March 27, 2025 • 28 mins
In this episode of Spectruss Speakeasy, we're diving skin-deep with Emily Brewer, founder of The Derm Center in Chattanooga and host of the upcoming Derm Expert Podcast. With 17 years in dermatology, Emily shares her journey from accidental discovery to passionate provider, her patient-first philosophy, and the psychology behind skincare. We talk real skin struggles—from rosacea to melanoma—and why education, empathy, and less-is-more treatment approaches matter. Plus, get a sneak peek at her new podcast and hear practical springtime skin tips that go beyond SPF.
Visit: thedermcentertn.com
Coming soon: The Derm Expert Podcast (Launching June 1st)
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Emily Brewer (00:00):
Going to the beach for me or going to a water park
.
It's almost overwhelmingsometimes because I'm looking
and I'll tell my husband.
I'll say gosh, look at thatspot on the back of that
person's leg.
Like that looks, like it'sconcerning.
Wonder if they know that'sthere.
It's this type of melanoma thatwill present as a pink spot or
a white spot.
It's very concerning.
Honestly, there is such ademand in dermatology.
(00:21):
I think that there is a lot ofmisconception too around the
field and that a lot of people,I think, default to thinking
that dermatology is all cosmetic, it's something that will be
for everyone.
Sam Silvey (00:36):
Welcome back to another Spectra Speakeasy
podcast.
Today we've got Emily Brewerwith us of the Derm Center here
in Chattanooga, tennessee.
Welcome to the show.
Emily Brewer (00:45):
Thank you for having me.
Sam Silvey (00:46):
Absolutely.
Now the Derm Center, of courseyou have that, but you also have
the Derm Expert podcast that'sabout to be released here, right
, in the next couple of months.
Emily Brewer (00:56):
Yes, so excited to get that started.
Sam Silvey (00:59):
Awesome, so I'm excited to hear about that and
also want to learn about theDerm Center and your journey
into dermatology 17 years now,right?
Emily Brewer (01:08):
17.
Sam Silvey (01:10):
And what made you want to get into dermatology?
Emily Brewer (01:12):
So you know, it's funny because dermatology was
really not a specialty that Ireally planned to go into as I
was going through school.
We were required to completehours in dermatology to graduate
and that was actually my firstexperience in the derm field and
when I went for that rotation Iwalked away from it and was
like this is it.
(01:33):
This is for me all the way.
I can't see myself doinganything else.
And it's funny because as Iwent through other rotations,
other specialties, I would belistening to a patient breathe,
or their heart, their heartbeat,and the whole time I'm looking
at their skin and I'm thinkingyou know, I'm, I'm doing
dermatology on these patients,you know, and this is just
(01:54):
absolutely the right direction.
Sam Silvey (01:56):
Oh, wow, yeah.
So I've got to say I wasthinking actually this morning I
was getting ready for the day,I was thinking about our podcast
you we're going to talk about,and one thing that crossed my
mind it was like a little bit ofanxiety was similar to I have a
buddy of mine who's apsychologist.
He's a PhD psychology and heactually teaches at UTC and
every time we have breakfastjust to chit chat and it's just
a common conversation, I alwaysget so nervous that he's going
(02:18):
to be like analyzing me becausehe's a psychologist.
So sitting down here is likeshe's going to be analyzing my
skin.
So I make sure to put on mymoisturizer and I was like I
hope I did my skincare routineenough.
I hope I don't get too nervousand my cheeks get red.
Emily Brewer (02:30):
I love it.
Sam Silvey (02:31):
When people walk around like do you see, like all
the different skin issues?
Emily Brewer (02:48):
no-transcript this , this is just too much.
Sam Silvey (02:54):
Do you ever go up to him Like, hey, you might want
to get that checked out?
Emily Brewer (02:56):
So I don't typically.
Now, if I was at the grocerystore and I saw something in
front of me that I was really Imean, like a melanoma or
something that I was reallyconcerned about, I might at that
point but not ordinarily.
I don't typically go to peoplein the grocery store and say
have you had your rash checked?
Sam Silvey (03:14):
I'm sure the beach has to be like a sensitive area,
Cause, like I know, every timeI'm at the beach especially if
it's, like you know, the redderareas of Florida like you're
going to see some good oldpeople out there with no
sunscreen and like smoked red.
Emily Brewer (03:25):
It's tough.
That is tough, honestly, to goto the beach and literally see
tanning oil still happening.
Yeah, blows my mind.
Sam Silvey (03:32):
I've got to admit I've done that before.
Emily Brewer (03:34):
Oh no.
Sam Silvey (03:35):
Yeah, I'll probably be sad.
I mean, I've already come seeyou for my skin as it is that's
actually how we met was through,because I've had, I've dealt
with, red cheeks, and wintertimealways gets really hard for me
and I've seen a lot ofdermatologists in the past and
it started around like I guess30 years old, I started noticing
in the wintertime I get thesered splotches on my face and it
(03:57):
was kind of isolated in mycheeks and I've tended to always
kind of flush easily, you know,like drinking a whiskey or a
wine, some sort of alcohol, orif I have too much caffeine, um,
if it gets warm.
But the splotches were differentand so I went to, I think, a
dermatologist at first and Iforgot who it was.
But they walked in the door Ithink I've told you this story
probably the first time that weever met at your uh, at your
(04:18):
clinic.
But they were like it's rosaceaand basically just tossed me
some sample prescriptions andthen walked out the door I mean
it was literally maybe a45-second visit and then walked
out and so I tried these heavyrosacea medications for a long
time but it kind of wreakedhavoc on my skin more.
Yeah, and it was like drying itout more, but it would still get
red and splotchy.
And then I went to an allergyclinic and they're like you're
(04:43):
allergic to dogs.
Well, I have the furriest dogs,australian shepherds and it
definitely doesn't help.
But it wasn't until literallyjust a couple of years ago.
I finally went and I saw you atthe Durham center and we kind
of went through all thedifferent tests and it
definitely seemed peculiar.
But it's like really dry skinand now, since I've stayed on
top of not letting my skin gettoo dry, so I feel like either a
(05:07):
baby or old people use like thehumidifiers at night.
Emily Brewer (05:11):
Let me tell you, though, I actually recommend it
all the time to patients, but Imean it really is good for your
skin, but to your point.
You know that's such anunfortunate story because I hear
that from patients all the timethat have you know skin
diseases that in the dermatologyworld are very common for us to
see and treat.
So it is very easy, I think, toget into that habit of saying,
(05:32):
oh, here's what you've got,here's a treatment, see you in
six months.
And for us it's common and itseems like it's that
straightforward and that simple,but for the patient it's not.
It's the first time they maybehave heard that, or it's the
first time that they haveactually understood what is
happening with their skin.
And, truth be told, at the DermCenter that's a really huge
(05:52):
part of what we focus on istaking the time to spend with
the patient, educate on what'sgoing on and educate on the
treatment plan so that they comeaway from it feeling empowered
by the knowledge of what'shappening and then they can
treat it and have betteroutcomes.
Sam Silvey (06:06):
Yeah, yeah, and in my experience that was
definitely the case and I likedhow, because I came back
multiple times and we weretesting different things and you
didn't just write me offimmediately, which is nice,
because I'd seen a lot ofdermatologists and allergists
and different people and I'mabout to turn 40, so it's almost
a decade of me dealing with red, rosy cheeks and still to this
day, I carry some and I hate toadmit this, but some like cover
(06:31):
up in my bag, cause if I had todo a commercial or some sort of
video at work, it's embarrassingto have, you know, blotchy face
.
Emily Brewer (06:35):
And I totally get it.
I have rosacea too, so Icompletely get it.
