F*ck, Let’s Rethink Skin Health! with Dr. Philip Tong

Episode Transcript
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Dominique Hind (00:00):
Hi, I'm Dom Hind and F*ck, I'm nearly 50.
Actually, I'm 47 and fourmonths, and I am starting to
count.
Let's be real. Ageing is a bitof a minefield. One minute, your
skin is holding it together, andthe next, you're wondering when
your jawline started migratingsouth, why your face looks

(00:20):
permanently tired, and if thatnew freckle is just a freckle or
something more sinister. And ofcourse, the beauty industry
loves this moment of panic. Theythrow every miracle cream serum
and skin tightening treatment atus like we're supposed to
believe. They'll actually dosomething, and I've seriously

(00:43):
tried so many of them and beendisappointed. We're bombarded
with ads promising to reverseageing, and yet no one really
tells us what's actuallyhappening to our skin or what it
really needs as we get older.
Because here's the thing, yourskin is not the enemy. It's the
largest, largest organ in yourbody. It regenerates itself, and

(01:05):
it's constantly working toprotect you, and yet we're
conditioned to think of it assomething we need to fix. But
what if we stopped obsessingover wrinkles and instead
focused on keeping our skinhealthy. What if we stopped
treating skin cancer as anafterthought and actually looked

(01:28):
at how to prevent it? That'sexactly what we're getting into
today, because skin care is onething, but skin health is the
real game changer. And my guesttoday, he's not just working in
dermatology, he's changing itand he's challenging it. So
let's get into it because fuck,I'm nearly 50, and isn't it

(01:50):
amazing? YouI Dr Philip Tong isn't just a
dermatologist. He's a force forchange in an industry that
desperately needs it. He's themastermind behind dermscreen, an

(02:11):
AI powered skin cancer detectionplatform, making checks faster,
more accessible and moreaccurate than ever. He's also
the founder of dermatologyjunction, a clinic that's
flipping the traditional modelof dermatology on its head. He's
all about early detection,smarter systems and putting

(02:32):
patients first. And for me, thisconversation is personal.
Growing up in Noosa, sunscreenwas optional, and a deep tan was
practically currency. Theresult, I've had melanoma grow
back eight times in my righteyebrow, it's been cut out six
times. I've gone through ourDara treatment twice, which, for

(02:55):
the record, is revolting, but itworks, and it kick starts your
immune system to attack abnormalcells. And let me tell you, it's
not gentle. And through everybiopsy, every Is this normal
text that I sent him, and everytreatment, Phil has been the

(03:17):
calm voice of reason in today'sepisode, we're cutting through
the noise. We talk about what'sactually happening to your skin
as you age, what's worth yourtime and money when it comes to
sagging skin, and how AI isshifting the game when it comes
to skin cancer detection. Wealso get into how hormones,

(03:37):
lifestyle habits like sugar andstress can impact the way your
skin looks and feels in your 40sand your 50s, plus the biggest
myths we need to let go of onceand for all. So let's get into
it. Phil, welcome to fuck. I'mnearly 50.

Dr Philip Tong (03:59):
Thank you. Dom

How would you how would you introduce yourself
in the least medical waypossible?

Isn't that the way and the only way that I
introduce myself these days?
Yes, so I would say I'm a verycurious person. I like finding
out about new things. Yes,venturing into spaces that make
me uncomfortable, and I wouldsay I'm the eternal optimist.
Yeah,

I would absolutely agree with that. I
really my

passions are the intersection between health,
which is, I'm a practisingdermatologist here in Sydney,
wellness. Part of what I do ismaking people well, and I
practice that both in mypersonal and professional life,
but technology as well. And Iguess that's why we're here
today, yes

and yes, I think it is why we're here today,
because you're doing someamazing things in technology,
but we will talk about thatlater. But for now, let's talk
about skin. Love it. Yeah. Yeah,what's really happening to our
skin in our 40s and 50s, and whydoes it feel like everything
suddenly shifts?

That's an excellent first question. And
you know, it all starts kind ofafter 30 so I know this podcast
is about kind of two decadeslater, but the changes in your
skin are quite noticeable evenafter the age of 30, whereby
you're losing about 1% ofcollagen every year from that

(05:33):
point on. But the changes aremore than that. You start losing
that elasticity in the skin. Youstart noticing pigmentation,
yeah, you start losing the fatand that change, those changes
in your face, is what we aseveryone will see as ageing. And
that's normal, yeah? And that'sthe real emphasis of this. As a

(05:55):
dermatologist, we want to tellpeople that these are normal
changes, yeah. We can helppeople achieve the skin that
they want in the, I guess,freshest possible, possible way.

And so with the collagen, because everyone's
talking about collagen, is thecollagen that you can drink,
which I drink every morning,noon and lunch and afternoon? Is
that actually helping withbuilding those collagen
supplies? Or

that's a really interesting question, and, and
it's a very controversialquestion. Actually, I think
there has been research done insmaller mammals, yes, say yes,
and there is certain evidencethat would suggest that the
collagen that you're talkingabout, it's called hydrolyzed

(06:41):
collagen, and it's often fromprotein like Marine, yes, or
bovine, they somehow make itsway into the skin in those
laboratory settings, right?
Okay. Now, whether thattranslates to human settings,
yeah, remains to be seen, okay,and unfortunately, I haven't
seen that evidence yet. Okay,right, all right, you'll keep

(07:02):
hoping, though.

