Latest / The Science of Skin / International Series Inaugural Interview: Dr Cara McDonald (Australia)

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International Series Inaugural Interview: Dr Cara McDonald (Australia) · The Science of Skin

• 0:09
  SPEAKER_01: Hello and welcome to Skincare Confidential, a podcast supporting the Science of Skincare Summit, an educational conference occurring in Austin, Texas, on November 8th through 10th in 2024.
• 0:22
  SPEAKER_01: Today I am so excited.
• 0:24
  SPEAKER_01: My name is Dr.
• 0:25
  SPEAKER_01: Ted Lane.
• 0:26
  SPEAKER_01: I am the host of the podcast today, along with my co-host, Dr.
• 0:29
  SPEAKER_01: Patty Ferris, who couldn't be with us today.
• 0:31
  SPEAKER_01: But I am excited, as you can tell, to introduce my guest today, Dr.
• 0:35
  SPEAKER_01: Cara McDonald.
• 0:37
  SPEAKER_01: So we are kicking off our international dermatology series.
• 0:41
  SPEAKER_01: So I'm going to start interviewing dermatologists from around the world.
• 0:45
  SPEAKER_01: And we're just learning about their life and what it's like to practice in a different country, but also about what's important in terms of skin care in that country and in that region and how they integrate skincare into their both medical and aesthetic practice.
• 0:58
  SPEAKER_01: But Cara, thank you so much for joining us today.
• 1:02
  SPEAKER_00: My absolute pleasure.
• 1:03
  SPEAKER_00: Thank you for inviting me to join you.
• 1:05
  SPEAKER_01: And as you can tell, Cara is from Australia.
• 1:07
  SPEAKER_01: Where are you in Australia?
• 1:09
  SPEAKER_00: I'm in Melbourne.
• 1:11
  SPEAKER_00: So pretty uh big city, but my practice is actually just on the outskirts of Melbourne.
• 1:17
  SPEAKER_00: So we also see a big rural population, actually.
• 1:20
  SPEAKER_01: Okay, great.
• 1:21
  SPEAKER_01: And so, Cara, tell us about kind of your training, how you became a dermatologist, why you became a dermatologist, especially in Australia where dermatology is so important.
• 1:32
  SPEAKER_00: Yeah, well, it's always kind of a bit of a long story, isn't it?
• 1:35
  SPEAKER_00: But um I I've always I've loved working with people.
• 1:39
  SPEAKER_00: And when I was at school, I thought about being um a painter or an artist as my profession, and I decided I'd be very bored because I wouldn't be with people.
• 1:50
  SPEAKER_00: But as soon as I uh started doing medical school and got exposure to exposure to dermatology, I loved the visual aspect of dermatology, and I think it really ties back to that artistic and visual um component of me that I have a creative component.
• 2:08
  SPEAKER_00: And I loved that I could see different things in dermatology.
• 2:12
  SPEAKER_00: I loved that I could see different rashes, different spots, different dots, and a lot of the diagnosis is visual, um, and that really appealed to me.
• 2:20
  SPEAKER_00: I think that was the first thing.
• 2:21
  SPEAKER_00: But then I also um realized that I'm very task-oriented.
• 2:26
  SPEAKER_00: I like to be able to see something and preferably do something about it.
• 2:30
  SPEAKER_00: And I think there's no specialty like dermatology where you can combine um medicine looking after people and actually being able to help not only their skin, but help them in their lives as well.
• 2:42
  SPEAKER_00: So I think that appeals to me.
• 2:44
  SPEAKER_00: Um and really the the reasons just kept adding up for me what appealed to me about dermatology.
• 2:51
  SPEAKER_00: And I still absolutely love it.
• 2:53
  SPEAKER_00: I love it as a specialty.
• 2:55
  SPEAKER_00: I love helping people, I love seeing the difference in um their skin and then in their self-esteem and confidence when you can help them.
• 3:02
  SPEAKER_00: I love the fact that we get to see people from, you know, literally birth through to death.
• 3:07
  SPEAKER_00: Um and, you know, I probably shouldn't say this, but I do love the fact that they're not most of our patients aren't actually sick.
• 3:13
  SPEAKER_00: Um, we help them, they've got something wrong with them, but we're not actually dealing with people who are very unwell, um, which, you know, being a kind of um upbeat person, I I uh always find that quite pleasing.
