WEBVTT
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Welcome to Listen to your Skin by Moon and Skin, the podcast where science meets nature to celebrate the story of your skin.
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Your skin is a living canvas, ever evolving, deeply personal and uniquely yours.
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Each week, we'll dive into the science of healthy skin, share empowering stories and uncover transformative self-care rituals.
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We're here to help you embrace every phase of your journey with confidence and care.
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Hi, hi, thank you for having me.
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I love it.
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I have so many questions.
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I am 41.
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I am perimenopausal, really bordering like menopausal.
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I have so many questions about my skin because it's just not the same anymore.
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What actually works?
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What do I actually need to invest in?
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Right, yeah, so I'd say between 35 and 55, it's a really tricky time because everybody's aging at a different rate and it depends on what's going on in your environment, in your body, hormonally.
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And I don't think we talk enough about hormones and I understand you've gone through some things with your hormones which have lowered your estrogen dramatically, and what happens is is when we're in our 20s to 30s, we lose about one percent of collagen per year and then as we get perimenopausal which can be 15 years our estrogen drops dramatically and our collagen drops dramatically.
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And I often think of it as like a balloon.
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You know when you have a party and you have a balloon blown up and you clean everything up but you might have forgotten a balloon in the corner and you come back a couple weeks later and you find the balloon and it's deflated, where you have lots of little crinkles in there, like that crepiness of the skin, and that's what low estrogen looks like in the skin.
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Wow.
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So as a cancer survivor, am I allowed to use estrogen, or what do you think is the best way to battle that?
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Yeah, that's such a good question because when I was a resident, the women's health initiative came out that basically said that the hormone replacement was bad for everyone, and now we're finding a lot of evidence to the contrary, where we're finding that hormonal supplementation can be very beneficial for everything from our bones to our skin, to our brains and our cardiovascular health actually.
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But when you have a hormone-positive, receptor-positive breast cancer, we really are not on board with adding estrogen therapy.
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So we have seen intravaginal and topical estrogen cream be very beneficial for those organs, for both the vaginal mucosa to be plump and more moist and for the skin to have improved hydration and improved collagen.
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So by adding topical estrogen cream, which is compounded in a pharmacy, some women are using the vaginal estrogen topically on their skin and that those estrogen receptors are getting hit to produce more collagen topically in the skin without getting systemically absorbed in the body.
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We're not finding levels in the blood.
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Wow, okay, talk to me about dark spots, because I first started struggling with dark spots when I was going through my pregnancies and as I've gotten older, it just is something that I'm having a really hard time like solving.
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So what do I do about that?
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Yeah, so we'll talk about all dark spots.
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But on the topic of estrogen, um, during pregnancy or with birth control, having high estrogen levels can contribute to something called melasma, which I personally struggle with, and that's one type of dark spot.
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So while I'm 53 and while I want to apply topical estrogen to my skin, I often know I'm going overboard when I start getting more of that melasma back.
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There's different types of dark spots, so all dark spots are not created equal.
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There's what we call static or stable dark spots, and then there's dynamic or unstable dark spots.
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So melasma is unstable Anything that's going to inflame it or heat can make it worse.
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And then stable is sunspots, like the age spots on the back of your hands or the sunspots on your face and those you could just like ablate with a laser and they go away and it takes years for them to come back.
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But if you burn off, melasma or the dark spot that you get after a pimple or a cut goes away, which we call post-inflammatory hyperpigmentation that can come back tenfold immediately worse.
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Wow, Okay.
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So what's the difference between dark spots and rosacea and how do you treat them?
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Do you treat them the same or different?
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No, they're totally different.
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So rosacea is, I would say rosacea is most often confused with sensitive skin.
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So sensitive skin is a breakdown of the skin barrier.
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So we have this beautiful skin barrier that protects us from the outside world and when it's broken down, the worst case is like in a burn victim, when the skin barrier is completely destroyed.
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Burn victims die from infection and dehydration.
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So if you think about all of our bodies 60% water and it's being held in by our skin and we're not losing it and it's protecting us from environmental toxins and microbes and pathogens and all sorts of germs, basically.
