Latest / Skin Anarchy / Dr. Ava Shamban on the Transformative Power of Dermatology

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Dr. Ava Shamban on the Transformative Power of Dermatology · Skin Anarchy

0:00
SPEAKER_00: Hi guys, welcome back to Skincare Anarchy.
0:02
SPEAKER_00: This is the host Ekta, and I am so excited about the guest that we have here today.
0:08
SPEAKER_00: I am truly humbled that she's joining us, and I want to introduce you guys to Dr.
0:12
SPEAKER_00: Ava Shampin.
0:13
SPEAKER_00: She is a distinguished world-certified dermatologist, a Harvard graduate, and the author of Heal Your Skin.
0:19
SPEAKER_00: Dr.
0:20
SPEAKER_00: Ava is renowned for her work in dermatology, including her appearances on CBS's The Doctors and ABC's Extreme Makeover.
0:27
SPEAKER_00: With a career spanning both clinical practice and media, she brings a wealth of expertise and insight into the world of skin health.
0:34
SPEAKER_00: And that's why I'm just so thrilled to be hosting her here today.
0:37
SPEAKER_00: Welcome to the show, Dr.
0:38
SPEAKER_00: Chamblin.
0:39
SPEAKER_00: I'm so honored to host you.
0:40
SPEAKER_00: Oh, thank you, Ecta.
0:42
SPEAKER_00: And then please call me Ava.
0:43
SPEAKER_00: Okay, I will.
0:44
SPEAKER_00: Well, it's lovely to have you on the show, Ava.
0:46
SPEAKER_00: I'm so excited to learn from you.
0:48
SPEAKER_00: Um, honestly, and I I can't wait to dive in, but I want to get started.
0:52
SPEAKER_00: If you could tell us a little bit about what got you into dermatology, you know, what led to you pursuing this route in medicine?
0:59
SPEAKER_01: So I actually dermatology was just something I kind of more backed into.
1:04
SPEAKER_01: I was very interested in finding a specialty that had a combination of medicine and surgery.
1:10
SPEAKER_01: And because of my personality is in between both.
1:13
SPEAKER_01: And so I don't know how familiar you are with the personalities of various specialties, but surgeons tend to be like, let's get it done.
1:20
SPEAKER_01: And internal medicine people like, well, let's just talk about things for a couple of days, and then we'll figure out what we're gonna do.
1:27
SPEAKER_01: So I was definitely not in that camp.
1:29
SPEAKER_01: And I but I was definitely more in the camp with the surgery, like, let's think about it a little bit before we actually do it.
1:34
SPEAKER_01: So dermatology was a really nice mix of the two.
1:38
SPEAKER_01: And it turned out that I was super lucky because when I started dermatology, it was really a lot about just our skin illnesses such as eczema and psoriasis and acne and skin cancers and then cosmetic or making people look their very best.
1:54
SPEAKER_01: That was something that came in more recently.
1:57
SPEAKER_01: I mean, and when I say recently, that's probably like 35 years ago.
2:01
SPEAKER_01: And at that time, you know, we started with the lasers and all the injectables and the ability to do to really take care of people's, not just their appearance, but also if they had some abnormality that made them that made them stick out, you know, whether it was a scar or some asymmetry or something like that.
2:19
SPEAKER_01: So we could finally have the tools to address it.
2:21
SPEAKER_00: That's so interesting.
2:22
SPEAKER_00: And I like how you uh explain that, that it is a mix between surgery and I always found dermatology to be such a unique specialty.
2:29
SPEAKER_00: That's why I asked you because it's it is like, you know, from the surgery side and also from the more I think holistic side as well now, as we're progressing through.
2:37
SPEAKER_00: I mean, would you agree that it's becoming more holistic?
2:40
SPEAKER_00: Absolutely.
2:40
SPEAKER_01: It is, I mean, and so over the years we've come to understand how it how much the skin is an integral part of our immune system, which has always kind of been the case, but I think the the depth of understanding of how our skin interfaces and is part definitely big a big part of our immune system, is really important.
3:00
SPEAKER_01: So that's why we get vaccinations in our skin, essentially, because the T cells, which are your cells that communicate through your lymph nodes, that they tr they traffic in and out of the skin.
3:11
SPEAKER_01: And so the skin has a lot of bearing on the internal health of the other or of organs as well.
3:16
SPEAKER_00: Yeah, no, absolutely.
3:17
SPEAKER_00: And I think we're finally from the consumer side of things, I think people are kind of coming into this realization that your skin is tied to everything and or it reflects everything rather.
3:27
SPEAKER_00: I love seeing that in the world of just consumerism, that people are finally coming around to this kind of, I guess, a little bit of an understanding of that.
3:35
SPEAKER_00: But on that note, I want to ask you when it comes to skincare and skin health, there's a lot of things that are obviously a lot of misinformation out here.
3:43
SPEAKER_00: And I always think it's important um to set some pillars down.
3:47
SPEAKER_00: So if you were to say, you know, what are some foundational pillars of a good skincare routine or a good skin health routine that really maintains your skin in terms of the health?
3:57
SPEAKER_00: More not so much aesthetic, but just overall good health.
4:00
SPEAKER_01: So that's a really good question.
4:02
SPEAKER_01: And so actually, I think a lot your skin health skins internally.
4:06
SPEAKER_01: So it it is very tied to what you eat.
4:10
SPEAKER_01: It's also the health of your skin is tied to lifestyle habits.
4:15
SPEAKER_01: So, for example, getting enough rest, exercising, and then of course, doing the basics in terms of protecting your skin against the insult from the environment, such as ultraviolet exposure, exposure to pollutants.
4:32
SPEAKER_01: So these are all ways that we can maintain skin health by, of course, one of the one of the pillars is absolutely I would say you mean medical grade or just very high-end grade skincare, which doesn't have to cost a fortune, but having outstanding skincare and outstanding sun protection, internal health um reflected in the quality of your skin.
4:55
SPEAKER_00: Yeah, yeah, it makes sense.
4:56
SPEAKER_00: And and I think those are some things that I see resonated throughout the the whole beauty industry uh a lot, which is it thanks to a lot of great dermatologists like yourself.
5:06
SPEAKER_00: So I'm glad that we're actually on that baseline, I think, um, from the standpoint of consumers that we're starting to really kind of focus on health above all else.
5:15
SPEAKER_00: And I hope we are at least.
5:16
SPEAKER_00: And uh from that, I I want to actually I want to talk to you about this idea of because I know that you focus on this in your practice of this connection between obviously what we want to look like on the outside and also our self-esteem, right?
