February 8, 2024 • 41 mins
Martha has heard the questions about her cover images and selfies - what does she do to keep her face healthy, youthful, and glowing? Dr. Dan Belkin, a board-certified dermatologist at New York Dermatology Group, joins Martha for a frank conversation about taking care of your skin and body. Botox, fillers, retinols, skin tighteners, lasers - Dr. Belkin debunks the myths and dissects the science behind popular cosmetic procedures. What is hype and what is worth it? Which products are backed by evidence? For anyone interested in finding your best face, this is an episode you won’t want to miss.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
The biggest mistake that I see is people who go
do procedures and are disappointed. And the reason that they're
disappointed is because they are going to somebody who didn't
try to figure out what is the best thing for them.
Speaker 2 (00:20):
The cosmetic dermatology industry is an enormous business across the world,
and it's growing every year. New products and procedures emerge
all the time to meet the growing demand. I know
many people have questions about what procedures are safe and
effective and what they should avoid. So I thought we
could talk to doctor Dan Belkin, a board certified dermatologist
(00:44):
who practices at New York Dermatology Group. Dan graduated Amherst
College magna cum laude. He received his medical degree from
wild Cornell Medical College, and he studied non melanoma skin
cancer at Rockefeller University. I've been seeing him for quite
a few years and I rely on his thoughtful expertise.
(01:05):
Welcome to my podcast, doctor Belkin.
Speaker 1 (01:08):
Thank you so much for having me mine.
Speaker 2 (01:09):
I actually called doctor Belkan Dan, and he calls me Martha. Yes,
and how long have I been coming to your office?
Speaker 1 (01:16):
I think I met you about five years ago, maybe
six years ago.
Speaker 2 (01:20):
Introduced by my daughter. I think originally Alexis always finds
the very very best practitioners of their art. Yes, and
I consider dermatology and skincare and facial care and art
form for sure, are a real artist. D thank you
so much. It's really amazing what you can do to
(01:42):
help people look better feel better. And you're also your
advice is so good. And doctor Belkan actually practices so
many of the new techniques that you may not have
heard about. So I thought we would talk about all
the different kinds of things. Why don't we talk about
what you do for me? Because everybody is so interested
(02:02):
when they see a selfie of me posted on the internet.
So many comments are about my facelift and who did it,
when did I have it done? And all this and
how much retouching is on the photograph, And I just
want to set the record straight. How do you describe
what you do for me?
Speaker 1 (02:19):
So you know, I think you're an inspiration to a
lot of my patients who see you, and many people
wonder what you're doing and how you are looking so beautiful.
And I think you're a real testament to the idea
that taking care of your body, taking care of your skin.
Doing sort of minimally invasive treatments conservatively and regularly can
(02:44):
keep you looking beautiful at you know, any age, even.
Speaker 2 (02:48):
Longer, longer than you can imagine. Really yeah, yeah, And
there's so many articles day after day after day about
what people can do to reverse You're not going to
reverse aging, you're not going to get younger numerically, but
you can really prolong youthfulness, activity, energy by taking care
(03:13):
of yourself in several different ways. And I think going
to a really good dermatologist can help you feel better.
I remember when my mom, at eighty five years old,
went to a plastic surgeon and she said, I just
I want to face something because I just want to
look good. And he said, well, you're going to look good.
(03:35):
You're not going to look younger, but you're going to
look good. And she said that's enough for me. I
just want to look good.
Speaker 1 (03:41):
I think that's a great attitude. You want to try
to look the best you can at your age and
not necessarily younger. I think for you, you do look
a little bit younger than your age, which is a
great collateral. But for most people, I think what they
should aim for is to look the best for their age,
because I think when you try to start looking younger,
(04:02):
you can start looking a little bit uncanny where you
look where people can't tell what age you are, and
that's not so great either.
Speaker 2 (04:10):
Oh I don't know about that, well, I think in
your I don't. I never. I don't think a lot
about age. But I don't want to look my age. Yeah.
Well all, and that's why I really work hard at it.
I work hard at my exercise, I work hard at
my diet, which is a very healthy, normal diet. I
don't do fad diets and I don't do any pills
(04:33):
or anything like that. But I just eat really well
and I watch what I eat. That's really, I think
a secret. And so doctor Bell can describe what you do.
Let's start with my face first of all.
Speaker 1 (04:44):
Good, let's see. So what I look at when I
look at you or anyone is sort of what can
we do with all of the tools that we have
at our disposal. So we have botox like like products
that are neuromodulators that can soften some muscle and on you.
What I do with the botox is I try to
reduce downward pull on the face. So I do a
(05:06):
little bit in the jaw line and on the neck
so that we can reduce kind of the banding on
the neck and reduce the downward pull on the face
to keep those muscles a little weaker so the muscles
of the cheek can pull.
Speaker 2 (05:18):
Up more up. I see.
Speaker 1 (05:20):
Now we've tried a little botox on your upper face,
which has not.
Speaker 2 (05:24):
Gone that like that at all. My eyebrows kind of
go up in a V and that looks so unnatural. Yes,
and because I don't have lines in my forehead.
Speaker 1 (05:34):
Right, so it's not really necessary for you. So you know,
I've tried to give you a little lift. It hasn't
really worked that well on the upper face, but I
think neuromodulators like botox have worked really well for you
on the love.
Speaker 2 (05:45):
I have a nice neck for my age, you do,
and a nice jaw line. My draw looks good. It
looks better after you than any at any other time. Really,
it's for a long time I was worried about that
because that was my mom's problem, a little jowlly right,
and and after you, really it has really really helped
the appearance of my face.
Speaker 1 (06:05):
I'm happy to hear that.
Speaker 2 (06:06):
Yeah, very good. And now you're doing something else in
my cheeks.
Speaker 1 (06:09):
I do. So. The other thing that we use on
you is filler. Now there, filler is sort of controversial
these days. I think there is a trend to dissolve
filler and a lot of kind of a lot of
celebrities are famously dissolving their filler. And I think the
reason is is because filler is done kind of on
every corner, especially in New York and all these medi spas,
(06:32):
and you don't know who's doing it and how well
trained they are about that. Yeah, and so when we
use so filler can be really overdone. When you look
around and.
Speaker 2 (06:43):
Was that when you see a really plump lip, yes,
oh I see.
Speaker 1 (06:47):
Really big cheeks.
Speaker 2 (06:49):
I don't go for that.
Speaker 1 (06:50):
No, and so on you. When we do filler, we
do it very conservatively. We don't do it that often.
And for you, I like to use fillers that what
we are what we call biostimulatory fillers. So I would
say this is another trend moving a little bit away
from hyaluronic acid fillers, like regular fillers.
Speaker 2 (07:11):
That kind of erase a line or increase right. Okay,
that's hyerlonic.
Speaker 1 (07:16):
That's hyaluronic acids, which is your body's natural moisturizer and
your skin and your joints, and it's still a great tool,
and we can use it to kind of hydrate the
lips or soften some lines. But I think it's been overused,
and I think a lot of people respond to that,
and many people come into the office and say, please
don't overfill me. Please don't make me look like the
(07:37):
Real Housewives of New Jersey, you know, and so sorry, real,
I shouldn't, I shouldn't denigrate anybody, but on you. I
try to steer more toward what we call biostimulatory fillers.
And there are two that are on the market. One
of them is called Sculpture and one of them is
called Radis. They're both biocompatible, biodegradable, but they're not made
(08:03):
of hyaluronic acid. They're made of lactic acid and calcium, respectively,
and they've been shown to stimulate collagen and elastic fibers.
Speaker 2 (08:11):
Because you'd put some in my cheeks and.
Speaker 1 (08:13):
A little on the jaw jaw, so.
Speaker 2 (08:16):
You're giving me more plumpness in my cheeks where you
tend to get hollower, as you.
Speaker 1 (08:21):
Say, exactly, and it doesn't only create volume but it
doesn't create volume just by patching in exactly. It creates
volume by stimulating your own skin cells. Alp sculpture which
is lactic acid based, and radius, which is calcium based,
and those create volume by stimulating your own collagen, almost
(08:44):
like a fertilizer in the skin. So it doesn't only
give you volume, but it can help with skin texture too,
and a little elasticity so that when we do it
on the jaw, you have not only improvement in terms
of volume, but also a little improvement in terms of
skin quality and what else. And other things that we
do for you are laser. So laser is a very
(09:06):
wide category.
Speaker 2 (09:07):
And doctor bell Can, by the way, everyone is an
expert with all the latest and best lasers. That's one
of your specialties also, it is. And I'm really pleased
with the results of any any laser treatment that you've
given me. Thank you, you know, because here in that
v of your decolte, that's sun damage, that's a brown
(09:28):
spot here or there. Those lasers are really effective and
they really work. They're a little painful, yes, and ask
your germansologist to make sure they give you all that
nice cream that that sort of deadens deadens the effects
of chains, the sensations. But but it really works because
this part of me, my decolte and I across my
(09:50):
chest is looks so good now, and that that is
a combination of your work and also pilates. Yes, I
even find that it's getting nice and bony and looking
good and flat and nice.
