February 26, 2020 • 44 mins
Marc Glashofer was diagnosed with alopecia areata as a child, and was inspired as a hair loss patient to become a hair loss expert. Now he’s a dermatologist that specializes in skin cancer surgery and cutting-edge thinning hair treatments. In this extremely informative episode, Dr. Glashofer breaks down the stigma of thinning hair in women and explains what can be done—and answers questions about the most common skin complaints, from dryness and hormonal acne to rosacea and lines. Bobbi also opens up about philosophy on aging and her experience with Botox. You don’t want to miss their lively debate about the pros and cons of fillers.
For more from Dr. Marc Glashofer, please visit www.thedermgroup.com and follow him on Instagram @drmarcg.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Beyond the Beauty is a production of I Heart Radio.
I'm your host, Bobby Brown. I get asked a lot
of questions from so many women about what to do
to stay looking young, to stay looking healthy. My advice
is always the same. Start with what you're putting in
(00:25):
your body number one, and then you know what, There's
so many things that you could do to look better
without altering the way you look. So my philosophy of aging,
and I don't even like that word, because we are
all aging and that's a good thing. It's not negative.
But my philosophy is, if there's things that are really
bothering you, examine how you could make them better without
(00:48):
changing your face. I am not a fan of fillers
because most fillers I could see when people put it
in their face, it doesn't always work perfectly. I'm sure
they're any of fillers and people's face that look great.
I have seen a lot that haven't do. I wish
I had less lines in my face, yes, but I
(01:09):
don't even bother that energy because there's nothing I could
do about it. And I find that when I'm rested
and I am hydrated from the inside out, and I
have the right moisturizers and creams on my skin. I
can handle my age. I wanted to have a dermatologist
on the podcast because there's so many questions I want
to ask him about what can be done without altering
(01:32):
your face. I first started seeing Dr Glasshowfer because I
was concerned about thinning hair and just what happens to
hair as you get older. He also has a condition
called alopecia, which means he doesn't have any hair, but
he happens to be a hair lost expert. I probably
because he was a hair lost patient. He has a
(01:54):
lot to teach about our concerns. Here's my conversation with
Dr Mark glass Hoffer. Doctor Mark glass Hoffer, is that
how I said? Okay, pretty good? A dermatologist, but more
than a dermatologist, an expert in not only skin, but
(02:15):
also an expert in hair loss. Yes, that's correct. So
I'm expert hair loss as well as I'm fellowship trained
in MOSE micrographic surgery and cosmetic dermatology. And for those
don't know, MOSE surgery spelled m o h S, named
after the surgeon who invented the technique, is a way
of delicately removing skin cancers from usually head and neck
(02:36):
in other sense of areas of the body. Okay, well,
very interesting. The other thing about Dr glass Hoffer, he's
my dermatologist, and I went to see him first because
of hair loss. And when I walked in to say hello,
because he was recommended to me by another dermatologist. And
when I went into say hello, the first thing I
noticed is that he didn't have any hair. So your
(02:59):
story is that you were diagnosed as a kid with alopecia. Yeah,
so it is ironic that I've gotten into this field.
You know, people walk in, they're dealing with hair loss,
and the first thing they see is this shiny dome
and a gentleman who has no hair and tattooed eyebrows,
and they're like, well, am I in the right place?
But a really cute face? So how many guys look
(03:20):
good with tattooed eyebrows? And yeah. So my my story
and what sort of partially led me on this path
is I was diagnosed at the age of eight with
alopecia areata. When people refer to alopecia, that's generally meaning
hair loss, but alopeciata is a specific form of hair
loss that's an autoimmune condition. So basically my body and
people who have this condition, our body's immune system gets
(03:43):
confused and instead of attacking bad things like viruses and
bacteria and god forbid, cancers, it attacks our own selves,
our our own auto self. And so in my case
it attacks it very efficiently. And I have no hair,
So I have a form of alpeciata called alopecia universalis,
which is I'm or extreme form. Of course you had
to get the better one, of course. Of course, well,
if I'm gonna do it, I'm gonna do it right.
(04:04):
But it was an evolving process. And so when I
was first diagnosed, what I remember or constructed at this
point in life is that when I was eight years old,
my father took me to the barber and the barber
pointed out a quarter sized bald patch. And I've heard
a lot of patients tell me that story kind of
that an initial original patch, and then I don't really
(04:25):
remember it till I was around twelve or so. Coincidentally,
I was diagnosed with some form of crones yep, and
so I was on steroids at that point, which is
one of the treatments for alpi shada. So probably masked
the progression until later on. And then I remember through
high school and junior high, high school just sort of
kind of having various patches of loss. I would go
(04:46):
to dermatologists. It's one of the reasons I'm in Dermatology
is one of my mentors. One of the doctors I
was seeing, Dr Larry Miller, who passed about a year ago.
He evolved into a very close friend of mine, and
he guided me into his condition and I used to
go to every six weeks for shots and light therapy,
and as you can tell, nothing really helped, but he
really provided me with a lot of comfort. Basically, from
(05:07):
about twelve to sixteen seventeen or so, I had patchy
hair loss. And then I remember distinctly my senior year
of high school, was in the middle of a soccer game.
My brother was there, and uh, I remember coming off
the sidelines and sweating and I wiped my face and
this shocked look came over his face and some of
my teammates. I kind of had wiped off like half
my brow. I didn't quite know that till the game
(05:28):
was over. Obviously devastating and you don't really know you
know where to go with that, so I started doing
shots of cortizone in the eyebrows, which it helped the
cord zone shots that was getting from from Dr Miller.
I would grow a patch of hair back and then
I would develop another patch, and it's sort of like
chasing your tail. As things progressed, I started losing eyelashes
right before starting college, so kind of, uh, you know, tough,
(05:51):
tough way to start freshman year. It kind of went
in some actually remission. I did a treatment when I
was around twenty three that grew on my hair back
on my scalp treatment, so yes, that's one of things
I want to touch on it. It It was basically it's
called immunotherapy, and you apply a substance, a chemical to
the scalp that causes a mild irritation, and the concept
(06:12):
is is that you're creating an inflammatory response on the
skin that draws the inflammatory cells from the hair follicle
away and takes it somewhere else. It was like a
better party for the inflammatory cells to go to and
it allows the hair to grow. And it worked for me,
but it then stopped working, and unfortunately that's somewhat the
case with a lot of the treatments for this specific
(06:34):
form of hair loss is it sometimes things work for
one person that don't work for another person, or sometimes
things work and then they stopped working. And then after
that treatment, all of a sudden in med school, over
a one month period of time, I lost about seventy
percent of my hair. I was on a particularly tough
and challenging rotation at that time. Kind of can't stop,
you can't just not show up for rounds and things
(06:54):
of that nature. And then next thing I know, I
was down to about ten percent and then it was
time to, you know, to shave off the last little whisps.
And since then I've had the clean look that you see,
do you have any hair on your head? Like do
you have to shave it at all? Or now it's nothing.
I occasionally will get a wisp of hair, which is
kind of funny exactly. It's sort of like this little
(07:15):
like snoopy hair that goes up and my daughter gets
excited and it's funny, but she wants to pluck it
out right when it comes. But the thing that was
the best for me, ironically is after I lost it
all and everybody was like, wow, you look so good,
or this is, And it was sort of like this
kind of coming out type situation where I was like,
oh gosh, like how different and awkward must have looked
(07:36):
over all this time, and nobody wanted to say anything,
and I was like a chance for everybody, like this
is good and embrace this. So it's kind of like
finally not having to fight or worry about is this
patch gonna come? Is this gonna grow back? It was
sort of like, all right, this, this is it, This
is who I am, This is down to the core.
Obviously still working on that, but I think there's a
couple of actors that finally just took their hair pieces off.
(07:58):
I don't know, was it John travill To, I don't remember,
And it's like, you know what, so what exactly exactly?
For me, I'd say, you know, back then it was
probably Michael Jordan was one of the few people that
you know, could really rock that look. You know, it's
hard growing up with this type of condition, And nowadays
I look around and I'm like, wait a second, I
had to have so much grief grown up with us.
Now everybody just has my look, And when did you
(08:18):
get your eyebrows tattooed? So probably two My aunts took
me around some makeup artists. We were trying to get
the right brow color and stencils and shapes, and it
was horrendous and I was actually trying to draw my
brows on, not very artistic in that sense, and came
upon somebody who's a phenomenal cosmetic makeup artist and he
(08:39):
does the tattooing. And so since then I've had it
done and I've had some touch ups along the way. Well,
this is a podcast, and no one could see what
you look like, but you don't look weird at all,
Like you look normal, Like you just look like some
guy that has like a shaved head. Ironically, after some
years having to explain myself of what I have, ironically,
now people come up to me like I remember this one.
(08:59):
I was in ving for dermatology positions and I was
in Penn station and a particularly creepy bathroom and this
is Timing came up and he was like insistent on
finding out what my secret was for shaving my head.
He was like, what what magic solution do I use?
What blade do I use? What direction or angle do
I go in? And I kept insisting on telling him,
you know that this is not something I shave, and
I don't think he was completely coherent, and he was
(09:21):
getting angry and angry with my response. I wasn't actually
giving him my secret. But I have that from time
to time and when a lot of patients come in
and say, what do you do, and I explained, this
is this is the condition. And what's nice about with
the role that I play with having so much exposure
to patients, is that when I tell people that this
is not something that I actually chose, but I have
this condition, people say, oh, that's interesting. You know Bob
(09:43):
in accounting has this, or my next door neighbor's child
has this, so it sort of increases awareness. Yeah, you,
I mean certainly. The first person I heard was a
friend of a friend, a girl who was making mushroom
tea which now turns out to be kombucha because she
was told of that would help. So I don't know
if things like that help. There's there's no clinically proven,
(10:06):
rigorous studies to show that a lot of things with
the hair are coincidence. Sometimes for whatever the reason is,
especially with what I have, the ALP share out if
you get it later in life, sometimes it develops is
a patch that just spontaneously regrows, and we don't know
why it happened, why things got off kilter, and so
there's a lot of times spontaneous regrowth can occur, and
so if you're doing X, Y, and Z, we sometimes
(10:27):
like to attribute it to that, but often isn't the case.
It just happens. So we're going to talk about what
works and what doesn't work in your opinion, But what
are the causes of hair loss, particularly in women? Absolutely
so you can break down the causes in terms of
inflammatory and noninflammatory. It's one way of looking at it.
