India’s Top Dermatologist Reveals What’s Aging Your Skin | Dr Jaishree Sharad

India’s Top Dermatologist Reveals What’s Aging Your Skin | Dr Jaishree Sharad

Author Name:Mukul Deora

Youtube Channel Url:https://www.youtube.com/@mukul_deora

Youtube Video URL:https://www.youtube.com/watch?v=PDGhExOulVY



Transcript:
(00:00) Skin has become like a content creating machine. It's aspiration, it's wealth, it's success, everything. It's always I'm not good enough. You're always like, "What is wrong with my skin today?" >> Why do Indians get dark circles so easily? >> If you have to eliminate one thing that has [music] to be sugar.
(00:20) Smoking will cause dark circles. Insulin resistance, hypothyroidism, if [music] you have PCOD, again you can get dark circles. Why Korean skin care may not work really well for us? Because their genes are different. We're genetically very differently wired. Their environment is different. They can afford to do the 10-step skin care routine. We can't.
(00:38) Our pores will get clogged. We'll be sweaty. >> [music] >> You're going to get acne. You're going to get milia. You're going to get folliculitis because of the pollution and blackheads [music] will increase, whiteheads will increase. Skin sensitivity, more inflammation. [music] It's not meant for our skin. >> What is the most common routine you see that is harming people? >> So, they feel they should use every possible ingredient that is out there.
(01:02) Mhm. So, my skin needs AHA, BHA, niacinamide, vitamin C, retinol, hyaluronic acid, alpha arbutin. [music] So, there are 10 different ingredients. You're confusing your skin. Your skin doesn't even need it. I think vitamin C is a grossly overrated ingredient. A lot of [music] times we tend to break out more when we use vitamin C.
(01:25) Skin longevity is the next big thing now. We're not talking about anti-aging anymore. [music] We are talking about preventative and skin longevity. So, if you want to just use one product [music] every single day, um you must use a >> Today we have Dr. Jaishree Sharad, one of India's leading dermatologists. I want you to know that we spent a lot of time choosing the right skin care expert for you because we wanted someone who not only understood the skin cosmetically, but also as an organ.
(01:53) We get into why sunblock is a non-negotiable, why pigmentation shows up before wrinkles, why over exfoliation can make you darker, and why Korean skin care may look harmless, but can still cause problems. You will leave this episode knowing what to stop doing, what to take seriously, and what is actually normal.
(02:11) Watch this till the end. Let's just pause. Subscribing here isn't just about supporting our channel. It's about choosing what kind of thinking you want around you regularly. So, if that resonates, you know what to do. You know, it seems everyone is talking about skin care now. 20 years ago, even when I was younger, skin care meant Pond's cream, or some coconut oil on your face or something.
(02:36) >> Talcum powder. >> Talcum powder was a big thing. Uh and soap. And now, everyone in India knows something or the other about skin care, peptides, you know, everybody has some idea about something. So, is the average Indian consumer in 2026 actually more informed about their skin, or are they just more anxious about it? >> I think a bit of both.
(02:59) You know, they are informed because you know, now you have digital platforms. Uh we we do all these podcasts. There's, of course, uh you know, Instagram. Um and people are talking about skin. In fact, skin has become like a content creating >> Mhm. >> machine now. >> For sure. >> Cuz you can do so many things about it. Um and so, I think there is awareness.
(03:29) Where people did not know that sunscreen should be applied even when you're at home, or a sunscreen is a thing, you know. Uh now, they understand that, okay, the importance of sunscreen. People, as I was just telling you, did not know that something called a retinoid or a retinol existed. Now, they think that it is important.
(03:48) I have youngsters coming to me with bags of like >> Mhm. >> products, and they are aware of AHAs and BHAs and arbutin and stuff like that. I have people in their 40s, 50s also saying, "Oh, but do don't you think I should use hyaluronic acid?" You know, or don't you think you know, my skin is sensitive, so maybe I should not use retinol, but I think I should use peptides.
(04:11) So, the awareness is there. Um but they're also This is also leading to a lot of anxiety because you know that you have to you know, sort of take care of your skin, but you don't know your skin type. You don't know the compatibility of the various products that you're using. You don't know what is good for you, not good for you.
(04:33) You don't know what um actually works for you. You don't have to use so many products. >> Right. >> And then you're because there is comparison, because there's so much judgment, because there are harsh lights, front cameras, high-definition cameras, strong lights, filters, everybody looking, you know, great on social media, you start that anxiety crops in somewhere.
(05:00) And it's always I'm not good enough, and you're always not looking into the mirror thinking um I look >> I look good. It's always like, "What is wrong with my skin today?" That's the shift. That's the shift, and it's not a great shift, but I think we have to have a balance and somewhere find out and put a foot stop to this anxiety.
(05:22) >> If you had to describe the current relationship between Indians and their skin in one image or analogy, what would that be? >> So, I think now uh as I said, they don't see it as just an organ of the body. They see it more with uh you know, it's my It's a commodity that I need to take care of, and it should look beautiful, and it should >> It's my It's my passport in a way.
(05:50) It's my >> It's absolutely my >> My calling card. >> calling card, you know. I think that's their relationship. >> It's my flex. >> This is how it you know it it's This is what depicts me. >> Yes. >> And >> It's It's kind of like a um >> It's It's aspiration. It's wealth. It's success. Everything. It's confidence. >> of me.
(06:09) >> It's completely a reflection of me. >> I think that's that's that I think that is the key. That's a very good point that for everyone today because of social media etc. and and all the extra um emphasis on looks the your face becomes a reflection of who you are. >> Absolutely. >> Which it's not. >> It's also something that's that you know I am using these expensive products so I am doing X number of treatments.
(06:37) So I am showing my wealth. I'm aspiring. I'm amidst all these uh a group of ladies or men who are discussing things and who is doing a better treatment. Um so that kind of an aspiration. Um how successful are you? You know, depends on what kind of products are you using and how >> using their face as the new Louis Vuitton handbag.
(07:02) >> Yes. >> I have a bag but look at my face. Look at the things I've done. And again it's so interesting because you may have >> like it. Why would you want to spend on a Louis Vuitton bag? You spend on your face. >> No, I I agree. >> in the right way. >> Yeah, in the right way. Because my point was that you can do a lot on your face and people do a lot on their face now.
(07:22) And a lot of procedures also which you know for not without any judgment they obviously think it makes them look better. But it's not going to have the same effect to everyone on everyone else. So >> 100%. >> Yeah. >> Yeah. >> Uh like a Louis Vuitton bag. You can carry a Louis Vuitton bag. You may think it's the best thing or not but someone else would be like why the hell are you showing off >> Yeah.
(07:39) >> and coming for a lunch with your Louis Vuitton bag. >> Yeah. Yeah. >> So it's an interesting uh But that's what the face is now. So, let's talk a little bit about skin. What is the difference between Western skin and Indian skin? >> See, the most important thing is that our color is different, right? So, Western skin is skin types 1 and 2.
(08:01) They have a pigment called pheomelanin, which makes them whiter. We have a pigment called eumelanin, which makes us duskier or darker. Okay, that's the primary difference. Now, this pigment, the melanin, basically, if you have more eumelanin, which we have, we have more protection from ultraviolet rays.
(08:26) And that is why you get away without using a sunscreen. Right? Whereas a Western white skin, a Caucasian skin, cannot get away with without using a sunscreen because they do not have melanin eumelanin in them. So, there's no protection from UVA, UVB. So, they get wrinkles much sooner. Also, the second point is our collagen is much much thicker.
(08:50) Collagen is something that's giving us structure, our skin's structure. It's making our skin firm. Now, uh we have more collagen and the skin is thicker. Their skin is thinner and they have collagen breakdown is rapid. They have lesser collagen. Which means they have wrinkles at a faster rapid at an earlier age than us.
(09:11) So, all in all, Indian skin is better than a Caucasian skin. We age gracefully. We Our lines and wrinkles come at a slower pace. Our pigment melanin, which is like it's our protective shield, it's protecting us from UVA, UVB. Uh it's it's If you see, Indians don't have so much of skin cancer, right? Caucasians are always, you know, basal cell carcinoma, squamous cell.
(09:39) It's not that you don't see it in India, you see it in people who are chronically outdoors. Right? So, that's the biggest advantage that we have. Our color protecting us from >> So, our dark skin is actually our protection. >> Absolutely. >> But because we are so look obsessed, we've made it into a negative thing. >> Yeah.
(09:56) >> Basically, you know, what >> Absolutely. >> Now, now >> People should realize that and that's why they should say, "Listen, dark is definitely beautiful." >> And with with with Africans, it's even more so. >> Even more >> so much collagen. You can see you can see a 60-year-old Eddie Murphy >> Hardly having wrinkles.
(10:11) >> He's he's I don't know how old he is. 60-plus. He looks the same as he was when he was 30. His skin is Yeah, he's he's 70 now almost, no? >> Yes, 70. >> And look at him. So, it's even more so. >> You understood it. >> But yet all over the world the darker the population is, the more obsessed they are with being fair, which includes Africa and India.
(10:29) >> to be tanned. They're always, you know, >> So, it's an interesting it's an interesting mix. >> The grass is always greener on the other side, right? >> So, tell me the the negative bits about Indian skin. The positive bits is that our darkness helps us against the real problem, which is cancer and and wrinkles.
(10:45) But what is the negative bit about having too much melanin? >> There's really nothing negative about having melanin. The negative aspect is that our melanocytes, which are the cells which produce melanin, become very active very quickly. So, if we are exposed to sun or if we you know, there's an injury or if there's a lot of friction or if we have an allergy uh these melanocytes which produce pigment become like they are like a factory which will they will start churning pigment.
(11:21) It's, you know, like a battlefield where suddenly there is, you know, there's an enemy like the sun and so all these soldiers start to function and they start to work. So, they create excess pigment. >> Mhm. >> Right? In order to try to protect you, they're doing that, but that is causing hyperpigmentation.
(11:41) That is causing uneven skin tone, blotchy skin. You get an injury, you end up with a dark mark which doesn't go too soon. So, that's called post-inflammatory hyperpigmentation. You have acne, it heals, but you have those dark spots. So, that is the excess hyperactivity of the melanocytes, and that's the negative of Indian skin.
(12:02) >> Got it. So, basically our soldiers, our skin soldiers, are slightly hypervigilant, which is actually a good thing for our health, but can visually not look so good. >> Not look so good. >> And therefore, we're tripping out about it, basically. >> Completely. >> So interesting, no? Uh what is the difference between Korean skin and Indian skin? >> See, Korean skin and Japanese skin, they're somewhere a mix between white and our color, right? And their cells, the melanocytes, are not so hyperactive.
(12:32) >> Mhm. >> Apart from that, the other things, okay, what is the difference? Why Korean skin care may not work really well for us? Because their genes are different. We're genetically very differently wired. Their environment is different, right? Look at us and our climate. >> Mhm. >> Hot, humid, okay? Their products are made for cold climates.
