Latest / Skin Anarchy / Ava Shamban, MDCosmetic Dermatologist / Owner of Ava MD and Skin Five

Transcript

Ava Shamban, MDCosmetic Dermatologist / Owner of Ava MD and Skin Five · Skin Anarchy

• 0:00
  SPEAKER_00: Next guest is Dr.
• 0:01
  SPEAKER_00: Ava Shambin.
• 0:02
  SPEAKER_00: She is a cosmetic dermatologist and owner of Ava MD and Skin 5.
• 0:07
  SPEAKER_00: She is a renowned board-certified dermatologist and truly a visionary.
• 0:12
  SPEAKER_00: Dr.
• 0:12
  SPEAKER_00: Shambin has been on the editorial board for New Beauty Magazine.
• 0:17
  SPEAKER_00: She's always featured in big publications like Allure, Bazaar, Wall Street Journal.
• 0:22
  SPEAKER_00: She's been on L, MSN, Yahoo Many.
• 0:25
  SPEAKER_00: So without further ado, I want to introduce you guys to Dr.
• 0:29
  SPEAKER_00: Shambin.
• 0:29
  SPEAKER_00: Dr.
• 0:29
  SPEAKER_00: Shonban, thank you so much for making the time for our show.
• 0:32
  SPEAKER_00: Oh, I'm so happy to be here.
• 0:34
  SPEAKER_00: It's such a pleasure to host you.
• 0:36
  SPEAKER_00: I would I would love to um to learn more about your background because I know I covered very little.
• 0:41
  SPEAKER_00: So well, I've had a spotty background.
• 0:45
  SPEAKER_01: Um very impressive background, I would say.
• 0:49
  SPEAKER_01: Well, I actually did I actually did a lot of I started out in bench research, like in a laboratory looking at the expression of the collagen and elastin gene.
• 0:59
  SPEAKER_01: So a lot of my background really begins from a very science-oriented perspective.
• 1:03
  SPEAKER_01: Then I um I went undergrad to Harvard and then I went to medical school at Case Western in Cleveland.
• 1:09
  SPEAKER_00: Oh my gosh, I'm an alum of Case Western!
• 1:12
  SPEAKER_01: You are?
• 1:13
  SPEAKER_00: Yes, I got my master's in medical physiology there.
• 1:15
  SPEAKER_00: Oh my gosh.
• 1:17
  SPEAKER_00: The best school ever.
• 1:19
  SPEAKER_00: It's the best school ever, absolutely.
• 1:22
  SPEAKER_00: Go ahead.
• 1:22
  SPEAKER_00: I interrupted you though.
• 1:24
  SPEAKER_01: Yeah, no, not at all.
• 1:25
  SPEAKER_01: And so then I so then I um let's see, I worked for actually Howard Murad, who came up really, he was one of the big creators of glycolic acid and its use in skincare.
• 1:36
  SPEAKER_01: And then I opened my own practice.
• 1:38
  SPEAKER_01: And then shortly after I opened my own practice, I started to do, and I it was so I was there at the very beginning of I would say aesthetic medicine, where we just started, like when I first bought my practice, we had three lasers, and that's like all that there were.
• 1:54
  SPEAKER_01: Um, and there was just injectable collagen, there was no Botox, there was no all these hyaluronic acid fillers, and so I was privileged to be at the very beginning of all of this work.
• 2:05
  SPEAKER_01: And then over the years, I so I did all the dermatology for the show Extreme Makeover, which was the most profound experience of my career because I just saw how transformative it was to people's lives when they felt better about how they looked.
• 2:21
  SPEAKER_01: Right, right.
• 2:22
  SPEAKER_01: That was one part, and then the other the other big part of my career now, too, is I do a lot of clinical trials.
• 2:28
  SPEAKER_01: So basically, everything that you have injected into you, I've been a clinical investigator for.
• 2:33
  SPEAKER_01: And so these, of course, are for companies and we prepare them.
• 2:37
  SPEAKER_01: We do the data for FDA approval of their use.
