Latest / Aesthetics Unscripted / Medical vs. Cosmetic Dermatology: What You NEED to Know with Dr. Paula Malhotra

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Medical vs. Cosmetic Dermatology: What You NEED to Know with Dr. Paula Malhotra · Aesthetics Unscripted

• 0:05
  SPEAKER_01: Welcome to Aesthetics Unscripted.
• 0:08
  SPEAKER_01: I'm your host, Kim, and I'm happy to welcome today Dr.
• 0:12
  SPEAKER_01: Paula Maholtra.
• 0:13
  SPEAKER_01: She is a board-certified dermatologist and wears many hats.
• 0:18
  SPEAKER_01: Thank you so much for coming today.
• 0:20
  SPEAKER_01: Thanks for having me, Kim.
• 0:21
  SPEAKER_01: I want you to introduce yourself, please, because from Building Skin Institute from the Inside Out, starting your medical journey from Northwestern Medicine for a decade and raising two boys at the same time.
• 0:36
  SPEAKER_01: There's a lot going on in your life.
• 0:37
  SPEAKER_01: Give us your origin story, please.
• 0:40
  SPEAKER_00: Like you said, Paula Malhotra, board certified dermatologist.
• 0:44
  SPEAKER_00: You know, I did my training back in Kentucky.
• 0:47
  SPEAKER_00: That's where I'm from.
• 0:48
  SPEAKER_00: I'm actually in Kentucky right now for my brother's wedding week.
• 0:52
  SPEAKER_00: So shooting from my old uh office in our home.
• 0:55
  SPEAKER_00: Um, but really excited to be here.
• 0:58
  SPEAKER_00: And, you know, I did my medical school training in Louisville, went on to do my residency there as well.
• 1:05
  SPEAKER_00: Once I graduated from residency, I started my first job at Northwestern.
• 1:10
  SPEAKER_00: And it was such a privilege to have gotten such a prestigious job right out of residency.
• 1:15
  SPEAKER_00: And I actually stayed there for 10 years.
• 1:17
  SPEAKER_00: Um, and during that time, I was able to teach medical students, I was able to teach residents, and it was really fulfilling because there's nothing better than giving back to, you know, that next generation of students, and also helped me really stay on top of my game and stay ahead of um all the top literature and the data, and was really privileged to be able to work there for so long.
• 1:44
  SPEAKER_00: I had um amazing patience and an amazing experience.
• 1:48
  SPEAKER_00: Um, but you know, as things happen in life, we moved from downtown Chicago to the suburbs.
• 1:54
  SPEAKER_00: And, you know, I decided it was time for me to maybe venture out and start my own practice and kind of tailor it and um nurture it and kind of present it in the sort of culture that I wanted to give to my staff and to my patients.
• 2:12
  SPEAKER_01: I totally understand that.
• 2:13
  SPEAKER_01: Everything you're saying resonates with me.
• 2:16
  SPEAKER_01: I'm all about continuing education on a nonstop level.
• 2:20
  SPEAKER_01: And I love that you mentioned the giving back.
• 2:22
  SPEAKER_01: You have children to pay it forward with and to pass it on to, but your all-encompassing passion for giving back to the medical community that's coming up underneath you.
• 2:32
  SPEAKER_01: I think that's really awesome.
• 2:34
  SPEAKER_01: I also wanted to ask you, because I know the difference, but for our viewers' sake, I know you are a specialist with medical dermatology, but also cosmetic dermatology.
• 2:45
  SPEAKER_01: So can you please explain the difference?
• 2:47
  SPEAKER_00: As a medical doctor, we went through four years of college, undergrad, four years of residency, um, a one-year internship in internal medicine, and then a three-year residency program where we were trained uh profusely in all things related to medical dermatology, surgical dermatology, pediatric dermatology, as well as cosmetic dermatology.