Yeah. Do you know what? I always say that I
love to buy hope, and I do loveto buy hope because it's like,
Yes, I hope it works. And whenpeople say, does it actually
work? I'm like, Well, I don'tknow, because I'm not going to
stop it because it makes me feelbetter. But

there's nothing wrong with hope. Yeah, true.
There is nothing.

There's nothing wrong with hope. No. Well, as
the eternal optimist, there'sdefinitely nothing wrong with
hope. This the saggy skin, whatactually works and what is a
waste of money.

Let's start with what's a waste of money. Yeah,
those topical skin firmingcreams, okay? With a lot of
claims, yes, beautifulpackaging, yes, probably save
you money there, right? I thinkwe've touched on collagen
supplements, yeah, but there area number of strategies that one
can prove either both, generallyin the clinic, yes, to improve

(08:04):
sagging skin, obviously,hyaluronic acid fillers, yes,
are available globally. And thereason why they work is because
we lose the, if you like, thecement in between the bricks and
mortar. Yeah, we lose thatextracellular matrix and the
hyaluronic acid that's inbetween them keeping the skin

(08:27):
looking plump. So there is nodoubt that fillers do help and
actually draw in water into theskin, but each has their own
issues as well. Other ways ofimproving sagging skin include a
technique called needle radiofrequency, whereby we deliver
energy underneath the skinthrough these tiny needles.

(08:49):
Again, that's very useful.
Another way of delivering thatenergy is a technique called
high intensity focus ultrasound.
Yes, that's or HIFU, also knownas hip you're very well versed
DOM. Only because I've done itso that those technologies do
have evidence and are generallydone in medical grade practices.

Yes, okay, so not the ones on the side of the
road

only because these technologies have risks
and it needs to be delivered byprofessionals who know what
they're doing, and also to getthe results that

you want. Yeah, true. And to know how you how
far you can actually push it.
That's right, because, you know,some people get scared, and for
me, I'm like, if I'm paying forit, I want the best results
possible.

Yeah, it's be able to know what is the
capabilities of the equipment,the machine, and also balance
that with the patient's skintype, yeah, and and the outcome
that they want to achieve. Can

I just ask you talked about hydrolonic acid? I
can never say that word. Ialways get it mixed up. But
topical hydrologic acids, whatdo you think of that

probably just sits on the top of the

skin? Oh. Oh, well, I think it's been amazing
for me. But again, I'm buyinghope. It may not

be what you think is happening, but it
probably gives you theimpression that the skin is
brighter, okay, yeah, and that'swhat you see is working. So
there are a lot of things thatyou can do topically, yes, that
can help make the skin lookbrighter and that gives you the
appearance of, you know,youthful skin.

Okay, I actually like that, like the there's the
topical. So is that like thesuperficial, immediate, but it's
not the longer term. That's

right, so that, but in this is what we do for
all our patients. Yes, there arethings that you can do
topically, at home, treatments,the the the things that you can
do in between, this is what Iwould call your homework. Yeah,
and then there's the in clinictreatments as well, which you
can do, which we help you with.

Okay, so the two have to work in, I think so,
yeah, okay, good. And what do,like, what's the bare minimum
skin routine that you think weshould be doing from well, you
say 30 is when it starts to gosouth, yeah, fall apart. But
what about when you're like mid40s or getting towards your 50s?

(11:13):
What do you think the skinroutine should be? There's

still hope.
Yeah, good,

great. Thanks.

I would like to start with the three pillars,
cleanser, yeah, a moisturiserand a sunscreen, okay, and if
you could add a fourth by May,topical tretinoin, if you could
do those four, hang on. What'sthe last one? Tretinoin? Okay,
it's a prescription gradeversion of retinol. Okay,

right, okay, okay. And why? Why all those
four

so a cleanser will help remove dead skin from
the face, yeah, and if you canincorporate a cleanser that has
some anti ageing ingredients,okay, right, like glycolic acid,
that will help to remove thedead skin from your face that
comes through just wear andtear, pollution and so forth.
And then a good moisturiserwould help, just to fill in

(12:07):
those cracks and just rehydrateyour skin again, from what we
subject our skin to, yeah,pollution, sweat, makeup, etc,
beach, swimming, all of thatsalt and then obviously, a good
sunscreen makes a hugedifference. Broad spectrum,
factor 50, protecting againstUVA and UVB rays. Again, the

(12:32):
reason why we that's soimportant is because the sun has
incredible effects on breakingdown collagen, elastin, yeah,
for skin, and that's some of thetelltale signs of ageing, right?
See, it's so hard because,

I mean growing off indies, I love, love, love,
love the sun, yeah, which is whymelanoma eight times. But it's
so hard to can you still go outin the sun with the sunscreen on
and or you were just saying,hard, no,

you know, I have this conversation with my
patients all the time, and welive in a beautiful country,
which is Australia, and there'sno reason why we should not
enjoy that outdoor lifestylethat we're blessed to have. I
just think we can just do itsafely, okay, not in the middle
of the day. Well, a broad brimhat, sunnies, sunglasses,

(13:24):
sunscreen, and reapplying thatsunscreen every four hours,
covering it where you can longsleeves and yes, try not to go
out in the middle of the daywould be ideal. Try to seek some
shade. And I think that's thebest you can do.

