Latest / The Science of Skin / Injectables and Their Evolution

Transcript

Injectables and Their Evolution · The Science of Skin

• 0:05
  SPEAKER_00: Hello and welcome to the Science of Skin Podcast.
• 0:08
  SPEAKER_00: My name is Dr.
• 0:08
  SPEAKER_00: Ted Lane.
• 0:09
  SPEAKER_00: I am a board-certified dermatologist practicing in Austin, Texas.
• 0:13
  SPEAKER_00: And with me today, I have a very special guest, Dr.
• 0:15
  SPEAKER_00: Hassan Galidari.
• 0:17
  SPEAKER_00: Dr.
• 0:17
  SPEAKER_00: Galidari is worldwide, world-renowned.
• 0:21
  SPEAKER_00: He is an associate professor at the UAE University and is also a co-owner of Galidari Derma in Dubai.
• 0:29
  SPEAKER_00: Hassan, how are you?
• 0:31
  SPEAKER_00: I'm very well.
• 0:31
  SPEAKER_00: Thank you, Ted.
• 0:32
  SPEAKER_00: Thank you for having me.
• 0:33
  SPEAKER_00: Oh my gosh, we're so excited to have you.
• 0:34
  SPEAKER_00: So Hassan and I are and Patty are all in Germany, where we have just finished up a longevity summit uh at the Beyersdorf headquarters.
• 0:43
  SPEAKER_00: But uh Hassan and I have known each other for some time now, and I thought I traveled a lot, Hassan.
• 0:48
  SPEAKER_00: Uh and then there's you.
• 0:52
  SPEAKER_00: I mean, in addition to being a university professor, in addition to to kind of running your practice and practicing with your father, which I think is just amazing, you also are in charge of trying to get world congress to Dubai.
• 1:06
  SPEAKER_01: That is correct.
• 1:07
  SPEAKER_01: Yes.
• 1:07
  SPEAKER_01: Yeah, we've been trying to get that Congress.
• 1:10
  SPEAKER_01: I mean, the first time that we thought about it was after the uh Seoul World Congress in 2011.
• 1:15
  SPEAKER_01: So we bid a couple of times before.
• 1:17
  SPEAKER_01: We lost to Milan, so it went to Milan, and then we lost to Singapore, it went to Singapore.
• 1:21
  SPEAKER_01: We decided that we're not going to do it for the for one time, which and that's the reason why it's in Guadalajara, but hopefully the next one, we're definitely shooting for that one in 2031.
• 1:31
  SPEAKER_00: Wow.
• 1:31
  SPEAKER_00: So persistence, huh?
• 1:33
  SPEAKER_00: Oh yeah.
• 1:34
  SPEAKER_00: Oh yeah.
• 1:34
  SPEAKER_00: Not giving up.
• 1:35
  SPEAKER_00: What is it?
• 1:36
  SPEAKER_00: What's involved with trying to host a world congress?
• 1:40
  SPEAKER_01: Ah, a lot of things are involved.
• 1:42
  SPEAKER_01: I mean, there is the international aspect of things, and then there is the national aspect of things.
• 1:46
  SPEAKER_01: The international aspect is actually pretty easy.
• 1:50
  SPEAKER_01: Uh, you have to kind of garner support from all the different societies that are member of members of the International League of Dermatological Societies, which is the ILDS.
• 1:59
  SPEAKER_01: That's the organizing body that puts together the World Congress of Dermatology.
• 2:03
  SPEAKER_01: So uh it can it has at least, I believe, 250 member societies.
• 2:08
  SPEAKER_01: So those member societies are the ones who vote of where the World Congress is going to be held.
• 2:13
  SPEAKER_01: So the next vote is going to happen in Guadalajara.
• 2:15
  SPEAKER_01: They're going to be voting for 2031 and where the Congress is going to be.
• 2:19
  SPEAKER_01: So that's the reason why I travel a lot, is that because I need to gain their support.
• 2:23
  SPEAKER_01: And for me to do so, I need to kind of go there, see them, shake their hands, make sure that they're happy, uh, that you know they they they know that the the organizer or the president of the bid is a nice guy, and then they, you know, they put in the vote.
• 2:36
  SPEAKER_01: It's it's the same thing as like, you know, at the American elections, I guess.