5:29
SPEAKER_00: And what it means internally and externally when it comes to beauty.
5:32
SPEAKER_00: So on that note, can you talk to us a little bit about what is prejuvenation and the changing trajectory of aging?
5:39
SPEAKER_00: Because for a long time we've been using these words like anti-aging, right?
5:43
SPEAKER_00: And I do it never sat well with me personally, but I I like the word prejuvenation.
5:49
SPEAKER_00: I would love to learn more about that if you could explain.
5:51
SPEAKER_01: Yeah, okay.
5:52
SPEAKER_01: So let's yeah, let's start with prejuvenation.
5:54
SPEAKER_01: Okay, so we all want to age, we want to be here, right?
5:59
SPEAKER_01: But we just want to look good while we get older.
6:02
SPEAKER_01: So it turns out that how do we do that?
6:05
SPEAKER_01: How do we accomplish that?
6:06
SPEAKER_01: And I think that we're starting to see the effects of long-term prejuvenation.
6:11
SPEAKER_01: And you can see it in the actresses now.
6:13
SPEAKER_01: Because if you look at these actresses who are in their late 50s and still have very vibrant careers, and you compare it to actresses from a prior generation who were in their late 50s, they were completely shoved to the side.
6:27
SPEAKER_01: And the reason for that is because of all of these prejuvenation techniques that we now have.
6:33
SPEAKER_01: So, what does that mean exactly?
6:35
SPEAKER_01: Well, it turns out that the DNA expression of our skin is different according to how we treat it.
6:43
SPEAKER_01: And so how we treat it has to do with what kind of active ingredients we put on it and also what office procedures that we do, and even at-home procedures as well to include.
6:55
SPEAKER_01: So, for example, what we have found is that if you have a laser treatment, it can be something like just an intense pulse light, a so-called photofacial, that it it changes the genetic expression of your skin to be more youthful.
7:10
SPEAKER_01: And we know that if you do two treatments like that a year, um, and then you follow it with using at least one of the products, something in the retina, in the in the tretinoin or the retinoid category, and use sunscreen, then your skin is going to look completely different 10 years from now than any other people who aren't doing that.
7:33
SPEAKER_01: So, and it doesn't have to be an intensible slight.
7:35
SPEAKER_01: It could be even they're so showing it with a light chemical peel or radio or microneedling or radio frequency microneedling.
7:44
SPEAKER_01: So just something needs to be done, and that completely changes the way you age without having some big procedure.
7:51
SPEAKER_00: That's very interesting.
7:51
SPEAKER_00: So is it linked to exfoliation?
7:54
SPEAKER_00: I mean, the techniques that you mentioned were a little bit um I I mean they're different.
7:58
SPEAKER_00: So I'm wondering like what's the underlying uh I guess technique or or really the the thing you're doing that's causing this effect?
8:05
SPEAKER_00: I mean, what is it?
8:05
SPEAKER_00: Is it a foliage?
8:07
SPEAKER_01: It's fascinating.
8:07
SPEAKER_01: Well, I would say it's not just exfoliation, it's more a controlled injury to the skin.
8:13
SPEAKER_01: And so if you look at if you look at men who shave, you can see in the areas where they are shaving.
8:20
SPEAKER_01: So I guess that's kind of exfoliation, but it's also if you really look mic if you microscopically where they shave, they're also kind of creating all these tiny little nicks to the skin.
8:31
SPEAKER_01: And so they're all they're constantly the map constantly micro injuring their skin every day, and they don't get fine lakes and wrinkles in the areas where they're shaving.
8:40
SPEAKER_01: You don't see it, unless you're having a truck driver who gets, you know, sun exposure on one side of his face, if it's a man.
8:47
SPEAKER_01: Yeah.
8:47
SPEAKER_01: And we have seen those pictures to show you the value of seeing out of the sun.
8:52
SPEAKER_01: But it's it's more like a controlled injury, and it's a fascinating sequence of events that takes place that just improves the aging process.
9:01
SPEAKER_01: I mean, it just changes it because you get a more youthful expression.
9:05
SPEAKER_01: Yeah, yeah, of the genome of literally of your DNA.
9:09
SPEAKER_01: So, which is so exciting that uh we've kind of figured out the connection.
9:13
SPEAKER_01: But it really looks, I mean, look at Jennifer Aniston.
9:16
SPEAKER_01: I mean, she looks good, and she definitely looks um older, but you can't ever completely look like you did when you were 30 or something, but you can look like an awesome 55.
9:28
SPEAKER_01: And I think she's about 55 now.
9:30
SPEAKER_00: Yeah, I mean, she looks amazing for her age, like absolutely amazing.
9:33
SPEAKER_00: I I know what you mean.
9:34
SPEAKER_00: I've noticed that actually with a lot of people, like you know, you always say, Oh, so and so um must have good genes or genetics because they're not aging like I am, or you always find those people here and there that are just looking amazing, but they're 60 years old and they look 45.
9:48
SPEAKER_00: Always makes you wonder what are they doing so differently.
9:51
SPEAKER_00: But this is very fascinating to me.
9:53
SPEAKER_00: What you're mentioning is this controlled level of uh micro injuring your skin versus what we hear about a lot in terms of buzzwords like micro-traumas, right?
10:03
SPEAKER_00: In the industry.
10:04
SPEAKER_00: I feel like everyone's talking about micro trauma.
10:06
SPEAKER_00: So if you were to compare the two, like, well, just for our listeners, comparing what you just explained and then that micro traumas, how would you do that?
10:14
SPEAKER_01: Well, I mean, there it's just that's kind of words.
10:17
SPEAKER_01: I mean, it is trauma to the skin.
10:19
SPEAKER_01: It's just it is an injury, and so I think the words are interchangeable.
10:23
SPEAKER_01: But I think what people thought they had to do is methane and then go in and have a big procedure, like a hugely deep chemical peel or a facelift, or back in in the old days, we used to do like a very deep chemical peel or even a derm abrasion, not a microderm abrasion, a derm abrasion where basically you're sanding off layers and layers of skin.
10:47
SPEAKER_01: So you're kind of it's really bloody, it's a bloody mess.
10:50
SPEAKER_01: We don't do that anymore because you don't need because it's counterproductive, actually.
10:54
SPEAKER_01: So that's why we call it the micro injury, micro trauma, where we're just sort of continually, not every single day, but you know, several times a year that you're challenging the skin to start wake-up cells, turn over, make new collagen, get rid of the old, because it's basically cleaning the house, the skin cleans house.
11:15
SPEAKER_01: It literally breaks down old collagen that's been damaged by having there's something called um advanced glycation end product.