(12:57) Hardly any pollution, >> Yeah. >> right? Look at the diet. Diet plays a huge role uh in your skin care, you know, in the way your skin looks. Uh look at their diet and look at our diet. It's completely different. They can afford to do the 10-step skin care routine. We can't. Our pores will get clogged.
(13:18) We'll be sweaty, you know? >> The 10-step skin care routine is not good for our skin. >> not good for us. Right from starting to clean your face to the last product before, which is sunscreen, before your makeup is the it's a 10 step routine. >> Mind-blowing. >> All right. So, if you're going to apply so after cleansing if you're going to apply nine things on your face.
(13:38) >> nine things to apply. I thought it was 10 including like washing I don't know what. >> is the washing. But one to nine is applying the different things. >> So, they have nine layers. >> And if you're going to do that in a climate like ours, your pores are going to get clogged. You're going to get acne. You're going to get milia.
(13:54) You're going to get folliculitis because of the pollution and you know all of that. Blackheads will increase. Whiteheads will increase. Skin sensitivity, more inflammation. So, it's not something that is uh you know, it's not meant for our skin. And we need to understand that. Yeah, you may use their some of their products are very lightweight.
(14:13) So, you may use their you know, moisturizers and you may use uh maybe their toners. But their sunscreen again may not be adequate for our kind of sun. We're close to the equator or tropical. >> Mhm. >> You know, um we also need a blend of chemical and physical. >> What is the single biggest thing that Western dermatologists get wrong about Indian skin? >> Hyperpigmentation.
(14:44) You know, so they do not know how to treat Indian skin. Um specially when it comes to devices and even creams. I mean, they will not give a hardcore tretinoin to an Indian skin. They'll give you a retinol or a really mild retinal ester like a retinal propionate like a very mild retinol. Whereas me here will not hesitate in giving you a tretinoin.
(15:10) I'll say, okay, take it. We know how to deal with your with our skin. They wouldn't they're very scared because they're scared of post-inflammatory hyperpigmentation. Doesn't happen in Caucasians. So, they will use all the possible lasers at the highest intensity. >> They can do a phenol peel, you know, this phenol peel was trending and I was getting lots of DMs.
(15:31) Doc, why don't you do we phenol peel, phenol peel? They actually apply phenol on the entire face. It's a very deep peel, a lot of crusting, there's, you know, oozing and all of that for about 2 weeks and then yeah, it's it's a scary picture and then the skin becomes flawless, literally. Okay, you try doing that in India. You will burn the skin and there will be a permanent hyperpigmentary like, you know, dark skin literally forever. So they're scared.
(15:59) They don't they cannot you can't use the same kind of lasers and products on Indian skin. >> Got it. What ingredients you think a couple of ingredients that, you know, that were designed globally and work very well but that Indians should be very careful about using? >> I think vitamin C is a grossly overrated um ingredient.
(16:23) It's a very good ingredient, mind you. You take you pop in vitamin C, um you know, it'll protect you. It's a very good antioxidant. Even a topical vitamin C, very good antioxidant. Protects you from UVA, UVB, um you know, helps in uh collagen remodeling, all of that it does. It's a tyrosinase inhibitor, very common now people will understand this term because it reduces the production of melanin.
(16:48) >> Oh. >> This uh tyrosinase inhibitor. But with our kind of climate, humidity, heat, um a lot of times we tend to break out more when we use vitamin C. >> Okay. >> You know? And so vitamin C is usually not probably when you're making it manufacturing in India, they are doing it a little better than what they're doing abroad.
(17:16) And I think that's one overrated ingredient. The other one is niacinamide. You know, so you don't really need so much niacinamide. We talk of niacinamide all day long. Um, every Korean or Caucasian serum will have niacinamide in it. And we don't need so much of it. It doesn't It's like a jack of all trades and master of none.
(17:41) >> Um, I'll say it again. What What do you say is the biggest myth that Indians have about skin care? >> Exfoliation. I think people feel that the more you exfoliate, the more clean and fair your skin is going to get, you know. >> They think the darkness will be like scratched out basically. >> Right? >> [snorts] >> So, you know, I'd have mothers come and see the skin color and they go, "You You don't have any hair, you know?" This uh neck is really dark.
(18:13) That could be like juvenile diabetes or insulin resistance. >> Probably some internal problem. >> something. But, the mother is just scrubbing the neck thinking it's going to go away. So, that exfoliation We've used pumice stones on our body. We I've used as a child. Of course, apart from the basin lips and all of that.
(18:34) Um, then of course, now you have the loofahs. >> Yes. >> people don't realize that it's not a great idea because you have the >> those uh face washers. I remember I bought one month which has those micro >> Yeah, the beads. >> Beads in them which are >> Yeah, they're exfoliants. They may be fruit uh you know, the rind of fruits or fruits seeds and stuff like seeds of fruits or um they could be some of these synthetic beads.
(18:58) Well, all of them, as fancy as they are, will cause friction. Friction will stimulate our melanocytes. Give signals to the melanocytes. They will be like agile. They'll start producing more melanin, and the skin will turn dark. All boils down to the same thing. Right? >> So, over exfoliation not good for Indian skin.
(19:23) >> Over exfoliation or even exfoliation when you're exfoliating too much, you are A creating more pigment. >> And um another thing like oily skin I wanted to ask you about was dark circles. >> Okay. >> Which uh Indians love dark circles or dark circles love Indians? >> Dark circles love Indians. >> Yes. Why do Indians get dark circles so easily? >> See, um it's actually one of the most common problems.
(19:54) You see even kids with dark circles. >> Yeah. >> Um there are various reasons for dark circles. The most common which everybody thinks is not adequate sleep, and so you get dark circles. Well, dark circles can worsen. That could be one reason, but there are other reasons. Genetic. Genetically, you have thin skin under the eyes, and you have more pigment under the eyes.
(20:16) That could be one reason. Second could be allergies. So, if you have eye allergies or if you have uh you're allergic to cosmetics or whatever makeup or creams or perfumes, fragrance, incense sticks, room diffusers. >> Really, fragrance also? >> Fragrance. >> Fragrance can give you dark circles? >> Can give you dark circles, right? Yeah.
(20:38) Now, when you have all these allergies, you're also prone to unconsciously or subconsciously rubbing your eye. >> Right. >> That friction clubbed with your thin skin, clubbed with the skin's ability to produce more melanin, is going to give you dark circles. >> Don't rub your eyes in the morning when you wake up.
(20:56) >> Don't rub your eyes anytime of the day. Then, if you're low if you're anemic, low hemoglobin, you'll get dark circles. A lot of times people don't realize that. If you have insulin resistance, you have hypothyroidism, if you have PCOD, uh again, you can get dark circles. Of course, when you have insulin resistance, the skin under the eye, all these thin areas, and the body folds becomes thicker also.
(21:22) It's a condition called acanthosis nigricans. So, there you get dark circles. >> If you're If you have insulin resistance, which means if you're like pre-diabetic kind of thing, you get dark circles. >> Because what happens is the skin gets thicker and there's pigment deposition. >> Oh, I see. >> It's a proper condition called acanthosis nigricans.
(21:41) >> That explains probably cuz 25% of Indians are diabetic or pre-diabetic. >> And they have really dark under eyes, like raccoon eyes. >> yeah. I was not going to say that, but yeah, in Japan they call it panda eyes, I think. >> Panda eyes. >> Panda eyes or raccoon So, really, that's a really good indicator to take care of your health.
(21:56) >> Yeah. >> And tell me, so 25% of Indians have that, but for a lot of people like your clients who may not be diabetic or pre-diabetic, but all of everybody has a weight problem, like, you know, we are everybody in India is on the edge of insulin resistance, metabolic disease, the more I see is pretty much everyone in India has some level of metabolic disease, with [snorts] our visceral fat and all that.
(22:15) >> Yes. >> 100% carb diet, or like some protein, and not doing What are we doing? Like 1 out of exercise a day. >> Sedentary lifestyles. >> Um eating late at night, blah blah blah. How much is that lifestyle linked to dark circles? >> You know, uh I would estimate it as 60-65%. Um Because again, when you're having sugar, it has its own It's another ballgame altogether, right? There's something called glycation that happens.
(22:44) Okay? And that results in breakdown of collagen, the skin becomes thinner, again, more prone to pigmentation. That, plus this hyperpigmentary >> Sugar causes dark circles? >> Sugar can cause dark circles. >> My god, that's the end of that. >> So, that It's that one culprit, sugar, if you you know, in the whole in the entire diet that we have, if you have to eliminate one thing that has to be sugar.
(23:09) >> Which is also interestingly the hardest thing to eliminate. >> The other thing about you know, under eye circles tired eyes are because sometimes inherently our bone, you know, this is called this is a maxilla, this is called maxilla. Uh, inherently it's concave. And because it's concave you have sunken eyes, you have hollow eyes.
(23:29) And as we age bone starts to break down. We don't it's not just skin which is breaking down. The bone is also breaking down. And you know, so this part the upper and inner socket and this part the outer socket, this will break down first. And so you start to see like this droop here, the eyelids tend to droop and the uh, under eye sockets become larger and so there's a shadow.
(23:57) Every time light falls it casts a shadow. And your dark circles will look darker or if you don't have dark circles that shadow will create >> It's a shadow, right, right. >> So that's also an issue and you see it you know, I have patients who are in their 20s, early 20s and they come even 19, 20 year olds come for fillers under the eye.
(24:17) >> Wow. >> Because of this under eye hollow which makes them look tired. We've slept for 10 hours doc, we've slept for 12 hours and we still look tired. >> You have to plump up this area. >> You can either put fat you know, surgically you you know, you do a liposuction, take out fat and then you know, you put it back under the eye.
(24:39) Um, or you do a filler. You know, hyaluronic acid filler. >> All right. >> So these are the two things but these days pre- for prevention we do a lot of other things. We do PRP, we do PRF. We do PDRN that's the salmon sperm DNA that we do. So the newer things which are coming about. >> So, to that point someone is 30, 40, 50, whatever, and they're noticing dark circles because it's so common.
(25:09) So, take us through what we can do preventatively. You use the word preventative, so I'm catching that word because that's so interesting. Otherwise, everything is is, you know, reactive. >> I think it starts as early as, you know, in your teens, right? Uh and for all age groups, the first important thing is you sleep well.
(25:27) >> Mhm. >> The second is that you need to moisturize the skin under the eyes. So, anything, Vaseline, >> Vaseline, palms. >> coconut oil, almond oil, >> Right. >> moisturizer. So, just dab it under the eye. So, that's the third thing. Do not rub your eyes. Always, whatever you product you want to, you know, use it, you dab it, and don't rub your eyes when you wake up in the morning.
(25:50) So, that is another thing. If you have eye allergies, you need to consult with your ophthalmologist. Too much of screen time, again, your eyes become dry, so you might want to use some of those eye drops like the refresh eye tears or whatever. >> [snorts] >> Uh because it's important to keep your eyes moist so that you don't rub your eyes.