Yeah, okay, all right. And so what was the
fourth one, the topical

tretinoin, okay,

right? I'm not doing that.

Or maybe you are okay. I'm not sure.

We'll talk about that later. Talk about that
later. What's your go totreatment for looking fresher,
not frozen? Oh,

very good.
Tretinoin will be part of that,because that really helps cell
turnover. So what that means isthat your skin, the dead skin
cells, are removed, pigmentationis reduced. So that's a really
good foundation for that.
There's nothing wrong with alittle bit of toxin. Yep,

(14:21):
particularly, well, hang

on and you're talking about like, Botox
rather, yeah, that's right inlike,

Unknown (14:28):
can you

come on, yes, that is what I'm talking Okay,
right, right. Okay,

well, placed in the right areas, done
judiciously, carefully and withconsideration. Yes, can do
wonders just to make you feellike bit fresher, fresh. Yeah, I
had a, I had a presenter come tome yesterday, two weeks after
her first treatment. Oh, and shewas, you know, towards, you

(14:58):
know, I. You know, around 50,around your age, is what you
were trying to say, But, but?
And she said, because all herfriends were doing it, and she
wanted to see what it would dofor her, yeah, and she was
amazed what to be achieved. Butshe just felt that confidence
that she gave and the and then,as a result of that, she was

(15:20):
actually getting inquiries aboutadditional jobs. And, oh,
really, she was getting

Yeah, and confident, yeah, it's a little
confidence. Yeah. The thing thatreally annoys me, what is the
age that someone should bestarting or, I mean, I know it's
a personal thing, but like whenyou're sitting there and you
hear an 18 to 21 year oldtalking about their injections,

(15:46):
because it's all preventative,yeah, is that something that
should be considered, or isthat, I

think that's very controversial.
Prejuvenation is a term that'sbeing used preventative
rejuvenation. And I think whenthere's no obvious lines that
are static, so lines that arepresent at rest. So you're

talking about wrinkles correct, like any
normal person's language,

I should be like wrinkles at rest. Yeah,

right? Wrinkles at rest. Great.

That's probably the time that you should
consider it. So I would say, Idon't offer those types of
treatments to 18 year olds. Iwould only offer it to those
that I can actually see visiblesigns of

wrinkles at rest. Wrinkles at rest. Okay,
great. That's right. It is like,yeah, it is very interesting.
What are the other go totreatments?

It there aren't this. Gets this question gets
asked by dermatologists all thetime. There's not much you have
to do to your skin to make itlook healthy. Yeah,
moisturising. Vitamin A, whichis tretinoin that I mentioned
before, a good sunscreen. Okay,all right. Is a good is a good
foundation.

So many of us don't realise that our skin is
being impacted by perimenopause.
What is going on under thesurface then?

So they say that when you go through
perimenopause, oestrogen has ahuge impact on collagen content,
so they say with there arestatistics that inform us that
once you hit perimenopause, orhave gone through menopause,

(17:39):
collagen drops by up to 30,yeah, right. And that's where
that sudden cliff, if you like,yeah, changes. And
unfortunately, there's a veryminimal ways that you can help
with that. There are, of course,hormone replacement therapies,
HRT, that you could do to helpwith that. But you know, if
you're losing collagen thatrapidly, there are very few

(18:01):
things that can replenish that,but there are, of course,
treatments that you can do thatare available, yeah, in clinic
to help with that.

Yeah. And do you think so? Because I do know a
few of them, like sculpture, orwhat they're talking about now
is Roger and on the salmon spermone correct. Do you think in the
lead up to going throughperimenopause or menopause, it's
better to try and stock, bankthose collagen stores so that
when it does fall down, there ismore that is there, and

to add to that profile? Oh, yeah, sorry,
profile, yeah, that is all. Buteverything that you've listed
is, is our treatments for that,we don't have the evidence as
yet to say whether stop bankingprior to menopause could
actually have a preventativeeffect right post menopause.

(18:55):
It'd be very interesting in,say, 10 years time. Yeah, to see
what to see those that have beenusing these types of treatments
in their 30s and 40s. Whatthey're compared to those who
have only started after theafter turning 50, whether or not
that early intervention makes adifference. Now, that being
said, this has been done in with

hasn't been done in Korea for such a long time.
It's it has

been done in Korea. But that being said, I
haven't seen any studiesactually compare that to those
that have started it later.
Okay, so it's that, it's thatproviding that control trial
that hasn't been done. But youknow, all I could say is that
there has been studies done ontreatments such as topical
tretinoin. Those who havestarted earlier in their life.

(19:39):
Do look better than those whohave started later? Yeah, those
who have used botulinum toxin,Botox as a brand earlier in
their life, they find that theamount that they need to use
later on, right? Yeah. Okay.

(20:00):
Yeah. So there are those typesof studies that have shown that.

Okay, so what you're saying is start now to
start preventing, you know thethe impacts of ageing,
potentially, yes, yeah, like,depending on what, what works
for you. That's right, yeah. Andhow, what? What can we do now to
start supporting our skinthrough those hormone changes?