Speaker 1 (10:04):
Well, you do a great job of taking care of
yourself sort of from the inside out, which which makes
my job much easier. And you're also good with sun protection,
which makes my job much easier. But lasers can be
used to target pigmentation, target redness, and target sun damage
and sort of resurface the skin. And so that's what
(10:26):
we do for you. Those are the main three things.
Speaker 2 (10:28):
So it's not so complicated, and it's not cutting me
and sewing me up. It is really preventative and very
encouraging because it really does make me look better.
Speaker 1 (10:39):
The other thing that I like about this stuff is
that in a way, it's many of these things are
actually good for the health of the skin. Laser resurfacing
not a blade of resurfacing like a fraxle for example,
that's been shown to reduce pre cancerous cells, so it
actually can prevent skin cancer.
Speaker 2 (10:57):
Too on my chest, Yes, and that really does result
in a very nice smooth skin.
Speaker 1 (11:02):
Yeah.
Speaker 2 (11:03):
What's the age group of your patients.
Speaker 1 (11:06):
My patients are from their twenties to their nineties.
Speaker 2 (11:12):
Yeah.
Speaker 1 (11:13):
Especially after it came out that you were one of
my patients, I get a lot of women in their sixties, seventies,
eighties wanting to look like you.
Speaker 2 (11:24):
How are they doing?
Speaker 1 (11:26):
They're doing good, Well, we're good.
Speaker 2 (11:28):
Well. My friend Charlotte went to you recently, and Charlotte's a
little older than I am. I'm eighty two. And Charlotte
looks amazing. She is so happy that she found you
through me. But she's so happy because she's she's a
pretty woman and she just needs a little attention. Yeah.
Speaker 1 (11:47):
I think sometimes little things go a long way, and
I think people sometimes, you know, when I see on
your Instagram some of the trolls that you get, one
of them is, you know, tell us who you're plastic
surgeon is, And I end up telling a lot of
people there wasn't a plastic surgeon. It's it's just minimally
invasive things for a long time in a really thoughtful,
(12:10):
excellent way. And the other thing is well, of course
Martha can do it because you need millions of dollars,
and that's not really true. You just have to choose
what's the most impactful treatment. So, you know, I think
the problem with a lot of these what's out there
and these medi spas and even all of the articles
(12:33):
about kind of the next best thing, people will go
in somewhere and say I want Morpheus. Morpheus is radio
frequency micro needling, and everyone's talking about Morpheus and it's
just a tool. So if you want Morpheus because you
have brown spots and so you think Morpheus is going
to rejuvenate you.
Speaker 2 (12:52):
You're wrong.
Speaker 1 (12:52):
So you spend all this money, you go through all
this pain, and your brown spots.
Speaker 2 (12:57):
Are still and they will not be told that that's
wrong treatment.
Speaker 1 (13:01):
They usually are not. I mean, if you have a
good doctor who's thoughtful and is not trying to sell
you something, then you.
Speaker 2 (13:09):
They know because somebody will asks. They'll see a friend
who's had Morpheus, and then they'll say, oh, I need
that too, and they don't really need it, right. Yeah, yeah,
I'm not like that at all. I never come in
asking for anything extraordinary that somebody else had, because actually
I don't really ask people. So much what do you do?
And then I might say, oh, what are you wearing?
It looks really great, But I don't really ask them
(13:30):
so much about their You.
Speaker 1 (13:31):
Know, honestly, you're a pretty easy patient, maybe surprisingly to
some people, because I think you recognize expertise and you
defer to it, and not.
Speaker 2 (13:43):
Only expertise artistry. I call what you do artistry because
you have to be an expert. But if you don't
have if you can't look at me and see that
one little thing is more crooked on one side than
the other side, then I don't want to work with you.
I want you to have the same I have a
very strict artistic eye, right and I can see defects,
(14:04):
and I want my doctor to see the defects also,
and you do. You're you're one of those guys that
can really see a defect and fix it. Thank you.
And that's so important listeners to pay attention to, because
you can go to a doctor who might look make
you look like everybody else that he sees, and you
don't want that. No, there's no one note in skincare
(14:26):
and dermatology. It's just not a one note thing. Everybody's
face is so different structured differently, and you might all
have the same bones, but you certainly have a different
confirmation of those.
Speaker 1 (14:38):
Book definitely, and everyone has different things that make them beautiful.
Speaker 2 (14:41):
And so you don't want to go when you say,
like this laser is going to hurt. Have you tried
it on yourself? Or has somebody done it on you
before you do it other people? Do? You always test things?
Speaker 1 (14:50):
Not always?
Speaker 2 (14:51):
Not always?
Speaker 1 (14:52):
But I have tried a lot of things, and I'm
not a good patient, and I understand that these things hurt,
and I'm not good at tolerating it. But you know
how it hurts, I do.
Speaker 2 (15:04):
Okay, that's good. Yes, that's good because I think some
doctors don't know that, and it's like, oh my gosh,
you're getting shocked to do.
Speaker 1 (15:12):
But it's very even botox gives me tears in my eyes,
which is really not that painful.
Speaker 2 (15:18):
Well, doctor Billiken is a young doctor, a handsome young
doctor who I don't think you need too much stuff
done to your fat.
Speaker 1 (15:26):
But I've got you know what I'm going in your
direction where I've you know, since I was in residency
when I was in my late twenties. I do little
things here and there, to sort of stay fresh and
hopefully never need anything more aggressive.
Speaker 2 (15:40):
Right. Oh that's good, Well you look great. So let's
debunk some treatments that people are talking about all the time.
What are benefits, which ones are worth it, and which
(16:02):
should be skipped?
Speaker 1 (16:04):
Botox Botox is a great treatment, of course. The reason
is is because what happens is with time, your skin
loses some collagen and elasticity, so it loses some of
the proteins that give it firmness, but your muscle strength
stays the same. So when you're young, you make expression
(16:27):
and your skin bounces back, and as you get older,
your skin doesn't bounce back the same way. And so
what botox does is it balances the muscle strength to
the elasticity of the skin, so that you should have expression,
but we're reducing it a little bit to sort of
match up with the elasticity of the skin. And I
(16:47):
find that people who have done botox somewhat regularly for
a long time look incredible in their older years because
they've prevented a lot of these lines and and crinkles
from forming. And you're one of those people, you've done
it for a while, and now even if you don't
do it for a year, you still relatively smooth because
(17:11):
your skin has stayed You've kept it nice and smooth.
Fillers fillers, So fillers is it's a great tool. Like anything,
it's just a tool. So you have to know what
you're trying to treat and you have to use it
to treat that. Fillers are great. I think a lot
of people are scared of them, and I understand why.
(17:32):
Hyaluronic acid fillers actually have been shown to give you
some collagen stimulation. So when they're used conservatively and well
and smartly, they can be really helpful for long term
skin aging. But when they're overused, and we've all seen
examples of that, and I won't name anybody, but when
they're overused, you can look very odd. Yeah, lasers, Lasers
(17:58):
are fantastic. They're powerful. Again, you have to think about
what you're trying to treat, so you are if you
want to treat sunspots, you have to use a certain
type of pigment laser. If you want to treat malasma,
even though it's pigmented and brown, you wouldn't use the
same type of pigment laser. You have cars scars, you
(18:19):
can treat scars, you have to and similar to you know,
even with scars, what are you trying to treat? Are
you trying to treat texture, redness, browning? So lasers are great,
but they're just tools and one size really never fits all.
Speaker 2 (18:35):
So how many different kinds of lasers do you have
in your office?
Speaker 1 (18:38):
What you say, I probably have about like twenty or
fifteen to twenty kinds of devices maybe, and some of
them are are not We don't even use anymore because
we have something better.
Speaker 2 (18:49):
And by the way, doctor Bilkin and his partners have
an amazingly modern office with the latest equipment and peckably
clean and bright of your lighting because it's so bright
and you can see everything, right, which is so important. Right,
But I really think you have a great, great office
(19:09):
for the treatment of skin. Yeah, what about skin tightening? Now,
have I ever had skin tightening?
Speaker 1 (19:17):
We've done I don't know what I've had. We've done
a little bit of skin tightening on you. We've done
a little ultrasound tightening. I think we've done I think
a long time ago we did a little soft wave,
which is an ultrasound based tightening device. And I think
we've done a little bit of all thera, which is it?
I think we did, Yes, we did, so that that's
(19:38):
a great ultrasound based skin tightening that I think works. Again,
it has to be done by the right person, it
has to be done thoroughly, but I really like all Therah.
