October 30, 2025 • 45 mins
Precision dermatology is rewriting the skin health playbook—and we dig into what that means for you. We sit down with Dr. Elle de Moll, a board-certified dermatologist and entrepreneur, to unpack why the skin is best understood as an immune organ, how biologics target disease without blanket suppression, and where wellness fits as research on the skin and gut microbiome accelerates. The conversation blends rigorous science with real life: female pattern hair loss in perimenopause, evidence-based treatments like spironolactone and low-dose oral minoxidil, and the emotional weight hair carries for identity and confidence.
We go deep on sun safety and expect straight forward answers on SPF 30, UV index, mineral vs chemical filters, UPF clothing, vitamin D supplementation, and why prevention beats a future Mohs scar on your lip or nose. For parents, you’ll hear practical hacks to make sunscreen kid-friendly—think brush applicators, texture choices for eczema-prone skin, and knowing when low UV days let you relax the rules. We also clarify medical dermatology versus aesthetics, why access matters, and how to find a board-certified dermatologist through the American Academy of Dermatology or your insurance network.
Finally, we talk entrepreneurship and motherhood: deciding to build a medical practice that prioritizes access and continuity, choosing what “glass balls” never drop, and letting the rubber ones bounce. The thread through it all is agency—choosing precision over perfection, asking for help, and making small, consistent choices that compound into healthier skin and a saner life.
If this conversation helped you rethink your routine or your care plan, subscribe, leave a review, and share it with a friend. Your support helps us empower more women to live all in—and it takes less than a minute to make a big difference.
Elle's Book Recommendation: Wild by Cheryl Strayed
More about Dr. de Moll:
A Castle Connolly Top Doctor, Dr. de Moll brings a wealth of experience and expertise to her practice, Elite Dermatology Physicians. Dr. de Moll is a board-certified dermatologist and dermatopathologist who completed her training at Mount Sinai, in New York City. Dr. de Moll has a passion for solving complex medical dermatology cases. She thrives on helping patients overcome challenging skin conditions that haven't responded to previous treatments. Dr. de Moll takes pride in her collaborative approach and her commitment to finding lasting solutions for her patients.
https://www.instagram.com/elitedermatologyphysicians?igsh=MTJoeWRuNWFiNDlkYw%3D%3D&utm_source=qr
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
In your field, what is the latest and greatest that
you're kind of like readingabout?
What are people talking about indermatology?
SPEAKER_01 (00:07):
That idea of the skin as an immune organ is like
really panned out.
All of our newest medicines arecalled biologics.
They're very precise medicines,most of which are given as
injections because they're soprecise that if you took them as
a pill, your stomach acid woulddegrade them.
They're very clean molecules.
We're changing the lives ofpatients with psoriasis, with
eczema, paragonodularis, chronicerbicaria, hydra adenitis.
(00:32):
We're taking these people'simmune system, which is really
what's causing their skinissues, and we're tweaking it,
not suppressing it.
We're not crushing it like wedid with the old-day medicines.
We're not using chemo drugs,which we used to have to use
off-label for derived things.
We have very precise cleanmedicines that fix their disease
from the inside.
SPEAKER_00 (00:49):
Welcome to the House of Germar podcast, where
wellness starts within.
The House of Germar is alifestyle brand empowering women
to live all in through materialdesign and personal wellness.
We are a destination for womenready to reimagine what is
possible in their homes andlives and then create it.
(01:09):
We are honored to have you joinus on our mission to empower one
million women to live all in.
I am your host, Gene Collins,and I invite you to become
inspired by this week's guest.
Hello, everybody.
Welcome.
I am Gene Collins, and today,get ready.
We are talking aboutentrepreneurship and
dermatology.
(01:30):
I am so excited.
I have Dr.
Elle DeMaul on the podcast, andshe is a personal friend of
mine.
She is also my doctor.
And I love this woman in so manyways.
First of all, her background,her experience, her jumping 100%
two feet in into being adermatologist is so great.
And she is so qualified.
And she really specializes oncomplex problems.
(01:52):
I'm going to put her whole bioin the show notes.
So I'm not going to read it foreverybody.
But Elle, welcome to the show.
Thank you so much for having me.
I am so excited.
So we're going to talk allthings dermatology, all things
skin.
But before we do, I really liketo specialize and tell people
about your story and yourjourney.
And I want to focus on thatspecifically for you because I
(02:15):
did not realize until I went andhad coffee with you how
difficult it is to become adermatologist.
SPEAKER_01 (02:22):
Everybody wants to be a dermatologist these days.
I don't know.
It's the skincare trend.
SPEAKER_00 (02:26):
And but like that's actually not easy to do.
And folks, she has two youngkids and a husband who's also a
doctor.
So if you wouldn't mind, like,how in the world did you even
get into dermatology?
And if you would share a littlebit about that journey and that
also that journey took you tobecome an entrepreneur and have
your own practice at a veryyoung age.
(02:47):
And that is kind of scary.
And so I would love to talkabout that to start off.
Yeah.
SPEAKER_01 (02:51):
I think that's great.
I think, you know, while a lotof times people don't realize
what dermatology is, there's alot of aesthetics now and lots
of people interested in takingcare of skin.
But dermatology really is a, youknow, a field of medicine.
I went to Haberford College inPhiladelphia.
I wasn't always sure I wanted tobe a doctor.
And um, it was kind of a secondlater in college decision for
(03:12):
me.
And so I was scrambling, fittingin all my prerequisites during
the summer months and takingextra courses and trying to get
it done because my interest wasin anthropology.
I was an anthropology major.
I wrote my senior thesis ontattooing.
I worked at a tattoo shop, wentto tattoo conventions, loved
everything about self-expressionand display, and particularly
the role of women in tattooing,which was traditionally a male
(03:34):
field.
So I have read almost every bookthat exists on tattooing in the
skin written in the last 50years.
And then I decided to go tomedical school to make sure I
could have a career because Iwasn't sure where tattooing
would take me because I'm not anartist myself.
Don't get me wrong.
I could not actually do theartwork.
And I decided to be a doctor.
I went to the University ofConnecticut School of Medicine,
(03:56):
which was great.
I tried everything.
I loved everything.
I delivered babies in Guatemala.
I loved emergency medicine.
I was in the interest group.
I'd been in EMT in college.
And I just was looking for afield where I felt like I could
make a big difference inpeople's lives, where I could
know my patients for a longtime.
And I decided to take a year offin medical school to be sure
(04:17):
about that, and did some work inmouse model research for
melanoma, which is, you know,one of the leading causes of
death in skin cancer.
And I really thought that thiswas an exciting time to study
the skin because it's one of ourlargest immune organs, meaning,
you know, our immune cells arethere and play a big role.
And that hasn't beentraditionally how we thought
(04:38):
about skin, but it is where thegreatest research is growing in
medicine in general.
And so after a year of workingon little baby mice models and
giving them metastatic melanoma,I was pretty sure that I'd found
my calling in taking care ofpatients with skin concerns and
melanoma.
And so I did a lot of researchand met a lot of people and
shook a lot of hands and triedto know everything I could about
(05:01):
being in dermatology and waslucky to match at the Icon
School of Medicine for Residencyand Dermatology, which I did for
four years.
And then I liked it so much Istayed for an additional year as
a Durham Path Fellow.
So reading the slides we allmake as dermatologists.
And I just, I couldn't getenough.
I stayed for a long time.
SPEAKER_00 (05:20):
When you told me how many years you were in school
and how many years you workedbefore you were actually able to
do this on your own and startout and have your own practice,
I was like, I had no idea.
SPEAKER_01 (05:31):
Yeah, it's a long road.
It's not for the faint of heart,but if you like it, it doesn't
feel like a road to somewhere.
You know, it that's all part ofit.
SPEAKER_00 (05:38):
Yes.
Yes.
But I really personally had noidea.
And I think a lot of peopledon't know and don't really
understand that dermatology isjust like medical school and the
amount of education andknowledge that's required and
the amount of ongoing education.
So in your field right now,we're going to stick to this for
a second.
In your field, what is thelatest and greatest that you're
(06:00):
kind of like reading about?
What are people talking about indermatology?
SPEAKER_01 (06:04):
That idea of the skin as an immune organ is like
really panned out.
All of our newest medicines arecalled biologics.
They're very precise medicines,most of which are given as
injections because they're soprecise that if you took them as
a pill, your stomach acid woulddegrade them.
They're very clean molecules.
We're changing the lives ofpatients with psoriasis, with
eczema, parigonodularis, chronicerticaria, hydroadenitis.
(06:29):
We're taking these people'simmune system, which is really
what's causing their skinissues, and we're tweaking it,
not suppressing it.
We're not crushing it like wedid with the old day medicines.
We're not using chemo drugs,which we used to have to use off
label for der things.
We have very precise cleanmedicines that fix their disease
from the inside.
Wow.
SPEAKER_00 (06:46):
Okay.
I have no idea.
So, as part of that though, doeslike overall wellness of your
clients come into play?
SPEAKER_01 (06:56):
I think wellness is the next frontier in
dermatology.
I think we're starting to lookat the skin microbiome the way
we're looking at the gutmicrobiome, and they're actually
very closely linked.
And I think in the next 10years, we're going to see more
studies linking gut and skin,like, you know, flora health
with eczema and other, you know,conditions, even things like
mycosis fungoides, you know,skin lymphomas, because I think
(07:17):
that connection has beenunderrepresented.
That being said, I think there'sa lot of people who want that
data to be here now, and it'sjust not.
Like I would love to recommendprebiotics, probiotics, more
wellness-based things for theskin.
But I think that's where we'regoing.
SPEAKER_00 (07:32):
Okay.
And I love that because I thinklike holistic wellness is
actually so important.
And I feel like it comes up ineverything else that we do.
It comes up.
It's no longer just go have likeyour annual physical and do your
basic blood work.
It's like it goes so muchdeeper, especially as a woman
with hormones.
And I mean, it's justeverything.
SPEAKER_01 (07:51):
Yeah.
SPEAKER_00 (07:52):
It's everything, holistic wellness.
SPEAKER_01 (07:54):
Totally.
I think everything holisticwellness.
And I think hormones play a bigrole.
I've I've done a really bigeffort to educate myself as a
doctor as we've really shiftedour thinking in hormone
replacement therapy for women.
And it's getting, you know,totally rethought by the FDA and
attending several lectures byYale experts in perimenopause
and menopause HRT.
I think that's part of it.
I don't prescribe it.
I think it's outside my lane,but we're definitely looking at
(08:15):
it.
We're looking at estrogen on theskin, directly on the face.
Is that helpful?
I think the data is stillcoming.
And I don't like to recommendthings because they're trendy.
I really want to see the sciencebehind them so that when we make
a recommendation, I know whereit's coming from.
But I love that that's wherewe're going.
SPEAKER_00 (08:30):
I do too, personally.
Yes.
And we have to personally talkabout something because since
you are my doctor, we're goingto talk about two things.
We're going to talk about skincancer and the sun and all that
good stuff.
And we're going to dig intothat.
But before we do, we are goingto talk about hair growth for
women.
So these are my extensions.
(08:51):
I've had them for three years.
This is actually the lastpodcast I'm going to record with
my extensions because I am goingto take them out.
Not because my hair is fullygrown yet or that I even like my
hair.
So this is a whole emotionalgrowth, learning to love
yourself the way you are, lovinghow you look at yourself, which
also plays into the sun as well.
And we'll talk about that.
But can you talk to me a littlebit about some of the trends on
(09:14):
things that people might notthink to go to a dermatologist
for, such as hair growth?
SPEAKER_01 (09:20):
Yes, hair is well under our purview as
dermatologists.
We also do nails.
And I think there's this feelingthat women shouldn't lose hair
or don't lose hair becausethat's more of a men's thing.