• 3:14
  SPEAKER_00: And that included things such as um facial anatomy or precision when we are doing injectables like fillers and you know, biostimulants, as well as laser technology.
• 3:28
  SPEAKER_00: Um, so just like a vast background of a lot of knowledge.
• 3:34
  SPEAKER_01: Well, that's fantastic.
• 3:35
  SPEAKER_01: But then um you that's also the cosmetic side of it.
• 3:38
  SPEAKER_01: So there are dermatologists that I know do not venture into the cosmetic side, and they say on the medical side.
• 3:45
  SPEAKER_01: So for that definition to clarify for our viewers, that would be more like a Mo surgeon or a MO specialist, uh, maybe a pediatric dermatologist.
• 3:55
  SPEAKER_01: Anyone that doesn't have that shingle added as cosmetic dermatology, would that be correct?
• 4:01
  SPEAKER_00: Yeah, I would say so.
• 4:02
  SPEAKER_00: Um, not everybody gets that deep level of cosmetic training in their residency.
• 4:06
  SPEAKER_00: Right.
• 4:07
  SPEAKER_00: Um, so I would say that that's completely accurate.
• 4:10
  SPEAKER_00: Fortunately, I went to a residency program that offered a really great uh substance of training in in all the departments.
• 4:19
  SPEAKER_01: I think that's fantastic.
• 4:20
  SPEAKER_01: Yes, because that's where the world is now anyway.
• 4:23
  SPEAKER_01: And at least if you're exposed to everything, at least it gives you an option and you've gotten your feet wet.
• 4:28
  SPEAKER_01: So you understand the differences between being strictly medical in the dermatology field or middle of the road or just going after just the cosmetic side.
• 4:38
  SPEAKER_00: I really truly love having the balance of being able to treat the full facet of skin, you know, from starting from that medical sort of base and then expanding upon that.
• 4:51
  SPEAKER_00: Whether it's a patient who, you know, I diagnosed with a skin cancer and then doing their surgery, or a patient's child who may have eczema or acne.
• 5:02
  SPEAKER_00: Um, and then also that same patient who maybe had that surgery, who now wants to treat that scar or um, you know, treat their fine lines or wrinkles.
• 5:16
  SPEAKER_00: It's just nice for me to be able to offer everything under one roof and be confident in um providing them with excellent care in all aspects.
• 5:27
  SPEAKER_01: Absolutely.
• 5:28
  SPEAKER_01: I can't imagine how fulfilling that is for you.
• 5:30
  SPEAKER_01: And I feel that the patient-doctor relationship is becoming more and more important with every generation that's coming up.
• 5:39
  SPEAKER_01: So there's been yet another alarming social media trends with tanning to the extreme.
• 5:47
  SPEAKER_01: To me, this is horrific.
• 5:48
  SPEAKER_01: I'm an 80s, 90s kid where we were using black blankets and tan accelerators and oils and reflectors and putting peroxide in our hair.
• 5:58
  SPEAKER_01: Whatever we could do to get as dark as we could as quick as we could at the beginning of the summer.
• 6:02
  SPEAKER_01: But now I know about all of the damage, and I wish I would have never done any of it from the advanced aging, the hyperpigmentation, you know, the age spots, melasma, fine lines and wrinkles, like I just said, and also skin cancer being very, very real.
• 6:18
  SPEAKER_01: I mean, I'm seeing these younger persons online in tanning beds using tanning accelerators while they're on their phone.
• 6:27
  SPEAKER_01: This is like three things you're not supposed to be doing.
• 6:29
  SPEAKER_01: So please, how do you feel about this and share your insight about the dangers of tanning, especially in tanning beds?
• 6:37
  SPEAKER_00: I can't believe that this is making a comeback.
• 6:40
  SPEAKER_00: Um, I actually think that this conversation highlights one of the biggest challenges in medicine today.
• 6:46
  SPEAKER_00: You know, I think people are just getting their health information from social media, where I guess maybe confidence often gets mistaken for credibility.