• 2:39
  SPEAKER_00: Yeah.
• 2:39
  SPEAKER_00: It's if you ever walk with Hassan in an international symposium, it's amazing because people from every part of the world would stop and say hi.
• 2:48
  SPEAKER_00: And Hassan, you know everyone's name.
• 2:51
  SPEAKER_00: It's amazing.
• 2:54
  SPEAKER_00: I I try.
• 2:55
  SPEAKER_00: I try.
• 2:56
  SPEAKER_01: Sometimes people will come in and they were like, Hey Hassan, how are you?
• 3:00
  SPEAKER_01: And like, you know, they shake your hands and they hug you, and then they go and they're like, Who was this person who just passed by?
• 3:06
  SPEAKER_00: Yeah, but for the most part, you know everybody.
• 3:08
  SPEAKER_00: It's really incredible.
• 3:09
  SPEAKER_00: But you know, in addition to all of the work you're doing trying to bring the World Congress to Dubai, and if I had a vote, I would vote for it.
• 3:17
  SPEAKER_00: Uh, I think you also are are kind of a worldwide leader in injectables, right?
• 3:22
  SPEAKER_01: I do, yes.
• 3:23
  SPEAKER_01: That's that's my claim to fame.
• 3:24
  SPEAKER_01: I mean, I do a lot of work uh with injectables.
• 3:27
  SPEAKER_01: Uh I'm the most of my publications and my research are is in the world of injectables.
• 3:31
  SPEAKER_01: Uh so yes, so I've I've been doing it, I would say.
• 3:35
  SPEAKER_01: The reason for this is that because my mentor, when I was a long time ago, a fellow at UCSF, uh, my mentor was uh was Rick Glogau, and uh he was the world-renowned in injectables, so I kind of picked up the baton from him, and that's that's how it continues.
• 3:52
  SPEAKER_00: And so, you know, I I remember we have spoken about biostimulatory fillers quite a bit, and and I feel like based on the research that I'm doing in Austin and and certainly your experience, that is the few it seems to be the future of fillers worldwide.
• 4:06
  SPEAKER_00: Um, what do you think?
• 4:08
  SPEAKER_01: I I think so.
• 4:09
  SPEAKER_01: I mean, there it's it's kind of split between two ways.
• 4:12
  SPEAKER_01: I mean, there is a push pretty much from society right now, and and social media is basically telling us we don't want to be overfilled anymore.
• 4:21
  SPEAKER_01: We want to look natural.
• 4:23
  SPEAKER_01: And um the hyonic acids, I mean, if you look at them in terms of like you know, the way that they've been utilized across the medium, the many decades that they've been around, it they just simply filled uh a compartment.
• 4:36
  SPEAKER_01: Uh so skin quality, stimulating urine collagen, and so forth, even though those other materials, such as for example, calcium hydroxylapatide, polyelactic acids, were available during that time, they were not really kind of utilized as much.
• 4:48
  SPEAKER_01: Uh, but now, given the fact that there is definite demand and there's just a ton of research that basically showcases how those materials work, that's the reason why there's been kind of a shift now, a paradigm shift from just the HA fillers to more of the biostimulatory fillers.
• 5:06
  SPEAKER_00: So when you're thinking about the biostems and and you are trying to decide between, for example, hybrid dilute calcium hydroxylapetite versus a polylactic acid, what are the decision points that you have in your mind as you look at a patient and try and ensure you get the best possible outcome?
• 5:22
  SPEAKER_01: So, I mean, there there are many different different things.
• 5:25
  SPEAKER_01: First of all, it's the phenotype of the patient itself.
• 5:27
  SPEAKER_01: I mean, are we talking about a patient who is gaunt, who's quite thin, the skin is also quite thin, and they would require a stepwise approach in which you would want to kind of lead to a thickening of uh basically the dermis to get that you know biostimulatory effect.
• 5:42
  SPEAKER_01: And here you would think about things, for example, such as your polyelactic acid.
• 5:46
  SPEAKER_01: They will they they don't work, you know, uh they work very gradually.
• 5:49
  SPEAKER_01: That's let's put it that way.
• 5:50
  SPEAKER_01: They require multiple treatments, but once they are settled in, you know, the results are there for a long period of time.
