a cleanser. You see how your skin does with the cleanser and the moisturizer over a few days and then it can allow you to sort of pivot and see in which direction you're going. But that puts the control back in your hands that you're not just living this crazy life of reactivity and trying to calm it with this and use that. And then it stings more and it gets more inflamed and it's this never ending cycle. It just cuts, resets it and allows you to restart in a very systematic and academic way so you can pinpoint where are the shortcomings and how can I pivot.

A (49:22)

So if you're dealing with reactive skin.

B (49:24)

Yeah.

A (49:25)

Take a step back, calm down, stop everything. Start with a moisturizer that's not got active stuff in it because we gotta rebuild the barrier. And then we can slowly start to add in a cleanser and do some of the basics to give our skin a break.

B (49:42)

You're a very good listener.

A (49:43)

Yes, well, because I want to learn, I want to make sure I'm getting this.

B (49:46)

That's exactly it.

A (49:47)

Because I think I've overcomplicated everything my whole life.

B (49:49)

You and most people.

A (49:51)

Yeah. Let's talk about acne. It affects up to 50 million people a year in the US alone. And I understand that there are different types of acne. And so can you explain the different types of acne and how someone can tell what they're dealing with?

B (50:07)

Yes, for sure. So acne is not just a teenage problem. I want to start off by saying that I have so many women who are 28, 35, 44 who get acne, who are like, I don't understand. I'm not a teenager anymore. Wasn't I past this stage of my life? But there's four subtypes. One. And we're going to just start with hormonal acne, because I mentioned these women. But hormonal acne is driven by hormonal fluctuations that come and go. And because your skin is your biggest visible organ that has a feedback system, it's going to show up on your skin, especially due to androgen sensitivity. So testosterone, like hormones. Hormones and patterns are key here. With hormonal acne, you tend to notice it mostly along the jawline, where you get these deep cystic pimples along your jawline in a cyclical fashion around your period. And so that clinical history and the physical distribution usually points towards hormonal acne. Then you have Inflammatory acne. Number two, inflammatory acne you can kind of think of as that classic red pimple pustule on your face, coming and going, a little haphazard on your cheeks, your nose, your forehead, chin, et cetera. And it is often triggered by over exfoliation, hard products, barrier damage, people who've overstripped their skin, harsh winters, even if you had done nothing, it can cause it. That inflammatory acne, if not under control or taken care of, can lead to deeper cystic acne, which is number three, the deep painful pimples and nodules that can leave really bad scarring. And this is one where it is a spectrum, there is a continuation, but you can also just go straight to cystic acne on your own, just as a predisposition. And what breaks my heart is when I, I'm all for body positivity, but when you see people with really bad cystic acne just trying to use a pimple patch when you could try to treat it to minimize the scarring left behind, it's huge. And it can change your overall confidence, it can change how you show up in social settings, it can change how you present for yourself. And it really has a very strong mental connection. And then you have number four, comedonal acne. Comedones are blackheads, whiteheads, so you can have a little bit of everything, of course. But it's nice when you try to pinpoint what is the biggest root cause and start treating it there so you can start to see the improvements.

A (52:23)

Dr. Idris, why does adult acne happen and what is different about it? When you suddenly have acne in your 30s, 40s or 50s versus being a

B (52:35)

teenager, because your hormones are not stabilized, they're fluctuating. So you are a hormonal up and down. Compound that with the fact with as we age, our cells turn over every 28 days or so, but with each decade you can add 10 days. So in your 30s it might be 38 days, in your 40s it might be 48 days. So your cells are not differentiating as fast. So now we have inflammation, now we have slower cell turnover, now we have hormonal fluctuation. And so we tend to be more sensitive to it as we're going through those cycles of life.

A (53:12)

What are some of the sneaky triggers that can cause a flare up of acne that people don't even realize are the cause of acne?