And I think it's much easier ifwe call it patterned loss.
You know, a lot of people talkabout male patterned loss.
And yes, that is what men oftenget, but women get female
patterned loss and they tend tohave a slightly different
(09:43):
pattern.
They lose more prominently inthe temples often.
And we describe a widening ofthe part or Christmas tree
pattern.
But it's very common slashnormal, I dare to say, that some
of your hair thins.
For some women, that startsunfortunately as young as their
20s.
But almost everybody aroundperimenopause starts to see a
change because our hormones areshifting.
And that directly affects hairgrowth, how long the cycles are,
(10:06):
the size of the hair follicleitself.
And I think women feel liketheir options are kind of more
to get extensions or to getpowders or to cover it up.
And they don't really think thatthere might be something that
could help them keep the hairthey have.
SPEAKER_00 (11:08):
And I've been working with you.
And so, as part of my journey,I'm going to share publicly on
social media part of my journeyof doing this because I think
there are so many women thatstruggle and perimenopause,
menopause, like it's just reallyhard.
You know, your body's changingand you don't like what's
happening and you feel like youdon't have any control.
(11:28):
And it's when you go and youlook in the mirror, there are
all these changes happening.
And then on top of that, youhave hair loss and it's sort of
like compounding.
And it's and it's really tough.
It's really hard.
And so I am going to take myextensions out because I am
taking medication thanks to you.
My hair hasn't really started togrow yet, but you know, we're
gonna find out what happens, andit's also part of the journey, I
(11:52):
think for me, of wellness forwomen and learning to like what
you see when you look in themirror, which is not always that
easy.
SPEAKER_01 (11:59):
It's not easy, and I I wish it was.
I talk about hair a lot fromalopecia areriada and my young
patients, and you know, alltheir hair falling out all of a
sudden in six weeks, which wedon't have a good story for to,
you know, to pattern glass.
And I I said to somebody, youknow, losing your hair, if we
lived in a totally visuallyblind society, you would be
(12:21):
fine, you know, just trying todrive home the point that this
was just hair without saying thephrase this is just hair,
because it isn't.
We don't live in a visuallyblind society.
Hair means a lot, it means a lotabout gender and self-expression
and identity.
So I never try, you know what Imean?
But it's important when peoplethink that their hair loss is a
(12:41):
sign of something bigger,because oftentimes we do talk
about that too.
Like, are you healthy?
Is it your iron?
We think about unfortunatelycancer patients losing their
hair.
Although, as a side note tothat, there are a lot of
increasing movements, cold caps,and things that people are doing
during chemo to keep their hair.
But, you know, we tend toassociate hair loss with illness
and and just so many negativethings that it's just as an
(13:02):
anthropologist, right?
It's just such an interestingtopic that ties in a lot of
feelings and social norms.
And so I think it's reallyinteresting to use the medicines
we have.
And if right now there's nothingFDA approved for female hair
loss, but there's a lot ofmedicines that have been used
for a long time, includingsporonal lactone and oral
monoxidone and even finasteridethat off-label have a lot of
(13:23):
benefits for hair and that havebeen studied in there's case
series and evidence that thiscan be something that really
helps women hold on to the hairthey have, in addition to HRT,
which is always something that'sworth discussing and making part
of the conversation because thatis one of the benefits of HRT.
SPEAKER_00 (13:38):
Yep.
I'm on that too.
SPEAKER_01 (13:40):
Yeah, I'm trying it all, girl.
I think women, you know, thisidea that menopause happens and
then that somehow we losefemininity or our identity or
our vitality.
I I think we have to rewrite thestory on menopause.
And there's so many veryinteresting people doing that.
And so I'm really honored when Ican help women, you know, claim
some parts of their identityback by get growing their hair.
SPEAKER_00 (14:02):
Yeah.
Yeah.
Well, and so much of what youdo, like you're helping my
daughter, right?
My daughter's working with youfor her skin and she has eczema
and all kinds of things.
And I feel like one of thethings I love about your
practice is that you help peopleat all ages, and you bring
modern science, just the latestin what's out there, to all
(14:23):
different ages.
How do you remember all of this?
SPEAKER_01 (14:27):
I love dermatology.
I'm a big nerd.
I keep telling people I don'treally have hobbies.
So, like collecting cool rashesor like seeing that great case
and cunning for me is like thewin.
And I'm a bit of a competitor aswell.
I was a college athlete.
And so I love when somebodycomes in and said, I've seen
another doctor and nobody canget rid of this.
Can you?
I'm like, well, great.
Like now there's a challengecomponent to it too.
(14:48):
You know, this is what I like todo.
You know, I think AI is growing.
There's an a wonderful app forall physicians called Open
Evidence, which is uses AI forto, you know, kind of simplify
medical data because there'salways going to be new medicines
in other fields and things, youknow, like the GLP ones coming,
they're causing hair loss andacne.
So I didn't train in ageneration with GLP ones.
I'm also not prescribing GLPones, but I need to know a lot
(15:11):
about them.
And so attending lectures,having access on a day-to-day
basis to even AI and textbooksand community, uh, I'll help
make sure that I'm not missingsomething when I see patients
come in on the new latest andgreatest drug.
SPEAKER_00 (15:24):
So much to learn, so much to know.
Oh, I have so much to ask you.
Let's stick to this.
Let's stick to appearance.
Let's stick to the sun.
Our friend the sun.
Everyone, you need to go followElle on social media because we
all try in our own individualbusinesses, especially as
entrepreneurs, to walk the walk,talk the talk.
(15:45):
Like we got to do it.
And you, girl, do it.
You are outside, you've got yourhat, you've got your sunscreen,
you've got your glasses, likeyou are living it with
protection against UV.
But this subject is another onewhere it's like people are used
to, and I would say everyone Iknow would say they feel like
they look better with a tan.
Yet the sun is terrible for us.
(16:08):
So, what do you tell yourclients who are like, but I look
dead, I look better with a tan,and you know that the sun is bad
for them.
How do you deal with that withyour clients?
SPEAKER_01 (16:18):
So, you know, one in five Americans gets skin cancer.
That's just the statistics.
So, you know, I don't have totry to convince anybody I'm
gonna be really busy no matterwhat, because this is
unfortunately a problem thataffects a lot of people.
And our love of a tan is verylike transient in the grand
scheme of human culture, right?
And many other cultures beingvery, very fair and showing that
(16:39):
you haven't been outside and itcomes with all sorts of class
and privilege, you know,connotations to not be tan.
So feeling that tan is like agood thing is very American and
very of the last, I don't know,60 years.
And I would tell them that theways to have a fake tan, whether
that's a mousse or an at-homelotion or a spray tan, all of
these things are so much betterthan they used to be.
(17:00):
I have tons of patients who looktan fabulously without frying
their sun, their skin in thesun, pardon.
And UV causes damage, you know,whether you're somebody who
thinks they tan easily, so it'slike less for you or not.
What UV B particularly does ispenetrate the dermis, attack
your DNA in your skin cells, andcause mismatch repairs.
(17:23):
And so your skin is gettingthese little disconnects in the
ladder of DNA.
And your body's really good atfixing that.
And for a while it will.
It will catch a lot of thesemistakes and you're fine.
So you're going out tanning,you're 30, 40, 50, nothing bad
has happened yet.
See, I'm fine.
But over time, that DNA mismatchcorrection that we're supposed
to be doing is gonna miss one.
It's not perfect, right?
(17:43):
And that's just hard because alot of these skin cancers come
up on places where you've hadthe most sad eyelids, edges of
the nose, ears, lips, places youdon't really have a lot of skin
that you want to be losing inthe most surgeries that I send
people for.
And so I think a little, youknow, ounce of prevention is
worth a pound of cure.
I don't think people need to beperfect.
I don't think people need to notgo outside.
(18:06):
I want people to go hiking andfishing and do all their life
adventures.
But pretending that yousunscreen's not going to help
you or protect you from some ofthat damage is is kind of
foolish for no reason.
SPF 30 blocks 97% of UVV rays,so you don't need the hundred.
You can track the UV index onyour weather app.
(18:26):
So if it's a UV index of one ortwo, sure.
Go out that day with lesssunscreen or without your hat.
You know, let's be realistichere.
Not, it's not all the same.
You know, I'm totally willing tomeet people where they are in
terms of the data, which is yes,there are nuances to this
question.
And so when the UV index waszero and we were at the pool and
I told my husband he didn't needto reapply sunscreen on my three
(18:46):
and five-year-old, he was like,What?
And I was like, Look at look,science, science, the UV index
is zero.
Like we do not need to.
So I I, you know, I'm not one ofthose crazy, you know,
sunscreen, uh like, you know,absolute fanatics.
I don't have any of the weirdmasks or hoods or things that my
husband wouldn't walk out inpublic with me.
But I think it's important toprioritize that health.
(19:08):
And there's a lot of good dataabout vitamin D and the role
that that plays.
And don't we need to be gettinga little bit?
I promise everybody, especiallywith lighter skin tones, skin
colors graded one through six,so one, two, and three on the
lighter side, is getting enoughsun from May till October if
they're outside 15 minutes aweek with their face and arms
exposed.
(19:29):
But we don't store vitamin D, sono one's getting it in
Connecticut in the winter.
Yeah.
If you have a darker skin tone,you might not be getting enough.
I think vitamin D comes in acapsule form, and that's a
perfectly lovely way to get it.
SPEAKER_00 (19:41):
And I do take vitamin D, and I've been doing
that for years.
I did not know that I needed to,but I did.
And I wish I could get more ofit naturally, but that just
doesn't happen.
As you said, in Connecticut, wedon't see the sun enough.
SPEAKER_01 (19:53):
No, and it's not worth a trade-off for me.
I tell people if you could getvitamin C from sucking on a
cigarette, is that trade worthit to you?
Because somehow it feels a lotmore natural to get it from the
sun, but it doesn't necessarilymake it better.
SPEAKER_00 (20:04):
Right.
And you did say something that Idon't want to miss.
You talked about because the UVindex was zero, you didn't have
your husband reapply sunscreen,but yet he still has sunscreen
on.
SPEAKER_01 (20:17):
Yes.
Yeah.
Sunscreen is good for about twohours, is what we know.
And then it's not like it turnsoff.
It's not a yes-no question, butit does wear off.
And so we recommend if you'regoing to be somewhere where the
UV index is five or six, then atthe two-hour mark you reapply.
SPEAKER_00 (20:34):
Okay.
Two-hour mark.
All right.
What is, and this is a little inthe in the weeds of sunscreen,
but I think it's importantbecause not all sunscreen is
created equal.
And I think sunscreen hasdifferent products in it, some
of which, you know, definitelyare not considered as good as
others.
Because of the hair extensions,I actually can't use sunscreen
(20:54):
with a lot of those products, alot of the sprays and stuff.
So I'm using sunscreens thathave a lot of zinc.
So my stuff comes out white andit is impossible to get it off
in the shower.
But if I don't, my extensionswill turn pink.
So there we go.
I go with like a zinc-basedsunscreen.
Is there a difference insunscreen?
Or you're just like, anysunscreen is better than no
(21:14):
sunscreen, so I don't care.
Or is there really somesunscreens that are actually
better for our skin?
SPEAKER_01 (21:20):
That's an interesting question.
And I'm very pragmatic, clearly.
So any sunscreen is better thanno sunscreen, period.
Full stop.
SPF 30 that is FDA regulated,I'm happy.
There are concerns in a growingportion of people who are
looking at the data.
And again, I still use allsunscreens, but they're looking
at the fact that if you look atblood levels of sunscreen when
(21:43):
you are covered head to toe,chemical sunscreen particles are
small enough to cross the skinbarrier and you can find them in
the blood.
That's the whole story that weknow.
The concern is is it doinganything when it gets there?
There's concern for endocrinedisruption and some other
things.