• 5:57
  SPEAKER_01: So I would utilize those, for example, for patients who are quite thin and also patients who are glow-gal.
• 6:04
  SPEAKER_01: I I love using the glow gal wrinkle scale.
• 6:06
  SPEAKER_01: So I would the photoaging scale there for me would be a global type three or four.
• 6:11
  SPEAKER_01: Uh a global type severe.
• 6:13
  SPEAKER_01: Yeah.
• 6:14
  SPEAKER_01: So a global type two or three, those are the less severe individuals, would probably you know get better results with the hyperdilute calcium hydroxylapatite.
• 6:23
  SPEAKER_01: So that's the reason why I would utilize that a little bit more.
• 6:26
  SPEAKER_01: You have more of the natural skin that is still there, it just needs a little bit of a push, a little bit of neocollagenesis.
• 6:33
  SPEAKER_01: They don't require the polyolactic acid effect.
• 6:35
  SPEAKER_01: So that's the reason why I would utilize caja for them.
• 6:38
  SPEAKER_00: You know, practicing in the UAE, I would imagine most of your patients are type 3-4.
• 6:43
  SPEAKER_00: Uh is that right?
• 6:44
  SPEAKER_00: Uh I see a lot of young patients actually.
• 6:47
  SPEAKER_00: Oh, do you?
• 6:48
  SPEAKER_00: Yeah.
• 6:48
  SPEAKER_00: Well, do yeah.
• 6:49
  SPEAKER_00: I'm actually talking about phototype 3-4.
• 6:51
  SPEAKER_00: Sorry.
• 6:51
  SPEAKER_00: I should say, uh, you're talking about Fitzpatrick, yes, yes.
• 6:54
  SPEAKER_00: Yeah.
• 6:54
  SPEAKER_00: And so do you feel like there's any difference in the product choice based on the phototype or just on the Glogau type?
• 7:01
  SPEAKER_01: No, it's mainly on the Glow Gal type.
• 7:03
  SPEAKER_01: Okay.
• 7:03
  SPEAKER_01: Uh now that being said, I mean, if you look at the Fitzpatrick type also, I mean, the the skin is definitely thicker in patients who are of type 5 and 6, as compared, for example, to those patients of type 1 and 2.
• 7:14
  SPEAKER_01: So for those type of individuals, you would definitely kind of shoot more or less with the calcium hydroxylapetite rather than, for example, your polyolactic acid.
• 7:23
  SPEAKER_00: Another major kind of player in in Europe, at least, and I would imagine in the in the Emirates as well, is is uh PDRN.
• 7:32
  SPEAKER_01: Yes.
• 7:33
  SPEAKER_00: Which we don't, we can only use topically in the United States.
• 7:36
  SPEAKER_00: And and so, and we're just trying to learn about it more, how how effective it is topically.
• 7:41
  SPEAKER_00: We love the idea of it working through the A2 receptor for anti-inflammatory purposes as well as being kind of a reservoir of of material to help repair DNA.
• 7:51
  SPEAKER_00: But how what are your experiences with it injected?
• 7:54
  SPEAKER_01: So, uh first of all, we have to differentiate between polynucleotides and pdrns.
• 8:00
  SPEAKER_01: Thank you.
• 8:01
  SPEAKER_01: Yes.
• 8:01
  SPEAKER_01: So that that's that's very, very important.
• 8:03
  SPEAKER_01: The polynucleotides are much larger, they're the ones that are being injected.
• 8:07
  SPEAKER_01: The PDRNs are usually not, they're the ones that are found more or less topically.
• 8:11
  SPEAKER_01: Uh their source is also different.
• 8:13
  SPEAKER_01: One is actually from their salmon sperm, the other one is actually from the salmon testes.
• 8:18
  SPEAKER_01: So they're the the in terms of sourcing is also very different.
• 8:21
  SPEAKER_01: So these are the two uh two basic kind of differentiations between the two of them.
• 8:27
  SPEAKER_01: Now, you've mentioned correctly, I mean, in terms of what the pathways, there are two pathways in which they tend to work.
• 8:32
  SPEAKER_01: One is the alpha-2 receptors and basically affecting the inflammatory process, then the other one is that it's it has this DNA salvage pathway, so you're injecting material that basically contains a lot of you know, pretty much DNA, bioproducts, and materials that the body is then able to kind of utilize because there's a reservoir of it and kind of puts it together and allows pretty much for the for you know a stimulatory effect.
