Skin longevity is more than just a trend; it’s a vital aspect of overall health. Join Dr. Zakia Rahman, Clinical Professor of Dermatology at Stanford University, as she shares her insights on the evolving field of dermatology. Discover the transformative role of lasers in dermatologic patient care and the importance of education in promoting equity and safety. We'll discuss the latest advancements in treating common dermatologic conditions and gain a deeper understanding of fractional lasers for scar remodeling. Together, we’ll explore holistic approaches to maintaining skin health and longevity.
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Episode Transcript
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(00:00):
(upbeat music)
- Welcome to Stanford Medcast,the podcast from Stanford CME
that brings you the latest insights
from the world's leadingphysicians and scientists.
If you're joining us for the first time,
be sure to subscribe on Apple Podcast,
Amazon Music, Spotify, or YouTube
(00:22):
to stay updated with our newest episodes.
I am your host, Dr. Ruth Adewuya.
Today I am joined by Dr. Zakia Rahman
who is a clinical professor of dermatology
at Stanford University
and director of the ResidentLaser and Aesthetic Clinic.
She's affiliate faculty at theStanford Center on Longevity
and also serves as assistant chief
(00:44):
and co-director of Dermatologic Surgery
at the Livermore Division
of the VA Palo Alto Healthcare Assistant.
Due to her commitmentto advancing precision
and inclusivity in dermatologic care,
she has helped pioneer lasers
and energy-based devices for skin of color
through leading scientific advisory boards
on multiple aestheticmedical device companies.
(01:06):
Dr. Rahman is an invitedlecturer nationally
and internationally on skinof color, skin longevity,
laser and aesthetic dermatologic surgery,
social media, beauty ideals,
and physician burnout and wellness.
She's a media expert and has been featured
in the New York Times,Bloomberg News, Huffington Post,
NBC, CBS, and Scientific American.
(01:26):
She serves in the AmericanMedical Association,
AI Subspecialty Collaborative,
and on the national board of directors
for the American Society forLaser Medicine and Surgery.
Her numerous awards includethe Melanie Grossman Award
for leadership, mentorship, and advocacy
for Women in Medical Sciences,
as well as the AmericanAcademy of Dermatology,
presidential citation
(01:47):
for Advancing Diversity inthe Field of Dermatology.
Dr. Rahman, thank you for being here.
- Thank you, Dr. Adewuya, for having me.
- You have been at the forefront
of laser dermatology equity and care.
I'm curious to hear fromyou what initially drew you
to this intersection of science,aesthetics, and advocacy?
- I credit my parents fora lot of who I am today,
(02:08):
particularly in instillingservice as a core value
really early on in my life.
Growing up, I did a lot of volunteering.
My parents sent me to alocal senior citizen center
where I worked creatingmeals for Meals on Wheels.
So I got to get an interest
and realize how much value senior citizens
have in our lives.
Early on in my dermatology training,
one of my attendingsasked me to be involved
(02:31):
in a clinical study
on a condition calledPseudofolliculitis barbae
using lasers with an extended pulse width
to safely treat those patients.
That was an aha moment for methat sealed my love of lasers
and also in being able to use technology
to treat everybody safely.
Dermatology is the onespecialty where it's so obvious
(02:54):
because you have to go through the skin.
As physicians, we take the oath
to beneficence and nonmaleficence,
the different phenotypes that we see
in skin, hair, and nails.
For me, how important it was
to be able to treat my patientssafely and effectively.
- It's clear how deeplyyour personal values
and upbringing have influenced your work.
(03:15):
That intersection of service,scientific curiosity,
and strong sense of advocacycomes through so clearly
and it's striking that even early on,
you saw dermatology asa field of innovation,
but also as a space where real disparities
could be addressed throughmeaningful clinical work.
That makes me want to zoom out a bit.
(03:36):
Dermatology is evolving quickly.
Technologically, socially, and clinically.
From your perspective,
what do you think has changedthe most in the last decade
and what still hasn't changed enough?
- One of the things thathas changed the most
is the expansion of smartphoneuse throughout the world.
As of April 2025, 70.7%
(03:58):
of the world's population or5.81 billion have smartphones.