• 6:56
  SPEAKER_00: Um, so I would break it down into three parts.
• 6:59
  SPEAKER_00: Like, let's think about what does the science actually say?
• 7:04
  SPEAKER_00: You know, we know we've got remarkably consistent data that UV radiation from the sun or from UV radiation from tanning booths.
• 7:15
  SPEAKER_00: Um, it's a well-established human carcinogen.
• 7:20
  SPEAKER_00: Um, we've got research showing that um, that the cumulative damage of UV over time can cause skin cancers, basal cells, squamous cells, and even melanoma.
• 7:31
  SPEAKER_00: Um, and of course, like you mentioned, it accelerates that premature aging process where we're getting um those fine lines, those deep wrinkles, pigmentation, the decrease in or loss of collagen.
• 7:47
  SPEAKER_00: And so then think about the science also that we have with sunscreen.
• 7:53
  SPEAKER_00: Um we have decades of evidence that shows that regular use of sunscreen reduces the risk of sunburns.
• 8:01
  SPEAKER_00: Um, it slows visible photoaging, it prevents precancerous lesions, and of course, it very much lowers your risk of skin cancer.
• 8:09
  SPEAKER_00: We know that if you can lower your risk of sunburns, that itself lowers your risk of developing a skin cancer in the future.
• 8:17
  SPEAKER_00: So it's not based on just two studies, it's based on years and years and years of consistent studies across multiple countries and multiple different scientific organizations.
• 8:31
  SPEAKER_00: So I think the science is there to prove that the sun or the UV rays are not good for our skin.
• 8:40
  SPEAKER_00: It's true that the sunlight does have benefits.
• 8:43
  SPEAKER_00: It helps regulate our circadian rhythm, it can help improve mood, uh, it can help contribute to vitamin D synthesis, um, but they don't require getting a sunburn or using, you know, methods of that tan acceleration.
• 9:01
  SPEAKER_00: One of the things I love to tell my younger patients, especially, because I think that education is so important.
• 9:08
  SPEAKER_00: My acne patients, for example, I tell every single one of those patients in their teens, like, please start wearing sunscreen.
• 9:16
  SPEAKER_00: It is part of their daily regimen that I, you know, write out for them.
• 9:21
  SPEAKER_00: Um, and I don't say it's because I don't want you to get skin cancer, because right now they're not even thinking about that, right?
• 9:28
  SPEAKER_00: Like, yes, I do preface it by yes, I hope that this will, this habit will early in life will help prevent skin cancers down the road.
• 9:36
  SPEAKER_00: But I want you to start doing this now because I don't want you to start seeing those sunspots when you're in your 20s or those fine lines.
• 9:44
  SPEAKER_00: Like you're gonna, if you start using sunscreen now, you are going to look better than every single one of your friends when you're in your 20s and your 30s.
• 9:51
  SPEAKER_01: Absolutely.
• 9:52
  SPEAKER_01: And then we both know certain ethnicities are prone to skin tags and moles.
• 9:56
  SPEAKER_01: So, you know, if they're a little bit like looking at some of their relatives, like, ugh, well, hello, you could actually avoid that type of hyperactivation by taking care of your skin.
• 10:07
  SPEAKER_01: I'm gonna play devil's advocate because um this is also under the sunscreen moniker and the subject, uh, something that I'm passionate about, is that I I will in our clinic in New York City, IT intelligent treatment, get some kickback occasionally about, well, you know, um I'm I'm educated on the fact that sunscreens are linked to endocrine disruptors and some of them are even carcinogenic, carcinogenic, some of these ingredients.
• 10:34
  SPEAKER_01: Uh, so I'd rather just go without.
• 10:36
  SPEAKER_01: But that's why we only carry zinc as the active ingredient.
• 10:40
  SPEAKER_01: So we explain to patients, and I'm curious to see how you feel about this.
• 10:45
  SPEAKER_01: Like, okay, I agree.