B (53:24)

So other than like the basic ones, right? Hair products. Hair products can cause acne, can sometimes be very, very oily and can clog pores. So you have to be careful in what you're using. Touching your face not just with your hands, but like I just took my hands. I do have a problem. I touch my face a lot. But even through your phone? When's the last time you really cleaned your phone?

A (53:45)

Oh, God.

B (53:46)

And making sure your glasses.

A (53:47)

I always get stuff underneath my glasses.

B (53:49)

Especially if you're wearing makeup. So things that are coming into contact with your face that are not just your hands. And this goes even into the makeup world. Have we washed our brushes? Are we washing them regularly? Most people are not. They're using an old beauty blender that's been around. And so it doesn't mean that you're dirty, but it just means these are things that we have to take into consideration when we're thinking about our face. Heat and sweating definitely can also impact. And then diet. I think diet, like I said, is part of the picture. It's not the whole picture. But you can support better skin with a better diet.

A (54:21)

I am so glad you're breaking this down. This is so important. I can think of three people in my life right now that I wanna share this with immediately. And I know you can too. So let's hit the pause button. Give our sponsors a chance to share a few words with you. And I want you to have a chance to share all of this incredible information and tactical advice and all of the BS she's calling out with the people that you care about. And don't go anywhere because when we come back, Dr. Idris has so many more specific things that she wants to teach you and you need to know. Alrighty, we'll be right back. If you're standing in front of the mirror wondering what's going on with my skin right now. Dryness, sensitivity. It can feel overwhelming to figure out all on your own with all the products out there. That's why Sephora is a trusted destination for skincare. You can find high quality products from brands like Summer Fridays, Rhode laneige and Caudalie. And Sephora's beauty advisors will help with personalized recommendations based on what your skin actually needs. Shop skincare at Sephora.

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A (56:01)

This podcast is brought to you by Expedia. Planning a family vacation is a lot. Everybody has different schedules, different needs, and strong opinions. So wouldn't it be nice to have a copilot, something that makes the planning part way easier? That's where Expedia comes in. Expedia lets you book flights, hotels, vacation rentals, cars, activities all in one place. And when you bundle it together, you can save up to 30% plus if plans change, because they always do. At least in my family, Expedia helps you stay in control. Expedia, the one place you go to go places. Members only. Savings vary. CSITE for details. Welcome back. It's your friend Mel Robbins. And today we're spending time with Dr. Sherene Idris, board certified dermatologist, one of the most trusted voices in skin health who says your skin is not a problem to solve, it's a relationship to build. All right, Dr. Idris, you say that one of the most common things that people come into your clinical practice seeking help for is melasma. What is that?

B (57:12)

I studied it in theory, I studied it in medical school, I learned about it in residency, and then I experienced it when I went through ivf. But melasma is hormonal pigmentation that is driven by your hormones and it usually appears on your face in patches. Sometimes they're discrete and sometimes they're bigger, usually on your cheeks or your forehead. And they can get really emphasized with your pregnancy, going through ivf, with your period, going through menopause, life stress, you cannot predict it. And so with melasma, it's so tricky because the gold standard is treating it with a prescription medication like hydroquinone. But you can't be on hydroquinone forever in perpetuity. You have to take breaks when you use hydroquinone. And.

A (58:00)

And if you take a break, does it come back?

B (58:02)

Exactly. So your over the counter routine has to be geared towards sustaining how you produce pigment so that the prescriptions can really have hopefully more impact on a longer term, so you're not always running back to them. Now, in recent years, there have been recent discoveries like oral medications that can help with deeper melasma, like dermal melasma. Not everyone is a candidate, but it's called tranexamic acid. If you're prone to blood clots, it's not for you. But if you've never had one. It can change how you see yourself. And the reason I'm telling you this is when my melasma flared, I felt like a crypt keeper overnight. And I was 34, 35. And I remember my younger cousin, this hot young girl from Geneva, comes over and she's like, hi. Ooh. And that was. I was like, what? I just had a baby. And she goes, that's your first reaction? She goes, yeah, but what happened to your face? And it hit me like it was like a dagger to my heart, like, because I felt bad about myself. And so when you have melasma, there's this constant feeling that you need to hide your face. And it's a very heavy feeling. That sounds so silly and vain, but the repercussion is so much deeper that I didn't want to take a picture with my baby. I don't have any pictures of my daughter when she was the first couple of weeks old.

