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Beek on being SKIN SAVVY · Beek on being

• 0:00
  Melissa Shere Beek: Hi, I hope you are well. This podcast is a place for people to share personal and professional perspectives, talk openly and ask questions. From serious to silly to sublime, it's all about communication and connection. Always coming from a place of kindness and curiosity, we talk about shared humanity, discuss ideas, and highlight people creating a better world. We've got to keep learning, keep growing, keep being.
• 0:27
  I'm Melissa Beek, and this is Beek on being. Today's episode is Beek on being skin savvy. It's the only skin we're in, and we need to take great care of it. From enhancing your skin's natural beauty to repairing damage, from general skin care to cosmetic dermatology, we want to know all about prevention, protection and procedures that can keep us staying healthy and aging well. Today in studio, we have board certified dermatologist, fellow of the American Academy of Dermatology, and the director of Skin Associates of South Florida, Doctor.
• 1:01
  Joely Kaufman, to tell us everything we need to know about being skin savvy. I am so honored to have you here, so welcome. I'm thrilled.
• 1:10
  Dr. Joely Kaufman: Thank you so much, Melissa. It's fun. I said I could come and chat all day with you, so this is perfect.
• 1:15
  Melissa Shere Beek: I love it. I love it. Love it. So for our listeners, can you tell them a little bit about yourself and how you got into dermatology?
• 1:22
  Dr. Joely Kaufman: Sure. So my name is Joely Kaufman. I'm actually born and raised in Miami and have actually known Melissa for quite some time Forever. Since we were kids. And I'm a dermatologist.
• 1:34
  I work at Skin Associates of South Florida. We actually have seven providers there, so it's not just me. We have a whole group of dermatologists and PAs and NPs. I started my career at the University of Miami, so in teaching, academics, and research, and now have rolled over into private practice. But still there, we do a lot of research.
• 1:54
  So, yes, we do dermatology. Yes, we do cosmetic dermatology, but we also do a lot of the f d FDA trials that bring new products, new drugs, new injectables, new botoxes to our market in The US. We have fun, and we all work together as a team. It's nice.
• 2:10
  Melissa Shere Beek: Yeah, your team is amazing. The best team. The best team in the entire world. Okay, so I wanna cover general dermatology to cosmetics, but can you just tell us first a little bit about the key aspects of general dermatology?
• 2:20
  Dr. Joely Kaufman: Okay. So, I mean, the thing that first attracted me to dermatology is because skin is just the window to the rest of the body. So really dermatology encompasses every single part of medicine. So there are a lot of findings we see in the skin that we send people for, hey, maybe you need to see your cardiologist, your fingertips are getting blue, or you need to go to a doctor for your leg veins because we see a rash on the leg. So the fun part about it is that it's a lot of problem solving.
• 2:51
  Yeah. We also see So we see patients of all ages. That's another wonderful thing about our job is that we can see babies. So there's babies that are born with birthmarks and skin diseases, genetic diseases, all the way up through adulthood, and that's when we start seeing more of the skin cancer type stuff as people get So it's enjoyable because it's different every single day.
• 3:14
  Melissa Shere Beek: Yeah, nothing's the same. I love that. Okay, so we live in a tropical area. Does that factor in as far as dermatology conditions like things that you see in this climate that maybe the northerners don't have?
• 3:26
  Dr. Joely Kaufman: Right. A 100%.
• 3:28
  Melissa Shere Beek: Okay.
• 3:28
  Dr. Joely Kaufman: So we're in the sun every day. Yes. So a lot of people talk to me about, oh, shouldn't I just be lying in the sun for my vitamin d? And I say, yes, if you live in Seattle. I tell you, please go lie in the sun and get some vitamin d.
• 3:40
  But we're in the sun every day no matter how much sunscreen we wear. Right. You're not gonna block it out. So we do see more skin cancer, more rashes associated with the sun. Right.
• 3:51
  So things like heat rash, we call it PRP, like we get we get a lot of like itchy things from sweating, things like that. Skin cancer
• 4:00
  Melissa Shere Beek: Yeah.
• 4:01
  Dr. Joely Kaufman: Big one. Sometimes people with autoimmune diseases are more affected by sun, so this is a tough climate for them. Things like lupus, discoid lupus, those patients have a tough time in the sun. And honestly, we don't have that many seasonal changes here. Yeah.
• 4:15
  So whereas I work up north also in New York, I have to change people's skincare regimens by the season. Was gonna have From summer, that can cut back on their moisturizer at night, they can use more Retin A. In the winter they have to cut back on a lot of the drying things and add them here we're kind of the same year round.
• 4:33
  Melissa Shere Beek: Yeah, except
• 4:33
  Dr. Joely Kaufman: for
• 4:34
  Melissa Shere Beek: three days in January.
• 4:35
  Dr. Joely Kaufman: Yeah, and we get sun year round. So, you know, it's a different climate, it's a different practice of dermatology.
• 4:41
  Melissa Shere Beek: Okay, so there's like 10,000 things you hit upon that I want to continue with. Table the skin cancer for a second, but you were talking earlier about like when you have patients and you can tell the skin that maybe there's something going on. Are there internal health indicators that can cause skin conditions? You just said a little bit about lupus or things like that.
• 4:59
  Dr. Joely Kaufman: Yeah, absolutely. So one of the diagnostic features of lupus, one of the diagnostic features is skin rash. So they get a butterfly rash. You go in the sun and you turn bright red in a butterfly pattern. So across the cheeks and across the nose.
• 5:15
  So a lot of times, even things like for transplant patients, we know in the skin that the transplant could be rejecting before they know in the transplant. So a lot of times, at the university when they have a patient that gets admitted who's had a transplant, if they're wondering if they're having graft versus host, which is rejection of the transplant, they'll do a biopsy of the skin. Wow. So they don't even go to the organ, they look at it in the skin. So really honestly, that quote of the skin is the window to the rest of your body or to your soul is actually really, really true.
• 5:47
  So it takes an astute person to really look like when you're doing a skin check to look at some features that might say, Hey, maybe you should get your thyroid checked because your skin looks very, very dry to me, abnormally dry, know,
• 5:59
  Melissa Shere Beek: Right, drier and it's an indicator for all these other different diseases that are underlying health wise. Yes. Fascinating. Oh my God. Okay, so back to the skin cancer part.
• 6:08
  How often should someone come in just for regular checkups?
• 6:13
  Dr. Joely Kaufman: So in adulthood, so generally after age 18, unless you have a family history, you should start having a yearly skin check. Okay. In Florida, more important than anywhere else because we've already had eighteen years if you grew up here of a lot of sun. Right. Most of our sun exposure happens when we're young.
• 6:30
  Melissa Shere Beek: Mhmm.
• 6:30
  Dr. Joely Kaufman: So Yeah. They there are recent reports out about tanning beds, and they said that for people who used tanning beds before they were 35 years old, they're noticing a more than fifty percent increase in the chance of having melanoma.
• 6:46
  Melissa Shere Beek: Melanoma, not just like basal or
• 6:47
  Dr. Joely Kaufman: sinus Not not the little ones, the real ones. So we know we know that UV exposure, UVB, UVA is associated with formation of skin cancers. Right. Of course, people like being tan, they like looking good, and so we're attracted to do it. Plus, I love being outside.
• 7:04
  Yeah. It's nice, you know, enjoying the reason. Yeah. So it's hard, but Okay. You know, and God forbid you end up with something you really don't want it on your face, so please start there.
• 7:15
  You know, the rest of the body we can cover sometimes. Wear a lot of sun protective clothing. Yeah. But again, here every day, we're outside every single day. So you get enough sun to get a skin cancer with a couple sunburns.
• 7:27
  Melissa Shere Beek: I
• 7:27
  Dr. Joely Kaufman: know. Know. Melissa.
• 7:28
  Melissa Shere Beek: I know you take very care of me though. So once someone has been diagnosed, let's say with basal cell or squamous, should they come in more frequently?
• 7:36
  Dr. Joely Kaufman: So the rule would be once a year. Once you've had a skin cancer, it's every six months. And then after two years you can go back to a year check. For melanoma, it's even more frequent. So you're pretty much on a six month schedule for the rest of your life with melanoma.