(10:50):
In terms of inflammatory conditions, they're they're rare. So we
talked about what I have, the alp shariata. There's rare conditions,
something called like in planet Polaris, or variation of that
called frontal fibrosing alopecia, which is being diagnosed a little
bit more. And women come in with often a very
itchy or painful scalp and a particular type of hair
loss which is clinically recognizable. You want to treat that
(11:12):
sooner rather than later, because it's actually a scarring form
of hair loss. It's another way of categorizing hair loss.
Between scarring and non scarring, meaning the hair follicles themselves
are scarred down and if they're scarred from the inflammation,
you're not going to grow more hair through that follicle,
through that opening, So you really want to treat that. Early.
Rarer forms of alopecia can be seen in Natians have
lupus and so same thing, you want to prevent that
(11:33):
from scarring. So in terms of the inflammatory scarring alopecias,
we have that category, then we have the more common categories.
So the majority women that coming to see me have
female pattern hair loss otherwise known as androgenetic alopecia. And
just like we all know there's male pattern hair loss,
we've known that for a long time, female pattern hair
loss does exist and it's just represented, under recognized, and
(11:55):
not talked about as much. But I also see a
lot of women that they don't necessarily have, you know,
the bald pattern, but they just have really thin hair
where you could see their scalp yes, like, what is
that from. It's a diffuse form of hair loss, and
it's basically men and women they have different ways of balding,
they have different patterns. So the pattern you're describing with
that diffuse hair loss and sort of the the part
(12:16):
gets wider and the central scalp and a little bit
the temporal recession. That's usually how women have their balding
pattern and their hair loss pattern compared to men. Just
going back to touch on it. Another form of hair loss,
which is very common in both genders, but I see
it more in female patians, is something called intelligent effluvium,
and that's when you have rapid shedding of the hair.
So a lot of times you see it or you
(12:37):
hear about it after pregnancy. A couple of months later,
you might have a rapid shedding and diffuse shedding of hair.
And it's very alarming because you're in the shower and
clumps the hair coming out, and you're seeing in the
sink or in the hairbrush or on the bed. And
it can happen after any type of shocked the body,
so any type of stress, so pregnancy is very stressful,
or a surgery or a big stress. Not you know,
(12:59):
daily stresses and nuisances, but something like death in the family,
loss of a job, divorce, rapid weight loss, any type
of restrictive diets that can lead to telligent of fluvium.
You also need to make sure when you're seeing somebody
with air loss that they don't have underlying medical conditions.
So thyroid disease of very common condition, especially in women.
About ten percent of women will develop some form of
(13:20):
thyroid abnormality and that could lead to hair changes. And
then just going down the list of things you want
to rule out any new medications. I want to rule
out any nutritional deficiencies, which are really rare in this country.
You thank goodness, but there are times when people are
iron deficients or have deficiencies and other things. But it's
not as common. But isn't hormones like people always say,
(13:42):
check your hormones? Are your hormones? Okay? Exactly? So that
ties back into so what does androw genetic alopecias? So
Androw refers to hormones basically, mainly testosterone Specifically, and Andrew
genetic genetic means just that it's the luck of the draw,
the roll of the dice, how we were born. So
as women men mature, they have less estrogen and testosterone
(14:03):
levels don't increase, but they play more of a role.
So testosterone is what's responsible in the byproducts of testosterone
are what are responsible for causing hair miniaturization and decreased
hair growth and the thinning that we see in both
men and women. And so with men, we we do
have decreased testosterone as we mature. Women you have decreased
estrogen and more of an effect of the testosterone, not
(14:26):
necessarily more testosterone, which is more relative effect of the testosterone,
and so you don't necessarily have to have hyper testosterone.
So a lot of times if you check the labs,
all the labs look fine, but the effects of the
testosterone around the hair follicle are more susceptible at a
later age. Additionally, the genetic and we don't know the
exact combination of things that lead to baldness, but we
(14:48):
do know there's receptors and there's molecules, and some people
are more sensitive to the effects of testosterone. And I
bring that up because sometimes we see female pattern hair loss. Unfortunately,
I have patients that come in their twenties or thirties,
and you can have premature both male and female pattern
hair loss. And so it's not just something that occurs
later in life. But about fifty women after the age
(15:09):
of fifty do have some noticeable signs of female pattern
hair loss. Okay, so what could these women do? Like
who who could expect to get a benefit and who
really shouldn't bother And we always want to have an answer,
and usually there's not a good answer, and that's unfortunate
because human beings like control and like to be able
to blame things. So often you you can't predict. And
so some people come in and say, you know, my
(15:31):
mom and my dad have full heads of hair, and
I have this, and well, it doesn't always work like that,
but it's not uncommon that when will come in and say,
I have a couple of ants, or my mother had
very thin hair and they're in their eighties, and I
just I don't want to end up like that, And
that's one of the things that we'll bring them into
initiate treatments. So one of the things in terms of
trying to create a treatment plan is education affirming that
(15:52):
what they have is normal, because a lot of women
come in and they think they're the only one suffering
from this. And also it's it's a stressful period because
it does to indicate that we're getting a little bit
more mature. I keep using that mature older. Well, because
you know what, no one talks about women's hair loss.
It's all men's hair loss. On a personal note, when
I first noticed things were changing for my hair, you know,
(16:14):
I I didn't understand it. You know, I didn't know
anyone else had had this issue. And it turns out
two things were happening to me personally. One is my
hair is white. No one out there who knows what
I look like can even imagine what I would look
like with white hair. I've been coloring my hair since
I'm twenty five, and apparently the hair follicle is thinner
(16:36):
when it's gray, correct, it can appear thinner. Yeah, so
I have, you know, less density in my hair. But
then I also was finding that that I was getting,
you know, some spaces in my hair without the hair grows.
So you know, I freaked. I'm in the public eye.
You know, I'm someone that actually I'm my beauty is
always like all about my hair, you know, my skin
(16:56):
and my hair, and it was kind of scary. So
I went to see you, and you know, you automatically
gave me this treatment p RP, so would you And
I have to say it worked. It was a little painful.
A little expensive, but it's so worth it. But could
you tell everyone what it is? Certainly so, PRP is
(17:19):
one of the most recent and newest advances in medicine
and specifically hair loss. So prpsints are platelet rich plasma.
So the platelets are these bags. They're technico even cells,
but these bags that are floating through our bloodstream. And
when we get injured, either internally or externally, the platelets
they rupture and they release all these growth factors and
regenerative molecules, and these things help promote tissue healing. And
(17:44):
so originally PRP was used in athletes and before going
to surgery. Some interesting orthopeda started playing around the PRP
and injecting into these injured joints, and they found that
it was able to push off patient's need for surgery.
So in the lab and else where, people start to, well,
what else can platelests do? And we started using it
for a college and rejuvenation on the face, and then
(18:05):
some early pioneers started using it in practice. And then
about four years ago I said, hey, you know this,
this is interesting, and I'm not quite sure why exactly
this would work, but it's it's the science is looking good,
And so I said, I have to start trying it,
And so I start trying it on some patients and
and lo and behold, I saw results. Now, Now what
a results mean? And this is part of understanding is
I always tell patients that no matter what you do,
(18:27):
whether it's PRP or other treatments, when you are having
a hair loss, you can only think about hair growth.
How how can I get more growth? And what you
forget is that how do you stop the loss? How
do you minimize the loss? How do you minimize the
thinness and the shedding? So that's success if you can
do that. It's a harder thing to see, but about
fifty percent of patients will get an increase in hair
(18:47):
thickness and density and some regrowth with PRP in what
I've seen now, that's just in my use of it
and what I've seen amongst my patients. There's unfortunately, currently
there's no definitive case controlled rand my studies. They are coming,
but it's not there quite yet. But I started doing it,
and I went from saying, Okay, this seems like it
(19:09):
could work too, Yes, this is this works, And I
can now offer this consciously that I know that this
is something that I can promote to patients and give
them an option. Before PRP, I used to say, Okay,
we have row gain and we could potentially do some
oral medications, and then there's hair transplant and and there's
nothing in between. People like I don't want to get
a hair transplant, and it's generally safe, but there's some
(19:30):
invasive things involved that people do. You know, it works
and it's great, but it's end of the road. Do
you think rogain works ro gain is of benefit for
slowing the process down? I do not think it quote
unquote works and regrowth and I don't think it has
a big wow effect, but it's something that does benefit
in terms of slowing the progression. The PRP results are
(19:51):
more beneficial when you're using the row gain rogain alone.
I do try to get people to get to start that,
but by itself, I'm not super impressed. So some people
come in and say, I don't want to do row
gain because it's a pain to do, and you know,
it's I have to do. It's Bessie. But you know PRP,
it's natural and people like that. It's it's your platelets.
There are no side effects short of some of the
(20:12):
discomfort that you you you can attest to. You know.
I like to say in terms of the pain talking
about that, it's like the gym. You know, you're not
gonna stay in good shape. Plus you expend some efforts.
If ten is the worst pain in your life and
one is nothing, I tell patients it's probably about a
two to three out of ten, I would I would
give it a six. I mean, no, it hurts. It hurts,
but it's not that I mean, look, I've done it
(20:34):
because I did the first series, which was what five times.
The way I do it, I do one treatment per
month for four months. That's what I call the loading phase.
We try to jump start the hair follicles. And then
I recommend a maintenance phase, usually every four months. Sometimes
people can push you to six months. And so it's
like two or three times per year for the maintenance.
(20:54):
And what does it normally cost? I know it it
varies where you live, it varies. And so you're a
New Jery is he not New York? So yeah, it's
not as bad as New York executive New York, you know,
things are everything is more expensive here. I charged seven
and basically I'm a true believer that it's the platelets
that are doing the heavy lifting and having the results.
There's a lot of things out there where people say
(21:15):
PRP with stem cells. Stem cells haven't quite made it
to real life there in the lab, and there's great
potential of them, but there's no such thing as really
true stemselves out there. I don't personally believe that those
things help anymore than just sort of being able to
charge more. That's that's my opinion. UM. I also don't
want to outprice anybody. I know it is pricey, but
(21:37):
I feel like that's a good price point for many
people to be able to get it, and there's so
many people suffering from it. I'm definitely a believer. But
you don't believe in by at In or any of
that stuff. To you, the studies have never played out.
The whole by at In story, so to speak, comes
from back in the day whatever you want to describe
that as eight nine hundreds, when we didn't have as
(21:58):
rich of a diet. If you had a by Ittin
deficiency and it was diagnosed, so you'd have a lot
of hair loss, and then you would have by as
in rich foods and things, and you'd go your hair
back and so so wow, it's amazing. It's a magic here.
So somebody was smart and said, well, everybody has hair
loss and they all want to take by it, you know,
they want something to do. So that's where the bit
(22:19):
and market came. I make a make a bytin gummy
and you know, I eat it every day. I still
have hair and people tell me that they've noticed their
hair like coming in. You know, I I can only
hope that it's true. I will never tell somebody, you know,
to not take it in the sense it's not harmful.