A (59:14)

That is so sad, because I didn't

B (59:15)

want to see my face. And so I think when you have conditions like this, it really does amplify that. Skin is not just a cosmetic organ, it's a whole person issue. And melasma is such a visual of that that for me, it's one of those conditions that I really do try to help people through. Not just in my practice, not just through my skincare routine, but educating online so that they know that they have tools at their disposal to help themselves.

A (59:40)

All right, for the moment I've been waiting for personally, I want to talk about aging skin.

B (59:45)

Okay.

A (59:46)

You said there are two key ages when your skin really changes. What is going on biologically beneath the skin that causes these spikes with your skin change?

B (60:00)

The first thing is understanding that aging, it's not a linear process. There are moments in your life when you age faster, there are moments in your life when you age slower. And understanding that timing and having your finger on the beat of that pulse helps because it allows you to know what to expect. So everything I'm going to tell you is not to breed insecurity or scare you, but it's so that you go into it feeling more prepared, less intimidated, et cetera. So the first peak is really in your late 20s, early 30s, where over the course of six months, you notice something shifts and you can't quite put your finger on it. And I think today's generation is much more attuned to it because of social, because of zoom, because of all the screen time that they have and selfies that they take. They see it faster.

A (60:45)

And what are they seeing? In your late 20s and 30s, what do your patients come in and kind of report to you?

B (60:51)

You're going from a growth phase where you're producing collagen in your teens and early twenties, to the beginning of a maintenance phase. And Starting in your mid-20s, you start to lose around 1% of collagen a year. Okay, so what they described is very subtle and not really ill defined, but they notice like a flattening on the sides of their face, like something looks a little flatter. They don't really know what they're pointing out to, but they look. I don't know what it is, but I just look different. The second peak is a little bit more dramatic. It happens. And I've noticed this myself. I'm going to be 42 in a week. But this happened at 38, where over the course of a month, suddenly I thought I developed jowls. And I saw them. And it's because the bony and structural foundation of your face, your bone structure, what's holding your face, starts to get thinner. And for me, it also coincided after breastfeeding and having babies. And something shifted in my structure. And I remember walking by that elevator being like, oof, what is that? But it was good and very humbling to feel it because it allowed me to understand what my patients are going through. But your facial bone remodeling, that is actively happening. It's like a scaffold, right? Think of a scaffold holding up a structure as it starts to get smaller, what's happening around it? Your volume, your fat pads, your skin starts to shift and fall.

A (62:14)

Yeah, it's hanging there.

B (62:15)

It starts hanging.

A (62:16)

Yes.

B (62:17)

Then the.

A (62:18)

I've hit that one.

B (62:19)

I've hit it too. But this is where bone health matters, by the way. This whole concept of really, you know, weightlifting and taking care of your bones is huge for women. And the first place you really start to see it is your face.

A (62:30)

Shut up. So I can get rid of my jowls by lifting weights.

B (62:33)

I think when you really build a strong bone structure and really make sure that you're focusing on your bone health, you're not necessarily going to get rid of them, but it's going to make sure that you stay more intact. Now, genetics come into play.

A (62:45)

Yes.

B (62:46)

But you can try to help yourself. Okay, now this is the third peak that has been scientifically proven. And the actual age that they say, I think is 44. There's a biomolecular shift and your cells age faster at this age. And What I hear from my patients, and I've heard this time and time again, is I've gone to sleep and I woke up and I don't recognize myself. And it's happening, and should I get a facelift? And it's like panic, panic, panic, panic, panic. On top of the fact that they're probably in perimenopause and their estrogen levels are starting to decline. And estrogen is really, you know, a hormone that helps with skin thickness. It helps with hydration, collagen production, oil production. So as the levels start to go down, your skin starts to feel thinner. Plus the inherent DNA change that happens in both men and women, and it's like all hell breaks loose.