• 7:50
  The first two years after melanoma, most people will be checked every three months. The beauty of it is that most of the skin cancers like basal and squamous are very, very, very treatable when caught early. So that's why you do these screening things, that we find something little, you can go get it excised, and unlike a lot of skin cancers, lot of other cancers, this can be cured. You can be pretty much 100% cured by excising a basal cell.
• 8:18
  Melissa Shere Beek: I think what you said though was like, get it done early. Prevention is the key.
• 8:24
  Dr. Joely Kaufman: The smaller it is, the easier it is
• 8:26
  Melissa Shere Beek: The more that you have been diagnosed with, does that increase the percentage of developing more skin cancer or a melanoma if it's just a basal or squamous?
• 8:37
  Dr. Joely Kaufman: You know, the more sun you've had, the more your risk increases. So the fact that you've had a couple skin cancers means you've probably had a lot of sun. There are some other things that can cause skin cancer like radiation. So years back, it's not in our generation, but the generation above us, they used do radiation for acne, which we don't do anymore. And then I had a patient one time who had a bunch of basal cells in her scalp, and they lived near a well where they actually had low, low, low amounts of arsenic in the well in another country.
• 9:12
  Anyway, so there are other reasons but really the primary cause of skin cancer
• 9:16
  Melissa Shere Beek: is So the in cases like that and maybe sun, does it make a genetic blueprint for offspring? Like if you have it, does that mean
• 9:26
  Dr. Joely Kaufman: No. You know, genetic part would be for melanoma. Okay. There melanomas definitely can be genetic Okay. And not just sun.
• 9:35
  Melissa Shere Beek: Okay.
• 9:36
  Dr. Joely Kaufman: So Bob Marley died of melanoma on his toe, so most likely he did not get a lot of sun on his toe, and as we know, he was dark, so it's not like he was sunburned all
• 9:45
  Melissa Shere Beek: Right, the right.
• 9:46
  Dr. Joely Kaufman: So there is a genetic component for sure. If a family has started melanoma, start early. The other part of genetics would be if you're really fair skinned. So, you know, those people we call skin type one and two, which are very fair, which means when you go in the sun, you burn. Wear a hat.
• 10:02
  Yeah. Wear a hat. Wear I mean, I get it. It's hard to apply sunscreen. I just started taking up golf, and I'm I'm trying to figure out how you apply sunscreen after nine holes when you're, like, sweating and Right.
• 10:14
  Right. And how do you recover your arms. Yeah. And, you know, sun protective clothing is nice. It's not so ugly anymore.
• 10:20
  Right. Like, I have cute ones that have zippers and patterns and Right. I I think we've
• 10:24
  Melissa Shere Beek: gotten I guess that you're the chicest one on the golf I can imagine. Most covered
• 10:28
  Dr. Joely Kaufman: one on the golf course. But but I still love being outside because I don't tell anyone stay inside because of this, like just be wise like anything else we do.
• 10:37
  Melissa Shere Beek: Okay, good. Alright, so you mentioned acne. So can we talk a little bit about in regards to acne, do you see it primarily with teenagers? Is there another population that, you know, hormone influxes after pregnancies?
• 10:52
  Dr. Joely Kaufman: So our classic picture would be teenagers when they're going through puberty. So that's different for boys and girls when they start, and it's that T zone kind of acne. But there are other types of acne, so perimenopausal acne for sure is a real thing. Hormonal acne is for sure a real thing. There are some medications that can cause acne, so we always look at those things.
• 11:14
  Most products are pretty wise now about being non comedogenic, meaning non pore clogging, not oil, you know, not based in an oil base. And so we less associate it with cosmetics than we do, you know, with other things, internal things like hormones and stuff like that. But there still are, you know, in this day now you look at Instagram, it is every product in the world. Yeah. I mean, I know even my daughter who's 20 now knows so much about skincare, and she'll be like, no, you need to buy this one.
• 11:44
  You need where'd you learn that on on Instagram? But, you know, be careful what you Your skin likes to have a routine.
• 11:51
  Melissa Shere Beek: Right.
• 11:51
  Dr. Joely Kaufman: So varying it up a lot is gonna cause maybe not only pimples, but also irritation, redness, some Reactive. Crazy Right. Reactive inflammatory kind Okay. Of
• 12:03
  Melissa Shere Beek: Are there so what are the treatments for acne?
• 12:06
  Dr. Joely Kaufman: I mean, lucky for us now, we have a lot of better treatments than radiation.
• 12:09
  Melissa Shere Beek: Right. Right. Right.
• 12:11
  Dr. Joely Kaufman: You know, we always start with topicals, so we go through a regimen with, you know, face washes and topicals. You know, if it's teenage acne, we usually start with a retinoid.
• 12:20
  Melissa Shere Beek: Uh-huh.
• 12:21
  Dr. Joely Kaufman: So a retin A, you've heard of that. Got it. And I know some people come in and say, oh, I can't use a Retin A, it's too irritating, I'm gonna get too dry. And it's all the way you use it. Right.
• 12:29
  So we have better formulations than we used to have. And and again, your skin likes routine. So with things like Retin A, you need to be on a routine, whether it's every other night or every night or every third night, whatever you can tolerate, it needs to be a regular routine. But there's topical antibiotics, there's oral antibiotics, and happily, we still have Accutane on the market, which is an oral form of Retin A. It's a vitamin A derivative.
• 12:54
  Got it. And that's reserved for very severe acne or acne that causes scarring.
• 12:59
  Melissa Shere Beek: Right. Okay, so scarring. When you let's say that they're done with their treatments, they're not breaking out anymore, but you have scarring, discoloration, divots, redness, how do you treat that?
• 13:12
  Dr. Joely Kaufman: So it's actually nice when it's in the teenage population because they grow a lot more collagen than we do. So treating them tends to be a lot easier and our results happen Yes. Okay. A lot So, you know, when we do a treatment on somebody, you know, in their eighties, they're not growing a lot of collagen. So it's hard to really get it, you know, to bounce But young people do really well.
• 13:34
  Obviously, our first goal is to prevent the scarring. Yeah. So if we need to use Accutane, we do. Some people just can't tolerate topicals or their acne is so severe, or cystic acne, that's a very good indicator for Accutane. So some of the treatments we can do are fractional lasers, we do something called RF microneedling, which is a radio frequency with needles, so the needles pop in the skin.
• 13:58
  They heat the underside of the skin, so the outside of the skin is left intact, which keeps it very safe from infection. And heating the underside of the skin makes you grow collagen. So you can literally treat those acne scars. And then sometimes if we have to, if we get older and we're really not getting anywhere with the collagen stimulation, we can actually just fill the scars.
• 14:19
  Melissa Shere Beek: With a filler?
• 14:19
  Dr. Joely Kaufman: So you can take a little filler and put it into the scars.
• 14:21
  Melissa Shere Beek: Okay. And it doesn't create more dense or anything like that?
• 14:24
  Dr. Joely Kaufman: And it doesn't create
• 14:25
  Melissa Shere Beek: more Okay. Alright. So, people want to know. Getting rid of wrinkles, age spots, discoloration, saggy skin. We need to get into cosmetic dermatology.
• 14:35
  I know there's so many things that I don't even know of, because I'm a chicken shit. Don't do anything. So, will you break down the different types of cosmetic treatments there are for enhancing skin, for looking refreshed, for rejuvenation?
• 14:54
  Dr. Joely Kaufman: So this could probably be like a 10 series podcast. Okay. So we'll brush like category. Okay. You know, like the deep dive is probably just, you know, a lot.
• 15:07
  I think my my first thing about cosmetic dermatology is that it's become a social media phenom.
• 15:14
  Melissa Shere Beek: So
• 15:15
  Dr. Joely Kaufman: you see all these social media experts on online talking about what you should do, and I think it's fine to scroll, and believe me they pop up on my Instagram
• 15:25
  Melissa Shere Beek: Oh, wow.
• 15:26
  Dr. Joely Kaufman: All the time. You know, because if you stop and look at something obviously I'm looking at skincare and I'm looking at Yeah. You know, things. And it's fine to scroll that way, but trust your provider. So find a board certified dermatologist that you trust that does this for a living.