(26:09) Check your hemoglobin because if that's low, you need to supplement yourself. Your iron's low, you need to give either in the form of, you know, iron supplements or diet. Then, if you're allergic to cosmetics, you have to make sure, you know, you'll find out. When you use a mascara, you'll start rubbing your eye or you use a kajal, you'll start rubbing your eye.
(26:28) You have to stay away from them. That's a very difficult part. >> Mhm. >> You know, when it comes to a female, we say, "Oh, don't use a mascara." Doc, how is it possible, yeah? >> Mhm. >> I mean, you have to make it possible. >> Mhm. >> Right. These days, false eyelashes. >> Mhm. >> I have seen so many people have allergies to the glue.
(26:48) >> Mhm. >> And that, again, they're constantly rubbing their eyes, and the dark circles are increasing. So, that. Um People are not going to like me for this, but you have to quit smoking. >> I got it. >> If you And then, "No, doc, I don't smoke. I just, you know, vape." It's the same thing. >> I got it. >> You vape, you do Jewel, even hookah and shisha >> Mhm.
(27:09) >> to a certain extent. So, you will have to somewhere either quit if you don't want your dark circles, or you know, at least reduce as much as possible. So, these are all the preventative things, no rubbing, no, you know, and sunscreen. People Okay, a lot of times what happens, you use a sunscreen, and the common complaint that people give, they come and they say, "You know what? Our eyes burn when we apply sunscreen.
(27:35) " So, some of the ingredients, the chemical ingredients in a sunscreen, can make your eyes burn. So, then in such a situation, you'll have have to opt for a sunscreen which has a physical block in it, like a zinc oxide or a titanium dioxide. Then don't use a chemical. So, that's what you have to do, or better still, wear those nice, chic, UV protective eye shields, goggles, dark glasses, whatever.
(28:01) So, that's something you can do. Uh then, you can use ingredients like vitamin C and vitamin K. Okay, so that also will help to great extent. So, start using um a vitamin C serum or a vitamin C and K serum under the eye once a day, that's enough. So, day you moisturize, night you start using this. So, these things will help you over a period of time.
(28:26) Then, you can also, if you have a family history, you know, genetically and you're going to get it, you've still not got it, you know, your skin is ultimately a window to your inner health. So, you probably don't even realize that it's just about the beginning of insulin resistance or diabetes or hypothyroidism or even PCOS.
(28:47) So, you need to get your your, you know, tests done apart from getting your hemoglobin checked. So, these are some things. Then, of course, coming to the treatments, you can do PRP, you can do microneedling. Do not use a derma roller device on your own at home. Doctor G said, "Use microneedling." No, please. You have to do it at a clinic.
(29:08) Why? Because A, the needles have to be completely sterile. B, they're medical-grade needles. They have to the the depth of the the penetration has to be uniform. Okay? You cannot use a 1.5 mm uh length needle under the eye. You're going to injure that skin there, and then you'll have even more dark circles. Right? So, there is a system for everything.
(29:33) So, you will have to do microneedling at a clinic. Um when if you already have a little bit of pigment, we do use the corneal shield, and then you have to put a corneal shield inside the eye. You have to protect the eye. And then do a Q-switch ND:YAG laser or a pico laser if it's really close to the eye. So, that's So, lasers also help with Lasers will break the pigment and dissipate them, so your pigment goes off, but you got to be extremely careful.
(30:00) Now, commonly people come, and they come, and they say, "Oh, laser, I can't do hair removal." I have patients who come, you know, "Doc, you know, I'm trying to get pregnant." That laser is not going to penetrate deeper than your lower layer of the skin. It's got a wavelength. It doesn't hurt. And so, it doesn't do anything to your muscle, forget the uterus.
(30:21) Right? However, extremely unsafe for your retina. It can get into the eye at the blink of an eye. So, that's very important that whenever you're doing lasers, close your eyes, and that's why when you're treating dark circles, you need to be extra cautious. Got it. So, these are the different things, and then, of course, salmon sperm PDRN I don't know who invented it, but I need to find out but that DNA is very similar to the skin DNA DNA of our skin, human skin.
(30:51) >> Right. >> And that to a certain extent is giving us some promising results. Causes a lot of swelling. >> Oof. >> Uh you inject it every 3 to 4 weeks. >> So you inject salmon sperm into your hair? >> Yeah, under the eye. It's not yet FDA approved. So what we're doing it doing is just rolling a microneedling device and pouring it.
(31:14) But a lot of Koreans um whatever they are government whatever they've got approval. So they inject the salmon sperm. The swelling takes about 10 days to go. But you do it you do about three four sessions your dark circles reduce considerably. But then to live with that one week to 10 days and Indian skin we tend to retain more water again.
(31:36) So with our kind of uh maybe it's because of our diet. That's swelling will then last you for three weeks and then it's time for you to do another session. So it's not practical enough. >> Right. >> But it is an option out there. >> [snorts] >> You know? And then uh ultimately of course if you have hollow eyes, you do fillers.
(31:54) Now if you have dark circles, you can't just do fillers and say my dark circles are going to go. If there's pigment, if it's just inherently anatomically hollow, then you do fillers and that will improve your dark circles. >> Got it. So if you had to pick the most common skin problems that your clients are walking into your clinics with, what would they be? >> Dark circles with the would be I think the first common thing, right? But that's more now.
(32:24) >> Right. >> Okay. Um hyperpigmentation in all age groups and typically people in their 30s onwards, you see a lot of hyperpigmentation. You'll see melasma, you'll see blotchy skin. There's something called lichen planus pigmentosus I'd like to talk about which is which people do not know, but it is very very common.
(32:47) A lot of people now come with suddenly violaceous, you know, like the the neck looks dark gray to violet and then it turns black. A lot of people have it. Um then it slowly spreads to the face. The most common condition, the most common reason is a PPD containing hair dye or hair color. And then in Indians we use a lot of mustard oil.
(33:12) >> Mhm. >> Okay? That triggers it. All these incense sticks will trigger it. You know, I had this patient who came to me, he's a guy, very very loyal, very, you know, very compliant. You give him a protocol, a skin care program, he will follow it to the T. Um he would and you tell him, "Okay, I think we should do a peel." He would do a chemical peel.
(33:35) Do a laser, he'd do it. So, we're doing everything and I'm telling him, you know, stay away from all of these things. He's avoiding mustard oil, avoiding fragrance, avoiding perfumes, avoiding everything. >> every day. >> Putting sunscreen, following my vitamin C and alpha lipoic acid and arbutin and everything.
(33:55) Then doing peels, doing lasers, not improving. Improving, going back to square one. Improving, back to square one. And I am like now I've given up. What do I do with this person because he's just not improving. We've done his He doesn't have insulin resistance. He doesn't have any hormone issue. >> Not. >> So, one day something, you know, somebody gave me some stones, you know, gifted me those.
(34:20) Nowadays all these stones are very much uh they're very popular. And they were lying on my table. And uh this guy walked in, this gentleman walked in and he said, "Oh my god, you know, it's very important for negativity to, you know, what away a negativity. So, it's good that you have this doc along with this you know what to what Kapoor Jalal it's really good.
(34:42) And that rang a bell and I'm like hello, are you doing that at home? Haha made it every room has camphor in it and I am like oh god, you know, we've discussed incense sticks, but we've forgotten camphor. And that's why I will never forget that for now it's this was like some two decades like two decades ago and so I make it a point because most Indian households will light Kapoor and that can cause this lichen planus pigmentosus. It's it's nasty.
(35:13) And it's an autoimmune disorder. >> It's like poison. >> And then we omitted that and gradually you won't believe it with simple things the color went away. Took us about a year. >> Got it. Can you tell me about a patient who walked in with a skin care problem they thought was a skin care problem but it was completely not that.
(35:33) >> I had this 26 year old girl. Okay. Um You know, dark circles first of all. And then So, I did the usual hormone tests. I said take a dark circles. Okay, it's not hormones. Everything was normal. Slowly as she kept coming to me Um Her arms started getting pigmented. Her face started getting pigmented. I looked at it I said I have a lot of doses there.
(36:03) Thyroid over. First thyroid color. Antibodies color sub color low inverse T3 color low everything's normal. Insulin resistance first color low normal third month. She comes back with puffy eyes. No complaints. No symptomatic issues. No, you know, liver kidney nothing nothing nothing. Puffy eyes and a blotchy pigment now all over her face.
(36:30) Okay. That's when I said, "Get your urea and creatinine done." Creatinine was over the roof. >> Mhm. >> Kidneys were were like fired. And no one will be can can even think of it. No one will detect it. You don't You will still think of hormones. I mean, I've spoken to you for so long, and I've only spoke of spoken of hormones.
(36:52) >> Mhm. >> We are not looking at the liver and the kidney. You need to get that sorted. You need to get that tested. Creatinine was 7.something. Kidneys were fired. She had a genetic condition, polycystic kidneys. And as she was growing up, it was getting worse and worse. She had no urinary complaints. Nothing.
(37:16) >> That started later. She thanks me even today. Although we caught it late, mind you. We caught it, and this also was early years of practice. You know how it is when you just about start practice, a lot of things don't just register immediately. Comes with experience. >> Uh and you know, sometimes I I mean, she's fine now.
(37:36) She's everything's She does have to be She's not on dialysis. She was, but now she's okay. But you know, you feel that oh my god, you could have caught it. You may have, you know, probably all those treatments that she had to undergo. Maybe you could have caught it at an earlier age. So, it's very important as a doctor to understand the biology, physiology, anatomy of the entire body, and to always correlate the skin.
(38:05) You see something different on the skin, you have to correlate it with something inside your body. That's so important. >> You know, you're working with skin care, and as we said, skin care is People see their face as a reflection of who they are, for rightfully or wrongfully. Other than dark circles and other massive area is acne. >> Oh, yeah. >> Um especially adult acne.
(38:29) Can you tell us what is acne and why does it happen? >> Um So, acne is an inflammatory disorder of the oil glands, right? You have grade one, which is blackheads, whiteheads. A lot of times people feel that is not acne. They think that's just blackheads, but that's also acne. When they and then sometimes they become pustules. That's also acne.
(38:53) Then they become larger cysts and then they are these acne beneath the skin, which are nodules. So, these are various grades of acne. Um Now, in our oil glands, you have these normal bacteria, microorganisms called cutibacterium acne. Back in the day they were called propionibacterium. Now they called cutibacterium.
(39:12) I don't know, they're not cute at all. >> Um I was going to say, yeah. >> Yeah. So, they when there's more oil production because of a hormonal imbalance, these bacteria will feed on that oil and they will multiply. And when they multiply, you get these blackheads turning into pimples. That's what acne is all about. >> Got it.
(39:33) So, are pimples and acne are the same? >> They're the same. >> Pimples, acne >> Blackheads >> Blackheads, it's all the same. >> They're all the same. >> It's an infection. >> It's a medical term >> Right. >> for all these, pimples, blackheads, whiteheads, cysts. They're all acne. Right? >> Different from ingrown hair? >> Different from ingrown hair.