A (63:32)

Yes.

B (63:33)

And then there's a fourth peak that happens in our early 60s, where at this point, I think we've come to a better understanding of who we are and how we're aging. It's something that's not as dramatic because it's not so sudden as at 44. But you have your bones, you have your volume, you have your skin quality. All three of them are kind of shifting at the same time. And there's another little accelerated burst in the aging process.

A (63:57)

You know, as a dermatologist, I want to know because I've had this conversation with so many friends. You know, one day you look in the mirror and you think, oh, my God, who is that? How do you best deal with the emotional sign of aging? Sagging, texture changes, and this recognition that it just feels like it's out of your control.

B (64:21)

This is probably, for me, I think, one of the most important questions that you ask, because hopefully we all have long lives and our skin is so tied to our visible identity that we don't often think of the opposite of how our skin affects our mental health. And as we get older, things shift relatively fast. Give yourself some grace. It's not because you didn't do. It's not because you didn't use. It's not because you did. Binge life was going to happen. But what can we do now to support ourselves? Having that sort of understanding really does lower that sort of energy around the aging process. And then just being open to learning about what is at your disposal, from over the counter skincare, to maybe prescription, to maybe something minimally invasive, to maybe something more extreme. And what is it that you want to do to help support yourself? Because when you help yourself, it's not like you need this to be confident. The goal is, hopefully you're confident with yourself. And this is a cherry on Top. But when you support yourself, it makes you feel better in how you show up for the world and taking away that judgment, even though you had that judgment prior. But once you live through something, you see it through a different lens and you realize that. But, you know, there are ways that you can help yourself without changing who you are and still be who you are.

A (65:42)

I love that. What do we do about these sagging jowls? Why do we develop them? And what the heck can we do about them?

B (65:52)

The dreaded jowls.

A (65:53)

I hate these things.

B (65:54)

Even the word sucks.

A (65:56)

I hate them. It's like skin purses hanging. It's like, where did these pockets come from? I'm not a squirrel that needs to store nuts in the winter, so I don't need this extra skin. I want to get rid of it. What? What do I do?

B (66:09)

Okay, so first, it's important. It's not a skincare failure. It's not because you didn't have a good skincare routine. It's not because you didn't wear sunscreen correctly. It's not. It's a structural problem.

A (66:19)

Yeah. It feels like a face failure.

B (66:21)

It's a fundamental. It's a structural issue.

A (66:22)

Okay.

B (66:23)

And so the four things that lead to jowls. Right? Your bone, your structural bone changes. That scaffold that's holding your face up is slowly disintegrating. Right. And so what's happening from there? Our fat pads in our face. And you have many of them.

A (66:37)

Yep.

B (66:37)

They start to redistribute and drop, in addition to the fact that they shrink. And then on top of it, the surface, your skin, almost like the fabric of a couch, doesn't have anywhere to go. Plus it's losing that collagen and elasticity, so it tends to just drape around it. So all of those three reasons compounded with potentially a fourth, which is repetitive muscle movement. There are some people who talk a lot like this or pull their teeth, and you could see their lower teeth when they speak. That emphasizes it. And so that is something that I think is really important that you understand so that you don't go buy, for example, a firming cream or a foam. It's not gonna do anything. And so at some point, you're gonna have to know where it's like a skincare failure or an anatomic failure. But if you get them and if they're affecting you from an emotional perspective, and if they're making you feel confident and you're thinking about it more often than not.