It's more just that I can't recommend it because it
hasn't been proven to be the case in a scientific way,
(22:41):
like most supplements. Like most supplements, exactly most supplements get
paid out. There is actually a recent study showing that
too much byton can actually affect certain lab tests. So
if you're taking high doses of by it in and
you go get certain routine bloodwork from your primary care doctor,
those tests might be altered if you're taking too much byton.
So well, we tell people only two gummies, and I
know there's people, so I won't tell you to not
(23:03):
take your gummies. If you want, you can you know,
and maybe it does work for some and maybe it
doesn't for others. But a lot of times people we
want something to do. For instance, an analogy is when
I'm doing skin cancer surgery, people will come back and say, hey,
I want I want something to put on my scar.
And there's certain things you can recommend, usually silicone sheeting
and things of that nature. But a lot of times
(23:25):
your body is pretty amazing and it's healing, and people
come back and say, I use this product and God,
and you know, my scar went away. It's more your
scar went away because it was well sutured and your
body just did what it was supposed to do. Oh,
I don't know. I I might disagree with the doctor.
I'm only an honorary doctor. But you know, whether you
put vitamin E on something or some kind of ointment
(23:46):
that you're you are correct, You are correct. It's not
vitamin E. And that's another myth that I'm gonna spell now.
Vitamin actually can cause a contact dermatitis. Vitamin E keeps
the wound moist, and so we found that it's not
the vitamin E. Per se, you can use vasoline which
can keep the area moist. So moist wounds, moist scars,
and things of that nature. Hydrated skin heals better, and
(24:08):
that's sort of the concept of silicone sheeting. Silicone sheeting
creates sort of a micro environment where it's more moist
and things of that nature are going on. All right, Well,
we learned a lot about hair. Now let's go to skin. Okay,
because you treat people skin, well, what's the biggest complaint
(24:32):
when people come in. So at this time of year,
you see a lot of dry skins. We mature our
skin and I'm starting to see it too, our our
legs and our skin. Stork gets very dry and very scaly,
and we don't like that. And sometimes not just dry
and scaly, someone who becomes itchy and get these little
patches of exema the form. So that's seasonal things. You
see that pretty frequently. Of course, acne is one of
(24:52):
the top diagnosis we always see, and we see a
lot of that year round. And what is adult acne
caused by So adult acne, especially female adult acne's which
is usually who gets the adult acne, is hormonally driven.
I saw a woman today who had clear complexion all
throughout her teenage years. In early twenties, and now she's
breaking out. And and the adult female acne usually has
(25:13):
this characteristic picture doesn't always, but of usually kind of
the cystic a little bumps underneath the skin. They're they're
often hard to get rid of, and they usually on
the jaw line around the mouth. And what's showing is
that that same medication I mentioned before, spironolactone, which is
used at times for hair loss, it has a great,
great significant effect on adult female acne, so I usually
(25:34):
will recommend that over an antibiotic combines with a retinoid.
So so retinoids are the first line agents in acne,
in any form of acne. What it does is it
helps break up all the dead skin cells that are
in the follicle, and that's the process that causes acne.
We have these dead skin cells behind that you get
a backup of oil. Within the oil, you can get
bacteria growth and then an inflammatory process. Acne is there
(25:58):
is a bacterial component, but acne is actually an inflammatory process.
And the retinoids they hit every level of acne. They
open up the pores, they decrease oil size and oil productions.
You're not as greasy, so you can't have as much
bacterial growth, and they also do have some effects on
the bacteria. So retinoids is the first line agent for
any form of acne. Retinoids also slow down the breakdown
(26:20):
of collagen, So there's an enzyme that naturally breaks down
the collagen we have, and on the molecular level, retinoids
help minimize the effect of that enzyme, so it keeps
our collagen more plumped and more around. And retinoids can
help with fine lines and dark spots and just overall
complexion and rosy glows. How do we keep the collagen
(26:44):
or can you? So patients come in and they say,
you know, I was at X, Y and Z store
and I saw all these things on the shelves. What
should I do for my skin? So the two things
I always recommend, two things I'd love to have every
patient on, and I have my wife on it, and
my mom on it and myself. So sunscreen. Anytime you're
gonna be outside side for a significant period of time,
you have to remember, not just during summertime. If you
(27:04):
know it's April and you're going outside for you know,
forty five minutes here and there, all that sun adds
up when we in our sixties and seventies and eighties,
we we see those effects sometimes earlier. Of course, if
you're going skiing, you know you have to consider the
rims of the ears and nose. Those areas get burned
pretty pretty easily. Top your head, top your head, so
sunscreen for any significant sun exposure you can have. And
then at nighttime I recommend some form of a retinoid
(27:26):
because the renoise are really just great for rejuvenation cell turnover.
And we talked about the decrease in collagen breakdown and
the fine lines and dark spotts. And is that a
prescription or non prescription. I think the prescription strength products
work better. There are retinal products that are on the market.
They work fine enough, but if you're gonna do something,
I would go for the actual product that technically works better.
(27:48):
But some people don't have time to go see the
doctor and get a prescription. So if you do something,
a retinal based product is a benefit, and you have
to make sure that you're not over using it. It's
one of those things where less is more use it
just so you at the benefits you put under your
eyes or not, so you can be put it very
very sparingly it's not recommended to do that much of it,
(28:09):
or to use a very high strength. I would when
I use retinoids, I moisturize first, and then I take
a piece size and mountains spread it to my entire
face underneath my eyes. I might do it like once
or twice a week, a very small amount. Sometimes when
I see my mom, she's scaling in what's called the
national labi or faults from from the nose to uh
to the lips, and she's like, I'm using that cream,
but why am I getting this? And I'm like, are
(28:30):
you just putting it like right in that area because
that's where you have a lot of volume loss and
you're trying to stimulate information. She's like, yep, I'm like,
it's not how you want to do it. And what
about rose sha, I have a lot of people that say,
what do I do about rosation? Sure so, roseatia is
a frustrating condition. Roseta sort of a cousin of acne
and some people rosatious acne rosasia. It's a combination of
(28:51):
inflammation where you get the red bumps, and a vascular
condition where people's blood vessels are just more sensitive, you know,
spicy foods and red wines and citrus fruits, things like that.
You know, things that we enjoy can cause the blood
vessels to open, and so we get a combination of
flushing and redness as well as bumps. Some people have
both those components. Some people just have the red some
people just have the bumps. So there's a lot of
(29:11):
things you can do. Topical medications, some of the same
ones you'd use for acne, and then we also use
anti inflammatories. There's some medications that work like steroids but
are safer than steroids. There have benefit. And then some
people come in for just the redness, and there's some
molecules are specifically meant to clamp down the blood vessels
topically to help get rid of the redness temporarily, and
at times we use lasers. Lasers actually work the best
(29:33):
for the redness of rosation. Like what lasers there's vascular lasers,
and lasers work based on wavelength and what they target.
There's lasers have a five eighty five and five ninety
five wavelength. There's one laser in particularly I like called
the v beam lasers. Another one called XLV which really
helped target those blood vessels and basically makes the blood
vessels go away, makes you less red. I think lasers
(29:54):
are amazing. Lasers are amazing, and people come in they say,
I want laser. There's so many different uses of them.
It's not is one lasers. How much of your practice
as lasers, I'd say about twenty five of my practice
is cosmetic, and within that I do fer amount of lasers.
Some some people that's their entire business, exactly some people.
And we owe a debt of gratitude to those people
because a lot of often are doing the trials to
(30:17):
prove the efficacy of those lasers. All right, well, let's
talk about wrinkles, or I like to call them lines. Lines.
So there's like, right, so what could you do about
lines in the face? So so lines in the face
depends where in the face, and so we're talking about
most commonly the we call them the elevens, those lines
in between the brows. That region is called the glabella.
(30:37):
And there's three muscles there that when we use that
over years and years and decades, they start to make
those muscles they create creases in the skin. So the
lines in the glabella region between the brows and the
foreheadlines and what we call the crow's feet around the eyes.
Botox is the best medication for that. And I love botox.
I hate botox. Don't you like about it. We're gonna
(31:00):
have a debate. Number One, it's bottle is um. It's poison.
So you're putting it in your face. Okay, it's got
to go somewhere. It's got to end up in the brain.
It's gotta It doesn't just like go into thin air.
It's an interesting perspective, and that's what people do. But
it is created from Bochlin toxin and basically it's so
(31:20):
diluted out, so diluted out, it has no adverse effects
like eating a bed, micro dosing heroine. Yeah, well what
we do that for pain? And you know, God forbid,
when somebody has cancer, we're using poisonous substances to try
to eradicate that. Not comparing obviously cancer and and cosmetics.
(31:41):
But it's it's basically we are using such a micro
dose if you want to look at it, that it
is safe. So it's not like you're eating a old
can of beans that you found and you're eating getting
a whole dose of that will kill you. All right,
So I've done it a couple of times, and when
it first came out, I must have been in my forties,
and we didn't know, you know, if it was good,
(32:02):
if it was bad. It just came out. I had
two of the worst side effects ever. I had a
brow drop once and my husband thought I was having
a stroke and I never admitted to him that it
was botox. And the other time, I had, you know,
an eyebrow that like shot and I went to like
the best New York germs that you can go to.
(32:24):
It just and I'm like, all right, God is telling
me something and I just stopped. That's one thing. Okay,
So I've had bad I've also seen so many women.
I've seen really good botox. Okay, but I've seen so
many women who have this like intense shiny forehead and
the rest of their face and body is wrinkled. And
it doesn't So when you get to a certain age,
(32:46):
like it just doesn't work. So I I agree with you.
Let's address the side effects. So anything in that potential
side effects basically how boche of them talks and works
or botox is it Basically it causes the muscles and
make facial expression. It minimizes their movements, you know, so
some people say it it doesn't make a complete paralysis
(33:06):
unless you use a large difference and until it leaves
your body, then you start moving. And it's a protein.
It's basically it's a protein that's taken up by receptor
and that protein breaks down over time over the next
couple of months. So it doesn't stay in your body.
It doesn't eat away your brain, it doesn't do anything
that's definitely been proven that should lay your concerns there
doesn't work like that. You get botox every four to
six months. Some people do it even more frequently for
(33:28):
decades and you're not gonna have any long term side effects.