No studies show that yet.
Again, the amount of sunscreenyou need to put on your whole
(22:03):
body to see those blood levelsthat they did in these studies
is more than I'm sure anybody'susing.
But it's something to look for.
And I I, you know, I believe alot in UPF protective clothing
and other mechanisms ofprotecting yourself from the
sun.
I think too much of anything isbad in life.
That's just kind of something Ithink we've learned from mistake
and mistake again, where wealways think we've found the
(22:25):
silver bullet to aging.
And then, you know, surprise,too much of a good thing's bad
again.
Zinc is super interesting.
It is a physical barrier, zincand titanium.
Sunscreens physically block thelight.
They do not absorb it and turnit to heat, which is what
chemical sunscreens do.
And non-nano particles of zincand titanium are too big to
cross the skin barrier, so theycannot be absorbed.
(22:47):
So if people have theseconcerns, I think it's perfectly
reasonable to use a physicalsunscreen like zinc or titanium.
Again, the non-nano ones.
The nano ones are really nicebecause they're a lot more
invisible, but then they'resmall enough to cross, and
you're left with the samequestion.
But I'll take what I could get.
SPEAKER_00 (23:02):
Okay.
Yeah.
And I will say to people, like,I have to tell you, because I've
had to do this and I've hadMoe's surgery, I've had it on my
lip.
That was so not fun, folks.
I they didn't even tell me whenI did it that I could only drink
things with a straw for a week.
I couldn't eat real food.
They didn't even tell me untilafter it was over.
And I had no idea.
I was so ill prepared.
(23:23):
And I also had one like right onmy chest.
And I was like, once again,terrible spot to have a scar.
Really terrible spot to have ascar.
So I personally have had to, youknow, because of all of these
things, pay a lot more attentionto the sun and to the sunscreen
that I use.
And I very often will put onlike baby-based sunscreen, which
(23:44):
has zinc in it.
And it's really like it's white.
It's so hard to get it off.
I'll, you know, I'll go toMexico and it's like all white.
I'm like at the beach and I'mall white.
You know, it's like I'm trying.
I'm really trying.
So I have one more questionabout sun, too, actually.
A first question is the mindsetof the skin damage that I am
getting now.
So when I have something pop upthat we have to remove, is that
(24:08):
from something I've donerecently?
Could that have been for what Idid when I was 12?
Like, where does the damagehappen?
Or, like you said, is it justthat it compounds?
So it doesn't really matter whatI did when I was younger, if
that question makes sense.
SPEAKER_01 (24:22):
Absolutely.
A lot of the sun damage is sunfrom when we were younger.
And I try to tell people that sothey don't lose hope that like
what they're doing now stillmatters.
Your exposure of UB over yourlife is cumulative.
So whatever age you are, if nowis the age you decide to get
careful, there's benefit.
It's never too late.
Maybe 90 plus.
Maybe at that point it's toolate.
But anything below 90 plus or ifyou decide to be careful, you
(24:42):
know, that is a good thing.
The damage can take a reallylong time to develop.
And so I, you know, even if youfind, you know, are a reformed
son lover like I am, who was inthe tanning beds in the 90s.
I was not a dermatologist.
I wanted to be tanned from myhigh school prom.
I looked so great, you know,that's scary.
And the reality is burns andtanning bed use as a child are
(25:05):
worse for you than they are inadulthood.
They have a bigger impact inyour cancer risk.
So being careful with our kidsis really important.
SPEAKER_00 (25:12):
Yeah, that's me.
Yep.
Mm-hmm.
In college in Arizona, a sun andtanning beds.
Oh my goodness, when I thinkback about it and I think back
to when I was younger and weused to go lie out on the
blacktop with trays, aluminumfoil trays, and put baby oil
with iodine on them and justlike reflect the sun onto our
face is so terrible.
So terrible.
(25:33):
Yeah.
Okay, so let's talk about kidsfor a second.
What suggestions can you make topeople about how to get their
kids to embrace the concept ofsunscreen?
Because I am sure my daughter isno different when she was little
to the children now, even thoughshe's 19 now.
Putting on sunscreen ain't sofun when you're a kid, and
that's not cool.
So, how do you help kids embracethe concept of sunscreen, just
(25:54):
like wearing a helmet when youride a bike?
SPEAKER_01 (25:56):
Because it is like wearing a helmet when you ride a
bike.
And in my house, if you're notwearing a helmet, you're not
riding that bike.
And when you give kids wiggleroom, I think they, you know,
you know, capitalize on that.
You give them an inch, they takea mile.
I've got a three-year-old who'sreally committed to seeing how
far she can get away witheverything.
And I think they also, you haveto meet kids where they are.
You're not gonna buy them anuncomfortable helmet.
You're not gonna buy them ahelmet for like hockey when
(26:16):
they're doing bike riding.
I think giving them the righttools.
So we have a little applicatorwith a makeup brush that my kids
can do independently, that'simportant for one of my
daughters.
Uh, another daughter has badeczema and like thicker
sunscreens really flare her.
So we do use more sprays becausethat's what makes her skin more
comfortable and she's stillgetting the sun protection.
So who am I to complain?
And, you know, also having likea little, you know, hacks and
(26:39):
that and and recognize when theUV index is zero so that I'm not
always the hovery mom that'slike making them afraid of the
sun or being outdoors, because Ithink that's really good for
kids to grow up outside.
unknown (26:48):
Yeah.
SPEAKER_00 (26:49):
And you don't want your kids to be like, oh yeah,
my mom doesn't let us doanything because she's a
dermatologist and the sun isbad.
And, you know, yeah.
Especially because you have abusiness locally in town and you
are very well known locally intown.
So let's talk about being anentrepreneur and starting a
business.
What made you decide you wantedto do that?
SPEAKER_01 (27:09):
I decided that I wanted to be the master of my
own destiny.
And I think, you know, I keptthinking there are ways that I
was gonna do that, working forother people.
And at the end of the day, youknow, if you have the
opportunity to really takecontrol of your life and and
work for yourself, that that'sthe best opportunity to do that,
to really say how every day isgonna look, what the small and
(27:31):
medium and long-term, you know,uh horizons are gonna look like.
And especially when I feel likeas a physician, patients at the
end of the day look to me andthey say, Well, the buck stops
with you.
Like, you know, you're mydoctor, you take care of me.
When you're a cog in a wheel ofa big thing, that's not always
true, but you feel like itshould be.
So I, you know, now it reallystops with me.
SPEAKER_00 (27:50):
Which is amazing.
So I don't want to neglect thefact that you have two little
children and you also have ahusband who's a doctor.
Yes.
How in the world do you jugglethis?
Because you're not just likerunning a business, you're
running a family, you're runninga household, you've got little
people, and you have you.
How do you juggle it all?
Just as like a woman to woman.
(28:10):
How are you doing this?
SPEAKER_01 (28:12):
I think juggling is an interesting idea.
And somebody once told me that,you know, there are glass balls
and rubber balls that you'rejuggling, and it's okay if the
rubber ones hit.
And I think when you're reallybusy, you have to decide what
the glass balls are.
Time with your kids, you know,put downs, reading stories,
making sure, you know, myhusband and I have some grown-up
time, you know, being here formy patients on time, ready, like
(28:34):
thoughtful for that.
Those are glass balls.
Those are things that are notgonna ever be negotiable for me.
But things that are, you know,having the right backpack for my
kids or the latest and greatesttoy, you know, or having signed
them up for the rightextracurricular when those
signups go up so fast, that's arubber ball.
My kids are gonna learn maybe alittle bit of disappointment and
resilience and move on.
And everything can't be soprecious that I'm frozen by the
(28:59):
ability that some things aregonna get missed.
SPEAKER_00 (29:01):
You're not striving for perfection.
SPEAKER_01 (29:04):
No, perfection is the enemy of the good.
And I think being a mom, everyevery mother knows that.
And when you just keep adding onto that mother title, which as
we all know is like the mostimportant one, well, every time
we add on to that title, it'smore and more clear.
You have to be more and morestringent about what the glass
balls are gonna be in your life.
SPEAKER_00 (29:22):
Yeah.
So I have a business questionfor you.
When do you decide likeexpansion?
How do you decide that as anentrepreneur?
Like, I'm going to expand thebusiness, I'm going to hire
another doctor, I'm going tojust make the business bigger,
just as a business person.
How do you make that decision?
SPEAKER_01 (29:39):
It's a good question.
I I've been really lucky to openin New Canaan and be very busy.
I think we have a little bit ofan underserved medical market in
town.
People want to stay in town forthings that merits a mess.
106 has been under constructionfor years.
Like it's hard to leave town.
You have to leave 25 minutes togo basically anywhere.
So I feel like, you know, we'remeeting an unmet need.
(30:00):
And the other reality is that alot of dermatology has shifted
to cosmetics.
So even just within the county,by being a practice that focuses
exclusively on medicaldermatology, we just have more
ability to take care of thepoison ivy, the shingles, the
skin check than somebody whosetime is being pulled in many
directions.
And so I want to keep growingthis vision until we've met
(30:20):
everybody's needs and untilpeople can call and the wait
list is, you know, the wait listisn't three months.
And you know what I mean?
That I can only do that byrecruiting other people.
I've got the same, you know, 80hours in a week to try to get
stuff done at work thateverybody else does.
And, you know, I've got to startborrowing other people's hours
to kind of make this dream cometrue where busy medical practice
that you know you can get thecare you need.
SPEAKER_00 (30:42):
Like word of mouth for your practice is incredible,
and the number of people thatcomment on how great your
practice is.
Because I think your practicehas a vibe of small town doctor,
which is not a part, but yetyou're affiliated with a big
hospital.
Like so you've accessed all thebig things and you are not in
small town in terms of yourskill set and your knowledge and
(31:04):
what you're bringing to thetable.
But yet you walk into youroffice or you call on the phone,
you get to talk to a humanbeing.
And it feels like everybodyknows everybody and you run into
people that you know in town.
So I just have to say that'svery cool because that does not
happen in most practicesanymore, because most practices
are just such a part of a largerconglomerate.
So you have created an energy ofwellness in your practice.
(31:27):
And part of that wellness isjust knowing your patients and
knowing who they are.
SPEAKER_01 (31:31):
Yeah, I think it's a shame the way medicine has
evolved in the last 50 yearswith a number of middle managers
and administration folksoutnumbering doctors, you know,
10 to one.
I don't think that helps peoplefeel taken care of.
I don't think that helps peoplebe seen or be well or get the
kind of attention they need.
And, you know, the system whenit's big and clunky doesn't make
(31:53):
allowances for, oh, well, youknow, so-and-so is pregnant and
having a baby tomorrow.
Like, let's get them in.
Like, let's really help themout, or so-and-so's kids leaving
away for the semester, you know,abroad, and like this is their
last chance to get in.
Like, let's really do everythingwe can to like help them.
These might not be life or deafdeaf decisions every day.
This is dermatology.
I recognize that, but they arelike quality of life decisions.
(32:14):
They are impactful to how wecarry out our everyday, even
more so now that we're onscreens all the time and and and
how your skin looks is just castabout all over all over.
SPEAKER_00 (32:23):
Mm-hmm.
And especially for the youngergeneration.
I will say, you were soaccommodating to put my daughter
on the wait list, you know,instead of having to wait three
months to see her.
You managed to like squeeze herin one day and it was great.
It was so fantastic.
And uh, she is so indebted tothe help that you were giving to
her.
So thank you for that.
So I want to talk about onething that you talked about, and
(32:44):
I don't want to skim over thismedical dermatology versus, and
correct me getting the termwrong, medical dermatology
versus like, is it calledcosmetic dermatology?
SPEAKER_01 (32:54):
Yeah, or even aesthetics, because a lot of
it's being done bynon-dermatology folk.