• 3:27
  SPEAKER_01: And so you have primarily a uh outpatient practice, right?
• 3:31
  SPEAKER_01: So you're you're therefore not in the hospital very much seeing patients?
• 3:35
  SPEAKER_00: Yeah, look, I actually do have a hospital position as well, but um certainly in Australia we have very few inpatients in dermatology uh these days.
• 3:46
  SPEAKER_00: We do we do still have ward beds.
• 3:48
  SPEAKER_00: Um my role in the hospital system uh training the residents is mostly in the surgical side.
• 3:55
  SPEAKER_00: Um it has varied over the years, but at the moment my my teaching is all surgical.
• 4:01
  SPEAKER_00: So I'm not dealing with the medical inpatients very much.
• 4:05
  SPEAKER_00: And the majority of my work is in private practice, um, which is a mixture of aesthetic, laser, surgical, and um some medical dermatology.
• 4:17
  SPEAKER_00: I do less medical now than than I used to, but I still do a mix of everything.
• 4:22
  SPEAKER_01: And so and by surgery, you're doing MOSE surgery?
• 4:25
  SPEAKER_00: Um, no, so just basic surgery.
• 4:28
  SPEAKER_00: We do have a MOSE surgeon in our practice, and um so we have a huge tumor load in Australia.
• 4:36
  SPEAKER_00: Okay, yeah, and you know, most of our patients don't have MOSE surgery.
• 4:40
  SPEAKER_00: That's probably one of one of the bigger differences um in Australia, I think, compared to the US.
• 4:46
  SPEAKER_00: But I would say, you know, 90% of the patients don't have MOSE surgery for their skin cancer surgeries.
• 4:52
  SPEAKER_00: We only use MOSE surgery probably just because of the the availability and and cost.
• 4:58
  SPEAKER_00: If it's a you know poorly defined tumour or a difficult site, um so I I see quite a big load of skin cancer patients and almost all of them have uh you know surgical excisions done in um in the private practice without MOES.
• 5:17
  SPEAKER_01: How about that?
• 5:18
  SPEAKER_01: So are you doing flaps and grafts and the whole bit?
• 5:20
  SPEAKER_00: Yeah, okay.
• 5:21
  SPEAKER_00: So we'd we'd get a fair bit of that training in our in our training program in our residency.
• 5:26
  SPEAKER_00: Um so yep, I do pretty much anything you can do under local anesthetic, big flaps, grafts, um, but you know, when it's appropriate to to um do that, we you know, as I said, we do still use Mo's, but the access to it um is more limited.
• 5:44
  SPEAKER_00: So, you know, maybe um, you know, it's white, slightly wider margins, but most of these um, you know, older sun-damaged people are very happy to, you know, go ahead with that kind of surgery.
• 5:57
  SPEAKER_01: Yeah.
• 5:57
  SPEAKER_01: And I know you're a very busy dermatologist.
• 6:00
  SPEAKER_01: You you're an owner of the practice as well.
• 6:02
  SPEAKER_01: Uh, but you also balance a very hectic family life, right?
• 6:07
  unknown: Yeah.
• 6:08
  SPEAKER_00: Yes.
• 6:09
  SPEAKER_00: I I do have three children um who are aged eight, ten, and twelve now.
• 6:13
  SPEAKER_00: So they're a bit older, a little bit more self-sufficient.
• 6:16
  SPEAKER_00: Um I have a very, very supportive husband who does probably, I would say, the the lion's share of the mental load and physical load at home with the kids.
• 6:27
  SPEAKER_00: Um and so that allows me, yes, because I I do I do work too much, shall we say, according to the family at least.
• 6:35
  SPEAKER_01: Yeah.
• 6:36
  SPEAKER_01: Well, Cara and I know each other from the skincare world primarily.
• 6:40
  SPEAKER_01: Um, we've met on a few different um advisory board calls and and other fun things that that we were able to do.
• 6:48
  SPEAKER_01: And you really bring a really unique perspective, in my view, a unique perspective to the skincare um industry because you have such a strong surgical practice and you really think about how you utilize skincare for that type of patient in terms of truly prevention of sun of skin cancer, sun damage leading to skin cancer, but also you bring the the strong aesthetic practice that you have into kind of all of your consulting.
• 7:15
  SPEAKER_01: And so let's let's talk about, you know, is that is that unique to Dr.