But even in the best of hands, you can get
a brow drop. Basically, there's a muscle around the eye
called you know, the bigularius oculi, and if you put
it too close to the brow, you will get that
brow drop. But sometimes there's even diffusion. Even in the
best of hands, people know their anatomy, you can inject
it and you can get the bo tex going in
a place. It gives you a spock or give you
(33:49):
a drop. But I always sell patients. You know, it
doesn't happen frequently, but it is a risk. And now
they're putting botox under the chin for next. So there's
there's something called platisma bands that you sort of see
when people when they clenched down on their teeth. You
could see those bands, especially if somebody is very thin,
and that can release those muscle bands. There's a muscle
down in the lower face. Put a little botox taken,
(34:11):
given a little upward turn of the smile. I'm a
big fan of of botox. But if you can do
agent gage free, it's perfect. And I'm an advocate for that,
and I wish I could be more like that. When
you do these things, you have to do things conservatively.
I call like the newscaster look, and it's it's a
look you see these people on TV and they're frozen,
like they are just completely frozen. And I personally do
(34:31):
not like that look. I hate that look. And it
looks like they're done. They don't look natural, there's no expression.
And how many actresses do you see and you're like, who,
I can't even tell if that's who it is, and
and and that happens, and that sometimes happens a stage
of life, and I feel for people that's that's their career,
and they're they're so wrapped up in what what they
look like. I can empathize with that because, you know,
(34:54):
just with my hair loss, I can imagine as an
actor or somebody who's in the public I and you
have it in your certain look at one point and
then all of a sudden, you're you're changing, and you don't.
You try to capture that, and sometimes you overjump it.
And when you overjump it, whether it's uh, you know,
an overdone eye job or too much filler and cheek implants.
It all can be done well, and many colleagues that
(35:15):
do do it amazingly well. But some people think that,
you know, go go bigger, go home. And I think
there's like this over lasered look, as over botox, over filled,
overlaser look. And just like you're saying, it's like people
they might look quote unquote good, but it almost doesn't
look natural. But I think of it like when I'm
weeding my garden. Okay, you're making it look better, but
(35:36):
like where do you stop? Where does the obsession? When
am I done? And it's the same thing on your face,
It's like, you know, okay, I'll do this I'll do
a little bit of this, and all of a sudden
it's like, all right, that's not working. Let me do
this too. And then all of a sudden, what do
you do? You're in your sixties seventies. There's a high
degree of body this Morfi syndrome and facial syndrome and
people trying to chase after every single do you see
(35:57):
this crease? Do you see this sprinkle? And it's a
serious thing. And I will tell people you really don't
need this. I actually think that you should not be
pushing things that people don't need and put the brakes
on it when when they need it. Yeah, But I
also think there's a certain time in your life where
you just have to say, okay, okay, I'm not that anymore.
This is who I am now. Yeah, no, no, And
(36:18):
you know, I mean, look, I planned to be, you know,
a grandmother one day. You know, I don't want to
look like one. But it's okay, you look great personally.
And years ago these products weren't around. You know, Collagen
was the first filler out there. Even actually silicone was
the first filler out there, yeah, I believe it or not.
And it was actually a decent filler, but except now
all these women have to take their silicones out because
(36:38):
it's affecting their body. That's a different Yeah. No, But
I'm a holistic health coach because I really do believe
that you have to be a little careful of what
you're constantly putting in your agree completely, I agree, and
you know, tying into the hormones, and yeah, girls are
having that periods earlier. Yeah, we you have to be
careful of what we're putting in, what we're consuming, what's
in our environment, No, no doubt. So the things weren't
(37:00):
around before, and so people did age gracefully and there's
a lot to be said for that when used correctly
and in moderation. Like everything, you can make that case.
Everything these products, whether it's fillers, lasers, botox, or other approaches,
can provide a certain person benefit. Okay, I will. I
(37:21):
will accept that. And I do believe that it's okay
to contour. If you're someone that wants to contoy your face.
I don't like contouring, that's okay. We're allowed to have
different things, and I'm I am. I'm also very excited
because I think there's going to be more things on
the horizon. That will help. And I know one day
there's gonna be a laser that gets rid of you
know that eleven between your between your brow, So I
(37:43):
will talk, Yeah, I will. I will sign up for that,
Thank you. And what do you think about the you know,
the body treatments, like do you think you know whatever
those things are called that gets rid of the fat
cells whatever? Cool skulls? Yeah, I mean they work. They work.
Once again, you were is always you gotta you're really encapsulate.
What work means? You can't come in and be obese
(38:04):
and say cool sculpt me, and you know you're gonna
walk out the six pack. Cool scope is really specifically
meant for somebody who isn't relatively decent shape for their age,
but you know, the hormones are slowing down and they've
got certain pockets of fat they got you know, the
love handles and the spare tire and the thighs and
things of that nature, and they're like, this is annoying.
I go to the gym experience, you know, five times
(38:26):
a week and I can't get rid of it. So
cool scope is helpful for that. Once again, when you
get cool sculpt it's not like you just grab this
pocket of fat and it just all goes away. You'll
have about a thirty percent reduction with each treatment you do,
and so there there are benefits. Pretty good. It is good.
It's painful though, right it can be once again, I'm
gonna believe you know. Pain is pain is pain. There's
cool Sculpture's two different ones. The cooling technique basically is
(38:48):
based on if you cool the fat cells such a degree,
you kill the fat cells and one in fat cells
us early their finite amounts. So once they're gone, they're gone.
You know what happens when you, you you know, put on
the weight again, you'll you'll you'll add the fat too
well to the cells that persist. It's not gonna get
rid of every single But so there's the cooling and
then there's the heating. They both work by by working,
(39:10):
you have to sort of meet with somebody and really
assess your goals and really have a realistic goals, have
a nutrition plan, workout plan, and then basically you can
do these other things. It's another technique out there called
m scalpe, which actually caused these micro contractions and can
tone muscles. That's for a very unique group of people.
Well exact, basically, you have to be in good shape.
Once again, if you have too much adipose, too much
(39:33):
fat covering your muscles. So it's meant for somebody who's
in really good shape, who just needs to who wants
to get toned up. I mean personally, I think it's
somebody who's probably a model or an actor. Okay, so
now I've got a speed round of questions. All right,
what's the last thing you ate? Cheese, sandwich? What's your
drink of choice? I hate to admit this dia pepsi.
(39:56):
I know pepsi. I was talking about Tequilan vodka, wine.
Gonna get that diopepsi. All right, now your health coach
is starting. Okay, I'm taking over this episode. No diapepsi.
I'm trying to I'm really trying to cut back. My
wife refuses to buy it for me. She knows. How
many do you know it's unhealthy? You drink coffee? You do?
I'm a big fan of coffee. I'm big believer in caffeine. See, okay,
(40:17):
caffeine is fine. But there's green tea, there's espresso. I mean,
you know, I know you're a guy that likes chemicals.
But it's that and you like science, go read read
about the signs. It's the nial. But but my drinker
tries to vodka. Vodka, okay, how do you drink it?
Martini up with blue cheese olives my favorite? Nice? What's
(40:38):
your personal skincare routine? Less is more? I use a
moisturize of sunscreen in the morning and which one whatever
is in my drawer, usually some form of a sample
that somebody wants me to try. And then in the evening,
I if I remember I am a guy. At the
end of the day, I try to do some form
of retinoid a couple times a week. Maybe. What do
you think a skincare item that most women don't have
(40:59):
but need some form of a retinoid? I'll tell your
skincare item that I hate that women have. Two things.
I'm not a big fan of exfoliators. Thanks foliating is
actually quite bad or routine exfoliating I think drives out
the skin and can possibly cause more acne and more
dryness and decreased glow, so to speak. And second thing
is the magnifying mirror. Oh gosh, now you for what
(41:23):
you do? You you probably advocated don't well for putting
on makeup. I don't. I don't. I don't believe in
magnifying mirrors. I believe in skinny mirrors. I believe in
good lightmres that. I never look in a mirror in
a in a airplane bathroom, magnifying mirror. One of my
professors back in training at two Lane used to say,
do you have a magnifying mirror home? And if you
answered yes, you'd say throw it out. That's the first
(41:44):
thing you have to do because nobody sees you like that.
You take that magnifying mirror, you're like, oh my god,
what's going on? You don't look like that either? You
don't look like that. You don't. I wish women would
get rid of that, and men too. So when you
talk about exfoliating, do you mean just a washcloth alofa
or you're talking about scrubs? Are you talking about you know,
whatever those treatments are that gets yourselves off. So I'm
(42:04):
not I'm not against all exfoliation. If you have like
one of those clasonic rushes or a competitive that if
you do that from time to time, once a week,
once every two weeks, it's not horrible But some people
come in and I say, you know what treatments or
medication you're using, And they say, well, exfoliating. I bought
this exfoliator CVS, and I bought this and and and
they're actually they're physically they think the acne is caused
(42:24):
by dirt, and so they're physically scrubbing and rubbing, and
they're using loofahs and they're they're just stripping away the
natural moisturizing elements of the skin, and they're creating irritation
and it makes your skin more prone to acne. And
so that's what I mean by exfoliating. You know, there's
a role for chemical peals as a role for exfoliating,
but not exfoliating in a way that's too harsh and
too frequent. So you're probably not a fan of the
(42:46):
Obagi method, which is purely exfoliating. It's a little rough.
It's a little rough. Moderation, moderation, Okay, So tell me
if these things are worth it in your opinion. Facials
my opinion. People ask me, oh, do you know what
do you think about facials? I think facials are like massages.
So you know, if you have back pain or you
have a serious worth peak issue. If you get a massage,
(43:07):
it's not gonna address the underlying issue, but it will
make you feel good. I think the same thing with facials.
How about sheet masks. Not a huge fan of masks.
I think they do more harm than good, but people
think they're doing something. How about facial rollers, those new
jade rollers, whatever those are you see? Yeah, not not
a big fan. There's something got derma rolling too, that
was interviewed on in the past. People like to be
(43:29):
physically involved in their regiments and so, and they feel
like they're doing something or like back in the day
they used to have like those clinchers that you could
like do the muscle exercises and so I don't believe
in a lot of those things. Yeah, facial exercises do
they work in theory? I mean if you're stimulating the
muscles and facial expression, but it would have to be
such a amount of facial movements in reality, No, it
(43:53):
does not work. Okay, well, this is really interesting, and
I want to make sure that I get a prescription
for retin voids before before the day is done. But
where could people find you? So? I practice in Northern
New Jersey, primarily in Livingston, but I run between a
number of different offices because I do skin cancer surgery
and a few different offices. But to the days per week,
I'm in Livingston doing cosmetic dermatology, hair loss and some
(44:17):
of the general and no Instagram. I should have. I
should have Instagram. I'm sort of in that funny generation
where I I know Facebook, I can email and do
things of that nature. Well, your daughter, hopefully we'll be
coming up and she could do it. I might develop
the newest exactly. But this is really informative and I
really appreciate that you came in. Thank you so much.