• 2:40
  SPEAKER_01: And I've done that with lasers too.
• 2:43
  SPEAKER_01: So, and then I also in recent years I opened up the skin fives because I felt that it was really important for people to have the opportunity to do prejuvenation procedures.
• 2:55
  SPEAKER_00: Yeah.
• 2:56
  SPEAKER_01: Distilled it down to five treatments for face and five treatments for body, and then finally, most recently, I just started a subscription box because there's no dermatologist curated subscription box for skincare called Oh my gosh, I'm totally getting it, first of all.
• 3:11
  SPEAKER_01: That's amazing.
• 3:13
  SPEAKER_01: It's really good.
• 3:13
  SPEAKER_01: We just are having our second box come out for the spring.
• 3:17
  SPEAKER_01: Wow.
• 3:17
  SPEAKER_01: Yeah, so those are you know, that's kind of like that's the highlights.
• 3:22
  SPEAKER_01: Oh, yeah, and I wrote a book called Heal Your Skin.
• 3:24
  SPEAKER_00: Yes, I saw that.
• 3:25
  SPEAKER_00: I I'm I'm so impressed.
• 3:27
  SPEAKER_00: You have done so much, Dr.
• 3:28
  SPEAKER_00: Shan.
• 3:29
  SPEAKER_00: But how do you how did you do that?
• 3:30
  SPEAKER_01: First of all, I think in order to be able, in order to have a wide range in your career, you have to be able to delegate.
• 3:40
  SPEAKER_01: Yeah, you have to figure out what you need to supervise and make happen, and then what other people can help you.
• 3:46
  SPEAKER_01: And you have to be able to share the credit and to share, you know, share responsibility.
• 3:52
  SPEAKER_01: And so and share and share your money.
• 3:55
  SPEAKER_01: So I just feel really grateful.
• 3:58
  SPEAKER_01: And actually, one of my one of the things I'm most proud of is that I have I've I employ 50 women, um, most of whom are the primary wage earners in their family.
• 4:07
  SPEAKER_01: And so I'm just so excited.
• 4:09
  SPEAKER_00: Wow.
• 4:09
  SPEAKER_00: Yeah.
• 4:10
  SPEAKER_00: Wow, that is truly, truly, truly impressive.
• 4:13
  SPEAKER_00: I'm I'm in shock.
• 4:14
  SPEAKER_00: That's amazing.
• 4:16
  SPEAKER_00: I love that.
• 4:17
  SPEAKER_00: So I I actually have some questions for you because obviously um you are the experts, and I and I want to know about you know how much skincare is enough.
• 4:27
  SPEAKER_00: I mean, do we need skincare?
• 4:29
  SPEAKER_00: How beneficial is it?
• 4:30
  SPEAKER_00: You know, what have you noticed with with your background and your your experience um in the field?
• 4:36
  SPEAKER_01: Skin care.
• 4:38
  SPEAKER_01: So um, skincare, I would say the best analogy is like dentistry.
• 4:42
  SPEAKER_01: So if you go to the dentist and you have your teeth cleaned once a year, twice a year, three times a year, and then you never brush your teeth, do you think that your teeth are gonna still look good?
• 4:52
  SPEAKER_01: And the answer is, you know, if you wash your hair like once a month or something and then you never brush it, is it gonna look good?
• 4:59
  SPEAKER_01: The answer is no.
• 5:00
  SPEAKER_01: And so I think people they tend to discount the value of skincare, but in fact, it's just as essential as having an in-office procedure because you're just never gonna see the full result of the procedure and you're never gonna maintain the result.
• 5:15
  SPEAKER_01: So skincare is is just it's a cornerstone of all beauty treatments for sure.
• 5:21
  SPEAKER_00: No, I I want to know um what your opinion is about just you know a normal skincare routine.
• 5:27
  SPEAKER_00: I know that everyone's looking for their ideal skincare routine.
• 5:30
  SPEAKER_00: What are some things that you think are absolutely important for almost everybody?