(39:52) Talk about acne cysts. So, every acne, the black a blackhead or a whitehead is not infected. That's just a clogged pore. >> Got it. >> So, the oil is not getting to the surface. So, it's getting clogged inside and then it becomes that whitehead or blackhead. And then you're these bacteria feeding on them and then it becomes a pimple.
(40:15) It turns into a pimple. Sometimes you're trying to squeeze that blackhead or whitehead, you are introducing bacteria inside, and then that gets infected, it becomes a pimple. And that's why you should not squeeze and touch your acne. So, this is in general what acne is all about. Underlying issue, most of the time, is a hormonal imbalance.
(40:35) So, that's why it's very common, you know, in teenagers, because, you know, you're going through puberty. But now you see a lot of adults getting acne. So, adult acne has become more common. Why? Because of the stress levels which are going high. So, obviously, the androgens or the male hormones are increasing.
(40:53) With the stress increasing, your oil glands are getting more signals from the ovaries to produce more oil uh in cases of females, and then you get more adult acne in females. PCOD is also very common. So, again, 26 years ago, I would see one PCOD in a month. Now, I see 10 PCOD per day. >> Wow. >> Right? So, that's the difference.
(41:17) So, that's the thing again, you get That's why you get acne. Um another very common reason in today's day and age is layering the skin. >> Mhm. >> So, when you use so many different products on the skin, and they clog your pores, you will develop blackheads and whiteheads. So, that's also acne. >> Which is a bit of a catch-22 situation, no? You're trying to protect your skin or, you know, hide your blemishes, so you're putting more product, but the more product is causing more problems.
(41:44) >> Absolutely. In fact, just yesterday I had a lady who came with all her products, and they were really nice brands, but they were all And she thought she was doing fantastic skin care, and but her acne was not going. And uh she was 47. Okay? And so, I said, "Okay, who, you know, just out of curiosity, I said, don't name the doctor, but was this given by a dermatologist or a GP or" And she said, "Oh, this is chat GPT.
(42:15) " So, she was using that, and she thought this is great for her acne and for her skin. And I said, "Okay, fine. You spent so much, use it on your legs and arms, and we will start new skin care for your face." And it was the cheapest skin care, and she's like, "But doc." I said, "Yes, that's what it is." So, sometimes, yeah, it this this layering can be detrimental to your skin.
(42:39) >> So, what is the biggest myth about acne that you would like to bust? >> For example, people feel that, "Oh, I drink enough water and I still get acne." There is no correlation. Water is very important for your skin and for your health, but there's no correlation between acne and water, you know, because acne is about oil glands and those microorganisms and hormones.
(43:02) So, that is one. The second is, you know, my gut is not clean and so I'm getting acne. Not all acne are related to gut. You know? Okay, a certain class of acne and rosacea will be related to gut. So, that's another thing. I'm constipated, so I'm getting acne. Not necessarily. Could just be a hormonal imbalance.
(43:25) I eat healthy, but I get acne. Now, yes, if you have acne and you have sugar, dairy, you know, processed food, fried potato kind of stuff, your acne will increase. >> What food causes acne? >> I think I would say what food triggers acne. Anything with high glycemic index. So, sugar. And sugar could be jaggery, could be honey, could be normal cane sugar.
(43:56) Maida. So, that's again high carbs, high glycemic index. Potatoes, specially fried potatoes. Okay? >> So, french fries are very bad for acne. >> French fries and you know, potato chips and all of that. Veggies and I love veggies, but I refrain from them. That's my cheat diet once in a month. Um, so these will these are not good for your skin.
(44:21) So sugar, so ice creams, chocolates and pastries and all of them, biscuits and all are out. Maida is out, so then out goes your pizzas and pastas unless you're using, you know, the >> Whole grain. Whole grain. >> and nachni and jowar and those kind of >> So you really have to eat healthy if you don't want acne. >> Wow. >> Um >> There's no shortcuts.
(44:41) >> There is no shortcuts. Your milkshakes and your cereals with milk will have to be replaced with almond milk or oat milk. >> Achha, so milk is not good for acne. >> Milk is definitely not good for acne because there are enough studies which show that nowadays, I mean back in the day it used to be different, but now yes, your the milk that you're getting unless it is purely purely organic.
(45:04) Now, I don't know about the A2 and how organic it is. They have a lot of hormones in them because you're pumping the cow with hormones and antibiotics. And so that is getting transferred and you're having you're drinking milk which has hormones in it. That's one thing. When you talk about sugar, uh it's increasing a hormone called IGF-1, insulin-like growth factor one, and androgens which are the male hormones.
(45:29) And that will make your oil glands produce more oil. And then it's a vicious cycle. So that's why food with high glycemic index. So again, when patients come and say, "Okay, doc, so you know, I'm going to avoid." It's like there's nothing like avoid, you have to stop. >> Oh. >> Right? If you want your acne to come under control.
(45:51) Once it's under control, then you could have your, you know, food in moderation, whatever. I'm not saying don't live your life, but try and eat healthy as much as possible and have a cheat day once maybe in a month or once in a fortnight. >> And you lose weight? >> You lose weight, yes. >> Everyone's dream. >> Everybody, yes. >> Um So, I just want to talk about what is um modern urban life doing to our skin? You know, like someone in our audience who is in the air condition the whole day, sitting in the car, being in the office, being at home,
(46:22) being on a screen for hours, 5 hours plus every day. Um what is all that doing to our skin? >> Havoc. >> Right. >> Right? Because there is no discipline. Right? You think you are not getting exposed to ultraviolet rays because you're indoors. However, you are you have so much screen time. And that is blue light.
(46:50) Blue light is a part of visible light, mind you, from the sun. But you also get blue light from your screen. So, unless you have those filters, the blue light filters, which most people don't. >> Not all of them. >> Some people do, but most don't. And especially even if you are using your cell phone constantly, people don't like to put that blue light filter on the phone because it starts to look different.
(47:10) >> Right. >> Especially yours when you're scrolling Instagram and stuff. So, you're getting exposed to blue light, which means it is damaging your collagen and causing more lines and wrinkles and sagging and causing dilated pores and causing hyperpigmentation. So, that's one aspect. Then you are in the AC all day long, which means your skin is getting dehydrated.
(47:32) How many of us are making it a habit to get up and drink water because you're constantly getting dehydrated. Good job, but most people don't, right? Um And the And the AC is really dehydrating your skin. How many of us are going and applying a moisturizer? Look at my skin now. It looks like See? I've I here for 2 hours and see how >> It's a >> bit dry. Bit dry on the top.
(48:00) >> And I have applied tons of moisturizer in the morning, but I've sat in this AC for 3 hours. >> have dry skin? >> I have extremely dry skin. >> I mean, I have dry skin. >> It's gotten drier. So, obviously, the AC is going to dry it more because it's just going to zap your moisture. So, that is happening. Then, you know, your occasional tea, coffee is also not great.
(48:23) Tea is okay, but coffee is not great all the time. And then, you're intermittently going out in the sun. And you're sweating it out, but you're in the sun. So, obviously, your sunscreen is not working because you're sweating. So, you you are playing or whatever whatever in the sun. >> Okay, small pause. Uh this is the part where I'm supposed to ask you to subscribe.
(48:47) But honestly, only do it if you want more conversations that actually make you think. That's the whole point of the secret sauce. All right? Back to it. Pollution damage and sun damage are two different things. Uh but yet, people talk about them as one shield. Uh what is the actual clinical difference? >> So, sun is going to cause hyperpigmentation and wrinkles.
(49:09) Pollution is going to cause sensitive skin and wrinkles. >> Wrinkles everywhere. >> Wrinkles everywhere. >> [laughter] >> But sensitive skin. Why? Because pollution will break your skin barrier. >> Right. >> And so, you get more rashes, you get allergies, you get acne. There's a study which talks about how it's basically the barrier is going for a toss.
(49:31) So, skin being a hormonal organ, your hormones are going haywire. >> And dust? >> you're getting Yes, dust. So, you're getting a lot of acne. So, that's the thing about the difference, the main difference between these two. So, a sunscreen will protect you from UVA, UVB, you know, visible light. These days, you have better sunscreens which will also protect you from visible light, infrared rays, blue light.
(49:56) But for your pollution, you will need to use something which will protect your skin barrier. That means ceramides, vitamin C, vitamin E, ferulic acid, uh resveratrol, these kind of products. Um so, I think a mix of both is what you need, and that's why we say a sunscreen which is broad spectrum and a moisturizer every single day. And for men, it has to be a combination of both, a product which has both.
(50:19) >> Right. Um you've spoken a lot about sunscreen, and I just want to understand from you how important it is, because it sounds like to me that that's the single most important thing that we can use. Is that true? >> So, if you want to just use one product every single day, um because of your busy schedule or just that you don't want to use things, you must use a sunscreen.
(50:47) It has to be a sunscreen. And I could get a little more clever there and say that these days there are sunscreens which have moisturizers in them, so it becomes a two-in-one product, and so go ahead and use that. So, that's one thing you cannot, it's a non-negotiable. >> A non-negotiable. I'm going to buy one. I'm going to ask you later for the brand and buy one today.
(51:06) >> Yes, absolutely. >> And and and and you get moisturizer with sunscreen. So, either way, get a sunscreen moisturizer or moisturizer sunscreen. And that's >> And that's it. >> What [snorts] ingredients should I look out for when I'm buying a sunscreen? >> You look at the label because looking at ingredients gets a little tougher people.
(51:25) So, see if it says broad spectrum, see if it says uh UVA UVB protective, and um if you're working indoors, then it should also have a visible light component. So, it should say blue light or uh visible light protective. When you look at it again, it's not just SPF, you have to look at the PA plus, that is the protection from ultraviolet A.
(51:51) Because we Indian skin needs protection from ultraviolet A, visible light, and blue light more than protection from UVB. >> Oh, so SPF is not as important as >> as PA. >> PA, I didn't even know this. I Yeah. So, when you look at sunscreen, you look at PA more than SPF because you always look SPF 15, now they have SPF 60, Indians want SPF 200, you know, how it is.
(52:11) >> So, that's another big myth, right? >> Right. >> If you use an SPF of 50, it's giving you 92% protection. If you use SPF 100, it's giving you 97% sun protection. That 4% difference really hardly makes a difference. Um >> But the number one thing is not SPF. >> at PA triple plus, PA four plus, that's better.
(52:32) And, you know, if there is a visible light component there, it's it's mentioned if they have iron oxide, even better. Tinted sunscreens, they have iron oxide. And that will protect you from blue light. So, you know, if you don't want to use a filter on your phone, then that's blue light protection. Also, if you have large windows, you know, you and I have discussed we both like light.
(52:53) Uh I just love light. There's large windows all the time. So, I use a tinted sunscreen. A sunscreen with iron oxide will protect me from that visible light. >> So, a tinted sunscreen and what is the other thing you said? You >> UVA, UVB. So, SPF is UVB. PA is UVA. And tinted is blue light. >> And PA, there are some different classifications you said.