(44:37):
Thank you. I appreciate you having it. For more podcasts
from I Heart Radio, visit the I Heart Radio app,
Apple podcast, or wherever you listen to your favorite shows.
Beyond the Beauty is a production of I Heart Radio.
I'm your host, Bobby Brown. I get asked a lot
of questions from so many women about what to do
to stay looking young, to stay looking healthy. My advice
is always the same. Start with what you're putting in
(00:25):
your body number one, and then you know what, There's
so many things that you could do to look better
without altering the way you look. So my philosophy of aging,
and I don't even like that word, because we are
all aging and that's a good thing. It's not negative.
But my philosophy is, if there's things that are really
bothering you, examine how you could make them better without
(00:48):
changing your face. I am not a fan of fillers
because most fillers I could see when people put it
in their face, it doesn't always work perfectly. I'm sure
they're any of fillers and people's face that look great.
I have seen a lot that haven't do. I wish
I had less lines in my face, yes, but I
(01:09):
don't even bother that energy because there's nothing I could
do about it. And I find that when I'm rested
and I am hydrated from the inside out, and I
have the right moisturizers and creams on my skin. I
can handle my age. I wanted to have a dermatologist
on the podcast because there's so many questions I want
to ask him about what can be done without altering
(01:32):
your face. I first started seeing Dr Glasshowfer because I
was concerned about thinning hair and just what happens to
hair as you get older. He also has a condition
called alopecia, which means he doesn't have any hair, but
he happens to be a hair lost expert. I probably
because he was a hair lost patient. He has a
(01:54):
lot to teach about our concerns. Here's my conversation with
Dr Mark glass Hoffer. Doctor Mark glass Hoffer, is that
how I said? Okay, pretty good? A dermatologist, but more
than a dermatologist, an expert in not only skin, but
(02:15):
also an expert in hair loss. Yes, that's correct. So
I'm expert hair loss as well as I'm fellowship trained
in MOSE micrographic surgery and cosmetic dermatology. And for those
don't know, MOSE surgery spelled m o h S, named
after the surgeon who invented the technique, is a way
of delicately removing skin cancers from usually head and neck
(02:36):
in other sense of areas of the body. Okay, well,
very interesting. The other thing about Dr glass Hoffer, he's
my dermatologist, and I went to see him first because
of hair loss. And when I walked in to say hello,
because he was recommended to me by another dermatologist. And
when I went into say hello, the first thing I
noticed is that he didn't have any hair. So your
(02:59):
story is that you were diagnosed as a kid with alopecia. Yeah,
so it is ironic that I've gotten into this field.
You know, people walk in, they're dealing with hair loss,
and the first thing they see is this shiny dome
and a gentleman who has no hair and tattooed eyebrows,
and they're like, well, am I in the right place?
But a really cute face? So how many guys look
(03:20):
good with tattooed eyebrows? And yeah. So my my story
and what sort of partially led me on this path
is I was diagnosed at the age of eight with
alopecia areata. When people refer to alopecia, that's generally meaning
hair loss, but alopeciata is a specific form of hair
loss that's an autoimmune condition. So basically my body and
people who have this condition, our body's immune system gets
(03:43):
confused and instead of attacking bad things like viruses and
bacteria and god forbid, cancers, it attacks our own selves,
our our own auto self. And so in my case
it attacks it very efficiently. And I have no hair,
So I have a form of alpeciata called alopecia universalis,
which is I'm or extreme form. Of course you had
to get the better one, of course. Of course, well,
if I'm gonna do it, I'm gonna do it right.
(04:04):
But it was an evolving process. And so when I
was first diagnosed, what I remember or constructed at this
point in life is that when I was eight years old,
my father took me to the barber and the barber
pointed out a quarter sized bald patch. And I've heard
a lot of patients tell me that story kind of
that an initial original patch, and then I don't really
(04:25):
remember it till I was around twelve or so. Coincidentally,
I was diagnosed with some form of crones yep, and
so I was on steroids at that point, which is
one of the treatments for alpi shada. So probably masked
the progression until later on. And then I remember through
high school and junior high, high school just sort of
kind of having various patches of loss. I would go
(04:46):
to dermatologists. It's one of the reasons I'm in Dermatology
is one of my mentors. One of the doctors I
was seeing, Dr Larry Miller, who passed about a year ago.
He evolved into a very close friend of mine, and
he guided me into his condition and I used to
go to every six weeks for shots and light therapy,
and as you can tell, nothing really helped, but he
really provided me with a lot of comfort. Basically, from
(05:07):
about twelve to sixteen seventeen or so, I had patchy
hair loss. And then I remember distinctly my senior year
of high school, was in the middle of a soccer game.
My brother was there, and uh, I remember coming off
the sidelines and sweating and I wiped my face and
this shocked look came over his face and some of
my teammates. I kind of had wiped off like half
my brow. I didn't quite know that till the game
(05:28):
was over. Obviously devastating and you don't really know you
know where to go with that, so I started doing
shots of cortizone in the eyebrows, which it helped the
cord zone shots that was getting from from Dr Miller.
I would grow a patch of hair back and then
I would develop another patch, and it's sort of like
chasing your tail. As things progressed, I started losing eyelashes
right before starting college, so kind of, uh, you know, tough,
(05:51):
tough way to start freshman year. It kind of went
in some actually remission. I did a treatment when I
was around twenty three that grew on my hair back
on my scalp treatment, so yes, that's one of things
I want to touch on it. It It was basically it's
called immunotherapy, and you apply a substance, a chemical to
the scalp that causes a mild irritation, and the concept
(06:12):
is is that you're creating an inflammatory response on the
skin that draws the inflammatory cells from the hair follicle
away and takes it somewhere else. It was like a
better party for the inflammatory cells to go to and
it allows the hair to grow. And it worked for me,
but it then stopped working, and unfortunately that's somewhat the
case with a lot of the treatments for this specific
(06:34):
form of hair loss is it sometimes things work for
one person that don't work for another person, or sometimes
things work and then they stopped working. And then after
that treatment, all of a sudden in med school, over
a one month period of time, I lost about seventy
percent of my hair. I was on a particularly tough
and challenging rotation at that time. Kind of can't stop,
you can't just not show up for rounds and things
(06:54):
of that nature. And then next thing I know, I
was down to about ten percent and then it was
time to, you know, to shave off the last little whisps.
And since then I've had the clean look that you see,
do you have any hair on your head? Like do
you have to shave it at all? Or now it's nothing.
I occasionally will get a wisp of hair, which is
kind of funny exactly. It's sort of like this little
(07:15):
like snoopy hair that goes up and my daughter gets
excited and it's funny, but she wants to pluck it
out right when it comes. But the thing that was
the best for me, ironically is after I lost it
all and everybody was like, wow, you look so good,
or this is, And it was sort of like this
kind of coming out type situation where I was like,
oh gosh, like how different and awkward must have looked
(07:36):
over all this time, and nobody wanted to say anything,
and I was like a chance for everybody, like this
is good and embrace this. So it's kind of like
finally not having to fight or worry about is this
patch gonna come? Is this gonna grow back? It was
sort of like, all right, this, this is it, This
is who I am, This is down to the core.
Obviously still working on that, but I think there's a
couple of actors that finally just took their hair pieces off.
(07:58):
I don't know, was it John travill To, I don't remember,
And it's like, you know what, so what exactly exactly?
For me, I'd say, you know, back then it was
probably Michael Jordan was one of the few people that
you know, could really rock that look. You know, it's
hard growing up with this type of condition, And nowadays
I look around and I'm like, wait a second, I
had to have so much grief grown up with us.
Now everybody just has my look, And when did you
(08:18):
get your eyebrows tattooed? So probably two My aunts took
me around some makeup artists. We were trying to get
the right brow color and stencils and shapes, and it
was horrendous and I was actually trying to draw my
brows on, not very artistic in that sense, and came
upon somebody who's a phenomenal cosmetic makeup artist and he
(08:39):
does the tattooing. And so since then I've had it
done and I've had some touch ups along the way. Well,
this is a podcast, and no one could see what
you look like, but you don't look weird at all,
Like you look normal, Like you just look like some
guy that has like a shaved head. Ironically, after some
years having to explain myself of what I have, ironically,
now people come up to me like I remember this one.
(08:59):
I was in ving for dermatology positions and I was
in Penn station and a particularly creepy bathroom and this
is Timing came up and he was like insistent on
finding out what my secret was for shaving my head.
He was like, what what magic solution do I use?
What blade do I use? What direction or angle do
I go in? And I kept insisting on telling him,
you know that this is not something I shave, and
I don't think he was completely coherent, and he was
(09:21):
getting angry and angry with my response. I wasn't actually
giving him my secret. But I have that from time
to time and when a lot of patients come in
and say, what do you do, and I explained, this
is this is the condition. And what's nice about with
the role that I play with having so much exposure
to patients, is that when I tell people that this
is not something that I actually chose, but I have
this condition, people say, oh, that's interesting. You know Bob
(09:43):
in accounting has this, or my next door neighbor's child
has this, so it sort of increases awareness. Yeah, you,
I mean certainly. The first person I heard was a
friend of a friend, a girl who was making mushroom
tea which now turns out to be kombucha because she
was told of that would help. So I don't know
if things like that help. There's there's no clinically proven,
(10:06):
rigorous studies to show that a lot of things with
the hair are coincidence. Sometimes for whatever the reason is,
especially with what I have, the ALP share out if
you get it later in life, sometimes it develops is
a patch that just spontaneously regrows, and we don't know
why it happened, why things got off kilter, and so
there's a lot of times spontaneous regrowth can occur, and
so if you're doing X, Y, and Z, we sometimes
(10:27):
like to attribute it to that, but often isn't the case.
It just happens. So we're going to talk about what
works and what doesn't work in your opinion, But what
are the causes of hair loss, particularly in women? Absolutely
so you can break down the causes in terms of
inflammatory and noninflammatory. It's one way of looking at it.
(10:50):
In terms of inflammatory conditions, they're they're rare. So we
talked about what I have, the alp shariata. There's rare conditions,
something called like in planet Polaris, or variation of that
called frontal fibrosing alopecia, which is being diagnosed a little
bit more. And women come in with often a very
itchy or painful scalp and a particular type of hair
loss which is clinically recognizable. You want to treat that
(11:12):
sooner rather than later, because it's actually a scarring form
of hair loss. It's another way of categorizing hair loss.