A (67:32)

I am. And here's the thing I want to now I'm. So what happened for me is I started to notice it and I obviously have a public career, but since we all have cell phones, everybody's seeing their face all the time. And so you just start to notice what is this sagging thing that's happening? And now that I know that it's structural and I can't buy a cream, I'm depressed. So now I else. But I started talking about it with my sister in law, Christine, who's my business partner. And then Kris Jenner gets the most incredible facelift I've ever seen. I talked to my sister in law, Christine about it. I now have my entire feed on social media of those plans. Dermal, whatever the heck it is. Facelift things. Plus all these women trying to teach you how to massage with your knuckles straight up. I even tried the face massage. I'm like, I am so not disciplined. I don't think I could do this for two years straight. Does this stuff work? What are we doing?

B (68:33)

Okay, I know you're probably stressing yourself out. Okay, okay, okay. So first thing is at least you know that it's bothering you. A lot of people don't realize that and they don't know what it is, but they're just getting angrier or more upset. So at least you know it's bothering you.

A (68:45)

Yes.

B (68:46)

When you know it's bothering you, you know. Okay, what are my options? Extreme is surgery. But there's a whole slew of things you could try to do for yourself if you do not want surgery or if it's not for you.

A (68:56)

Let's try. Let's talk about the things that are not surgery.

B (68:58)

We can absolutely talk about those things.

A (69:00)

So what are the options? What am I doing?

B (69:02)

Okay, starting with what you've already done.

A (69:04)

Yes.

B (69:04)

Your facial massaging. What you're doing when you're massaging, your face is moving lymphatic fluid around. So on the margin it's going to minimize that puff that's accumulating in gravity dependent areas.

A (69:15)

Okay.

B (69:16)

Is it going to make you look like a fetus? Probably not. So again, understand what you're doing and why. So you know how to continue.

A (69:24)

So it's not changing. When I take my knuckles or that L shaped thing and I do one of these things and I do this, then people are like this and do all this and they're like. And then you look like this.

B (69:35)

It's a temporary improvement.

A (69:37)

And so I might be emptying the bags of some of the things in there, but they're not. That the extra skin isn't going anywhere. It's a structural issue.

B (69:45)

It's a structural issue, exactly. So this is not me saying that it's useless. If you look better before a red carpet event, of course do it. But if you're doing it thinking you're getting your skin to get tighter. No, I am. You're not.

A (69:56)

You're not.

B (69:56)

You're not. You're not. You're just not. So that's not going to help. Oh, my God. So that's that. So beyond skincare and into the office. Yeah, right. There is a whole slew of things. And before we get into the details of every single treatment, what I tell my patients is, when you think of aging, there's like five or six categories that you can think of that you can actually help with. One is the lines that are built in on your face that are due to repetitive movement. That's Botox. But Botox can also change how you speak with your expression. So, like, let's say you pull down. It can help to minimize that pull, to minimize the look of the jowls.

A (70:31)

Okay.

B (70:32)

Two is, where are we from a volume standpoint? Do we have a lot of volume, but we're sagging? And again, I'm generalizing. Right. There's always shades of gray. Or do we have volume, but we're sinking now because it's kind of like going in and we're caving in. And this is where fillers come into play. Not to fill, not to create new proportion. And that's where people get into trouble. But when you use fillers very, very conservatively to keep the proportion of your face intact overall, and it's not symmetry, because symmetry doesn't exist. You can look more cohesive from a volume perspective, but that alone, volume fillers. Right, or stimulants are not going to necessarily get rid of the fine lines that are etched on your face. Different problem, different solution. I don't treat my depression with an antibiotic. Same thing. Okay, then you have your skin tone. Do we have brown spots? Do we have redness? And this, for me, I'm very passionate about, because it's the one place where people can take control and ownership over their skin tone by using the right products at home first. And if someone comes in and tells me, I want a laser treatment, but they're not doing anything for their skin, I look at them and I say, do you go to the dentist for a dental cleaning, but you don't brush your teeth every day, right? No, no. One does that. If you're not brushing your teeth, you're not really going for, you're not getting a dental cleaning once a year. So a laser is your dental cleaning and everyday maintenance is your most important part.