11:25
SPEAKER_01: So if your blood sugar runs a little bit high, or if you eat a lot of sugar, then it's going to it's going to tack on to your collagen bundles and they're damaged, and your skin loses its nice firmness and it feels dry.
11:39
SPEAKER_01: And so the body's like, okay, this isn't supposed to be here.
11:42
SPEAKER_01: That's what you get with when you have the micro injury.
11:44
SPEAKER_01: And this is just what we've learned over time.
11:47
SPEAKER_01: You know, we just started when we really started doing these procedures like 20, 25 years ago, that um this is what has happened.
11:55
SPEAKER_00: That's so intriguing.
11:56
SPEAKER_00: And I'm I'm actually fascinated to learn about any of the latest advancements in the prejuvenation treatments.
12:02
SPEAKER_00: I mean, you had mentioned a couple, I think, briefly, but could you dive a little bit more into them?
12:06
SPEAKER_01: Into the prejuvenation treatments, yes.
12:08
SPEAKER_01: So one is intense pulse light, another one is a fractionated resurfacing, such as fraxal, or the lighter version of that, which is called clear and brilliant.
12:19
SPEAKER_01: Another treatment is radiofrequency microneedling, such as Vivaci or the Morpheus.
12:25
SPEAKER_01: Another is just straight-up microneedling.
12:28
SPEAKER_01: Um, and others we do very light peels like a glycol peel or a low strength TCA peel.
12:35
SPEAKER_01: Just depends what the person's skin condition is like and also their ethnicity and skin tone in terms of what we choose.
12:44
SPEAKER_01: But as I said, I sort of equate it now to people taking care of their teeth.
12:48
SPEAKER_01: Like you might go in and have teeth whitening done in the office, maybe twice a year, let's say, but then at home you're gonna use your tray, which is why I developed skincare.
12:58
SPEAKER_01: But I know you wanted to talk about beauty and what beauty has to do with uh the connection between beauty and self-esteem, right?
13:05
SPEAKER_00: Yeah, yeah, absolutely.
13:07
SPEAKER_00: I I want to actually really dive into that because I'm very curious from your perspective, right?
13:12
SPEAKER_00: I mean, you've seen so many patients.
13:13
SPEAKER_00: I mean, you know the clinical side, the medical side of things, but then when it comes to this tie-in between internally accepting yourself and then the work we do on the outside, I mean, what are your thoughts around that and just some information that you can provide on that?
13:28
SPEAKER_01: Okay, so besides lecturing about all these different techniques and also just the different modalities, like different types of lasers and injectables and how they all interface.
13:38
SPEAKER_01: I also have lectured a lot on the theory of beauty and why is beauty so important in our culture and what does it have to do with our self-esteem?
13:47
SPEAKER_01: Um there's a lot of this in the realm and having to do the effect that your appearance has on your self-esteem.
13:55
SPEAKER_01: So it turns out that there's something called the facial feedback hypothesis, which is when you look in the mirror and you look good, you feel better.
14:03
SPEAKER_01: And we all know, like when we have a good hair day, that we feel we feel more confident, or if you if you get a professional makeup, uh you know, makeup artist work on you to prepare you to go to a party, you feel better because you're like, oh my god, how did she do that?
14:19
SPEAKER_01: What did you what happened here?
14:20
SPEAKER_01: I look so good.
14:22
SPEAKER_01: Um and so and they have more confidence.
14:26
SPEAKER_01: And so this is this concept is totally um backed up by studies that have that there's this facial feedback hypothesis.
14:34
SPEAKER_01: Now, this is also tied into the way our brain works.
14:38
SPEAKER_01: So we have most of our communication is nonverbal, and we know that, and it's below the part of your brain, the cortex that thinks is subcortical, it's reflex.
14:51
SPEAKER_01: And the reason that we have this nonverbal communication is for safety.
14:55
SPEAKER_01: So if you go into a room and there are people who are dangerous to you, then you're going to you you're gonna read all their expression and their body stance, and you're gonna be like, oh my goodness, I could get hurt here.
15:07
SPEAKER_01: And that happens like this is the same reflex that if you if you're standing by the curve and all of a sudden you see a young child dash into the street, and you go and you grab that child so the child doesn't get hit by a car.
15:20
SPEAKER_01: It's that and you don't even think about it.
15:22
SPEAKER_01: Grief, it's a danger reflex, and so that's non-verbal communication, which just shows you how important appearance is to our daily life, because your appearance also affects your um the your posture, how you look at people.
15:38
SPEAKER_01: So the we know how important that is and so the and the tie-in is has actually Darwin wrote a whole book about this, and the tie-in is to sexual selection, so it's not natural selection, it's really how you select a person who you are going to have a child with, because we know that as we've been talking about, how your skin does reflect your internal health.
16:06
SPEAKER_01: So, so I mean with heterosexual couples, men are going to choose a woman who looks healthy because that woman is much more likely to be able to bear his genes.
16:17
SPEAKER_01: Now, every single creature wants to procreate.
16:21
SPEAKER_01: It's so interesting to me, whether it's a plant or whether it's a you know a mosquito, what it's a lot of peacocks, peacocks have a whole dance, you know.
16:30
SPEAKER_01: So yeah, yeah, a dance and they have feathers.
16:33
SPEAKER_01: Yeah.
16:33
SPEAKER_01: So so really began out of my work on extreme makeover where I saw the self-confidence that people had after they went through the whole process, after they lost some weight and they got a little more fit and they had their face done, if they needed some plastic surgery, they had that done, and then they were all made up and and clothed by the stylist.
16:53
SPEAKER_01: And it was it was like transformative, and you could tell how much better they felt about themselves.
16:58
SPEAKER_01: And since then, I've done clinical trials.
17:00
SPEAKER_01: There was one called the Harmony Study, where people had everything treated, and that was only injectables and late's, but people just on their their snare, they felt they filled out about how they felt about themselves.
17:13
SPEAKER_01: They felt better.
17:14
SPEAKER_01: And so then I thought to myself, as women, um and I think certainly said men, but especially women, like we really, we really want to look good, and and it makes us feel good.
17:24
SPEAKER_01: And I thought, now what's the purpose behind that?
17:27
SPEAKER_01: Well, I think we're hardwired for that all because of sensual selection.
17:31
SPEAKER_01: So I can change it, it's just the way it is.
17:34
SPEAKER_00: Yeah, yeah, absolutely.
17:36
SPEAKER_00: And I think that's such an interesting point that you make because we don't often discuss that anymore.