• 7:20
  SPEAKER_01: McDonald?
• 7:20
  SPEAKER_01: Or do you feel like that is kind of how the Australia dermatologists, Australian dermatologists really views things because of this heavy tumor burden that you guys deal with?
• 7:30
  SPEAKER_00: Yeah, look, I think it's um it's definitely not unique to me, um, but it is something that in Australia we would be much more cognizant of and much more focused on.
• 7:43
  SPEAKER_00: I think in Australia there are probably similar to elsewhere, we have some dermatologists that are really focused on medical dermatology.
• 7:53
  SPEAKER_00: And um unfortunately I think that they don't integrate skincare enough into their practices because I feel like you almost need the you need the pressure from the patients who are interested in skincare and want, you know, the best skin possible.
• 8:11
  SPEAKER_00: You know, when as dermatologists, we're we're often dealing with something that's abnormal or broken or unhealthy skin, and we're and we're just trying to get it back to normal.
• 8:21
  SPEAKER_00: But then as dermatologists on the aesthetic side, we're crossing over into people who have normal skin, who want better skin.
• 8:28
  SPEAKER_00: You know, they just want that next level.
• 8:31
  SPEAKER_00: And they're a very different patient with a very different problem.
• 8:34
  SPEAKER_00: And if you've only ever focused on getting the broken to normal and not really thought about how to take it to that next level, you miss out on a lot of the um tools that we can use as aesthetic practitioners, particularly skincare, but also procedures, to help even get the abnormal to normal, I think, but certainly to get them to the best possible skin they can have.
• 8:58
  SPEAKER_00: So, yes, in Australia, we certainly have a big group of dermatologists that are really medically focused and probably uh are not as focused on skincare or procedural work.
• 9:09
  SPEAKER_00: Um, we have a small group that are very much just surgical, um, doing you know, most surgeons essentially.
• 9:16
  SPEAKER_00: And then we have a growing um portion that have started to combine um more aesthetic dermatology.
• 9:26
  SPEAKER_00: I would certainly say in the last 10 years, pretty much every dermatologist who has completed their residency um, you know, integrates aesthetic skincare and medical um into their normal dermatology practice.
• 9:40
  SPEAKER_00: Whereas prior to that, um, it was less common.
• 9:44
  SPEAKER_01: And aesthetic-wise, are you and I know you do a lot of laser work, is are are lasers very popular or do you deal more with the injectables?
• 9:53
  SPEAKER_00: Um me personally, I am more focused on injectables.
• 9:58
  SPEAKER_00: I um do more work uh in the KOL space with the injectables, um, and I think that kind of create creative artistic um side of me loves that injectable part of dermatology.
• 10:13
  SPEAKER_00: Our practice, we do do a lot of lasers, and my um co-director of my practice is um more laser focused in just her um aesthetic practice.
• 10:23
  SPEAKER_00: So it's kind of a nice balance that she's um got more laser expertise than me, and and probably you know, the other way around with injectables.
• 10:31
  SPEAKER_00: But we certainly both do both, and and we both have a lot of experience compared to probably an average dermatologist.
• 10:38
  SPEAKER_00: So just on balance, more injectables for me.
• 10:41
  SPEAKER_00: Um we have a lot of lasers in our practice, and we we have um but in Australia, uh, I would say that laser is not very not regulated at all.
• 10:55
  SPEAKER_00: And so lasers can be sort of operated from you know anyone really with no qualifications through to aesthetic nurses, um estheticians, uh, dermal clinicians, dermatologists.
• 11:10
  SPEAKER_00: So there are a lot of people who sort of seem to have a laser in their practice and somebody using it.
• 11:16
  SPEAKER_00: Um I just had a patient the other day and she said, Oh, yeah, I had this laser.
• 11:20
  SPEAKER_00: Um, she was offered, you know, a package, and I said, What laser is it?
• 11:24
  SPEAKER_00: And she said, Oh, it's the one that all the doctors have.
• 11:26
  SPEAKER_00: And I was like, Okay, that one.
• 11:28
  SPEAKER_00: Um, because she'd been told, you know, this is a package, we've got the best laser, it's the one that all the doctors have.
• 11:34
  SPEAKER_00: You know, so it's just a big market out there, which is very confusing for patients.
• 11:40
  SPEAKER_00: And as I'm always having to say to patients, because I might recommend a laser and the patient will say, Oh, I've had that laser.
