Episode 380: Sometimes Less Is More: A Dermatologist Takes Your Questions with Dr. Jenny Wang
Dr. Jenny Wang, Founder of SoCal Skin and Surgery (and Elise’s dermatologist!), joins the pod to answer listener questions about skincare and busts some of the recent trending cosmetic procedure myths. She digs into why your skin suddenly rejects products you’ve used for years, how to deal with blackheads (aka sebaceous filaments), the not-so-secret to anti-aging, the legitimacy of exosomes, and so much more!
Mentioned in this Episode
Eucerin
Cerave
Salicylic Acid
OTC Retinol
Tretinoin
Hyaluronic acid
Connect with Dr. Jenny Wang
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Transcript
The transcript for this episode is AI generated.
Doree Shafrir (00:10):
Hello and welcome to Forever 35, a podcast about the things we do to take care of ourselves. I'm Doree Shafrier.
Elise Hu (00:17):
And I'm Elise Hu and we're just two friends who like to talk a lot about serums.
Doree Shafrir (00:22):
And today we have a very special guest.
Elise Hu (00:24):
She's very special.
Doree Shafrir (00:25):
Very special to you, certainly. Yeah. None other than Elise's dermatologist.
Elise Hu (00:32):
That's right. Dr. Jenny Wang. Dr. Jenny Wang is based here in Southern California and she treats me. She treats my eldest daughter, Ava, because Ava had some skin concerns as she was entering puberty. So yeah, she's really lovely. And she's not a big person on the whole podcast guest circuit. She's just like a very knowledgeable, well-educated dermatologist who is out there treating patients every day. And so we brought her some of y'all's skin questions because sometimes when we ask for makeup questions for Rachel Goodwin, they tip over into dermatologist or aesthetician land. And so we brought those to Dr. Jenny Wang and she was great. She handled all of them. We didn't prep her or anything.
Doree Shafrir (01:17):
Yeah, she was awesome. When we were like, "Oh, we want to have a dermatologist on. " And we reached out to some social media famous dermatologists.
Elise Hu (01:26):
Celebrity. Right.
Doree Shafrir (01:27):
And they didn't get back to us. And then Elise was like, "Actually, my dermatologist would probably be great." And I was like, okay. And then she was great as advertised. So thank you, Elise.
Elise Hu (01:38):
And y'all will hear her for yourselves later on in the show, but we just want to remind folks, since it is December and it's gift giving season that we are out now with our Forever35 gift guide, holiday gift guide. That episode came out last Monday as we were coming back from Thanksgiving break. And if you haven't heard it yet or seen the guide, you can find it on our Patreon.
Doree Shafrir (02:04):
Yes. And our Patreon is patreon.com/forever35. And in fact, we are running a promo right now on our Patreon. You can get 20% off for limited time. It ends next Friday, December 19th, right before midnight. So sign up, you get 20% off either a monthly membership or an annual membership. And there's a code and the code is Serums in all caps.
Elise Hu (02:32):
Yeah. See you there. We just posted on our Patreon our pop culture, our monthly pop culture episode. So if you become a member of our Patreon at one of the paid tiers, the Dory's Hotel Lounge or Dory's Hotel Spa tiers, you get an extra episode per week because every Friday we have the casual chats where we just kind of chat. And then there are monthly pop culture episodes where we have recommendations in music and books and film and television and podcasts occasionally. And then we also have, on Tuesdays, a special bonus questionnaire from our Monday guests. And you can hear about their favorite things and the books that they recommend to everybody and how they feel about the age 35, whether it's before them or after them. So it's a good time. And for a limited time only, 20% off.
Doree Shafrir (03:27):
Yeah. Super fun. And we are doing a really fun live casual chat recording on December 10th at 7:30 Eastern 4:30 Pacific PM. We will be doing casual chat live with our Patreon supporters. So join our Patreon and we will see you on December 10th. It's very exciting.
Elise Hu (03:53):
That's going to be really fun. It's going to be super fun. Yeah. We haven't done a live chat like this for a minute,
Doree Shafrir (03:57):
So
Elise Hu (03:58):
Yay.
Doree Shafrir (03:59):
So usually our casual chat is just us casually chatting, but we will be taking listener questions and just kind of hang in. So I'm excited for that.
Elise Hu (04:08):
Yeah. Good, good. Well, we are getting to catch up for a little bit because before we get to Jenny, you are just back or recently back from your Thanksgiving trip to see family in New England, somewhere in New England, because I don't know the geography, like somewhere up there. Boston. Now it's just this running joke. Boston. I don't know. Somewhere on Eastern time. You're basically like New Hampshire? Is that a state? If you ask me to name them on a map, I probably could, but ... Connecticut is very, very small. It's very
Doree Shafrir (04:50):
Small, but also often like when you're ... It's sort of a running joke among people who drive from New York to Boston. Connecticut, it feels very long, especially if you take 95. It's like very- You're just stuck in Connecticut. Connecticut. For a long time. But anyway, I was in Boston and one of the things I did over Thanksgiving was I went to my 30th high school reunion.
Elise Hu (05:19):
Wow. Did you go to your 20th and your 10th?
Doree Shafrir (05:21):
I went to my-
Elise Hu (05:22):
So had you seen this evolution?
Doree Shafrir (05:24):
Over
Elise Hu (05:24):
The decade.