(53:18) >> Three two plus, three plus, four plus. >> What should we use? >> Four is the highest. So, if you want the best, it has to be four. >> So, you What's it called again? PA. >> PA, protection from UVA. >> I see. So, PA, they call it PA. PA four plus is is is something that I did not know. Right, very interesting. Okay.
(53:35) >> Opt for mineral sunscreens if you have sensitive skin, pregnant women, again mineral sunscreens. Mineral sunscreens means they have physical blocks like zinc oxide and titanium dioxide. Now, back in the day they were not nanoparticles, so they were like they would form that white cast, but now they are, you know, they're the particle size is really small.
(53:57) So, they don't form that white cast anymore. >> So, you know, one thing I've understood while talking is that for you sun sunscreen is like, as you said, a non-negotiable. So, we don't normally talk about brands, but because this is such an important thing and it's so specific, what brands you recommend for sunscreen? >> My thing is that don't use a cosmetic brand.
(54:20) Use a cosmeceutical or a pharmaceutical brand. So, something that is available at a pharmacy, right? Uh my favorite ones are La Roche-Posay. >> Mhm. >> Okay, you have Anthelios by La Roche-Posay. Uh Heliocare. Okay, Eucerin is again right now my current favorite. It's got this ingredient called Thiamidol, which is very, you know, it's really good for hyperpigmented skin.
(54:46) So, that's again my favorite. So, three of my top favorite ones. And then there are these um others like Suncros. You have one called Photon, which are Indian brands, which are decently priced and they're very good also. >> What is the price range for sunscreens? Cuz you were given some crazy numbers. >> Yeah. So, um like I think Suncros is around 800 or something.
(55:11) >> Right. >> Uh Photon is around 600. Um and Isdin that I, you know, use very commonly, Photoprotector Isdin is around 3,000 something. Um sometimes I also use the ZO or the ZO. That's around 20,000. >> Wow. >> Um but I love it because it does the job. Eucerin for melasma and people with hyperpigmentation, excellent.
(55:36) It's around 4,000 bucks. Um >> So, what is this? This is 20,000 rupee one. It's a daily one. >> Yeah, it's a daily one. >> And what does it do? >> It protects your skin from sunlight, from UVA, B. >> Wow. >> So, um >> And it's worth it? >> It's worth it. >> Wow. >> It's totally worth it. I mean, there's this ZO growth factor serum with a lot of um anti-aging ingredients and these growth factors.
(56:02) And that's one serum that you use I use that one serum every day. It's 28,000. >> Wow. >> But I use that every day at night. In the morning, I use a sunscreen. That's my skin care. That is my skin care and moisturizer. I moisturize my entire body because my skin is very dry. And um I don't really bother about uh choosing my face wash.
(56:26) I'll use something mild. It can be a different one every time. But something without fragrance because I have sensitive skin. So, that and then I will just use a moisturizer and a sunscreen in the day. And at night, I use the growth factor serum by ZO. >> What is in it for 28,000 that makes it so good? >> They have a patented ingredient in it which they don't disclose and they call it growth factor.
(56:46) >> Right. >> So, Dr. Zein Obagi is the founder. He's from California. Um I have met him and you know, done his workshops with him. And he has these patented products. And there's a lot of research. I've gone to their, you know, factory. There's a lot of research that goes in this pen. Lakhs and crores and crores of rupees in that research, you know.
(57:12) >> And actually finding out that oh, this ingredient is going to actually work on your DNA. It is not just about collagen >> on your DNA? >> It works on your DNA. And that is why it's a great serum for like an anti-aging and pigment and everything. Okay? >> So, that is the best anti-aging serum in the world. >> I I love it. Works beautifully for me.
(57:36) >> Wow. >> Then, similarly, I went to the Beiersdorf office in, um, you know, in Germany, uh, Hamburg. And I saw how the kind of research that they've done, just years of research and crores of rupees, millions of rupees or whatever for them, to just get that one ingredient called Thiamidol. You know that one dual serum, in fact, stopped even the, um, asking you to use that.
(58:05) It just changes the way your skin behaves and looks. >> Wow. >> You know? >> So, what what does alcohol do to the skin? >> So, alcohol, number one, it dehydrates your skin. So, if your skin is getting dehydrated, it looks dull, sallow, you get fine lines, you get, you know, allergies, all of that. Then, there's sugar in alcohol, right? Uh, I think, I don't know which types of alcohol.
(58:35) I'm a non-drinker, but there is sugar. And sugar is inversely proportional to your age. So, it breaks down your collagen at a rapid rate. The process of glycation, which is where your collagen is just breaking down, is much more. So, when you have sugar, it goes and it attaches itself, the sugar molecules would attach themselves to the collagen and the elastin fibers and >> So, sugar kills collagen.
(59:02) >> Yes. It just makes it brittle and breaks it down. And even the elastin fibers, so the elasticity goes, the recoil of the skin goes. So, obviously, you know, your skin begins to sag. Um, so, that's something that it does. Premature aging can happen with alcohol. And then, of course, you can get dark circles and puffy eyes.
(59:25) It's There's of water retention that can happen with alcohol and therefore you get puffy eyes. >> What about coffee? >> Coffee in moderation is good as long as you're having black coffee. The moment you add milk to it, it has lost its um antioxidants and polyphenols. Caffeine has antioxidants, so it's good. So, black coffee maybe one or two a day is all right.
(59:49) >> Got it. Um how bad is smoking for the skin? >> It's detrimental to If you want good skin, you have to like there is nothing like, you know, having one cigarette in a week also. >> Really? >> Yeah, because nicotine really will break down your collagen at a faster rate. At a super fast rate. So, you get you know, which is why you get crow's feet.
(1:00:16) You get dark circles. You get dark lips. So, hyperpigmentation, sallow skin, fine lines, wrinkles, dilated pores. Um all of that, you know? Of course, with all the other issues that it comes along with when it comes to your body. So, I think when it comes to skin, smoking is a complete no. I went to um Hamburg.
(1:00:41) I represented India at a longevity conference. And skin longevity is the next big thing now, right? We're not talking about anti-aging anymore. We are talking about preventative and skin longevity. And they said they've done enough studies to show that that breakdown, there's something called DNA methylation and cell senescence, all of the that happens with number one, sunlight.
(1:01:06) Number two, stress. Number three, smoking. >> Wow. >> And then, sugar. Okay. Not following your circadian rhythm. >> Hmm. >> That's another big thing now, you know? Enough studies and research to show that, you know, you must follow your circadian rhythm. So, in that order of skin the sinisters of skin longevity, smoking is number three.
(1:01:29) >> Better quit smoking. Does eating mangoes damage the skin? >> I love mangoes. Uh but I will have them in moderation. Also, I don't have acne-prone skin, which is why I get away. But if you have acne-prone skin, the sugar in mangoes, if you have mangoes every day and you have like three, four, or whatever, there could be a possibility that your acne may aggravate.
(1:01:51) That's a possibility. >> [snorts] >> Some people do get those heat boils with mangoes, but not everybody. So, if you fall into that bracket, maybe you should avoid. Otherwise, it's all right. Also, mangoes are very rich in vitamin A, carotenoids, antioxidants. So, it's a good fruit to have in moderation. >> What is metabolic beauty in everyday language? >> Holistic beauty, right? That you are healthy from within, your organs are healthy, and so it reflects on your skin, and your skin is healthy and vibrant, and it's glowing.
(1:02:24) >> Right. >> For example, if you have a thyroid disorder, it will show on your skin. You'll have dry skin. You will have hyperpigmentation. You'll have dark circles, puffy eyes. If you have insulin resistance, again, you have dark body folds, you have acne. If you have PCOD, you'll have acne, you'll have hair fall.
(1:02:46) So, it's all These are all metabolic disorders which reflect on the skin. So, metabolic health, internally, if your organs are okay and if your metabolism is fine, your skin is automatically healthy and glowing. >> Got it. Um you know, we talked about insulin resistance, PCOD, thyroid dysfunction, chronic inflammation, all very common things, I think, in Indians as they as they get older.
(1:03:11) How does each one show up differently on the skin? >> Yeah. So, if you have insulin resistance, you know, you'll get all your body folds will get darker and thicker. Velvety, okay? The condition is called acanthosis nigricans. You can get acne. You can get hyperpigmentation. Um you can get skin tags. Skin tags are genetic, but a lot of times and a lot of times people call them warts.
(1:03:39) >> Got it, yeah. >> Warts are different. Warts are viral. >> Right. >> But these are just extra piece growths of skin on the body. So, you can get that with insulin resistance. You can also get it with obesity. Right? That is also a metabolic syndrome. It falls under that. If you have hypothyroidism, as I said, you can get hair fall, you can get dry skin, you can get pigmented blotchy skin.
(1:04:03) You get amyloidosis, which is like a sheet of darkness on your arms and your back. That's very very very common. If you have PCOS, again, acne, uh hirsutism, which means hair growth on the body, apart from hair loss, uh darkening of skin around your mouth, under eyes. So, that's again very common. Um nutritional deficiencies, again, you end up with pigmentation or hair fall, most commonly. Nails become very brittle.
(1:04:32) People forget that nail is also a part of your skin. So, that can happen. Um then when you get into slightly, you know, complicated things like a renal issue. You get puffiness of the face, you get puffy eyes, puffy face, pigmentation. So, that's when your kidneys are failing. Liver is going to give you raised bilirubin, yellow eyes and then gradually yellow skin.
(1:04:55) >> Mhm. >> [snorts] >> And um yeah, I think >> Got it, yeah. >> you know, a lot of these conditions will reflect on your skin. >> You know, you spoke about um how important diet is also. In in in in your full in in so many years of practice, what single dietary change have you seen that made a big difference to someone's skin? >> Stop sugar.
(1:05:14) >> Wow. >> Yeah. That's one thing that you know is going to make a huge difference because aging as well as acne, so it's it's catering to all your age groups and it's slowly you know, it's like a slow poison. It's not like you had one chocolate today and your skin is going to get damaged.
(1:05:38) But if you have like a dessert every day, I like dessert and I'm going to have like I have a small piece of chocolate dark every day. A piece of dark chocolate, okay. You know? But I have dark chocolate, but okay, how much is it? A 40% 50% not going to work. There's enough sugar in it. So cumulative effect. You know, anything in moderation you can pass off, but a cumulative >> your sugar massively.
(1:06:04) >> Yeah. As far as possible, your skin will get better. Your acne will reduce, your fine lines and you know, you will not you will prevent your skin from premature aging. >> Got it. Um You see like you mentioned, you see patients every day who are doing everything that they learned on social media for their skin.
(1:06:26) Their skin still gets worse. What is the most common routine you see that is harming people? >> So you know, people now because of courtesy social media and so much of information, okay, sometimes it's misinformation. They feel they should use Suddenly everybody knows about ingredients. So they feel they should use every possible ingredient that is out there.