• 15:41
  Melissa Shere Beek: I think that's key what you just said.
• 15:42
  Dr. Joely Kaufman: And ask the questions you need to ask. Right. Because unfortunately, we all know social media is fake, and it's fake in medicine too.
• 15:50
  Melissa Shere Beek: Yeah.
• 15:51
  Dr. Joely Kaufman: I always say like when someone comes in, they're like, why don't you put the Botox right here? I saw it on Instagram. They said if you put it here, it's gonna lift my eyebrow. And I said, do you walk into the cardiologist and tell them how to do your cardiac cath?
• 16:03
  Melissa Shere Beek: Right.
• 16:04
  Dr. Joely Kaufman: Like, it's a no. It's just a no. It's not real medicine. So, yes, learn, browse, skincare. It's great to educate yourself on skincare on social media, but like when it comes to the real stuff, I like, go and just ask the appropriate questions.
• 16:19
  Melissa Shere Beek: Yeah. And if you're not comfortable right provider.
• 16:21
  Dr. Joely Kaufman: Yeah. And if you're not comfortable with that person, ask another person. Right. But ask the questions. So, you know, a broader view, the place I start with most cosmetic consults is that I tell patients what you do at home is as important as what I can do in the office.
• 16:36
  Okay. Because you may see me every three to four months, but you're at home every single day with yourself. So your skin is yours and you need to take care of it. And so I designed a regimen upfront. It's a big commitment, but once you get into it and you realize how great skin looks when you actually have a great regimen.
• 16:55
  You know, sometimes it saves you a lot of money from doing other things. After the skin regimen, we'll go into like kind of starter things. So there's something we call neuromodulators, that's a fancy word for the Botox type molecules. So we have seven on the market now in The US. Botox was the originator.
• 17:13
  They're all made right now from the same botulinum toxin, pulse train. So they're all the same active ingredient, they're just made differently. Again, up to your provider which one they want to use. They all work fantastic, they're all approved by the FDA, they have all been through rigorous trials with thousands and thousands of patients. So they're safe in my eyes when put into the right hands.
• 17:36
  Melissa Shere Beek: Got it.
• 17:36
  Dr. Joely Kaufman: The other type of injectable would be a filler. And there are two categories of filler right now. One is called hyaluronic acid that would be like Juvederm, Restylane, those. They fill immediately. That's what we use in lips.
• 17:50
  Melissa Shere Beek: I was gonna ask you, where are you putting the fillers?
• 17:52
  Dr. Joely Kaufman: So HAs, you have hyaluronic acid in your body. It's in your joints, it's in your skin, so it's a natural ingredient in your body. They make these hyaluronic acids in a lab, so they're sterile, but they're very very similar to what you have in your body. So the good thing about them is that, you know, it's only a one pretty much in several 100,000 chance that you would ever react to it. Right.
• 18:15
  If that happens, we dissolve it and it's gone.
• 18:17
  Melissa Shere Beek: Does it dissolve naturally once
• 18:18
  Dr. Joely Kaufman: you It get dissolves naturally. So your body recognizes it as its own and it'll gradually break it down. So these things go away, the whole filler phenomenon about like migration of filler from, you know, the nasal labial fold to the backside of the face is really not real unless it's injected very very wrong.
• 18:38
  Melissa Shere Beek: Right, okay. So go to Jolie, don't go to other people.
• 18:41
  Dr. Joely Kaufman: These things, I mean they're real medicines. Yeah. This is not, going and getting your hair colored. This is real medicine. So, pick someone wisely.
• 18:51
  So, that would be one type. And then the other type that's become even more popular now is the bio stimulators. They're still injectables. The two names that you would have heard of would be Sculptra and Radiesse. So these ones are injected, yes to provide a little bit of volume, but they're more for collagen growing.
• 19:08
  That same
• 19:08
  Melissa Shere Beek: concept So they we stimulate talked collagen growth.
• 19:11
  Dr. Joely Kaufman: Yes, stimulate collagen. So we don't put these in the lips actually, because they don't plump. They're more like tighteners, brighteners, so we call things that we talk about like glow in the skin can be generated by these type of So kind of a different purpose in my eyes than a hyaluronic acid filler.
• 19:31
  Melissa Shere Beek: What are most I'm curious, what are most people doing? Would say it could be
• 19:36
  Dr. Joely Kaufman: an even split. Like there are certain places I love certain things. So like Sculptra, again collagen stimulator, the collagen grower. I love for the hollow of the cheek. So we have a frame, you have your cheekbone and you have your jawbone.
• 19:50
  And in between there as we age, this starts caving in, then we get all those crisscross wrinkles. Got it. And the more sun you have, the more you get that. Right. So there's like a great one on the internet of a guy who drove a truck his whole life, Never used sunscreen.
• 20:08
  The left side of his face was exposed to sun and not his right side. So you can look up truck driver, UV exposure, My left arm
• 20:15
  Melissa Shere Beek: and my right arm.
• 20:15
  Dr. Joely Kaufman: Right. Same story. Right,
• 20:17
  Melissa Shere Beek: Melissa? Right. All my cancers are on my my cool arm.
• 20:20
  Dr. Joely Kaufman: The one
• 20:20
  Melissa Shere Beek: that was out the window.
• 20:21
  Dr. Joely Kaufman: Yep. And it's real. So all the kids now
• 20:24
  Melissa Shere Beek: So true.
• 20:25
  Dr. Joely Kaufman: Are on Instagram saying Yeah. Sun doesn't do any damage. It's the sunscreens that do damage. I'm like, okay. Read the real articles, and then we'll talk.
• 20:32
  Melissa Shere Beek: Right. Right.
• 20:32
  Dr. Joely Kaufman: Right. The Instagram article is not good.
• 20:34
  Melissa Shere Beek: Okay.
• 20:35
  Dr. Joely Kaufman: Anyway, he has all the sun damage on his left side. But this area wouldn't really look good, you would imagine with a water absorbing filler. Right. You don't wanna look puffy.
• 20:46
  Melissa Shere Beek: Right. Be like the blueberry girl.
• 20:48
  Dr. Joely Kaufman: Yeah. Again, the choices of where to put these things also needs to be decided by the person injecting you. And it needs to be someone who's familiar with what they look like. Right. And how they act and how they behave.
• 20:59
  Melissa Shere Beek: And the effect that you want. Does anybody come in and say, want something and it's just too much or too extreme, and you say to them that doesn't really fit with your face or
• 21:08
  Dr. Joely Kaufman: You know, I do. Uh-huh. And I'm okay with somebody leaving me for that reason and going to somebody else. Right. And somebody will do them.
• 21:16
  Yeah. There's enough people in Miami that will inject somebody, you know, where they look weird or different or that we see them.
• 21:23
  Melissa Shere Beek: Not authentic or natural.
• 21:25
  Dr. Joely Kaufman: But to me it's like an art and all the faces like to me are part of the whole artistic side of So if it's you know, I want somebody to look like them. You know, we keep pictures of people over the years so that you just look healthier. Refresh. You know, a little prettier, a little younger, but you don't look like a different person.
• 21:46
  Melissa Shere Beek: Right.
• 21:46
  Dr. Joely Kaufman: Because if you walk down the street, nobody recognizes you again.
• 21:49
  Melissa Shere Beek: Not good.
• 21:49
  Dr. Joely Kaufman: It's not great, you know? I mean, believe me, I'd like to be younger and you know, with not a single line on my face. Right. But, I think I might not look like me if I
• 21:58
  Melissa Shere Beek: look Yeah. Okay. So chicken shit. Yeah. Frady, don't do anything, but I do have a huge routine like every night.
• 22:08
  Yeah. Every night I I'm moisturizing. I'm doing whatever, like, from, like, my whole body. What can someone do if they are afraid to do the injectables or all of the things that you just said? Are there topical things that they can do?
• 22:22
  What what should we be doing to make sure that we're aging as gracefully as we can or just keeping the skin looking fresh and feeling good?