Doree Shafrir (05:26):
I did go to my 10th, which was a very informal affair. It was just, as I recall, it was just at a bar, very hastily organized. I mean, traditionally, I don't know if it's like this everywhere on the country, but traditionally, I guess the Wednesday night before Thanksgiving was always like ... Or the Friday night of Thanksgiving was the night that people who had come back from college or being a young adult would go out
(05:59)
And see people at high school. So it felt like sort of just an extension of that as I recall. And I don't think that many people were there, but I have very hazy recollection of this reunion. I mean, it was very long time ago. I did not go to my 20th. I don't even know if we had a 20th. My class was sort of like, I think notoriously not apathetic, but we definitely were at that tail end of Gen X where it was sort of like ... Slacker generation. Yeah. Slacker generation. It was not cool to show school spirit, you know what I mean?
Elise Hu (06:35):
Yeah. Okay. So our
Doree Shafrir (06:36):
School, we didn't have homecoming or any ... We didn't even have valedictorian. We didn't have class rank or anything. And we had a lot of sports, so all the ... It was very dispersed. There was just not a lot of ... It didn't feel like there was sort of a unifying principle of Brookline High School, even though it's a very good school.
Elise Hu (06:57):
Okay.
Doree Shafrir (06:58):
I don't know. People didn't feel that connected to it, I guess. So anyway, one of my really close friends from high school, we had texted months ago and she was like, "We should go. " And I was like, "We should go. We look great and we're like, it'll be fine." And then as it was getting closer, she was like, "Are we making a mistake?" I was like, "No, it'll be fine." I did get my hair done though because I was like- It looked awesome. Thank you. You put it on your Instagram
Elise Hu (07:26):
And I saw it and I was like, "Hair. Hello."
Doree Shafrir (07:29):
Well, I found this place on the internet. It seemed to have good reviews and it was around the corner from the hotel that my brother and sister and I were staying at. So I was like, "Okay." And I walked in and it was Saturday afternoon, it was slammed. It was like every chair was taken. People were getting blowouts color. The air was thick with hairspray, literally I needed a gas mask for all the hairspray. And at first I was like, "Ooh, is this too done?" And then I was like, "No, this looks good. I like it. " Yeah. So I did get my hair done and I actually had a really good time. I was afraid that I was just going to have these sort of small, talky, superficial conversations with people. And I did have a couple of those where I was sort of like, "Okay, really nice to talk to you.
Elise Hu (08:20):
Ya, ya
Doree Shafrir (08:22):
But I also had a really nice catch up with a friend from elementary school who I hadn't seen in so long and we just were sitting there laughing and I was like, "Oh yeah, she was so fun." And yeah, that was really nice to see those people. The people who I'm Facebook friends with, I'm Facebook friends with most of them. So I feel like I sort of knew stuff about their lives, but I hadn't seen them in a really long time. So it was really nice. I recommend going to your 30th reunion because I feel
Doree Shafrir (08:58):
Like 10
Doree Shafrir (08:58):
Is too close, you know? Right.
Elise Hu (09:01):
You've just seen each other
Doree Shafrir (09:03):
Probably. Exactly. But 30th, I mean, people have really changed and the world has really changed.
Elise Hu (09:08):
I don't know if we're going to have a 30th because we very strangely had to do a 25th due to being the graduating class of 2000. And so the year of our 20th reunion was COVID, so there was no way to do it. And so the 25th ended up, which was this year, ended up being kind of the makeup.
Doree Shafrir (09:31):
Yes
Elise Hu (09:31):
Now I'm like, wait, are we going to have to do the next one with only a five-year interval? And who pays for these and who organizes it? I have no idea who's behind it even because they started an Instagram account for my 25th high school reunion and I'm like, who's running this? And they were featuring who they were then and who they are now. And I'm like, what? I still don't understand who pays for reunions. Are you supposed to donate to a fund or does the district pay? I have no idea.
Doree Shafrir (10:00):
I mean, we bought ticket. We were charged money for it.
Elise Hu (10:04):
Okay.
Doree Shafrir (10:05):
And
Elise Hu (10:05):
Then that's the case. That's got to be the case.
Doree Shafrir (10:07):
But there was a committee of people who volunteered their time and organized it all, which I was not a part of by choice.
Elise Hu (10:17):
Sounds like the folks who were involved in high school and still in Dallas were the ones who were organizing all
Doree Shafrir (10:24):
Of that. Okay, that makes sense. Actually, the people who organized ours, the lead organizer was in Connecticut, so not far, but then there were a couple of people who were ...
Elise Hu (10:35):
Remote?
Doree Shafrir (10:36):
Yeah. Who were remote. And a lot of people do still live in the Boston area, but there were a bunch of people who had flown in from California. Cool. I don't think anyone came in internationational. I was glad I went. I was a little bit like, "What's this going to be like? " But I was glad. Good. Good, good, good. Yeah. Well, should we introduce Dr. Jenny?
Elise Hu (11:03):
Yes. Dr. Jenny Wang is the founder of SoCal Skin and Surgery, a highly regarded board certified dermatologist. She specializes in medical and cosmetic dermatology. She graduated from the University of Chicago with a BA in biology and then completed her dermatology residency at UC Davis. Her research focus is on psoriasis and other complex inflammatory skin conditions. We didn't ask her about pssoriasis. It's her expertise.
Speaker 3 (11:32):
Yeah.
Elise Hu (11:35):
She's a member of the American Academy of Dermatology and in her spare time enjoys spending quality moments with her family and dog. And she also is a snowboarder. And as we mentioned, she's my dermatologist. We met at a book club.
Doree Shafrir (11:50):
So cool.
Elise Hu (11:50):
True story.
Doree Shafrir (11:51):
We didn't ask her about snowboarding.
Elise Hu (11:55):
No, I could see her shredding. I could see her shredding out there.