Then there's radio frequency based skin tightening that can be
really helpful to morpheus or radio frequency micro needling is
a very popular treatment right now now, and that's for
(20:01):
skin tightening. But I think, well, like what on my face?
Why would I have root you that we haven't done
that on now? Because it doesn't give you any lift.
It just plumps up. It stimulates cauldron in the dermis,
so it kind of plumps up the skin. So it
can be good for sort of a crepy texture, but
it's not going to give you lift, which I think
(20:22):
is what most people are looking for. And so it
still has a purpose and I still use it on
some people, but not that often, not as often as
you would think, you know, hearing about it in the media.
Speaker 2 (20:35):
Right, So what schedule do you recommend to your patients
for these treatments? Do you see someone once every three months,
once every six months? What's it? What's a normal A
regimen of treatment.
Speaker 1 (20:48):
I think it always depends on what somebody needs. I
think for you, we've been doing about six months probably
maybe yeah, I.
Speaker 2 (20:56):
Don't even count. I just look in the mirror and
I tell if I need to touch, yes, and what
it appeals to. I forgot to mention peels in that list.
What what? What are? Peels?
Speaker 1 (21:07):
Peels are a more old fashioned modality, and there are
some dermatologists that are really really artful with peels, but
it's a very specialized sort of sort of thing.
Speaker 2 (21:18):
That downtime after appeal to you do you do?
Speaker 1 (21:22):
And it depends on how strong the peel is. There
are very light peels where there's minimal downtime, and there
are really really deep peels where your whole face is
burned off. And there are dermatologists that really focus on peels.
As a laser fellowship trained person, I tend to prefer lasers.
I think they're more targeted. I think, you know, if
(21:43):
you have redness, we can target that, if you have brown,
we can target that. I find peels a little harder
in my hands, but.
Speaker 2 (21:49):
I find them harsh. I mean I have never done
I did a little surface peel once and oh I
hated it so much. But my skin doesn't require it,
I don't think I don't think so either, very smooth skin.
Speaker 1 (22:01):
And not No, it's a little bit more broad strokes.
It's not as targeted.
Speaker 2 (22:07):
But be careful everybody with peels, because you can do
damage with peels. You can do damage with all of
these things if you're in the wrong hand exactly. So
for a while people talked about baby botox. What's the
theory behind starting botox at a young age and when
is the right time to start.
Speaker 1 (22:28):
Yes, there was a time when baby botox was a
very popular concept, maybe a couple of years ago. I
usually tell people that when they're starting to see lines
that are at rest, that's a great time to consider
starting to get botox, Like what kind of lines, So,
like on your forehead, you have some lines with movement,
(22:50):
but if you are not making any movement and your
face is relaxed and you're starting to see little fine
lines there, that's a nice time to start.
Speaker 2 (22:59):
You know. Well, quite a few years ago I noticed
two lines between my eyebrows, yes, vertical lines, and some
doctors said, just put scotch tape on your face every
single night between your eyes and you will not have
those lines. And I did. I did it religiously. Just
put a piece of scotch tape here, and I don't
have those lines anymore, you know. There it's a habit
(23:20):
because you're squinching, right, or if your eyesight is bad
and you start to squinch, you start to get those
lines around your eyes exactly.
Speaker 1 (23:27):
And that's what I mean, those etched lines where even
when you're not squinting, you still have those eleven lines.
There are silicone patches that you can buy and put
them on at night to keep the skin smooth so
that you're not you know, you're not movement.
Speaker 2 (23:42):
Does that work? It does? That's that's good. So when
do you recommend someone get a face lift, which is
an operation versus treatments like fillers or botox. How do
you know when a person needs a facelift?
Speaker 1 (23:58):
Well, like with anything, all of this sort of elective stuff,
nobody really needs anything, So it really just depends on
what somebody's expectations and goals are. Facelifts can be done
so beautifully these days, where they're so natural they're hard
to detect, and it's a great treatment, But it just
(24:22):
depends on what somebody wants. There are people who just
feel very strongly that they never want to have a surgery,
they don't want to go under. And then there are
other people who are completely fine doing that.
Speaker 2 (24:36):
They can't wait to have one.
Speaker 1 (24:37):
They can't wait to have one. And there and then
there are other there are some people who want, for example,
the neck, if you wanted if you told me, I
don't want any laxity on my neck, I want I
want all of these bands gone, I would say, well,
that's going to be a surgical issue. Then then you
would need to have a necklift, a surgical necklift. But
(24:58):
if you say, I'm okay with getting that reduced, I'm
okay with having them be a little bit retracted and
not as prominent, then I would say.
Speaker 2 (25:06):
Okay, we can do that with boattox. Right, what does
what does next surgery require? Where do you cut and
how do you.
Speaker 1 (25:15):
Next surgery would be Usually they would combine it with
the lower face and they would make incisions around the
ear and so I'm sure everybody is seen, you know,
scarring around the ear, which can be you know, noticeable,
but you get scarring around your ear, and then they
go under and they tighten up, not only the skin,
(25:37):
but also the fascia of the face, so the layer
of the face that's muscle and connective tissue, So that
gets moved too. That gets moved too, because it's not
just skin that's becoming lax with age, it's also the
underlying tissues of the face.
Speaker 2 (25:51):
You set me on to something that I love so
much and I will not leave the house without it.
In the morning. You recommended that I use tinted elast Yeah,
what is elastin? Really? It comes in a tube. It's
mine is tinted and you can get it also like
a smooth clear ointment, right or cream.
Speaker 1 (26:11):
Alastin Is is a company that a lot of dermatologists
really like because they have clinical trials that show whatever
they want to show, and a lot of these kind
of anti aging skincare products there's no evidence behind them.
It's it's really just a marketing employ and so when
I recommend something, I look for things that have some
(26:33):
evidence that show that, Okay, if it's anti aging, is
it stimulating collagen, is it stimulating elastic fibers? And so
that's why I like Elastin. They have trials that show
that with skin biopsies there's something that I've recommended for you,
which is the nectar, which is that sort of clear one.
Speaker 2 (26:50):
Yeah, that's so good too, It's great.
Speaker 1 (26:52):
And then the sunscreen is just a sunscreen, but a
tinted sunscreen has more coverage, so it has more UV coverage.
And UVA is the type of UV that causes aging
signs of aging, and so to have a tint means
that you're you're blocking more of the UVA and typically
you get better coverage with that.
Speaker 2 (27:12):
I'm wearing that also, Yeah, you do every day? Yeah,
I put I put the lass in the chinge It
moisturizer on every single morning. I add to it a
little serum and so I thin it out a little
tiny bit and I just put it all over my face,
all over my chest, all over my lower arms, in
my hands, and it works. It really works. And it
(27:32):
looks like you have to make upon Yeah it does.
And even if you don't, you look really better with it.
Speaker 1 (27:37):
You look a little bronze done.
Speaker 2 (27:39):
It looks really great. What's the correct order in which
to layers, serums, moisturizers and SPF And how much does
the skin really absorb these things?
Speaker 1 (27:50):
The skin doesn't really absorb that much of them. So
there are certain things that the skin does absorb. So
retinol is a great ingredient to look for. It's a
vitamin A. A retinol or a retinoid is a prescription
version of it, and the skin does absorb retinol well.
And so there are certain products that we know is
(28:11):
absorbed really well. There are other things that the skin
probably doesn't absorb very well. So you know, there are
certain peptides. For example, peptides are protein chains. Many products
will advertise that there are peptides. Well, peptide just means
a protein chain. So if it's a large protein chain,
(28:35):
it may not be getting to where you want it
to go. It may be sitting on the surface of
the skin. The skin has a stratum coranium, which is
is a barrier. It prevents absorption. So that's why I
look for studies that show that you're actually getting an effect.
Vitamin C is another ingredient that can be a great
ingredient when the vitamin C is active, but it oxidizes
(28:58):
very easily and quickly, right quickly. Yeah, So many products,
if it's really not from a super reputable brand, they
may have vitamin C that that oxidizes very quickly or
sort of inactive when you buy it, and you know
they're going to advertise that it has vitamin C in it,
but it doesn't mean that you're actually getting that benefit.
Speaker 2 (29:17):
So in your practice, have you found any kinds of
creams or serums that really are superior to all others.
Speaker 1 (29:28):
I think that the two brands that I think have
very good evidence behind them in terms of anti aging
products are Elastin and the peptides that Elastin uses, and
then skin Medica, which uses growth factors, and those are
typically the two that I will recommend for sort of
(29:51):
an anti aging regimen. Now there's a lot of brands
and products that I like because they feel good, because
they moisturize well, but that's little less hard to come by.
Speaker 2 (30:02):
I have not tried skin Medica, have I. I don't know.
I'll get you some. I need some. Yeah. I like
to try everything. Yeah, And I am like a human
experiment and I really think it's important. But it's not
just as important as what you put into your body
your skin, as it is what you put on it.