• 5:35
  SPEAKER_00: Um, other than SPF, obviously, I think everyone wants to say SPF.
• 5:39
  SPEAKER_01: Well, you know, it's really interesting because the Korean community they love doing like multiple steps, and so I don't know, they get up a half hour earlier or more like an hour or an hour, so they can do like nine different things to their skin, and honestly, when they do it, skin looks really good.
• 5:55
  SPEAKER_01: But you know, us Americans, we don't really have time for all of that.
• 5:59
  SPEAKER_01: We're multi-tacking away.
• 6:01
  SPEAKER_01: So, what do I think is important?
• 6:02
  SPEAKER_01: Well, obviously, sunscreen, sun protection, because that is the number one um you know um preventable cause of skin aging.
• 6:13
  SPEAKER_01: And then uh the other thing I really like is I do like something at retinoid, and I know everybody's like, ah, the dermatologist, all she says is suscreating, you know, her retinoids, you know.
• 6:24
  SPEAKER_01: Well, but the truth is that retinoids can do so much for your skin, yeah.
• 6:29
  SPEAKER_01: Evening out the pigment from evening out the pigment layer from helping reverse precancerous changes to increasing collagen production, eliminating fine lines and wrinkles, giving you an even texture, you know, it goes on and on and on.
• 6:41
  SPEAKER_01: Um, the trick with the retin the retinoids is pairing it with something to reduce the irritation because in Southern California, obviously it's very dry.
• 6:49
  SPEAKER_01: So I like to pair it with a hyaluronic acid and a vitamin C.
• 6:52
  SPEAKER_01: So, what do I think is essential?
• 6:54
  SPEAKER_01: I think that in the morning, if you can put on some kind of an antioxidant under your sunscreen, yeah, I think that's really important.
• 7:01
  SPEAKER_01: In the morning, it shouldn't be that much of an effort to cleanse your face unless you have oily skin and are and are prone to acne.
• 7:08
  SPEAKER_01: I think that in the afternoon now, I think for people who are prone to getting maskne, which is just about everybody, or even masquerosacea, that when you take your mask off and you obviously want to treat your mask like your underwear and wash it every day, that then you can put on something soothing, even if it's like an aloe gel or a toner that has antioxidants and anti-inflammatories in it.
• 7:30
  SPEAKER_01: And then at night, that's your opportunity to put a peptide on.
• 7:34
  SPEAKER_01: So one of the growth factor um products, you could put another antioxidant, never hurts, um, and then sometimes an emollient uh moisturizer.
• 7:45
  SPEAKER_01: So, how many steps is that?
• 7:47
  SPEAKER_01: I mean, you know, three steps maybe.
• 7:51
  SPEAKER_01: Yeah, it's about three.
• 7:52
  SPEAKER_00: You're right.
• 7:52
  SPEAKER_01: Yeah, and so it shouldn't take that long.
• 7:54
  SPEAKER_01: So yeah, do it.
• 7:55
  SPEAKER_00: So, I mean, I want to ask you about peptides because what is exactly like in from a skincare standpoint, I get so confused because when I think of peptides, I think of um stability of things like this, right?
• 8:08
  SPEAKER_00: And then when you're putting it in skincare and it's like mass marketed, like I mean, how effective are they?
• 8:13
  SPEAKER_00: How do they work?
• 8:14
  SPEAKER_00: What are some of your recommendations for people who want to go out there and and buy a product that is uh you know a peptide product?
• 8:21
  SPEAKER_01: So excellent questions.
• 8:23
  SPEAKER_01: So peptides are little short chains of proteins and they act like what are called cytokines, where they they message from cell to cell.
• 8:32
  SPEAKER_01: And so the message may be to the cell, you know, reproduce yourself turnover.
• 8:38
  SPEAKER_01: Um, or the message may be to the cell, ideally, you know, make some collagen, or the message may be to this to the cell, all right, relax, like for muscle, relaxing peptides.
• 8:48
  SPEAKER_01: You know, with cosmoceuticals, it's a it's a uh tricky road that the companies walk because if they show a real biological effect, then it becomes a pharmaceutical.