• 10:47
  SPEAKER_01: There are a lot of sunscreen ingredients that we've used here in the United States over the years that are either banned or frowned upon in other major countries.
• 10:57
  SPEAKER_01: So I tell patients, you don't need a huge education on reading the back of the label.
• 11:01
  SPEAKER_01: Just turn the label around.
• 11:02
  SPEAKER_01: If it says oxy anything, just look for the zinc.
• 11:05
  SPEAKER_01: That's all you have to do.
• 11:06
  SPEAKER_01: Just look for zinc or titanium dioxide zinc combination.
• 11:09
  SPEAKER_01: You're good.
• 11:10
  SPEAKER_01: It takes two seconds.
• 11:11
  SPEAKER_01: So, how do you feel about that?
• 11:13
  SPEAKER_00: So, I actually tell my patients the same thing.
• 11:15
  SPEAKER_00: Like if you have a problem with any of these chemical sunscreens, I highly recommend using zinc or titanium oxide-based sunscreens.
• 11:24
  SPEAKER_00: Um, and they've come such a long way now.
• 11:27
  SPEAKER_00: These sunscreens, they used to be those ones that leave that white cast on your skin.
• 11:31
  SPEAKER_00: They are so much better nowadays, you know, like they they make them so cosmetically elegant that even on my dark complexion, there are so many amazing zinc sunscreens that leave no white cast.
• 11:44
  SPEAKER_00: So um there's really no excuse.
• 11:46
  SPEAKER_01: No excuse.
• 11:47
  SPEAKER_01: 247, 365.
• 11:49
  SPEAKER_01: That's what we always say.
• 11:50
  SPEAKER_01: So um, speaking of clinics, Skin Institute, S-K N, let's talk about that.
• 11:56
  SPEAKER_00: So, Skin Institute is my baby.
• 11:58
  SPEAKER_00: It's my third baby, maybe my fourth, if you include my husband as one of my butt it is a passion project, I would say.
• 12:07
  SPEAKER_00: You know, it's something I've wanted to do for a very long time.
• 12:10
  SPEAKER_00: I thought about, I've been thinking about doing my own practice since I graduated residency, but you know, part of me was always thinking, well, I need more experience.
• 12:20
  SPEAKER_00: I need to get, I just need to gain more and more and more experience, both in corporate medicine, in private practice, because I just felt like I needed to have that well-rounded background before I could start something special of my own.
• 12:36
  SPEAKER_00: And the timing was never right.
• 12:38
  SPEAKER_00: You know, you you graduate residency, you have kids, and and then you want to be there for those kids.
• 12:45
  SPEAKER_00: And starting a practice just never felt right.
• 12:47
  SPEAKER_00: But um, once my kids were, they're both now in school full-time, I decided now's the time for me to do this and for me to share this passion with my patients.
• 12:57
  SPEAKER_00: And I wanted to create this work environment where people, my staff, love to come to work.
• 13:04
  SPEAKER_00: They really feel as passionate as I do for taking care of our patients.
• 13:09
  SPEAKER_00: And so I've been very lucky to be able to hire a team where we share, you know, this passion for dermatology.
• 13:18
  SPEAKER_00: And also we, you know, find value in making sure that our patients feel valued and appreciated.
• 13:29
  SPEAKER_00: And, you know, they want to come see us and we want to see them.
• 13:34
  SPEAKER_00: I found that all too often in the medical healthcare system, patients felt like they were just a number, and physicians felt like they were just another cog in the wheel.
• 13:46
  SPEAKER_00: And so there was a very much disconnect between being able to spend quality time with patients and really hear them and listen to them and um and be able to have time to dig a little deeper into what their ailments really are.
• 14:00
  SPEAKER_00: And so at Skin Institute, it's exciting because that patient experience starts from the second that they call to make their appointment, from the moment they walk through the door to check in for their appointment, from the experience of being pulled back into the room, getting their history and their intake.