• 11:47
  SPEAKER_00: And I'll say, Yeah, but it's not the laser that that does the job, it's it's the operator, really.
• 11:53
  SPEAKER_00: It's the settings, it's the experience.
• 11:56
  SPEAKER_00: Um so yeah, unfortunately, it is difficult for patients, I think.
• 12:01
  SPEAKER_01: Yeah, it's buyer beware, right?
• 12:03
  SPEAKER_01: And we have that here in the states as well, where it's in so many different states, it's it's unregulated in terms of who can operate and and drive the laser.
• 12:10
  SPEAKER_01: Yeah.
• 12:11
  SPEAKER_01: Um, and so the outcomes vary widely between different places.
• 12:17
  SPEAKER_01: And so it's absolutely is buyer beware.
• 12:19
  SPEAKER_01: And I feel sorry for the consumer, honestly, because it's very difficult, especially as you try and compete on price, or they look at price as as the major way of determining where they're going to go.
• 12:30
  SPEAKER_01: So as we kind of turn more towards skincare, Cara, um, you know, when you look at the skincare industry, especially as you speak with your patients and and what you have in Australia, what what's really exciting to you now?
• 12:41
  SPEAKER_01: What are you focusing on and recommending quite a bit?
• 12:46
  SPEAKER_00: Look, I think you know, the skincare world is is certainly exciting because it's changing rapidly.
• 12:52
  SPEAKER_00: We're seeing um new developments um all the time.
• 12:57
  SPEAKER_00: I think what's you know, what's again worrying is is that you know, there are a lot of a lot of confused people out there and they are basing their skincare decisions off um influencers, social media, and um uneducated people who who are being paid for advertising uh these products.
• 13:20
  SPEAKER_00: And so what I'm seeing in my practice um is actually a lot of people with problems from their skincare and a lot of confusion out there.
• 13:30
  SPEAKER_00: And I think it is exciting that people are starting to realize that they need some expert advice in in the area of skincare.
• 13:40
  SPEAKER_00: And you know, it is interesting that we we always, as you know, go back to basics a lot of the time with skincare, and it can get awfully complicated.
• 13:50
  SPEAKER_00: People can start to think that they need, you know, 18 different active ingredients in every skincare routine.
• 13:57
  SPEAKER_00: And um, you know, I'm a big one to simplify things, keep it simple, and try to get people into some consistency and with their key ingredients first before they they start getting into those novel ingredients.
• 14:13
  SPEAKER_01: So your key ingredients then are what, like retin A, tretinoin?
• 14:16
  SPEAKER_00: ABC, you know.
• 14:18
  SPEAKER_01: Yeah, okay.
• 14:19
  SPEAKER_01: Antioxidants.
• 14:20
  SPEAKER_01: Pretty much, you know.
• 14:21
  SPEAKER_00: We've got our literally ABC, I think, is great for skincare, isn't it?
• 14:25
  SPEAKER_00: We've got our you know, retinoid family, uh, which has so much evidence behind it.
• 14:30
  SPEAKER_00: And of course, there are newer iterations, there are some um retinol-like ingredients that are probably less irritating.
• 14:38
  SPEAKER_00: And I'm sure we're going to see hopefully some science behind, you know, the alternatives to retinol.
• 14:46
  SPEAKER_00: Um, because at the moment there's a lot of ingredients that are starting to claim, you know, retinol-like action, but we don't have that good evidence behind them.
• 14:56
  SPEAKER_01: The studies like Bacucciol or Biden's Pelosa or something like that.
• 15:00
  SPEAKER_01: Exactly.
• 15:01
  SPEAKER_00: And you know, it would be great, wouldn't it, to have some of the science behind that.
• 15:05
  SPEAKER_01: Yeah.
• 15:05
  SPEAKER_00: Like in terms of longevity and histopathology, and you know, true, you know, real science to prove that it's equivalent or or near equivalent.
• 15:16
  SPEAKER_00: But you know, at the moment it's still one of the gold standards to go back to the retinoid family.
• 15:21
  SPEAKER_00: And then, you know, the vitamin B group are so important, especially in Australia.
• 15:26
  SPEAKER_00: We we really promote niacinamide very strongly because you know, there is evidence um for that in terms of photoprotection, reducing our risk of skin cancer.