• 8:55
  SPEAKER_01: So the way that if you look at it under the microscope, it has a scaffold, it looks like an actual scaffold.
• 9:02
  SPEAKER_01: And the the more viscous the product is, the more the scaffolding it is, and uh that's how it tends to work out.
• 9:08
  SPEAKER_01: So you're just simply creating these scaffolds in the dermis that allows pretty much stretching of the fibroblasts, because we've known that stretching the fibroblasts themselves allows it to be activated.
• 9:20
  SPEAKER_01: So that's how it tends to work out in a way.
• 9:23
  SPEAKER_01: But I have to admit, and they also admit, pharma research, for example, one of the leading companies that makes uh polynucleotides out of South Korea, have you know, admit that there is definitely a lot of studies that are coming out on the pipeline that will hopefully showcase how the actual material tends to work.
• 9:41
  SPEAKER_01: When it comes to polynucleotides, you know, the hype kind of beat the science, but the science is definitely catching up.
• 9:47
  SPEAKER_01: And hopefully once that happens, you'll definitely see a lot of you know a lot of it pretty much in the literature.
• 9:54
  SPEAKER_00: I didn't realize that it acted as a scaffold.
• 9:56
  SPEAKER_00: I've always wondered if it was a true filler or is it just kind of biostimulatory in and of itself, and it sounds like it's the latter.
• 10:02
  SPEAKER_00: Yes, yes, it is.
• 10:03
  SPEAKER_00: Okay.
• 10:04
  SPEAKER_00: And what kind of results do you see?
• 10:06
  SPEAKER_00: I mean, is this something where you inject in the deeper dermis as well as superficially?
• 10:10
  SPEAKER_00: Are there multiple different types of products?
• 10:12
  SPEAKER_01: I I I love this question.
• 10:14
  SPEAKER_01: Uh so that you you have to think of the aging process as complex and at the same time as multi layer.
• 10:18
  SPEAKER_01: So if you're looking at the aging complex when it comes, for example, to the skeletal aspect of things, here you would use things that are of volumizing in nature, high G prime things that are quite stiff that is able to give you structure.
• 10:31
  SPEAKER_01: So here, a perfect example would be your high volumizing HA fillers, would work very, very well into that area.
• 10:37
  SPEAKER_01: Deep fat compartments also you would utilize your volumizing high G prime HA fillers.
• 10:43
  SPEAKER_01: Now we're moving a little bit more to the upper parts of the skin, the uh superficial fat compartments, very close to the dermis, but you're still subdermal.
• 10:51
  SPEAKER_01: For those individuals, you're basically going to be utilizing your dilute or hyperdilute calcium hydroxylapatite or your polyelactic acid.
• 10:59
  SPEAKER_01: So it works in a way, and it's been published, you know, Sebastian Kodofana has mentioned this a number of times, that even if you're injecting it subdermally, there is a communication into the dermis where you actually see thickening of the dermis if the material is injected in the subdermal plane.
• 11:14
  SPEAKER_01: So that happens into that area, and then more superficial to ensure that you are in the dermis itself, that's where you would utilize something like your polynucleotides, because that's where they're going to work on.
• 11:26
  SPEAKER_01: Now, granted, there have been some studies, and pharma research is working on it, or some of the companies are working on it.
• 11:32
  SPEAKER_01: If you do inject them in the subdermis, because of that communication, you can see an effect.
• 11:37
  SPEAKER_01: Up until now, however, for you to get the optimum results, they have to be injected mainly into the dermis with a needle.
• 11:44
  SPEAKER_00: Okay, mainly in the dermis with the needle.
• 11:46
  SPEAKER_00: And are the results immediate or does it take some time?
• 11:50
  SPEAKER_01: So, yeah, so that's also a good question.
• 11:52
  SPEAKER_01: The only thing that's very immediate that happens immediately is probably your HA volumizing fillers.
• 11:57
  SPEAKER_01: You see the results, boom.
• 11:58
  SPEAKER_01: This is, you know, you get you get your correction, uh, usually more or less one-to-one if you want to get the best results.