• 14:20
  SPEAKER_00: And then it ends with, you know, it kind of culminates with me being their provider, sitting down, listening to them, looking them in the eye.
• 14:27
  SPEAKER_00: I I don't ever scribe or um turn my back to them to take, to take notes, you know, it's it's a one-on-one.
• 14:36
  SPEAKER_00: I'm looking you in the eye, I'm looking at your skin.
• 14:38
  SPEAKER_00: Um, and then they walk out with a personalized plan.
• 14:43
  SPEAKER_00: And I I hope that patients find value in that because I find value in providing that.
• 14:50
  SPEAKER_01: So with you and your staff and your mission at Skin Institute, I think is very commendable because you're talking about relationship and that's what patients are looking for.
• 14:59
  SPEAKER_01: So I think uh for providers that are listening, this is so key.
• 15:04
  SPEAKER_01: It's a key element.
• 15:05
  SPEAKER_01: It doesn't matter if you're a patient or a provider and you're not within Dr.
• 15:09
  SPEAKER_01: Paula's area.
• 15:11
  SPEAKER_01: So you're not going to be able to see her as your practitioner, doesn't matter.
• 15:16
  SPEAKER_01: This is a great example of how you want to mold your own practice.
• 15:20
  SPEAKER_01: And it's a great example if you're seeking a new dermatologist or any doctor, this is what you should be looking for out of that new office.
• 15:28
  SPEAKER_01: While we were on the subjects of social media, viral trends, a lot of them very unhealthy ones.
• 15:34
  SPEAKER_01: How do you handle your patient that comes in, maybe with a picture, and they're like, I want to look exactly like this?
• 15:41
  SPEAKER_01: Can you fill me?
• 15:42
  SPEAKER_01: Can you do neurotoxins?
• 15:43
  SPEAKER_01: Can you laser me?
• 15:44
  SPEAKER_01: What can you do?
• 15:45
  SPEAKER_01: But I want to look exactly like this.
• 15:47
  SPEAKER_01: And their bone structure, their facial structure, their maybe even their skin color, it's nothing like the picture that they're holding up.
• 15:55
  SPEAKER_01: So how do you deal with that?
• 15:57
  SPEAKER_00: If I'm being perfectly honest, I've actually never had a patient bring in a photo to me.
• 16:03
  SPEAKER_00: Um, I'm probably one of the lucky.
• 16:06
  SPEAKER_00: Yes, absolutely.
• 16:06
  SPEAKER_00: Lucky for sure.
• 16:08
  SPEAKER_00: Um, because you know, when we schedule a cosmetic, a cosmetic consultation, what we do initially is we take a um, it's called an aura aura scan of the patient.
• 16:19
  SPEAKER_00: So the patient can actually see scientifically uh what they're doing well and what we could improve upon.
• 16:28
  SPEAKER_00: So I don't think that in that cosmetic consultation, they even have time to really pull up a picture and show me what they want to look like.
• 16:35
  SPEAKER_00: But at the end of the day, my commonality with cosmetic procedures and consultations is that I'm not trying to change what you look like.
• 16:48
  SPEAKER_00: What I can offer you is to enhance your natural beauty.
• 16:51
  SPEAKER_00: And so if I can help you look a little bit more refreshed, if I can help your friend say, hey, what are you doing?
• 16:58
  SPEAKER_00: Your skin looks amazing, your skin's glowing.
• 17:01
  SPEAKER_00: That is the ultimate compliment in my book.
• 17:04
  SPEAKER_00: And so that's what I think my patients know that coming to me is I'm a very, very much a naturalist.
• 17:10
  SPEAKER_00: I strive to give patients a very natural appearance, not overfilled, um, not fake looking whatsoever.
• 17:21
  SPEAKER_00: And I think they get that from word of mouth, um, from social media.
• 17:27
  SPEAKER_00: I think that they have this understanding that I'm not the girl to come to with those pictures.