A (71:55)

Got it?

B (71:56)

Okay. Number four is your overall elasticity and texture. Do we have acne scars? Are we losing that? There are treatments in office that can be done to try to strengthen the foundation of your skin.

A (72:08)

Really like to get rid of that crepey old couch saggy ass thing a little bit.

B (72:12)

It's not going to get rid of it. Again, realistic expectations. But do we have radio frequency energies, we have ultrasound energy, heat based devices. But it's a tipping point. You don't want to overdo it and get rid of fat. So you have to find the right provider who understands your structure, where you're at and what your wants are for down the road. So you're, you're mapping the arc of your life. How do you want to age? And then we're plugging and playing and then you have, like I said, your bone structure. And then there is this whole world of bioregenerative. What can we use from our own body to stimulate our own skin to the best of its ability? I don't know what there is PRP and PRF from our blood. And these has growth factors, but growth

A (72:51)

factors, is that that vampire facial thing?

B (72:53)

Yes, but growth factors, it's interesting. Growth factors are like fertilizer. It's going to stimulate as good as the environment that you put it in. It's not always a home run. And I tell patients very honestly, the biggest thing you risk losing is money. But you're never going to know until you try. Then you have your fat where through fat you can revolumize. But the more interesting part about fat is that you can get fat stem cells and that's like a seed for plants. When you, you plant the seed, something is going to grow. And with fat stem cells, you can really regenerate tissue in your face, in your face, in your underarms, on your neck, your chest, your hands, your knees. Like I've done it all over. But it's something that you can help yourself with. It's not something you do all the time, maybe two, three times a decade. But it's something that, let's say you're in your early 40s, you're hitting this perimenopause, you start to help your body regenerate as everything else is declining over time. Will you look more cohesive where maybe you can Push back surgery if your structure allows. Right. And let's say you do want surgery, does it give you better results because your whole ecosystem looks better for you.

A (74:02)

Got it.

B (74:02)

So there are many layers to this onion and it's not. I'm going to get a laser treatment for my volume. Lasers are not going to give you the volume because it's not the problem that it's addressing. And that's something that's often missed in cosmetics where people think, oh, it's a magical laser or a magical device or a magical injectable. But the reality is you have to understand again, expectations meeting reality.

A (74:27)

Wow, that was so helpful. So where does collagen fit into all of this?

B (74:31)

It's a great question.

A (74:32)

Can you boost it and what are the two best ways if you can?

B (74:36)

So people think fine lines, wrinkles, they think collagen.

A (74:38)

Yes.

B (74:39)

And collagen is the main structural protein in your skin. Skin. But we know starting in our late 20s, it starts to decline at a rate of around 1% a year. Right. And this is due to internal changes, sun, hormones, maybe even inflammation. But I think when you're trying to simplify it, three ways that you can think of boosting your collagen. Starting with number one and the most trend worthy, collagen supplements and diet. There's confusion in marketing. Diet is very important. Like I said, it's going to support your collagen production, it is going to help your collagen production. And if you have a very well balanced diet, you do not need the supplement. Okay. But just taking a collagen supplement and expecting it to go straight to your skin for good skin, you're misleading yourself. And it's not a necessity. It's very expensive. It can be a whole budget on its own. So really I would focus on the well balanced diet where you're getting that protein intake, you're getting all of that to create that foundation for your skin. And if you want to add the collagen supplements, great, they're not going to hurt you, but they're not going to be the only answer to help yourself.

A (75:43)

Got it. Okay.

B (75:44)

Number two, topical skincare. This works with consistency and maintenance. It does not work as a one off. So being consistent with a retinol can stimulate collagen production over time.

A (75:56)

Got it.

B (75:57)

Protecting your skin with sunscreen is not going to make collagen today, but over time, when you look back, you will look better. And so having those maintenance points in your skincare can help. And number three, in office procedures, if skincare is maintenance in office procedures are like little accelerators. Right. Microneedling can boost a little bit your collagen production and your cell turnover. Certain laser treatments can help you help yourself. So there are little ways that you can help yourself through outside interventions to keep that collagen boosted over time.