17:41
SPEAKER_00: I feel like right now, the way that social media is, and from what I've noticed, at least, you know, the way the social media atmosphere and what we're putting out there, it's all about this whole um we're focusing on things, you know, when it comes to aesthetics, like fillers and botox and so many things that you can get done, but then no one wants to address the underlying reasoning for why we're doing everything we're doing.
18:02
SPEAKER_00: So from that, I want I'm I'm curious what your thoughts are on this new era that we are coming into where social media is really dictating what patients are coming in and requesting or what they want in terms of you know, whether it's altering their features or enhancing them.
18:18
SPEAKER_00: Um, what are your thoughts on that as compared to what you explained just now, which is we have this innate need, right?
18:25
SPEAKER_00: The sexual selection.
18:26
SPEAKER_01: Um, I think it's really important.
18:29
SPEAKER_01: So part so the basis for um my concept of beauty, and then the other idea that I've developed, and I actually have to get a do a second book about this, it's totally unrelated to the first book, is signature feature.
18:44
SPEAKER_01: So I believe that everybody has a point of beauty about them and uniqueness.
18:49
SPEAKER_01: And so we know that that eyes, shape, and color is unique to every individual, and the same really with the mouth.
18:56
SPEAKER_01: And so people can have different types of signature features.
19:00
SPEAKER_01: I mean, there are some famous ones like Barbara Streisand's nose, um, like I don't know, Farrah Fawcett was so beautiful in so many ways, but people talked about her hair quite a bit, and there are other features, but in general, it's mostly eyes and mouth.
19:17
SPEAKER_01: And so it's really important with all the treatments that we do, it's really designed to highlight and showcase that individual piece of beauty.
19:28
SPEAKER_01: And so, signature feature is something that we all, it doesn't matter like how much money you have or where you come from or what color your skin is or anything else about you.
19:41
SPEAKER_01: It it your age, it's something specific to you.
19:45
SPEAKER_01: And so when you start with that idea that everyone is unique and individual, and they come in and they say, Well, I want to do this, I want to look like this person or that person, you're like, no, no, no.
19:55
SPEAKER_01: You don't want to look like anyone else.
19:56
SPEAKER_01: You want to look like the best version of yourself.
20:00
SPEAKER_00: Yes, I love that.
20:02
SPEAKER_00: I love that you said that.
20:03
SPEAKER_00: And I think that needs to be on every sweatshirt and every t-shirt that, you know, of anyone going in for a procedure, genuine.
20:10
SPEAKER_00: Because I I cannot tell you how many times I I see this, you know, whether it's social media or even just, you know, your friends and colleagues, you everybody has this, like, you know, when you go for a haircut, it's like, oh, this is the haircut I want.
20:21
SPEAKER_00: But then with aesthetics, it's like, oh, this is the nose I want, or this is the, you know, these are the lips I want.
20:26
SPEAKER_00: It's just like, how do you know that's gonna look good on you?
20:28
SPEAKER_00: You know, you don't stop yeah, it's ridiculous.
20:31
SPEAKER_01: I mean, and people have to understand that like treating the face is like it's like putting together an outfit for someone.
20:37
SPEAKER_01: Everything has to fit.
20:38
SPEAKER_01: You can't proportion.
20:41
SPEAKER_01: You know, you can't have lips, you can't have Cam Kardashian lips or one of those lips if you have like a tiny little little face.
20:49
SPEAKER_01: I mean, there's but there's ways of enhance features without destroying the face.
20:56
SPEAKER_01: I mean that it's it's really I mean, if I can take this message and and propel it, I mean it's very interesting because I talk about the use of signature feature in the context of the cosmetic consult.
21:07
SPEAKER_01: Because people come into the office and they and they like, I hate this, I hate that, I hate this.
21:12
SPEAKER_01: Oh, and here's a picture of who what I want to look like.
21:16
SPEAKER_01: Like, that's absurd.
21:17
SPEAKER_01: It's like first of all, you don't want to talk about what you hate about yourself.
21:20
SPEAKER_01: Let's talk about what's great about yourself and how we're gonna make that shine.
21:24
SPEAKER_01: Yeah, I love that.
21:26
SPEAKER_00: Yeah.
21:26
SPEAKER_00: Yeah, that's the way it's supposed to be.
21:28
SPEAKER_00: Well, that's it.
21:29
SPEAKER_00: No, I'm just gonna ask in terms of managing expectations, right?
21:32
SPEAKER_00: I mean, how is that like what you've seen lately with managing these expectations of these patients that do come in and are requesting these kind of drastic changes?
21:41
SPEAKER_01: Well, I mean, I think I'm so advanced in my career now that no one dares do that with me.
21:47
SPEAKER_01: I don't want to get up.
21:48
SPEAKER_01: And my reputation is for really not changing not, you know, I I mean, if anybody really says it to me, I'm like, wait a minute, I'm not working in the witness protection program, okay?
21:59
SPEAKER_01: So So we're not this is the wrong doctor for you.
22:04
SPEAKER_01: And I, you know, it's really it's just something I I should talk more about on my own social media.
22:09
SPEAKER_01: And um I don't know beauty's big.
22:12
SPEAKER_01: I mean, you can tell by all the trends in TikTok and all the other all the other sitter out there that people want to talk constantly about their skin and about their beauty and what to do and how to look their best.
22:26
SPEAKER_01: And and I have found it's really interesting looking at it generationally.
22:30
SPEAKER_01: And when we were talking about generations, we're really talking about the labels that the generations have, whether you're I guess the silent generation, where they don't talk about anything, they all still want to drive for God's sakes.
22:41
SPEAKER_01: We're like, no, no, no, let's take away your damn license.
22:44
SPEAKER_01: You just you just almost ran that person over.
22:47
SPEAKER_01: You get that, you know, right?
22:48
SPEAKER_01: And then then you get to the Gen Zs and the alphas, and they're like, they don't want to drive ever, you know?
22:54
SPEAKER_01: They're like, let me have a credited Uber.
22:57
SPEAKER_01: I mean, and it's so interesting.
22:59
SPEAKER_01: They don't get their licensing.
23:00
SPEAKER_01: But when you look at at the really the the people that are coming in for these treatments, you got the boomers and you've got the Gen X's, then you've got the Millennials, and you got the Gen Z.
23:10
SPEAKER_01: And you see different trends in the different groups, which are it's fascinating.
23:16
SPEAKER_01: And interestingly enough, it's the boomers.
23:19
SPEAKER_01: It's like the can do, like, okay, well, we can do.
23:22
SPEAKER_01: They don't tend to want to come in and though and have a different look.
23:25
SPEAKER_01: They just want, they don't want to age.
23:27
SPEAKER_01: They don't want to age forever, and they're gonna do anything to prevent aging because these are children of the 60s, you know, these flower people, these are like, yeah, we're young forever.