• 22:33
  Dr. Joely Kaufman: So, again, the first place always is a skincare regimen. Like if somebody doesn't want to commit to that, you're kind of throwing away money on the other side. Because you're still aging every day. And so, you're not going to do something about that side of it, I think you're to be just chasing it.
• 22:50
  Melissa Shere Beek: Right, and disappointed with results anyways because you're not gonna So
• 22:54
  Dr. Joely Kaufman: you do a great laser, but then you don't wear any sunscreen, and you don't use any topicals, and all the brown spots come back. So if I had to design a perfect regimen, and again it changes all the time because we get new technologies. Yeah. But I guess number one would be sunscreen. Yeah.
• 23:11
  So that's the primary thing, and I don't wanna be like a crazy person about it. I wear it every day, but I still go outside, and I'm out there and I go on boats, and I do things in the sun, and I live and I enjoy. So my morning sequence would look like a gentle wash. Some people even just use water in the morning. Right.
• 23:29
  And I'm totally fine with water in the morning. Because you
• 23:31
  Melissa Shere Beek: don't wanna get rid of all the natural oils.
• 23:33
  Dr. Joely Kaufman: Not good with water at night because we are exposed to a lot of chemicals during the day and pollution and stuff like that. But water in the morning if you have sensitive skin or a very gentle cleanser. I like all the antioxidant type products during the day. If you can imagine especially in Make Florida sure my routine So at home is like if you're gonna get free radicals, you're gonna get damage from pollution, from sun, it's generally happening during the day. That's when you wanna protect yourself.
• 24:01
  And a lot of these things that we know about like vitamin C and the other antioxidants, green tea extracts, all these antioxidants also help protect us from sun. Got it. So you're adding another layer to your sunscreen.
• 24:14
  Melissa Shere Beek: Okay.
• 24:14
  Dr. Joely Kaufman: So I usually layer a couple. I do b c.
• 24:17
  Melissa Shere Beek: Do you layer the sunscreen first?
• 24:19
  Dr. Joely Kaufman: No. Or Your your ingredients will be first Okay. And then your sunscreen
• 24:22
  Melissa Shere Beek: will go Sunscreen on on top. Okay. Got it.
• 24:23
  Dr. Joely Kaufman: So and then sometimes you can gauge it by your thinnest thing first.
• 24:27
  Melissa Shere Beek: Okay.
• 24:28
  Dr. Joely Kaufman: So you want them
• 24:29
  Melissa Shere Beek: to Like a serum absorb before cream or a moisture.
• 24:31
  Dr. Joely Kaufman: You want them to be able to absorb Uh-huh. Before you put the next layer on.
• 24:34
  Melissa Shere Beek: Oh, okay. So if
• 24:35
  Dr. Joely Kaufman: you put something really thick like an oil
• 24:37
  Melissa Shere Beek: Uh-huh.
• 24:38
  Dr. Joely Kaufman: Which I have nothing against oils, but think about an oil as a sealant. Right. Like back in the day when they used to seal the cars so you wouldn't get wax. Any dents. And It's if you put the wax on first, you're
• 24:50
  Melissa Shere Beek: wasting your vitamin C
• 24:51
  Dr. Joely Kaufman: by putting it on top. And some of the hyaluronic acids, believe it or not, act like a wax also. Really? So long chain H A seals the skin, which is wonderful, So but don't want to be greedy do your little vitamins like vitamin C, vitamin B, the green teas, any of your antioxidants first, then start layering. At night, I still love the retinoids.
• 25:17
  Yeah. So there's a million of them, and it'll depend which one you can use by how sensitive your skin is, or how dry your skin is. Yeah.
• 25:24
  Melissa Shere Beek: So,
• 25:24
  Dr. Joely Kaufman: and you can gradually get used to it, so you can just bump it up a little bit each year as you get used to it and tolerate it more. Right. I usually alternate a retina if I can't use it every night or someone can't use it every night with another technology the newer technologies are growth factors.
• 25:43
  Melissa Shere Beek: Okay.
• 25:44
  Dr. Joely Kaufman: So TGF beta is a big one. Then another Or can category now
• 25:49
  Melissa Shere Beek: can get like over the counter to put on at night? Yep. I'm making more notes.
• 25:52
  Dr. Joely Kaufman: So one of those products that I love that's like that is called TNS, it's by the people who make Botox.
• 25:57
  Melissa Shere Beek: Okay, and that's just a topical you put on after you wash you wash your your face, then if you're not doing a retinoid, you put that on.
• 26:04
  Dr. Joely Kaufman: Yep. Okay. Then the alternating Collagen effect on the stimulants.
• 26:08
  Melissa Shere Beek: Collagen, okay. And
• 26:09
  Dr. Joely Kaufman: then a newer type of growth factor is called an exosome. It's not a growth factor, but it's a collagen stimulator. It's a microvesicle that really is a signal from a stem cell to tell you to do certain things. The exosomes actually are anti inflammatory, as well as collagen stimulating and elastin stimulating. So those have become recently very popular.
• 26:32
  So that whole thing didn't exist a couple years
• 26:35
  Melissa Shere Beek: It's Over the not something that you have to go as far as a procedure in the office. Right. It's like, oh.
• 26:39
  Dr. Joely Kaufman: It's a topical. So a lot of them are like medical grade, meaning a lot of them you can't just order Right. On the internet necessarily. That's my other plug is that like ordering some things if you're not ordering from the store itself on Amazon, you're just ordering from a vendor on Amazon, be careful.
• 26:56
  Melissa Shere Beek: Yeah.
• 26:57
  Dr. Joely Kaufman: Like, these things, some of them are expensive. Like, one of the exosomes that we have in the office is $250 a vial. So they make fakes of these things, they really do. Like even SkinCeutical products.
• 27:07
  Melissa Shere Beek: No, if you're investing in your skin, then you think you need to go to a provider like you or someone Or who
• 27:12
  Dr. Joely Kaufman: just order from the actual store, you know, from SkinCeuticals or from Skin Better, that's another one that sells those. But the exosomes are a new category, the most popular one or who kind of like started this whole phase was a product called Plated, and it's actually made at Mayo. So it's a real product that was made in a lab, actually they were using these exosomes to actually heal people after heart attacks. So a lot of these things come from real medicine, and then we translate them into how can we get these into the How can we put them in a vehicle that will work well in the skin? How can they stay stable in a vial and without refrigeration, So and things like that's the tricky part I think to products.
• 28:02
  So just because you buy a vitamin C that says vitamin C and it's $150 but then you find one that says vitamin C and $20, doesn't necessarily mean they're the same. Right. So vitamin c happens to be a tricky one that it can be unstable, and it's supposed to be in a dark glass container. Yeah. Unless it's stabilized with something else.
• 28:22
  So I think a lot of these ingredients, even though they're in there, you wanna make sure they're actually really working and really able to get into your skin.
• 28:30
  Melissa Shere Beek: Right. Okay. That's perfect. So other treatments at home though, not, you know, besides the topicals, what about things like the LED mask and stuff like that? Are those effective or Yeah.
• 28:40
  Dr. Joely Kaufman: I mean, it's become a craze Right. And there's great science behind LED. So I believe I really do believe in it. Mhmm. I believe in especially focusing on the areas where you need help, like a lot of people are under eye people that, you know, are like, oh, I'm happy with my skin everywhere else, but under my eyes.
• 28:57
  So maybe buy an under eye LED. They really do grow collagen in a lab, and they really do grow collagen in skin when you biopsy skin. I think it takes a diligent routine Right. To be able to get it, you know, to use it effectively
• 29:14
  Melissa Shere Beek: To the level of effectiveness that you want results okay. So every day? Yeah.
• 29:18
  Dr. Joely Kaufman: So you really do need to do it all the time on a regular routine. Got it. I don't think it's something that you do and you wake up two months later and you're like, oh my god. Like, I look
• 29:28
  Melissa Shere Beek: amazing. Right. Right.
• 29:30
  Dr. Joely Kaufman: But I do think it's part of a regimen and it's a nice part It's part
• 29:34
  Melissa Shere Beek: of prevention.