(1:06:56) So my skin needs AHA, BHA, niacinamide, vitamin C, retinol, hyaluronic acid, alpha arbutin. So So, are 10 different ingredients. You're confusing your skin. Your skin doesn't even need it. A, if you're layering so much, your skin is getting clogged. Then, you know, you are developing acne and milia, etc.
(1:07:19) Sometimes they say, "No, doc, we don't use everything together. We use one in like three things in the morning, three things at night." You're still doing much too much. Sometimes your skin doesn't need it. So, too much of AHA BHA, you have dry skin. Your skin is drying up more. Okay? Or you have acne-prone skin, you're using vitamin C, you're getting more acne.
(1:07:41) You don't even have hyperpigmentation, so why are you using alpha arbutin? You don't have dry skin or your skin is okay with a moisturizer, why are you even using hyaluronic acid? But it it's become a thing. >> Mhm. >> That I must use every ingredient that I know of. And if I'm going to talk about more ingredients, you'll start using all of them.
(1:08:02) And that's what Everyday there's a new ingredient which is there in the market. And a person feels entitled to using that. And what is How is it coming about? A, it's the it's the industry, it's the beauty industry. They're [snorts] creating these and they're talking about some problem that they're creating and then they're creating solutions.
(1:08:24) And then you have the influencer who talks about it and nowadays you have a lot of unfortunate paid partnership. >> [snorts] >> Even some doctors do it. Even some dermats do it. Um and then, you know, obviously you people tend to get influenced. >> Right. >> You know? So, I think that's >> So, the more the problem of plenty is the biggest problem.
(1:08:45) >> Keep it minimal. Skin minimalism. >> Can Do you think someone can actively assess their skin properly? I mean, can Do you think someone can assess their skin themselves on a regular basis or just very complicated? >> I think it's complicated. I think I think it's important to consult with a dermatologist at least once to try and understand.
(1:09:06) Number one. Number two, do not do ChatGPT. It's not good to, you know, AI is can never take over. I mean, it's going to help you a little bit. >> But it'll go circular after some point. It can give 50 things and it'll give you a yes to all the 50 things in some way or the other. It'll tell you what you want in a way.
(1:09:21) >> Yes. >> It's very good mind reader. >> It's my It's a mind reader. >> that you want 50 things, so it'll give you 50 [laughter] things, basically. >> It will tell you Dr. Jaishree is the best dermatologist in the world. >> Yes. Um Retinol has been built up, you know, you've talked a lot about retinol as one of the holy grails of anti-aging.
(1:09:43) What is the biggest myth about retinol that you would like to bust? >> That it thins the skin. >> Mhm. >> Right? Uh why did that myth come about? Because when you use retinol incorrectly, if the concentration is not right, or if you've used too much of it, you know, too much of the product, your skin barrier's compromised and you've still used it.
(1:10:06) You don't even know your skin barrier's compromised, but you're using it. Uh you're not adding a moisturizer when you're using a higher concentration, retinol will dry the skin. It'll cause peeling. When your skin peels, obviously your barrier's getting exposed. Your deeper layers are getting exposed.
(1:10:25) The skin becomes more sensitive. So, it's a normal, common perception that my skin is getting sensitive. That means my skin is becoming thinner. >> Mhm. >> Now, retinol actually stimulates fibroblasts, which produce collagen. So, it is building collagen. It is improving something called the glycosaminoglycans, which means it is making the skin more compact and thick over a period of time.
(1:10:53) As long as you know the right concentration, the right type of retinol for your skin. You may not Your skin may not be in a position to use a tretinoin, which is the strongest medical grade retinol, retinoid. You may use a retinol, which is somewhere in between. You have sensitive skin, you may use a retinal, you know, a retinal ester.
(1:11:15) So, you have different types of retinols, and that's not so easy. You need to get to go to a consult, you know, to a dermatologist. >> And you have to use a sunblock after you use retinol. >> So, don't use a retinol in the day because when it gets exposed to light, it gets oxidized, and it loses its efficacy.
(1:11:35) >> Got it. >> So, there's no point in using that retinol. Why do we say always use a sunblock when you're using a retinol? Because there is a certain amount of microscopic exfoliation happening. Macroscopic to hey, hey, you can tell when the skin is peeling, but also there is a certain amount of microscopic exfoliation.
(1:11:54) And you don't want So, the skin is at that time naive. So, you want to protect it, and therefore you use >> It becomes a bit sensitive. >> Sensitive. So, you use a sunblock. And you also moisturize because retinol can dry the skin if you use too much. So, the right way to use a retinol is first understand which type >> Mhm.
(1:12:14) >> your skin would take because it depends on your skin uh type, your skin at that moment, the climate. Use it once a week initially, then build it to twice a week, then three times a week. Not more than piece like like in a like in a pea size. Sometimes people are just lathering it. >> Mhm. >> So, all these things are important.
(1:12:35) So, eventually it's going to make your skin thicker, not thinner. >> Got it. You know, you talked about the biggest problem is people using too many products. I think everybody has that problem because like you said, it's it's everywhere. It's in front of you the whole day. So, how many products does an Indian adult need for their skin care routine? >> Cleanser, moisturizer, sunscreen, and then a targeted serum depending on your skin type.
(1:13:06) And the series, the order should be first cleanser, then serum, then moisturizer, then sunscreen. At bedtime again, cleanse your face or remove all your makeup. Use a targeted serum. It could be hyaluronic acid, vitamin C, retinol, one of those, not all. Then use a moisturizer. >> And so my two questions that come up there is, what about men who are lazy and are not going to do four things? >> One product.
(1:13:35) >> One product. I mean, face wash will have one face wash and then something on the face. >> On the face. So that >> Remove, put on. >> That's it. >> So what do we do? >> It's tough for even my husband to use a product. >> of course. >> So we use a sunscreen with a moisturizer in the day. And at night we wash our face and use a moisturizer and that's it.
(1:13:53) Now again, you can be a little more clever and use a moisturizer with, you know, a retinol in it. There are such creams. There are moisturizers with some antioxidants in them. So you can use those. >> I just want to talk a little bit about menopause skin. What What happens to your skin during menopause and what can you do about it? >> Yeah, it's the thankfully the most talked about thing now because we used to shy away >> All things menopause are now talked about.
(1:14:25) I think I think this generation of, whatever it is, 40, 50 year old women are >> Yeah. >> Ready to talk. >> ready to talk. >> Yes. >> Um >> And about time. >> Yes, of course. So there is an estrogen dip. There's a dip in the progesterone. The male hormones, the androgens are increasing. The cortisol is increasing. So all that is happening when you menopause.
(1:14:47) Because of which your skin gets dry, it gets hyperpigmented. You know, you end up with hair growth on the body a lot of times. You have hair fall. Um melasma is very, you know, it sort of sets in in a lot of people and a lot of people surprisingly it goes away also because of the dip in progesterone. But um yeah, I just had a patient yesterday.
(1:15:13) She said I've had um my my skin has turned four shades darker. And so she had to be put on HRT and over a period of time without any skin care products, her skin again, you know, she regained her color. So yeah, these are the very These are the common things and you know, apart from that, menopause will cause a lot of mood swings, anger, depression, sadness.
(1:15:42) All of that affects the skin again. Cuz all of that will again affect the hormones, your cortisol and catecholamines. And also your sleep. So when you're sleeping, your skin is repairing itself. The melatonin is helping, the growth hormones are helping. But when you don't sleep because of menopause, you know, you have hot flashes, you have night sweats, you don't sleep, that is going to affect the skin.
(1:16:08) So indirectly also it's affecting the skin. Directly it's affecting. >> do directly for the skin when you have menopause? >> I think consult a gynecologist and uh you have a lot of these HRTs that they give you. From the skin point of view, you need to use uh moisturizers which have ceramides which will build your um you know, your skin barrier.
(1:16:27) Moisturizers which have squalene, urea. Urea is a very nice ingredient which is not often talked about. Uh hyaluronic acid, of course. So these are things that you start using. >> You know, you have some of the India's top um actors and actresses as your as your clients. Um So for for actors and actresses, you know, like cuz we talked about skin being a reflection of who you are along with the health of the skin.
(1:16:54) It's health as well as you know, security and security kind of thing. And of course, actors and actresses have the highest level. So in a way, what I why I'm asking this is not to get into some celebrity gossip, but it's like they are the high-performance athletes of the skin care world. That's what I'm framing it as. Uh you know, like a tennis player can talk about he's at the high pressure level of of some physical endurance.
(1:17:16) An actor and actress is at the high pressure level of their skin because they have to go out the whole day. They have to wear makeup all the time for their shoots. Uh stressful times, you know, lights uh uh shooting timings go wrong. They're They're living in a high pressure world where their skin is constantly under the spotlight.
(1:17:32) What can we, the average human being, learn from them? >> Discipline. >> Right. >> So consistency and discipline is very important. And that's something that they do, right? Whether it's their diet or their exercise or their skin care, uh that's something they have to do. They don't have a choice. >> Mhm. >> And consistency.
(1:17:53) So you can't say, "Oh, I'm doing it for I'm using this cream for 3 weeks, 4 weeks. It's not giving me results." You have to be consistent for that particular cream to give you a result. Similarly with the skin treatment. Whatever you do, unless it's something like a Botox, okay, fine, you did a Botox, your lines have disappeared for 4 months.
(1:18:13) But otherwise, generally, suppose you have acne scars and you want to do uh like say a it's not possible it's not you your scars are not going to disappear 100%, but even if you want a 70% improvement, it takes about a year, and you have to be consistent. For a retinol or a peptide or a you know, or even a sunscreen to show results, you need to be consistent.
(1:18:36) And so discipline and consistency are two things I really admire them for that. >> Got it. Um One more question that comes to my mind in that that thing is that along with being under pressure and being consistent and disciplined all they also do a lot of procedures. Um again, what I'm just trying to understand what can someone learn from it? Like like what should someone do? What should someone not do? >> I think um it's not bad It's not wrong to do procedures. So you start early.
(1:19:08) You start by the age of 30 to 33 and you start with basic things like a PRP or micro needling. You don't have to get into heavy stuff. Then you can move on to skin boosters. And really the requirement for you know, hardcore treatments will reduce because you have sort of, you know, done a preventative treatment. The problem arises when one goes overboard and that's what happens even to celebrities sometimes.
(1:19:43) When you don't know where to cross the line and you've crossed the line. You've not even realized. Right? Also, I will you know, to a certain extent sometimes doctors are also to blame. Of course, even the patients are because sometimes they are very you know, they will be very adamant. They don't want to listen to you. >> I want this procedure.
(1:20:03) >> I want this. So of course, scientifically you will tell them. And then it it's a dilemma. There are people like me who say, "Sorry, please go somewhere else. I won't do it." >> Right. [snorts] >> But then there are a lot of clinics which are chains where the doctor you know, is only working there. And so they have they don't want the patient to go.