(30:23):
Oh definitely. So I'm experimenting a lot with what I'm
eating and to see what makes a difference.
Speaker 1 (30:29):
Are there any supplements that you like that you've used.
Speaker 2 (30:32):
That not really? You know, if I get a blood test,
and which I do twice a year, I think that's
a very good thing to get and have someone analyze
your blood. Do you agree with that having your blood red?
Kind of like? Yeah, I was low in vitamin beach well,
oh definitely. So why would I be low invitamin beach twelve?
(30:53):
I don't know, but I must not be eating the
right things. So I've changed my diet enough to add
enough vegetables that have more vitamin B twelve. Also, I
take vitamin B twelve now as a supplement just to
and it went up like three hundred points. Great, so
for the next you know, in the next four months
or something. And iron, I'm low on iron. It turned
(31:14):
out that the same time that my blood my BE
twelve was going up, the iron was going down. Now
why why would iron go down? Anemia a little bit,
or being under the weather or being tired or whatever.
Speaker 1 (31:27):
Well, definitely, all these things if you feel crappy, I mean,
all of these things can cause you to feel not
so great, right.
Speaker 2 (31:35):
So so you have to take care of that stuff, right,
And that is a big effect on your appearance, right.
And I also think that what we've gone through for
the last three years, the pandemic and the covids and
the and now the rsvs and everything else that's coming around,
I think that we have to be much more aware
of and get and get a blood test every now
and then and see see if you're failing in any way. Yeah,
(32:07):
what are some of the non evasive options to improve
your skin regimen that doesn't require needles and surgery? What
would you say? It was a good daily regimen.
Speaker 1 (32:19):
A good daily regimen. So everybody really should be using
sun protection. I know every dermatologist says it, But we
know that culture violet is a carcinogen. We know that
it upregulates enzymes that break down collagen. So if you're
doing if you're spending any money on laser or injections,
(32:41):
but you're tanning, you're sort of you're being counterproductive. So
a really good sunscreen sun protection, and there's many different types.
And I always tell my patients that if you find
it greasy or you just don't like the feel of it,
that you're not going to wear it every day, tell
me and I'll find something that you like, because I
(33:02):
like the elastin product, but there are many sunscreens that
I hate wearing. So sunscreen, A retinol or a retinoid
is great for most people, not everybody, but it's we
know it's it's a really good powerhouse skincare ingredient. It
has great evidence behind it. We know that it stimulates
(33:24):
collagen and helps reduce skin cancers and wrinkles.
Speaker 2 (33:29):
Once you're is there a brand of that that we
could recommend.
Speaker 1 (33:32):
Or retinal there's there's a lot of a lot of
good options for retinol. You Beauty has something called the
Resurfacing Compound that I really like that has retinol in it.
Elastin has a good retinol.
Speaker 2 (33:45):
And then, of course we're all finding out that skin
cancer is quite rampant because of our laxity and using sunscreen,
and that's a pretty dangerous thing to get some a
spot that then turns into a skin cancer. Or you're
an expert in that too. I read I didn't know
you were an m H, which you want to avoid
(34:07):
at all costs.
Speaker 1 (34:08):
Right, it's a guy's name who invented this procedure where
you take just a little bit of the skin cancer away.
You look under the microscope and then if you still
see it there, you just take a little bit more.
Speaker 2 (34:20):
I see, Okay, that's I know. I avoided it so far,
so yes, hopefully I can avoid it forever. I was
never a big sunseeker. I didn't I didn't lie out
in the sun too much. But we used to put
you know, lemon juice in our hair and baby oil
all over our skin when we were kids. Right, but
that has stopped, yes, of course.
Speaker 1 (34:40):
And people you know who are really really careful with
the sun or sometimes wondering, well, why did I get this?
Why do I have sunspots? Why do I have a
skin cancer? Unfortunately, it's sort of from cumulative sun exposure.
So if you've had a lot of sun exposure in
your younger years, it does catch.
Speaker 2 (34:57):
Up with you. Yeah, so if you have young children,
it's going to I did to make sure they have
sunscreen on them, right, and and also wearing the long
sleeves while you're swimming. I I wear those you know,
sun what are they called sun rash right?
Speaker 1 (35:10):
Rash cards?
Speaker 2 (35:11):
Rash cards? Oh? Yeah, of course you always wear a hat,
but helmetch So how do you approach treatment for skin cancers.
I know that when when I when I noticed a
tiny little spot on my nose, you sent me immediately
to have it tested, right, which, and then there's a
what is that appointment that you can put on. You
(35:32):
can hardly spill it and say it I am I.
Speaker 1 (35:36):
Q you I I O D M O D and
that is we're using sort of off label, but it's
it's an immune stimulator to keep skin cancer at bad.
Speaker 2 (35:51):
Okay.
Speaker 1 (35:52):
The most common are basal cell carcinoma and square a
cell carcinoma, which many people who are fair skinned enough
sun will get. And those typically are not that dangerous,
but they're frustrating because they're often on the face or
the neck and they have to be cut out, and
(36:15):
so we do MOS on those because MOS allows us
to take as little as possible and keep it very
very small, and then we have a very small defect
to reconstruct, and so usually we can keep it sort
of cosmetically elegant.
Speaker 2 (36:28):
Oh good.
Speaker 1 (36:29):
There's a third type of skin cancer. The most third
most common type is melanoma, which is much more dangerous,
and that is when if you saw in your body
a dark spot that was changing or growing, it can
happen anywhere, even where the sun doesn't shine, and that
can be much more lethal. Where finding a lot of
(36:50):
those really early, we're taking them out surgically and we're
not you know, and you don't have to do anything further.
But they are the type of cancer that sometimes they
go into your lymph nodes, sometimes they spread further than that.
Sometimes they need chemo, and sometimes they can be lethal.
Speaker 2 (37:06):
So be very careful with any changes in your skin
or any spots that appear that are right. Yes, what
mistakes you see people make when it comes to taking
care of their skin, Yeah.
Speaker 1 (37:18):
I think I think the biggest mistake that I see
is people who go do procedures and are disappointed. And
the reason that they're disappointed is because they are going
to somebody who didn't evaluate them and didn't try to
(37:38):
figure out what is the best thing for them, and
they're doing something that's missing what their goal is. And
I think that can happen with filler, and it can
happen with radio frequency micro needling, and it can happen
with laser. And so I even if somebody wants to
(37:59):
do some thing locally, maybe they live in New Jersey,
they want to go to a medspa New Jersey. I'll
still advise them, you know, go for this, not that,
because I don't want them to make that mistake and
be upset and have a complication and that sort of thing.
Speaker 2 (38:18):
So when you get when you get home to after
work and you have your nice dinner or you've gone
out for dinner, what do you do before you go
to bed? What would you advise anybody to do before
they go to bed?
Speaker 1 (38:30):
So you want to wash your face for sure?
Speaker 2 (38:33):
Using what?
Speaker 1 (38:34):
Using? Most you know, even drug store gentle cleansers are
totally fine. There are some other cleansers that I that
I really like. There's one from again New Beauty that
is what it's called the conditioning wash, which is very moisturizing.
I think I've given you one of those.
Speaker 2 (38:52):
I love that. Oh and by the way, I've just
finished it too, that I use in the shower. I
love it. I use it all over my body. Yes,
and it's it is so it SuDS up nicely, but
it's it does leave your skin very moisture somehow.
Speaker 1 (39:07):
It moisturizes instead of drying you and it's clean to
really clean.
Speaker 2 (39:12):
And I use a I use like an oil camellia
oil to clean my face at night.
Speaker 1 (39:17):
That's great.
Speaker 2 (39:18):
It's hot wet rag.
Speaker 1 (39:19):
Yeah, you know that's called oil cleansing, which is which
is helpful because your skin has you know, your sebum
on your face is oil based.
Speaker 2 (39:27):
And I would never go to bit with my makeup
on it, right right, I won't. I mean even no
matter how tired I am. But my face gets washed
and lubricated and serumed and everything before I go to bed.
Speaker 1 (39:41):
So cleansing is very important. And then you know, you
would use you most people can use a little bit
of moisturizer, so you might use a hyaluronic acid serum
something to give your skin some moisture. And then most
people could benefit from some sort of barrier, like something
a little thicker that keeps the moisture in overnight. You
(40:02):
have a lot of repair going on at night in
your skin, and so keeping it hydrated is.
Speaker 2 (40:07):
Helpful for that. And then when you wake up, you
take your shower.
Speaker 1 (40:12):
And then when you wake up, you wash your face again,
you put on some moisturizer, you put on some sunscreen,
and you're good.
Speaker 2 (40:19):
Yeah. Yeah, So taking care of yourself is not so hard,
but it does take a bunch of care, and it
does take some thought and it also takes some good
advice from a dermatologist. And I've put my trust at
doctor Belkin. I think that your explanations of all these
things that we talked about today are so good. And
(40:42):
thank you so much for joining me on the podcast.