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So sensitive skin is when there's a compromise of the skin barrier and it could be.
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Typically it's from overuse of soap or using too many chemicals on the skin that the skin can't protect itself anymore.
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Rosacea looks like sensitive skin and it does have a sensitive skin component, but it also has something called vasomotor instability, or basically the blood vessels are not stable.
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So there's three forms of rosacea.
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There's a really long word called erythematalangetatic form, which is basically flushing, when people get really red and they flush up and down.
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The second form is papulopustular and that looks like pimples and the pimples are typically on the central part of the face and they're red juicy pimples or they're whitehead pimples.
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You never see blackheads and whiteheads.
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So someone 20s, 30s and 40s can get that type.
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And then the third form is like the WC Fields nose.
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So rosacea is more about unstable blood vessels.
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So we want to get the blood vessels stable again and we do that with some of the strategies that we use for sensitive skin, as well as other strategies that we do internally.
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Wow, that's amazing.
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So much.
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I have so many more questions.
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So tell me about chocolate and breaking out, because one thing that I've noticed is I love chocolate so much, but sometimes it makes me break out.
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Is it something like an ingredient in the chocolate?
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Is it sugar?
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Is it what?
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kind of chocolate are you?
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having.
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Um, I mean, I like dark chart, like dark chocolate, like cacao.
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But does that break you?
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out.
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Yeah, really Okay.
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There's a couple of interesting things about chocolate, because I always felt like it was more the sugar in the chocolate, because the quicker your blood sugar jumps up, the more likely you're going to have high insulin and then inflammation and that leads to acne.
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Some chocolate is also high in cadmium, which is a heavy metal found in the earth.
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It tends to pull it up, but that hasn't really been linked to acne.
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I suspect it's more the sugar going on, because cocoa itself really we haven't found a really good link to acne.
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It's more the sugar.
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But because cocoa itself really we haven't found a really good link to acne, it's more the sugar.
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But I mean, I always say listen to your body, listen to your skin, and if your body's telling you something, you have to listen to it.
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I've heard all sorts of things over the years and I just want people to listen to their own body.
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That's so fair, okay.
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So one last question.
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I feel like there are so many products out there, I so one last question.
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I feel like there are so many products out there.
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I mean it's so hard to narrow down.
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Do I need 15 different products that are going to do all of the things for my skin, or what is a good like go-to, you know process for my skin?
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That's a really good question.
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So it depends on where you're starting, right.
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So I think simple is better, because we do have science for individual products.
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We don't have great science for how these products interact with each other.
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So when we're layering five, six, seven, eight layers together, what's going on there?
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You look at sodium and sodium mixes with chloride and makes salt, no problem.
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You take sodium and you mix it with water and it makes an explosion.
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So just because five ingredients are good, I don't know how they're going to be together.
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So I like to keep it simple.
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With a good cleanser that's not going to strip your skin barrier and cause sensitive skin.
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Then a vitamin C product in the morning, something that's stable.
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So ascorbic acid is the active form of vitamin C and it's unstable.
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So as soon as it hits light, heat or oxygen, it doesn't work any longer and it becomes unstable.
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So there's other forms like THD ascorbate and sodium ascorbyl phosphate that convert into ascorbic acid in the skin and I prefer those forms because they're more stable on the shelf.
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Right, because we're not in the lab, we're in our bodies.
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So we want things to work in our bodies and we want things to work in our bodies.
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And then if someone's dealing with pigmentation or acne, I'll have them use a targeted serum at that point and then moisturize their sunscreen in the morning.
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That's the most anyone needs.
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Now, if someone, I tend to be a little oily.
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I don't use a moisturizer in the morning, I only use it at night.
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So at night I like cleansing, get the makeup and the dirt and debris off your face and then put a retinol on your skin, something that's not going to be irritating Less is more.
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It works through cell signaling.
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So Having heavy coverage with a retinol is going to irritate the skin more.
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We don't need a lot.
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We have to trust the science because it signals through the nucleus of the cell and we don't need a lot of coverage.