• 29:35
  Dr. Joely Kaufman: Right, and maybe we're growing a little bit of collagen, but it might not be clinically like hugely obvious when
• 29:40
  Melissa Shere Beek: you Okay, got it. Is there one in the office that you do that
• 29:45
  Dr. Joely Kaufman: So the ones in the office are a little stronger, but requires you coming in More frequently. On a regular basis.
• 29:49
  Melissa Shere Beek: I would say
• 29:50
  Dr. Joely Kaufman: where that might be worth it is, you know, the blue lights are very, very effective against acne.
• 29:55
  Melissa Shere Beek: So they're
• 29:55
  Dr. Joely Kaufman: antibacterial. So a lot of times like in a pregnant patient where we can't use a lot of the topicals, you can't use oral antibiotics, or in a young kid who's sensitive, they can come in for blue light treatments, and it would be twice a week, those kind of treatments.
• 30:09
  Melissa Shere Beek: Oh, really? That frequent? Okay. Got it. Alright, perfect.
• 30:13
  Alright, so what about things like because we talked about Vitis C, what about peptides? You said something about hyaluronic acid, but what about peptides, microdermabrasion? Should these be part of our routine too? Not microdermabrasion in the office, but
• 30:27
  Dr. Joely Kaufman: like the at home ones.
• 30:29
  Melissa Shere Beek: So
• 30:30
  Dr. Joely Kaufman: the microdermabrasion is okay for exfoliation. I don't think it's like a huge collagen stimulator.
• 30:38
  Melissa Shere Beek: Okay.
• 30:38
  Dr. Joely Kaufman: It's nice as we age, we shed skin more slowly. So when you look at someone and they have like a nice light reflection off their skin, that's because the outer layer, the stratum corneum isn't so thick.
• 30:50
  Melissa Shere Beek: Got it.
• 30:51
  Dr. Joely Kaufman: And so the light reflects better. So they look younger and it happens naturally with young people. But as we get older, that stratum corneum gets sticky.
• 30:59
  Melissa Shere Beek: Okay.
• 30:59
  Dr. Joely Kaufman: And so it looks like uneven mounds of dead skin. And you can imagine that light doesn't reflect off that as nicely.
• 31:05
  Melissa Shere Beek: Right.
• 31:06
  Dr. Joely Kaufman: So exfoliation is good. Microdermabrasion like an at home scrub or something would be a physical exfoliation.
• 31:14
  Melissa Shere Beek: Okay.
• 31:15
  Dr. Joely Kaufman: I personally prefer a chemical exfoliation because you're not damaging the skin. So things you could use at home, Retin A, one, take Stratum Corneum off. Glycolic acid, so like maybe a glycolic pad once a week to exfoliate. Lactic acid is even Easier
• 31:31
  Melissa Shere Beek: more better than the scrubs. So these are penetrating?
• 31:34
  Dr. Joely Kaufman: No, not necessarily, but less irritating for sensitive. Okay. You know, my thing, I have a couple scrubs that I really like.
• 31:42
  Melissa Shere Beek: Okay.
• 31:42
  Dr. Joely Kaufman: Like Elastin makes a scrub that I really, really like. Zoe makes a scrub that I really like, and it's because their beads in the scrub are smooth. So remember that old
• 31:53
  Melissa Shere Beek: Yeah. Apricot. That was like taking my whole body But it was like removing layers.
• 32:00
  Dr. Joely Kaufman: Yes. So that has a bead that is not even. It has
• 32:04
  Melissa Shere Beek: a jacket. One is the
• 32:05
  Dr. Joely Kaufman: one with the bead? So elastin makes one that are smooth and so does Zoe.
• 32:10
  Melissa Shere Beek: But you also said you like the pads for
• 32:12
  Dr. Joely Kaufman: And I like the pads. Okay. Yeah.
• 32:13
  Melissa Shere Beek: I took one to week off. You know, the regimen that I'm starting.
• 32:18
  Dr. Joely Kaufman: And you do look bright the next morning when you do those pads because it takes that, you know, just a little bit of dead skin.
• 32:24
  Melissa Shere Beek: Right.
• 32:24
  Dr. Joely Kaufman: For those people who have like thicker skin or more oily skin, they can use the pads, those kind of pads more often.
• 32:30
  Melissa Shere Beek: Does it help de clog the pores Yes. Okay. Yeah. I need to call you about a new regimen. Are you kidding?
• 32:36
  Dr. Joely Kaufman: Your regimen. I mean, there's so many things and you mentioned peptides. I like peptides too. Again, that's in the collagen stimulating category. It's a non irritating
• 32:45
  Melissa Shere Beek: Do those come in cup moisturizers and serums? They do.
• 32:49
  Dr. Joely Kaufman: In both. So I would say the high end one that's in that that you might have heard of is Augustinus Bader or Augustinus That one's like a super fancy one.
• 33:01
  Melissa Shere Beek: Have skin cute
• 33:02
  Dr. Joely Kaufman: little
• 33:02
  Melissa Shere Beek: There
• 33:02
  Dr. Joely Kaufman: are peptides in a lot of so P Tox from SkinCeuticals is a peptide, And peptides do lots of things. They make peptides that act like Botox. So some of those peptides might be useful for places like crow's feet for that kind of wrinkle if you don't want Botox. And again, P Tox is one of those, but there are a couple of companies that make ones like that. But Olay Regenerist was one of the first peptides.
• 33:29
  Melissa Shere Beek: Oh yeah, that's right.
• 33:31
  Dr. Joely Kaufman: So a lot of these ingredients, it's very tricky, can be found in drugstore brands, And then you can also find them in $300 brands.
• 33:39
  Melissa Shere Beek: Okay, so someone's gonna say, why didn't you ask, is there a difference between La Mer or what did you say about
• 33:49
  Dr. Joely Kaufman: the In Olay region.
• 33:51
  Melissa Shere Beek: Olay, yeah. What's the difference? And should we be getting it more from like a skin cuticles or that kind of Skin Better Science? Or are the ones that are over the counter at Bloomingdale's? Is that just as efficient?
• 34:06
  Dr. Joely Kaufman: Think, I would say I have to waiver on the answer. Sometimes spending more is better, and sometimes spending more is a waste, it just depends on what product you're buying. Part of the regimen is your consistency. So if you love the way it feels, or you love the way it smells and it's gonna make you use it, I'm super happy with you doing it. There are some things that I use that like one of them smelled to me like socks.
• 34:34
  I mean a super popular brand, but like I don't know why, just I put it on I was like, oh socks.
• 34:38
  Melissa Shere Beek: Oh there's one that smells like hot dog water.
• 34:40
  Dr. Joely Kaufman: Yeah, hot dog. Mhmm. That's the same one to me.
• 34:43
  Melissa Shere Beek: Is it the same one? Yeah, smells like hot dog
• 34:44
  Dr. Joely Kaufman: water If it doesn't smell good It's hard
• 34:49
  Melissa Shere Beek: to just laid out the smell. It's terrible.
• 34:52
  Dr. Joely Kaufman: It's hard to go to bed like putting something on that doesn't like make you feel good. Right. But but certainly there is some crossover and certainly marketing plays some role
• 35:01
  Melissa Shere Beek: Yeah.
• 35:01
  Dr. Joely Kaufman: In this. That being said, in a medical office you'll generally see that your board certified dermatologist has done some research, and we generally choose things that have research behind them.
• 35:13
  Melissa Shere Beek: Got it.
• 35:14
  Dr. Joely Kaufman: So, SkinCeuticals is one of the first ones to ever do that, but Skin Better Science also does But it takes being owned by a very big company with lots of money to spend on research to be
• 35:26
  Melissa Shere Beek: able to
• 35:27
  Dr. Joely Kaufman: create a brand like that. So, some of the pop ups, while they look good, and they feel good, and they're super cool packaging, and they're super trendy, it takes a lot of financial support to be able to do rigorous testing on a lot of these things. So if you're really looking for true science, I would kind of sway toward one of the companies that does more science based products. But maybe if it's your moisturizer that you're putting on top of your based product, maybe pick what you love or what smells great or what makes you relax at night or something like that. So I think I would say like my face wash is inexpensive, very inexpensive.