Between scarring and non scarring, meaning the hair follicles themselves
are scarred down and if they're scarred from the inflammation,
you're not going to grow more hair through that follicle,
through that opening, So you really want to treat that. Early.
Rarer forms of alopecia can be seen in Natians have
lupus and so same thing, you want to prevent that
(11:33):
from scarring. So in terms of the inflammatory scarring alopecias,
we have that category, then we have the more common categories.
So the majority women that coming to see me have
female pattern hair loss otherwise known as androgenetic alopecia. And
just like we all know there's male pattern hair loss,
we've known that for a long time, female pattern hair
loss does exist and it's just represented, under recognized, and
(11:55):
not talked about as much. But I also see a
lot of women that they don't necessarily have, you know,
the bald pattern, but they just have really thin hair
where you could see their scalp yes, like, what is
that from. It's a diffuse form of hair loss, and
it's basically men and women they have different ways of balding,
they have different patterns. So the pattern you're describing with
that diffuse hair loss and sort of the the part
(12:16):
gets wider and the central scalp and a little bit
the temporal recession. That's usually how women have their balding
pattern and their hair loss pattern compared to men. Just
going back to touch on it. Another form of hair loss,
which is very common in both genders, but I see
it more in female patians, is something called intelligent effluvium,
and that's when you have rapid shedding of the hair.
So a lot of times you see it or you
(12:37):
hear about it after pregnancy. A couple of months later,
you might have a rapid shedding and diffuse shedding of hair.
And it's very alarming because you're in the shower and
clumps the hair coming out, and you're seeing in the
sink or in the hairbrush or on the bed. And
it can happen after any type of shocked the body,
so any type of stress, so pregnancy is very stressful,
or a surgery or a big stress. Not you know,
(12:59):
daily stresses and nuisances, but something like death in the family,
loss of a job, divorce, rapid weight loss, any type
of restrictive diets that can lead to telligent of fluvium.
You also need to make sure when you're seeing somebody
with air loss that they don't have underlying medical conditions.
So thyroid disease of very common condition, especially in women.
About ten percent of women will develop some form of
(13:20):
thyroid abnormality and that could lead to hair changes. And
then just going down the list of things you want
to rule out any new medications. I want to rule
out any nutritional deficiencies, which are really rare in this country.
You thank goodness, but there are times when people are
iron deficients or have deficiencies and other things. But it's
not as common. But isn't hormones like people always say,
(13:42):
check your hormones? Are your hormones? Okay? Exactly? So that
ties back into so what does androw genetic alopecias? So
Androw refers to hormones basically, mainly testosterone Specifically, and Andrew
genetic genetic means just that it's the luck of the draw,
the roll of the dice, how we were born. So
as women men mature, they have less estrogen and testosterone
(14:03):
levels don't increase, but they play more of a role.
So testosterone is what's responsible in the byproducts of testosterone
are what are responsible for causing hair miniaturization and decreased
hair growth and the thinning that we see in both
men and women. And so with men, we we do
have decreased testosterone as we mature. Women you have decreased
estrogen and more of an effect of the testosterone, not
(14:26):
necessarily more testosterone, which is more relative effect of the testosterone,
and so you don't necessarily have to have hyper testosterone.
So a lot of times if you check the labs,
all the labs look fine, but the effects of the
testosterone around the hair follicle are more susceptible at a
later age. Additionally, the genetic and we don't know the
exact combination of things that lead to baldness, but we
(14:48):
do know there's receptors and there's molecules, and some people
are more sensitive to the effects of testosterone. And I
bring that up because sometimes we see female pattern hair loss. Unfortunately,
I have patients that come in their twenties or thirties,
and you can have premature both male and female pattern
hair loss. And so it's not just something that occurs
later in life. But about fifty women after the age
(15:09):
of fifty do have some noticeable signs of female pattern
hair loss. Okay, so what could these women do? Like
who who could expect to get a benefit and who
really shouldn't bother And we always want to have an answer,
and usually there's not a good answer, and that's unfortunate
because human beings like control and like to be able
to blame things. So often you you can't predict. And
so some people come in and say, you know, my
(15:31):
mom and my dad have full heads of hair, and
I have this, and well, it doesn't always work like that,
but it's not uncommon that when will come in and say,
I have a couple of ants, or my mother had
very thin hair and they're in their eighties, and I
just I don't want to end up like that, And
that's one of the things that we'll bring them into
initiate treatments. So one of the things in terms of
trying to create a treatment plan is education affirming that
(15:52):
what they have is normal, because a lot of women
come in and they think they're the only one suffering
from this. And also it's it's a stressful period because
it does to indicate that we're getting a little bit
more mature. I keep using that mature older. Well, because
you know what, no one talks about women's hair loss.
It's all men's hair loss. On a personal note, when
I first noticed things were changing for my hair, you know,
(16:14):
I I didn't understand it. You know, I didn't know
anyone else had had this issue. And it turns out
two things were happening to me personally. One is my
hair is white. No one out there who knows what
I look like can even imagine what I would look
like with white hair. I've been coloring my hair since
I'm twenty five, and apparently the hair follicle is thinner
(16:36):
when it's gray, correct, it can appear thinner. Yeah, so
I have, you know, less density in my hair. But
then I also was finding that that I was getting,
you know, some spaces in my hair without the hair grows.
So you know, I freaked. I'm in the public eye.
You know, I'm someone that actually I'm my beauty is
always like all about my hair, you know, my skin
(16:56):
and my hair, and it was kind of scary. So
I went to see you, and you know, you automatically
gave me this treatment p RP, so would you And
I have to say it worked. It was a little painful.
A little expensive, but it's so worth it. But could
you tell everyone what it is? Certainly so, PRP is
(17:19):
one of the most recent and newest advances in medicine
and specifically hair loss. So prpsints are platelet rich plasma.
So the platelets are these bags. They're technico even cells,
but these bags that are floating through our bloodstream. And
when we get injured, either internally or externally, the platelets
they rupture and they release all these growth factors and
regenerative molecules, and these things help promote tissue healing. And
(17:44):
so originally PRP was used in athletes and before going
to surgery. Some interesting orthopeda started playing around the PRP
and injecting into these injured joints, and they found that
it was able to push off patient's need for surgery.
So in the lab and else where, people start to, well,
what else can platelests do? And we started using it
for a college and rejuvenation on the face, and then
(18:05):
some early pioneers started using it in practice. And then
about four years ago I said, hey, you know this,
this is interesting, and I'm not quite sure why exactly
this would work, but it's it's the science is looking good,
And so I said, I have to start trying it,
And so I start trying it on some patients and
and lo and behold, I saw results. Now, Now what
a results mean? And this is part of understanding is
I always tell patients that no matter what you do,
(18:27):
whether it's PRP or other treatments, when you are having
a hair loss, you can only think about hair growth.
How how can I get more growth? And what you
forget is that how do you stop the loss? How
do you minimize the loss? How do you minimize the
thinness and the shedding? So that's success if you can
do that. It's a harder thing to see, but about
fifty percent of patients will get an increase in hair
(18:47):
thickness and density and some regrowth with PRP in what
I've seen now, that's just in my use of it
and what I've seen amongst my patients. There's unfortunately, currently
there's no definitive case controlled rand my studies. They are coming,
but it's not there quite yet. But I started doing it,
and I went from saying, Okay, this seems like it
(19:09):
could work too, Yes, this is this works, And I
can now offer this consciously that I know that this
is something that I can promote to patients and give
them an option. Before PRP, I used to say, Okay,
we have row gain and we could potentially do some
oral medications, and then there's hair transplant and and there's
nothing in between. People like I don't want to get
a hair transplant, and it's generally safe, but there's some
(19:30):
invasive things involved that people do. You know, it works
and it's great, but it's end of the road. Do
you think rogain works ro gain is of benefit for
slowing the process down? I do not think it quote
unquote works and regrowth and I don't think it has
a big wow effect, but it's something that does benefit
in terms of slowing the progression. The PRP results are
(19:51):
more beneficial when you're using the row gain rogain alone.
I do try to get people to get to start that,
but by itself, I'm not super impressed. So some people
come in and say, I don't want to do row
gain because it's a pain to do, and you know,
it's I have to do. It's Bessie. But you know PRP,
it's natural and people like that. It's it's your platelets.
There are no side effects short of some of the
(20:12):
discomfort that you you you can attest to. You know.
I like to say in terms of the pain talking
about that, it's like the gym. You know, you're not
gonna stay in good shape. Plus you expend some efforts.
If ten is the worst pain in your life and
one is nothing, I tell patients it's probably about a
two to three out of ten, I would I would
give it a six. I mean, no, it hurts. It hurts,
but it's not that I mean, look, I've done it
(20:34):
because I did the first series, which was what five times.
The way I do it, I do one treatment per
month for four months. That's what I call the loading phase.
We try to jump start the hair follicles. And then
I recommend a maintenance phase, usually every four months. Sometimes
people can push you to six months. And so it's
like two or three times per year for the maintenance.
(20:54):
And what does it normally cost? I know it it
varies where you live, it varies. And so you're a
New Jery is he not New York? So yeah, it's
not as bad as New York executive New York, you know,
things are everything is more expensive here. I charged seven
and basically I'm a true believer that it's the platelets
that are doing the heavy lifting and having the results.
There's a lot of things out there where people say
(21:15):
PRP with stem cells. Stem cells haven't quite made it
to real life there in the lab, and there's great
potential of them, but there's no such thing as really
true stemselves out there. I don't personally believe that those
things help anymore than just sort of being able to
charge more. That's that's my opinion. UM. I also don't
want to outprice anybody. I know it is pricey, but
(21:37):
I feel like that's a good price point for many
people to be able to get it, and there's so
many people suffering from it. I'm definitely a believer. But
you don't believe in by at In or any of
that stuff. To you, the studies have never played out.
The whole by at In story, so to speak, comes
from back in the day whatever you want to describe
that as eight nine hundreds, when we didn't have as
(21:58):
rich of a diet. If you had a by Ittin
deficiency and it was diagnosed, so you'd have a lot
of hair loss, and then you would have by as
in rich foods and things, and you'd go your hair
back and so so wow, it's amazing. It's a magic here.
So somebody was smart and said, well, everybody has hair
loss and they all want to take by it, you know,
they want something to do. So that's where the bit
(22:19):
and market came. I make a make a bytin gummy
and you know, I eat it every day. I still
have hair and people tell me that they've noticed their
hair like coming in. You know, I I can only
hope that it's true. I will never tell somebody, you know,
to not take it in the sense it's not harmful.