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We have to just trust that the molecule will get where it needs to be to enhance cell renewal and then let that dry and put a really good moisturizer on.
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I love finding moisturizers that can be used as eye creams and neck creams, so you don't have to have multiple products.
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And then I like people to change with every season.
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So our skin takes about six to 12 weeks, depending on how old we are, to turn over and we want to look with the changes of the seasons, like are we going to add something to exfoliate the brown spots off in the fall?
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That's a great time.
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Are we going to add more moisturizer in the winter?
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So I do like people to modify things.
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So you may have 10 or 15 products, but you're not using them all at the same time.
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You're kind of rotating them and cycling them in and out and going back to topical estrogen.
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You would add that either as your moisturizer, depending on how it's compounded, or as your step after the retinol, before your moisturizer at night and then after your vitamin C in the morning, before your moisturizer and sunscreen in the morning.
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So we can incorporate things to make a more bespoke plan, depending on what someone's skin needs are.
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That makes sense?
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Okay, one more, one more.
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Last, last question.
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I love it.
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Big pores.
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Is there really a solution to the pores situation?
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Yeah, so there is a laser.
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There's a laser that can actually help reduce pore size, believe it or not.
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I'm not even going to give the wavelength.
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I think it's a 13, 20 nanometer wavelength, but don't, don't hold me to that, because I don't.
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Yeah, so there's different lasers for different things.
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And the cool thing about lasers is lasers are basically attracted to certain chromophores or targets in the skin.
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So, like I said, with the liposomal technology of the retinol, it can bypass the epidermis.
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Lasers can bypass damaging the top layers to target hemoglobin in a blood vessel to help collapse the blood vessel, or bypass the epidermis to attach to the sebaceous gland or the oil gland and do things like that.
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Or be attracted to pigment, whether it's deep pigment at a hair follicle for hair removal, or more superficial well, depending on the depth of the tattoo, like different levels for tattoo removal or for each spots or brown spots.
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So lasers basically target certain things.
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So I I like lasers.
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What was I even talking about?
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Pores, pores, yeah, so for pores in general, for most people that aren't going to spend thousands of dollars on a laser for reducing their pore size.
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Really, what you want to do is just clean out your pores.
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So I like products containing salicylic acid because it's a keratolytic, which means it breaks down keratin or the dead skin cells, but it's attracted to oil.
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So glycolic acid just kind of loosens up the dead skin cells, but salicylic acid goes to the oil glands to remove the skin cells.
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So if you have a big pore and a big opening and it's filled with something, it's going to look larger.
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So if you can clean out the debris and the dead skin cells and the dirt and the oxygen and everything inside there, it will appear smaller, even though it's not actually smaller.
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And what really matters is how it appears at the end of the day.
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And that's basically it.
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Speaking of the time of day, are there certain masks that you should use at different times of day?
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You know like, should I do charcoal in the morning and a moisturizing mask at night, or does it matter?
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Yeah, I don't think it really matters.
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I don't think there's a lot of science with the circadian clock for masks.
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I'm not like the hugest mask person.
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I'm more about the compound effect, like little things over time, how it makes a difference If you're dealing with, if you want to do a detox or something, you could do a charcoal mask every once in a while.
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Or if you need hyperinfusion of hydration, then you could do a hydrating mask overnight, Like overnight you want to do more hydration because that's typically when we're losing the most water with our circadian clock.
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I've been getting way more disciplined about my diet and how I'm eating because I'm starting to become so much more conscious of how I feel in my body with the food, which is amazing.
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But are there certain foods that are best to avoid, or maybe even certain foods that are best to digest?
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That will help my skin.
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Yeah.
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So you know it's interesting.
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I heard a quote from Mother Teresa years ago talk about somebody said are you going to go fight against that war?
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And she goes no, they go.
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So you want war?
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And she said, no, she goes I don't.
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I will fight for peace, but I'm not going to fight against something.
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So I often look at diet that way too.
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It's so easy to say don't do this and don't do that.
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And yes, I don't find benefits of sugar.