SPEAKER_00 (32:59):
What is the difference?
Like, how does someone know?
SPEAKER_01 (33:02):
Totally.
I think everyone should bereally transparent in their
advertising.
And I think a lot of places arethat they're focused on skincare
and injectables and cosmetics.
And I try to make it very clearon my, you know, practice
website and all of my materialthat I am not.
I have never been a makeupperson or a skincare girl.
I don't have a complicated skinregimen myself.
I do do cosmetics and I try tobe very honest about that.
(33:24):
I was just seeing my good friendDr.
Butler this weekend, IPLing offsome of the sun damage from when
I was, you know, 19 in a tanningbed.
You know, I think that feelinggood and looking good to your
point is a part of being happyand successful and, you know,
living my best life.
But I do zero of that in myoffice.
I don't like it.
I don't enjoy attending themeetings on it.
(33:45):
I couldn't tell you what's thelatest and greatest in cosmetics
because I don't go to thosemeetings.
And they're separate meetings,and there's a whole scientific
community who's very interestedin answering those anti-aging
questions.
But I am here for you fordiagnosing all the melanomas and
treating complex hydranitis andscraping molluscum off kids and
doing the things we need to dothat make life better medically.
(34:09):
Okay.
SPEAKER_00 (34:10):
Which is important.
At what age should someone startto do sun screening of your
skin?
SPEAKER_01 (34:17):
The United States Protective Task Force, which is
the governing body that decidesbased on all the data and the
risks and the cost of cancerwhen screenings are appropriate,
that just lowered the guidelinesfrom 50 to 45 for colonospedes,
does not recommend skin cancerscreenings across the board.
Like they do not recommend themat all because cost-wise,
(34:38):
whether your basal cell is thisbig or the size of a half dollar
doesn't really matter anddoesn't change the cost that
much.
And very often basal cells andsquames, once they're big and
obvious and bleeding andeveryone would pick them up,
they can still be treated andmanaged.
And they're not routinelyrecommended and they're not
covered under preventativescreening, like reimbursement,
(35:00):
which is hard to explain topeople because I also think that
skin cancer screenings are agood idea, but I can't convince
the government of that.
Um so I generally tell people ifyou have a first degree relative
with melanoma, that meansparents, siblings, uh, or kids,
then you need a screening everyyear because melanoma is fairly
heritable.
If you have fair skin, a historyof blistering sunburns or
(35:22):
tanning beds, like you should bestart getting a skin check
probably by 30, 35.
And if you have any medicalconditions that predispose you,
which your specialist should betelling you about immune
suppressance, radiation,anything like that, CLL, all of
which decrease your body'sability to fight skin cancer.
Like side note, our body'sreally good at fighting skin
cancer.
And when we immune suppresspeople for any reason, their
(35:42):
skin cancers go crazy.
So those are the populationsthat really need it.
And then, you know, I can't saythat there's a universal age of
everybody needs to see me everyyear.
Okay, that was so not the answerI expected.
It's always data for me.
I want to say, like, I want tosee everybody always.
SPEAKER_00 (36:00):
But I know, but I love that.
But I'm actually shocked thatit's not considered part of a
regular protocol that thegovernment recommends, a regular
protocol, just like a physical.
Like I'm shocked at that.
That is that's why I expectedthat there was actually an age
answer to that question.
There is not.
Okay, well, I've been going.
(36:21):
I I'm now on every six-monthplan, folks.
So, you know.
Prevention is a good thing.
All right.
So, like I said, you are a superbusy mama.
Two little ones, you are runningyour own business, your husband
is a doctor.
How in the world do you maketime for you?
SPEAKER_01 (36:39):
I think that's an interesting question.
I think the moms who juggle anddo all the things that were
really good at getting every allthe glass balls not to drop, but
the one that you have to kind ofcreate out of thin air would be
like your own kind of likewellness.
And I think that's a lot harderto do.
I've done a really interestingjob meeting a lot of cool
entrepreneurs and women businessowners in town, you're starting
(37:00):
with yourself last summer when Iwas in the very early days of
opening my doors.
And, you know, I think it'sfascinating.
I love meeting these otherwomen.
I love meeting these othercolleagues who are doing similar
things, and we talk about it alot.
And I don't think there's aneasy answer.
And there are weeks wherethere's no self-care wellness
and it would be, you know,misleading or kind of paint a
(37:20):
rosy picture of what my life isto say that there is.
And then there's weeks where,you know, I take like a good
chunk of time, a whole Saturday,and I go to the library and I go
for a run, and my husband or mynanny, you know, like not for
nothing.
My husband works every otherweekend.
And and learning that I wasallowed to get care, child care
for myself without an explicitagenda was very eye-opening.
(37:44):
As a working mom, I felt like Ishould be working or with my
kids.
And since I work a lot, thatmeant there was really no time
for me in that schedule,especially because I became a
mom in the pandemic.
There was nowhere to go.
Um, but I think that, you know,creating space for myself and
not me feeling that childcare islike a luxury or something that
needs to be saved for if I'mworking has been really, really
(38:05):
helpful because sometimes youjust need six hours to not get
smeared like peanut butter on.
SPEAKER_00 (38:11):
And that is so perfect that you said that.
And I'm so glad you shared thatbecause it's about you making
yourself a priority.
And that is just as much of apriority as everything else.
And so often women feel guiltyabout doing that and about
taking that time where they'renot at work.
I'm feeling like, okay, if I'mnot at work, then I need to be a
(38:31):
mom and taking some of that momtime or some of that work time
and saying, no, I'm gonna carvea little piece out for myself,
and that does mean I need childcare because I'm gonna shave off
a little on either side.
But if you don't take care ofyou, and you know that's being
in the medical profession, ifyou don't take care of you, it
impacts everything in life.
You have to.
It's so important and mind,body, spirit, all of it.
(38:52):
Just making time you've madetime to come and meet me for
coffee.
That's hard to do as anentrepreneur.
SPEAKER_01 (38:57):
It's busy.
But I think as since I'm raisingtwo daughters, you have a
daughter.
I think the importance of doingit is I now see kind of mom
guilt in in raising them that myfocus on wellness will teach
them focus on wellness.
And if I don't do it, how willthey ever?
Yes.
SPEAKER_00 (39:12):
Yes.
All right.
So I have a couple morequestions, and then I'm taking
so much of your time.
I know you have to get back toyour patients.
So, first question is someonewho is watching this or
listening to this and they'venever been to a dermatologist
before and they're trying tofind one, but they don't live in
New Canaan, Connecticut, or inour surrounding areas.
How do you suggest they go aboutfinding appropriate good quality
(39:34):
care?
SPEAKER_01 (39:34):
There's two ways to do this.
One is to start with theAmerican Academy of Dermatology
website, find a derm.
You will find a board-certifieddermatologist and not somebody
kind of masquerading as somebodywho's interested in skincare and
you can work backwards that way.
The other is to start with yourinsurance and filter by
dermatology that way, becausethat'll be two words of one
stone.
You'll also find somebody who'sin network for you, and that's
(39:57):
really helpful as opposed togoing to Google where I feel
like there's a lot ofadvertising for kind of
skin-related things, and it canbe a little bit more confusing.
SPEAKER_00 (40:04):
Perfect advice.
And yes, it is covered byinsurance.
Like it doesn't necessarilycover all of it, depending on
your insurance, but a lot ofthose things can be covered by
insurance, which is reallyhelpful.
You're not always just anout-of-pocket, out-of-network
type of service.
So thank you for that as apatient.
Thank you.
Is there anything I didn't askyou that you think is really
important to communicate,whether it be about dermatology,
(40:26):
trends, yourself, your business,women, any subject?
Did I miss something?
SPEAKER_01 (40:31):
You didn't miss anything.
I just really like being intown.
I like connecting with you,connecting with other patients
and women in particular, andkind of sharing the experience,
sharing what I've learned, goingout on your own, doing your own
thing, you know, whether you'rein medicine or not.
I think some of the same themesuh are kind of shared.
(40:51):
And I want to give every womanwho's thinking about making that
life shift, career or otherwise,like a hug and like it's so
worth it.
And future you're gonna be sohappy you did it.
SPEAKER_00 (41:02):
Perfect.
And you're so correct.
And there's so many people.
And I think I found from meetingyou and other women, like you
said, you don't have to be adoctor.
You could be going out trying todo your own thing on so many
different levels and so manydifferent things.
And there's so many people thatare out there to support you and
to help you because some of thechallenges that we have as
entrepreneurs are similar nomatter what business you're in,
(41:25):
what field you're in, what townyou're living in.
It's a similar juggle with allof this.
So don't be afraid to reach outto people.
Yeah.
SPEAKER_01 (41:33):
I think when you go in with, I'm doing this too, can
you help me?
I've had so many more yeses thanno's.
Yes.
Yes, me too.
Asking for help.
SPEAKER_00 (41:41):
Yeah.
Which is hard sometimes, askingfor help.
Yeah.
SPEAKER_01 (41:44):
Oh, yeah.
So if you're not ready to askfor help, you're not ready to
take the leap.
You have to be ready to ask forhelp.
SPEAKER_00 (41:49):
You have to be ready to ask for help, right?
And you have to be ready.
I also found you really have tobe ready to let go of some
things.
And you don't have to controlevery single part of your
business or do every single partof your business.
You need to learn where yourspecialties lie and how do you
resource to provide things thatyou don't know.
You don't have to know how tobuild a website.
(42:11):
You don't have to know some ofthese things.
It's okay.
You have to outsource and findpeople that do to help build a
tribe to help you.
SPEAKER_01 (42:18):
Absolutely.
I think that will bury you inthe details if you think every
single piece of your business isthe thing you need to do.
But at the same time, listeningto my amazing friends and
colleagues who have done thingswho have a great website.
Like, hey, yours is great.
People love to tell you.
Like, I love my website too.
Thank you.
Let me give you my person.
SPEAKER_00 (42:36):
Exactly.
That is so true.
All right.
Before we go, I love to ask allof my guests to recommend a book
that has impacted thempersonally or professionally.
I'm a huge proponent of reading.
I know you read a ton.
You already announced you're anerd.
You read so much.
What book would you like torecommend that you think people
should check out?
SPEAKER_01 (42:55):
My book's a throwback.
Maybe a lot of people have readit already.
It is called Wild by CherylStrade.
She is a very powerful femaleauthor, and I think has had a
lot of life experience.
And the book details her comingof age and hiking the Pacific
Crest Trail on the West Coastwith really no preparation.
And I read it every year, prettymuch at least once.
(43:16):
I go back and read it, and Ifind different pieces of it at
different phases of my lifereally uh inspirational.
And so I find that it's apowerful read.
I'll I'll say that, but I areally good one.
SPEAKER_00 (43:26):
Ooh, I like that.
I've never read it.
So I'm gonna have to go getthat.
I'll lend you my copy.
It's always in my desk.
Oh, I love it.
That is so great.
Thank you.
And I have a book for you.
Have you read 10X is easier than2X?
SPEAKER_01 (43:38):
No.
SPEAKER_00 (43:39):
Gotta go read it.
It's a business book, but it's agood one.
It's a good one because I knowyou're really you're looking to
expand your business and reallydo a lot more and like really
make a difference in the world.
Yeah.
And that sometimes is hard to dowhen you have a list of things
you want to do that are reallylong.
And I found that helped me a lotas I was trying to like step
into bigger and better and more.
(44:00):
Really good one.
10X is easier than 2X.
Love that.
I love that.
So thank you so much, Al,personally, for being my doctor.
You are just so amazing.
And you're also just anincredible woman.
I am always so inspired by you.
I love following you onInstagram.
You give really practical, greatadvice about products and sun
and what to do and the spongething that you use for your kids
(44:20):
to put on sunscreen.
Like you put that in.