It's more just that I can't recommend it because it
hasn't been proven to be the case in a scientific way,
(22:41):
like most supplements. Like most supplements, exactly most supplements get
paid out. There is actually a recent study showing that
too much byton can actually affect certain lab tests. So
if you're taking high doses of by it in and
you go get certain routine bloodwork from your primary care doctor,
those tests might be altered if you're taking too much byton.
So well, we tell people only two gummies, and I
know there's people, so I won't tell you to not
(23:03):
take your gummies. If you want, you can you know,
and maybe it does work for some and maybe it
doesn't for others. But a lot of times people we
want something to do. For instance, an analogy is when
I'm doing skin cancer surgery, people will come back and say, hey,
I want I want something to put on my scar.
And there's certain things you can recommend, usually silicone sheeting
and things of that nature. But a lot of times
(23:25):
your body is pretty amazing and it's healing, and people
come back and say, I use this product and God,
and you know, my scar went away. It's more your
scar went away because it was well sutured and your
body just did what it was supposed to do. Oh,
I don't know. I I might disagree with the doctor.
I'm only an honorary doctor. But you know, whether you
put vitamin E on something or some kind of ointment
(23:46):
that you're you are correct, You are correct. It's not
vitamin E. And that's another myth that I'm gonna spell now.
Vitamin actually can cause a contact dermatitis. Vitamin E keeps
the wound moist, and so we found that it's not
the vitamin E. Per se, you can use vasoline which
can keep the area moist. So moist wounds, moist scars,
and things of that nature. Hydrated skin heals better, and
(24:08):
that's sort of the concept of silicone sheeting. Silicone sheeting
creates sort of a micro environment where it's more moist
and things of that nature are going on. All right, Well,
we learned a lot about hair. Now let's go to skin. Okay,
because you treat people skin, well, what's the biggest complaint
(24:32):
when people come in. So at this time of year,
you see a lot of dry skins. We mature our
skin and I'm starting to see it too, our our
legs and our skin. Stork gets very dry and very scaly,
and we don't like that. And sometimes not just dry
and scaly, someone who becomes itchy and get these little
patches of exema the form. So that's seasonal things. You
see that pretty frequently. Of course, acne is one of
(24:52):
the top diagnosis we always see, and we see a
lot of that year round. And what is adult acne
caused by So adult acne, especially female adult acne's which
is usually who gets the adult acne, is hormonally driven.
I saw a woman today who had clear complexion all
throughout her teenage years. In early twenties, and now she's
breaking out. And and the adult female acne usually has
(25:13):
this characteristic picture doesn't always, but of usually kind of
the cystic a little bumps underneath the skin. They're they're
often hard to get rid of, and they usually on
the jaw line around the mouth. And what's showing is
that that same medication I mentioned before, spironolactone, which is
used at times for hair loss, it has a great,
great significant effect on adult female acne, so I usually
(25:34):
will recommend that over an antibiotic combines with a retinoid.
So so retinoids are the first line agents in acne,
in any form of acne. What it does is it
helps break up all the dead skin cells that are
in the follicle, and that's the process that causes acne.
We have these dead skin cells behind that you get
a backup of oil. Within the oil, you can get
bacteria growth and then an inflammatory process. Acne is there
(25:58):
is a bacterial component, but acne is actually an inflammatory process.
And the retinoids they hit every level of acne. They
open up the pores, they decrease oil size and oil productions.
You're not as greasy, so you can't have as much
bacterial growth, and they also do have some effects on
the bacteria. So retinoids is the first line agent for
any form of acne. Retinoids also slow down the breakdown
(26:20):
of collagen, So there's an enzyme that naturally breaks down
the collagen we have, and on the molecular level, retinoids
help minimize the effect of that enzyme, so it keeps
our collagen more plumped and more around. And retinoids can
help with fine lines and dark spots and just overall
complexion and rosy glows. How do we keep the collagen
(26:44):
or can you? So patients come in and they say,
you know, I was at X, Y and Z store
and I saw all these things on the shelves. What
should I do for my skin? So the two things
I always recommend, two things I'd love to have every
patient on, and I have my wife on it, and
my mom on it and myself. So sunscreen. Anytime you're
gonna be outside side for a significant period of time,
you have to remember, not just during summertime. If you
(27:04):
know it's April and you're going outside for you know,
forty five minutes here and there, all that sun adds
up when we in our sixties and seventies and eighties,
we we see those effects sometimes earlier. Of course, if
you're going skiing, you know you have to consider the
rims of the ears and nose. Those areas get burned
pretty pretty easily. Top your head, top your head, so
sunscreen for any significant sun exposure you can have. And
then at nighttime I recommend some form of a retinoid
(27:26):
because the renoise are really just great for rejuvenation cell turnover.
And we talked about the decrease in collagen breakdown and
the fine lines and dark spotts. And is that a
prescription or non prescription. I think the prescription strength products
work better. There are retinal products that are on the market.
They work fine enough, but if you're gonna do something,
I would go for the actual product that technically works better.
(27:48):
But some people don't have time to go see the
doctor and get a prescription. So if you do something,
a retinal based product is a benefit, and you have
to make sure that you're not over using it. It's
one of those things where less is more use it
just so you at the benefits you put under your
eyes or not, so you can be put it very
very sparingly it's not recommended to do that much of it,
(28:09):
or to use a very high strength. I would when
I use retinoids, I moisturize first, and then I take
a piece size and mountains spread it to my entire
face underneath my eyes. I might do it like once
or twice a week, a very small amount. Sometimes when
I see my mom, she's scaling in what's called the
national labi or faults from from the nose to uh
to the lips, and she's like, I'm using that cream,
but why am I getting this? And I'm like, are
(28:30):
you just putting it like right in that area because
that's where you have a lot of volume loss and
you're trying to stimulate information. She's like, yep, I'm like,
it's not how you want to do it. And what
about rose sha, I have a lot of people that say,
what do I do about rosation? Sure so, roseatia is
a frustrating condition. Roseta sort of a cousin of acne
and some people rosatious acne rosasia. It's a combination of
(28:51):
inflammation where you get the red bumps, and a vascular
condition where people's blood vessels are just more sensitive, you know,
spicy foods and red wines and citrus fruits, things like that.
You know, things that we enjoy can cause the blood
vessels to open, and so we get a combination of
flushing and redness as well as bumps. Some people have
both those components. Some people just have the red some
people just have the bumps. So there's a lot of
(29:11):
things you can do. Topical medications, some of the same
ones you'd use for acne, and then we also use
anti inflammatories. There's some medications that work like steroids but
are safer than steroids. There have benefit. And then some
people come in for just the redness, and there's some
molecules are specifically meant to clamp down the blood vessels
topically to help get rid of the redness temporarily, and
at times we use lasers. Lasers actually work the best
(29:33):
for the redness of rosation. Like what lasers there's vascular lasers,
and lasers work based on wavelength and what they target.
There's lasers have a five eighty five and five ninety
five wavelength. There's one laser in particularly I like called
the v beam lasers. Another one called XLV which really
helped target those blood vessels and basically makes the blood
vessels go away, makes you less red. I think lasers
(29:54):
are amazing. Lasers are amazing, and people come in they say,
I want laser. There's so many different uses of them.
It's not is one lasers. How much of your practice
as lasers, I'd say about twenty five of my practice
is cosmetic, and within that I do fer amount of lasers.
Some some people that's their entire business, exactly some people.
And we owe a debt of gratitude to those people
because a lot of often are doing the trials to
(30:17):
prove the efficacy of those lasers. All right, well, let's
talk about wrinkles, or I like to call them lines. Lines.
So there's like, right, so what could you do about
lines in the face? So so lines in the face
depends where in the face, and so we're talking about
most commonly the we call them the elevens, those lines
in between the brows. That region is called the glabella.
(30:37):
And there's three muscles there that when we use that
over years and years and decades, they start to make
those muscles they create creases in the skin. So the
lines in the glabella region between the brows and the
foreheadlines and what we call the crow's feet around the eyes.
Botox is the best medication for that. And I love botox.
I hate botox. Don't you like about it. We're gonna
(31:00):
have a debate. Number One, it's bottle is um. It's poison.
So you're putting it in your face. Okay, it's got
to go somewhere. It's got to end up in the brain.
It's gotta It doesn't just like go into thin air.
It's an interesting perspective, and that's what people do. But
it is created from Bochlin toxin and basically it's so
(31:20):
diluted out, so diluted out, it has no adverse effects
like eating a bed, micro dosing heroine. Yeah, well what
we do that for pain? And you know, God forbid,
when somebody has cancer, we're using poisonous substances to try
to eradicate that. Not comparing obviously cancer and and cosmetics.
(31:41):
But it's it's basically we are using such a micro
dose if you want to look at it, that it
is safe. So it's not like you're eating a old
can of beans that you found and you're eating getting
a whole dose of that will kill you. All right,
So I've done it a couple of times, and when
it first came out, I must have been in my forties,
and we didn't know, you know, if it was good,
(32:02):
if it was bad. It just came out. I had
two of the worst side effects ever. I had a
brow drop once and my husband thought I was having
a stroke and I never admitted to him that it
was botox. And the other time, I had, you know,
an eyebrow that like shot and I went to like
the best New York germs that you can go to.
(32:24):
It just and I'm like, all right, God is telling
me something and I just stopped. That's one thing. Okay,
So I've had bad I've also seen so many women.
I've seen really good botox. Okay, but I've seen so
many women who have this like intense shiny forehead and
the rest of their face and body is wrinkled. And
it doesn't So when you get to a certain age,
(32:46):
like it just doesn't work. So I I agree with you.
Let's address the side effects. So anything in that potential
side effects basically how boche of them talks and works
or botox is it Basically it causes the muscles and
make facial expression. It minimizes their movements, you know, so
some people say it it doesn't make a complete paralysis
(33:06):
unless you use a large difference and until it leaves
your body, then you start moving. And it's a protein.
It's basically it's a protein that's taken up by receptor
and that protein breaks down over time over the next
couple of months. So it doesn't stay in your body.
It doesn't eat away your brain, it doesn't do anything
that's definitely been proven that should lay your concerns there
doesn't work like that. You get botox every four to
six months. Some people do it even more frequently for
(33:28):
decades and you're not gonna have any long term side effects.
But even in the best of hands, you can get
a brow drop. Basically, there's a muscle around the eye
called you know, the bigularius oculi, and if you put
it too close to the brow, you will get that
brow drop. But sometimes there's even diffusion. Even in the
best of hands, people know their anatomy, you can inject
it and you can get the bo tex going in
a place. It gives you a spock or give you
(33:49):
a drop. But I always sell patients. You know, it
doesn't happen frequently, but it is a risk. And now
they're putting botox under the chin for next. So there's
there's something called platisma bands that you sort of see
when people when they clenched down on their teeth. You
could see those bands, especially if somebody is very thin,
and that can release those muscle bands. There's a muscle
down in the lower face. Put a little botox taken,
(34:11):
given a little upward turn of the smile. I'm a
big fan of of botox. But if you can do
agent gage free, it's perfect. And I'm an advocate for that,
and I wish I could be more like that. When
you do these things, you have to do things conservatively.