• 36:05
  In fact someone came to our office to sell us a face wash the other day that was $65 and I was like $65. Like, I'll spend 200 on my cream, but like $65 for a face wash. So I think you can find loopholes
• 36:18
  Melissa Shere Beek: Right. And There's can
• 36:19
  Dr. Joely Kaufman: find like very good economic products like sunscreens, you know, the Ulta line is beautiful. Yeah. It's good. And they're very affordable. You do not need to spend $600 on each piece of your skincare
• 36:32
  Melissa Shere Beek: Oh, no.
• 36:33
  Dr. Joely Kaufman: In order to see results.
• 36:33
  Melissa Shere Beek: Right.
• 36:34
  Dr. Joely Kaufman: You just don't. But you may have a couple pieces that you They're really
• 36:38
  Melissa Shere Beek: investments. Right. Yeah, but that's okay. You're investing in yourself and your skin. Right.
• 36:42
  Yeah. So should we change our skin routine as we age?
• 36:46
  Dr. Joely Kaufman: Oh definitely.
• 36:46
  Melissa Shere Beek: Okay.
• 36:47
  Dr. Joely Kaufman: Yeah. Obviously when we're young, listen, collagen, the decrease in collagen production starts young. They start detecting it in our thirties. Really? So it does start young, but we're really not looking to stimulate it that young.
• 37:02
  Like what does a 25 year old need? More bounce, you know? They're looking for more things like pores probably and texture closing the pores or acne control or maybe some of them have redness from old acne, things like that. And as we get older, our tune switches. So we need a lot more hydration.
• 37:20
  We're gonna be using a lot thicker products, especially post menopausal.
• 37:24
  Melissa Shere Beek: Yeah.
• 37:24
  Dr. Joely Kaufman: You know, that's a big drive. For people who are not on estrogen, estrogen's great for the skin. And so it's a tough, it gets really dry as we start to go through menopause.
• 37:36
  Melissa Shere Beek: Okay, so changing it as we age and then you said earlier changing it seasonally.
• 37:41
  Dr. Joely Kaufman: Yeah, I mean not in my amineur. Maybe in my amineur we don't need to as much. Mhmm. In fact, even this week I was saying to someone, well, maybe we shouldn't do your laser in the summer because of the sun, you know, and she's like, I'm in the sun less in the summer because it's too hot in Miami. It's hot.
• 37:56
  It's hot. I am not walking outside, so laser me now. So, I think every place is different as far as how much you have to change.
• 38:05
  Melissa Shere Beek: Right. Yeah, because if you're living up north in the winter, you're gonna have to and it's so dry, you're gonna have to change up your moisturizing and things like Right. Big shots.
• 38:12
  Dr. Joely Kaufman: Big shots up north.
• 38:13
  Melissa Shere Beek: So, what's the latest and greatest and newest thing in aesthetic dermatology?
• 38:18
  Dr. Joely Kaufman: So, I think like everything else, this longevity type medicine is focusing on not only rejuvenation, but regeneration. How do we actually make new cells and grow new cells, and get those cells to act like young cells? So things we talked about already, there are topicals like that that are stimulators like exosomes and peptides.
• 38:43
  Melissa Shere Beek: Yeah, was fascinating.
• 38:45
  Dr. Joely Kaufman: So those are kind of regenerative medicine type products. We're doing a lot more micro needling, not just with the needle, but just using the needle as a way to get these peptides to penetrate. So peptides can be many different sizes, and if they're very big, they have trouble getting through the skin. So a lot of times you need a little bit of a needle, and there are little at home ones Really? People Yeah, they're very very superficial and you could
• 39:10
  Melissa Shere Beek: do That's a okay to do.
• 39:11
  Dr. Joely Kaufman: Uh-huh, it's okay to do.
• 39:13
  Melissa Shere Beek: I consult you on anything. Gotta call Julie first.
• 39:16
  Dr. Joely Kaufman: Well, you have rosacea, very sensitive skin. Yeah,
• 39:18
  Melissa Shere Beek: allergic to everything.
• 39:19
  Dr. Joely Kaufman: Do a little test spot
• 39:21
  Melissa Shere Beek: for me,
• 39:22
  Dr. Joely Kaufman: but you can, it's not so much the benefit of the needle, the benefit is that you're creating that a tiny you could put wonderful ingredients through. Got it. Again, and those people with thicker skin, more robust skin, oilier skin do a little better with these kind of at home invasive procedures.
• 39:39
  Melissa Shere Beek: Good to know.
• 39:40
  Dr. Joely Kaufman: Again, regenerative medicine is huge, so you see younger people coming in saying, I'd like to do things to prevent looking like my What's good That's what my daughter says already.
• 39:51
  Melissa Shere Beek: No, but what's a good age to start all these things? If someone wants to do Botox or if they wanna do any of the things that you're saying, is there a particular age that they should start working on that or prevention, so it looks more natural as
• 40:04
  Dr. Joely Kaufman: the So, I think the whole term baby Botox kind of started this whole drive with the young kids. Like, I need to do baby Botox so that I don't ever get a frown line.
• 40:15
  Melissa Shere Beek: I
• 40:17
  Dr. Joely Kaufman: wouldn't put an age on it, but I would say mid twenties is probably the average age that you'll see people coming in and asking. I don't think everybody needs to do this in their twenties at all. Like I'm not Botoxing my kids.
• 40:32
  Melissa Shere Beek: It's each individual case, their person.
• 40:33
  Dr. Joely Kaufman: But I have had people come in at 25 that are just, they always squint and they already really have
• 40:39
  Melissa Shere Beek: That deep recess.
• 40:40
  Dr. Joely Kaufman: Yep. Like more accelerated aging in an area.
• 40:44
  Melissa Shere Beek: So it just depends on the person and their skin, okay.
• 40:47
  Dr. Joely Kaufman: Again, they're safe in the right hands, and as long as we don't abuse the whole process, then I think it's a really safe way to prevent. So a lot of times to me baby Botox means you're not gonna do it as often as someone our You're gonna, you know, maybe do it once a year with tiny amounts and just preventatively. And maybe one year you're like skipping it, because everything looks good and you're happy with the way you look. But again, I always start on skincare. So that's the perfect place to start.
• 41:18
  You don't need a lot of it. You just need the right products for your skin
• 41:22
  Melissa Shere Beek: care. For your skin.
• 41:23
  Dr. Joely Kaufman: So again, ask a lot of questions. Go see someone who loves skincare. I mean You. Yeah. No.
• 41:31
  There a lot of women are obsessed with skincare. Not only me, but I I mean, it takes like trying things Yeah. And knowing what they work on and understanding the science.
• 41:41
  Melissa Shere Beek: And what works for
• 41:42
  Dr. Joely Kaufman: you. And and then, you're right, judging each person.
• 41:45
  Melissa Shere Beek: Is there like a rare fascinating case that you've had? Oh my god, what?
• 41:50
  Dr. Joely Kaufman: You know, Miami's super interesting because anything can walk in the door. You know, we are the gateway to South America and to the islands. So a lot of people come fly in for health care into Miami, which is so fun. I mean, training at Jackson Memorial Hospital is like just like a poet of every single disease. In fact, at Jackson, the dermatology clinics there have a leprosy clinic.
• 42:15
  Melissa Shere Beek: Really?
• 42:15
  Dr. Joely Kaufman: So that still exists even though nobody it's not as contagious as we always
• 42:19
  Melissa Shere Beek: island in Hawaii. Right. Right. Right. The leprosy colony there.
• 42:22
  Dr. Joely Kaufman: Was. Think about it. Was. Okay. And now that island does not have Right.
• 42:26
  Leprosy patients anymore, and they can just walk in a regular door and it's not as contagious as we thought. I mean, it's contagious to people who are directly with them and live with them. But So you've seen So, in you know, it's it's an interesting, you know, we have all sorts of infectious diseases here because our climate, we can grow all sorts of things in this We never have a freeze season, you don't see those things. Right. Right.
• 42:50
  Right. People walk in the sand a lot, so a lot of times we see little, you know, vermin that get into the skin in the sand. Most of them can't get anywhere once they get in your skin, so there's something called cutaneous larvae migrans that gets in. He dies in the skin anyway, so we don't really have to do much to it, but it's a funny little rash that looks like a little guy traveling along your foot.