And you know it is embarrassingwhen you get anxious or hot or
like, to your point, alcohol,anything that you know can be a
trigger.
That's, it's stressful when youfeel that that flushing
happening with your face.
Sam Silvey (06:51):
Yeah, but since staying on top of, like, really
hydrated skin, that hyaluronicacid and a good moisturizer,
humidifier, feeling like an oldperson, baby, whichever one, I'm
not sure yet but it's this hasbeen the best winter yet.
Like it's very rarely flared up.
You know, maybe if I'm a fewwhiskey drinks in at home, you
know you'll see a little bit,but it's really not been bad and
(07:11):
that's been really nice.
Like you know, what you all doreally directly affects
confidence levels, I think youknow, because so much of the
skin you know it's, it's on ourface.
Emily Brewer (07:25):
You can't really cover it up.
There's actually a really hugepsychological component that we
deal with in dermatology a lot.
You know, when you're talkingabout rosacea, you're talking
about acne, you know skindisorders where patients they
pick, they pull their hair out,they pull out their eyelashes,
their eyebrows.
I mean there is a hugepsychiatric element that we deal
with in dermatology too.
Yeah.
Sam Silvey (07:43):
So I mean especially the face, I mean, I'm sure, all
parts of the body, especiallythe ones that are become painful
, and that sort of thing, butyou really can't cover up your
face and our society and it.
You know you need to walkaround and most people can't
even wear hats in a lot ofplaces and it's kind of hard to
cover this stuff up.
Emily Brewer (08:00):
Yeah.
Sam Silvey (08:01):
Um, so really I could see how I mean it helps my
own confidence.
You know, when I'm like allright, my skin's clear and
better, like when it's having abreakout, like I do not like
going out, you know, likestaying inside.
So you went to school boardcertified dermatology and then
came out, worked in dermatologyand then started your own
practice.
(08:21):
How long have you had your ownpractice now?
Emily Brewer (08:23):
So we opened our doors in January of 2023.
So we are in our starting ourthird year, now headed into our
third year, and we have grownexponentially in such a very
short time.
I was by myself when I openedthe practice and at the start of
year two we hired another nursepractitioner, and now here at
the start of year three and wejust hired a new PA.
(08:45):
So we're growing and a big partof our mission is making sure
that we're available for ourpatients, that we are available
for appointments, that we'reavailable when patients have a
problem and they need to be seen.
So accessibility is a huge partof what we are at the Derm
Center.
Sam Silvey (09:04):
Yeah, that's awesome .
Yeah, and so these new peopleyou're hiring I mean, they come
from background dermatology andhow is it finding them?
Emily Brewer (09:14):
So the nurse practitioner that works at our
office, she does have abackground in dermatology.
She has a little better than 10years of experience in working
in Derm, our PA that we justhired.
She's new into the field ofdermatology.
Truth be told, and I don'tthink she would mind me saying
this, she's actually been apatient of mine for quite some
time and she just has atremendous love for the field.
(09:37):
So she's very motivated tolearn and she is going to be
incredible.
That's great, yes.
Sam Silvey (09:46):
And you've got a whole admin staff as well.
So how many total work there?
Emily Brewer (09:49):
So we have eight and we actually are in the
process.
We just hired a new medicalassistant as well, um, so the
growth has been tremendous forus.
Sam Silvey (09:57):
Probably about to outgrow that space, right?
Emily Brewer (10:01):
We're close, in fact we're.
We're probably to our max.
So kind of thinking throughwhat that growth plan looks like
is kind of where we're at rightnow too.
Sam Silvey (10:10):
Gotcha, yeah.
Now what is like the majority?
Do you have?
Like?
What's your average patientlook like?
I mean, is there an average oris it all over the?
Emily Brewer (10:17):
map.
It is a wide range, truthfully.
We treat from birth to you know, 90s, 100s.
I had a patient just the otherday.
He was 101.
So I mean we treat a full rangeEczema, we do skin checks, we
treat skin cancer, psoriasis,the list goes on.
(10:37):
We treat a tremendous number ofskin and nail and hair diseases
.
Sam Silvey (10:42):
Okay, and so I know we're talking before this about,
like you know you're I guesswhat's the right word for it
You're um, the way you like totreat you know, like the least
amount of pharmaceutical drugspossible, and I mean, what's
kind of your, your principlesthere, that you're, how do you
operate normally?
Emily Brewer (11:02):
Yeah, I definitely .
When I treat a patient I like totreat very aggressively right
out of the gate because I likefor patients to see results.
Patients want to see results, soI like to get patients better
as fast as we possibly can.
It, you know, builds theirconfidence in themselves, but it
built their confidence in us asproviders.
But then, once we get to apoint to where they have
(11:25):
stabilized, then I like to startseeing okay, if they're on a
systemic treatment, I like tostart decreasing that dose
steadily to find, okay, whereyou were doing great at 100
milligrams of a medication,let's see how you do at 50.
Let's see how you do at 25.
And then find that dose thatthey can stay on, where they are
able to continue to seepositive results but yet we're
(11:47):
titrating down.
I like to do that because, forme personally, I like to take as
few things as I possibly can.
I like to try to keep a healthy, clean diet and be mindful of
the supplements I take, themedications that I like to take
as few things as I possibly can.
I like to try to keep a healthy, clean diet and be mindful of
the supplements I take, themedications that I have to take,
and I really like to have thatsame mindset with my patients
too.
Sam Silvey (12:05):
Yeah.
Emily Brewer (12:05):
And I think by and large patients appreciate that.
Very few people come in and sayI want the heaviest dose of
everything you can give me.
Sam Silvey (12:11):
Yeah.
You know, Absolutely, and mypersonal story I was telling a
little bit.
Um, that was the first thingsomeone came in to do was
through, you know, at anotherpractice, just through
pharmaceutical drugs.
I mean it's like, all right,well, good luck, basically, and
like I didn't know what, rosaceaSavannah to go home and look it
all up.
It was kind of a bizarreinteraction.
Emily Brewer (12:28):
And that is the last thing that I want for my
patients.
I do not want my patientsleaving that visit and having to
go look things up and research.
Sam Silvey (12:35):
Because if they get a WebMD like, they've got cancer
and they're dying Right.
Emily Brewer (12:40):
It is ending with that every time, but no, with
patients.
You know the education is ahuge element Educating the
patients on what they have, onhow it needs to be treated.
What are the triggers?
Rosacea specifically, there arevery specific triggers that
will cause a flare up and for apatient it's important to
understand that.
So the education is a hugeelement.
(13:02):
So if we don't discuss itverbally in a room, we're
sending patients home witheducation that they can have
that we have, provided that theycan look through and understand
things better.
Sam Silvey (13:12):
Now you said 17 years practicing.
Have you seen a change in whatpatients deal with over 17 years
?
Emily Brewer (13:17):
Absolutely have, even specifically with melanoma.
So that one in particular is agood one, I think, for us to
talk about, because obviouslymelanoma is deadly and it's
interesting because, goingthrough school melanoma, we were
taught to look for the blacksuspicious mole and while you
know many times that is stillthe case, you know there is a
type of melanoma that we do seewith patients that quite
(13:40):
honestly, as a provider, I thinkall of us would say we lose
sleep over.
It's this type of melanoma thatwill present as a pink spot or
a white spot.
It's very, it's very concerningbecause it's not something that
our eyes, as traineddermatology eyes, is not
something that we wouldnecessarily see just right off
the bat the way we would a blackmole.
(14:02):
So I'm very diligent inexplaining to my patients, when
you're doing your skin checks athome, anything that looks
different.
So if you have all brown molesand then all of a sudden now
this pink one has appeared, orif you have a red spot that's
just not healing up, those arethe things that you really need
to be monitoring for as well,not just the black mole that
(14:23):
everybody in their mind defaultsto when they think melanoma.