I think we have mentioned some treatments
already, but they can be veryexpensive. Yeah, that's the
thing. It's not necessarilyaccessible to everyone and but
by all means, if you can explorethose treatments. I think they
are worth exploring. But movingbeyond that, I think looking at

(20:52):
needle radio frequency

or RF, needling, RF, needle in normal, yes,

RF, needling, or needle RF, which is what the how
they call it on the street, asthey say, and hi, food, yeah,
those are treatments that maynot be as expensive. They still
are treatments, yeah, that mightbe able to provide longer
lasting effects. Okay? Becausewhat they're doing is actually,
again, stimulating the body'sown response to produce elastin

(21:21):
and collagen. Okay, great,

all right. Okay, so we've talked about skin.

Oh yes, the last probably thing that one can do,
if I mean, and people might beagainst this, but you know, if
you want potentially bang forbuck, yeah, a facelift,
obviouslyyou can't go but, well,

you've seen Kris Jenner lately. Oh my gosh, her
70 year old.

She all that's wrong, but I think she's had a
combination of things. Oh, okay,what do you think she's had
done? I think she's had bothinjectable treatments as well as
surgical treatments. Yeah, okay.
And I think that it's that, andI think it was done very well,
yeah, to be honest, yeah. Ithink that ability to know what
can be achieved with nonsurgical and surgical strategies

(22:09):
is why you go to someone that isa true professional,

yeah? And I think that it is, yeah, the
right thing. And the other thingis, it's your face, it's your
skin. It's like, you do want tomake sure that you are going to
someone

trusted. Well, I mean, I think Christiana can
afford that.

I think someone was telling me the other day
that her, after that facelift,there's now a three year wait
list surgeon. I was like, what?
Anyway, they still put theirname down. It is that's a US. So
you've been part of my melanomastory for years. What do most
people not understand about skincancer?

That even though you've done the damage, say, in
Noosa, you've done the damage inyour 20s, 30s and 40s,
protecting your skin now, fromthis point forward, can still
have a measurable impact onpreventing skin cancers later on
in life, and they've proven thisin the lab, right? Yes. So there

(23:18):
was a University of Queenslandstudy that actually says, Yes,
we do suffer damaging DNA fromdamaging the DNA from the UV
rays early on in life. We knowall that, right, but protecting
your skin now can still preventthose effects of DNA damage on

(23:39):
cells that then transform intoskin cancer. Oh, wow. So a lot
of people say, Oh, I've done allthe damage. I can't do anything
about it. Yeah, okay, it's notcorrect, right? So it's still
worthwhile, okay, right,protecting your skin and not
giving up hope,

okay, good, like that, hope. Besides SPF, what
can actually help protect ourskin from long term damage. So

again, drawing from what's been published in
the literature. Yeah, there hasbeen early evidence of the use
of a vitamin B supplementnicotinamide. Yes, that has been
shown to the reduce pre cancersand some skin cancers, right? So
that's available as a supplementin pharmacies, and you just

(24:27):
follow the instructions to takeit. And for some dermatologists,
they swear by it. I think a lotof us dermatologists do
recommend it to their patients.
Okay, I do know it's popularamong some people who have spent
a lot of time outdoors, and somepatients swear by it, okay, but
it's, it's very safe,

yeah, okay. And I'm sure what you don't use, or
what your body doesn't use, itjust excretes anyway, correct?

And the idea is that it quenches all those free
radicals that gets generatedfrom the from UV damage. Damage
and DNA damage, right? And whatwas it called, again,
nicotinamide,

vitamin B.
Nicotinamide. Okay, great forpeople with a history like mine.
What extra steps should we betaking? I think just from what
you said, is making sure thatthe damage can be stopped,
that's a big one that I've takenout, I

think threefold, one, have daily habits and
routines to help prevent futureoccurrence of skin cancer, and
that includes takingsupplements, wearing sunscreen,
checking yourself, yes, soeither in the mirror or with the
aid of you know, if you've gotsome photographs in the past, I
know you keep a really excellentdiary to have a healthy

(25:46):
relationship with your GP and ordermatologist, and I think
that's where having thatrelationship is very good,
because that way you can ifyou're worried about something,
you don't feel embarrassed to goto No just to Speak up. Because
I think the worst thing that canhappen is that, you know, I
think most people actually knowthat that part of their body

(26:08):
doesn't look quite right, butthey don't want to say anything,
or they feel embarrassed thatthey might be wrong or that it's
just nothing. But I think havingthat relationship with your
doctor can actually make a hugeimpact regarding early

detection. I think that is, it is so
important. I mean, you know thatI love Dr Susie, because she's
just the best and will make surethat you are looked after 100%
of the time. But it is a gamechanger, having a doctor that
you can actually talk to andsay, Hey, what about this? Yeah,
and not feeling because, youknow, in the past, I've had

(26:44):
doctors that are so like,bedside manner is they're just
not warm. They don't want arelationship with you. They're
just wanting to get through tothe next patient. But when
someone actually cares aboutyou, it makes such a difference.