Doree Shafrir (11:59):
Well, before we get to Dr. Jenny Wang, just a reminder that you can visit our website, forever35podcast.com. We have links there to everything we mention on the show. We are also on Instagram at Februar35 podcast and our Patreon, which again is on sale 20% off for a limited time. Code is serums is at patreon.com/Freber335. You can shop our favorite products at shopmy.us/fober35. We have a shelf with our gift guide recommendations so you can go check that out at shopmy.us/febr35. And our newsletter is now on Patreon also. So sign up for that at patreon.com/freber35 and call or text us at 781-591-0390 and email us at forever35podcast@gmail.com. And we will be right back with Dr. Jenny Wang.
Elise Hu (12:49):
We'll be right back. Dr. Jenny Wang, welcome to the show.
Dr. Jenny Wang (13:00):
Yay. Thank you so much for having me. I'm very excited.
Elise Hu (13:03):
We are excited because we have lots of questions from listeners that have piled up for a dermatologist. So you are going to take these questions. They are above our level of expertise, but just so that folks can kind of get to know you first, we ask all of our guests what they do to take care of themselves. So what are you doing for self-care lately or something that you would consider self-care?
Dr. Jenny Wang (13:27):
Oof, that's a good question. I used to do a lot more lifting these days, because I am six months pregnant, that's kind of taken a bit of a hiatus. So I've been picking up more yoga just to kind of get my joints moving a little bit, deal with some lower back pain.
Elise Hu (13:52):
Can't stop working on the mobility and the strength as we get older. How did you get into it? Were you an athlete growing up or what made you start lifting in the first place?
Dr. Jenny Wang (14:03):
No, not really. I actually started lifting around med school. So in my early 20s and my husband actually and brother, they were lifting. And so it gave me more confidence to try it out because I had someone to show me how to pick up the weights at the gym. Otherwise, I think it would've been really intimidating to go at it by myself. And honestly, I kind of fell in love with it because I like how in lifting there's a finite goal that you're trying to achieve and you can see that progress from a week to week basis. You can see yourself getting stronger. And I thought that was really exciting, gratifying. And I was more goal oriented. I've never been great at cardio, so that's something I've always struggled with. And I'm still trying to pick up a good cardio sport for myself, but lifting was just easy.
(14:59)
And it's something I've kept for, I guess now well over a decade.
Doree Shafrir (15:03):
Yeah. Wow. Well, Dr. Jenny, we got quite a few questions for you. So I'm going to jump right in. This first question is about eczema. Our listener writes, "I had eczema as a child, but it disappeared for decades. And now as I near 40, it seems to be coming back. I'd love any and all wrecks for creams, daytime and overnight. My skin is itchy, very sensitive to the sun/wind and sensitive to most things. I've pivoted to a mostly cotton wardrobe, which helps, and Eucerin eczema cream is soothing too, though it doesn't feel very fun or lavish. I've upped my vitamin D as it was very low. See also living in a gray city and always covering up, which I'm hopeful will help too, but open to other supplements that are known to be helpful. Thanks.
Dr. Jenny Wang (15:55):
Yes. Yes. That's a really common question that I get. Eczema is very common, especially here in our side of California because it's very dry.
(16:07)
And we do know that eczema is caused by certain triggers. Number one, it's very genetic. So some people just have more sensitive skin and they have a more weakened skin barrier. And what happens is when you get exposed to environmental exposures, sometimes sweat is a big one. So in the summertime, when you sweat, that's very irritating. And definitely nowadays, just our skincare products. And it's difficult to always eliminate these skincare exposures because a lot of these fragrances are found in all of our household products, whether it's detergents, just gentle lotions, moisturizers. And so sometimes it can be very challenging for my patients to find products that they are able to tolerate. And so I always tell them, try thinking about a skincare diet. And it sounds just as boring as a regular diet. You essentially eliminate all of your products. That includes all of your non-essentials, fragrances.
(17:13)
If you have essential oils at home, if you have even special detergents, if you use special soaps, bath bombs, all of those things, just you have to pause them, take a hiatus for now, and slowly allow your skin bear to recover. Sometimes you have to give it maybe two, four weeks, and then slowly you can reintroduce one product at a time. And in general, for my eczema patients, I do say simple is key.
(17:42)
And you might not be able to tolerate all of your anti-aging serums, your toners, all the fun stuff. You have to stick to boring and basic. Eucerin is a great brand. Some of the other very basic boring brands I like are Serave, Vana Cream. These are readily accessible at your local drugstore. They're not expensive. And usually that's how I tell my patients to start.
Elise Hu (18:09):
Okay. Even though Eucerin isn't very lavish or very fun.
Dr. Jenny Wang (18:14):
No. It's dermatolysis who recommend it. Exactly. Yeah. I recommend the most boring products and use it for myself. Yeah. I use it for my daughter. Just super simple.
Elise Hu (18:25):
Okay.
Dr. Jenny Wang (18:25):
All right. Next question.
Elise Hu (18:28):
I was wondering if you have any requests for dealing with blackheads. I have otherwise very easygoing skin, but I sometimes feel like I can't reduce my blackheads to save my life and I'm cursed to walk around with black dots all over my face. Any recommendations to implement at any stage of the skincare process would help.