• 15:37
  SPEAKER_00: So it's it's certainly a favorite ingredient, a good you know, it's an old ingredient, but it it's still good.
• 15:44
  SPEAKER_00: And um panthanol, you know, another good vitamin B.
• 15:48
  SPEAKER_01: Yep.
• 15:49
  SPEAKER_00: And and then vitamin C, you know, my favorite.
• 15:52
  SPEAKER_00: Um, we still want to have that in in every routine if we can.
• 15:58
  SPEAKER_00: Um, we want to make sure we're packing those antioxidants in.
• 16:02
  SPEAKER_00: And and again, there are new new forms of antioxidant um that that are really exciting, and but we don't we don't have enough evidence to give up vitamin C, that's for sure.
• 16:15
  SPEAKER_00: It's still still the best, still the God's standard.
• 16:18
  SPEAKER_01: Oh, I just have to tell you, I learned something.
• 16:20
  SPEAKER_01: So the ABC is not something I haven't heard that in a long time.
• 16:24
  SPEAKER_01: So, so just to make sure everyone understands, so vitamin A, right?
• 16:27
  SPEAKER_01: Retinoids are are vitamin A derivatives, okay?
• 16:30
  SPEAKER_01: So you've got tretinoin, which is all transretinoic acid, then you've got others that and then retinol, retinaldehyde that are kind of precursors to tretinoin.
• 16:39
  SPEAKER_01: So that's your vitamin A for the A vitamin B is your you know, vitamin B3 is niacinamide, B5 is panthanol, for example.
• 16:46
  SPEAKER_01: And so that's where she's it's ABC, and then C is vitamin C.
• 16:50
  SPEAKER_01: I love that.
• 16:51
  SPEAKER_01: I haven't heard that in a long time.
• 16:52
  SPEAKER_01: I totally forgot about that.
• 16:53
  SPEAKER_01: That's good.
• 16:54
  SPEAKER_00: Yeah, it's it's funny because it's you know, obviously we use our ABC in our mole checks too.
• 16:58
  SPEAKER_00: Um but you know, I think when you can come back to that really basic ABC plus your barrier and cleanser, um you you're really and obviously your sun protection there.
• 17:12
  SPEAKER_00: Um but if if you've got people on A, B, and C, really they're getting a very, very good skincare routine, just back with those really old school basic ingredients that have come so far, and we now know that you know they're we've got good delivery vehicles and and you know, lower irritation and and so on from our current, you know, options available.
• 17:37
  SPEAKER_00: But yeah, if if you've got confused people, you know, it's it's a great place to start.
• 17:43
  SPEAKER_01: That's great.
• 17:44
  SPEAKER_01: Okay.
• 17:44
  SPEAKER_01: And so and and it really just kind of sets the tone for look, this is it's basic and ABCs, we all understand that, but really this is so, as you said, justified by the science to use these ingredients and completely agree.
• 17:56
  SPEAKER_01: When you're looking at moisturizers, Cara, what what do you think?
• 17:59
  SPEAKER_00: Can I just say we can also go for D, which is DNA um repair?
• 18:03
  SPEAKER_00: Ah, we can go for E, which is vitamin E combined with good old C E ferolic, which takes us to F, which is pheroic.
• 18:13
  SPEAKER_00: Going through that alphabet, but those first um those first letters are pretty good.
• 18:18
  SPEAKER_01: Yeah, I like that.
• 18:19
  SPEAKER_01: Yeah, and vitamin, you know, the D for the DNA repair, we should not discount that, right?
• 18:23
  SPEAKER_01: Because we have those really great um products now that have a lot of research behind them to show that we can absolutely do that, especially in a sun, sunny climate like in Australia, right?
• 18:34
  SPEAKER_00: Yeah, absolutely.
• 18:35
  SPEAKER_00: And that's where I um, you know, I like to sort of as I you know start with it, it's almost in order.
• 18:43
  SPEAKER_00: Like, you know, A is probably the one with the most evidence, B is the next C, you know, yeah.
• 18:49
  SPEAKER_00: Um it's a great alphabet.
• 18:52
  SPEAKER_01: Yeah, I love it.
• 18:53
  SPEAKER_01: Okay, great.
• 18:54
  SPEAKER_01: Um, and then okay, let's go back to your moisturizers.
• 18:56
  SPEAKER_01: So now we're at M for moisturizers.