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Sugar has no nutritional benefit for your body or for your skin, maybe your tongue, but that's about it, right.
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So I like to focus on what to add in right, and if we add the right things in, then we're going to naturally eliminate the things that we don't want without beating ourselves up.
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I love that that's so much less constrictive and restrictive, you know.
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Yeah, I mean, I do that to to myself.
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So the last thing I want to do is like, have that done to other people, but like, if we focus on for women in particular, we really want to focus on getting enough protein, and in the form of high quality protein, and soy is not the one that I want people to get.
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So, whether it's you pea protein or hemp protein, or I choose high quality regeneratively farmed meat and getting about one pound per ideal body weight.
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So you know, if you're overweight and you're aiming for 130, then go for 130 grams per day.
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So getting high quality protein in your ideal body weight in grams of protein per day, having as many vegetables as you want.
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This is an unpopular opinion, but I don't believe fruit is meant to be eaten in the winter.
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Fruit is there for the summertime, to make us a little chubby, so we could survive a winter.
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We don't live in that kind of world anymore, so I don't really eat fruit, except for the summertime and maybe into the fall, like we would naturally harvest, harvest it.
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But if you do have a sweet tooth and you want some berries or some mango, they're.
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They're definitely beneficial and there's studies showing that some mango up to I can't remember how many grams, but a certain number of grams per day actually helped improve the appearance of the skin.
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Then once you got past a certain threshold, it reduced the appearance of the skin.
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Then, once you got past a certain threshold, it reduced the appearance of the skin.
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And I think that what happens with a small amount of mango it was boosting the polyphenols, the healthy colorful nutrients that are in the fruit, in your skin, but too much boosted the sugar.
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So there's a sweet spot where a little bit will help your skin, but then too much the sugar outweighs's a sweet spot where a little bit will help your skin, but then too much the sugar outweighs the benefits of the polyphenols.
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So that's with fruit.
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And then I try to avoid processed carbohydrates like anything that's really in a package, if we can right, and instead we just want to focus on whole, real food.
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So I'm not a big fan of measuring the amount of olive oil you use or worrying about eating the whole avocado Anything that's a real food that has one ingredient.
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Go for it and I doubt you'll ever be overweight and you'll have enough ability to maintain muscle mass and all the building blocks for your skin if you have a whole food diet.
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Wow, that's really great.
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Are there any ingredients I should be looking for in my products?
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Skincare I know there's a lot to avoid, so just to keep it simple, kind of what we were talking about with the food like what food are we looking for?
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What ingredients are?
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Like yes, that's what I should have in my products.
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Yeah, so it depends.
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Product selection depends on a lot of factors.
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So it depends on what age you are, what season of life you're in, because what you're going to use as a teenager is going to be different from when you're 40, and also where you live.
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So somewhere like Arizona, you're going to need more hydrating products than if you live somewhere like Hawaii, for instance, right, so all of those variables taken into effect, I mean you want to find a cleanser that's going to remove effectively remove dirt from the skin without stripping your skin of its skin barrier, because that's going to compromise you and make you more prone to environmental toxins and breakdown of your collagen all the things we're trying to avoid.
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And then, in the morning, I really like people to use a vitamin C.
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It's one of the most tried and true things.
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The biggest thing with vitamin C is looking for a staple form of vitamin C with either sodium or ascorbyl phosphate, especially for anyone that is prone to acne.
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If they're prone to acne or rosacea, they want to look for a form with sodium ascorbyl phosphate, because a lot of people break out with vitamin C, so that form is less likely to break out with or THD ascorbate is another form.
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And then sunscreen.
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And with sunscreen I don't like the chemicals.
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I've never liked the chemicals since I was 30 using sunscreen.
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I've always recommended sunscreen with zinc oxide.
00:18:13.885 --> 00:18:28.926
And one of the things I noticed just from looking at tens of thousands of patients over the years when people put sunscreen on, they go center to out and I see most skin cancers right on the periphery of the face and, for men, behind the ear.
00:18:28.926 --> 00:18:34.491
So as we blend it out, it becomes thinner and not even applied peripherally.