23:40
SPEAKER_01: All of them, yeah.
23:42
SPEAKER_01: Yeah, but it's a yeah, right, Brona Pippi.
23:44
SPEAKER_01: So it's just it's very, it's really fascinating.
23:46
SPEAKER_01: It's uh it's such an interesting field that I just kind of lucked into.
23:50
SPEAKER_01: I can't even, because it touches on so many important points culturally and and also physiologically too.
23:59
SPEAKER_01: So it's just it's a nice blend.
24:00
SPEAKER_00: Absolutely.
24:01
SPEAKER_00: And speaking of physiology, I would love for you to speak on the skin median rhythm.
24:05
SPEAKER_00: Because I know this is something that I'd love to get your opinion because you're you've worked with this and you understand this and and its role with like genes and genetics.
24:13
SPEAKER_00: So if you could tell us a little bit about how that plays into our overall skin health.
24:17
SPEAKER_01: Yes, absolutely.
24:19
SPEAKER_01: So along the way, because I lecture, I mean, I go to at least uh I was just counting how many meetings.
24:25
SPEAKER_01: I go to probably about 10 a year, nine or ten a year.
24:30
SPEAKER_01: So almost once a month am I going to a meeting?
24:33
SPEAKER_01: And so I often lecture, I mean, I almost all of them I lecture, but then I attend the lectures.
24:38
SPEAKER_01: So it's really interesting, it's so fascinating keeping up to date and it's to the latest and the greatest.
24:45
SPEAKER_01: And so here for several years I had learned that there were light receptors in the skin.
24:49
SPEAKER_01: And I was trying to understand why would there be light receptors in the skin?
24:52
SPEAKER_01: It's not connected to your central nervous system to interpret it as site.
24:57
SPEAKER_01: It's just light receptors.
24:58
SPEAKER_01: So it turns out that these light receptors, which are called opsins, and they sit on all these different cells in the skin.
25:05
SPEAKER_01: So we have cells that create the top layer, those are called keratinocytes, we have cells that that develop the pigment, those are melanocytes.
25:13
SPEAKER_01: And then the third most important one is the cells, of course, that create collagen and elastin and other other items that you find in your skin, and those are called fibroblasts.
25:23
SPEAKER_01: So these lights, these light sensors, essentially, they uh sit on all these cells.
25:28
SPEAKER_01: And so then I learned about four years ago there was a um a Nobel Prize awarded for the discovery of clock genes.
25:39
SPEAKER_01: Yeah.
25:39
SPEAKER_01: So clock genes, and the work, you know, once you get a Nobel Prize, that means the work's been going on for 15 at least years.
25:47
SPEAKER_01: So clock genes turn out they control half of your genome, and they do exactly what it sounds like.
25:53
SPEAKER_01: They turn things off and they turn things on.
25:55
SPEAKER_01: And so these clock genes seem in this seem to be linked to these options.
26:00
SPEAKER_01: Like, and so what is your skin programmed to do during the day, and what is the skin program to do at night?
26:07
SPEAKER_01: Was fascinating to me.
26:09
SPEAKER_01: And so that's the circadian rhythm.
26:11
SPEAKER_01: Now we have a central circadian rhythm that said like you know, things your body does during the day and at night, and that's in the brain.
26:19
SPEAKER_01: But every organ system that we have has its own circadian rhythm, which is kind of it's it's in general connected and and run by the central one, but also individually.
26:29
SPEAKER_01: So I thought, or individually, but individual organs.
26:32
SPEAKER_00: So these skin options, like um, I'm interested about the photobiomodulation of skin health and how they're tied in.
26:40
SPEAKER_00: Could you go into a little bit more depth on that?
26:42
SPEAKER_01: Yes.
26:43
SPEAKER_01: So photobiomodulation is a long technical word for how light affects basically the biology of the cell.
26:53
SPEAKER_01: And it turns out that it's very healthy.
26:56
SPEAKER_01: I mean, not we're not talking about like a lot of ultraviolet light.
27:00
SPEAKER_01: We're talking about a little bit.
27:02
SPEAKER_01: And what it does is it stimulates the production of energy by um, and these are specific wavelengths, I should say.
27:10
SPEAKER_01: So it's really not ultraviolet, it's a different wavelength.
27:13
SPEAKER_01: These are the um like 500 nanometers, these are the light-emitting diode wavelengths.
27:19
SPEAKER_01: And it stimulates your mitochondria, which are the little energy, um, they're the basically energy factories in the cell.
27:26
SPEAKER_01: It stimulates them to make more energy, more ATP, and also has influence on what proteins are being made and can basically the cell.
27:37
SPEAKER_01: So photobiomodulation is a real, it's a really important part of our system.
27:45
SPEAKER_00: Yeah, yeah.
27:45
SPEAKER_00: No, it's such an interesting term.
27:47
SPEAKER_00: That's why I was like, I I gotta learn about this because I mean I feel like we say biomodulation for a lot of things, you know, in the body.
27:54
SPEAKER_00: And it when it comes to the skin, it's always a neat.
27:57
SPEAKER_00: You know, it's it what you said earlier really kind of uh rang a bell for about the little bit of light that you know you need to activate certain, you know, whether it's receptors or genes or whatnot, like it's interesting because everyone talks about how with this the sunscreen culture that we have now and everything, like you want absolutely no light to hit your skin ever, you know.
28:17
SPEAKER_00: So it's very interesting.
28:19
SPEAKER_00: Yeah.
28:19
SPEAKER_00: I mean, from that perspective, it makes you wonder, you know, what really is the role of light in our overall health.
28:25
SPEAKER_00: And I know that there's a whole conversation around, you know, the big things like vitamin D production and stuff, but this is very new, you know, this idea of a little bit does impact you genetically, you know, in the long term.
28:38
SPEAKER_00: So, you know, I guess one of my follow-up questions is, you know, have you seen any data or any uh information come across about like epigenetic modifications in this way, you know, of these clock chains?
28:49
SPEAKER_00: I mean, has anybody even talking about that?
28:52
SPEAKER_01: But epigenetics are so epigenetics, just for the listener in case they don't know exactly what it is, is so we have in our long strands of DNA, we have specific sections that dictate, like they say, okay, we're gonna make collagen to make an easy example.
29:11
SPEAKER_01: Or we're gonna make this this segment of DNA makes collagen.
29:14
SPEAKER_01: But then right next to that gene, that protein coding segment, right next to it is a bunch of DNA that we don't really know what it does.
29:25
SPEAKER_01: And so we call this epigenetics.