So amelanotic melanoma is whatthis type of melanoma is
referred to.
This is not something for mepersonally.
That was a huge part of what welearned about in school.
I would say over the past,probably 10, maybe 15 years, it
has become more prevalent andthere's more information for us
(14:47):
at least to go off of, of whatwe need to be monitoring for on
our patients, but then educatingour patients, for them to
monitor for on themselves.
Sam Silvey (14:51):
Wow, that's wild.
So has that really just come upin the last 17 years, you think
?
Or they just didn't think toteach.
Emily Brewer (14:57):
Yeah, I think it's just become more knowledge
around it.
Sam Silvey (15:00):
Okay.
Emily Brewer (15:01):
It's probably always been there, but I think
now there's a betterunderstanding of okay.
These are things that areproblems that we need to be
monitoring for, but there arealso other things that we've
seen more prevalent over thepast few years.
Hydradenitis is onespecifically.
It's a very painful, what wenow know to be autoimmune
disease that patients face wherethey have these very painful
(15:23):
boils that come up in areas thatare skinfold, so under the arms
and in the groin, under breastsfor women and it's very painful
and it can be very.
It can scar horribly.
And I think you know, over thepast several years more patients
.
There's been more awarenessbrought about this type of
disease that patients face,because I think a lot of people
(15:43):
were very embarrassed of it andthey wouldn't talk about it and
they didn't want to have to comeinto the office and show anyone
.
And now it I mean we see newbiologics coming on the market
that treat it and I think thatthere's more awareness around it
, thankfully.
Sam Silvey (15:58):
Yeah, I mean with autoimmune disease.
I mean usually that means it'snot really treatable, right, you
just try to keep them fromflare up, from happening, or
Manageable, I think, is the keyword.
Emily Brewer (16:07):
So, autoimmune diseases yeah, treatable would
not be the word that I would use, manageable would be the word I
would default to, but, yes,manageable.
Sam Silvey (16:15):
That's wild, I know.
I mean it seems like our bodiesalmost get confused with I
don't know if the things we'reputting into it or the things
we're around, or you think itwas this way a hundred years ago
or 200 years ago, like I thinkthings have changed.
Emily Brewer (16:28):
I think things have changed.
I think that things havechanged, but I think, honestly,
too, our knowledge has changed.
I think we're learning more.
I think more questions arebeing asked, I think more
information is available.
The research on severaldifferent topics is available
now for people to go after andform their own opinions and
(16:48):
conclusions, and I think thatthere is more conversation
around some of these things nowmore conversation around some of
these things now.
Sam Silvey (16:59):
Yeah, so I mean it's kind of perfect segue into the
Derm Expert podcast that gettingstarted off the ground now,
launching June 1st, right Junethe 1st yes.
So what I mean sounds likethat's the reason you're
launching this right Like, justfor the lack of information, any
other Derm podcast out therethat you've really seen?
Emily Brewer (17:14):
There are not any.
That will be the format that weare going to be launching.
So the DERM Expert podcast isgoing to be a way for us to
provide education because, likeI was telling you, education is
such a huge part of what we areat the DERM Center and it's a
huge part of what I try toimplement with my patients and
it's a huge part of what I tryto implement with my patients.
So, being able to reach apopulation of people and provide
(17:38):
this information so that we canbring awareness to certain skin
diseases and certain problemsthat people may be facing that
they don't understand thatthere's a treatment for, or that
they don't know that there's atreatment for, that's the type
of information that we want tobe bringing to light with the
podcast.
Sam Silvey (17:56):
I mean it seems like there's a need for it, right?
Emily Brewer (17:57):
Like there's a lot there.
Is there really is therehonestly.
There is such a demand indermatology and you know, I
think, that there is a lot ofmisconception too around the
field and that a lot of people,I think, default to thinking
that dermatology is all cosmetic, that it's all about, you know,
injectables or lasers orchemical peeling.
And while that is a part ofdermatology, there is a medical
(18:19):
side of dermatology too, thateveryone can be a patient for
dermatology.
Everyone can have a skin exam,everyone can have the education
about safe sun exposure,sunscreen, what's safe and how
do you apply it, how frequently.
So I think that it's somethingthat will be for everyone.
Sam Silvey (18:39):
So what do you see?
I mean, what's the layout goingto be, or the format of the
podcast, how?
Emily Brewer (18:43):
is it going?
Sam Silvey (18:44):
to differ.
Emily Brewer (18:45):
So there will be episodes where we have other
field experts that come on wherewe can talk about how their
field overlaps with dermatology.
So rheumatology, for example,you know, there are instances
where I'll see a patient withpsoriasis but the patient also
has psoriatic arthritis, whichis not in the field of
dermatology.
So there are patients wherethere are overlaps with
(19:07):
different specialties.
So I would love to have youknow, other experts in their
field come on and contribute tothose topics and then also would
love to have patients be ableto share their stories and talk
about how they've been impactedby different dermatology
diseases and diagnoses.
Sam Silvey (19:25):
Yeah, you know, the other doctors I've been to in my
life, you know, first one thatcomes on mind would be like all
the crashes I've had, racing,you know so broken bones, trauma
, yeah, trauma.
I always feel like when I go tothose doctors it's more like
absolute, like yes, we know theanswer.
Like we said it and we put itin some sort of cast.
Emily Brewer (19:46):
Very definitive.
Sam Silvey (19:53):
Yeah, Even with the head injuries, you know, like
you get a CAT scan, we make surethere's no brain bleed.
But with skin, I feel likethere's so much that's unknown
that people are trying to figureout all the time and compared
to like all these other fields,like just my own personal
experience, you know, there'snot as much.
I mean, there's a lot ofresearch, obviously, but there's
just a lot of unknown, At leastmy own little experience.
I feel like there needs to bemore information on this.
This could solve a big need, Iguess.
Emily Brewer (20:14):
I agree because I think, honestly, a lot of
dermatology patients, too, theygo to the internet.
They go online and they say,okay, and I've got this type of
bump or this type of rash, sothis must be what it is and I'm
going to go to the pharmacy andbuy a cream and treat it.
And it's basically putting theresponsibility of diagnosing and
treating on the patient withthat mentality, so by being able
(20:34):
to provide information onthings that maybe they can take
away and have an understandingof.
Ok, this is something I reallyneed to seek professional help
over, or this is something thatmaybe I can start with this
option at the pharmacy and seeif I get results, and if I don't
, then I need to speak withsomeone who can really customize
a treatment plan for me.
Sam Silvey (20:52):
Yeah, and you're really treating.
I mean, in dermatology, it'sthe whole body, right?
I mean not just the face, Imean it's.
Emily Brewer (20:58):
Full body largest organ, your skin is the largest
organ.
So, yes, we treat from top tobottom of the feet.
Sam Silvey (21:05):
Yeah.
Is there an area that standsout that you're treating most at
the Derm Center versus others?
Emily Brewer (21:11):
I would say we treat a lot of acne.
We treat a lot of psoriasis andeczema.
We do a lot of preventativeskin exams.
We do see skin cancers.
We treat a wide variety.
To be honest with you.
We also do some cosmetictreatments, but we keep that
very limited because the realfocus of the Derm Center is very
medical focused.
(21:31):
We want it to stay very medicalfocused.
Sam Silvey (21:34):
Yeah, yeah, well, even I mean the Botox and
fillers, those sort of thingsthat can still help.
Like you mentioned with theconfidence part, absolutely.
So many people think that'ssuperficial, but I think now
it's become so common Peoplewant to look younger and the
best they can for longer.
Emily Brewer (21:50):
Absolutely, and there are things, too, that are
available now, outside ofinjectables, that you can do,
that are not surgical.