A (76:29)

Let's talk about injectables. Who are they for?

B (76:33)

That's a very good question. I think it depends on the problem that we described. Do we have lines that are built in? Do we have volume issues? What are we trying to achieve through them? I think the reason why they've all got a bad rep and injectables being Botox and fillers altogether is not one single reason. I think it's multifactorial. I'm a provider myself and I think as someone in this field, providers do play a role. I think patients also come in expecting this instant gratification culture where more is more and they want to see the results right away. Way.

A (77:01)

Right.

B (77:02)

Botox is going to help you by minimizing how much you're moving your muscles. The goal of Botox is not to freeze you in perpetuity. I'm not trying to embalm you in Botox. Right. And so when you understand that, you start to see Botox through the lens of, oh, it's giving my face moments of pause throughout the year. So again, instead of aging more like this, this, I'm aging more like that.

A (77:30)

Yeah.

B (77:31)

Okay. Where instead of pulling down constantly, maybe it will help me change how I just move so I don't keep pulling because I know my jowls bother me.

A (77:38)

Yeah.

B (77:39)

So that's where Botox comes in. And side note, that's why I think I personally have an issue with like, the preventative Botox aspects of life. Because what are we preventing? What are you preventing? The lines are going to form. And so when people have no lines on their face and they want to start Botox, they're coming to me from a, a fear based, you know, motivation.

A (77:59)

Yep.

B (77:59)

And that for me is a sign that they shouldn't be doing it. Because when you do anything out of fear, you're not doing it for the right reasons. And starting too young is going to push you into this world where you think you need to be frozen. So I don't believe in it. And I usually tell young women what's too young.

A (78:15)

You think? Because I, I, I see this too, with the 20 somethings that I know, you know, wrenching up their forehead. I think I need to, I'm like, like what?

B (78:23)

I mean, I Think it's a great question that comes up and it's rightfully asked.

A (78:28)

Yeah.

B (78:28)

But it's hard to pinpoint a number. I've seen 20 year olds who look really old and I've seen 6 year olds who look really young. So I'm a little skewed. I think when the lines are there

A (78:36)

and, well, you see 100 patients a week even doing this, when they don't

B (78:39)

go away and they're really bugging you, that's when you can start. Gotcha fillers. Like I said, it's a different category. The goal is to keep the proportion of your face intact. And when it's done very, very subtly, you shouldn't be able to notice it. And it's not like you. Oh, and how often are you doing it? How much are you injecting? Where are you injecting? Are you injecting to try to catch up with time or are you injecting to play with where you're at right now? And so I think having that understanding is finding that provider that you fully trust.

A (79:06)

I love that. If the person listening is in a moment in their life where their confidence is in the gutter because of the state of their skin or one of their kids is in the gutter confidence wise because of the state of their skin, I would love to have you speak to them and tell them what a few simple things are that they can do this week to just feel better. Even if their skin is not there yet, is not gonna change overnight, it's gonna change over time.

B (79:39)

Okay? So if you're listening and you're feeling out of sorts because of how your skin looks, your confidence is not going to come from changing your skin first. It's going to come by changing your relationship to your skin first. So do not start by trying to fix everything all at once, because you're going to open the floodgates and it's never going to amount to anything. So three simple things that you can do today is one, simplify your skincare routine. Simplify, simplify, so you can be consistent. And even if that's just, I'm going to wash my face. Start with that. Small changes give you a sense of control and you start to feel better. Two, throw your magnifying mirror out. I cannot say this enough. Nobody is looking at you under a 10x zoom. Throw it out. It is causing more harm than good. And just start looking at yourself at a distance where people look at you and how you are seen and how you see yourself under the light that you Normally see yourself, but a magnifying mirror is probably your biggest enemy. And number three, do something for yourself. Even if it's not skincare related. Maybe it's wear mascara, put on a red lip, wear the sexy jeans that make you feel good, do something for yourself that helps you feel put together, like you're wearing an iron shirt. I think those three little things can cause automatic boosts of confidence and really allow you to start feeling like you're in control so you can make a change and a shift for yourself.