• 8:59
  SPEAKER_01: And so they usually, so with the claims usually reduces the appearance, you know, as opposed to reduces fine lines and wrinkles, it's always reduces the appearance of fine lines and wrinkles.
• 9:10
  SPEAKER_01: So you have to, but there has to be some data out there, and so I think that when you look to buy a peptide, you or a peptide-containing cream, you want to find something that actually has done some kind of a clinical trial to at least show that it reduces the appearance of fine lines and wrinkles or improves laxity because those and I have done some of those studies and they're real, so I think that's what you have to look for.
• 9:35
  SPEAKER_01: But which one is right for you?
• 9:37
  SPEAKER_01: That's a you know, that's a big question.
• 9:40
  SPEAKER_01: Yeah, that's a big question.
• 9:41
  SPEAKER_01: That's a big question.
• 9:42
  SPEAKER_01: I mean, I do like the the um TNS, yeah, um, growth factor.
• 9:48
  SPEAKER_01: I do like that one, but I kind of mix and match my skincare, you know.
• 9:52
  SPEAKER_00: Well, I'm I'm curious also because when when I think about you know things like peptides or growth factors, I often wonder um, well, how does it work in a formulation?
• 10:00
  SPEAKER_00: Because I'm guessing, you know, things obviously molecules interact, you know, everyone knows that.
• 10:04
  SPEAKER_00: And I I'm curious, like from that standpoint of a product that is, you know, like a multi-use product, like or purpose product, I mean, how logical is that?
• 10:15
  SPEAKER_00: Because these molecules, are they stable enough to be in a formulation together for the most part, or are they are are there things that you want in isolation, like a serum that only has one specific type of peptide?
• 10:27
  SPEAKER_00: You know, if it if you're trying to go for collagen production, you know, boost that, you have that only in there.
• 10:32
  SPEAKER_00: So, like, can you explain that a little bit more if that makes sense?
• 10:36
  SPEAKER_01: Yeah, well, formulation is all about the quality of the chemist.
• 10:39
  SPEAKER_01: And there are certainly chemists who are known in the field to to produce really good formulations, because of course you don't want two ingredients in the in the formula to cancel each other out.
• 10:49
  SPEAKER_01: Yeah.
• 10:49
  SPEAKER_01: And in general, that's why you do see an antioxidant formula that may have, you know, more than one antioxidant in it, may have, you know, 10 antioxidants in it because they play well together.
• 11:00
  SPEAKER_01: With growth factors, they do tend to be, or with peptides, they do tend to be all by themselves.
• 11:06
  SPEAKER_01: And it and to your point, probably because they're unstable.
• 11:09
  SPEAKER_01: But something like TNS, what they've what they've how they've solved that problem is they have a dual chamber so that when you press on the top, like some cream comes out from each you know, from separate chambers, and they just mix right there in your hand, and then you can put them on, and so they're not going to destroy each other.
• 11:26
  SPEAKER_01: But yeah, that's interesting.
• 11:28
  SPEAKER_00: That's very interesting.
• 11:29
  SPEAKER_00: I I actually want to ask you because I know that you mentioned you did um bench research with collagen and being your the focus.
• 11:36
  SPEAKER_00: So can you tell us something, um, a basic understanding of how collagen works in our skin layers and just for everybody listening out there to really understand the role of collagen in our skin health?
• 11:48
  SPEAKER_01: Okay, so collagen makes up 70% of the dry weight of skin.
• 11:53
  SPEAKER_01: So when I say dry weight, you know, you're taking out all the water, you're taking out the hyaluronic acid.
• 11:57
  SPEAKER_01: So it's it's most of the, you know, it's the it's the protein, they're they're triple helixes, they look like ropes in your skin, like tiny little ropes.
• 12:07
  SPEAKER_01: Um, that's number one.
• 12:08
  SPEAKER_01: The number two is that there are actually 13 types of collagen in your skin.