It's very effective Chemicalpeeling, microneedling, doing
things to get your skin toregenerate and do things that it
already knows how to do.
Naturally, I love that concept,so we do offer microneedling.
(22:11):
It's a very effective way toboost collagen growth and get
your skin to do what it alreadyknows how to do.
Sam Silvey (22:17):
Yeah, I definitely need to do that.
I haven't done that.
I've tried Botox before andit's wearing off.
I tried it probably six monthsago and I guess that's my third
time.
Mainly crow's feet.
I love it.
I hate whenever I smile and Iget those crow's feet on the
side.
Emily Brewer (22:31):
I had mine done a week ago.
It's still settling.
Sam Silvey (22:35):
But microneedling I need to try, just because I'm
turning 40 next month, as Imentioned, and I look in the
mirror I'm like holy shit, I'mstarting to see like the one,
the gray hairs and all the lines.
Emily Brewer (22:45):
I had a gray eyelash the other day.
I was like I didn't evenworking in the field of
dermatology, didn't even knowthat happened.
That was a terrible surprise.
What is that?
Sam Silvey (22:55):
Yeah, right, it's not fair.
Emily Brewer (22:58):
It's literally not .
Sam Silvey (23:00):
I think the longer people can stay looking younger,
I mean it's helping boostconfidence and helping helps me
feel better about it.
You know I don't want, toeveryone's like, smile for the
camera.
I give kind of a smize, youknow, but I don't want to see
the crow's feet.
Emily Brewer (23:12):
I totally get that .
Sam Silvey (23:15):
Hey, one other thing that's very interesting about
derm is, like you said, you'retreating from zero years old to
101 a couple of weeks ago.
It's everyone really deals withwith dermatology.
Emily Brewer (23:26):
My grandmother.
She came in not too long ago.
She's 96.
She'll be 97 tomorrow actually,and you know still treating her
and you know there isdermatology for everyone,
regardless of age.
Sam Silvey (23:40):
Yeah, so we've got spring coming up, which for me
I'm happy about, because my skinstarts settling down.
Emily Brewer (23:48):
Right.
Sam Silvey (23:48):
For whatever reason, I think vitamin D seems to play
an effect on my skin as well,probably just overall body.
Emily Brewer (23:54):
Cold weather, dryness is a problem.
Sam Silvey (23:56):
Yeah, yeah, and so now warm weather is coming out.
I'm excited about it.
My skin usually gets a littlebetter.
Tan probably covers it up too,which I know you probably don't
like that.
Emily Brewer (24:05):
I'll pretend I didn't hear the tan part,
although you can still tan withsunscreen.
I'm just going to put that outthere.
Sam Silvey (24:12):
Okay, how does that work?
I mean, what sunscreen do youuse?
Emily Brewer (24:15):
So now a mineral-based sunscreen.
You're not really going to seetanning from that.
But now a chemical-basedsunscreen, which tend to be
lighter weight products.
Most people like to use more ofa chemical base on their face
At least I do because it'slighter weight, I can make up on
top of it, but with a sunscreen.
So a chemical based sunscreenyou are still going to see some
(24:37):
tanning.
That can happen with your skin.
Sam Silvey (24:38):
You're really just preventing cellular damage.
Emily Brewer (24:39):
Okay, so you can still wear your sunscreen and
still get a tan.
Okay.
Sam Silvey (24:41):
All right Now.
What's your skincare routine?
Is that something you can share?
Sure?
Emily Brewer (24:46):
Honestly, I have a very simple skincare routine
because I have a busy life and Idon't have time for a 12-step
routine and, honestly, it's notnecessary.
So in the mornings I wash myface with just a gentle cleanser
.
I love hyaluronic acid, so I'ma big fan of the HA intensifier,
so I use that every day withoutfail.
Vitamin C I don't use itconsistently, but for the most
(25:08):
part I do and then I moisturizeand sunscreen every morning and
then at night it's very, veryconsistent Wash my face, same
cleanser.
Retinol is a must for me and Irecommend it for just about
every patient and thenmoisturize and that's it.
So it's super simple.
Retinols are great because theyhelp to keep your skin clear.
(25:28):
They help with cellularturnover, helps to keep your
skin looking young.
But then also, too, if you seelittle actinic changes or
precancerous changes happeningon the surface of your skin from
sun, if you're exfoliating thatroutinely and you're turning
those skin cells over faster,you can really help to fight
that precancerous change too.
So I love retinol because ithas a cosmetic element to it,
(25:53):
but there's also a medicalelement behind it that I also
love Gotcha.
Sam Silvey (25:54):
Now, is it the same brand across all those products
or different brands?
You kind of picking andchoosing.
Emily Brewer (25:58):
Yeah, I'm pretty consistent with SkinCeuticals.
I love their products becausethey have very good data behind
them.
I use them personally.
They work well for my skin.
I've seen them work really wellwith other patients too.
So I'm pretty dedicated to thatbrand.
But I will say, from time totime I do try other brands too.
Sam Silvey (26:16):
Okay.
Emily Brewer (26:16):
And, like we were talking earlier, I have a
daughter who's about to be 13,and she has just about every
brand that a pharmacy wouldcarry in her bathroom, so I get
to see the effects on her skin,sometimes the good and the bad
Gotcha.
Sam Silvey (26:30):
So is there a dermatology tip you like to give
for springtime?
I know that's pretty hard tohave a generic one, but is there
one that stands out out ofcuriosity?
Emily Brewer (26:38):
Two things actually.
So in the spring, I like totell patients do spring cleaning
for your skincare.
Go through all of your skincareproducts.
Anything that is expired, getrid of it.
Check your sunscreen expirationdates, because sunscreens also
expire.
Toss them if they're expiredand replace them.
So I like the spring cleaningskincare concept and then
(26:58):
sunscreen.
I reiterate with spring breakcoming up, summertime coming up,
really you should wearsunscreen all year long, but
during those times it's a goodtime to really start a new
routine with wearing itconsistently, 30 SPF minimum.
Every two hours that you'reoutside you should reapply it.
Sam Silvey (27:15):
Okay, yeah, I'm bad about that last one especially.
No, don't tell anybody, don'ttell my dermatologist.
Emily Brewer (27:23):
I won't write it in your chart.
Sam Silvey (27:27):
I mean, that's a lot of information.
I think we've covered a lottoday.
I don't know how you feel aboutit.
Emily Brewer (27:31):
Yeah, great, I'm excited about the podcast.
I'm excited to get it going andto get some information out for
listeners.
Sam Silvey (27:39):
Do you have your first guest already picked up?
Emily Brewer (27:41):
I do actually.
Sam Silvey (27:42):
Do you want to give that away a little?
Emily Brewer (27:44):
I do.
So our first episode.
We're going to talk aboutprobably one of the most common
topics in dermatology.
We're going to talk about acne,because it can affect teenagers
, it can affect adults and youknow it's definitely something
that at the pharmacy there areso many products that are for
acne to pick from and we'regoing to talk all about those
(28:05):
products and those topics andI'll be having Autumn Newman.
She's one of the nursepractitioners at the Derm Center
.
She'll be coming on as ourguest.
Sam Silvey (28:13):
Awesome yeah, so I look forward to hearing that Yep
, I'm excited.
Awesome.
Well, I think that was a goodintro for today and get people
kind of hyped for the upcomingpodcast.
Emily Brewer (28:23):
Yes.
Sam Silvey (28:24):
Anything else you want to add to that I may have
missed.
Emily Brewer (28:26):
I don't think so.
Wear your sunscreen, check yourmoles.
Sam Silvey (28:35):
Well, thanks for joining us today, Spectra's
Speakeasy podcast with EmilyBrewer.