Thank you so much for Dan Dan Belkin, and you
can follow Dan on Instagram at doctor Dan Belkan b
E l k I N for his advice on the
best skincare practices.
The biggest mistake that I see is people who go
do procedures and are disappointed. And the reason that they're
disappointed is because they are going to somebody who didn't
try to figure out what is the best thing for them.
Speaker 2 (00:20):
The cosmetic dermatology industry is an enormous business across the world,
and it's growing every year. New products and procedures emerge
all the time to meet the growing demand. I know
many people have questions about what procedures are safe and
effective and what they should avoid. So I thought we
could talk to doctor Dan Belkin, a board certified dermatologist
(00:44):
who practices at New York Dermatology Group. Dan graduated Amherst
College magna cum laude. He received his medical degree from
wild Cornell Medical College, and he studied non melanoma skin
cancer at Rockefeller University. I've been seeing him for quite
a few years and I rely on his thoughtful expertise.
(01:05):
Welcome to my podcast, doctor Belkin.
Speaker 1 (01:08):
Thank you so much for having me mine.
Speaker 2 (01:09):
I actually called doctor Belkan Dan, and he calls me Martha. Yes,
and how long have I been coming to your office?
Speaker 1 (01:16):
I think I met you about five years ago, maybe
six years ago.
Speaker 2 (01:20):
Introduced by my daughter. I think originally Alexis always finds
the very very best practitioners of their art. Yes, and
I consider dermatology and skincare and facial care and art
form for sure, are a real artist. D thank you
so much. It's really amazing what you can do to
(01:42):
help people look better feel better. And you're also your
advice is so good. And doctor Belkan actually practices so
many of the new techniques that you may not have
heard about. So I thought we would talk about all
the different kinds of things. Why don't we talk about
what you do for me? Because everybody is so interested
(02:02):
when they see a selfie of me posted on the internet.
So many comments are about my facelift and who did it,
when did I have it done? And all this and
how much retouching is on the photograph, And I just
want to set the record straight. How do you describe
what you do for me?
Speaker 1 (02:19):
So you know, I think you're an inspiration to a
lot of my patients who see you, and many people
wonder what you're doing and how you are looking so beautiful.
And I think you're a real testament to the idea
that taking care of your body, taking care of your skin.
Doing sort of minimally invasive treatments conservatively and regularly can
(02:44):
keep you looking beautiful at you know, any age, even.
Speaker 2 (02:48):
Longer, longer than you can imagine. Really yeah, yeah, And
there's so many articles day after day after day about
what people can do to reverse You're not going to
reverse aging, you're not going to get younger numerically, but
you can really prolong youthfulness, activity, energy by taking care
(03:13):
of yourself in several different ways. And I think going
to a really good dermatologist can help you feel better.
I remember when my mom, at eighty five years old,
went to a plastic surgeon and she said, I just
I want to face something because I just want to
look good. And he said, well, you're going to look good.
(03:35):
You're not going to look younger, but you're going to
look good. And she said that's enough for me. I
just want to look good.
Speaker 1 (03:41):
I think that's a great attitude. You want to try
to look the best you can at your age and
not necessarily younger. I think for you, you do look
a little bit younger than your age, which is a
great collateral. But for most people, I think what they
should aim for is to look the best for their age,
because I think when you try to start looking younger,
(04:02):
you can start looking a little bit uncanny where you
look where people can't tell what age you are, and
that's not so great either.
Speaker 2 (04:10):
Oh I don't know about that, well, I think in
your I don't. I never. I don't think a lot
about age. But I don't want to look my age. Yeah.
Well all, and that's why I really work hard at it.
I work hard at my exercise, I work hard at
my diet, which is a very healthy, normal diet. I
don't do fad diets and I don't do any pills
(04:33):
or anything like that. But I just eat really well
and I watch what I eat. That's really, I think
a secret. And so doctor Bell can describe what you do.
Let's start with my face first of all.
Speaker 1 (04:44):
Good, let's see. So what I look at when I
look at you or anyone is sort of what can
we do with all of the tools that we have
at our disposal. So we have botox like like products
that are neuromodulators that can soften some muscle and on you.
What I do with the botox is I try to
reduce downward pull on the face. So I do a
(05:06):
little bit in the jaw line and on the neck
so that we can reduce kind of the banding on
the neck and reduce the downward pull on the face
to keep those muscles a little weaker so the muscles
of the cheek can pull.
Speaker 2 (05:18):
Up more up. I see.
Speaker 1 (05:20):
Now we've tried a little botox on your upper face,
which has not.
Speaker 2 (05:24):
Gone that like that at all. My eyebrows kind of
go up in a V and that looks so unnatural. Yes,
and because I don't have lines in my forehead.
Speaker 1 (05:34):
Right, so it's not really necessary for you. So you know,
I've tried to give you a little lift. It hasn't
really worked that well on the upper face, but I
think neuromodulators like botox have worked really well for you
on the love.
Speaker 2 (05:45):
I have a nice neck for my age, you do,
and a nice jaw line. My draw looks good. It
looks better after you than any at any other time. Really,
it's for a long time I was worried about that
because that was my mom's problem, a little jowlly right,
and and after you, really it has really really helped
the appearance of my face.
Speaker 1 (06:05):
I'm happy to hear that.
Speaker 2 (06:06):
Yeah, very good. And now you're doing something else in
my cheeks.
Speaker 1 (06:09):
I do. So. The other thing that we use on
you is filler. Now there, filler is sort of controversial
these days. I think there is a trend to dissolve
filler and a lot of kind of a lot of
celebrities are famously dissolving their filler. And I think the
reason is is because filler is done kind of on
every corner, especially in New York and all these medi spas,
(06:32):
and you don't know who's doing it and how well
trained they are about that. Yeah, and so when we
use so filler can be really overdone. When you look
around and.
Speaker 2 (06:43):
Was that when you see a really plump lip, yes,
oh I see.
Speaker 1 (06:47):
Really big cheeks.
Speaker 2 (06:49):
I don't go for that.
Speaker 1 (06:50):
No, and so on you. When we do filler, we
do it very conservatively. We don't do it that often.
And for you, I like to use fillers that what
we are what we call biostimulatory fillers. So I would
say this is another trend moving a little bit away
from hyaluronic acid fillers, like regular fillers.
Speaker 2 (07:11):
That kind of erase a line or increase right. Okay,
that's hyerlonic.
Speaker 1 (07:16):
That's hyaluronic acids, which is your body's natural moisturizer and
your skin and your joints, and it's still a great tool,
and we can use it to kind of hydrate the
lips or soften some lines. But I think it's been overused,
and I think a lot of people respond to that,
and many people come into the office and say, please
don't overfill me. Please don't make me look like the
(07:37):
Real Housewives of New Jersey, you know, and so sorry, real,
I shouldn't, I shouldn't denigrate anybody, but on you. I
try to steer more toward what we call biostimulatory fillers.
And there are two that are on the market. One
of them is called Sculpture and one of them is
called Radis. They're both biocompatible, biodegradable, but they're not made
(08:03):
of hyaluronic acid. They're made of lactic acid and calcium, respectively,
and they've been shown to stimulate collagen and elastic fibers.
Speaker 2 (08:11):
Because you'd put some in my cheeks and.
Speaker 1 (08:13):
A little on the jaw jaw, so.
Speaker 2 (08:16):
You're giving me more plumpness in my cheeks where you
tend to get hollower, as you.
Speaker 1 (08:21):
Say, exactly, and it doesn't only create volume but it
doesn't create volume just by patching in exactly. It creates
volume by stimulating your own skin cells. Alp sculpture which
is lactic acid based, and radius, which is calcium based,
and those create volume by stimulating your own collagen, almost
(08:44):
like a fertilizer in the skin. So it doesn't only
give you volume, but it can help with skin texture too,
and a little elasticity so that when we do it
on the jaw, you have not only improvement in terms
of volume, but also a little improvement in terms of
skin quality and what else. And other things that we
do for you are laser. So laser is a very
(09:06):
wide category.
Speaker 2 (09:07):
And doctor bell Can, by the way, everyone is an
expert with all the latest and best lasers. That's one
of your specialties also, it is. And I'm really pleased
with the results of any any laser treatment that you've
given me. Thank you, you know, because here in that
v of your decolte, that's sun damage, that's a brown
(09:28):
spot here or there. Those lasers are really effective and
they really work. They're a little painful, yes, and ask
your germansologist to make sure they give you all that
nice cream that that sort of deadens deadens the effects
of chains, the sensations. But but it really works because
this part of me, my decolte and I across my
(09:50):
chest is looks so good now, and that that is
a combination of your work and also pilates. Yes, I
even find that it's getting nice and bony and looking
good and flat and nice.