• 17:32
  SPEAKER_01: It seems like we have two tracks with uh where patients are seeking their path moving forward when it comes to how they look.
• 17:43
  SPEAKER_01: They're either really clinging, like almost defiantly clinging to the idea of transformations that are unnatural and wanting to overblow and over-exaggerate every aspect of their face and body that they can.
• 18:00
  SPEAKER_01: And then you have the opposite lane, which is really pushing towards the demands for naturally enhanced beauty, as you said.
• 18:08
  SPEAKER_01: And that's that's exactly why we have the podcast, because we want to debunk, decode, and demystify and give persons, give the viewers, and even give providers a real look at options.
• 18:21
  SPEAKER_01: So you can make your own educated decision.
• 18:23
  SPEAKER_01: You know, we're not preaching to people, but I love that you said natural beauty and that's what you're all about because I too agree that it's okay to want to age gracefully and age beautifully, or do prevention when you're younger, as long as it's matching you yourself.
• 18:39
  SPEAKER_01: There's proper treatments for yourself and you still look like you.
• 18:42
  SPEAKER_01: I think that's so important.
• 18:43
  SPEAKER_00: And don't get me wrong, you know, I'm not um saying that there's anything wrong with filler or neurotoxin.
• 18:50
  SPEAKER_00: I definitely use plenty of those things for my patients, but I think that it's a balance of less is more.
• 18:59
  SPEAKER_00: Um we may do a little bit of filler in the cheek and a little bit of, you know, neurotoxin um in the forehead or the DAOs, but we're combining that with other modalities that can help stimulate and tighten and lift your muscle structure.
• 19:17
  SPEAKER_00: Um, and then other modalities on top of that to compound building and um development of new collagen.
• 19:24
  SPEAKER_00: So we're not getting all of that lift from filler because in order to get all of that lift from filler, you're just using a ton of it.
• 19:32
  SPEAKER_00: And that's where you look unnatural.
• 19:34
  SPEAKER_01: Something that you said also is going into layering and natural beauty and building up your musculature.
• 19:41
  SPEAKER_01: That's why I invented somacil, which is a non-surgical way to address in a non-wounding way, tightening and lifting your skin, because it's been proven for two decades now for connective tissue activation, which means being able to work on those connective tissues, not just skin deep, to be able to lift and tighten naturally.
• 20:02
  SPEAKER_01: And you can pair it with your neuromodulator.
• 20:05
  SPEAKER_01: You can pair it with a little bit of filler.
• 20:07
  SPEAKER_01: You can have even your lip filler if you have no filler in your face.
• 20:10
  SPEAKER_01: You don't have to worry.
• 20:11
  SPEAKER_01: And if you need more surface textural addressing, you can still get your laser afterwards as well.
• 20:17
  SPEAKER_01: But maybe instead of a fractionated laser series, maybe now you only need one.
• 20:22
  SPEAKER_01: So I don't know if you're familiar with somicel.
• 20:24
  SPEAKER_01: If not, I'd love to be able to talk to you more about that in the future.
• 20:29
  SPEAKER_00: I love that.
• 20:30
  SPEAKER_00: I mean, that sounds like it's right up my alley with being able to provide patients with something that is non-invasive, natural.
• 20:39
  SPEAKER_00: Um, I think the concept is genuinely exciting because I'm just such a big believer in being able to provide non-invasive collagen stimulation as part of the regenerative aesthetics that we want to provide our patients.
• 20:54
  SPEAKER_01: That's fantastic.
• 20:55
  SPEAKER_01: What else do you do at Skin Institute?
• 20:57
  SPEAKER_01: I know, so you do um your usual, the whole medical side, which is so important, of course, but then on the cosmetic side, your usual with neuromodulators, fillers, and then lasers are up needling.
• 21:12
  SPEAKER_01: What else?
• 21:12
  SPEAKER_01: What do you have?