Dr. Jenny Wang (18:46):
Blackheads is so challenging because there's no easy answer. I always tell my patients, so your blackheads are basically, they're very normal. We also call them sebaceous filaments. So what's happening is the pores on your nose and pores are natural. We need the skin to breathe. It's how the hair follicle comes out of the skin and everyone has it. Yeah, we can technically be poorless. We can't be poorless. And then we have now Instagram filters. I think it portrays this very false sense of beauty that is unattainable. And unfortunately, the pore size, I always tell patients, it's like your shoe size. How do you change your shoe size? You can't really. It's totally genetic. Some people are, unfortunately, they have more oily skin. They have larger pores.
(19:35)
Some people have drier skin, smaller pores. And so that pore size really dictates how prominent some of those blackheads appear. And blackheads, it's not really a skin problem. It's not a skin condition. It's totally natural. It's really your skin oils and the oxygen. When they oxidize together, it turns a little bit darker and it's going to keep coming up. We can do things to try to minimize the appearance of pores. Of course, making sure you're washing your face daily. Sometimes I recommend things like gentle exfoliants, maybe like a salicylic acid wash, something gentle. There are a lot of products out there that are marketed towards removing blackheads, but they can be very harsh, like an acid toner that's left on. If it's left on, sometimes it can just cause more irritation. And you get more irritation. The skin wants to try to combat that irritation by maybe producing more oils.
(20:37)
Maybe you're causing irritation and it can permanently disfigure those pore sizes and they become bigger. So even things like those strips, the blackhead strips, super popular. I think once in a while, sure, I think, and that's very satisfying to take it off and you see all the black dots.
Elise Hu (20:56):
Yeah. It's kind of fun just to
Dr. Jenny Wang (20:57):
Even see it. It's kind of fun. Yeah. So I'm like, it's kind of therapeutic. It's kind of fun, but you shouldn't be doing it regularly because you can really strip that skin barrier. And honestly, over the counter, retinols are great. Retinols are a way to help increase cell turnover so that you have less skin cell blockage. And a lot of times that's what ... It's like a traffic jam. So we're trying to move along that traffic jam, you're shedding off dead skin and that really helps.
Elise Hu (21:24):
Well, that's a good analogy. Dr. Wang, we talked before, not on this show, but just offline about different gel. Is that a retinol?
Dr. Jenny Wang (21:36):
Yes. Okay. So different, the generic is called Dapyline. It used to be actually prescription. And over the last few years, it actually became approved to be over the counter. So it's a great retinol that I recommend for my patients because it's a little bit more gentle. So it's kind of like a cousin of a tretinoin, which is a little bit stronger. I think adapalene is better tolerated for some of my teenager patients or patients with more sensitive skin.
Elise Hu (22:09):
Okay.
Dr. Jenny Wang (22:10):
Okay.
Elise Hu (22:10):
This is great.
Doree Shafrir (22:12):
All right. Next question. What do you do when your skin is revolting against you? I've been using the same products for several years and now all of a sudden, probably perimenopause is fault, my skin is reacting as if I'm allergic to them. They are hypoallergenic, fragrance free, everything, and I don't know what to do. Is there a line of products for the highly sensitive skin ladies out there?
Dr. Jenny Wang (22:37):
So this is something that I see a lot. Number one, you can absolutely develop a new sensitivity to a product you've been using for decades. I see it all the time.
(22:51)
Number two, companies, they will change their formulation. So just because it's the same product, they have a rebranding and they will add something. Usually maybe to make it more luxurious or maybe change the scent a little bit. So that could be the case. And number three, over time, as our hormones fluctuate, things happen to our skin. This is very common. We see it when you change things like maybe birth control. You go through pregnancy. Postpartum, you're going through being perimenopausal. All of these things will change the skin composition and something you have been using fine for decades, you can no longer tolerate. And in terms of products, once again, kind of like what I mentioned before, that idea of a skin elimination diet, you have to stop everything, slowly reintroduce one product at a time. You have to maybe think about taking out all of your non-essential serums, toners, and then try to stick to the basics.
(23:59)
Just start from square
Dr. Jenny Wang (23:59):
One.
Dr. Jenny Wang (24:01):
Your boring stuff. I'm not a spokesperson for these brands, but they're cheap and they're at your drugstore, Serave, Vana Cream, La Roche Pose. You just have to start simple and start there and one at a time.
Elise Hu (24:17):
Yeah. Yeah. And we should mention that you are not sponsored by any of these brands that we're talking about. Yes. So this is really just what you have to be tried and true for both your patients and your loved ones.
Doree Shafrir (24:31):
So we're just going to take a short break and we will be right back.
Elise Hu (24:43):
Okay. Next question. Our listener says, "Quick question. I'll keep this short and sweet. How do we feel about exosomes and growth factors infiltrating our anti-aging serums?" They are everywhere right now. Scam, magic bullet I've been looking for. Insight and expert consultation, welcome.
Dr. Jenny Wang (25:05):
Yes. So exosomes are very sexy right now. They've been around for much longer outside of the US, like in Korea, there's a lot more robust data on it. So with exosomes, it's very exciting. The idea of exosomes is that you have these extracellular cells and they carry signals that tell the cell what to do, whether it's how to repair itself, how to maybe fight anti-aging, promote collagen, and we use it in a lot of different fields, not just in aesthetics. I think the issue with exosomes right now is that it's still very new and it's not as tightly regulated right now. And the concern with that is there are all of these competing exosome companies that are trying to sell their product and we don't necessarily know where are these exosomes being harvested from. Are they coming from humans? Are they coming from animals,
Dr. Jenny Wang (26:09):
Plants?