29:27
SPEAKER_01: And so we're just kind of sorting it out.
29:29
SPEAKER_01: It's probably gonna take years to sort it out.
29:31
SPEAKER_01: But these this influence on the epigenetics, that those sections of the DNA actually are the ones that provide signals to turn on different genes and to turn off different genes.
29:43
SPEAKER_01: But and so, but they're not that those aren't the clock genes even, but they're still involved in the mix, and they're people used to think it was just junk DNA.
29:53
SPEAKER_01: And then that was year that probably 15 years ago or something, but now they know that they're influenced by environment and they're passed on, and so people that grew up or people who whose parents were in famine, like they have kids that get passed on, they have different food processing, like they literally will have a different kind of metabolism so that they hold on to food more.
30:19
SPEAKER_01: I mean, it's on it's really it's fascinating.
30:21
SPEAKER_01: It's fascinating.
30:22
SPEAKER_01: The body is is the mo is the biggest miracle ever, ever.
30:27
SPEAKER_00: It is, it really is, Dr.
30:29
SPEAKER_00: Sherman.
30:30
SPEAKER_00: I, you know, I was talking for everyone listening, I was talking to uh Dr.
30:33
SPEAKER_00: Sherman earlier, and I went to Case Western as well.
30:36
SPEAKER_00: And I remember my first lecture, Dr.
30:38
SPEAKER_00: Sherman at Case, we had a wonderful cardiologist come in, right?
30:42
SPEAKER_00: And she was starting our cardiologist section.
30:44
SPEAKER_00: You know, she said to me, um, this stands out now, and I love how she worded it.
30:48
SPEAKER_00: She said, you know, the heart, for example, like as an organ, it just starts out of nowhere, and we don't know how that happens.
30:55
SPEAKER_00: A lot of things in the body are like that.
30:58
SPEAKER_00: You're just we just can't explain it.
30:59
SPEAKER_00: And so when I look at skin health and I see all these things emerging, right?
31:03
SPEAKER_00: Like in terms of like the media and and the buzzwords that we love to use, it just makes you really appreciate that the human body is so dynamic, you know.
31:12
SPEAKER_00: We have we don't even know a percentage of what's going on and how it's all interacting together.
31:17
SPEAKER_00: So very, very fascinating, you know?
31:19
SPEAKER_00: Um yeah, I know, and well, it was such such an incredible medical school.
31:26
SPEAKER_01: I know, I know it's my favorite part of my educational experience as well.
31:30
SPEAKER_01: But so, but going back to what you were saying, I think that, you know, as we're starting to understand little by little, and then it actually helps us figure out the best treatment approach for whatever, for whatever organ system that we're looking at.
31:46
SPEAKER_01: And so for skin, the idea that your skin has certain tasks that it needs to do during the day and certain things that it needs to do at night, then what I decided was I thought, okay, well, there's no skincare program that really helps support all of the circadian rhythm of the skin, and to figure out like what are the best ingredients to help support the skin function.
32:12
SPEAKER_01: Like so I developed a skincare line that's called Althea that literally impacts the function of the skin during the day, and then it's a different formula for the function at night.
32:25
SPEAKER_00: So, what are the fundamentals of that, like the night and the day, um like the regimens you could go into?
32:30
SPEAKER_01: So the it has a proprietary the the um has the solar sink technology, which is a combination of botanically derived products that have been shown to improve cell function during the day, and the same at night.
32:43
SPEAKER_01: It's called lunar sink technology at night.
32:46
SPEAKER_01: So it's a it's a proprietary blend of peptides and antioxidants that yeah, and so and people who are using it, they really notice their skin has new glow and maybe it has a different because you're not kind of trying to fight against what the skin's trying to do.
33:02
SPEAKER_01: And I think that what's really interesting is there was there's a study ongoing looking at, for example, this is something that is easier to calibrate or to to measure, rather, is that kids who were in the intensive care unit, and these are kids who'd had bone marrow transplants and were very ill, and so they were receiving parental or IV nutrition.
33:26
SPEAKER_01: And so first they thought, well, we're just gonna feed them all the time, you know.
33:29
SPEAKER_01: So they turned on the they turned on the food like 24 hours.
33:33
SPEAKER_01: They would run.
33:34
SPEAKER_01: It's then it's an IV, 24 hours.
33:37
SPEAKER_01: And then they realized the kids weren't doing all that well.
33:39
SPEAKER_01: So then they then they tried doing it more like when you would eat.
33:44
SPEAKER_01: So during a 12-hour cycle.
33:46
SPEAKER_01: And they found that those kids did so much better.
33:49
SPEAKER_01: They gained more weight and they were able to leave the ICU sooner.
33:53
SPEAKER_01: Isn't that interesting?
33:54
SPEAKER_01: Wow, yeah, yeah, that is.
33:57
SPEAKER_01: So it's it was just based on the timing then.
33:59
SPEAKER_01: Um, right, because the body, because the body at night it doesn't process food.
34:04
SPEAKER_01: So you can imagine that the body's like trying to fend off all of this sugar that it's getting into the bloodstream, and where, you know, and probably that's causing a lot of inflammation because the body turns off.
34:18
SPEAKER_01: I'm just speculating here, but the body turns off all the systems that are designed to pull that sugar out of the blood system as opposed to letting it sit around and create these advanced glycation end products.
34:31
SPEAKER_01: So it's really so if you think about it, if you really kind of just even in a you know, 10,000 view thought about it, that you really need to be careful about what you're doing, about what time of day, because it does if your cells are trying to do certain things during the day and certain things at night, and if you mess around with them, it's not good.
34:49
SPEAKER_00: Right.
34:50
SPEAKER_00: Exactly.
34:51
SPEAKER_00: And you know, from that I want to actually ask, what are some if you could give us some tips on like, you know, what are some things maybe we should be doing, like, you know, in the daytime that is maybe going to be very, very beneficial down the road for our skin health.
35:04
SPEAKER_00: I mean, is there anything in terms of like lifestyle modifications that stand out to you that we could incorporate?
35:10
SPEAKER_01: Yeah, well, I mean, it's it's so the interesting thing is is all these things that we have known for a long time that are that are going to be good for you.
35:18
SPEAKER_01: So having a 24-hour routine, getting up at the same, you know, more or less the same time, going to bed more or the less, more or less the same time, eating, uh, you know, in a more narrow window.
35:32
SPEAKER_01: So not like, I mean, well, I don't know.
35:34
SPEAKER_01: I guess in Latin America, where I've been a lot this year, you know, people tend to eat later, but also they really don't eat much in the morning.
35:41
SPEAKER_01: They don't really eat in the morning, they really don't start eating till 12.