(1:20:28) >> Right. >> So they will say, "Okay, fine. You want to do it, you do it." >> Right. >> Right? That's one thing. The other thing is the concept. See, when we come to things like uh beautification of the face. Fillers, for example. It's an art. Okay? It's an amalgamation of science and art. You're sculpting the face.
(1:20:48) >> Right. >> You can't make every face We are taught that, you know, we have the five ratio. We have something called the Markets mask. You uh we are taught that this angle should be this much or whatever. But you cannot necessarily create that in every face because then the uniqueness goes away. And I have to Again, there are companies which produce these fillers initially, not now anymore, but initially when they were making manufacturing these fillers were teaching us Maybe that was their concept.
(1:21:25) Maybe it was a growing industry. They were teaching us to fill. So, I used to have this constant battle with them. Cuz they with their doctors because they would say uh eight syringes of filler on this face, and I would say no, two. You know? And so, that concept of overfilling, and that's why when you filled a face with hyaluronic acid back in the day, you look at all these actors actresses You know, I don't know if you saw that Madonna thing which was going around doing the rounds.
(1:21:53) She was like in in the Grammys, she was looking abnormal. Why? Because over a period of time, you've done fillers way too often every 6 months, and you also injected a lot. Hyaluronic acid will not dissolve completely. It's a humectant. It'll go sit somewhere. It'll absorb water and >> are different from injectables? >> It's an injectable.
(1:22:15) >> But fillers are different. You're saying you did fillers? >> Fillers There are different types of fillers, but hyaluronic acid is the most common. >> Got it. >> Now, if you're filling in hyaluronic acid every time, it's absorbing water and swelling. And so, one fine day you are a muskmelon or a watermelon. >> Right.
(1:22:32) >> Right? Which is why it's important to know that, "Oh, no. I'm only going to do it once in maybe 1 and 1/2 years, or I'm going to do a little bit on my lip so I do not look like It doesn't look like my lips have walked in before I have." So, you can also do subtle lips very beautifully. And similarly, when you're filling your faces, you do not overfill.
(1:22:54) Otherwise, you end up looking like And then when you dissolve it, the whole architecture of the face has changed. Suddenly, you've removed all the gas from the balloon and it's shriveled. Therefore, it's very important for the artist to understand the science and the art and then do the treatment. >> Got it. You are an international trainer for injectables.
(1:23:18) Botox, fillers, skin boosters, lasers. You know, most people use these words interchangeably. Can you just tell us a little bit about each of these? >> First of all, when you see a face which is like looking abnormal, people say, "Oh, she's heavily botoxed." Or, "He's heavily botoxed." >> Yes. >> Which is not true.
(1:23:35) >> No. >> Because uh that is probably overdone fillers, right? >> Botox is a medicine. It's given for cerebral palsy, migraines. >> It's a neurotoxin. >> To treat Yes, you know. >> um so it's it's injected into the muscle to relax the muscle, right? And so, when you relax the muscle So, when you're constantly frowning, you're looking at your iPad or your phone and you're constantly looking at it like that, you frown.
(1:24:04) And then you develop The muscle here becomes so active that it creates those lines. And you get a frown line. And so, to relax that muscle, these muscles over here, corrugators, procerus, you inject botox. Relaxes the muscle. >> tense. >> It's permanently tense. >> Is that what it is, basically? These wrinkles here >> Yeah.
(1:24:21) They're the muscles which are tense all the >> They're permanently tense. Okay. >> Showing on the surface as those deep lines. So, you relax the muscle with the Botox. And temporarily, the Botox effect lasts for 4 months. So, temporarily, those lines will go away. So, your frown lines, your crow's feet here, forehead lines. Lines on the nose, bunny's lines.
(1:24:40) These dimply, you know, see? These, yeah. So, these will go away if you want them to go away. But that is Botox. However, instead of 12 units here, if I inject like 30 units, I will freeze the muscle. So, there is no movement. And so, when I when there is no movement, you can't emote.
(1:25:02) So, you don't know whether you're sad or happy or angry or whatever because >> But a lot of people have that. I mean, I think So, that Why do they make that mistake? >> So, that is So, that's what I wanted to bring out. That that is the Botox face. All right? But that they don't make the mistake. So, it's the doctor who makes the mistake.
(1:25:21) Or, I do have people who want that look. Freeze me, doc. Freeze me. They like it that >> They like it, yes. >> They come and say, "Freeze me." >> It's clean. >> It's clean. So, yesterday, I had someone who said, "I want it clean." I said, "You need movement. You're a bride." "No, but I'm a bride. I want my forehead to be shiny." The concept is different.
(1:25:42) >> And it's reversible, I guess. So, it takes >> It It's there for 4 months. But that is Botox. Now, coming to fillers, right? A lot of botched faces that you see, where it's looking abnormal. It's looking crooked. It's looking like two big apples here or a very like a chin which is an extended >> Yes. >> thing, you know, attached here.
(1:26:03) Those are fillers. Hyaluronic acid comes in a syringe, pre-filled syringe. 1 ml, but if you More number of syringes would mean more ml. And you're just filling them. So, those are fillers. You can do them on the lip, cheeks. You can also do them along the jawline to create a jaw line. You can create a chin.
(1:26:21) You can reshape a nose which is flatter. Under eye hollows, temple hollows. And then of course now people also come with we want the forehead to be, you know, uh looking more convex and not flat. >> Oh my god. >> Cuz my profile doesn't look good. >> Got it. >> So that is fillers, right? Please do not overdo. I love fillers. I'm a trainer.
(1:26:43) But do not overdo. Then you talked about skin boosters. >> No. No. So you can reverse them 100% because it's hyaluronic acid. You want to dissolve them? You inject an enzyme called hyaluronidase. Dissolves within 24 hours. But who will inject it dissolve them after spending so much money? >> So they stay permanently? >> They 70% of it goes away in a year.
(1:27:08) >> Got it. >> 30% will remain permanently. And so that is why I said when you do it very frequently that 30% keeps accumulating and then it also absorbs water and somewhere it will cause a little bit of puffiness. >> Mhm. >> Okay. Then comes skin boosters. Skin boosters are there are types. There are two types.
(1:27:30) One is these, you know, skin vibe and uh Belotero Revive. These are the names. These will hydrate your skin. So you are like tiny injections of hyaluronic acid. So instead of applying a hyaluronic acid serum, you are injecting it. And so you get that glow because your skin is hydrated. Right? Then you have other types called Profhilo which will hydrate and also stimulate your collagen. So preventative.
(1:27:57) Those are skin boosters. And finally you have these biostimulatory agents like a poly-L-lactic acid which is becoming very popular now or a calcium hydroxylapatite. So Sculptra and Radiesse. Very popular, talked about highly uh on social media. You inject them. >> and what do they do? >> so you stimulate you inject them and you there's a protocol.
(1:28:23) For example, Sculptra you do every three or four months and you do about three sessions. It very slowly stimulates your cells, the fibroblast, to produce new collagen over a period of time. So, it firms the skin. So, you do a Sculptra today, you see a result after six months. Not immediately like a filler or a Botox. So, it is slowly making your skin produce its own collagen.
(1:28:47) >> All right. But, I guess those last two are a little different from Botox and fillers which are very cosmetic in nature and front-facing while the other two are working with your body. >> They're working with your body. Yes. And then there's PDRN which is salmon sperm DNA and then exosomes. Uh exosomes are derived either from human mesenchymal cells, fat cells, bone marrow.
(1:29:11) So, you take your fat and you get it. You take your bone marrow and you get it. Umbilical cord. Okay. Now, they are obtained from other people. So, there's a huge debate and they are not FDA approved because we do not know the purification, the standardization, uh the sterilization of that exosome. And if that exosome comes from a cancer cell, we don't know what it's doing.
(1:29:34) So, we are not injecting it currently. We use it with a derma derma pen. So, like a serum. PDRN which is salmon sperm DNA, excellent results, but again question marks because >> So, you use it? >> not standardized. I use PDRN, but um I use it with a microneedling device. >> Out of all these, what do you think has the most promise for someone who just wants better skin, you know, without changing too much? >> You know, for some reason, much as I do all these injectables, uh I love lasers.
(1:30:07) >> Mhm. >> So, if you do You're not putting in anything inside your skin. But, you do it at a low fluence. Uh, low energy, so you don't get hyperpigmentation. And you do it once in a month. It stimulates your collagen. And makes you So, I do a CO2 erbium laser on my face once every 3 4 months. >> The treatment? >> Mhm.
(1:30:30) >> 15 minutes. >> Is lying down or sitting? >> But, it has a downtime. So, every time I do it, my skin looks a little dark like and it has a grid for about 5 6 days. >> Oh. >> But, for me that's marketing. >> 5 days of pain for 1 month of fun. >> No pain. >> Not pain of unhappiness [snorts] for 1 month of fun.
(1:30:47) >> Yeah, I just put some makeup or lacto calamine. >> What about those home ones? You get those quite expensive home lasers that you put on your LEDs? How are those? >> Light emitting Light emitting diodes. >> that you wear. >> They cause photobiomodulation. That means what are they doing? They are They are these organelles called mitochondria in our skin.
(1:31:04) >> Mhm. >> So, these [snorts] are this light red light 630 to 680 should be the wavelength. All these random lights that you get online, don't buy them. If you want to buy them, look for a 630 to a 670 nanometer wavelength. Number one. And then you use it. Goes that laser light goes gets absorbed into the mitochondria.
(1:31:26) These will start producing cellular energy in the skin. And stimulate the fibroblasts. So, they are They're not a replacement for a facelift or a filler. But, when you use them say 5 days in a week for 15 minutes, you have to give it that much time. You can't say I'm using once a once in a week or once in a month. So, 4 to 5 days a week for 15 minutes.
(1:31:49) Good quality devices which have a good power, you know, 40 to 50 milliwatts uh, per centimeter square. That's what you're the specification that you look out for with the wavelength of 630 to 670, it will help in anti-aging. It's like you don't want to use all the products, so you just want to use apply this. It's good enough.
(1:32:14) But, if you have melasma or any kind of hyperpigmentation, don't use it. It's going to increase your melasma. >> So, again, go to a derm at first to be sure. Um I just want to talk about uh um botched injectables. You know, when when a mistake happens, like you mentioned uh very often you send uh people who come to you from other uh um >> places.
(1:32:39) >> other places uh for an MRI to check Can you tell us about that? What What What is a botched injectable and why do you need an MRI for it? >> There are two things here. Uh number one, the person who's injecting is either not qualified enough and doesn't know the anatomy, doesn't have the qualifications, and so is injecting wrong in incorrectly or using a lot of fillers.
(1:33:05) The second thing is the type of filler. Okay? I just got a recent WhatsApp message from some random person, and I'll show you that WhatsApp after this, where he said, "Am I the best here? Here? Here?" Like a sub somebody. You know? Or you cheap He's saying, "You cheap filler here? Here? Here? Filler here?" So, you inject all those kind of random stuff, and you get either you get some swelling or infection or you're doing too much, you're making the face look like an alien.