Dr. Jenny Wang (26:10):
How pure are these exosomes? Are we sure that it's just exosomes? How do we know there aren't additional proteins that are being attached to the sample? And right now the companies, they're less transparent about how they source these exosomes. And so it's hard to really compare then how effective one single product is. And then the other issue with exosomes right now is we, usually in offices,
(26:41)
We will pair it with other procedures. So what that means is you pair it with something like microneedling RF because exosomes, if you just layer it on top of the skin, it really doesn't penetrate. You need an opening in the skin bear for the exosome to penetrate deeper into the skin. So you need something to disrupt that skin barrier with like more of an invasive procedure like microneedling. Some people do. Other practices are doing ultrasound to create little channels. And so, how do we know, is it that actual technology that's doing more work? Is it the exosomes? It's hard to say, but it is very exciting. I think we just need a lot more data. We need to see the longevity of this technology.
Elise Hu (27:28):
How are exosomes primarily delivered right now?
Dr. Jenny Wang (27:32):
It's basically, it's applied topically, but it doesn't really work if you just apply it like a lotion or serum. It really needs to penetrate deeper. So that's where those other procedures help because things like microneedling, you're creating channels, you're creating open wounds on the skin, and then the exosome will be layered on top and it can penetrate deeper to deliver the messages it needs to deliver. Okay.
Doree Shafrir (27:59):
This is a question from me, but I think it's something that a lot of our listeners are curious about. For people who want to explore in- office treatments, in your opinion, what treatments give you the best bang for your buck?
Dr. Jenny Wang (28:17):
Oh yeah, that's really good. So when I start, when I see a patient for the first time and they tell me, "Hey, I just want to look maybe a little bit more refreshed, a little bit younger." The first thing I ask is, "How are you with sun protection?" Sun protection is the cheapest way to fight anti-aging. That and sun exposure and tobacco smoking are the quickest way to accelerate aging. So number one, I ask, how are we with that? Because it's not always something that's so natural for patients. Sun protection means daily sunscreen, physical sun protection, seeking shade, hats, clothing protection, because a lot of the things that they're seeing, whether it's pigment problems, they're seeing brown spots, they're seeing just a breakdown on their collagen,
(29:12)
All of that fine lines and wrinkles, all of that can be slowly ... We can't stop it. We can't stop aging, but we can slow it down. So you really want to give yourself the best advantage possible. So some protection is key, cheapest thing to do. And then also sometimes they do want to start with some type of skincare routine. So I do like the idea of retinols. So retinols is over the counter. Retinoids is prescription. It's basically it's a vitamin A medication, increases cell turnover, but it also stimulates collagen production. And there are actually relatively inexpensive retinols on the market as well. That plus a sunscreen I think will take you 80% of the way just with your home skincare without having to do a procedure.
Elise Hu (29:57):
Mhm
Dr. Jenny Wang (29:58):
Now, if you're starting to think about Okay, what are some other things I want to splurge on to kind of get me that less ... What if I came in just the money? Right, yes. Just money. Just can I throw money on my face now? What's the best? So usually I find that probably the best bang for your buck is probably a toxin. So toxin is what you think of as Botox. It's botulinum toxin. And what that does is it relaxes muscles because a lot of the signs of aging that we see are due to fine lines and wrinkles. It's just from the same dynamic expressions being performed over and over again, whether you're raising your forehead, throwing your brows, your crow's feet, your smile lines. And what a toxin will do is it helps soften those lines because it stops muscle activity. And over time, when you can do that, you can prevent those lines from being more etched in at rest.
(31:03)
So what that means is sometimes as we get older, we will have those lines even if we're not making that expression. Sure. So the idea of relaxing muscles helps with that aspect. If the lines are already etched in, we can't do too much to erase them completely at rest, but we can certainly prevent them from getting deeper.
(31:24)
That's one thing I like to talk about. And then also improving the skin quality, because that's also something that we notice. We will notice pigment issues. We will notice texturgularities. And so things that will help improve the skin texture, that can be done through different things, whether it's people like peels, microneedling, laser treatments, all of those things target to improve the skin texture and quality. So usually those are things I like to start bringing up for patients.
Elise Hu (32:00):
Yeah. I feel like a friend of mine was a big proponent of some of the laser treatments out there. Are there certain ones that you have found to be very popular with your patients?
Dr. Jenny Wang (32:12):
Yeah. So for me, it depends on what they're looking for. So a lot of times when they're dealing with pigment problems or once again, fine lines wrinkles, I do like to talk to them about a resurfacing technology. The idea of resurfacing is what we're doing is we're creating micro injuries to the skin in a very controlled way. So it sounds kind of scary,
(32:40)
But it's kind of like when you ... I don't know if you guys are runners. I'm not a runner, but I'll use the analogy. Yeah, you mentioned you didn't do much cardio. Don't talk about it. But the idea is that, so when you do high impact sports, you're creating micro traumas to your bones. And when those bones heal, it actually strengthens the bones and increases bone density, which is why things like running, even weightlifting, can help fight things like osteoporosis for some of our older women. And the same thing is true for things like laser resurfacing. So if you injure it too much, then that's really bad because then the skin really can't recover. Just like if you have a really bad fracture, things like that, the recovery's going to be really bad.
Doree Shafrir (33:30):
Yeah.
Dr. Jenny Wang (33:31):
So the idea is we're creating micro injuries to the skin and then it's able to repair itself very quickly. Anytime it does that, it basically promotes more collagen, better skin integrity, and actually it can improve overall skin health. So there's a lot of exciting new data out saying that a lot of these resurfacing technologies on the skin, not just cosmetic, it can actually minimize risks of skin cancer, which is huge. You're actually just reversing aging on the face.
Elise Hu (34:06):
Okay. Thank you for this explanation.