• 12:04
  SPEAKER_01: The uh biostimulators that you're injecting subdermally in the superficial plane, uh, those would require at least anywhere between, I would say, uh four to six weeks for you to see some, you know, some formal results.
• 12:18
  SPEAKER_01: And then you would have your polynucleotides, which also that are injected even much more superficial, you would require multiple treatments a month apart, and you know, you'd need at least three months of those treatments to see some significant results.
• 12:33
  SPEAKER_00: It's almost like a skin booster with the polynucleotides, is is how I'm thinking of it.
• 12:38
  SPEAKER_01: That's right.
• 12:39
  SPEAKER_01: But your skin boosters contain hyaluronic acid, so they hydrate, they're able to absorb water and they hydrate the skin.
• 12:44
  SPEAKER_01: This one does not do that.
• 12:45
  SPEAKER_01: This one does not work on the hydration aspect.
• 12:48
  SPEAKER_01: Is there quite a bit of inflammation since you're injecting something so foreign?
• 12:52
  SPEAKER_01: Quite the opposite, actually.
• 12:53
  SPEAKER_01: It's it it's it leads to less of an inflammatory response.
• 12:57
  SPEAKER_01: And you know, we've seen that also in terms of like, you know, the uh looking at all the inflammatory markers, we see that they become, they become less, you know, less active, let's put it that way, once uh your polynucleotides are injected.
• 13:10
  SPEAKER_00: Oh wow.
• 13:11
  SPEAKER_00: It's just totally fascinating to me, the whole the polynucleotides and PDRN.
• 13:15
  SPEAKER_00: I can't wait for the science to catch up, as you said.
• 13:18
  SPEAKER_00: It's much like exosomes.
• 13:19
  SPEAKER_00: I mean, I think we probably are a little bit more excited about polynucleotides than we are currently about exosomes, although maybe the science will catch up there as well.
• 13:27
  SPEAKER_01: I I can tell you, with it with regard to the exosomes, there's a lot of variability there because you're dealing with uh exosomes of different origins.
• 13:35
  SPEAKER_01: Um, and you know, plant origin is different than human origin exosomes.
• 13:39
  SPEAKER_01: That's one thing.
• 13:40
  SPEAKER_01: And then, you know, when it comes to the exosomes, exosomes are like a basket of materials that you don't know which one is actually actively working.
• 13:47
  SPEAKER_01: With the polynucleotides, I mean, you definitely know that that you've got polynucleotides that are there that are working for you.
• 13:53
  SPEAKER_01: With exosomes, I feel that the materials, you know, they are pretty much unnamed or unknown.
• 14:00
  SPEAKER_01: You don't you don't really know what's being injected or what's basically being applied, and you don't know which one is actually working for you.
• 14:07
  SPEAKER_01: So for me, exosomes is like a big umbrella that encompasses a lot of probable actives and a lot of probably inactive ingredients.
• 14:15
  SPEAKER_00: We're here at Beiersdorf because we were involved in a longevity summit, as I mentioned, and there's a new product from Beiersdorf really focused on the epigenome.
• 14:24
  SPEAKER_00: And I had the scientist on the podcast already, Dr.
• 14:27
  SPEAKER_00: Elka Groninger, talking about you know how you know demethylates and and how that can affect the epigenome.
• 14:34
  SPEAKER_00: But you know, above just a single product, just in your mind, as you are an expert in in aesthetic dermatology, including skincare, tell us what your thoughts are about longevity.
• 14:46
  SPEAKER_00: And is it is there longevity in dermatology with longevity?
• 14:53
  SPEAKER_01: You're not making it easy for me there, Ted.
• 14:58
  SPEAKER_00: You're an expert.
• 14:59
  SPEAKER_01: I mean, I I I could tell you, I mean, it it all depends on your your definition of what longevity is.
• 15:05
  SPEAKER_01: I mean, you can easily make a cell live longer, but like are you are you making are you allowing that cell to actually behave in a much more youthful kind of way?
• 15:14
  SPEAKER_01: Is the cell optimized to produce whatever it is it's supposed to be doing, whether it's the production of collagen, HA, or even elastin?
• 15:22
  SPEAKER_01: I mean, or is it just simply a viable cell?
• 15:24
  SPEAKER_01: So for me, I mean that's that's very very important for you to be able to kind of differentiate between the two because you know you could put a cell in a medium and allow it to live, but is it actually alive?