Be sure to check outthedermcenterTNcom for any of
your dermatology needs and alsobe on a lookout for the Derm
Expert podcast.
Our first episode will belaunching June 1st and have all
of your dermatology needs andanswers to all your complicated
questions.
Emily Brewer (28:52):
Stay tuned and thanks again for joining us.
Going to the beach for me or going to a water park
.
It's almost overwhelmingsometimes because I'm looking
and I'll tell my husband.
I'll say gosh, look at thatspot on the back of that
person's leg.
Like that looks, like it'sconcerning.
Wonder if they know that'sthere.
It's this type of melanoma thatwill present as a pink spot or
a white spot.
It's very concerning.
Honestly, there is such ademand in dermatology.
(00:21):
I think that there is a lot ofmisconception too around the
field and that a lot of people,I think, default to thinking
that dermatology is all cosmetic, it's something that will be
for everyone.
Sam Silvey (00:36):
Welcome back to another Spectra Speakeasy
podcast.
Today we've got Emily Brewerwith us of the Derm Center here
in Chattanooga, tennessee.
Welcome to the show.
Emily Brewer (00:45):
Thank you for having me.
Sam Silvey (00:46):
Absolutely.
Now the Derm Center, of courseyou have that, but you also have
the Derm Expert podcast that'sabout to be released here, right
, in the next couple of months.
Emily Brewer (00:56):
Yes, so excited to get that started.
Sam Silvey (00:59):
Awesome, so I'm excited to hear about that and
also want to learn about theDerm Center and your journey
into dermatology 17 years now,right?
Emily Brewer (01:08):
17.
Sam Silvey (01:10):
And what made you want to get into dermatology?
Emily Brewer (01:12):
So you know, it's funny because dermatology was
really not a specialty that Ireally planned to go into as I
was going through school.
We were required to completehours in dermatology to graduate
and that was actually my firstexperience in the derm field and
when I went for that rotation Iwalked away from it and was
like this is it.
(01:33):
This is for me all the way.
I can't see myself doinganything else.
And it's funny because as Iwent through other rotations,
other specialties, I would belistening to a patient breathe,
or their heart, their heartbeat,and the whole time I'm looking
at their skin and I'm thinkingyou know, I'm, I'm doing
dermatology on these patients,you know, and this is just
(01:54):
absolutely the right direction.
Sam Silvey (01:56):
Oh, wow, yeah.
So I've got to say I wasthinking actually this morning I
was getting ready for the day,I was thinking about our podcast
you we're going to talk about,and one thing that crossed my
mind it was like a little bit ofanxiety was similar to I have a
buddy of mine who's apsychologist.
He's a PhD psychology and heactually teaches at UTC and
every time we have breakfastjust to chit chat and it's just
a common conversation, I alwaysget so nervous that he's going
(02:18):
to be like analyzing me becausehe's a psychologist.
So sitting down here is likeshe's going to be analyzing my
skin.
So I make sure to put on mymoisturizer and I was like I
hope I did my skincare routineenough.
I hope I don't get too nervousand my cheeks get red.
Emily Brewer (02:30):
I love it.
Sam Silvey (02:31):
When people walk around like do you see, like all
the different skin issues?
Emily Brewer (02:48):
no-transcript this , this is just too much.
Sam Silvey (02:54):
Do you ever go up to him Like, hey, you might want
to get that checked out?
Emily Brewer (02:56):
So I don't typically.
Now, if I was at the grocerystore and I saw something in
front of me that I was really Imean, like a melanoma or
something that I was reallyconcerned about, I might at that
point but not ordinarily.
I don't typically go to peoplein the grocery store and say
have you had your rash checked?
Sam Silvey (03:14):
I'm sure the beach has to be like a sensitive area,
Cause, like I know, every timeI'm at the beach especially if
it's, like you know, the redderareas of Florida like you're
going to see some good oldpeople out there with no
sunscreen and like smoked red.
Emily Brewer (03:25):
It's tough.
That is tough, honestly, to goto the beach and literally see
tanning oil still happening.
Yeah, blows my mind.
Sam Silvey (03:32):
I've got to admit I've done that before.
Emily Brewer (03:34):
Oh no.
Sam Silvey (03:35):
Yeah, I'll probably be sad.
I mean, I've already come seeyou for my skin as it is that's
actually how we met was through,because I've had, I've dealt
with, red cheeks, and wintertimealways gets really hard for me
and I've seen a lot ofdermatologists in the past and
it started around like I guess30 years old, I started noticing
in the wintertime I get thesered splotches on my face and it
(03:57):
was kind of isolated in mycheeks and I've tended to always
kind of flush easily, you know,like drinking a whiskey or a
wine, some sort of alcohol, orif I have too much caffeine, um,
if it gets warm.
But the splotches were differentand so I went to, I think, a
dermatologist at first and Iforgot who it was.
But they walked in the door Ithink I've told you this story
probably the first time that weever met at your uh, at your
(04:18):
clinic.
But they were like it's rosaceaand basically just tossed me
some sample prescriptions andthen walked out the door I mean
it was literally maybe a45-second visit and then walked
out and so I tried these heavyrosacea medications for a long
time but it kind of wreakedhavoc on my skin more.
Yeah, and it was like drying itout more, but it would still get
red and splotchy.
And then I went to an allergyclinic and they're like you're
(04:43):
allergic to dogs.
Well, I have the furriest dogs,australian shepherds and it
definitely doesn't help.
But it wasn't until literallyjust a couple of years ago.
I finally went and I saw you atthe Durham center and we kind
of went through all thedifferent tests and it
definitely seemed peculiar.
But it's like really dry skinand now, since I've stayed on
top of not letting my skin gettoo dry, so I feel like either a
(05:07):
baby or old people use like thehumidifiers at night.
Emily Brewer (05:11):
Let me tell you, though, I actually recommend it
all the time to patients, but Imean it really is good for your
skin, but to your point.
You know that's such anunfortunate story because I hear
that from patients all the timethat have you know skin
diseases that in the dermatologyworld are very common for us to
see and treat.
So it is very easy, I think, toget into that habit of saying,
(05:32):
oh, here's what you've got,here's a treatment, see you in
six months.
And for us it's common and itseems like it's that
straightforward and that simple,but for the patient it's not.
It's the first time they maybehave heard that, or it's the
first time that they haveactually understood what is
happening with their skin.
And, truth be told, at the DermCenter that's a really huge
(05:52):
part of what we focus on istaking the time to spend with
the patient, educate on what'sgoing on and educate on the
treatment plan so that they comeaway from it feeling empowered
by the knowledge of what'shappening and then they can
treat it and have betteroutcomes.
Sam Silvey (06:06):
Yeah, yeah, and in my experience that was
definitely the case and I likedhow, because I came back
multiple times and we weretesting different things and you
didn't just write me offimmediately, which is nice,
because I'd seen a lot ofdermatologists and allergists
and different people and I'mabout to turn 40, so it's almost
a decade of me dealing with red, rosy cheeks and still to this
day, I carry some and I hate toadmit this, but some like cover
(06:31):
up in my bag, cause if I had todo a commercial or some sort of
video at work, it's embarrassingto have, you know, blotchy face
.
Emily Brewer (06:35):
And I totally get it.
I have rosacea too, so Icompletely get it.
And you know it is embarrassingwhen you get anxious or hot or
like, to your point, alcohol,anything that you know can be a
trigger.
That's, it's stressful when youfeel that that flushing
happening with your face.
Sam Silvey (06:51):
Yeah, but since staying on top of, like, really
hydrated skin, that hyaluronicacid and a good moisturizer,
humidifier, feeling like an oldperson, baby, whichever one, I'm
not sure yet but it's this hasbeen the best winter yet.