I was like, where was that 20years ago for me?
Like, where was that?
So I really encourage people tofollow you.
You're very real, which I thinkis really important in a in an
age where people are not soreal.
You show up as you are and youtry to help people with their
skin and with their challenges,but recognizing this is real
life and perfection is not it,folks.
(44:42):
Um so I thank you very much forcoming on the show and sharing
your brilliance.
And I hope you have a beautifulday.
SPEAKER_01 (44:47):
Thank you so much.
SPEAKER_00 (44:49):
Thank you for joining us for another episode
of the House of Germar podcast,where wellness starts within.
We appreciate you being a partof our community and hope you
felt inspired and motivated byour guest.
If you enjoyed this episode,please write us a review and
share it with friends.
Building our reach on YouTubeand Apple Podcasts will help us
(45:10):
get closer to our mission toempower one million women to
live all in.
You can also follow us onInstagram at House of Germar and
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through our website,HouseofGermar.com.
If you or someone you know wouldbe a good guest on the show,
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(45:34):
This has been House of GermarProduction with your host, Gene
Collins.
Thank you for joining our house.
In your field, what is the latest and greatest that
you're kind of like readingabout?
What are people talking about indermatology?
SPEAKER_01 (00:07):
That idea of the skin as an immune organ is like
really panned out.
All of our newest medicines arecalled biologics.
They're very precise medicines,most of which are given as
injections because they're soprecise that if you took them as
a pill, your stomach acid woulddegrade them.
They're very clean molecules.
We're changing the lives ofpatients with psoriasis, with
eczema, paragonodularis, chronicerbicaria, hydra adenitis.
(00:32):
We're taking these people'simmune system, which is really
what's causing their skinissues, and we're tweaking it,
not suppressing it.
We're not crushing it like wedid with the old-day medicines.
We're not using chemo drugs,which we used to have to use
off-label for derived things.
We have very precise cleanmedicines that fix their disease
from the inside.
SPEAKER_00 (00:49):
Welcome to the House of Germar podcast, where
wellness starts within.
The House of Germar is alifestyle brand empowering women
to live all in through materialdesign and personal wellness.
We are a destination for womenready to reimagine what is
possible in their homes andlives and then create it.
(01:09):
We are honored to have you joinus on our mission to empower one
million women to live all in.
I am your host, Gene Collins,and I invite you to become
inspired by this week's guest.
Hello, everybody.
Welcome.
I am Gene Collins, and today,get ready.
We are talking aboutentrepreneurship and
dermatology.
(01:30):
I am so excited.
I have Dr.
Elle DeMaul on the podcast, andshe is a personal friend of
mine.
She is also my doctor.
And I love this woman in so manyways.
First of all, her background,her experience, her jumping 100%
two feet in into being adermatologist is so great.
And she is so qualified.
And she really specializes oncomplex problems.
(01:52):
I'm going to put her whole bioin the show notes.
So I'm not going to read it foreverybody.
But Elle, welcome to the show.
Thank you so much for having me.
I am so excited.
So we're going to talk allthings dermatology, all things
skin.
But before we do, I really liketo specialize and tell people
about your story and yourjourney.
And I want to focus on thatspecifically for you because I
(02:15):
did not realize until I went andhad coffee with you how
difficult it is to become adermatologist.
SPEAKER_01 (02:22):
Everybody wants to be a dermatologist these days.
I don't know.
It's the skincare trend.
SPEAKER_00 (02:26):
And but like that's actually not easy to do.
And folks, she has two youngkids and a husband who's also a
doctor.
So if you wouldn't mind, like,how in the world did you even
get into dermatology?
And if you would share a littlebit about that journey and that
also that journey took you tobecome an entrepreneur and have
your own practice at a veryyoung age.
(02:47):
And that is kind of scary.
And so I would love to talkabout that to start off.
Yeah.
SPEAKER_01 (02:51):
I think that's great.
I think, you know, while a lotof times people don't realize
what dermatology is, there's alot of aesthetics now and lots
of people interested in takingcare of skin.
But dermatology really is a, youknow, a field of medicine.
I went to Haberford College inPhiladelphia.
I wasn't always sure I wanted tobe a doctor.
And um, it was kind of a secondlater in college decision for
(03:12):
me.
And so I was scrambling, fittingin all my prerequisites during
the summer months and takingextra courses and trying to get
it done because my interest wasin anthropology.
I was an anthropology major.
I wrote my senior thesis ontattooing.
I worked at a tattoo shop, wentto tattoo conventions, loved
everything about self-expressionand display, and particularly
the role of women in tattooing,which was traditionally a male
(03:34):
field.
So I have read almost every bookthat exists on tattooing in the
skin written in the last 50years.
And then I decided to go tomedical school to make sure I
could have a career because Iwasn't sure where tattooing
would take me because I'm not anartist myself.
Don't get me wrong.
I could not actually do theartwork.
And I decided to be a doctor.
I went to the University ofConnecticut School of Medicine,
(03:56):
which was great.
I tried everything.
I loved everything.
I delivered babies in Guatemala.
I loved emergency medicine.
I was in the interest group.
I'd been in EMT in college.
And I just was looking for afield where I felt like I could
make a big difference inpeople's lives, where I could
know my patients for a longtime.
And I decided to take a year offin medical school to be sure
(04:17):
about that, and did some work inmouse model research for
melanoma, which is, you know,one of the leading causes of
death in skin cancer.
And I really thought that thiswas an exciting time to study
the skin because it's one of ourlargest immune organs, meaning,
you know, our immune cells arethere and play a big role.
And that hasn't beentraditionally how we thought
(04:38):
about skin, but it is where thegreatest research is growing in
medicine in general.
And so after a year of workingon little baby mice models and
giving them metastatic melanoma,I was pretty sure that I'd found
my calling in taking care ofpatients with skin concerns and
melanoma.
And so I did a lot of researchand met a lot of people and
shook a lot of hands and triedto know everything I could about
(05:01):
being in dermatology and waslucky to match at the Icon
School of Medicine for Residencyand Dermatology, which I did for
four years.
And then I liked it so much Istayed for an additional year as
a Durham Path Fellow.
So reading the slides we allmake as dermatologists.
And I just, I couldn't getenough.
I stayed for a long time.
SPEAKER_00 (05:20):
When you told me how many years you were in school
and how many years you workedbefore you were actually able to
do this on your own and startout and have your own practice,
I was like, I had no idea.
SPEAKER_01 (05:31):
Yeah, it's a long road.
It's not for the faint of heart,but if you like it, it doesn't
feel like a road to somewhere.
You know, it that's all part ofit.
SPEAKER_00 (05:38):
Yes.
Yes.
But I really personally had noidea.
And I think a lot of peopledon't know and don't really
understand that dermatology isjust like medical school and the
amount of education andknowledge that's required and
the amount of ongoing education.
So in your field right now,we're going to stick to this for
a second.
In your field, what is thelatest and greatest that you're
(06:00):
kind of like reading about?
What are people talking about indermatology?
SPEAKER_01 (06:04):
That idea of the skin as an immune organ is like
really panned out.
All of our newest medicines arecalled biologics.
They're very precise medicines,most of which are given as
injections because they're soprecise that if you took them as
a pill, your stomach acid woulddegrade them.
They're very clean molecules.
We're changing the lives ofpatients with psoriasis, with
eczema, parigonodularis, chronicerticaria, hydroadenitis.
(06:29):
We're taking these people'simmune system, which is really
what's causing their skinissues, and we're tweaking it,
not suppressing it.
We're not crushing it like wedid with the old day medicines.
We're not using chemo drugs,which we used to have to use off
label for der things.
We have very precise cleanmedicines that fix their disease
from the inside.
Wow.
SPEAKER_00 (06:46):
Okay.
I have no idea.
So, as part of that though, doeslike overall wellness of your
clients come into play?
SPEAKER_01 (06:56):
I think wellness is the next frontier in
dermatology.
I think we're starting to lookat the skin microbiome the way
we're looking at the gutmicrobiome, and they're actually
very closely linked.
And I think in the next 10years, we're going to see more
studies linking gut and skin,like, you know, flora health
with eczema and other, you know,conditions, even things like
mycosis fungoides, you know,skin lymphomas, because I think
(07:17):
that connection has beenunderrepresented.
That being said, I think there'sa lot of people who want that
data to be here now, and it'sjust not.
Like I would love to recommendprebiotics, probiotics, more
wellness-based things for theskin.
But I think that's where we'regoing.
SPEAKER_00 (07:32):
Okay.
And I love that because I thinklike holistic wellness is
actually so important.
And I feel like it comes up ineverything else that we do.
It comes up.
It's no longer just go have likeyour annual physical and do your
basic blood work.
It's like it goes so muchdeeper, especially as a woman
with hormones.
And I mean, it's justeverything.
SPEAKER_01 (07:51):
Yeah.
SPEAKER_00 (07:52):
It's everything, holistic wellness.
SPEAKER_01 (07:54):
Totally.
I think everything holisticwellness.
And I think hormones play a bigrole.
I've I've done a really bigeffort to educate myself as a
doctor as we've really shiftedour thinking in hormone
replacement therapy for women.
And it's getting, you know,totally rethought by the FDA and
attending several lectures byYale experts in perimenopause
and menopause HRT.
I think that's part of it.
I don't prescribe it.
I think it's outside my lane,but we're definitely looking at
(08:15):
it.
We're looking at estrogen on theskin, directly on the face.
Is that helpful?
I think the data is stillcoming.
And I don't like to recommendthings because they're trendy.
I really want to see the sciencebehind them so that when we make
a recommendation, I know whereit's coming from.
But I love that that's wherewe're going.
SPEAKER_00 (08:30):
I do too, personally.
Yes.
And we have to personally talkabout something because since
you are my doctor, we're goingto talk about two things.
We're going to talk about skincancer and the sun and all that
good stuff.
And we're going to dig intothat.
But before we do, we are goingto talk about hair growth for
women.
So these are my extensions.
(08:51):
I've had them for three years.
This is actually the lastpodcast I'm going to record with
my extensions because I am goingto take them out.
Not because my hair is fullygrown yet or that I even like my
hair.
So this is a whole emotionalgrowth, learning to love
yourself the way you are, lovinghow you look at yourself, which
also plays into the sun as well.
And we'll talk about that.
But can you talk to me a littlebit about some of the trends on
(09:14):
things that people might notthink to go to a dermatologist
for, such as hair growth?
SPEAKER_01 (09:20):
Yes, hair is well under our purview as
dermatologists.
We also do nails.
And I think there's this feelingthat women shouldn't lose hair
or don't lose hair becausethat's more of a men's thing.
And I think it's much easier ifwe call it patterned loss.
You know, a lot of people talkabout male patterned loss.
And yes, that is what men oftenget, but women get female
patterned loss and they tend tohave a slightly different
(09:43):
pattern.
They lose more prominently inthe temples often.
And we describe a widening ofthe part or Christmas tree
pattern.
But it's very common slashnormal, I dare to say, that some
of your hair thins.
For some women, that startsunfortunately as young as their
20s.
But almost everybody aroundperimenopause starts to see a
change because our hormones areshifting.
And that directly affects hairgrowth, how long the cycles are,
(10:06):
the size of the hair follicleitself.
And I think women feel liketheir options are kind of more
to get extensions or to getpowders or to cover it up.
And they don't really think thatthere might be something that
could help them keep the hairthey have.
SPEAKER_00 (11:08):
And I've been working with you.
And so, as part of my journey,I'm going to share publicly on
social media part of my journeyof doing this because I think
there are so many women thatstruggle and perimenopause,
menopause, like it's just reallyhard.
You know, your body's changingand you don't like what's
happening and you feel like youdon't have any control.
(11:28):
And it's when you go and youlook in the mirror, there are
all these changes happening.