I call like the newscaster look, and it's it's a
look you see these people on TV and they're frozen,
like they are just completely frozen. And I personally do
(34:31):
not like that look. I hate that look. And it
looks like they're done. They don't look natural, there's no expression.
And how many actresses do you see and you're like, who,
I can't even tell if that's who it is, and
and and that happens, and that sometimes happens a stage
of life, and I feel for people that's that's their career,
and they're they're so wrapped up in what what they
look like. I can empathize with that because, you know,
(34:54):
just with my hair loss, I can imagine as an
actor or somebody who's in the public I and you
have it in your certain look at one point and
then all of a sudden, you're you're changing, and you don't.
You try to capture that, and sometimes you overjump it.
And when you overjump it, whether it's uh, you know,
an overdone eye job or too much filler and cheek implants.
It all can be done well, and many colleagues that
(35:15):
do do it amazingly well. But some people think that,
you know, go go bigger, go home. And I think
there's like this over lasered look, as over botox, over filled,
overlaser look. And just like you're saying, it's like people
they might look quote unquote good, but it almost doesn't
look natural. But I think of it like when I'm
weeding my garden. Okay, you're making it look better, but
(35:36):
like where do you stop? Where does the obsession? When
am I done? And it's the same thing on your face,
It's like, you know, okay, I'll do this I'll do
a little bit of this, and all of a sudden
it's like, all right, that's not working. Let me do
this too. And then all of a sudden, what do
you do? You're in your sixties seventies. There's a high
degree of body this Morfi syndrome and facial syndrome and
people trying to chase after every single do you see
(35:57):
this crease? Do you see this sprinkle? And it's a
serious thing. And I will tell people you really don't
need this. I actually think that you should not be
pushing things that people don't need and put the brakes
on it when when they need it. Yeah, But I
also think there's a certain time in your life where
you just have to say, okay, okay, I'm not that anymore.
This is who I am now. Yeah, no, no, And
(36:18):
you know, I mean, look, I planned to be, you know,
a grandmother one day. You know, I don't want to
look like one. But it's okay, you look great personally.
And years ago these products weren't around. You know, Collagen
was the first filler out there. Even actually silicone was
the first filler out there, yeah, I believe it or not.
And it was actually a decent filler, but except now
all these women have to take their silicones out because
(36:38):
it's affecting their body. That's a different Yeah. No, But
I'm a holistic health coach because I really do believe
that you have to be a little careful of what
you're constantly putting in your agree completely, I agree, and
you know, tying into the hormones, and yeah, girls are
having that periods earlier. Yeah, we you have to be
careful of what we're putting in, what we're consuming, what's
in our environment, No, no doubt. So the things weren't
(37:00):
around before, and so people did age gracefully and there's
a lot to be said for that when used correctly
and in moderation. Like everything, you can make that case.
Everything these products, whether it's fillers, lasers, botox, or other approaches,
can provide a certain person benefit. Okay, I will. I
(37:21):
will accept that. And I do believe that it's okay
to contour. If you're someone that wants to contoy your face.
I don't like contouring, that's okay. We're allowed to have
different things, and I'm I am. I'm also very excited
because I think there's going to be more things on
the horizon. That will help. And I know one day
there's gonna be a laser that gets rid of you
know that eleven between your between your brow, So I
(37:43):
will talk, Yeah, I will. I will sign up for that,
Thank you. And what do you think about the you know,
the body treatments, like do you think you know whatever
those things are called that gets rid of the fat
cells whatever? Cool skulls? Yeah, I mean they work. They work.
Once again, you were is always you gotta you're really encapsulate.
What work means? You can't come in and be obese
(38:04):
and say cool sculpt me, and you know you're gonna
walk out the six pack. Cool scope is really specifically
meant for somebody who isn't relatively decent shape for their age,
but you know, the hormones are slowing down and they've
got certain pockets of fat they got you know, the
love handles and the spare tire and the thighs and
things of that nature, and they're like, this is annoying.
I go to the gym experience, you know, five times
(38:26):
a week and I can't get rid of it. So
cool scope is helpful for that. Once again, when you
get cool sculpt it's not like you just grab this
pocket of fat and it just all goes away. You'll
have about a thirty percent reduction with each treatment you do,
and so there there are benefits. Pretty good. It is good.
It's painful though, right it can be once again, I'm
gonna believe you know. Pain is pain is pain. There's
cool Sculpture's two different ones. The cooling technique basically is
(38:48):
based on if you cool the fat cells such a degree,
you kill the fat cells and one in fat cells
us early their finite amounts. So once they're gone, they're gone.
You know what happens when you, you you know, put on
the weight again, you'll you'll you'll add the fat too
well to the cells that persist. It's not gonna get
rid of every single But so there's the cooling and
then there's the heating. They both work by by working,
(39:10):
you have to sort of meet with somebody and really
assess your goals and really have a realistic goals, have
a nutrition plan, workout plan, and then basically you can
do these other things. It's another technique out there called
m scalpe, which actually caused these micro contractions and can
tone muscles. That's for a very unique group of people.
Well exact, basically, you have to be in good shape.
Once again, if you have too much adipose, too much
(39:33):
fat covering your muscles. So it's meant for somebody who's
in really good shape, who just needs to who wants
to get toned up. I mean personally, I think it's
somebody who's probably a model or an actor. Okay, so
now I've got a speed round of questions. All right,
what's the last thing you ate? Cheese, sandwich? What's your
drink of choice? I hate to admit this dia pepsi.
(39:56):
I know pepsi. I was talking about Tequilan vodka, wine.
Gonna get that diopepsi. All right, now your health coach
is starting. Okay, I'm taking over this episode. No diapepsi.
I'm trying to I'm really trying to cut back. My
wife refuses to buy it for me. She knows. How
many do you know it's unhealthy? You drink coffee? You do?
I'm a big fan of coffee. I'm big believer in caffeine. See, okay,
(40:17):
caffeine is fine. But there's green tea, there's espresso. I mean,
you know, I know you're a guy that likes chemicals.
But it's that and you like science, go read read
about the signs. It's the nial. But but my drinker
tries to vodka. Vodka, okay, how do you drink it?
Martini up with blue cheese olives my favorite? Nice? What's
(40:38):
your personal skincare routine? Less is more? I use a
moisturize of sunscreen in the morning and which one whatever
is in my drawer, usually some form of a sample
that somebody wants me to try. And then in the evening,
I if I remember I am a guy. At the
end of the day, I try to do some form
of retinoid a couple times a week. Maybe. What do
you think a skincare item that most women don't have
(40:59):
but need some form of a retinoid? I'll tell your
skincare item that I hate that women have. Two things.
I'm not a big fan of exfoliators. Thanks foliating is
actually quite bad or routine exfoliating I think drives out
the skin and can possibly cause more acne and more
dryness and decreased glow, so to speak. And second thing
is the magnifying mirror. Oh gosh, now you for what
(41:23):
you do? You you probably advocated don't well for putting
on makeup. I don't. I don't. I don't believe in
magnifying mirrors. I believe in skinny mirrors. I believe in
good lightmres that. I never look in a mirror in
a in a airplane bathroom, magnifying mirror. One of my
professors back in training at two Lane used to say,
do you have a magnifying mirror home? And if you
answered yes, you'd say throw it out. That's the first
(41:44):
thing you have to do because nobody sees you like that.
You take that magnifying mirror, you're like, oh my god,
what's going on? You don't look like that either? You
don't look like that. You don't. I wish women would
get rid of that, and men too. So when you
talk about exfoliating, do you mean just a washcloth alofa
or you're talking about scrubs? Are you talking about you know,
whatever those treatments are that gets yourselves off. So I'm
(42:04):
not I'm not against all exfoliation. If you have like
one of those clasonic rushes or a competitive that if
you do that from time to time, once a week,
once every two weeks, it's not horrible But some people
come in and I say, you know what treatments or
medication you're using, And they say, well, exfoliating. I bought
this exfoliator CVS, and I bought this and and and
they're actually they're physically they think the acne is caused
(42:24):
by dirt, and so they're physically scrubbing and rubbing, and
they're using loofahs and they're they're just stripping away the
natural moisturizing elements of the skin, and they're creating irritation
and it makes your skin more prone to acne. And
so that's what I mean by exfoliating. You know, there's
a role for chemical peals as a role for exfoliating,
but not exfoliating in a way that's too harsh and
too frequent. So you're probably not a fan of the
(42:46):
Obagi method, which is purely exfoliating. It's a little rough.
It's a little rough. Moderation, moderation, Okay, So tell me
if these things are worth it in your opinion. Facials
my opinion. People ask me, oh, do you know what
do you think about facials? I think facials are like massages.
So you know, if you have back pain or you
have a serious worth peak issue. If you get a massage,
(43:07):
it's not gonna address the underlying issue, but it will
make you feel good. I think the same thing with facials.
How about sheet masks. Not a huge fan of masks.
I think they do more harm than good, but people
think they're doing something. How about facial rollers, those new
jade rollers, whatever those are you see? Yeah, not not
a big fan. There's something got derma rolling too, that
was interviewed on in the past. People like to be
(43:29):
physically involved in their regiments and so, and they feel
like they're doing something or like back in the day
they used to have like those clinchers that you could
like do the muscle exercises and so I don't believe
in a lot of those things. Yeah, facial exercises do
they work in theory? I mean if you're stimulating the
muscles and facial expression, but it would have to be
such a amount of facial movements in reality, No, it
(43:53):
does not work. Okay, well, this is really interesting, and
I want to make sure that I get a prescription
for retin voids before before the day is done. But
where could people find you? So? I practice in Northern
New Jersey, primarily in Livingston, but I run between a
number of different offices because I do skin cancer surgery
and a few different offices. But to the days per week,
I'm in Livingston doing cosmetic dermatology, hair loss and some
(44:17):
of the general and no Instagram. I should have. I
should have Instagram. I'm sort of in that funny generation
where I I know Facebook, I can email and do
things of that nature. Well, your daughter, hopefully we'll be
coming up and she could do it. I might develop
the newest exactly. But this is really informative and I
really appreciate that you came in. Thank you so much.
(44:37):
Thank you. I appreciate you having it. For more podcasts
from I Heart Radio, visit the I Heart Radio app,
Apple podcast, or wherever you listen to your favorite shows.
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