• 15:36
  SPEAKER_01: Is it doing something?
• 15:37
  SPEAKER_01: So uh when it comes to the stuff that, for example, the utilization of you know the epicilline that was mentioned, you're not just allowing the cell to live, you're actually allowing it to behave in the way that it's supposed to be doing.
• 15:50
  SPEAKER_00: So much more efficiently, right?
• 15:51
  SPEAKER_00: You're you're it's it's acting as a much more efficient cell uh and hopefully living for a longer period of time and allowing us to maintain our health for a longer period of time as well.
• 16:02
  SPEAKER_00: That's just kind of going back to the polynucleotides PDRN with the anti-inflammatory effect.
• 16:06
  SPEAKER_00: You wonder if you have, you know, I lectured yesterday on the we we have to look at multiple hallmarks of aging.
• 16:13
  SPEAKER_00: We have to have multiple pathways towards longevity.
• 16:16
  SPEAKER_00: And perhaps targeting the epigenome with one product, targeting inflammation with another product, that combination may be really interesting uh for longevity purposes.
• 16:28
  SPEAKER_01: Yeah, I mean i i i I I I I agree with you.
• 16:31
  SPEAKER_01: I mean, there's it seems to me that inflammation is probably the root of all evil when it comes to the aging process.
• 16:40
  SPEAKER_01: Hence the reason why there the the coin, you know, the term the inflammation has just kind of like been you know popping up everywhere now in terms of uh sessions or in terms of symposia or anything of that sort.
• 16:50
  SPEAKER_01: So and there's a number of ways in which you're able to do so, whether it's through the injectables, such as, for example, your polynucleitots, or whether it's your GLP ones.
• 16:58
  SPEAKER_01: I mean, you're we definitely see that the inflammatory processes and markers are much less in patients who are on GLP ones.
• 17:05
  SPEAKER_01: Uh, there was a discussion just recently, right now, is that people who are on GLP1s, if they are dosed correctly, you notice that their skin gets better.
• 17:14
  SPEAKER_01: You know, even though they may have they lose a lot of probably, you know, fat in the face and so forth and all that, but their skin texture, their tone, it gets better.
• 17:23
  SPEAKER_01: So it's all a matter of like finding the right balance between, you know, to decrease that inflammatory process.
• 17:29
  SPEAKER_00: I'm so glad you mentioned that, Hassan, because I feel like there's been some misinformation about GLP1s and its effect on appearance.
• 17:36
  SPEAKER_00: And certainly we lose muscle and fat, especially early on in the GLP1 journey.
• 17:41
  SPEAKER_00: And maybe if it's if the dose is too high as well, we just the sarcopenia can really outweigh uh a lot of the beneficial effects, and you look a little bit sallow because of that.
• 17:52
  SPEAKER_00: But if you look at the skin quality, right?
• 17:55
  SPEAKER_00: Not not the sagging like you mentioned, but if you look at the actual skin quality, I completely agree that I I think it it does improve whilst on a GLP one.
• 18:04
  SPEAKER_00: Uh maybe it's the reduction in inflammation.
• 18:07
  SPEAKER_00: I I think that's probably part of it.
• 18:09
  SPEAKER_00: Uh, but maybe there are other aspects which we which still need to be studied.
• 18:13
  SPEAKER_00: And I am, you know, I've been speaking to some companies that are in the medical space with the GLP1 agonist to, hey, can we can we start doing some skincare studies, like skin quality studies?
• 18:23
  SPEAKER_00: Because I really feel like there's a benefit there.
• 18:26
  SPEAKER_00: Uh, I just saw an article showing that GLP1 agonists decrease the risk of endometrial cancer over time.
• 18:32
  SPEAKER_00: Uh, you know, so there's it's incredible what these uh new medications are able to do.
• 18:38
  SPEAKER_00: And the next generations, which are able to avoid the sarcopenia effect, are going to be even more and more popular and probably more effective.
• 18:48
  SPEAKER_00: So uh I do believe that GLP1 agonists will become part of an anti-aging or a longevity routine, if not now, then very soon.
• 18:57
  SPEAKER_00: Uh, and so I think derms, it's incumbent upon us to really understand all the effects of GLP1s, including body and skin.