And then on top of that, youhave hair loss and it's sort of
like compounding.
And it's and it's really tough.
It's really hard.
And so I am going to take myextensions out because I am
taking medication thanks to you.
My hair hasn't really started togrow yet, but you know, we're
gonna find out what happens, andit's also part of the journey, I
(11:52):
think for me, of wellness forwomen and learning to like what
you see when you look in themirror, which is not always that
easy.
SPEAKER_01 (11:59):
It's not easy, and I I wish it was.
I talk about hair a lot fromalopecia areriada and my young
patients, and you know, alltheir hair falling out all of a
sudden in six weeks, which wedon't have a good story for to,
you know, to pattern glass.
And I I said to somebody, youknow, losing your hair, if we
lived in a totally visuallyblind society, you would be
(12:21):
fine, you know, just trying todrive home the point that this
was just hair without saying thephrase this is just hair,
because it isn't.
We don't live in a visuallyblind society.
Hair means a lot, it means a lotabout gender and self-expression
and identity.
So I never try, you know what Imean?
But it's important when peoplethink that their hair loss is a
(12:41):
sign of something bigger,because oftentimes we do talk
about that too.
Like, are you healthy?
Is it your iron?
We think about unfortunatelycancer patients losing their
hair.
Although, as a side note tothat, there are a lot of
increasing movements, cold caps,and things that people are doing
during chemo to keep their hair.
But, you know, we tend toassociate hair loss with illness
and and just so many negativethings that it's just as an
(13:02):
anthropologist, right?
It's just such an interestingtopic that ties in a lot of
feelings and social norms.
And so I think it's reallyinteresting to use the medicines
we have.
And if right now there's nothingFDA approved for female hair
loss, but there's a lot ofmedicines that have been used
for a long time, includingsporonal lactone and oral
monoxidone and even finasteridethat off-label have a lot of
(13:23):
benefits for hair and that havebeen studied in there's case
series and evidence that thiscan be something that really
helps women hold on to the hairthey have, in addition to HRT,
which is always something that'sworth discussing and making part
of the conversation because thatis one of the benefits of HRT.
SPEAKER_00 (13:38):
Yep.
I'm on that too.
SPEAKER_01 (13:40):
Yeah, I'm trying it all, girl.
I think women, you know, thisidea that menopause happens and
then that somehow we losefemininity or our identity or
our vitality.
I I think we have to rewrite thestory on menopause.
And there's so many veryinteresting people doing that.
And so I'm really honored when Ican help women, you know, claim
some parts of their identityback by get growing their hair.
SPEAKER_00 (14:02):
Yeah.
Yeah.
Well, and so much of what youdo, like you're helping my
daughter, right?
My daughter's working with youfor her skin and she has eczema
and all kinds of things.
And I feel like one of thethings I love about your
practice is that you help peopleat all ages, and you bring
modern science, just the latestin what's out there, to all
(14:23):
different ages.
How do you remember all of this?
SPEAKER_01 (14:27):
I love dermatology.
I'm a big nerd.
I keep telling people I don'treally have hobbies.
So, like collecting cool rashesor like seeing that great case
and cunning for me is like thewin.
And I'm a bit of a competitor aswell.
I was a college athlete.
And so I love when somebodycomes in and said, I've seen
another doctor and nobody canget rid of this.
Can you?
I'm like, well, great.
Like now there's a challengecomponent to it too.
(14:48):
You know, this is what I like todo.
You know, I think AI is growing.
There's an a wonderful app forall physicians called Open
Evidence, which is uses AI forto, you know, kind of simplify
medical data because there'salways going to be new medicines
in other fields and things, youknow, like the GLP ones coming,
they're causing hair loss andacne.
So I didn't train in ageneration with GLP ones.
I'm also not prescribing GLPones, but I need to know a lot
(15:11):
about them.
And so attending lectures,having access on a day-to-day
basis to even AI and textbooksand community, uh, I'll help
make sure that I'm not missingsomething when I see patients
come in on the new latest andgreatest drug.
SPEAKER_00 (15:24):
So much to learn, so much to know.
Oh, I have so much to ask you.
Let's stick to this.
Let's stick to appearance.
Let's stick to the sun.
Our friend the sun.
Everyone, you need to go followElle on social media because we
all try in our own individualbusinesses, especially as
entrepreneurs, to walk the walk,talk the talk.
(15:45):
Like we got to do it.
And you, girl, do it.
You are outside, you've got yourhat, you've got your sunscreen,
you've got your glasses, likeyou are living it with
protection against UV.
But this subject is another onewhere it's like people are used
to, and I would say everyone Iknow would say they feel like
they look better with a tan.
Yet the sun is terrible for us.
(16:08):
So, what do you tell yourclients who are like, but I look
dead, I look better with a tan,and you know that the sun is bad
for them.
How do you deal with that withyour clients?
SPEAKER_01 (16:18):
So, you know, one in five Americans gets skin cancer.
That's just the statistics.
So, you know, I don't have totry to convince anybody I'm
gonna be really busy no matterwhat, because this is
unfortunately a problem thataffects a lot of people.
And our love of a tan is verylike transient in the grand
scheme of human culture, right?
And many other cultures beingvery, very fair and showing that
(16:39):
you haven't been outside and itcomes with all sorts of class
and privilege, you know,connotations to not be tan.
So feeling that tan is like agood thing is very American and
very of the last, I don't know,60 years.
And I would tell them that theways to have a fake tan, whether
that's a mousse or an at-homelotion or a spray tan, all of
these things are so much betterthan they used to be.
(17:00):
I have tons of patients who looktan fabulously without frying
their sun, their skin in thesun, pardon.
And UV causes damage, you know,whether you're somebody who
thinks they tan easily, so it'slike less for you or not.
What UV B particularly does ispenetrate the dermis, attack
your DNA in your skin cells, andcause mismatch repairs.
(17:23):
And so your skin is gettingthese little disconnects in the
ladder of DNA.
And your body's really good atfixing that.
And for a while it will.
It will catch a lot of thesemistakes and you're fine.
So you're going out tanning,you're 30, 40, 50, nothing bad
has happened yet.
See, I'm fine.
But over time, that DNA mismatchcorrection that we're supposed
to be doing is gonna miss one.
It's not perfect, right?
(17:43):
And that's just hard because alot of these skin cancers come
up on places where you've hadthe most sad eyelids, edges of
the nose, ears, lips, places youdon't really have a lot of skin
that you want to be losing inthe most surgeries that I send
people for.
And so I think a little, youknow, ounce of prevention is
worth a pound of cure.
I don't think people need to beperfect.
I don't think people need to notgo outside.
(18:06):
I want people to go hiking andfishing and do all their life
adventures.
But pretending that yousunscreen's not going to help
you or protect you from some ofthat damage is is kind of
foolish for no reason.
SPF 30 blocks 97% of UVV rays,so you don't need the hundred.
You can track the UV index onyour weather app.
(18:26):
So if it's a UV index of one ortwo, sure.
Go out that day with lesssunscreen or without your hat.
You know, let's be realistichere.
Not, it's not all the same.
You know, I'm totally willing tomeet people where they are in
terms of the data, which is yes,there are nuances to this
question.
And so when the UV index waszero and we were at the pool and
I told my husband he didn't needto reapply sunscreen on my three
(18:46):
and five-year-old, he was like,What?
And I was like, Look at look,science, science, the UV index
is zero.
Like we do not need to.
So I I, you know, I'm not one ofthose crazy, you know,
sunscreen, uh like, you know,absolute fanatics.
I don't have any of the weirdmasks or hoods or things that my
husband wouldn't walk out inpublic with me.
But I think it's important toprioritize that health.
(19:08):
And there's a lot of good dataabout vitamin D and the role
that that plays.
And don't we need to be gettinga little bit?
I promise everybody, especiallywith lighter skin tones, skin
colors graded one through six,so one, two, and three on the
lighter side, is getting enoughsun from May till October if
they're outside 15 minutes aweek with their face and arms
exposed.
(19:29):
But we don't store vitamin D, sono one's getting it in
Connecticut in the winter.
Yeah.
If you have a darker skin tone,you might not be getting enough.
I think vitamin D comes in acapsule form, and that's a
perfectly lovely way to get it.
SPEAKER_00 (19:41):
And I do take vitamin D, and I've been doing
that for years.
I did not know that I needed to,but I did.
And I wish I could get more ofit naturally, but that just
doesn't happen.
As you said, in Connecticut, wedon't see the sun enough.
SPEAKER_01 (19:53):
No, and it's not worth a trade-off for me.
I tell people if you could getvitamin C from sucking on a
cigarette, is that trade worthit to you?
Because somehow it feels a lotmore natural to get it from the
sun, but it doesn't necessarilymake it better.
SPEAKER_00 (20:04):
Right.
And you did say something that Idon't want to miss.
You talked about because the UVindex was zero, you didn't have
your husband reapply sunscreen,but yet he still has sunscreen
on.
SPEAKER_01 (20:17):
Yes.
Yeah.
Sunscreen is good for about twohours, is what we know.
And then it's not like it turnsoff.
It's not a yes-no question, butit does wear off.
And so we recommend if you'regoing to be somewhere where the
UV index is five or six, then atthe two-hour mark you reapply.
SPEAKER_00 (20:34):
Okay.
Two-hour mark.
All right.
What is, and this is a little inthe in the weeds of sunscreen,
but I think it's importantbecause not all sunscreen is
created equal.
And I think sunscreen hasdifferent products in it, some
of which, you know, definitelyare not considered as good as
others.
Because of the hair extensions,I actually can't use sunscreen
(20:54):
with a lot of those products, alot of the sprays and stuff.
So I'm using sunscreens thathave a lot of zinc.
So my stuff comes out white andit is impossible to get it off
in the shower.
But if I don't, my extensionswill turn pink.
So there we go.
I go with like a zinc-basedsunscreen.
Is there a difference insunscreen?
Or you're just like, anysunscreen is better than no
(21:14):
sunscreen, so I don't care.
Or is there really somesunscreens that are actually
better for our skin?
SPEAKER_01 (21:20):
That's an interesting question.
And I'm very pragmatic, clearly.
So any sunscreen is better thanno sunscreen, period.
Full stop.
SPF 30 that is FDA regulated,I'm happy.
There are concerns in a growingportion of people who are
looking at the data.
And again, I still use allsunscreens, but they're looking
at the fact that if you look atblood levels of sunscreen when
(21:43):
you are covered head to toe,chemical sunscreen particles are
small enough to cross the skinbarrier and you can find them in
the blood.
That's the whole story that weknow.
The concern is is it doinganything when it gets there?
There's concern for endocrinedisruption and some other
things.
No studies show that yet.
Again, the amount of sunscreenyou need to put on your whole
(22:03):
body to see those blood levelsthat they did in these studies
is more than I'm sure anybody'susing.
But it's something to look for.
And I I, you know, I believe alot in UPF protective clothing
and other mechanisms ofprotecting yourself from the
sun.
I think too much of anything isbad in life.
That's just kind of something Ithink we've learned from mistake
and mistake again, where wealways think we've found the
(22:25):
silver bullet to aging.
And then, you know, surprise,too much of a good thing's bad
again.
Zinc is super interesting.
It is a physical barrier, zincand titanium.
Sunscreens physically block thelight.
They do not absorb it and turnit to heat, which is what
chemical sunscreens do.
And non-nano particles of zincand titanium are too big to
cross the skin barrier, so theycannot be absorbed.
(22:47):
So if people have theseconcerns, I think it's perfectly
reasonable to use a physicalsunscreen like zinc or titanium.
Again, the non-nano ones.
The nano ones are really nicebecause they're a lot more
invisible, but then they'resmall enough to cross, and
you're left with the samequestion.
But I'll take what I could get.
SPEAKER_00 (23:02):
Okay.