• 19:00
  SPEAKER_01: Um, and so what are you looking for in terms of ingredients?
• 19:03
  SPEAKER_01: What do you like to recommend?
• 19:05
  SPEAKER_00: Look, I think this is really a personal thing and varies a lot in skin type by skin type.
• 19:13
  SPEAKER_00: But yeah, you know, our our ceramides are certainly, you know, a favorite ingredient um for people with dry, sun-damaged, eczema prone, um, irritated skin, which is many, you know, Australians, um, you know, our other fatty acids, cholesterol, uh I love um just good old glycerin, which you know is a humectant, um, very good at holding moisture in the skin, hyaluronic acid, you know, it it's got a lovely texture.
• 19:46
  SPEAKER_00: A lot of people enjoy products with hyaluronic acid in it, but I think it's overhyped a bit in terms of you know what it actually does in topical application, and it really needs to be sealed in uh with a barrier to hold moisture in the skin.
• 20:03
  SPEAKER_00: Um, and you know, shea butter and and lots of you know again, old school ingredients for barrier and moisture, but I do find that really comes down to patient preference and what their skin skin is like, because you can really find a good moisturizer or or a good barrier for for most people, um, but it does vary a little bit.
• 20:31
  SPEAKER_01: Yeah.
• 20:31
  SPEAKER_01: And you know, just to circle back to hyaluronic acid, I think you're completely right.
• 20:35
  SPEAKER_01: The the issue with hyaluronic acid, in my view, is that most of the products up till now um have been using single molecular weight HA, which, you know, either high or low, and they do very different things.
• 20:46
  SPEAKER_01: And some of the ultra-low molecular weight HA is actually inflammatory in the skin, so you have to be careful with that.
• 20:52
  SPEAKER_01: And so looking for products that have multi-weight HA is probably the best way to go just because the low molecular weight tends to penetrate further, it tends to it acts as a cumectant to bring water in.
• 21:02
  SPEAKER_01: The higher molecular weight tends to sit on the top of the skin, which hydrates the very top of the skin, but also acts as a moisturizer to seal in some of the some of the the water already there, the hydration there.
• 21:11
  SPEAKER_01: So that's a great point.
• 21:13
  SPEAKER_01: You know, HA, you've got to be careful how it's used in a moisturizer, to your point.
• 21:17
  SPEAKER_00: Yeah, yeah, yeah.
• 21:19
  SPEAKER_00: And I think people get confused again because we inject HA all the time.
• 21:26
  SPEAKER_00: They assume that putting it on the top will will give a similar or possible, you know, effect penetrating, but we know it doesn't penetrate through um to the dermis.
• 21:37
  SPEAKER_00: It's only really superficial epidermis.
• 21:39
  SPEAKER_00: And as you said, if you go too low, um it actually just becomes pro-inflammatory, which is not not good for anyone, especially um for those with dry or irritated skin.
• 21:49
  SPEAKER_01: Yeah.
• 21:49
  SPEAKER_01: Um, and then because it's Australia and because we have an expert here, we should talk about sunscreen.
• 21:54
  SPEAKER_01: And so, you know, my favorite topic.
• 21:57
  SPEAKER_01: Yeah, I'm very jealous because the filters that you have.
• 22:00
  SPEAKER_01: Available to you and your patients are so different from the ones that we have here in the States.
• 22:04
  SPEAKER_01: But but talk about you know slip slap slop, of course, but uh you know, even further than that, how you integrate sunscreen and sure with everything that you do and all the different products that you have, it's amazing.
• 22:16
  SPEAKER_00: Yeah, look, it's it's actually an interesting point you you make about the filters because there's we're we've kind of got this um mixed blessing with our sunscreen regulation.
• 22:28
  SPEAKER_00: So the first thing in Australia is that sunscreen is regulated like a drug, and that's pretty unusual.
• 22:33
  SPEAKER_00: So it has to be approved by the equivalent of our FDA to be named as a primary sunscreen, and and our sunscreens have an approval number on them.
• 22:43
  SPEAKER_00: They have to be manufactured or tested in only a number of approved testing facilities around the world.
• 22:51
  SPEAKER_00: So when they say SBF 50, we know you know that it is SPF 50, whereas um, you know, I've seen a lot of uh literature around products that are labeled one thing, but actually not they they don't come up to that in testing, which is always um worrying, I suppose.