• 12:13
  SPEAKER_01: There's different types of collagen around the blood vessels, there's different types of collagen at the at the junction between the epidermis, which is the cellular part of the skin, and to the dermis, and on.
• 12:24
  SPEAKER_01: Most of the collagen, all that being said, though, most of the collagen in our skin is type one and type three, with type one being having the biggest presence.
• 12:32
  SPEAKER_01: And that's what's really in our dermis.
• 12:33
  SPEAKER_01: What does collagen do?
• 12:35
  SPEAKER_01: Collagen gives the firmness to the skin.
• 12:39
  SPEAKER_01: And I'm trying to think about the analogy.
• 12:42
  SPEAKER_01: Well, I mean, you know, it's the meat below the skin.
• 12:45
  SPEAKER_00: Yeah, yeah.
• 12:46
  SPEAKER_01: Chicken thigh or something.
• 12:48
  SPEAKER_01: Right.
• 12:48
  SPEAKER_01: So it really, although it's not muscle fibers, but it's it's in muscle fibers, but it's it's yeah, it's gives you the firmness to the skin.
• 12:57
  SPEAKER_01: It gives the firmness.
• 12:59
  SPEAKER_00: Whereas No, what about another, you know, if with collagen products, I know that the synthesis of collagen is a very like, you know, it it's very, very complex.
• 13:07
  SPEAKER_00: So, you know, thinking about it from that research standpoint, how important would it be to add factors such as copper or you know, um, like some of the things that are used in the actual physiological synthesis of collagen?
• 13:19
  SPEAKER_00: Does that make sense?
• 13:20
  SPEAKER_00: Or do formulations do that, or have you seen that in your practice in some products?
• 13:24
  SPEAKER_01: The cofactors, yeah.
• 13:26
  SPEAKER_01: So copper containing products, actually, copper has been shown to increase um or to improve wound healing.
• 13:32
  SPEAKER_01: And it was all that research with copper was done on wounded, you know, like cut like uh cuts and um ulcers in skin.
• 13:41
  SPEAKER_01: Yeah.
• 13:42
  SPEAKER_01: So, but adding um, well, vitamin C is one of the cofactors, and so that's why so many of these creams, the vitamin C turns out that it stimulates collagen production.
• 13:51
  SPEAKER_01: The other thing is, you know, when you cut yourself, or if it, you know, if you have surgery or something, then why does the skin, how does it know to heal?
• 13:59
  SPEAKER_01: Yeah, well, there's a whole bunch of different signals, but one of them is disrupted or like collagen like just shreds.
• 14:06
  SPEAKER_01: They tell the body, like, oh my god, there's damaged collagen in here.
• 14:09
  SPEAKER_01: Okay, we have to make new, we have to get rid of the old.
• 14:12
  SPEAKER_01: Because obviously there's enzymes to digest the damaged collagen and old collagen.
• 14:17
  SPEAKER_00: Yeah, yeah.
• 14:18
  SPEAKER_00: And and you know, I'm curious about how you would regulate the production of type one versus type three collagen.
• 14:25
  SPEAKER_00: Like, that's where I get confused.
• 14:27
  SPEAKER_00: You know what I mean?
• 14:27
  SPEAKER_00: Because obviously, like one is more for like you know, fibrous changes, right?
• 14:31
  SPEAKER_00: It's it's more of like a it's a harder, I don't know how to describe it.
• 14:36
  SPEAKER_01: The big fibers, yeah.
• 14:38
  SPEAKER_00: Yeah, so like how do you how do you regulate that?
• 14:40
  SPEAKER_01: Yeah, you can't, you can't really actually what happens is type three is laid down first and then it's replaced by type one.
• 14:46
  SPEAKER_01: It's just part of they can lay down type three first, but you can't, we can't, we don't have any way of controlling.
• 14:52
  SPEAKER_00: Yeah, we have no way of controlling it makes sense.
• 14:54
  SPEAKER_00: Um, so I I actually want to ask you a general question.
• 14:57
  SPEAKER_00: Do you have any advice for all of the budding dermatologists out there?