Dr. Jenny Wang (34:09):
Yeah, of course.
Elise Hu (34:11):
Okay. The next question from a listener says, "I am 55 and I'm looking for a good hydrating serum that does not contain hyaluronic acid. My skin does not love it for some reason and it makes me drier even when I use a face mist before I apply." Every hydrating serum seems to contain this ingredient. Please help. It's getting cold here and my skin is getting drier by the moment.
Dr. Jenny Wang (34:37):
Yeah. So hyaluric acid is very popular. I think it's very popular because it feels very nice. It feels very lubricating and soft and really it is just meant to be a moisturizer. So if we're looking for a good moisturizers, you can certainly go for a thick water-based moisturizer like a cream. So in general, creams are going to be thicker than lotions. Even a big tub of something like a Eucerin or Syrave cream, and they sell them in large bulks, you could probably get them at Costco as well. That, and sometimes if that's not enough, you can almost do, it's like a slugging effect where you take Vaseline, which is petroleum jelly, which is very occlusive and you can thicken your moisturizer by doing that. And the key with all of these moisturizers is that you should do it when your face is slightly damp. So after you clean your face, pet the face down dry, put the moisturizer on so it really occludes the moisture that's already on your face.
(35:47)
Because if your skin's super dry and you put it on, it's not going to really trap that moisture. And that's what really, really trying to do. So I don't think you have to necessarily go try all these expensive serums. You can certainly try with something basic like this, and you can really get the same effect. Sometimes if I have a dry patch, even from overuse of a retinoid, I'll just put a bunch of Vaseline on my face and the next day it actually looks much better.
Elise Hu (36:12):
How do you feel about face oils?
Dr. Jenny Wang (36:16):
So in general, when a patient comes to me and they bring their products and they tell me, "Go over my skincare routine, tell me what I need to change." And I ask them, "Do you like your skincare routine? Is it working for you? Because if it is, there's no need to change it. " I think skincare is so personal and it's very therapeutic. So some of my patients do have a 10 step skincare routine and they love it. And I say, "Don't change it. " So if you find that you like your skin oil, you like the way it feels on your skin, go for it. But if you're coming to me because you're having issues, then I'll maybe change course a little bit. So face oils, I can see issues with a lot of my patients that have oilier skin at baseline, acne prone skin.
(37:03)
The reason is our faces naturally produce oils. And when we introduce more oils to the face, it starts becoming almost like a, it's like a buffet for the organisms that are already present on your face. So this sounds super gross and patients always get freaked out when I tell them this, but you have low levels, just normal levels of mites on your face. It's called Demodex. You have fungus on your face, you have bacteria on your face. This is super normal. It's just everywhere. When you introduce more oils, it's literally, it's just a food source for them and these things can thrive. And I sometimes will see certain skin problems that will get a lot worse with the use of essential, with oils, face oils. It can sometimes make acne a little bit worse. I see really bad dandruff. It's called suburic dermatitis where you just get these yellow flaky patches.
(38:02)
Hairy oral dermatitis is super common with my patients. They get this red rash around their mouth sometimes around the eyes. Super common. And sometimes overgrowth of Demodex, which is those mites and you get these little yellow pustules on the face, they get really itchy. So I always tell them that, yeah, you got to take away the oil based toners, the oil based cleansers, the face oils. Yeah. You just really got to start basic. Sometimes just less is more, less is more.
Elise Hu (38:32):
Yeah. Yeah. It's a good reminder.
Doree Shafrir (38:34):
I have a question about fillers because I feel like in the last, I don't know, six to 12 months, there's been a lot of conversation on social media about how fillers are like the devil and they stay in your face forever. Or they
Elise Hu (38:52):
Migrate funny, right? Or
Doree Shafrir (38:54):
They migrate. And it feels like there's been this real shift in terms of like how people are thinking about fillers. So my question to you is, how much of this is real and have you seen this shift also like in your own patients? Are people kind of moving away from fillers?
Dr. Jenny Wang (39:13):
This is such a timely topic because you're absolutely right. There has been a huge shift and it's something that is actually brought up a lot at conferences. I mean, definitely, I think the companies that cell fillers are definitely, they're noticing this because they can track. They can track how much product is being pushed and it's definitely gone down significantly.
Doree Shafrir (39:37):
Oh wow. Okay.
Dr. Jenny Wang (39:38):
And yeah, so it's a very real phenomenon, just even financially. And I do think that a lot of it is due to what we see on social media and what we see with maybe our celebrities and pop culture. What we see are examples of unfortunately bad filler. So whether it's too ... Usually it's too much filler. So when we think of the stereotypical overfilled face, you cannot achieve that with one session. One session is not going to do that. That's usually someone who has gone to get fillers multiple times.
(40:17)
And at some point, you get something called perception drift, which means you see yourself in the mirror and that's your normal. You put some filler in there, now you will get yourself in the mirror. That is your new normal. And each time that new normal shifts a little bit. And at some point you lose sight of what you're supposed to look like in the beginning. And I do think as physicians, as practitioners, we do have a responsibility to tell our patients maybe when is too much, too much. But sometimes in me, that's not always the case and they do end up getting more and more and more, or they might see different physicians or different offices
Elise Hu (41:02):
And
Dr. Jenny Wang (41:03):
They don't know what they have done. And I say, "You're just walking to my office for the first time. Of course, I want to give you good experience. I'll deliver what you ask for. " And so I think there's just a lot of bad examples of filler out there, but what people don't realize is no one talks about the examples of good filler. Because it's imperceptible. It's imperceptible, yeah. Where a lot of non-celebrities or just people walking out in society, you can't really tell. They just kind of keep looking pretty good. And that's usually what we're trying to achieve. And of course, every physician has their own philosophy, but for me, definitely I like a more natural look. I'm not trying to change the way anyone looks. I'm just trying to help make someone feel their best selves. And so in regards to, does it migrate?