00:18:34.491 --> 00:18:46.760
So I like people to apply sunscreen from outward to inward because we're always going to cover our nose and see that in front of us and that way we'll be less likely to get skin cancers and brown spots on the periphery of the face.
00:18:46.800 --> 00:18:56.780
Where I see them day in and day out, especially on the left side of the face from driving, because the UVA comes through the windows, so at night, what I like people to use is a retinol.
00:18:56.780 --> 00:19:00.009
So retinol is it's not the hottest thing.
00:19:00.009 --> 00:19:05.086
It's been around since the 1970s, since Dr Kligman discovered retinol, and it works in so many ways.
00:19:05.086 --> 00:19:07.431
It helps lift off pigmentation.
00:19:07.431 --> 00:19:13.815
Retinol helps remove the dead layers of the skin because this slows down with age.
00:19:13.815 --> 00:19:26.012
Over time it also sends signals to produce collagen, so it really works in so many ways to reverse sun damage, to help improve the appearance of skin and fine lines and wrinkles.
00:19:26.012 --> 00:19:29.726
The problem with retinol is that it could be really irritating to the skin.
00:19:29.726 --> 00:19:39.902
So I want people to start slow and go slow, just starting three times a week for two to three weeks and then increasing one night every two weeks until they could tolerate it every night.
00:19:39.902 --> 00:19:45.313
But retinol is definitely something that should be a staple in everyone's plan, unless you're pregnant.
00:19:45.894 --> 00:19:46.335
Amazing.
00:19:46.335 --> 00:19:55.251
Yeah, I think the hardest or the most confusing part for me was going through breast cancer and becoming extra sensitive in my skin to pretty much every product.
00:19:55.251 --> 00:19:59.044
So I think, just a little clarity on how do I help my skin heal.
00:19:59.044 --> 00:20:06.392
So I think, just a little clarity on how do I help my skin heal, you know, if it's dry or if it's just feeling like I don't really know what to do with it or for it.
00:20:06.392 --> 00:20:09.635
I think just knowing you know how to heal it.
00:20:11.519 --> 00:20:11.980
Yeah, so less is more.
00:20:11.980 --> 00:20:15.692
If you're dealing with sensitive skin, the more things you apply, the more irritating they're going to be.
00:20:15.692 --> 00:20:20.688
Something that you could tolerate when your skin barrier is not broken down you can't tolerate when it is.
00:20:20.688 --> 00:20:31.563
So if someone is dealing with sensitive or irritated skin or going through what you've been through, I would definitely recommend very, very gentle cleanser twice a day, no toner at all.
00:20:31.563 --> 00:20:53.192
Definitely skip a toner, and I'd probably avoid vitamin C and retinol at the time and use a high quality moisturizer, something that contains hyaluronic acid or niacinamide Niacinamide is very calming and soothing and just keep the hydration simple until your skin barrier is maintained, and then you could slowly start introducing something.
00:20:53.192 --> 00:21:00.261
When your skin barrier is maintained and you're not sensitive anymore, you introduce one new thing every two to three weeks.
00:21:01.083 --> 00:21:02.124
That's what I was just going to ask.
00:21:02.124 --> 00:21:05.787
Do you recommend a certain way, like a certain ingredient, to start with?
00:21:06.126 --> 00:21:27.243
I'd probably start with the vitamin C in the morning and then wait two to three weeks, make sure you're not having any issues and that you're tolerating it well, and then you're starting to get a little bit of a brightening effect from the vitamin C, which is great, and then the retinol is going to be the next thing you're going to want to add, because that's always the sensitivity trigger, but it also gives us the most benefits.
00:21:27.243 --> 00:21:29.530
So you know no pain, no gain, but we don't want the pain.
00:21:29.530 --> 00:21:30.843
There's ways to do it without pain.
00:21:31.083 --> 00:21:32.226
Yeah, amazing.
00:21:32.226 --> 00:21:33.409
Thank you so much.
00:21:33.409 --> 00:21:36.902
I appreciate all the help and support my pleasure.