A (81:06)

I love that. Thank you. If you had to distill everything that you have taught us today into a very simple takeaway, what's the number one thing Dr. Idris that the person listening or watching on YouTube should remember and do after listening to this?

B (81:24)

I think if you're going to take away one thing from listening to this today, it's that your skin is not a problem to solve, it is a relationship to build. And you have to get to know your skin, understand the feedback, understand the signals, and hopefully gain a better understanding of what's at your disposal. So that when you're treating yourself, your expectations are met and you're not feeling like you're in a never ending cycle of nothingness. Because ultimately it's consistency that matters most. You want to show up without shame and I think telling people that you care about how your skin looks can sometimes be shameful. And you want to care for yourself without that shame. And I think understanding the basics will always serve you better than the trends.

A (82:14)

I am so thrilled that you came. I Learned so much. Dr. Idris, what are your parting words?

B (82:20)

Be kind to yourself. In the process, I think life is going to happen. Don't beat yourself up, but also be willing to change your own perspectives and have an open mind when it comes to yourself and the aging process. Because what I've seen in my life and in my practice and also in my own personal experience is more often than not, we are the ones who stand in our own way. So I think this is something that may sound superficial, in vain, but really just be really kind to yourself from the inside out and the outside in.

A (82:48)

Your skin is not a problem to solve, it's a relationship to build. And I am grateful that you have taught us using the research and the facts about the simple things that we can do, whether it's sleep or the taking a step back or really looking holistically or just the three simple things that you need, identifying the issue or the thing you wanna improve as you build a better Relationship with yourself and your skin. I feel more comfortable in my own skin. I feel empowered. I'm so excited by what you have taught us today. So from the bottom of my heart, thank you. Thank you. Thank you on behalf of myself and every single person around the world who's gonna listen to this and share this as a free resource with the people that they love.

B (83:35)

Well, I'm very grateful and thank you for allowing me the time and the space to dive in.

A (83:40)

Well, you destroyed it, woman. And I also wanna tell you before you leave, as your friend, I am so excited that you took the time to listen to something and to educate yourself. I learned so much. I know you did too. I have so many friends I am sending this to. I feel like we got a consultation with a world renowned dermatologist who has helped both you and me understand what we need to do to take care of the largest organ in our body and be comfortable and our skin and how cool is that? And as your friend, I want to be sure to tell you, in case nobody else does, that I love you and I believe in you. And I believe in your ability to create a better life. And what you learned today and the relationship that you can build with yourself will absolutely make your life better. So I hope you take the words to heart and you do it. Alrighty. I will be waiting for you in the very next episode. I'm going to welcome you in the moment you hit play. I'll see you there. Trace, you ready? Okay. I am so excited that you're here.

B (84:47)

I'm so grateful, honestly, like, genuinely, thank you so much. This is nuts. Like, to be like, what am I doing here?

A (84:54)

What are you doing here? I don't know. You are somebody that we notice and you're somebody that deserves a larger platform.

B (85:02)

Well, thank you.

A (85:03)

Well, I'm grateful you said you. Yes. Oh, you're doing great.

B (85:05)

Really. Okay.

A (85:06)

I'm like, you need to be on HSN TikTok shop, baby. I actually have to go to the bathroom. So let's see. Can we take like a two minute pause?

B (85:14)

Was that good or no? I don't know.

A (85:15)

It was fantastic.

B (85:16)

What I said is this. People are gonna be interested.

A (85:19)

Interested. You're so good. Oh, and one more thing. And no, this is not a blooper. This is the legal language. You know, what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist or other qualified professional. Got it? Good. I'll see you in the next episode.

B (86:00)

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