Like it's very rarely flared up.
You know, maybe if I'm a fewwhiskey drinks in at home, you
know you'll see a little bit,but it's really not been bad and
(07:11):
that's been really nice.
Like you know, what you all doreally directly affects
confidence levels, I think youknow, because so much of the
skin you know it's, it's on ourface.
Emily Brewer (07:25):
You can't really cover it up.
There's actually a really hugepsychological component that we
deal with in dermatology a lot.
You know, when you're talkingabout rosacea, you're talking
about acne, you know skindisorders where patients they
pick, they pull their hair out,they pull out their eyelashes,
their eyebrows.
I mean there is a hugepsychiatric element that we deal
with in dermatology too.
Yeah.
Sam Silvey (07:43):
So I mean especially the face, I mean, I'm sure, all
parts of the body, especiallythe ones that are become painful
, and that sort of thing, butyou really can't cover up your
face and our society and it.
You know you need to walkaround and most people can't
even wear hats in a lot ofplaces and it's kind of hard to
cover this stuff up.
Emily Brewer (08:00):
Yeah.
Sam Silvey (08:01):
Um, so really I could see how I mean it helps my
own confidence.
You know, when I'm like allright, my skin's clear and
better, like when it's having abreakout, like I do not like
going out, you know, likestaying inside.
So you went to school boardcertified dermatology and then
came out, worked in dermatologyand then started your own
practice.
(08:21):
How long have you had your ownpractice now?
Emily Brewer (08:23):
So we opened our doors in January of 2023.
So we are in our starting ourthird year, now headed into our
third year, and we have grownexponentially in such a very
short time.
I was by myself when I openedthe practice and at the start of
year two we hired another nursepractitioner, and now here at
the start of year three and wejust hired a new PA.
(08:45):
So we're growing and a big partof our mission is making sure
that we're available for ourpatients, that we are available
for appointments, that we'reavailable when patients have a
problem and they need to be seen.
So accessibility is a huge partof what we are at the Derm
Center.
Sam Silvey (09:04):
Yeah, that's awesome .
Yeah, and so these new peopleyou're hiring I mean, they come
from background dermatology andhow is it finding them?
Emily Brewer (09:14):
So the nurse practitioner that works at our
office, she does have abackground in dermatology.
She has a little better than 10years of experience in working
in Derm, our PA that we justhired.
She's new into the field ofdermatology.
Truth be told, and I don'tthink she would mind me saying
this, she's actually been apatient of mine for quite some
time and she just has atremendous love for the field.
(09:37):
So she's very motivated tolearn and she is going to be
incredible.
That's great, yes.
Sam Silvey (09:46):
And you've got a whole admin staff as well.
So how many total work there?
Emily Brewer (09:49):
So we have eight and we actually are in the
process.
We just hired a new medicalassistant as well, um, so the
growth has been tremendous forus.
Sam Silvey (09:57):
Probably about to outgrow that space, right?
Emily Brewer (10:01):
We're close, in fact we're.
We're probably to our max.
So kind of thinking throughwhat that growth plan looks like
is kind of where we're at rightnow too.
Sam Silvey (10:10):
Gotcha, yeah.
Now what is like the majority?
Do you have?
Like?
What's your average patientlook like?
I mean, is there an average oris it all over the?
Emily Brewer (10:17):
map.
It is a wide range, truthfully.
We treat from birth to you know, 90s, 100s.
I had a patient just the otherday.
He was 101.
So I mean we treat a full rangeEczema, we do skin checks, we
treat skin cancer, psoriasis,the list goes on.
(10:37):
We treat a tremendous number ofskin and nail and hair diseases
.
Sam Silvey (10:42):
Okay, and so I know we're talking before this about,
like you know you're I guesswhat's the right word for it
You're um, the way you like totreat you know, like the least
amount of pharmaceutical drugspossible, and I mean, what's
kind of your, your principlesthere, that you're, how do you
operate normally?
Emily Brewer (11:02):
Yeah, I definitely .
When I treat a patient I like totreat very aggressively right
out of the gate because I likefor patients to see results.
Patients want to see results, soI like to get patients better
as fast as we possibly can.
It, you know, builds theirconfidence in themselves, but it
built their confidence in us asproviders.
But then, once we get to apoint to where they have
(11:25):
stabilized, then I like to startseeing okay, if they're on a
systemic treatment, I like tostart decreasing that dose
steadily to find, okay, whereyou were doing great at 100
milligrams of a medication,let's see how you do at 50.
Let's see how you do at 25.
And then find that dose thatthey can stay on, where they are
able to continue to seepositive results but yet we're
(11:47):
titrating down.
I like to do that because, forme personally, I like to take as
few things as I possibly can.
I like to try to keep a healthy, clean diet and be mindful of
the supplements I take, themedications that I like to take
as few things as I possibly can.
I like to try to keep a healthy, clean diet and be mindful of
the supplements I take, themedications that I have to take,
and I really like to have thatsame mindset with my patients
too.
Sam Silvey (12:05):
Yeah.
Emily Brewer (12:05):
And I think by and large patients appreciate that.
Very few people come in and sayI want the heaviest dose of
everything you can give me.
Sam Silvey (12:11):
Yeah.
You know, Absolutely, and mypersonal story I was telling a
little bit.
Um, that was the first thingsomeone came in to do was
through, you know, at anotherpractice, just through
pharmaceutical drugs.
I mean it's like, all right,well, good luck, basically, and
like I didn't know what, rosaceaSavannah to go home and look it
all up.
It was kind of a bizarreinteraction.
Emily Brewer (12:28):
And that is the last thing that I want for my
patients.
I do not want my patientsleaving that visit and having to
go look things up and research.
Sam Silvey (12:35):
Because if they get a WebMD like, they've got cancer
and they're dying Right.
Emily Brewer (12:40):
It is ending with that every time, but no, with
patients.
You know the education is ahuge element Educating the
patients on what they have, onhow it needs to be treated.
What are the triggers?
Rosacea specifically, there arevery specific triggers that
will cause a flare up and for apatient it's important to
understand that.
So the education is a hugeelement.
(13:02):
So if we don't discuss itverbally in a room, we're
sending patients home witheducation that they can have
that we have, provided that theycan look through and understand
things better.
Sam Silvey (13:12):
Now you said 17 years practicing.
Have you seen a change in whatpatients deal with over 17 years
?
Emily Brewer (13:17):
Absolutely have, even specifically with melanoma.
So that one in particular is agood one, I think, for us to
talk about, because obviouslymelanoma is deadly and it's
interesting because, goingthrough school melanoma, we were
taught to look for the blacksuspicious mole and while you
know many times that is stillthe case, you know there is a
type of melanoma that we do seewith patients that quite
(13:40):
honestly, as a provider, I thinkall of us would say we lose
sleep over.
It's this type of melanoma thatwill present as a pink spot or
a white spot.
It's very, it's very concerningbecause it's not something that
our eyes, as traineddermatology eyes, is not
something that we wouldnecessarily see just right off
the bat the way we would a blackmole.
(14:02):
So I'm very diligent inexplaining to my patients, when
you're doing your skin checks athome, anything that looks
different.
So if you have all brown molesand then all of a sudden now
this pink one has appeared, orif you have a red spot that's
just not healing up, those arethe things that you really need
to be monitoring for as well,not just the black mole that
(14:23):
everybody in their mind defaultsto when they think melanoma.
So amelanotic melanoma is whatthis type of melanoma is
referred to.
This is not something for mepersonally.
That was a huge part of what welearned about in school.
I would say over the past,probably 10, maybe 15 years, it
has become more prevalent andthere's more information for us
(14:47):
at least to go off of, of whatwe need to be monitoring for on
our patients, but then educatingour patients, for them to
monitor for on themselves.