35:44
SPEAKER_01: So they're sort of eating at like a 12 to 10 at night uh program.
35:49
SPEAKER_01: Probably isn't that good for them.
35:51
SPEAKER_01: And even though they don't do it all the time.
35:53
SPEAKER_01: But so for for us, you know, it's better to have like eat during the day when it's light.
35:59
SPEAKER_01: Don't eat after, you know, 9 p.m.
36:02
SPEAKER_01: at night or 8 p.m.
36:03
SPEAKER_01: at night, let your cells like turn to their other job, which is basically repairing damage from well, because when we eat, we create oxidative um free radical byproducts.
36:15
SPEAKER_01: That's also just from eating, not just from exposure to toxins.
36:19
SPEAKER_01: And so that's damaging to the cells.
36:21
SPEAKER_01: So you want to let all the cleanup repair committee get in there and not have to worry about processing food.
36:27
SPEAKER_01: So basically, so going back to life, it's a lot of lifestyle.
36:30
SPEAKER_01: It's eating, it's eating foods that are high, they're high-quality foods.
36:36
SPEAKER_01: These don't have to be expensive.
36:37
SPEAKER_01: You can go get some dried beans and put them in a pressure cooker and then just get some vegetables and eat, you know, beans and vegetables and and uh brown rice and very lean protein, but most of the food on your plate is a is a variety of vegetables.
36:54
SPEAKER_01: And you eat well, you sleep well, you exercise.
36:57
SPEAKER_01: We're designed, we're not designed.
36:59
SPEAKER_01: I mean, this is one of our big problems.
37:01
SPEAKER_01: We're really not designed to sit at a desk for eight hours a day.
37:05
SPEAKER_01: We're just not.
37:06
SPEAKER_01: We're designed to walk around eight hours a day.
37:09
SPEAKER_01: And so if you're at if you have a desk, you know, hopefully you can get a walking desk.
37:14
SPEAKER_01: Or at least if you are at a desk, at least get up once an hour and do some, you know, do some quick yoga breathing, maybe expand your lungs, go up and down.
37:25
SPEAKER_01: I mean, what I do, I do a lot of walking.
37:27
SPEAKER_01: I that's kind of because I you do it as a walking meditation.
37:31
SPEAKER_01: Meditation is good, of course.
37:32
SPEAKER_01: I do a walking meditation and um and and then I talked to call people on the phone.
37:38
SPEAKER_01: But what I found, and so I'm outside of the streets in Los Angeles, is that I'll now I wear a mask because because of the pollutants, because I don't want to breathe in the exhaust from the cars, which of course have all these you know nappings there too.
37:55
SPEAKER_01: So yeah, it's a lot of it's a lot of like the basics, like your mother, I go to bed, you know, don't eat too late.
38:02
SPEAKER_01: Why are you eating that jump food?
38:05
SPEAKER_00: Right, but that's my mother used to be.
38:18
SPEAKER_00: And just in the beauty world, like we love to go on these like tangents, right?
38:22
SPEAKER_00: Of like, oh my gosh, if I do this, my skin's gonna be perfect.
38:25
SPEAKER_00: But then it's like you really have to reevaluate, you know, what are your fundamentals?
38:30
SPEAKER_00: You know, what are you doing?
38:31
SPEAKER_00: Like what the things that you mentioned, for example, like are you exercising?
38:34
SPEAKER_00: Are you sleeping?
38:35
SPEAKER_00: You know, are you eating like a healthy diet?
38:38
SPEAKER_00: I mean, those kind of questions.
38:39
SPEAKER_00: I just I it always baffles me that we're just we somehow lose psych, you know what I mean?
38:44
SPEAKER_00: And we end up coming back.
38:46
SPEAKER_01: Absolutely.
38:47
SPEAKER_01: Absolutely.
38:48
SPEAKER_01: And so, and one of my one of my heroes in the in uh in the uh well in the general field is this woman Elizabeth Blackburn.
38:55
SPEAKER_01: Sounds like a pri a pirate to me.
38:58
SPEAKER_01: So she got a Nobel Prize for for talking for uh really just and writing about the telomerase enzyme and also the telomers.
39:08
SPEAKER_01: So the telomeres are the little protein caps at the end of your of your DNA, your chromosome and your of your DNA.
39:16
SPEAKER_01: And so they're almost like the ends of of your laces and shoes.
39:19
SPEAKER_01: And so when they get, as they get shorter, that means your life, it's basically like like it, like the sand running out on the time of your life, because the shorter they get, the more like that that's kind of then they're about to be done with all the things they all the um items they support.
39:37
SPEAKER_01: So there is an enzyme to repair these telomers.
39:40
SPEAKER_01: It's called telomerase.
39:42
SPEAKER_01: And so the activity of the telomerase is also really tied to the tied to your overall health.
39:50
SPEAKER_01: And so she wrote, then she wrote a book about like how to increase the activity of your telomerase.
39:55
SPEAKER_01: Well, what do you think it is?
39:56
SPEAKER_01: It's the same thing.
39:58
SPEAKER_01: It's like don't eat crappy food, all that, all those high sugar fat, they're gonna they're gonna reduce the activity of your telomerase.
40:08
SPEAKER_01: Don't get better.
40:11
SPEAKER_01: Yeah, foods that are high in the antioxidants.
40:13
SPEAKER_01: It's all the same stuff.
40:15
SPEAKER_01: And you're like, really?
40:16
SPEAKER_01: The same message?
40:17
SPEAKER_01: I mean, I don't know if you remember the movie Sleeper with Woody Allen when he wakes up from his deep sleep.
40:22
SPEAKER_01: Yes, I mean when he wakes up from his deep sleep and the woman who's just like defrosted him or whatever says, Well, we've discovered that eating steaks and French fries is good for you.
40:35
SPEAKER_00: Yeah, I do, yeah.
40:37
SPEAKER_00: No, I mean I it's just so interesting because you know, yeah, like it really does.
40:41
SPEAKER_00: It comes back to fundamentals, and that's very interesting about the you know, the telomere is because I mean, even that conversation.
40:48
SPEAKER_00: I remember at one point, I think I don't think it was on the podcast, but somebody said something to me about telomeres.
40:53
SPEAKER_00: They were had this like very extensive theory, right, that they had going on.
40:57
SPEAKER_00: And I was sitting there, I'm like, you know, honestly, I don't think any of what you just said has anything to do with shortening or prolonging their life, right?
41:06
SPEAKER_00: It just it does didn't make any sense because it was so elaborate.