Speaker 1 (10:04):
Well, you do a great job of taking care of
yourself sort of from the inside out, which which makes
my job much easier. And you're also good with sun protection,
which makes my job much easier. But lasers can be
used to target pigmentation, target redness, and target sun damage
and sort of resurface the skin. And so that's what
(10:26):
we do for you. Those are the main three things.
Speaker 2 (10:28):
So it's not so complicated, and it's not cutting me
and sewing me up. It is really preventative and very
encouraging because it really does make me look better.
Speaker 1 (10:39):
The other thing that I like about this stuff is
that in a way, it's many of these things are
actually good for the health of the skin. Laser resurfacing
not a blade of resurfacing like a fraxle for example,
that's been shown to reduce pre cancerous cells, so it
actually can prevent skin cancer.
Speaker 2 (10:57):
Too on my chest, Yes, and that really does result
in a very nice smooth skin.
Speaker 1 (11:02):
Yeah.
Speaker 2 (11:03):
What's the age group of your patients.
Speaker 1 (11:06):
My patients are from their twenties to their nineties.
Speaker 2 (11:12):
Yeah.
Speaker 1 (11:13):
Especially after it came out that you were one of
my patients, I get a lot of women in their sixties, seventies,
eighties wanting to look like you.
Speaker 2 (11:24):
How are they doing?
Speaker 1 (11:26):
They're doing good, Well, we're good.
Speaker 2 (11:28):
Well. My friend Charlotte went to you recently, and Charlotte's a
little older than I am. I'm eighty two. And Charlotte
looks amazing. She is so happy that she found you
through me. But she's so happy because she's she's a
pretty woman and she just needs a little attention. Yeah.
Speaker 1 (11:47):
I think sometimes little things go a long way, and
I think people sometimes, you know, when I see on
your Instagram some of the trolls that you get, one
of them is, you know, tell us who you're plastic
surgeon is, And I end up telling a lot of
people there wasn't a plastic surgeon. It's it's just minimally
invasive things for a long time in a really thoughtful,
(12:10):
excellent way. And the other thing is well, of course
Martha can do it because you need millions of dollars,
and that's not really true. You just have to choose
what's the most impactful treatment. So, you know, I think
the problem with a lot of these what's out there
and these medi spas and even all of the articles
(12:33):
about kind of the next best thing, people will go
in somewhere and say I want Morpheus. Morpheus is radio
frequency micro needling, and everyone's talking about Morpheus and it's
just a tool. So if you want Morpheus because you
have brown spots and so you think Morpheus is going
to rejuvenate you.
Speaker 2 (12:52):
You're wrong.
Speaker 1 (12:52):
So you spend all this money, you go through all
this pain, and your brown spots.
Speaker 2 (12:57):
Are still and they will not be told that that's
wrong treatment.
Speaker 1 (13:01):
They usually are not. I mean, if you have a
good doctor who's thoughtful and is not trying to sell
you something, then you.
Speaker 2 (13:09):
They know because somebody will asks. They'll see a friend
who's had Morpheus, and then they'll say, oh, I need
that too, and they don't really need it, right. Yeah, yeah,
I'm not like that at all. I never come in
asking for anything extraordinary that somebody else had, because actually
I don't really ask people. So much what do you do?
And then I might say, oh, what are you wearing?
It looks really great, But I don't really ask them
(13:30):
so much about their You.
Speaker 1 (13:31):
Know, honestly, you're a pretty easy patient, maybe surprisingly to
some people, because I think you recognize expertise and you
defer to it, and not.
Speaker 2 (13:43):
Only expertise artistry. I call what you do artistry because
you have to be an expert. But if you don't
have if you can't look at me and see that
one little thing is more crooked on one side than
the other side, then I don't want to work with you.
I want you to have the same I have a
very strict artistic eye, right and I can see defects,
(14:04):
and I want my doctor to see the defects also,
and you do. You're you're one of those guys that
can really see a defect and fix it. Thank you.
And that's so important listeners to pay attention to, because
you can go to a doctor who might look make
you look like everybody else that he sees, and you
don't want that. No, there's no one note in skincare
(14:26):
and dermatology. It's just not a one note thing. Everybody's
face is so different structured differently, and you might all
have the same bones, but you certainly have a different
confirmation of those.
Speaker 1 (14:38):
Book definitely, and everyone has different things that make them beautiful.
Speaker 2 (14:41):
And so you don't want to go when you say,
like this laser is going to hurt. Have you tried
it on yourself? Or has somebody done it on you
before you do it other people? Do? You always test things?
Speaker 1 (14:50):
Not always?
Speaker 2 (14:51):
Not always?
Speaker 1 (14:52):
But I have tried a lot of things, and I'm
not a good patient, and I understand that these things hurt,
and I'm not good at tolerating it. But you know
how it hurts, I do.
Speaker 2 (15:04):
Okay, that's good. Yes, that's good because I think some
doctors don't know that, and it's like, oh my gosh,
you're getting shocked to do.
Speaker 1 (15:12):
But it's very even botox gives me tears in my eyes,
which is really not that painful.
Speaker 2 (15:18):
Well, doctor Billiken is a young doctor, a handsome young
doctor who I don't think you need too much stuff
done to your fat.
Speaker 1 (15:26):
But I've got you know what I'm going in your
direction where I've you know, since I was in residency
when I was in my late twenties. I do little
things here and there, to sort of stay fresh and
hopefully never need anything more aggressive.
Speaker 2 (15:40):
Right. Oh that's good, Well you look great. So let's
debunk some treatments that people are talking about all the time.
What are benefits, which ones are worth it, and which
(16:02):
should be skipped?
Speaker 1 (16:04):
Botox Botox is a great treatment, of course. The reason
is is because what happens is with time, your skin
loses some collagen and elasticity, so it loses some of
the proteins that give it firmness, but your muscle strength
stays the same. So when you're young, you make expression
(16:27):
and your skin bounces back, and as you get older,
your skin doesn't bounce back the same way. And so
what botox does is it balances the muscle strength to
the elasticity of the skin, so that you should have expression,
but we're reducing it a little bit to sort of
match up with the elasticity of the skin. And I
(16:47):
find that people who have done botox somewhat regularly for
a long time look incredible in their older years because
they've prevented a lot of these lines and and crinkles
from forming. And you're one of those people, you've done
it for a while, and now even if you don't
do it for a year, you still relatively smooth because
(17:11):
your skin has stayed You've kept it nice and smooth.
Fillers fillers, So fillers is it's a great tool. Like anything,
it's just a tool. So you have to know what
you're trying to treat and you have to use it
to treat that. Fillers are great. I think a lot
of people are scared of them, and I understand why.
(17:32):
Hyaluronic acid fillers actually have been shown to give you
some collagen stimulation. So when they're used conservatively and well
and smartly, they can be really helpful for long term
skin aging. But when they're overused, and we've all seen
examples of that, and I won't name anybody, but when
they're overused, you can look very odd. Yeah, lasers, Lasers
(17:58):
are fantastic. They're powerful. Again, you have to think about
what you're trying to treat, so you are if you
want to treat sunspots, you have to use a certain
type of pigment laser. If you want to treat malasma,
even though it's pigmented and brown, you wouldn't use the
same type of pigment laser. You have cars scars, you
(18:19):
can treat scars, you have to and similar to you know,
even with scars, what are you trying to treat? Are
you trying to treat texture, redness, browning? So lasers are great,
but they're just tools and one size really never fits all.
Speaker 2 (18:35):
So how many different kinds of lasers do you have
in your office?
Speaker 1 (18:38):
What you say, I probably have about like twenty or
fifteen to twenty kinds of devices maybe, and some of
them are are not We don't even use anymore because
we have something better.
Speaker 2 (18:49):
And by the way, doctor Bilkin and his partners have
an amazingly modern office with the latest equipment and peckably
clean and bright of your lighting because it's so bright
and you can see everything, right, which is so important. Right,
But I really think you have a great, great office
(19:09):
for the treatment of skin. Yeah, what about skin tightening? Now,
have I ever had skin tightening?
Speaker 1 (19:17):
We've done I don't know what I've had. We've done
a little bit of skin tightening on you. We've done
a little ultrasound tightening. I think we've done I think
a long time ago we did a little soft wave,
which is an ultrasound based tightening device. And I think
we've done a little bit of all thera, which is it?
I think we did, Yes, we did, so that that's
(19:38):
a great ultrasound based skin tightening that I think works. Again,
it has to be done by the right person, it
has to be done thoroughly, but I really like all Therah.
Then there's radio frequency based skin tightening that can be
really helpful to morpheus or radio frequency micro needling is
a very popular treatment right now now, and that's for
(20:01):
skin tightening. But I think, well, like what on my face?
Why would I have root you that we haven't done
that on now? Because it doesn't give you any lift.