That's right, it's a real partnership, I
think, yeah, between the healthprofessional and the patient,
yeah,

and, I mean, I've learned because I've got
amazing people around me, likeyou and Pascal and Susie, but
you do have to have thatrelationship, and you have to
own it as well. Like, if youpersonally do not own your
health, yes, the doctors aren'tgoing to Yes, like they care,
but it's on you to own it Yes.
And

the third tip that I would give would be have
some kind of record, and itcould be a record on your phone.
You could have something a bitmore structured and
standardised, like what we dohere at home screen. It doesn't
really matter, as long as youhave some kind of record keeping
to allow you to track your skinover time. I think then it
empowers the patient outside ofthe consultation, because at the

(27:50):
end of the day, I'm only seeingthe patient at one time point,
and that's I can't follow you atthe time, so I kind of need the
patient to be part of thischecking process. Yeah.

But you know what I love about dermscreen,
and I always say this, like,with everything, is it to
baseline? Like, it is yourbaseline check in, and you only
have to do it once. I mean, youupdate it, but like, once as
your baseline. And I know I'vesent you so many spot checks,
going, oh my gosh, I've got thisis this? And you go, no, no, it

(28:24):
was on the original photos. It'sfine. It doesn't look like it's
changed. But if I didn't havethat baseline, I'd be freaking
out all the time. And I think,yeah, that record keeping, but
having photos that you can referback to, yeah, like that is a
game changer.

They say, with more data points, you can make
better decisions, right? Yeah,and that's just more data points
that

was such a sign that was such a medical thing to
say, oh, sorry,

I've been labelled this. I've been
labelled again.

Why is early detection so crucial? I

think when it comes to certain types of skin
cancers, like melanoma, earlydetection makes a huge
difference. But also, you know,using tools like what we do here
at dermscreen means that we canalso reassure patients, yes, and
because the last thing I wanthappen is a young person because

(29:20):
they are anxious about theirskin, or are anxious about their
moles, they ended up having itcut out and resulting in scars.
Yeah, and I have seen thesepatients, and not that, you
know, getting it cut out wasnecessarily the wrong thing, but
if we had a second set of eyes,yeah, or an opportunity to

(29:40):
follow that up, could we havesaved that person an additional
scar? And I think these, youknow, over your lifetime, these
scars

accumulate, yeah, but they also grow as you
grow. They grow as well, sure.

And I think you need someone who is can actually
take that entire journey of yourskin, so to speak, into content.
Text and say, Hey, yes, by allmeans. And this is the same
mole, but you've kind of growntaller, more sideways, yeah.
What are you saying? Not sayinganything. And, and it's just the

(30:15):
same mole, yeah, right. And likeI said that to a lot of my
younger patients, they comingme, coming to see me. So as you
grow taller, this mole willstretch. Yeah, normal, don't be
alarmed,

yeah. And I think that you do need that
steadying voice. And I knowbecause when I I mean the first
three times it was cut out of myeyebrow, it literally looked
like I was in a bar fight,because I didn't go to a plastic
surgeon. I just went in clinicto a dodgy doctor that I
shouldn't have, and the gap wasmassive. But you know, over
time, you get to know thedoctors and the people on your

(30:49):
team, and they help recreate or,I guess, correct it. I

do feel for patients, because it's it's here
in Australia, the there aredifferent people that checks
your skin, and everyone hasdifferent levels of
qualification. And as aconsumer, it's hard to actually
see who, who, where along thequalification line those people

(31:15):
sit at the end of the day, aslong as you have a good
relationship with that doctor,GP, dermatologist, plastic
surgeon, that's all that

matters. Yeah, okay. All comes back to the
relationship and owning yourowning your own. Think

so. I think there's an element of empowering
the patient to be comfortable,to come to you when they feel
that they're worried aboutsomething, but at the same time
reassure them to say actually,and be confident enough to
reassure them to say, actually,we can watch that. Yeah, I'm not
worried. Yeah.

And I think that's what you do really well,
is that I normally come infreaking out, and you go, no,
no, let's look at the photos. Orno, we can just watch it. I'm
not worried about it. Just putyour mind at rest. But your

journey, you're not alone in this journey. No, a
lot of people being diagnosedwith melanoma do have that
health anxiety. They're checkingtheir skin all the time because
they don't want to get anothermelanoma that yeah, and they
don't want to be anotherstatistic. And I don't blame
them, but at the same time, it'sit's important I don't feed into
that health anxiety. Yeah, yeah.
And be that voice of reason tosay, hey, let's just watch this.

(32:23):
I'm not concerned right now, butwe're not going to let it go.
No, keep an eye on it

well. And I think it's hilarious. Justin
said that he came to see you theother day, and I'd given him 20
things

reality here,

he was just like, oh, Dom, she's just to her
anxiety levels about everything.
Just let it go. But I think youdo, you get cautious and you
just want to make sure that it'schecked.

But I don't expect consumers or patients to
diagnose their skin problems,and it's so it's completely
acceptable to flag something,but then we need a process to be
able to ensure that thosepatients who are concerned,
their concerns are addressed.
Yes, timely manner, yeah, I

think that the timely manner is a big thing. So
we talked about dermscreenbefore, and so what it is, it's
total body photography in like,my language, not yours. Sure,
what is it and what are thephotos that you do need to get

(33:31):
done?