(1:33:35) And this happens pretty often nowadays. And of course, we have hyaluronidase to sort of inject and dissolve that hyaluronic acid, but whether it is really hyaluronic acid or something else, number one. Number two, where has that hyaluronic acid spread into your face? Because I You tell me I did uh chin filler, I will inject hyaluronidase here, but if it's migrated somewhere, I don't know.
(1:34:00) And so that botched face will still look like a botched face. So, I I prefer to send my patients for an MRI or an ultrasonography, but there are very few people who can, you know, catch that filler on an ultrasound or an MRI because it's a very new field. >> Got it. >> So, abroad, they are getting in there.
(1:34:21) A lot of dermats have ultrasound devices in their clinics. We are not allowed in India. Yeah, you can't have an ultrasound device unless you're a gynecologist or a >> you know, a radiologist. They'll tell you exactly where the filler is placed. And then you look at that and you either do an MRI guided on-table dissolving if it's a difficult case, or if it's not so difficult, it's not the filler's not gone and, you know, it's not sitting under some bone, you can look at that MRI and, you know, dissolve the filler.
(1:34:51) >> You know, this It's interesting that you spoke about this. So, what are what are the things that a client must verify before letting anyone near their face with the needle? >> First of all, I think it's important to see whether the person is a dermatologist or a plastic surgeon or a qualified aesthetic physician.
(1:35:08) So, look at their degrees. Um these days there are fake degrees, there are fake promises, there are fake diplomas, there are fake fellowships, um there are fake certificates displayed not just on the wall, but also on your website. So, go to the national medical commission. It's a bit bit of a task, but you can get First of all, if the person is renowned, then, you know, a lot of times it's okay.
(1:35:34) >> Go through recommendation. >> go through, but also see how many associations, dermat associations they are associated with. So, if a person is a member of the Indian Academy of Dermatology, Venereology, Leprology, IDVL, um or a member of the Association of Cutaneous Surgeons of India, they do not accept uh non-qualified people as members.
(1:35:57) So, that membership itself will tell you. The other one is National Medical Council, where you put in the name and you can you get to know whether they are, you know, a part of the National Medical Council. So, one is that. The second is not every doctor will have the aesthetics and the eye to, you know, do a particular filler or create a face, you know, sculpt a face.
(1:36:20) So, I think it's important to look at their work. So, see what their work is like. >> You'll have to go to them and say, "Show me your patients." >> Yeah. >> And they'll have to show you their biodata and all. >> patients or if they've posted on Instagram or, you know, whatever. >> But, you need to see the proof and all.
(1:36:37) >> this this proof. There's also a joke that look at the doctor. >> Mhm. >> Right? >> Yes. >> Uh I It's rude on my part to say that, but yes, a lot of time patients say, "If my doctor looks natural, then I know that >> And how like how I want to look, basically. >> How I like Yeah, because that's how I perceive beauty, right? And >> personal.
(1:36:56) >> It's very personal. So, if I'm percei- if I'm perceiving beauty in a particular way, I can sort of go a little uh off sometimes. >> Um >> Also, uh another important thing is uh check the products. >> Right. >> Right? So, a person may be saying, "I'm doing Botox." but injecting some random Chinese brand or some as I said that >> You look So, if it had it says Botox, look at the vial, it says Botox from Allergan.
(1:37:27) Look at the vial, it'll say Dysport from Galderma. Uh the fillers are Juvéderm. So, look at the box, it says Juvéderm. It says So, you come to know. >> Got it. Last few questions. >> Yeah, yeah, yeah. >> You've said that the most important skill for a dermatologist today is when to say no. >> Yeah. >> What do you think is wrong with the industry when that is the most important skill? >> I think there's a lot of pressure to look good all the time.
(1:37:55) So, we're all following in that validation trap. We all want to put, you know, one photograph is filtered uh automatically you have a filter on your phone and, you know, if nothing is just brightening your face. And so, there's you're not looking good to yourself. You're not doing things to look good to yourself anymore.
(1:38:15) You're just doing things to get more number of likes, get more followers, get more validation. People are constantly judging you. They're comparing you. So, and then you have that fear and you want to just please everybody. And which is why you want to then come to a doctor and want to do end number of things. So, now an amateur or somebody who's just starting will say, "Hey, let me not say no.
(1:38:42) " Because you're losing business also. Or you're losing, you know, that that person will feel, "Oh, this doctor doesn't know." So, there are two aspects to it. But you should learn to say no. Cuz for the benefit of the person, you should learn to put your foot down. And you have to do it in a very nice way. You have to explain the science to them.
(1:39:03) You have to hold their hand, a little bit of hand-holding, a little bit of empathy. All that falls into play. And then you make them understand that you need to love yourself at the end of the day and look good to yourself. You're doing something just for yourself, not to make somebody else, um you know, say, "Hey, you're looking damn good.
(1:39:26) " >> There's this new term Sephora kids. What is that? >> So, Sephora, don't kill me, but Sephora has they have come out with a lot of brands, uh a lot of products, which are meant for kids. So, kids who are like 9, 10, 11, 12 >> 9? >> Yeah, early teenage. >> Wow. >> So, they have all these kid range of products. Whether it's a moisturizer, a sunscreen, a serum.
(1:39:55) And obviously you know, although you have whatever Instagram, I think some of the countries, Sweden and all they've banned, China, they've banned kids from >> social media >> using social media. But most countries don't have that ban and kids use social media and they are, you know, now really aware about skin care and ingredients and I have 10-year-olds and 11-year-olds who can rattle all the ingredients and tell me the pros and cons.
(1:40:26) And Sephora, I think has cashed on that and they've made these products. And the kids are using these products all the time. Now this is the time your skin is maturing, it's growing, it's building, it's sensitive, it's thin. And it's also naturally, you know, learning to build its immunity. You don't need support.
(1:40:49) This is the time you need internal support. This is the time you need to eat healthy, you need to learn to form that discipline, exercise, sleep. But you're not doing that. You are already crippling yourself by holding on to something else which may eventually be detrimental to your skin. >> So, what do you tell a >> You know.
(1:41:08) >> a parent who, you know, can you tell me like what happens? Like a parent comes to you with their kid. Like their 10-year-old kid who's, you know, hooked on to Sephora. >> It's very difficult. >> Right. >> Teenagers and youngsters, because they will look at you in their mind they've formed an opinion that this doctor doesn't know anything.
(1:41:27) >> Mhm. >> You know. So, it's a battle that the parent and I have to sit together and discuss and the parent is on my side. I've seen a 10-year-old who's uh come to the clinic with cystic acne. Like like really terrible acne and deep scars, which is just unheard of, okay? And uh so partly, of course, it was the bad diet, cuz it was like a lot of burgers and all of that every day.
(1:41:59) But this person was using oils very regularly. And also makeup very regularly and not cleaning their makeup her, you know, her makeup >> 10-year-old girl, how will she clean it? Yeah, yeah. >> Not doing it right. So clogging the pores consistently with makeup, with the wrong kind of products, with oils, because she's been told that these oils are very good for the skin.
(1:42:25) And using a lot of serums, like just a complete mess. Um in boarding, so parents were not allowed. So she was trying and doing her own thing. Again, because everybody said she was not good-looking and she was dark. >> Mhm. >> So that dark was the stigma. >> Mhm. >> Not good-looking was the stigma. And obviously now, you know, kids have friend male friends and you know, and if boys are not making friends with them, they're not attracted to them, they do feel even at the age of 10.
(1:42:58) And so she was doing all this and uh it took us about eight months to cure her. >> Oh. Um what is genuinely the exciting in skin science right now and what is just hype? >> Uh the theory of longevity is very exciting. So imagine you have biostimulators, you have this cryotherapy, you have hyperbaric oxygen. Um nascent right now.
(1:43:24) Uh you have products which are going to be bespoke depending on your DNA. They're already out there. But again, very much in their infantile state. Um but that's really very very exciting. Um to understand skin and to prevent aging. You know, aging is a good thing, but as I said, as long as you're not looking haggard and tired all the time.
(1:43:52) So, that's an interesting phase. Uh what is not nice is this you know, this big boom, if you look at the beauty industry, uh around 2010, it was about somewhere around 100 or something billion. By 2030, it's supposed to jump to some insane billion, you know. I don't know the stats, maybe you look it up, 230 billion, I think so, around 230 billion.
(1:44:18) So, exposing people to this kind of uh you know, these kind of various kind of products and overwhelming them and creating that fear in them and uh that anxiety in them. I think that's not what we're looking at. And it's not just that, it's also in terms of procedures. Okay. >> [snorts] >> The same um device is packaged in a different way by a different company.
(1:44:44) And then you have a Kim Kardashian, you know, vouching for it, that she's getting the treatment done. And then everybody will want to do that. I'll get 100 DMs saying, "Doc, what is this?" Here, I have this particular device since 2017. It happened with Morpheus 8. So, I've been using microneedling RF for acne scars and, you know, accident traumatic scars and all that since uh 2015-16, okay? And now suddenly Morpheus has become very popular, not now, but a couple of years back, 2-3 years ago.
(1:45:18) Suddenly became very popular because uh Kim, you know, showed this whole reel on Instagram and also on YouTube. Everybody in the clinic wanted to do Morpheus 8. I would try and convince them and tell them, "Look, this is one A, you may not need it. I do it only for scars. I don't do it for tightening. Maybe it'll take off a lot of fat from your face. Let's not do it." No.
(1:45:45) Kim has said it's good, so it's good. We don't want to do Secret. We don't want to do Endymed RF. They're all the same technology. We want to do Morpheus. Okay. To the point that, you know, because like a high-profile clinic like mine, I've had to buy the Morpheus 8. So, I have two other MNRF devices, and I have Morpheus 8 also.
(1:46:06) >> All right. >> Right? Became very popular. Now, you have this whole FDA, you know, thing that has come out. It's in news that Morpheus 8 can take away your fat. So, don't do it. So, something that was so popular 2 years ago, 3 years ago, >> has gone. >> is now gone. Actually, the truth is that you have random clinics without with people randomly doing these treatments, not understanding the science, and just doing it for tightening and whatever, and doing it on gaunt faces.
(1:46:42) It's a device meant for scars and stretch marks and, you know, all of that. >> So, even a big celebrity endorsing something doesn't mean because they could also be just looking at a snapshot and be misinformed themselves. >> Absolutely. And sometimes they're not even using it. They're just >> selling it. >> Selling it. They're endorsing it.
(1:47:01) They're selling it. They're pretending to do it, but behind the camera they're not. >> Not. Thank you so much, Doc. It was fantastic. Jayashree, thank you so much. It was really interesting, and I'm looking forward to getting a bunch of tips from you for myself. Best sunscreen, moisturizer, retinol, drying but moisturizing mix.
(1:47:23) The The all-in-one The all-in-one thing that every every man should put. >> I've got to give you all the secrets now. >> Yes. Thank you. >> Thank you so much for having me. Thank you. >> Thank you.