• 43:12
  Melissa Shere Beek: Oh my god.
• 43:12
  Dr. Joely Kaufman: So if you walked in the sandbox or something, you might have gotten that one. But, you know, again, the fact that we're warm year round allows a lot of these things
• 43:20
  Melissa Shere Beek: to So cook
• 43:23
  Dr. Joely Kaufman: it makes dermatology very, very fun.
• 43:26
  Melissa Shere Beek: Okay. Will you tell us a little bit about the clinical research that you're doing and what's on the horizon for skin care?
• 43:31
  Dr. Joely Kaufman: Yep. So we have a skin research institute at the office where a totally separate unit that's run and all the doctors participate depends on what trial. But again, lot of the focus right now so there are a couple new botulinum toxins that are being studied. There's a new one that we just finished the studies on that should be released maybe this year, that's gonna be a short acting quick onset. So you know when you get Botox right now, it takes about five days to start working, but it takes ten days to really be look the way you wanna look.
• 44:07
  So if you have an event, you gotta kinda think ahead. So if you have a wedding or you're getting married, you're gonna kinda plan these things way in advance when it's gonna look its best. So this new one that they were developing kicks in within eight hours. So we inject it within eight hours it's in, but it wears off by three weeks, three to four weeks. So, you know, or if somebody thinks, you know, they forgot and they want it, or somebody who may have been a chicken all along and didn't wanna really try one of the ones that might last four months, you could try this one.
• 44:39
  Uh-huh. It's almost like just wearing it for a little bit and see if you like the way it looks, and then you could go on
• 44:45
  Melissa Shere Beek: to getting a long acting. But I'm so supportive for everybody.
• 44:48
  Dr. Joely Kaufman: Right. That's one of the newest ones. There's always new fillers. Again, I think the focus now is turning toward kind of this regenerative type medicine, like how can we grow collagen? How can we keep ourselves young?
• 45:02
  Melissa Shere Beek: The one that you were talking about that came out of stem cell that was sending signals to the body,
• 45:07
  Dr. Joely Kaufman: that was fascinating science. Exosomes.
• 45:09
  Melissa Shere Beek: Amazing.
• 45:10
  Dr. Joely Kaufman: Yeah.
• 45:10
  Melissa Shere Beek: That's really cool.
• 45:11
  Dr. Joely Kaufman: So and they're tiny enough that they can penetrate the skin.
• 45:14
  Melissa Shere Beek: See, that's really fascinating.
• 45:15
  Dr. Joely Kaufman: So actually, they just developed one for hair growth, which I have started. Wow. That's nice. Yeah. So it works differently than what we're used to when we use hair growing ingredients.
• 45:25
  So this one's an exosome, again it triggers and tells the hair follicle, hey wake up, start growing hair again.
• 45:31
  Melissa Shere Beek: So it stimulates the hair growth without having to have transplants or any of those things, that's So
• 45:37
  Dr. Joely Kaufman: that's an easy one to start because Rogaine's kind of messy. Most of my patients they'll start and then they're like, makes my hair all greasy, and then I gotta shower, and I can't go to work on time, So I put it in twice a it's just hard to comply, but again very effective. Right. It's also transitioned. A lot of people take the Rogaine, which is called Minoxidil by mouth.
• 45:57
  Melissa Shere Beek: Okay.
• 45:58
  Dr. Joely Kaufman: So you can take a pill also to
• 46:00
  Melissa Shere Beek: No, but throw the exosome thing is fabulous to me. You'll I think that's so hear
• 46:04
  Dr. Joely Kaufman: more and now your Instagram is gonna blow up
• 46:05
  Melissa Shere Beek: on I can't wait to hear more about them. We'll talk after about everything too. What about what is like the biggest beauty myth that you hear all the time?
• 46:16
  Dr. Joely Kaufman: You know, right now honestly, again, are getting their information from social media.
• 46:20
  Melissa Shere Beek: Got it.
• 46:21
  Dr. Joely Kaufman: So I think there's so many myths. I mean, the biggest one right now that I hear from the kids is that sunscreen is what causes skin cancer. And if you really are concerned about chemicals, get it. Some of the sunscreens are chemical.
• 46:32
  Melissa Shere Beek: Right. But
• 46:32
  Dr. Joely Kaufman: zinc and titanium are not chemicals, so there's no argument against using a zinc or titanium. And even the over the counter ones are nice, they're elegant, like CeraVY just made a new zinc and titanium that's light, it's not white at all, it's very thin, easy to use. And again, the Ulta products have those in them too, they even make them for acne, so you don't have to worry about being greasy. There really isn't an excuse in Miami in my opinion to I'm not do
• 47:01
  Melissa Shere Beek: laughing because before all of these new ones came out, and I'm allergic to like half the things that were in sunscreen, I would put like on a zinc thing.
• 47:08
  Dr. Joely Kaufman: Right. You've white.
• 47:09
  Melissa Shere Beek: Whiter than white. Just pasty. Pasty, glowing.
• 47:13
  Dr. Joely Kaufman: And you know it know it works because what are the surfers still wear? Right. They still They wear like do the thing.
• 47:19
  Melissa Shere Beek: They have zinc all over them.
• 47:20
  Dr. Joely Kaufman: When they're out for five hours on the water. Absolutely. You know?
• 47:23
  Melissa Shere Beek: Yeah. Because it doesn't come off so easy. Right. Yeah. So funny.
• 47:26
  Okay. What do you wish your patients knew?
• 47:32
  Dr. Joely Kaufman: I wish, and we already touched on it a little bit, but skin is your biggest organ. And you can reach it topically. So you can reach it and you can have your own effect on it if you're consistent with it. Whereas a lot of the other organs we can't do too much about it, we don't really see the results immediately. Like this is so gratifying to commit to something so easy, like just switching around your regimen a little bit.
• 48:00
  And in Florida, think also I wish people knew that some of the lasers actually act as not only beauty, you know making you look better, but they're also prevention of skin cancer. They've done a lot of research now on Fraxel, which is one you've probably heard of.
• 48:17
  Melissa Shere Beek: Yeah.
• 48:18
  Dr. Joely Kaufman: We do the whole face, basically the whole top layer comes off with the Fraxel treatment, and it takes all the pre cancers off also. So while it's not approved by insurance, so it won't be paid for it, it's a cash payment. They have looked, actually looked at patients who get a lot of skin cancers and showed that if they were consistent with doing a Fraxel, you know periodically through the year that they would reduce the amount of skin cancers.
• 48:41
  Melissa Shere Beek: The Fraxel is the peel or a laser?
• 48:43
  Dr. Joely Kaufman: It's a laser peel.
• 48:44
  Melissa Shere Beek: Your skin
• 48:45
  Dr. Joely Kaufman: comes off, but it's laser.
• 48:46
  Melissa Shere Beek: Is what I'm doing?
• 48:48
  Dr. Joely Kaufman: What are you doing, Fraxel?
• 48:49
  Melissa Shere Beek: I'm coming in to do something to get rid of all the cancers on here.
• 48:53
  Dr. Joely Kaufman: Yeah. He was like, I don't know, whatever
• 48:54
  Melissa Shere Beek: you told me to do. So I was like, okay, this sounds fascinating.
• 48:57
  Dr. Joely Kaufman: It's Fraxel.
• 48:57
  Melissa Shere Beek: Okay, that's what I'm doing. Okay.
• 48:59
  Dr. Joely Kaufman: The there are lighter ones. So you could do something like it used to be called IPL, intense pulse light. Now it's called BBL, which is broadband light, and it takes brown off, it takes red off. So it'll, you know, take off sun damage, but not necessarily all pre cancers.
• 49:15
  Melissa Shere Beek: Got
• 49:15
  Dr. Joely Kaufman: it. So that one's a little bit different.
• 49:16
  Melissa Shere Beek: That's cool to
• 49:17
  Dr. Joely Kaufman: know. Again, for people who are at risk, we know that the topicals help with prevention and that the devices, so things like the Fraxel laser will also help.
• 49:27
  Melissa Shere Beek: So it's important to get the right information from the right doctors.