So dome screen is actually entire platform, as
you said in the introduction,it's, it's incorporating
photographic technology whichhas been around before, yeah,
but a process with which we'reable to efficiently but
comprehensively flag lesions ofconcern by taking individual

(33:53):
spot photos, but also do a wholescan of your body in a very
standardised way. By doing so wehave, as you say, your first
baseline, yeah, and then we usethat baseline scan for future
skin checks for my higher riskpatients. I see them in between,
but I effectively use dermscreenas a triaging surface. Yes,

(34:16):
something that I think could bedone more efficiently here in
Australia, because when wereceive a referral to have a
skin check, there's no photos.
There's no estimate of how longit's been there or how severe it
looks. But by actually havingand reviewing these photos with
the person that's been there,and this doesn't have to happen
at the same time as well, andthat's where the we can improve

(34:39):
access that's when we canactually prioritise patients
that should not be sitting on await list, yeah, and bring them
forward and have that reviewedin person, and if necessary, do
a biopsy than them sitting onthat wait list. And for some
dermatology waiting list, that'scould be months. Yeah, I know
right in. Imagine havingsomething on your skin that

(35:00):
maybe you may or may not beaware of, something on your
back, on the back of your leg,or maybe you are aware of, but
you just this, just can't getin. Imagine waiting all those
months, having to then realise,oh, I should have done a biopsy,
but if you could compress thatto a matter of weeks, wouldn't
that be better for everyoneinvolved, yeah,

yeah. And I think the thing that with when I
first did the full bodyphotography, it's always a bit
like, Oh, this is a bit weird,but at least you go, I've got
it. I know, I know it's there.
I've got my five or six shots ofevery part of my body, and it's
just, yeah, just that safetynet, I think,

because, I think as we get into the whole concept
of, you know, whole body healthassessment, so, yeah, that's an
emerging part of health thatwe're seeing, and as that
becomes much more standardisedacross Australia, as well as
globally, the concept ofactually stripping down to your

(36:04):
underwear and having this scanperformed may not seem as
confronting as it sounds, yeah,

and I think it is. It's, you know, the initial
first one, and then you're like,Oh, whatever. If it's going to
help me, I'll just get it done.
And how are you using So we'vetalked a lot about AI and how,
because you've got a lot ofdifferent photos of melanomas,
moles, lesions, as you like tocall them, how are you using AI
to help with the detection? So

that's a really interesting point. A lot of the
AI tools are not available for,I would say, clinical use, yes.
So a lot of the AI tools we usefor more as a check, but at the
end of the day, a dermatologistis reviewing every scan, every
Yes, where AI comes in isactually improving the workflow

(36:59):
efficiencies with the reportturnaround and helping the
reports look very structured andbeautiful, but ultimately, what
will happen is, and we're seeingthis with some of the bigger AI
companies out there, thatthey're actually able to digest
an image like a radiology filmand actually produce a report

(37:23):
faster than the reporting human,yeah, and I don't think skin is
that far away, so we're actuallypoised to capitalise on that
advancement when it is ready,yeah, for clinical use. And when
do you think it is going to beready? I think within the next
five to 10 years, right? Wow,

yeah. So that'll even made speed to getting
assessed is a lot quicker.
Absolutely

we can, we can get through more patients. And
there it's actively beinginvestigated by the government,
right? Yeah. The government hasinvested just under $10 million
to set up these scanningfacilities all around Australia
to assess the ability oftechnology to actually address
the burden of undetected skincancer that's just in the

(38:09):
community, just because theworkforce to address that is
just at it seems what

and I mean that will also help with the size of
Australia as well. Because,obviously, getting into regional
Australia is, you know, thehigher risk of skin cancer
because they're not detected orgetting to a dermatologist or a
GP,

that's right. So dermscreen is actually has a
separate platform that is moreto assist doctors, yeah, in
regional areas, whereby, say,getting to a dermatologist could
be hundreds of kilometres away.
So I support GPS, say as farwest as Broken Hill, as far
south as Ulladulla, as far northas Port Macquarie, actually even

(38:53):
Toowoomba in Queensland, wherebythey can send a photo on a short
statement summary, and Iactually can reply back to them,
okay, and allow them to actuallytake care of the patient within
the home, within their location,yeah, which is good thing. Would
I think it's a good thing. Itmeans you get eyeballs on skin
and an opinion, and then thehealth practitioner, GP, feels

(39:16):
backed up. Yeah, yeah. Theydon't have to make that decision
themselves. And it just meansthat if, if we can actually get
a mole or a lesion assessedsooner by simply using special
tools to take a photograph,getting it sent to me, and I
could provide an opinion, thatjust means that, again, time to
treatment is shortened.

So with all of this, and I mean, we've spoken
about it, what about self guidedchecks at home? Like, How often
should we actually be lookingand checking our skin? I think

it depends on whether your your own risk
factors as well, but I do say asa minimum, maybe quarterly.
Yeah. Yep. And if you could doit kind of just after a shower,
in front of a mirror orsomething like that. And there
are guides to examine. If youhave two mirrors, it's even

(40:10):
better, right? You can then seeyour back, and we don't have to
do it on this podcast, but thereare plenty of you know
techniques to help you examineyour skin, yeah, okay, after
that, so, but of course, ifyou've had melanoma, for
example, yeah, important tocheck the scars. Yes. It's also

(40:31):
very important to feel yourlymph nodes right so you know,
the neck, yeah, under the itdepends on how aggressive the
melanoma was, yeah, but forthose patients that have a more
aggressive form of melanoma,it's also important to
incorporate that as part of yourself checks.