(42:03)
If you put too much of filler in one space, it will absolutely migrate because there's just not enough space for that filler to be held. So that goes for your lips, for instance, your cheeks. When a filler is properly placed in the right plane, because there's different planes on the face, that filler usually will stay there. And we do see very low examples of migration when properly placed in the right amounts. But unfortunately, we do just have bad examples out there. And I do think it's led to this fear of filler, which I don't think is ... I mean, I think it's very important for people to realize what can happen when these procedures go wrong. Yeah.
Elise Hu (42:48):
There are side effects sometimes.
Dr. Jenny Wang (42:49):
There are side effects, yes. There are some dangerous side effects for filler placement. And so I think it's very important to know who's injecting you. I think here, your training really matters, your expertise really matters. You could pretty much get Botox filler just around the corner anywhere
Dr. Jenny Wang (43:10):
In these
Dr. Jenny Wang (43:11):
Days.
Elise Hu (43:12):
That's true.
Dr. Jenny Wang (43:13):
Yeah. There's groupons. There's group bonds. And also there's products out here that they're not really FDA approved filler products. So you have different off label brands, off brands, exactly. So who knows how long those products can last for. So I think it's a little bit of a wild wild west out there, but I do tell my patients, I definitely tell them, "Hey, if you have a fear, we can talk about it. What are your concerns?" I can try to help you understand them, but at the end of the day, some people don't want to go for fillers, and I think that's totally fair. It's a cosmetic treatment at the end of the day.
Doree Shafrir (43:57):
Yeah. Right. Yeah. I have another sort of social media influenced question for you, which is I've seen a bunch of plastic surgeons on TikTok saying, "If you think you might get a facelift at some point, don't do Morpheus and don't do RF microneedling because it will melt your skin or something." I don't totally understand, but I'm wondering what you think of that. And then I have another follow up after that about dermatology treatments versus plastic surgery treatments.
Dr. Jenny Wang (44:36):
Yeah. Yeah. I actually haven't heard the one about don't do microneedling or Morpheus with facelifts, but I have heard don't do sculptra with facelifts, but just the idea that don't do X procedure because you're going to think about doing X, Y, Z. And actually, I have spoken to different plastic surgeons specifically regarding sculptra. So what sculptra is, it's a biostimulator. It's injected like a filler, so it carries some of the similar risks that a filler will carry as well, but the idea is that it boosts collagen, and so you don't receive the results till a few months down the road, sometimes up to a year. Oh, interesting. Okay. And then, but some of the side effects of that is because we're actually promoting collagen production, sometimes you can get fibrosis. So basically a little bit of thickening underneath the skin. And so the idea is that when you're doing a facelift, it's harder to actually get to the correct plane and safely lift the skin
Elise Hu (45:43):
Off
Dr. Jenny Wang (45:44):
To move it. And so I have been hearing a little bit of that concern with those two procedures. But plastic surgeons that actually do both, they're totally, they're like, "That's not a problem at all. "
Doree Shafrir (45:56):
Interesting.
Dr. Jenny Wang (45:56):
And it actually makes the procedures not necessarily easier. You want to know that they have a history of that. So you know what you're getting yourself into, but it actually improves the skin integrity. So rather than transposing a flimsy piece of skin, you have a little bit more- To work with. ... a little bit more integrity to work with.
Elise Hu (46:17):
Okay.
Dr. Jenny Wang (46:18):
So I think it really depends on what services do these plastic surgeons offer.
Elise Hu (46:25):
Is
Dr. Jenny Wang (46:26):
There a conflict of interest? Are they just trying to sell more facelifts?
Doree Shafrir (46:29):
Yes, exactly. This is my question.
Dr. Jenny Wang (46:32):
Yeah. Not everyone is going to go for a facelift. And also, it's not like you can get a facelift every decade. You can get at most maybe two facelifts. I'm not a plex surgeon, so I don't actually know the ... But each time you have a facelift, you do have more scar tissue. You can't do it in infinite amount of times.
Dr. Jenny Wang (46:55):
So
Dr. Jenny Wang (46:56):
If you're trying to delay that facelift, are you just not going to do anything in the meantime? There are safe, non-invasive things to try to help delay that first facelift even. Wow.
Elise Hu (47:07):
I feel like we could talk to you for a long time and we should probably ... We have a makeup artist who comes on kind of quarterly, so we should probably have you check in at least twice a year or something because it's been so enlightening and educational to catch up with you. It seems like skincare and the medicine behind it is constantly changing and innovating and improving. So learning a lot from you. Dr. Wang, thank you so much for coming on. And where can folks find you online or where should we point folks who are interested in learning about you and your practice?
Dr. Jenny Wang (47:41):
So yes, we are on social media. I'm not great at updating it, but our Instagram candle is @socalskinsurg. And we're a practice based in Ply Vista in West LA and we've been open for about a year and a half now and I would love to see ... Yeah, I would love to see patients in person. Fantastic. So that's what I do with my time.
Elise Hu (48:07):
Okay. Amazing. Fantastic. Thank you for coming on. It was so fun. Yeah, of course. It was really fun.
Dr. Jenny Wang (48:12):
Thank you so much.
Doree Shafrir (48:16):
Well, Elise, I am very loyal to my dermatologist, but I feel like if anything were to happen to him, I would know where I could go.