Sam Silvey (14:51):
Wow, that's wild.
So has that really just come upin the last 17 years, you think
?
Or they just didn't think toteach.
Emily Brewer (14:57):
Yeah, I think it's just become more knowledge
around it.
Sam Silvey (15:00):
Okay.
Emily Brewer (15:01):
It's probably always been there, but I think
now there's a betterunderstanding of okay.
These are things that areproblems that we need to be
monitoring for, but there arealso other things that we've
seen more prevalent over thepast few years.
Hydradenitis is onespecifically.
It's a very painful, what wenow know to be autoimmune
disease that patients face wherethey have these very painful
(15:23):
boils that come up in areas thatare skinfold, so under the arms
and in the groin, under breastsfor women and it's very painful
and it can be very.
It can scar horribly.
And I think you know, over thepast several years more patients
.
There's been more awarenessbrought about this type of
disease that patients face,because I think a lot of people
(15:43):
were very embarrassed of it andthey wouldn't talk about it and
they didn't want to have to comeinto the office and show anyone
.
And now it I mean we see newbiologics coming on the market
that treat it and I think thatthere's more awareness around it
, thankfully.
Sam Silvey (15:58):
Yeah, I mean with autoimmune disease.
I mean usually that means it'snot really treatable, right, you
just try to keep them fromflare up, from happening, or
Manageable, I think, is the keyword.
Emily Brewer (16:07):
So, autoimmune diseases yeah, treatable would
not be the word that I would use, manageable would be the word I
would default to, but, yes,manageable.
Sam Silvey (16:15):
That's wild, I know.
I mean it seems like our bodiesalmost get confused with I
don't know if the things we'reputting into it or the things
we're around, or you think itwas this way a hundred years ago
or 200 years ago, like I thinkthings have changed.
Emily Brewer (16:28):
I think things have changed.
I think that things havechanged, but I think, honestly,
too, our knowledge has changed.
I think we're learning more.
I think more questions arebeing asked, I think more
information is available.
The research on severaldifferent topics is available
now for people to go after andform their own opinions and
(16:48):
conclusions, and I think thatthere is more conversation
around some of these things nowmore conversation around some of
these things now.
Sam Silvey (16:59):
Yeah, so I mean it's kind of perfect segue into the
Derm Expert podcast that gettingstarted off the ground now,
launching June 1st, right Junethe 1st yes.
So what I mean sounds likethat's the reason you're
launching this right Like, justfor the lack of information, any
other Derm podcast out therethat you've really seen?
Emily Brewer (17:14):
There are not any.
That will be the format that weare going to be launching.
So the DERM Expert podcast isgoing to be a way for us to
provide education because, likeI was telling you, education is
such a huge part of what we areat the DERM Center and it's a
huge part of what I try toimplement with my patients and
it's a huge part of what I tryto implement with my patients.
So, being able to reach apopulation of people and provide
(17:38):
this information so that we canbring awareness to certain skin
diseases and certain problemsthat people may be facing that
they don't understand thatthere's a treatment for, or that
they don't know that there's atreatment for, that's the type
of information that we want tobe bringing to light with the
podcast.
Sam Silvey (17:56):
I mean it seems like there's a need for it, right?
Emily Brewer (17:57):
Like there's a lot there.
Is there really is therehonestly.
There is such a demand indermatology and you know, I
think, that there is a lot ofmisconception too around the
field and that a lot of people,I think, default to thinking
that dermatology is all cosmetic, that it's all about, you know,
injectables or lasers orchemical peeling.
And while that is a part ofdermatology, there is a medical
(18:19):
side of dermatology too, thateveryone can be a patient for
dermatology.
Everyone can have a skin exam,everyone can have the education
about safe sun exposure,sunscreen, what's safe and how
do you apply it, how frequently.
So I think that it's somethingthat will be for everyone.
Sam Silvey (18:39):
So what do you see?
I mean, what's the layout goingto be, or the format of the
podcast, how?
Emily Brewer (18:43):
is it going?
Sam Silvey (18:44):
to differ.
Emily Brewer (18:45):
So there will be episodes where we have other
field experts that come on wherewe can talk about how their
field overlaps with dermatology.
So rheumatology, for example,you know, there are instances
where I'll see a patient withpsoriasis but the patient also
has psoriatic arthritis, whichis not in the field of
dermatology.
So there are patients wherethere are overlaps with
(19:07):
different specialties.
So I would love to have youknow, other experts in their
field come on and contribute tothose topics and then also would
love to have patients be ableto share their stories and talk
about how they've been impactedby different dermatology
diseases and diagnoses.
Sam Silvey (19:25):
Yeah, you know, the other doctors I've been to in my
life, you know, first one thatcomes on mind would be like all
the crashes I've had, racing,you know so broken bones, trauma
, yeah, trauma.
I always feel like when I go tothose doctors it's more like
absolute, like yes, we know theanswer.
Like we said it and we put itin some sort of cast.
Emily Brewer (19:46):
Very definitive.
Sam Silvey (19:53):
Yeah, Even with the head injuries, you know, like
you get a CAT scan, we make surethere's no brain bleed.
But with skin, I feel likethere's so much that's unknown
that people are trying to figureout all the time and compared
to like all these other fields,like just my own personal
experience, you know, there'snot as much.
I mean, there's a lot ofresearch, obviously, but there's
just a lot of unknown, At leastmy own little experience.
I feel like there needs to bemore information on this.
This could solve a big need, Iguess.
Emily Brewer (20:14):
I agree because I think, honestly, a lot of
dermatology patients, too, theygo to the internet.
They go online and they say,okay, and I've got this type of
bump or this type of rash, sothis must be what it is and I'm
going to go to the pharmacy andbuy a cream and treat it.
And it's basically putting theresponsibility of diagnosing and
treating on the patient withthat mentality, so by being able
(20:34):
to provide information onthings that maybe they can take
away and have an understandingof.
Ok, this is something I reallyneed to seek professional help
over, or this is something thatmaybe I can start with this
option at the pharmacy and seeif I get results, and if I don't
, then I need to speak withsomeone who can really customize
a treatment plan for me.
Sam Silvey (20:52):
Yeah, and you're really treating.
I mean, in dermatology, it'sthe whole body, right?
I mean not just the face, Imean it's.
Emily Brewer (20:58):
Full body largest organ, your skin is the largest
organ.
So, yes, we treat from top tobottom of the feet.
Sam Silvey (21:05):
Yeah.
Is there an area that standsout that you're treating most at
the Derm Center versus others?
Emily Brewer (21:11):
I would say we treat a lot of acne.
We treat a lot of psoriasis andeczema.
We do a lot of preventativeskin exams.
We do see skin cancers.
We treat a wide variety.
To be honest with you.
We also do some cosmetictreatments, but we keep that
very limited because the realfocus of the Derm Center is very
medical focused.
(21:31):
We want it to stay very medicalfocused.
Sam Silvey (21:34):
Yeah, yeah, well, even I mean the Botox and
fillers, those sort of thingsthat can still help.
Like you mentioned with theconfidence part, absolutely.
So many people think that'ssuperficial, but I think now
it's become so common Peoplewant to look younger and the
best they can for longer.
Emily Brewer (21:50):
Absolutely, and there are things, too, that are
available now, outside ofinjectables, that you can do,
that are not surgical.
It's very effective Chemicalpeeling, microneedling, doing
things to get your skin toregenerate and do things that it
already knows how to do.
Naturally, I love that concept,so we do offer microneedling.
(22:11):
It's a very effective way toboost collagen growth and get
your skin to do what it alreadyknows how to do.