I think even the last time that it came back, it
was in the scar, like for me, itwas in the scar. And I actually
had one of those magnifyingmirrors, and I was like, what is
that? Oh, there's some pigmentthere. And that's when, yeah, I
saw that it came back. So it is,yeah, the scars are really
important to check.

Yeah, absolutely. So it's really
important that we know thepatient's history and check
their scars accordingly.

Okay, is there anything else we need to know
about skin or checking our skinbefore we move on to the great
stuff, like sugar?

I think we've covered it. Okay, good, pretty
well. I

think the key things are good relationship
with your GP and dermatologist.
You own your health. That'sright. It's not on the doctor to
own it, because they've got somany patients that they are
saying that if it's not youlike, you've got to be doing it
start now. So make sure that theskim routine is starting now,
and it can be customiseddepending on where you are and

(41:48):
irrespective of the damage thatyou have done to your skin in
the sun, you can still make adifference. Spot on. Yes, eight
plus. Okay, now let's talk aboutthe fun stuff, like just the
sugar that we were eating, orsugar, alcohol, sleep, stress,
yeah. How much do they actuallyimpact our skin? You know

how I was talking about those free
radicals before? Yes, okay,they're producing free radicals
in the skin and are ageing you,right? Yeah, so if you can limit
those types of stress on theskin, yep, seems unachievable,
but it is achievable.

Just in May, it's unachievable. Maybe in
June, it won't be

I think it could go a long way. But, I mean,
these are vices that one canhave, yeah, now and then, but
there are certainly much worsevices that you can do on your
skin, yeah, yeah, yeah, okay,like baking in the sun. Like
smoking. Oh, okay, right, yeah,okay. Like smoking, really,
ages, you.

Okay, all right, good. Thank goodness I don't
smoke. What's one smalllifestyle shift that makes a big
difference to skin health?

Drinking plenty of water.

What if you think water's boring?

Add a squeeze of lemon. Okay,

it's such a boring drink. And I know I need
to drink more, but it's soboring. Anyway, it might

stem off the sugar, and should we both
partake?

Yep, I'm gonna have a sip of water now. And I
know, I know I do need to take abottle with me wherever I go. So
I think I'm gonna, that's gonnabe one of my try this before 50
challenges is for two months,take a bottle wherever I go.
Great. Is there such a thing asglow from the inside out, or is

(43:47):
that just wellness marketing? I

think when you look after yourself, both from a
physical standpoint, you'reworking out, you're eating well,
you spend the time to take careof your skin, take care of your
hair, take care of your nails,yeah, you have that confidence.
And that is the glow that Ithink people, yeah,

okay, I think that's a great spin on it, the
confidence and it is, it istaking the time to invest in
you. That's right, like even nowI think about the exercise that
I'm doing, and I used to run alot of marathons, but now I'm
like, my 80 year old body willhate me if I'm still running. My
knees won't work, my jointswon't work, but it is taking

(44:33):
that interest in you. I

was listening. I was watching an old video Warren
Buffet, teaching some highschool kids about life lessons,
yeah, and he describes the humanbody as an automobile. You only
have one car, right? And youneed to make sure that you look
after that car the best that youcan, because you've only got one

(44:57):
and that changes your mentalityabout. Or body. I think, yeah,
because with you, without thatcar, you can't go to places you
can't so the more that you canactually think about looking
after your yourself, bothphysically, mentally,
emotionally, the further you cango, yeah, in that car. And I

(45:17):
thought that was reallypowerful. Yeah, it is. It's a
really important message foryoung people, I

think, yeah, I do, yeah. I think that, yeah,
yeah, I Yes. That's a greatthing. What's the most over
hyped trend you're seeing now,

the ice water facial Oh, really, have you seen
that? Yes,

I may have the cryo car. What is it? The cryos?
I don't know. It just makes youfeel like, okay, like you've

woken up. Yeah, that I've woken

up, which I need to do. It's great after. It's
great for soothing the skin,yes, if you've had a treatment
that hurts,

true, that is true. Yeah, the equivalent of
that is putting a spray bottlein the fridge and then spritzing
your face. Yeah,

all right, okay, so the ice water hilarious? Oh,
okay, good. And why do you findit hilarious? Oh,

because people are doing it all over the
internet. Yeah, no. And youknow, putting a bucket in it ice
takes time to make you have todunk your face in it. Water gets
everywhere. It's messy. Is

it messy? No, I've got the sticks the Kairos.
What are the other chiros? Okay,you've elevated it. I've
elevated it. So I just get thesticks out, put them on my eyes.
But I do only do it after atreatment, okay? Otherwise, I
forget. It's one of those thingsthat I'm not really good at. Um,
what's something people think ishelping their skin, but is

(46:42):
actually doing more harm thangood? I

would say exfoliating. Oh so. I mean,
before, a lot of skin cleansershave these kind of beads in them
designed to kind of take offthat top dead layer of skin. I
think that could be drying yourskin unnecessarily, right? So

(47:07):
there are good cleansersnowadays that can do that
chemically with glycolic acidsand so forth. So I don't think
it's good to over scrub, okay?
And that being said, in additionto that, if I have a may have a
second one the use of toners aswell. Oh, really, yeah. So
toners have a property that kindof helps to have that squeaky

(47:28):
clean feeling, particularly ifyou're wearing makeup. But
modern cleansers these dayshave, in my opinion, replaced
the need for toning, right?