Yeah.
And I will say to people, like,I have to tell you, because I've
had to do this and I've hadMoe's surgery, I've had it on my
lip.
That was so not fun, folks.
I they didn't even tell me whenI did it that I could only drink
things with a straw for a week.
I couldn't eat real food.
They didn't even tell me untilafter it was over.
And I had no idea.
I was so ill prepared.
(23:23):
And I also had one like right onmy chest.
And I was like, once again,terrible spot to have a scar.
Really terrible spot to have ascar.
So I personally have had to, youknow, because of all of these
things, pay a lot more attentionto the sun and to the sunscreen
that I use.
And I very often will put onlike baby-based sunscreen, which
(23:44):
has zinc in it.
And it's really like it's white.
It's so hard to get it off.
I'll, you know, I'll go toMexico and it's like all white.
I'm like at the beach and I'mall white.
You know, it's like I'm trying.
I'm really trying.
So I have one more questionabout sun, too, actually.
A first question is the mindsetof the skin damage that I am
getting now.
So when I have something pop upthat we have to remove, is that
(24:08):
from something I've donerecently?
Could that have been for what Idid when I was 12?
Like, where does the damagehappen?
Or, like you said, is it justthat it compounds?
So it doesn't really matter whatI did when I was younger, if
that question makes sense.
SPEAKER_01 (24:22):
Absolutely.
A lot of the sun damage is sunfrom when we were younger.
And I try to tell people that sothey don't lose hope that like
what they're doing now stillmatters.
Your exposure of UB over yourlife is cumulative.
So whatever age you are, if nowis the age you decide to get
careful, there's benefit.
It's never too late.
Maybe 90 plus.
Maybe at that point it's toolate.
But anything below 90 plus or ifyou decide to be careful, you
(24:42):
know, that is a good thing.
The damage can take a reallylong time to develop.
And so I, you know, even if youfind, you know, are a reformed
son lover like I am, who was inthe tanning beds in the 90s.
I was not a dermatologist.
I wanted to be tanned from myhigh school prom.
I looked so great, you know,that's scary.
And the reality is burns andtanning bed use as a child are
(25:05):
worse for you than they are inadulthood.
They have a bigger impact inyour cancer risk.
So being careful with our kidsis really important.
SPEAKER_00 (25:12):
Yeah, that's me.
Yep.
Mm-hmm.
In college in Arizona, a sun andtanning beds.
Oh my goodness, when I thinkback about it and I think back
to when I was younger and weused to go lie out on the
blacktop with trays, aluminumfoil trays, and put baby oil
with iodine on them and justlike reflect the sun onto our
face is so terrible.
So terrible.
(25:33):
Yeah.
Okay, so let's talk about kidsfor a second.
What suggestions can you make topeople about how to get their
kids to embrace the concept ofsunscreen?
Because I am sure my daughter isno different when she was little
to the children now, even thoughshe's 19 now.
Putting on sunscreen ain't sofun when you're a kid, and
that's not cool.
So, how do you help kids embracethe concept of sunscreen, just
(25:54):
like wearing a helmet when youride a bike?
SPEAKER_01 (25:56):
Because it is like wearing a helmet when you ride a
bike.
And in my house, if you're notwearing a helmet, you're not
riding that bike.
And when you give kids wiggleroom, I think they, you know,
you know, capitalize on that.
You give them an inch, they takea mile.
I've got a three-year-old who'sreally committed to seeing how
far she can get away witheverything.
And I think they also, you haveto meet kids where they are.
You're not gonna buy them anuncomfortable helmet.
You're not gonna buy them ahelmet for like hockey when
(26:16):
they're doing bike riding.
I think giving them the righttools.
So we have a little applicatorwith a makeup brush that my kids
can do independently, that'simportant for one of my
daughters.
Uh, another daughter has badeczema and like thicker
sunscreens really flare her.
So we do use more sprays becausethat's what makes her skin more
comfortable and she's stillgetting the sun protection.
So who am I to complain?
And, you know, also having likea little, you know, hacks and
(26:39):
that and and recognize when theUV index is zero so that I'm not
always the hovery mom that'slike making them afraid of the
sun or being outdoors, because Ithink that's really good for
kids to grow up outside.
unknown (26:48):
Yeah.
SPEAKER_00 (26:49):
And you don't want your kids to be like, oh yeah,
my mom doesn't let us doanything because she's a
dermatologist and the sun isbad.
And, you know, yeah.
Especially because you have abusiness locally in town and you
are very well known locally intown.
So let's talk about being anentrepreneur and starting a
business.
What made you decide you wantedto do that?
SPEAKER_01 (27:09):
I decided that I wanted to be the master of my
own destiny.
And I think, you know, I keptthinking there are ways that I
was gonna do that, working forother people.
And at the end of the day, youknow, if you have the
opportunity to really takecontrol of your life and and
work for yourself, that that'sthe best opportunity to do that,
to really say how every day isgonna look, what the small and
(27:31):
medium and long-term, you know,uh horizons are gonna look like.
And especially when I feel likeas a physician, patients at the
end of the day look to me andthey say, Well, the buck stops
with you.
Like, you know, you're mydoctor, you take care of me.
When you're a cog in a wheel ofa big thing, that's not always
true, but you feel like itshould be.
So I, you know, now it reallystops with me.
SPEAKER_00 (27:50):
Which is amazing.
So I don't want to neglect thefact that you have two little
children and you also have ahusband who's a doctor.
Yes.
How in the world do you jugglethis?
Because you're not just likerunning a business, you're
running a family, you're runninga household, you've got little
people, and you have you.
How do you juggle it all?
Just as like a woman to woman.
(28:10):
How are you doing this?
SPEAKER_01 (28:12):
I think juggling is an interesting idea.
And somebody once told me that,you know, there are glass balls
and rubber balls that you'rejuggling, and it's okay if the
rubber ones hit.
And I think when you're reallybusy, you have to decide what
the glass balls are.
Time with your kids, you know,put downs, reading stories,
making sure, you know, myhusband and I have some grown-up
time, you know, being here formy patients on time, ready, like
(28:34):
thoughtful for that.
Those are glass balls.
Those are things that are notgonna ever be negotiable for me.
But things that are, you know,having the right backpack for my
kids or the latest and greatesttoy, you know, or having signed
them up for the rightextracurricular when those
signups go up so fast, that's arubber ball.
My kids are gonna learn maybe alittle bit of disappointment and
resilience and move on.
And everything can't be soprecious that I'm frozen by the
(28:59):
ability that some things aregonna get missed.
SPEAKER_00 (29:01):
You're not striving for perfection.
SPEAKER_01 (29:04):
No, perfection is the enemy of the good.
And I think being a mom, everyevery mother knows that.
And when you just keep adding onto that mother title, which as
we all know is like the mostimportant one, well, every time
we add on to that title, it'smore and more clear.
You have to be more and morestringent about what the glass
balls are gonna be in your life.
SPEAKER_00 (29:22):
Yeah.
So I have a business questionfor you.
When do you decide likeexpansion?
How do you decide that as anentrepreneur?
Like, I'm going to expand thebusiness, I'm going to hire
another doctor, I'm going tojust make the business bigger,
just as a business person.
How do you make that decision?
SPEAKER_01 (29:39):
It's a good question.
I I've been really lucky to openin New Canaan and be very busy.
I think we have a little bit ofan underserved medical market in
town.
People want to stay in town forthings that merits a mess.
106 has been under constructionfor years.
Like it's hard to leave town.
You have to leave 25 minutes togo basically anywhere.
So I feel like, you know, we'remeeting an unmet need.
(30:00):
And the other reality is that alot of dermatology has shifted
to cosmetics.
So even just within the county,by being a practice that focuses
exclusively on medicaldermatology, we just have more
ability to take care of thepoison ivy, the shingles, the
skin check than somebody whosetime is being pulled in many
directions.
And so I want to keep growingthis vision until we've met
(30:20):
everybody's needs and untilpeople can call and the wait
list is, you know, the wait listisn't three months.
And you know what I mean?
That I can only do that byrecruiting other people.
I've got the same, you know, 80hours in a week to try to get
stuff done at work thateverybody else does.
And, you know, I've got to startborrowing other people's hours
to kind of make this dream cometrue where busy medical practice
that you know you can get thecare you need.
SPEAKER_00 (30:42):
Like word of mouth for your practice is incredible,
and the number of people thatcomment on how great your
practice is.
Because I think your practicehas a vibe of small town doctor,
which is not a part, but yetyou're affiliated with a big
hospital.
Like so you've accessed all thebig things and you are not in
small town in terms of yourskill set and your knowledge and
(31:04):
what you're bringing to thetable.
But yet you walk into youroffice or you call on the phone,
you get to talk to a humanbeing.
And it feels like everybodyknows everybody and you run into
people that you know in town.
So I just have to say that'svery cool because that does not
happen in most practicesanymore, because most practices
are just such a part of a largerconglomerate.
So you have created an energy ofwellness in your practice.
(31:27):
And part of that wellness isjust knowing your patients and
knowing who they are.
SPEAKER_01 (31:31):
Yeah, I think it's a shame the way medicine has
evolved in the last 50 yearswith a number of middle managers
and administration folksoutnumbering doctors, you know,
10 to one.
I don't think that helps peoplefeel taken care of.
I don't think that helps peoplebe seen or be well or get the
kind of attention they need.
And, you know, the system whenit's big and clunky doesn't make
(31:53):
allowances for, oh, well, youknow, so-and-so is pregnant and
having a baby tomorrow.
Like, let's get them in.
Like, let's really help themout, or so-and-so's kids leaving
away for the semester, you know,abroad, and like this is their
last chance to get in.
Like, let's really do everythingwe can to like help them.
These might not be life or deafdeaf decisions every day.
This is dermatology.
I recognize that, but they arelike quality of life decisions.
(32:14):
They are impactful to how wecarry out our everyday, even
more so now that we're onscreens all the time and and and
how your skin looks is just castabout all over all over.
SPEAKER_00 (32:23):
Mm-hmm.
And especially for the youngergeneration.
I will say, you were soaccommodating to put my daughter
on the wait list, you know,instead of having to wait three
months to see her.
You managed to like squeeze herin one day and it was great.
It was so fantastic.
And uh, she is so indebted tothe help that you were giving to
her.
So thank you for that.
So I want to talk about onething that you talked about, and
(32:44):
I don't want to skim over thismedical dermatology versus, and
correct me getting the termwrong, medical dermatology
versus like, is it calledcosmetic dermatology?
SPEAKER_01 (32:54):
Yeah, or even aesthetics, because a lot of
it's being done bynon-dermatology folk.
SPEAKER_00 (32:59):
What is the difference?
Like, how does someone know?
SPEAKER_01 (33:02):
Totally.
I think everyone should bereally transparent in their
advertising.
And I think a lot of places arethat they're focused on skincare
and injectables and cosmetics.
And I try to make it very clearon my, you know, practice
website and all of my materialthat I am not.
I have never been a makeupperson or a skincare girl.
I don't have a complicated skinregimen myself.
I do do cosmetics and I try tobe very honest about that.
(33:24):
I was just seeing my good friendDr.
Butler this weekend, IPLing offsome of the sun damage from when
I was, you know, 19 in a tanningbed.
You know, I think that feelinggood and looking good to your
point is a part of being happyand successful and, you know,
living my best life.
But I do zero of that in myoffice.
I don't like it.
I don't enjoy attending themeetings on it.
(33:45):
I couldn't tell you what's thelatest and greatest in cosmetics
because I don't go to thosemeetings.
And they're separate meetings,and there's a whole scientific
community who's very interestedin answering those anti-aging
questions.
But I am here for you fordiagnosing all the melanomas and
treating complex hydranitis andscraping molluscum off kids and
doing the things we need to dothat make life better medically.