• 15:00
  SPEAKER_00: Because I know that it's a very competitive field, and I know they're you know, the medical school classes are expanding like crazy these days, and everybody wants to go into medicine.
• 15:09
  SPEAKER_00: So, any uh career advice you have for our listeners?
• 15:13
  SPEAKER_01: Oh, for well, I think that it's really important to pursue your heart's desire and don't listen to anyone that says you can't do it, you will not be able to do it.
• 15:22
  SPEAKER_01: If that's what's in your heart and your head, and that's what you want to do, you should go for it.
• 15:27
  SPEAKER_01: You shouldn't go for it if you say, Oh, well, that's specialty, oh, I don't think I have to do that much call, or I'm gonna, you know, be able to do this or that.
• 15:35
  SPEAKER_01: You can certainly do a lot of these cosmetic procedures if you are in another specialty.
• 15:40
  SPEAKER_01: But if you really want to be a dermatologist, then you should be a dermatologist.
• 15:43
  SPEAKER_01: And what advice?
• 15:44
  SPEAKER_01: Well, I think that it's always good to, I mean, it's one of my my middle son who's actually in is residency right now, he did some work looking at leprosy in Nepal and so and also the Beruli ulcer in Africa.
• 16:01
  SPEAKER_01: And so if you have an an interest in going internationally when things open up again, that's always cool to kind of learn about some of these conditions.
• 16:09
  SPEAKER_01: And then the other part is working in a lab.
• 16:12
  SPEAKER_01: I think that um as long as you like it, you know, you want to every moment we have on this planet is precious, so you want to be sure that it's something you want to do.
• 16:19
  SPEAKER_01: But having sort of a more general background behind that is helpful in doing a in getting.
• 16:28
  SPEAKER_00: Hi guys, this is Ecta again.
• 16:30
  SPEAKER_00: I just wanted to pop in and say I hope you really enjoy this episode, and also just to mention that we are so excited about our new sponsorship package, and um, we've been getting an immense response from it.
• 16:42
  SPEAKER_00: So thank you so much to everybody who's responded.
• 16:44
  SPEAKER_00: And also, if you know anybody or if your brand that is looking to sponsor us, please shoot us an email at skincareanarchy at gmail.com.
• 16:52
  SPEAKER_00: Thank you so much for listening to the episode, and I will be back next time.
• 17:00
  SPEAKER_00: Hey guys, so I hope you love that episode.
• 17:02
  SPEAKER_00: Please make sure to hit subscribe if you're tuning in to us on any podcast platform.
• 17:07
  SPEAKER_00: We are available on so many different platforms.
• 17:10
  SPEAKER_00: So wherever it is that you're tuning in, just go hit subscribe.
• 17:13
  SPEAKER_00: You will be immediately notified when we publish new episodes.
• 17:16
  SPEAKER_00: This way, you're able to tune in to amazing insights from experts, brand founders, industry leaders, authors, all the wonderful people that we host.
• 17:24
  SPEAKER_00: And that's very important for me because I love to hear from you guys and really understand what you love and what you want to hear more of.
• 17:32
  SPEAKER_00: Also, make sure to give us a follow on all of our social media outlets.
• 17:35
  SPEAKER_00: We're available on Instagram, TikTok, X, you name it, we're there.
• 17:39
  SPEAKER_00: We also have a blog on Medium.
• 17:41
  SPEAKER_00: So if you're a reader and you love Medium blogs, check us out on Medium.
• 17:45
  SPEAKER_00: We publish some really great articles on there that do deeper dives than just what's available on the podcast.
• 17:50
  SPEAKER_00: And it's really a great place for all of you science geeks out there that want to learn a little bit more.
• 17:55
  SPEAKER_00: We go above and beyond with our research and making sure we're bringing you information that you usually probably won't hear about in other outlets.
• 18:02
  SPEAKER_00: So check us out, leave us a comment, leave us a review, and we'll be back next time with another episode.
• 18:07
  SPEAKER_00: Thank you.