41:09
SPEAKER_00: And I think one of the fundamentals I've always taken away from like whether it's medicine or just interacting with people, is just you have to understand that the body is very simplistic but complicated at the same time.
41:21
SPEAKER_00: There are fundamental, simplistic things we have to do, like you said, you know, and and we just somehow as a society we keep skipping over all of this stuff, you know.
41:31
SPEAKER_00: It's like you can't skip over exercise, you can't skip over eating well, you know.
41:35
SPEAKER_00: It just doesn't, you're not gonna have good results at the end of the day.
41:38
SPEAKER_00: I mean, I think now they have machines out that are uh shaking people to make them exercise or something.
41:44
SPEAKER_00: I saw something crazy colored down Instagram.
41:46
SPEAKER_01: Yeah, no, it's no, it's it's unbelievable.
41:48
SPEAKER_01: I mean, I just wanted before before we finish up, I just talk a little bit about, I just forgot to mention my everybody's gonna kill me, but the uh with the skincare one that I designed, we also have an add-home tool called Kara.
42:02
SPEAKER_01: And this tool, the tool does have some of these LEDs and it has electromagnetic stimulation, so you get a muscle contraction, it also has some radio frequency, which is healthy through the skin.
42:13
SPEAKER_01: So talk going back to those micro injuries, this you can do with this Cara device, which is gorgeous.
42:19
SPEAKER_01: Okay, good, but going back, yeah, so it's really nice.
42:22
SPEAKER_01: It's a nice companion piece, and so it's something that can extend if you've had a treatment um and enhance the treatment at an office, or if not, just something that you that you can just do on a regular basis and it's going to improve you, improve your quality of your skin.
42:39
SPEAKER_01: So, I mean, so that sort of ties into this whole idea of like, how do we stay healthy?
42:45
SPEAKER_01: How do we stay youthful?
42:47
SPEAKER_01: You know, we can have all the AI in the world.
42:52
SPEAKER_01: So if we ever like have AI put in, guess what the AI is going to tell these human bodies to do?
42:57
SPEAKER_01: It's gonna make sure that we eat, improve our food choices, it's going to make us exercise because you know, we're not the uh you can have all the bionics you want, but it's not gonna take away that need for exercising.
43:10
SPEAKER_01: And then it's going to make sure that you don't roast yourself in the sun like a moron, and it's make sure that you put your damn skincare on on a regular, you know, twice a day like you're supposed to.
43:22
SPEAKER_00: Yeah.
43:23
SPEAKER_00: Exactly, exactly.
43:24
SPEAKER_00: And that's the thing, is this it's the fundamentals, but it's very intriguing that you actually created a device for the um the micro injuries.
43:31
SPEAKER_00: That's very, very cool.
43:32
SPEAKER_00: And I I would actually love for our listeners to check that out because you know, it's really interesting your approach for Dr.
43:38
SPEAKER_00: Shambin to this idea of cell turnover.
43:41
SPEAKER_00: So I think coming back to that, like it is just very fascinating to me because the only time I ever hear this conversation take place is, you know, when we're talking about vitamin A derivatives.
43:50
SPEAKER_00: That's it.
43:50
SPEAKER_00: Nobody else seems to be talking about it.
43:52
SPEAKER_00: But um, I really encourage our listeners, you know, check that out because there's a lot of you know value and understanding.
44:00
SPEAKER_00: you know, how does the skin really turn over?
44:02
SPEAKER_00: You know, and how does it really rejuvenate itself?
44:04
SPEAKER_00: So this is this is brilliant.
44:06
SPEAKER_00: Um I'm glad that you brought that and mentioned it.
44:08
SPEAKER_00: But yeah, but Shuma, thank you so much.
44:10
SPEAKER_00: This has been so enlightening.
44:11
SPEAKER_00: And I want to round out the interview by just asking for some words of wisdom from you.
44:15
SPEAKER_00: You know, I know there's a lot of people in our um in our audience that are they they want to go into maybe medicine or they want to understand medicine more.
44:24
SPEAKER_00: Like what would you recommend to somebody who wants to do a deeper dive and learn more about these you know really in-depth dermatological like you know fundamentals and concepts where could they start and what should they be doing?
44:36
SPEAKER_01: And I haven't really thought about that.
44:39
SPEAKER_01: I think that first of all I think healthcare in general is a really interesting field.
44:45
SPEAKER_01: You don't have to be a physician.
44:47
SPEAKER_01: Being a physician is like I don't know it's so competitive to get into medical school.
44:51
SPEAKER_01: Not that if you want to do it, go for it.
44:53
SPEAKER_01: Yeah.
44:54
SPEAKER_01: Yeah go for it.
44:57
SPEAKER_01: I'm not going to discourage anybody.
44:59
SPEAKER_01: But let's say you know four years of medical school, four years of training, doing all the pre-med let's say that's a bit much for you.
45:05
SPEAKER_01: Well then I really suggest either doing becoming a nurse and then a nurse practitioner.
45:11
SPEAKER_01: And nursing school is three years and you can do it in accommodation with a bachelor's degree and then I think it's maybe four years over five.
45:21
SPEAKER_01: And then being a nurse for a while you can become a nurse practitioner.
45:24
SPEAKER_01: Also you can become a physician's assistant.
45:27
SPEAKER_01: That's only a two year program but you have to have two years of um experience somewhere in the medical field to be a physician's assistant.
45:35
SPEAKER_01: And then also just being an RN and then you can just check it out.
45:39
SPEAKER_01: So with dermatology specifically but I mean it's so easy and listen you can do a podcast but I'll have to I'll have to like get you some actual leads for that to see.
45:53
SPEAKER_01: Yeah.
45:53
SPEAKER_01: But dermatology is yeah dermatology especially is it's really a fascinating one.
45:58
SPEAKER_00: Absolutely absolutely and I I thank you so much Dr.
46:01
SPEAKER_00: Shannon this has been such a fun interview and I love learning from you.
46:05
SPEAKER_00: There's so much knowledge here for everyone listening I really encourage you to listen back on the episode and really look into some of the great great insights that Dr.
46:13
SPEAKER_00: Shannon has shown us and I will be tagging everything in the concept art for this episode so stay tuned for that and I'm definitely we'll be tagging the products as well from um the line that was mentioned and so please stay tuned and thank you so much for tuning in.
46:26
SPEAKER_00: Thank you Dr.
46:26
SPEAKER_00: Shambin it was such an honor to host you.
46:29
SPEAKER_00: Thank you so much.
46:30
SPEAKER_00: My pleasure hey guys so I hope you love that episode please make sure to hit subscribe if you're tuning in to us on any podcast platform.
46:38
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47:33
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47:38
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