• 21:13
  SPEAKER_00: The full gamut.
• 21:14
  SPEAKER_00: So, you know, starting from collagen stimulation with things like microneedling, a fraxal laser with the fraxyl dual to do both um go after pigment as well as collagen stimulation.
• 21:29
  SPEAKER_00: Um, we have soft wave, which is the ultrasound technology to help with stimulating um collagen that way.
• 21:36
  SPEAKER_00: We have something called M face, where we are using electrical muscle stimulation to help with tightening um and toning the muscle, the elevator muscles of the face.
• 21:48
  SPEAKER_00: We also have Exion, which uses a combination of radio frequency with ultrasound to help with ultrasounds, um, to help with collagen stimulation.
• 21:58
  SPEAKER_00: We have Las MD Ultra, which is just a baby fraxal for those patients who may not want the downtime of a fraxal or may not be able to tolerate the power.
• 22:09
  SPEAKER_00: We've got the Q-Tera laser.
• 22:11
  SPEAKER_00: I mean, we've got a lot of lasers.
• 22:12
  SPEAKER_00: So the name of the game I tell my patients is what can we do to stimulate your collagen?
• 22:18
  SPEAKER_00: And let's start early.
• 22:20
  SPEAKER_00: Because yes, we can do some things when we're in our later decades, but we can do so much more for you when you start early.
• 22:29
  SPEAKER_00: And it's so rewarding.
• 22:31
  SPEAKER_01: Yep, I totally agree with that.
• 22:33
  SPEAKER_01: There's nothing wrong with prevention as long as you're paired up and teamed up with the right provider that is not going to just throw everything at the wall and not understand the difference with your ethnicity, your lifestyle, your sun exposure, your past health history, all these things, as you and I both know come into play, especially when it comes to your heat-based devices.
• 22:54
  SPEAKER_01: Uh, the cool thing about SomaCell versus M-Face, I'm gonna throw this one out there, is that Sumacell has no single-use disposables.
• 23:01
  SPEAKER_01: So we're it works on all of the areas of their face, including like your lower orbital, that super important part.
• 23:09
  SPEAKER_01: So you are also working on the musculature, but you're you're really getting into defined areas.
• 23:15
  SPEAKER_01: But you know what I think is amazing with um Skin Institute and yourself is that you understand the difference between your lasers as well.
• 23:24
  SPEAKER_01: And I do want providers and uh viewers that are patients alike, everybody out there listening, there is no such thing as having a room full of lasers and just automatically assuming that person knows what they're doing for you.
• 23:38
  SPEAKER_01: So you want to make sure that they are keeping up after their continuing education and that they are of a caliber, as Dr.
• 23:46
  SPEAKER_01: Paula, who has a huge medical background behind her and is making sure her staff is well trained and not delegating to inexperienced people to treat you.
• 23:55
  SPEAKER_01: Okay, Dr.
• 23:56
  SPEAKER_01: Paula, let me ask you.
• 23:57
  SPEAKER_01: Um, we have all seen little charts and ABCDs.
• 24:00
  SPEAKER_01: It used to be ABC, now it's ABCD for skin cancer, but I don't know if anybody actually really pays attention to it.
• 24:07
  SPEAKER_01: So can you give us a quick rundown on what is the A B C D and why it's so important to go for your annual mole check?
• 24:15
  SPEAKER_01: Because I hear far too often, oh, I got my mole check like five years ago.
• 24:19
  SPEAKER_01: E that is E.
• 24:23
  SPEAKER_00: Yeah, you're right.
• 24:24
  SPEAKER_00: It's too long.
• 24:25
  SPEAKER_00: A, B, C, D, and E, we these are base, they basically stand for A is for asymmetry.
• 24:33
  SPEAKER_00: So take a look at your moles.
• 24:35
  SPEAKER_00: Try to take a look at your moles and your body at least once a month.