Elise Hu (48:28):
Yes, you know exactly. I know exactly.
Doree Shafrir (48:31):
No,
Elise Hu (48:31):
It is on the other side of the 405 from you, so I don't know. This is basically like a bicoastal trip.
Doree Shafrir (48:37):
Yeah. I mean, my current dermatologist-
Elise Hu (48:38):
Let's hope nothing happens to your dermatologist.
Doree Shafrir (48:40):
Yeah. He's in Century City, so it's not super close, but it's also manageable. Other side of the 405, that might be pushing it. All right. Well, Elise, you were going to exercise three to five times a week.
Elise Hu (48:56):
I am very proud to say I have done it. I have been lifting weights. Wow. I feel buff. I played a little tennis this morning with some moms, two of them who I'd never met, and one of them brought dead balls and I was very annoyed because- That's a bummer. ... because then you have some balls that are really bouncy, the ones that I brought, and then some balls that are not. And then I'm like, you have to kind of hit them differently based on whether there's air in them. And so that was kind of annoying, but I have exercised and I think you had a similar intention, if I recall.
Doree Shafrir (49:35):
I did. And I even brought some stuff to work out in Boston and I just didn't do it. I don't know, my sleep was so off with the time- Yeah, travel takes a lot.
Elise Hu (49:49):
Yeah.
Doree Shafrir (49:49):
And then with Henry, and it just didn't happen. And I don't know, I would really like to get back to group fitness classes. That would be fun. So I don't know. Maybe I'll look into that because I need to do something. I need to do some sort of weight situation. My parents go to the gym together every day.
Elise Hu (50:13):
I took Rob to mega former Pilates on Sunday, and it was so fun.
Doree Shafrir (50:17):
Wow.
Elise Hu (50:18):
Yeah, because he had no idea what was going on. It's really fun to watch.
Doree Shafrir (50:24):
Does Rob play tennis? Yeah,
Elise Hu (50:26):
He can play tennis too.
Doree Shafrir (50:27):
That's fun.
Elise Hu (50:28):
Yeah. But I mean, he's not great at it, but he can. My main thing with him is that I don't like to just go to the gym with him. He likes to go to the gym and just lift weights. And I find that kind of boring. So if I could get him to go to a group exercise class and just watch him futz around and not quite understand, it cracks me up. That's
Doree Shafrir (50:50):
Funny. So
Elise Hu (50:50):
What are you going to do for this week? What's your new intention?
Doree Shafrir (50:53):
Elise, I think my new intention is an old intention, which is I need to declutter my office. I was in a good decluttering rhythm for a little while, and then, I don't know, I guess the travel and just all the other stuff, I feel like I fell off the wagon, so I need to get back into that.
Elise Hu (51:18):
Mine is sort of the opposite. I'm going to clutter my house. I'm going to put up my Christmas decor. Oh
Doree Shafrir (51:24):
My gosh.
Elise Hu (51:24):
We have some lights up outside, but not complete, and then I still have pumpkins on the porch. I got to switch out. It's time to switch things out. And Rob is with us. So we have Chris McKa, we have Hanukkah and Christmas going on in here. So it's going to be a bit of a production.
Doree Shafrir (51:45):
We also need to put up our Christmas stuff, so that's a good reminder. Thank you. Rob
Elise Hu (51:50):
Did buy guilt already. We do have guilt.
Doree Shafrir (51:53):
Okay.
Elise Hu (51:53):
I'm ready. Yeah.
Doree Shafrir (51:54):
Nice. All right, listeners, this is the episode where we thank everyone who supports us at the $10 level and above. We are so grateful to you. This is just one of the many ways that we want to say thank you. If I could thank you every day, I would.
Elise Hu (52:11):
The folks we want to thank are Sarah Liska, Fiona Castro LeBrun, Felicia, Justice Byro, Jasmine, De Jesus, Christie, Heather Whaley, Caitlin H, Katie, Ashley Taylor, Teresa Anderson, Michelle, Nicole Gass, Maya, Barbra C., Amy, Amy Schnitzer, Megan, Shelly Lee, Kim Biegler, Sarah Buzi, Alison Cohen, Susan Berceth, Fran, Kelsey Wolfdene, Laura Eddie, Jdell Appde, Valerie Bruno, Julie Daniel, E. Jackson, Katherine Burke, Amy Maseko, Liz Rain, JDK, Hannah M, Julia P, Mattio Day, Marissa, Sarah Bell, Maria, Diana Coco Bean, Laura Haddon, Josie H, Nikki Bosser, Juliana Duff, Chelsea Torres, Tiffany G, Emily McIntyre, Stephanie Germana, Olivia Fahey, Elizabeth A, Christine Bassis, Jessica Gayle, Zulimel Lundy, Carolyn Rodriguez, Carrie Golds, Anne T, Katherine Ellingson, Kara Brugman, Sarah H, Sarah Egan, Jess Combin, Jennifer Olson, Jennifer H.S., Eliza Gibson, Jillian Bowman, Brianne Macy, Elizabeth Holland, Karen Perrelman, Katie Jordan, Sarah M, Kate M, Josie Alquist, Tara Todd, Elizabeth Cleary and Monica.
(53:24)
Thank you all so much and thank you to everybody in our community that listens every week. Yeah,
Doree Shafrir (53:30):
We're so thankful. And just a reminder that Forever 35 is hosted and produced by me, Doree Shafrir, and Elise Hu and produced and edited by Samee Junio. Sami Reed is our project manager and our network partner is Acast. Thanks everyone. Talk to you next time. Bye.