It just plumps up. It stimulates cauldron in the dermis,
so it kind of plumps up the skin. So it
can be good for sort of a crepy texture, but
it's not going to give you lift, which I think
(20:22):
is what most people are looking for. And so it
still has a purpose and I still use it on
some people, but not that often, not as often as
you would think, you know, hearing about it in the media.
Speaker 2 (20:35):
Right, So what schedule do you recommend to your patients
for these treatments? Do you see someone once every three months,
once every six months? What's it? What's a normal A
regimen of treatment.
Speaker 1 (20:48):
I think it always depends on what somebody needs. I
think for you, we've been doing about six months probably
maybe yeah, I.
Speaker 2 (20:56):
Don't even count. I just look in the mirror and
I tell if I need to touch, yes, and what
it appeals to. I forgot to mention peels in that list.
What what? What are? Peels?
Speaker 1 (21:07):
Peels are a more old fashioned modality, and there are
some dermatologists that are really really artful with peels, but
it's a very specialized sort of sort of thing.
Speaker 2 (21:18):
That downtime after appeal to you do you do?
Speaker 1 (21:22):
And it depends on how strong the peel is. There
are very light peels where there's minimal downtime, and there
are really really deep peels where your whole face is
burned off. And there are dermatologists that really focus on peels.
As a laser fellowship trained person, I tend to prefer lasers.
I think they're more targeted. I think, you know, if
(21:43):
you have redness, we can target that, if you have brown,
we can target that. I find peels a little harder
in my hands, but.
Speaker 2 (21:49):
I find them harsh. I mean I have never done
I did a little surface peel once and oh I
hated it so much. But my skin doesn't require it,
I don't think I don't think so either, very smooth skin.
Speaker 1 (22:01):
And not No, it's a little bit more broad strokes.
It's not as targeted.
Speaker 2 (22:07):
But be careful everybody with peels, because you can do
damage with peels. You can do damage with all of
these things if you're in the wrong hand exactly. So
for a while people talked about baby botox. What's the
theory behind starting botox at a young age and when
is the right time to start.
Speaker 1 (22:28):
Yes, there was a time when baby botox was a
very popular concept, maybe a couple of years ago. I
usually tell people that when they're starting to see lines
that are at rest, that's a great time to consider
starting to get botox, Like what kind of lines, So,
like on your forehead, you have some lines with movement,
(22:50):
but if you are not making any movement and your
face is relaxed and you're starting to see little fine
lines there, that's a nice time to start.
Speaker 2 (22:59):
You know. Well, quite a few years ago I noticed
two lines between my eyebrows, yes, vertical lines, and some
doctors said, just put scotch tape on your face every
single night between your eyes and you will not have
those lines. And I did. I did it religiously. Just
put a piece of scotch tape here, and I don't
have those lines anymore, you know. There it's a habit
(23:20):
because you're squinching, right, or if your eyesight is bad
and you start to squinch, you start to get those
lines around your eyes exactly.
Speaker 1 (23:27):
And that's what I mean, those etched lines where even
when you're not squinting, you still have those eleven lines.
There are silicone patches that you can buy and put
them on at night to keep the skin smooth so
that you're not you know, you're not movement.
Speaker 2 (23:42):
Does that work? It does? That's that's good. So when
do you recommend someone get a face lift, which is
an operation versus treatments like fillers or botox. How do
you know when a person needs a facelift?
Speaker 1 (23:58):
Well, like with anything, all of this sort of elective stuff,
nobody really needs anything, So it really just depends on
what somebody's expectations and goals are. Facelifts can be done
so beautifully these days, where they're so natural they're hard
to detect, and it's a great treatment, But it just
(24:22):
depends on what somebody wants. There are people who just
feel very strongly that they never want to have a surgery,
they don't want to go under. And then there are
other people who are completely fine doing that.
Speaker 2 (24:36):
They can't wait to have one.
Speaker 1 (24:37):
They can't wait to have one. And there and then
there are other there are some people who want, for example,
the neck, if you wanted if you told me, I
don't want any laxity on my neck, I want I
want all of these bands gone, I would say, well,
that's going to be a surgical issue. Then then you
would need to have a necklift, a surgical necklift. But
(24:58):
if you say, I'm okay with getting that reduced, I'm
okay with having them be a little bit retracted and
not as prominent, then I would say.
Speaker 2 (25:06):
Okay, we can do that with boattox. Right, what does
what does next surgery require? Where do you cut and
how do you.
Speaker 1 (25:15):
Next surgery would be Usually they would combine it with
the lower face and they would make incisions around the
ear and so I'm sure everybody is seen, you know,
scarring around the ear, which can be you know, noticeable,
but you get scarring around your ear, and then they
go under and they tighten up, not only the skin,
(25:37):
but also the fascia of the face, so the layer
of the face that's muscle and connective tissue, So that
gets moved too. That gets moved too, because it's not
just skin that's becoming lax with age, it's also the
underlying tissues of the face.
Speaker 2 (25:51):
You set me on to something that I love so
much and I will not leave the house without it.
In the morning. You recommended that I use tinted elast Yeah,
what is elastin? Really? It comes in a tube. It's
mine is tinted and you can get it also like
a smooth clear ointment, right or cream.
Speaker 1 (26:11):
Alastin Is is a company that a lot of dermatologists
really like because they have clinical trials that show whatever
they want to show, and a lot of these kind
of anti aging skincare products there's no evidence behind them.
It's it's really just a marketing employ and so when
I recommend something, I look for things that have some
(26:33):
evidence that show that, Okay, if it's anti aging, is
it stimulating collagen, is it stimulating elastic fibers? And so
that's why I like Elastin. They have trials that show
that with skin biopsies there's something that I've recommended for you,
which is the nectar, which is that sort of clear one.
Speaker 2 (26:50):
Yeah, that's so good too, It's great.
Speaker 1 (26:52):
And then the sunscreen is just a sunscreen, but a
tinted sunscreen has more coverage, so it has more UV coverage.
And UVA is the type of UV that causes aging
signs of aging, and so to have a tint means
that you're you're blocking more of the UVA and typically
you get better coverage with that.
Speaker 2 (27:12):
I'm wearing that also, Yeah, you do every day? Yeah,
I put I put the lass in the chinge It
moisturizer on every single morning. I add to it a
little serum and so I thin it out a little
tiny bit and I just put it all over my face,
all over my chest, all over my lower arms, in
my hands, and it works. It really works. And it
(27:32):
looks like you have to make upon Yeah it does.
And even if you don't, you look really better with it.
Speaker 1 (27:37):
You look a little bronze done.
Speaker 2 (27:39):
It looks really great. What's the correct order in which
to layers, serums, moisturizers and SPF And how much does
the skin really absorb these things?
Speaker 1 (27:50):
The skin doesn't really absorb that much of them. So
there are certain things that the skin does absorb. So
retinol is a great ingredient to look for. It's a
vitamin A. A retinol or a retinoid is a prescription
version of it, and the skin does absorb retinol well.
And so there are certain products that we know is
(28:11):
absorbed really well. There are other things that the skin
probably doesn't absorb very well. So you know, there are
certain peptides. For example, peptides are protein chains. Many products
will advertise that there are peptides. Well, peptide just means
a protein chain. So if it's a large protein chain,
(28:35):
it may not be getting to where you want it
to go. It may be sitting on the surface of
the skin. The skin has a stratum coranium, which is
is a barrier. It prevents absorption. So that's why I
look for studies that show that you're actually getting an effect.
Vitamin C is another ingredient that can be a great
ingredient when the vitamin C is active, but it oxidizes
(28:58):
very easily and quickly, right quickly. Yeah, So many products,
if it's really not from a super reputable brand, they
may have vitamin C that that oxidizes very quickly or
sort of inactive when you buy it, and you know
they're going to advertise that it has vitamin C in it,
but it doesn't mean that you're actually getting that benefit.
Speaker 2 (29:17):
So in your practice, have you found any kinds of
creams or serums that really are superior to all others.
Speaker 1 (29:28):
I think that the two brands that I think have
very good evidence behind them in terms of anti aging
products are Elastin and the peptides that Elastin uses, and
then skin Medica, which uses growth factors, and those are
typically the two that I will recommend for sort of
(29:51):
an anti aging regimen. Now there's a lot of brands
and products that I like because they feel good, because
they moisturize well, but that's little less hard to come by.
Speaker 2 (30:02):
I have not tried skin Medica, have I. I don't know.
I'll get you some. I need some. Yeah. I like
to try everything. Yeah, And I am like a human
experiment and I really think it's important. But it's not
just as important as what you put into your body
your skin, as it is what you put on it.
(30:23):
Oh definitely. So I'm experimenting a lot with what I'm
eating and to see what makes a difference.
Speaker 1 (30:29):
Are there any supplements that you like that you've used.