• 19:04
  SPEAKER_01: I mean, well one of the hypotheses that were that was mentioned uh during the symposium today was does it work on the the because we know that during the aging process we have glycation products byproducts that tends to happen in our skin.
• 19:15
  SPEAKER_01: And if you a person is on GLP1s, uh maybe there is changes in the glycation, and hence the reason why people start looking better.
• 19:23
  SPEAKER_01: The skin starts becoming more radiant, more luminous, and uh is of better quality.
• 19:29
  SPEAKER_00: I love that you brought that up.
• 19:30
  SPEAKER_00: I mean, anti-glycation, excuse me, advanced glycation end products are due to excess glucose in the system.
• 19:36
  SPEAKER_00: And unfortunately, our cells have receptors for advanced glycation end products.
• 19:41
  SPEAKER_00: They're called RAGE receptors, right?
• 19:43
  SPEAKER_00: Receptors for advanced glycation end products.
• 19:46
  SPEAKER_00: And that leads to all sorts of uh bad things in the cell, including increase in NF kappa B uh pathway uh activation and therefore inflammation.
• 19:56
  SPEAKER_00: So uh whatever we can do to decrease advanced glycation end products, it's really important.
• 20:02
  SPEAKER_00: And first of all, it's diet and exercise, but also their GLP1 agonists, perhaps by themselves as molecules, but also just by decreasing appetites, might do it.
• 20:12
  SPEAKER_00: Uh, and then we have some new skincare products that that target AGEs as well.
• 20:17
  SPEAKER_00: So um I love that you brought that up.
• 20:19
  SPEAKER_00: It's it's really interesting now, isn't it, Hassan, that in skincare we're talking about body care.
• 20:24
  SPEAKER_00: It's just all part and parcel of the same thing, isn't it?
• 20:28
  SPEAKER_00: It is, it is.
• 20:29
  SPEAKER_00: Yeah, we we all need to become full-body doctors.
• 20:32
  SPEAKER_00: Okay, I just wanted to take a few minutes, Hassan, just to talk about being a dermatologist in Dubai.
• 20:37
  SPEAKER_00: You what's it like?
• 20:38
  SPEAKER_00: It seems like such an itinerant city.
• 20:40
  SPEAKER_00: There's so many people coming through there.
• 20:42
  SPEAKER_00: What's it like?
• 20:44
  SPEAKER_01: All right.
• 20:44
  SPEAKER_01: Well, uh it's it first of all, it's amazing.
• 20:46
  SPEAKER_01: I have to tell you that.
• 20:47
  SPEAKER_01: Uh, I mean, I am from Dubai.
• 20:49
  SPEAKER_01: I mean, born and raised, I'm I'm I'm an Emirati.
• 20:52
  SPEAKER_01: Uh, we are a minority in our own uh country, which is fine because it allows us to become more, you know, uh more receptive to the outside world.
• 21:01
  SPEAKER_01: I mean, you call me international, and the reason why I'm international is because every all the nationalities that I see that I experience whenever it is that I travel, I've already seen, I've already experienced, I know how to communicate with them from back home because I've already seen them there.
• 21:14
  SPEAKER_01: I've been exposed to them.
• 21:16
  SPEAKER_01: Hence the reason why Dubai is just a wonderful city to be in.
• 21:18
  SPEAKER_01: Now, I can tell you that the Dubai that I grew up in uh back in the 80s and the 90s is much different than the Dubai that you're seeing right now with all the glitz and the buildings and so forth.
• 21:28
  SPEAKER_01: Uh, it's definitely changed, but it's changed for the better.
• 21:32
  SPEAKER_01: And for me, I mean, it's it's it's the city that I hope that all other cities that are from all over the world kind of like emulates.
• 21:39
  SPEAKER_01: And we like it.
• 21:40
  SPEAKER_01: We see the cities that are close by, whether it's, for example, cities such as Riyadh, uh, Kuwait, uh Muscat, we're seeing them also progress because they're emulating the model of Dubai, and we we enjoy that.
• 21:52
  SPEAKER_01: We love the fact that we have that positive effect uh for the cities that are our neighboring cities.
• 21:58
  SPEAKER_01: Now, being a dermatologist there, I mean, I did do my studies, my at least my medical school, it back back home.