(34:09):
Okay.
SPEAKER_00 (34:10):
Which is important.
At what age should someone startto do sun screening of your
skin?
SPEAKER_01 (34:17):
The United States Protective Task Force, which is
the governing body that decidesbased on all the data and the
risks and the cost of cancerwhen screenings are appropriate,
that just lowered the guidelinesfrom 50 to 45 for colonospedes,
does not recommend skin cancerscreenings across the board.
Like they do not recommend themat all because cost-wise,
(34:38):
whether your basal cell is thisbig or the size of a half dollar
doesn't really matter anddoesn't change the cost that
much.
And very often basal cells andsquames, once they're big and
obvious and bleeding andeveryone would pick them up,
they can still be treated andmanaged.
And they're not routinelyrecommended and they're not
covered under preventativescreening, like reimbursement,
(35:00):
which is hard to explain topeople because I also think that
skin cancer screenings are agood idea, but I can't convince
the government of that.
Um so I generally tell people ifyou have a first degree relative
with melanoma, that meansparents, siblings, uh, or kids,
then you need a screening everyyear because melanoma is fairly
heritable.
If you have fair skin, a historyof blistering sunburns or
(35:22):
tanning beds, like you should bestart getting a skin check
probably by 30, 35.
And if you have any medicalconditions that predispose you,
which your specialist should betelling you about immune
suppressance, radiation,anything like that, CLL, all of
which decrease your body'sability to fight skin cancer.
Like side note, our body'sreally good at fighting skin
cancer.
And when we immune suppresspeople for any reason, their
(35:42):
skin cancers go crazy.
So those are the populationsthat really need it.
And then, you know, I can't saythat there's a universal age of
everybody needs to see me everyyear.
Okay, that was so not the answerI expected.
It's always data for me.
I want to say, like, I want tosee everybody always.
SPEAKER_00 (36:00):
But I know, but I love that.
But I'm actually shocked thatit's not considered part of a
regular protocol that thegovernment recommends, a regular
protocol, just like a physical.
Like I'm shocked at that.
That is that's why I expectedthat there was actually an age
answer to that question.
There is not.
Okay, well, I've been going.
(36:21):
I I'm now on every six-monthplan, folks.
So, you know.
Prevention is a good thing.
All right.
So, like I said, you are a superbusy mama.
Two little ones, you are runningyour own business, your husband
is a doctor.
How in the world do you maketime for you?
SPEAKER_01 (36:39):
I think that's an interesting question.
I think the moms who juggle anddo all the things that were
really good at getting every allthe glass balls not to drop, but
the one that you have to kind ofcreate out of thin air would be
like your own kind of likewellness.
And I think that's a lot harderto do.
I've done a really interestingjob meeting a lot of cool
entrepreneurs and women businessowners in town, you're starting
(37:00):
with yourself last summer when Iwas in the very early days of
opening my doors.
And, you know, I think it'sfascinating.
I love meeting these otherwomen.
I love meeting these othercolleagues who are doing similar
things, and we talk about it alot.
And I don't think there's aneasy answer.
And there are weeks wherethere's no self-care wellness
and it would be, you know,misleading or kind of paint a
(37:20):
rosy picture of what my life isto say that there is.
And then there's weeks where,you know, I take like a good
chunk of time, a whole Saturday,and I go to the library and I go
for a run, and my husband or mynanny, you know, like not for
nothing.
My husband works every otherweekend.
And and learning that I wasallowed to get care, child care
for myself without an explicitagenda was very eye-opening.
(37:44):
As a working mom, I felt like Ishould be working or with my
kids.
And since I work a lot, thatmeant there was really no time
for me in that schedule,especially because I became a
mom in the pandemic.
There was nowhere to go.
Um, but I think that, you know,creating space for myself and
not me feeling that childcare islike a luxury or something that
needs to be saved for if I'mworking has been really, really
(38:05):
helpful because sometimes youjust need six hours to not get
smeared like peanut butter on.
SPEAKER_00 (38:11):
And that is so perfect that you said that.
And I'm so glad you shared thatbecause it's about you making
yourself a priority.
And that is just as much of apriority as everything else.
And so often women feel guiltyabout doing that and about
taking that time where they'renot at work.
I'm feeling like, okay, if I'mnot at work, then I need to be a
(38:31):
mom and taking some of that momtime or some of that work time
and saying, no, I'm gonna carvea little piece out for myself,
and that does mean I need childcare because I'm gonna shave off
a little on either side.
But if you don't take care ofyou, and you know that's being
in the medical profession, ifyou don't take care of you, it
impacts everything in life.
You have to.
It's so important and mind,body, spirit, all of it.
(38:52):
Just making time you've madetime to come and meet me for
coffee.
That's hard to do as anentrepreneur.
SPEAKER_01 (38:57):
It's busy.
But I think as since I'm raisingtwo daughters, you have a
daughter.
I think the importance of doingit is I now see kind of mom
guilt in in raising them that myfocus on wellness will teach
them focus on wellness.
And if I don't do it, how willthey ever?
Yes.
SPEAKER_00 (39:12):
Yes.
All right.
So I have a couple morequestions, and then I'm taking
so much of your time.
I know you have to get back toyour patients.
So, first question is someonewho is watching this or
listening to this and they'venever been to a dermatologist
before and they're trying tofind one, but they don't live in
New Canaan, Connecticut, or inour surrounding areas.
How do you suggest they go aboutfinding appropriate good quality
(39:34):
care?
SPEAKER_01 (39:34):
There's two ways to do this.
One is to start with theAmerican Academy of Dermatology
website, find a derm.
You will find a board-certifieddermatologist and not somebody
kind of masquerading as somebodywho's interested in skincare and
you can work backwards that way.
The other is to start with yourinsurance and filter by
dermatology that way, becausethat'll be two words of one
stone.
You'll also find somebody who'sin network for you, and that's
(39:57):
really helpful as opposed togoing to Google where I feel
like there's a lot ofadvertising for kind of
skin-related things, and it canbe a little bit more confusing.
SPEAKER_00 (40:04):
Perfect advice.
And yes, it is covered byinsurance.
Like it doesn't necessarilycover all of it, depending on
your insurance, but a lot ofthose things can be covered by
insurance, which is reallyhelpful.
You're not always just anout-of-pocket, out-of-network
type of service.
So thank you for that as apatient.
Thank you.
Is there anything I didn't askyou that you think is really
important to communicate,whether it be about dermatology,
(40:26):
trends, yourself, your business,women, any subject?
Did I miss something?
SPEAKER_01 (40:31):
You didn't miss anything.
I just really like being intown.
I like connecting with you,connecting with other patients
and women in particular, andkind of sharing the experience,
sharing what I've learned, goingout on your own, doing your own
thing, you know, whether you'rein medicine or not.
I think some of the same themesuh are kind of shared.
(40:51):
And I want to give every womanwho's thinking about making that
life shift, career or otherwise,like a hug and like it's so
worth it.
And future you're gonna be sohappy you did it.
SPEAKER_00 (41:02):
Perfect.
And you're so correct.
And there's so many people.
And I think I found from meetingyou and other women, like you
said, you don't have to be adoctor.
You could be going out trying todo your own thing on so many
different levels and so manydifferent things.
And there's so many people thatare out there to support you and
to help you because some of thechallenges that we have as
entrepreneurs are similar nomatter what business you're in,
(41:25):
what field you're in, what townyou're living in.
It's a similar juggle with allof this.
So don't be afraid to reach outto people.
Yeah.
SPEAKER_01 (41:33):
I think when you go in with, I'm doing this too, can
you help me?
I've had so many more yeses thanno's.
Yes.
Yes, me too.
Asking for help.
SPEAKER_00 (41:41):
Yeah.
Which is hard sometimes, askingfor help.
Yeah.
SPEAKER_01 (41:44):
Oh, yeah.
So if you're not ready to askfor help, you're not ready to
take the leap.
You have to be ready to ask forhelp.
SPEAKER_00 (41:49):
You have to be ready to ask for help, right?
And you have to be ready.
I also found you really have tobe ready to let go of some
things.
And you don't have to controlevery single part of your
business or do every single partof your business.
You need to learn where yourspecialties lie and how do you
resource to provide things thatyou don't know.
You don't have to know how tobuild a website.
(42:11):
You don't have to know some ofthese things.
It's okay.
You have to outsource and findpeople that do to help build a
tribe to help you.
SPEAKER_01 (42:18):
Absolutely.
I think that will bury you inthe details if you think every
single piece of your business isthe thing you need to do.
But at the same time, listeningto my amazing friends and
colleagues who have done thingswho have a great website.
Like, hey, yours is great.
People love to tell you.
Like, I love my website too.
Thank you.
Let me give you my person.
SPEAKER_00 (42:36):
Exactly.
That is so true.
All right.
Before we go, I love to ask allof my guests to recommend a book
that has impacted thempersonally or professionally.
I'm a huge proponent of reading.
I know you read a ton.
You already announced you're anerd.
You read so much.
What book would you like torecommend that you think people
should check out?
SPEAKER_01 (42:55):
My book's a throwback.
Maybe a lot of people have readit already.
It is called Wild by CherylStrade.
She is a very powerful femaleauthor, and I think has had a
lot of life experience.
And the book details her comingof age and hiking the Pacific
Crest Trail on the West Coastwith really no preparation.
And I read it every year, prettymuch at least once.
(43:16):
I go back and read it, and Ifind different pieces of it at
different phases of my lifereally uh inspirational.
And so I find that it's apowerful read.
I'll I'll say that, but I areally good one.
SPEAKER_00 (43:26):
Ooh, I like that.
I've never read it.
So I'm gonna have to go getthat.
I'll lend you my copy.
It's always in my desk.
Oh, I love it.
That is so great.
Thank you.
And I have a book for you.
Have you read 10X is easier than2X?
SPEAKER_01 (43:38):
No.
SPEAKER_00 (43:39):
Gotta go read it.
It's a business book, but it's agood one.
It's a good one because I knowyou're really you're looking to
expand your business and reallydo a lot more and like really
make a difference in the world.
Yeah.
And that sometimes is hard to dowhen you have a list of things
you want to do that are reallylong.
And I found that helped me a lotas I was trying to like step
into bigger and better and more.
(44:00):
Really good one.
10X is easier than 2X.
Love that.
I love that.
So thank you so much, Al,personally, for being my doctor.
You are just so amazing.
And you're also just anincredible woman.
I am always so inspired by you.
I love following you onInstagram.
You give really practical, greatadvice about products and sun
and what to do and the spongething that you use for your kids
(44:20):
to put on sunscreen.
Like you put that in.
I was like, where was that 20years ago for me?
Like, where was that?
So I really encourage people tofollow you.
You're very real, which I thinkis really important in a in an
age where people are not soreal.
You show up as you are and youtry to help people with their
skin and with their challenges,but recognizing this is real
life and perfection is not it,folks.
(44:42):
Um so I thank you very much forcoming on the show and sharing
your brilliance.
And I hope you have a beautifulday.
SPEAKER_01 (44:47):
Thank you so much.
SPEAKER_00 (44:49):
Thank you for joining us for another episode
of the House of Germar podcast,where wellness starts within.
We appreciate you being a partof our community and hope you
felt inspired and motivated byour guest.
If you enjoyed this episode,please write us a review and
share it with friends.
Building our reach on YouTubeand Apple Podcasts will help us
(45:10):
get closer to our mission toempower one million women to
live all in.
You can also follow us onInstagram at House of Germar and
sign up to be a part of ourmonthly inspiration newsletter
through our website,HouseofGermar.com.
If you or someone you know wouldbe a good guest on the show,
please reach out to us at thepodcast at houseofgermart.com.
(45:34):
This has been House of GermarProduction with your host, Gene
Collins.
Thank you for joining our house.
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