• 49:31
  Dr. Joely Kaufman: The industry, I'm not that old, but the industry has changed so much, and there's so much research going into the skin. Think because we realize that we really have access to so many ways to improve the skin. Again, not only for beauty, but for health. Right. And they're equally important, and it's an investment that's worth making for Thank you
• 49:56
  Melissa Shere Beek: so much. This was so fabulous to have Thank you you. Did I leave anything out?
• 50:02
  Dr. Joely Kaufman: No. Such a wealth of
• 50:03
  Melissa Shere Beek: information and knowledge and it's We so
• 50:06
  Dr. Joely Kaufman: even touched but we'll do maybe another time. We didn't touch so there's something they call energy based devices. That's like the whole other thing. That can include lasers, but it can also include tightening devices like radio frequency which we talked about a little bit for acne, but also for skin tightening, body tightening like post baby, things Neck, like
• 50:26
  Melissa Shere Beek: belly, arms. Tell us a There's little
• 50:29
  Dr. Joely Kaufman: a whole other class of things that we use. So one of the most common ones we do in the office is called Ulthera, and that is focused ultrasound. So, so many different kinds of sound waves and radio frequency waves, that laser is light we do to help again generate collagen, tighten the skin, stimulate collagen, shrink pores, things like that.
• 50:54
  Melissa Shere Beek: Is it a one time thing or multiple time?
• 50:56
  Dr. Joely Kaufman: Ulthera is a one time. You age through it, it's not a one and done for the rest of But your I would say once every year would be about what you would want to do. For low face and neck, they got FDA clearance, meaning they not only showed that they were safe, but they showed that they were effective at tightening. And those are important key words to look at when you do a device. Yeah.
• 51:19
  To make sure that it has FDA clearance.
• 51:20
  Melissa Shere Beek: That
• 51:21
  Dr. Joely Kaufman: Some of these things we see that people are injecting are not FDA cleared
• 51:25
  Melissa Shere Beek: to be So, And it's be wary sort of non invasive and the recovery
• 51:29
  Dr. Joely Kaufman: So the Aldara is not is non invasive. Remember how you look at a baby in the ultrasound like this? What they did with the technology is they flipped it and they made a point of heat under the skin. So it does nothing to the outside, it goes right under the skin, literally puts a point of heat in your basically in your skin, which is where your fibroblasts. And those are the ones that make collagen.
• 51:49
  So it tightens the skin and stimulates collagen.
• 51:52
  Melissa Shere Beek: I think that's fabulous.
• 51:53
  Dr. Joely Kaufman: I think obviously all these things work a little better if we start younger. Yeah, sure. You know, it's not great if a 90 year old comes in and is like, oh, I'd never done anything, I'd like to start. I'd like to start now. But, you know, there's there are always things that we can do, but it is when your collagen is growing Right.
• 52:11
  Melissa Shere Beek: It's a good time to The best do time to do it. Oh, I love that. Thank Thank you. I'm so honored to have you here. I this we could talk for hours about everything.
• 52:20
  I'm thank you. You're a wealth of information and knowledge, and I'm so lucky that you're in my life because I I know I call you with a thousand questions. No. But you've guided me right for a million years, and I appreciate
• 52:29
  Dr. Joely Kaufman: it. And I feel so lucky, honestly, to like even get to chat. But also honestly, to be in such a great field. Like I encourage any young physician who's looking at dermatology. I couldn't be happier with my job.
• 52:42
  Melissa Shere Beek: That's so cool.
• 52:43
  Dr. Joely Kaufman: And I think in general when you love what you do, you just keep on reading more and learning more. And any young person
• 52:50
  Melissa Shere Beek: And wants patients benefit from it. Thank you, thank you. Before I let you go, I do one last thing with my guests. Are you game?
• 52:57
  Dr. Joely Kaufman: I'm game.
• 52:58
  Melissa Shere Beek: Okay, quickie questions.
• 53:00
  Dr. Joely Kaufman: Real quick. Okay.
• 53:01
  Melissa Shere Beek: First thing you do in the morning?
• 53:06
  Dr. Joely Kaufman: Check my aura ring.
• 53:07
  Melissa Shere Beek: Oh, you do? I love that.
• 53:08
  Dr. Joely Kaufman: That's cute. But I didn't wanna say it because second thing is my vitamin c. But I wash and then my vitamin c. I have this vitamin c that I love that when I put it on, it makes my skin look better. Oh.
• 53:19
  So I can walk my dogs with, like, literally, like, out putting anything on in the morning and just feel like I look refreshed.
• 53:26
  Melissa Shere Beek: Gonna ask you off air about that too. Yeah. Okay. Alright. Most recent read or a book recommendation that you have?
• 53:33
  Dr. Joely Kaufman: I'm reading Bell Burden's The Strangers. Have you read it? No. Okay. It's a true story.
• 53:40
  Very well written. Thank you for being like such an honest storyteller. But it's a little, you know, it's our age, it's a story about a woman our age, and her whole life gets turned upside down, and it's a true story. But she shares, and it's like a nice learning thing to see what she went through, and I find her to be incredibly courageous. That's And so interesting.
• 54:01
  Melissa Shere Beek: Okay. Have to check that out too because I'm a big bookie person. Where's your happy place?
• 54:06
  Dr. Joely Kaufman: Wyoming. Oh, I love that. Total polar opposite of Miami.
• 54:11
  Melissa Shere Beek: No, but that's great.
• 54:12
  Dr. Joely Kaufman: Middle of nowhere. It's just gorgeous. Beautiful air. You could wake up in the morning and it'll be thirty, and by the end of the day, it might be 80.
• 54:20
  Melissa Shere Beek: That's okay.
• 54:21
  Dr. Joely Kaufman: You just never know what the weather's gonna be. It's kind of fun.
• 54:23
  Melissa Shere Beek: Gorgeous out there. Oh, that's a good one. Okay, what's your favorite journey?
• 54:30
  Dr. Joely Kaufman: We did a my favorite trip, we did a bike trip in Normandy with our children. And they, of course, said, I do not wanna do this. Why are you taking us biking? Right. Like, everybody else is having fun on Mykonos partying.
• 54:46
  Like, no. You're going biking with us. Right. They still say it was their best trip.
• 54:50
  Melissa Shere Beek: The best trip ever.
• 54:51
  Dr. Joely Kaufman: Oh, I
• 54:51
  Melissa Shere Beek: love that. That's so good. It's usually the one you complain the most. You had the best time.
• 54:55
  Dr. Joely Kaufman: Right. You're right. Where I can say I told you something.
• 54:58
  Melissa Shere Beek: Right. Right. Right. That's always good. Okay.
• 55:00
  Last time you really had a good belly laugh.
• 55:02
  Dr. Joely Kaufman: I have a best friend who's my mom our parents met us growing up in strollers. Like, the parents were walking in the neighborhood, so we met when we were born. And honestly, anytime I'm with her, like, we just laugh about everything. I think the husbands are so annoyed with us. Fifty six years later, they're still annoyed with us.
• 55:24
  But it's just like, I think it's always who you're with. Yeah. You know?
• 55:29
  Melissa Shere Beek: Yeah. But that's a really incredible gift to have someone that close that you could just be your authentic self and just giggle and just yeah.
• 55:36
  Dr. Joely Kaufman: And usually we laugh about like nothing. Right. Or the husbands. Yeah. Or them getting annoyed at us.
• 55:41
  Right.
• 55:42
  Melissa Shere Beek: Aw. Thank you. Thank much you again. Really appreciate it. Let me do my outro and we'll talk after.
• 55:46
  Dr. Joely Kaufman: Thank you.
• 55:47
  Melissa Shere Beek: To our listeners, thank you so much. So grateful you're here. Keep listening, keep learning, keep laughing, keep up with Beek on being. Listen to Beek on being wherever you get your podcast. All episodes are automatically transcribed.
• 55:59
  DM us to share thoughts, ideas, or nominate a guest. A big shout out and a huge thank you to Steven Chen at Penthouse Studios. Woo. Beek on being was recorded at Penthouse Studios and is a proud member of the Penthouse Podcast Network.