• 23:11
  SPEAKER_00: But having said that, it takes a long time in Australia to get new products approved, and um it costs the companies a lot.
• 23:20
  SPEAKER_00: So even though the ones we have are very good, we sometimes are a little bit slow getting in um new filters.
• 23:27
  SPEAKER_00: And we also, for example, you know, a brand like Skinseuticals has multiple sunscreens, but we have one in Australia because it's just too expensive for them to try and get them all approved, and then most of them are manufactured in um facilities that aren't approved by our TGA, so they just can't bring in multiple options for people.
• 23:48
  SPEAKER_00: Um so we actually miss out on a lot of things as well.
• 23:52
  SPEAKER_00: There's a there's a new filter known as UV Mune, which has been um developed by La Roche Passé, you probably know, um, and it's got a longer um uh it's got a a filter that covers a a long more of the UVA wavelength.
• 24:09
  SPEAKER_01: Um a wider spectrum.
• 24:11
  SPEAKER_00: A wider spectrum, thank you, uh compared to our current, so long UVA, uh, which we know again contributes to aging and our risk of skin cancer.
• 24:21
  SPEAKER_00: And no no no other filters are really covering that part of the spectrum very well.
• 24:26
  SPEAKER_00: Um, but you know, we we are still we still don't have it approved.
• 24:30
  SPEAKER_00: Like it is in approval, but we are waiting and waiting.
• 24:34
  SPEAKER_00: And you know, it's quite frustrating for us who are in the know, but also the companies, um, that they treat it so seriously that you know they the kind of um the regulatory bodies can make it very difficult.
• 24:52
  SPEAKER_00: Um, there needs to be enough science, enough studies to show that it's you know, this benefit and and so on.
• 24:58
  SPEAKER_00: And I think it's just a long, slow, expensive process for companies to bring sunscreens into Australia.
• 25:03
  SPEAKER_00: So that's that's the downside of it.
• 25:06
  SPEAKER_00: The upside is that, you know, it is taken very seriously.
• 25:10
  SPEAKER_00: Our sunscreens that we do have here are very high quality.
• 25:14
  SPEAKER_00: Um, and the message really is quite strong in Australia about photo protection, which is great.
• 25:21
  SPEAKER_00: It doesn't stop people from, you know, thinking they're invincible.
• 25:26
  SPEAKER_00: And we still see every day um, you know, some people that just don't, you know, use sunscreen regularly.
• 25:33
  SPEAKER_00: But more and more people are getting the message that sunscreen should be a year-round thing in Australia because we just have such high sun exposure that it adds up all year rather than it just being when you're going out to the beach or the park.
• 25:45
  SPEAKER_01: Yeah, you know, I've got multiple family members that live in Sydney and um you know the the the wives of my cousins are very careful with their sun exposure.
• 25:55
  SPEAKER_01: My cousins are not so much, despite me haranguing them and their wives haranguing them.
• 26:00
  SPEAKER_00: Um anyone that's worried about wrinkles now understands that you know we really need that sun protection.
• 26:07
  SPEAKER_00: The people that don't really care about their wrinkles are still a little bit blasé because they I s I especially find that age group between about 15 and 25, they're pretty reckless.
• 26:17
  SPEAKER_00: They, you know, they still want to get a tan.
• 26:20
  SPEAKER_00: Um and then, you know, men as well, just you know, won't happen to me.
• 26:26
  SPEAKER_00: I'll be right.
• 26:27
  SPEAKER_01: Don't like it.
• 26:28
  SPEAKER_01: You know, it's yeah, yeah, that's a big problem.
• 26:30
  SPEAKER_01: But in the States, we're getting this um uh a big issue now is called pre-aging, where these 15 to 25 year olds are really focused on skincare.
• 26:39
  SPEAKER_01: And so they'll go.
• 26:40
  SPEAKER_01: We many times I'll have a teenage patient come in with five to ten different products worth hundreds of dollars.
• 26:46
  SPEAKER_01: Yep.
• 26:46
  SPEAKER_01: Um, because they are, you know, influenced by social media or watching social media, which I'm not saying is all completely bad, right?
• 26:53
  SPEAKER_01: To be aware of your skin, to be understanding of the effects of the sun of the sun and aging process and the exposome, as we say, you know, everything that can affect the aging process.
• 27:01
  SPEAKER_01: It's probably not a bad thing when you're young.