• 22:05
  SPEAKER_01: And then, you know, I had a chip on my shoulder.
• 22:07
  SPEAKER_01: I, you know, I wanted to kind of go go go go to the US.
• 22:11
  SPEAKER_01: I've always wanted to go to the US.
• 22:13
  SPEAKER_01: And uh I got you know, I was lucky enough, I guess I was smart enough, if you want to call it that, to be accepted in the DEM program in Boston.
• 22:20
  SPEAKER_01: I was I was part of the Boston University, Tufts University joint program.
• 22:24
  SPEAKER_01: They're divorced now, but they used to be together at one point.
• 22:27
  SPEAKER_01: And uh I completed my residency over there, and then I did a fellowship at UCSF.
• 22:31
  SPEAKER_01: So I did the East Coast and the West Coast, so the best of two worlds, the most beautiful cities in the United States, I believe.
• 22:39
  SPEAKER_01: Uh, and then after that, I always knew that I was gonna have back.
• 22:42
  SPEAKER_01: My dad is a dermatologist.
• 22:44
  SPEAKER_01: I wanted to pick up on his practice, build up what he's already kind of established, but at the same time take it to the international level.
• 22:51
  SPEAKER_01: So I've kept my uh you know, my my connections with people from the US.
• 22:57
  SPEAKER_01: That's why I'm I'm close to a lot of my colleagues from the United States.
• 23:01
  SPEAKER_01: Uh, and uh this exchange of knowledge between from from the UAE basically or that part of our world to the US, back and forth is is great.
• 23:13
  SPEAKER_01: The the Americans love the fact that I they considered me one of their own because uh that's where I studied, but at the same time they've shipped me outside because you know they've they got me in an outpost there.
• 23:24
  SPEAKER_01: So it's it's it's wonderful.
• 23:26
  SPEAKER_01: Uh and I get to I I still am licensed in the US and California mainly, and I'm so hence the reason why, for example, if a meeting is in California or is in the US, I also get temporary license to start injecting and so forth, which is always very you know fun for me to do.
• 23:43
  SPEAKER_00: Oh, that's amazing.
• 23:44
  SPEAKER_00: Um I would just tell our listeners who are dermatologists, if you ever have the opportunity to to attend an international meeting, take it.
• 23:52
  SPEAKER_00: Because I learn so much from colleagues.
• 23:55
  SPEAKER_00: Well, I learned so much from my US-based colleagues, but internationally, where there's just a melting pot of cultures that come to an international conference.
• 24:04
  SPEAKER_00: It's it's so stimulating, uh, just both intellectually stimulating because you see how people do things in different parts of the world, but also emotionally it's stimulating uh because you get to make all these great connections with amazing people.
• 24:20
  SPEAKER_00: We're all dermatologists, so we have that in common.
• 24:22
  SPEAKER_00: So immediately you have a tie that binds, and then you get to go deeper uh with the relationship based on you know different ethnicities and personalities and backgrounds.
• 24:33
  SPEAKER_00: It's just it has added so much to my career that I really enjoy meeting incredible people like Dr.
• 24:38
  SPEAKER_00: Galidari here.
• 24:40
  SPEAKER_00: Uh so if you can do it, I would really urge you to take advantage of that.
• 24:43
  SPEAKER_00: Uh Hassan, we need to end here because the Beyersdorf people are kicking me out of the room.
• 24:48
  SPEAKER_00: Otherwise, I'd love to keep going.
• 24:51
  SPEAKER_00: But thank you so much.
• 24:52
  SPEAKER_00: I know it's been a very long two days, and I really appreciate you coming on.
• 24:56
  SPEAKER_00: Thank you again.
• 24:57
  SPEAKER_00: Thank you for having me, Tad.
• 24:58
  SPEAKER_00: Thank you.
• 24:59
  SPEAKER_00: Absolutely.
• 24:59
  SPEAKER_00: Thank you for listening to the Science of Skin podcast.
• 25:02
  SPEAKER_00: If you like this episode, please give us a five star rating and subscribe.
• 25:05
  SPEAKER_00: We found that our podcast grows because of word of mouth, so please tell your colleagues about us as well.
• 25:10
  SPEAKER_00: Otherwise, we will see you next week.
• 25:12
  SPEAKER_00: Thanks again.