Sam Silvey (22:17):
Yeah, I definitely need to do that.
I haven't done that.
I've tried Botox before andit's wearing off.
I tried it probably six monthsago and I guess that's my third
time.
Mainly crow's feet.
I love it.
I hate whenever I smile and Iget those crow's feet on the
side.
Emily Brewer (22:31):
I had mine done a week ago.
It's still settling.
Sam Silvey (22:35):
But microneedling I need to try, just because I'm
turning 40 next month, as Imentioned, and I look in the
mirror I'm like holy shit, I'mstarting to see like the one,
the gray hairs and all the lines.
Emily Brewer (22:45):
I had a gray eyelash the other day.
I was like I didn't evenworking in the field of
dermatology, didn't even knowthat happened.
That was a terrible surprise.
What is that?
Sam Silvey (22:55):
Yeah, right, it's not fair.
Emily Brewer (22:58):
It's literally not .
Sam Silvey (23:00):
I think the longer people can stay looking younger,
I mean it's helping boostconfidence and helping helps me
feel better about it.
You know I don't want, toeveryone's like, smile for the
camera.
I give kind of a smize, youknow, but I don't want to see
the crow's feet.
Emily Brewer (23:12):
I totally get that .
Sam Silvey (23:15):
Hey, one other thing that's very interesting about
derm is, like you said, you'retreating from zero years old to
101 a couple of weeks ago.
It's everyone really deals withwith dermatology.
Emily Brewer (23:26):
My grandmother.
She came in not too long ago.
She's 96.
She'll be 97 tomorrow actually,and you know still treating her
and you know there isdermatology for everyone,
regardless of age.
Sam Silvey (23:40):
Yeah, so we've got spring coming up, which for me
I'm happy about, because my skinstarts settling down.
Emily Brewer (23:48):
Right.
Sam Silvey (23:48):
For whatever reason, I think vitamin D seems to play
an effect on my skin as well,probably just overall body.
Emily Brewer (23:54):
Cold weather, dryness is a problem.
Sam Silvey (23:56):
Yeah, yeah, and so now warm weather is coming out.
I'm excited about it.
My skin usually gets a littlebetter.
Tan probably covers it up too,which I know you probably don't
like that.
Emily Brewer (24:05):
I'll pretend I didn't hear the tan part,
although you can still tan withsunscreen.
I'm just going to put that outthere.
Sam Silvey (24:12):
Okay, how does that work?
I mean, what sunscreen do youuse?
Emily Brewer (24:15):
So now a mineral-based sunscreen.
You're not really going to seetanning from that.
But now a chemical-basedsunscreen, which tend to be
lighter weight products.
Most people like to use more ofa chemical base on their face
At least I do because it'slighter weight, I can make up on
top of it, but with a sunscreen.
So a chemical based sunscreenyou are still going to see some
(24:37):
tanning.
That can happen with your skin.
Sam Silvey (24:38):
You're really just preventing cellular damage.
Emily Brewer (24:39):
Okay, so you can still wear your sunscreen and
still get a tan.
Okay.
Sam Silvey (24:41):
All right Now.
What's your skincare routine?
Is that something you can share?
Sure?
Emily Brewer (24:46):
Honestly, I have a very simple skincare routine
because I have a busy life and Idon't have time for a 12-step
routine and, honestly, it's notnecessary.
So in the mornings I wash myface with just a gentle cleanser
.
I love hyaluronic acid, so I'ma big fan of the HA intensifier,
so I use that every day withoutfail.
Vitamin C I don't use itconsistently, but for the most
(25:08):
part I do and then I moisturizeand sunscreen every morning and
then at night it's very, veryconsistent Wash my face, same
cleanser.
Retinol is a must for me and Irecommend it for just about
every patient and thenmoisturize and that's it.
So it's super simple.
Retinols are great because theyhelp to keep your skin clear.
(25:28):
They help with cellularturnover, helps to keep your
skin looking young.
But then also, too, if you seelittle actinic changes or
precancerous changes happeningon the surface of your skin from
sun, if you're exfoliating thatroutinely and you're turning
those skin cells over faster,you can really help to fight
that precancerous change too.
So I love retinol because ithas a cosmetic element to it,
(25:53):
but there's also a medicalelement behind it that I also
love Gotcha.
Sam Silvey (25:54):
Now, is it the same brand across all those products
or different brands?
You kind of picking andchoosing.
Emily Brewer (25:58):
Yeah, I'm pretty consistent with SkinCeuticals.
I love their products becausethey have very good data behind
them.
I use them personally.
They work well for my skin.
I've seen them work really wellwith other patients too.
So I'm pretty dedicated to thatbrand.
But I will say, from time totime I do try other brands too.
Sam Silvey (26:16):
Okay.
Emily Brewer (26:16):
And, like we were talking earlier, I have a
daughter who's about to be 13,and she has just about every
brand that a pharmacy wouldcarry in her bathroom, so I get
to see the effects on her skin,sometimes the good and the bad
Gotcha.
Sam Silvey (26:30):
So is there a dermatology tip you like to give
for springtime?
I know that's pretty hard tohave a generic one, but is there
one that stands out out ofcuriosity?
Emily Brewer (26:38):
Two things actually.
So in the spring, I like totell patients do spring cleaning
for your skincare.
Go through all of your skincareproducts.
Anything that is expired, getrid of it.
Check your sunscreen expirationdates, because sunscreens also
expire.
Toss them if they're expiredand replace them.
So I like the spring cleaningskincare concept and then
(26:58):
sunscreen.
I reiterate with spring breakcoming up, summertime coming up,
really you should wearsunscreen all year long, but
during those times it's a goodtime to really start a new
routine with wearing itconsistently, 30 SPF minimum.
Every two hours that you'reoutside you should reapply it.
Sam Silvey (27:15):
Okay, yeah, I'm bad about that last one especially.
No, don't tell anybody, don'ttell my dermatologist.
Emily Brewer (27:23):
I won't write it in your chart.
Sam Silvey (27:27):
I mean, that's a lot of information.
I think we've covered a lottoday.
I don't know how you feel aboutit.
Emily Brewer (27:31):
Yeah, great, I'm excited about the podcast.
I'm excited to get it going andto get some information out for
listeners.
Sam Silvey (27:39):
Do you have your first guest already picked up?
Emily Brewer (27:41):
I do actually.
Sam Silvey (27:42):
Do you want to give that away a little?
Emily Brewer (27:44):
I do.
So our first episode.
We're going to talk aboutprobably one of the most common
topics in dermatology.
We're going to talk about acne,because it can affect teenagers
, it can affect adults and youknow it's definitely something
that at the pharmacy there areso many products that are for
acne to pick from and we'regoing to talk all about those
(28:05):
products and those topics andI'll be having Autumn Newman.
She's one of the nursepractitioners at the Derm Center
.
She'll be coming on as ourguest.
Sam Silvey (28:13):
Awesome yeah, so I look forward to hearing that Yep
, I'm excited.
Awesome.
Well, I think that was a goodintro for today and get people
kind of hyped for the upcomingpodcast.
Emily Brewer (28:23):
Yes.
Sam Silvey (28:24):
Anything else you want to add to that I may have
missed.
Emily Brewer (28:26):
I don't think so.
Wear your sunscreen, check yourmoles.
Sam Silvey (28:35):
Well, thanks for joining us today, Spectra's
Speakeasy podcast with EmilyBrewer.
Be sure to check outthedermcenterTNcom for any of
your dermatology needs and alsobe on a lookout for the Derm
Expert podcast.
Our first episode will belaunching June 1st and have all
of your dermatology needs andanswers to all your complicated
questions.
Emily Brewer (28:52):
Stay tuned and thanks again for joining us.
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