• 27:03
  SPEAKER_00: No.
• 27:04
  SPEAKER_01: Um, but it is becoming more and more popular, this this idea pre-aging.
• 27:10
  SPEAKER_01: Um, so we're seeing skincare companies now develop products just for that patient population.
• 27:14
  SPEAKER_00: Yeah, look, and we're the same here.
• 27:16
  SPEAKER_00: We're we've we've got these young people obsessed with skincare.
• 27:20
  SPEAKER_00: Um absolutely.
• 27:23
  SPEAKER_00: But I and and look, I think they're putting sunscreen on their face and still sometimes going out and trying to get a tan on on the body for the weekend, um, on the weekend, which you know they'll learn um over time that they don't want their body wrinkly either, I suppose.
• 27:41
  SPEAKER_01: Um so they're taking care of their face, but they'll let their body go.
• 27:44
  SPEAKER_01: Okay, got it.
• 27:45
  SPEAKER_00: Yeah, they, you know, they they still they're less, you know, in that age group, they're just less concerned about risk.
• 27:52
  SPEAKER_00: They're less concerned about skin cancer, they're more concerned about how they look.
• 27:56
  SPEAKER_00: Um, so if you know, if it's a tan with all a million skincare products on their face, that that makes sense to them.
• 28:03
  SPEAKER_01: Okay, gotcha.
• 28:04
  SPEAKER_01: If they're putting the products on, at least it's helping them in some way.
• 28:07
  SPEAKER_01: Yeah.
• 28:07
  SPEAKER_01: Okay, got it.
• 28:08
  SPEAKER_01: But as we know, we should say this just as a you know professional disclaimer: a tan is damaged.
• 28:13
  SPEAKER_01: So any tan signifies potential DNA damage and should be avoided, right?
• 28:18
  SPEAKER_00: Correct.
• 28:19
  SPEAKER_00: Absolutely.
• 28:20
  SPEAKER_01: All right.
• 28:21
  SPEAKER_01: Listen, Cara, I enjoyed this so much.
• 28:23
  SPEAKER_01: I learned so much uh uh about you and about kind of being a dermatologist in Australia.
• 28:28
  SPEAKER_01: Thank you so much for being with us.
• 28:30
  SPEAKER_00: Oh, my pleasure.
• 28:31
  SPEAKER_00: Thank you again for having me.
• 28:33
  SPEAKER_01: Oh, it's it's this is great.
• 28:34
  SPEAKER_01: So again, this is Skincare Confidential.
• 28:36
  SPEAKER_01: I'm Dr.
• 28:37
  SPEAKER_01: Ted Lane.
• 28:38
  SPEAKER_01: Um, thank you for listening.
• 28:39
  SPEAKER_01: Dr.
• 28:40
  SPEAKER_01: Carr McDonald is our uh guest from Australia.
• 28:42
  SPEAKER_01: Carr, what is your Instagram handle?
• 28:45
  SPEAKER_00: Uh it is Dr.
• 28:46
  SPEAKER_00: Cara underscore dermatologist.
• 28:49
  SPEAKER_00: So D-R-C-A-R-A.
• 28:52
  SPEAKER_01: Underscore dermatologist.
• 28:54
  SPEAKER_01: Yeah, and I was just on today.
• 28:55
  SPEAKER_01: I was I was on your Instagram and you post some really educational stuff.
• 28:58
  SPEAKER_01: I think it's great.
• 28:59
  SPEAKER_01: So keep going.
• 29:00
  SPEAKER_00: I'm I'm not I'm not great on the Instagram.
• 29:03
  SPEAKER_00: You know, I think there's there's a formula and I don't seem to be able to follow it.
• 29:07
  SPEAKER_01: It's okay.
• 29:08
  SPEAKER_01: Whatever you're doing, it seems to be working.
• 29:10
  SPEAKER_01: So listen, everybody, thank you.
• 29:12
  SPEAKER_01: Uh if you like it, please give us a good five-star rating, subscribe, and refer us to friends as well.
• 29:18
  SPEAKER_01: We all appreciate your help in um getting the skincare confidential word out so that we can get these this great information to more and more people.
• 29:27
  SPEAKER_01: Uh, thank you very much.
• 29:29
  SPEAKER_00: Thanks for having me.
• 29:30
  SPEAKER_01: Absolutely.