Speaker 2 (30:32):
That not really? You know, if I get a blood test,
and which I do twice a year, I think that's
a very good thing to get and have someone analyze
your blood. Do you agree with that having your blood red?
Kind of like? Yeah, I was low in vitamin beach well,
oh definitely. So why would I be low invitamin beach twelve?
(30:53):
I don't know, but I must not be eating the
right things. So I've changed my diet enough to add
enough vegetables that have more vitamin B twelve. Also, I
take vitamin B twelve now as a supplement just to
and it went up like three hundred points. Great, so
for the next you know, in the next four months
or something. And iron, I'm low on iron. It turned
(31:14):
out that the same time that my blood my BE
twelve was going up, the iron was going down. Now
why why would iron go down? Anemia a little bit,
or being under the weather or being tired or whatever.
Speaker 1 (31:27):
Well, definitely, all these things if you feel crappy, I mean,
all of these things can cause you to feel not
so great, right.
Speaker 2 (31:35):
So so you have to take care of that stuff, right,
And that is a big effect on your appearance, right.
And I also think that what we've gone through for
the last three years, the pandemic and the covids and
the and now the rsvs and everything else that's coming around,
I think that we have to be much more aware
of and get and get a blood test every now
and then and see see if you're failing in any way. Yeah,
(32:07):
what are some of the non evasive options to improve
your skin regimen that doesn't require needles and surgery? What
would you say? It was a good daily regimen.
Speaker 1 (32:19):
A good daily regimen. So everybody really should be using
sun protection. I know every dermatologist says it, But we
know that culture violet is a carcinogen. We know that
it upregulates enzymes that break down collagen. So if you're
doing if you're spending any money on laser or injections,
(32:41):
but you're tanning, you're sort of you're being counterproductive. So
a really good sunscreen sun protection, and there's many different types.
And I always tell my patients that if you find
it greasy or you just don't like the feel of it,
that you're not going to wear it every day, tell
me and I'll find something that you like, because I
(33:02):
like the elastin product, but there are many sunscreens that
I hate wearing. So sunscreen, A retinol or a retinoid
is great for most people, not everybody, but it's we
know it's it's a really good powerhouse skincare ingredient. It
has great evidence behind it. We know that it stimulates
(33:24):
collagen and helps reduce skin cancers and wrinkles.
Speaker 2 (33:29):
Once you're is there a brand of that that we
could recommend.
Speaker 1 (33:32):
Or retinal there's there's a lot of a lot of
good options for retinol. You Beauty has something called the
Resurfacing Compound that I really like that has retinol in it.
Elastin has a good retinol.
Speaker 2 (33:45):
And then, of course we're all finding out that skin
cancer is quite rampant because of our laxity and using sunscreen,
and that's a pretty dangerous thing to get some a
spot that then turns into a skin cancer. Or you're
an expert in that too. I read I didn't know
you were an m H, which you want to avoid
(34:07):
at all costs.
Speaker 1 (34:08):
Right, it's a guy's name who invented this procedure where
you take just a little bit of the skin cancer away.
You look under the microscope and then if you still
see it there, you just take a little bit more.
Speaker 2 (34:20):
I see, Okay, that's I know. I avoided it so far,
so yes, hopefully I can avoid it forever. I was
never a big sunseeker. I didn't I didn't lie out
in the sun too much. But we used to put
you know, lemon juice in our hair and baby oil
all over our skin when we were kids. Right, but
that has stopped, yes, of course.
Speaker 1 (34:40):
And people you know who are really really careful with
the sun or sometimes wondering, well, why did I get this?
Why do I have sunspots? Why do I have a
skin cancer? Unfortunately, it's sort of from cumulative sun exposure.
So if you've had a lot of sun exposure in
your younger years, it does catch.
Speaker 2 (34:57):
Up with you. Yeah, so if you have young children,
it's going to I did to make sure they have
sunscreen on them, right, and and also wearing the long
sleeves while you're swimming. I I wear those you know,
sun what are they called sun rash right?
Speaker 1 (35:10):
Rash cards?
Speaker 2 (35:11):
Rash cards? Oh? Yeah, of course you always wear a hat,
but helmetch So how do you approach treatment for skin cancers.
I know that when when I when I noticed a
tiny little spot on my nose, you sent me immediately
to have it tested, right, which, and then there's a
what is that appointment that you can put on. You
(35:32):
can hardly spill it and say it I am I.
Speaker 1 (35:36):
Q you I I O D M O D and
that is we're using sort of off label, but it's
it's an immune stimulator to keep skin cancer at bad.
Speaker 2 (35:51):
Okay.
Speaker 1 (35:52):
The most common are basal cell carcinoma and square a
cell carcinoma, which many people who are fair skinned enough
sun will get. And those typically are not that dangerous,
but they're frustrating because they're often on the face or
the neck and they have to be cut out, and
(36:15):
so we do MOS on those because MOS allows us
to take as little as possible and keep it very
very small, and then we have a very small defect
to reconstruct, and so usually we can keep it sort
of cosmetically elegant.
Speaker 2 (36:28):
Oh good.
Speaker 1 (36:29):
There's a third type of skin cancer. The most third
most common type is melanoma, which is much more dangerous,
and that is when if you saw in your body
a dark spot that was changing or growing, it can
happen anywhere, even where the sun doesn't shine, and that
can be much more lethal. Where finding a lot of
(36:50):
those really early, we're taking them out surgically and we're
not you know, and you don't have to do anything further.
But they are the type of cancer that sometimes they
go into your lymph nodes, sometimes they spread further than that.
Sometimes they need chemo, and sometimes they can be lethal.
Speaker 2 (37:06):
So be very careful with any changes in your skin
or any spots that appear that are right. Yes, what
mistakes you see people make when it comes to taking
care of their skin, Yeah.
Speaker 1 (37:18):
I think I think the biggest mistake that I see
is people who go do procedures and are disappointed. And
the reason that they're disappointed is because they are going
to somebody who didn't evaluate them and didn't try to
(37:38):
figure out what is the best thing for them, and
they're doing something that's missing what their goal is. And
I think that can happen with filler, and it can
happen with radio frequency micro needling, and it can happen
with laser. And so I even if somebody wants to
(37:59):
do some thing locally, maybe they live in New Jersey,
they want to go to a medspa New Jersey. I'll
still advise them, you know, go for this, not that,
because I don't want them to make that mistake and
be upset and have a complication and that sort of thing.
Speaker 2 (38:18):
So when you get when you get home to after
work and you have your nice dinner or you've gone
out for dinner, what do you do before you go
to bed? What would you advise anybody to do before
they go to bed?
Speaker 1 (38:30):
So you want to wash your face for sure?
Speaker 2 (38:33):
Using what?
Speaker 1 (38:34):
Using? Most you know, even drug store gentle cleansers are
totally fine. There are some other cleansers that I that
I really like. There's one from again New Beauty that
is what it's called the conditioning wash, which is very moisturizing.
I think I've given you one of those.
Speaker 2 (38:52):
I love that. Oh and by the way, I've just
finished it too, that I use in the shower. I
love it. I use it all over my body. Yes,
and it's it is so it SuDS up nicely, but
it's it does leave your skin very moisture somehow.
Speaker 1 (39:07):
It moisturizes instead of drying you and it's clean to
really clean.
Speaker 2 (39:12):
And I use a I use like an oil camellia
oil to clean my face at night.
Speaker 1 (39:17):
That's great.
Speaker 2 (39:18):
It's hot wet rag.
Speaker 1 (39:19):
Yeah, you know that's called oil cleansing, which is which
is helpful because your skin has you know, your sebum
on your face is oil based.
Speaker 2 (39:27):
And I would never go to bit with my makeup
on it, right right, I won't. I mean even no
matter how tired I am. But my face gets washed
and lubricated and serumed and everything before I go to bed.
Speaker 1 (39:41):
So cleansing is very important. And then you know, you
would use you most people can use a little bit
of moisturizer, so you might use a hyaluronic acid serum
something to give your skin some moisture. And then most
people could benefit from some sort of barrier, like something
a little thicker that keeps the moisture in overnight. You
(40:02):
have a lot of repair going on at night in
your skin, and so keeping it hydrated is.
Speaker 2 (40:07):
Helpful for that. And then when you wake up, you
take your shower.
Speaker 1 (40:12):
And then when you wake up, you wash your face again,
you put on some moisturizer, you put on some sunscreen,
and you're good.
Speaker 2 (40:19):
Yeah. Yeah, So taking care of yourself is not so hard,
but it does take a bunch of care, and it
does take some thought and it also takes some good
advice from a dermatologist. And I've put my trust at
doctor Belkin. I think that your explanations of all these
things that we talked about today are so good. And
(40:42):
thank you so much for joining me on the podcast.
Thank you so much for Dan Dan Belkin, and you
can follow Dan on Instagram at doctor Dan Belkan b
E l k I N for his advice on the
best skincare practices.
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