Yeah. Okay, and it's one less step, I agree. How
good. Sam, what's one thing mostpeople over 45 wish they'd
started doing earlier. I knowyou wearing sunscreen?

No, I probably would say the use of tretinoin
or a vitamin A, topical vitaminA, okay, I think if you can
start that in your 30s, it's agood you will do
a lot of good later on. Whydidn't I start that? Funny? You
didn't meet me. But

what's the one skin care myth that drives you
mad

is that patients say, Oh, I'm indoors all the
time, so I don't need wearsunscreen. And you'll be
surprised how important it is tomake that as part of your
routine, because even if you'reindoors, you might be driving to
work the front wind windshieldis not tinted, yes, right?
You're sitting in an office.
Maybe there's a window. You'regetting UV coming through that

(48:37):
window, and don't forget theeffects of television screens,
computer screens, blue light,all has an effect on your skin.
So I believe wearing sunscreenas part of your daily routine
has a lot of anti ageingbenefits, okay, in addition to
obviously preventing skincancer.

So make sure you wear sunscreen inside, yeah,

even it may just make it part of your routine,
okay, all right. If it means youcleanse, moisturise, you put
your sunscreen layer, then yourmakeup, yeah, that is your
routine, and you don't deviatefrom that, even if you plan to
be inside the whole day, even ifit's a rainy day,

yeah, okay, I was gonna say, what about if it
is a rainy day, still justscreen. Okay, so it's just part
of everything you do is put thesunscreen on. Yeah, okay, if you
could write a midlife skinmanifesto, right? What would be
the top three things on it?

I know it sounds really boring, but I'm sure all
dermatologists would agreewearing sunscreen, topical
tretinoin, and getting theoccasional skin treatment. I
don't care what it is, as longas you're starting, whether it
starts from chemical peels,needle RF or some kind of
treatments, whether it'sinjectables, biostimulators and

(49:56):
so forth.

Hang on, what's a biostimulator? Like there's
there's collagen. Reducingcolleges producing ones,

they will at least help set you up for
success later on. Okay,

all right, good, okay. Phil, yeah, this has been
a great conversation to have. Ilove talking about skin. I can
always talk about skin and skintreatments, yes, before we wrap
up, if I could try just onething before I hit 50, something

(50:28):
that shifts my perspective,pushes me out of my comfort zone
or makes me do somethingdifferent. What do you think I
should do?

I've heard your other podcasts and
some of the guests that you havewho come from incredible
backgrounds and amazing lifejourneys, probably have much
more perspective than I willever be able to give. But if I
was to try my best to suggestsomething to you and your

(50:59):
listeners. It would be somethingthat one would have done in
their early 30s. So now, ifyou're heading towards 50 and
you want to, I would encourageyou to write a letter to
yourself, speaking to yourfuture 60 year old, Yep, yeah,

(51:21):
in the persona of your future 60year old, and listing out and
describing your life at in your60s or 70s and what you've
achieved, okay, in that periodof Time, and describing your
life, who your relationshipsare, where you are in the world,

(51:42):
what you've done in the last 10years, 1020, years, and frame
that up nice.

What? Put it away until you're 60 or

now, I think, keep it next to your study or
maybe in a room that you havefor reading or choir, yeah, and
just reflect on that.

Okay, good. So it's actually like a vision for
what the next period or the nextdecade will be and what you'll
need to do, absolutely. Yeah,okay, that's a good one. All
right, I will, I'll start that.
God, what do I actually want todo now?

But you're, you're, you're visualising, yes,
you are visualising your futureself, yeah, and writing it to
your present Yeah,

yeah. I think that's a good thing to do. We'll
just get you out of your head ofnow and thinking about where you
want to

be, but write it in the present tense, yes, as if
you've achieved it, yep. Okay,good.

I keep getting homework after that. Sorry. Ah,
seriously. All right, Phil,thank you for sharing your
expertise, and for me puttingyou on the spot, even with
things like beef tallow andpushing the boundaries of what
skin health can look like.
You've reminded us that ageingisn't something to dread, and
that we can still start nowirrespective of what age we are.

(53:08):
And I do love the glow fromwithin comes from confidence,
and that is, it's so true. Ifyou've got confidence, it really
doesn't matter what's happeningaround you, and take care of
taking care of yourself. Toeveryone listening, if you, if
this chat resonates with you, gobook in your skin. Check go and

(53:29):
check out DERM strength, DERMscreen. I do think it is amazing
to have a baseline of your bodyso that you know what has
changed what hasn't changed, andit does help with that skin or
that anxiety. And maybe finally,toss that overpriced toner away

(53:50):
and make sure that your cleanseris actually just a cleanser with
a little bit of acid in it. Andif you love this episode,
subscribe, send it to yourfriends and even maybe to your
mum. And maybe you should alsotake on Phil's challenge to
write a letter to your futureself as if it has already

(54:13):
happened, something that pushesyou and challenges you, because
I know that it gets you to thinkabout yourself, so let's all try
and be better to our skin, andwe can start now because fuck,
I'm nearly 50, and isn't itamazing? You?

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