• 24:39
  SPEAKER_00: Um, and if you see any moles becoming asymmetric, they don't look like they have symmetry or they're sort of breaking that mold, those are that that's a concerning feature.
• 24:50
  SPEAKER_00: Um, anything that has an abnormal border, that's what the B stands for.
• 24:56
  SPEAKER_00: Um, it's got squiggly lines, it's not like perfectly round.
• 25:00
  SPEAKER_00: Um, those are that's another sign.
• 25:02
  SPEAKER_00: Uh anything with a change in color, that's what the C stands for.
• 25:07
  SPEAKER_00: Color in the form of is this mole was perfectly uniform in its tan color or dark brown color, but now I'm starting to see shades of light brown or black, or um, it's lost its color.
• 25:22
  SPEAKER_00: So that's a concerning feature.
• 25:24
  SPEAKER_00: So I would like to know about that.
• 25:26
  SPEAKER_00: Um, D stands for diameter.
• 25:28
  SPEAKER_00: So is this mole getting bigger?
• 25:30
  SPEAKER_00: Is it changed in diameter?
• 25:32
  SPEAKER_00: Is it increasing in size?
• 25:34
  SPEAKER_00: That's another red flag.
• 25:35
  SPEAKER_00: Come see me.
• 25:36
  SPEAKER_00: Um, or any dermatologist near you.
• 25:38
  SPEAKER_00: Um, and then E stands for evolution.
• 25:42
  SPEAKER_00: Is this mole changing?
• 25:45
  SPEAKER_00: Is it evolving?
• 25:46
  SPEAKER_00: Is it um molding or morphing into something?
• 25:50
  SPEAKER_00: Has it like developed uh raised features to it?
• 25:54
  SPEAKER_00: Um, so those are the those are the ABCDs of of melanoma, but not just melanoma, melanoma is not the only skin cancer that we worry about.
• 26:04
  SPEAKER_00: I also tell my patients, if you ever see any spot that looks like it's a pimple that's not going away, uh, if you see any rough little scab that's just not healing, it keeps scabbing and going away, scabbing and going away.
• 26:19
  SPEAKER_00: That's another concerning feature that I need to know about.
• 26:21
  SPEAKER_00: Um, anything bleeding or not healing, again, other symptoms of concerning moles or concerning lesions that I should um I should see.
• 26:31
  SPEAKER_01: Yes, definitely.
• 26:33
  SPEAKER_01: Well, it's been a huge pleasure to have you here, Dr.
• 26:36
  SPEAKER_01: Paula.
• 26:36
  SPEAKER_01: And I hope we can circle back and get together again in the future.
• 26:40
  SPEAKER_01: But for those seeking to contact you, um what is your social?
• 26:45
  SPEAKER_01: What's your website?
• 26:46
  SPEAKER_01: What's your email?
• 26:47
  SPEAKER_01: How do they find you?
• 26:49
  SPEAKER_00: Well, thanks for having me.
• 26:50
  SPEAKER_00: I would love to be back.
• 26:51
  SPEAKER_00: And for anyone who wants to come see us, um, you can go to our website.
• 26:56
  SPEAKER_00: It's www.sknin.com.
• 27:01
  SPEAKER_00: You can also follow us on social media.
• 27:02
  SPEAKER_00: It's skn.institute.
• 27:06
  SPEAKER_00: And um, we'll hope to continue to provide really great educational um information.
• 27:12
  SPEAKER_00: And, you know, on social media, I like to provide a little bit of humor too, because we can't be serious all day.
• 27:17
  SPEAKER_01: Right, exactly.
• 27:18
  SPEAKER_01: We gotta have fun while we're going through this battle called life, right?
• 27:21
  SPEAKER_01: And for the viewers, if you have questions or comments, please subscribe and drop your comment here.
• 27:27
  SPEAKER_01: We're looking forward to it.
• 27:28
  SPEAKER_01: You can check out the website for all of the podcast episodes at au thepod.com or send us an email.