These phones that have photos in them,
and we know that 3.2 billion images
are uploaded every single day.
That's about 1.1 trillion a year,
and that number is expectedto go to 2.2 trillion
just by the end of this decade.
There's no organ that'smore image than the skin.
(04:19):
We see our own skin,
we see other people's skin all the time,
and that affects a lot of things,
including our sense of self-worth
from how we evaluate other people's,
mostly in their sense of vitality.
Often people thoughtdermatology is a vanity field,
but it isn't.
I like to use a differentV word, which is vitality
because we know that how people view us
(04:42):
affects things like if they view,
if we're intelligent,
if they view that we're guiltyor innocent on jury trials.
People wanting their skin to look the best
has even become more at the forefront.
Dermatology is also a fieldwhere because of these images,
use of artificial andaugmented intelligence
is something that we cando in skin cancer diagnosis
(05:04):
and in the diagnosis andtreatment of disease.
That gets me to wherewe haven't gone enough,
which are these disparities.
We still see majordisparities in diagnosis
and treatment of skin ailments
because how light reflects on the skin
affects how we're able to diagnose things
like pigmentary disorders, melanoma,
(05:24):
which we know that there'sdifferences in morbidity
and mortality at diagnosis,
So I think that there'sa lot more opportunity
where we haven't gone far enough.
- The distinction you madein saying dermatology,
as a field of vitality rather than vanity,
is especially resonant today.
Visibility has clinical implications.
(05:44):
We know appearance related concerns
can influence everythingfrom mental health
to how others assesscredibility or competence.
At the same time, theexpansion of tools like AI
raises the stakes for accuracy,
especially given the visualnature of this specialty.
Foundational disparities still persist,
particularly in how skin conditions
(06:05):
are diagnosed across different skin tones.
What recent advances in laser technology
do you think have truly changed the game,
not just in improving outcomes,
but in shifting how we thinkabout treatment itself?
- Talking about this ideaof vitality in dermatology,
think of lasers andlight-based technologies
and energy-based devicesas just another tool.
(06:28):
Lasers change the game in terms of
being able to effectivelyand safely treat people.
One is the advent of fractional lasers
that improve the accessof people who could safely
and effectively get laser treatments
for conditions like pigmentary disorders
or acne and acne scarring,
(06:48):
which we know has differentincidents and prevalence
depending on your racial background.
I still, to this day, see alot of people for complications
of laser-based technologiesthat they've had,
people with permanent loss of pigmentation
with lasers that don'tincorporate those new features
like fractional lasers.
(07:08):
When you look at traditional lasers
that were targeted at water,
they basically wouldbe able to treat things
like wrinkles or photodamage or acne scarring,
and they would treat ahundred percent of the skin.
That would mean that you're dependent on
the pilosebaceous unitsas well as the stem cells
and the edges of thewound to re-epithelialize.
(07:30):
That re-epithelialization
took anywhere from seven to 10 days
in ideal wound conditions,
which we know patientsoften will have a hard time
doing at home.
When you look at fractionallasers, that gets reduced
because you have thesesmall microscopic areas
where you either ablateor coagulate tissue.
You can quickly heal thatskin from the wound edges,
(07:52):
which reduces that risk ofpermanent loss of pigment
or hyperpigmentation, whichis often when you break
that epidermal dermal barrier,
you get pigment dropout andyou can get hyperpigmentation
in all people, butparticularly those of us
who have more pigmentation in our skin.
- The way you describe lasersas part of an expanded toolkit
(08:13):
and as biologically active toolswith broad clinical utility
underscores how the field is evolving.
As these technologiesgrow more sophisticated,
the convergence betweencosmetic and medical dermatology
seems to become moreapparent for clinicians
outside of academic centers.
That raises a question about access
not just to equipment, but to training.
(08:35):
How accessible is thiskind of laser technology
to the broader medical community
and what role does education play
in ensuring its used safely and equitably?
- That goes to access,
which is a major issuein healthcare all around.
Dermatologists are 1.2% of physicians.
The average wait time,
at least throughout thecountry is about 38 days,
(08:57):
but it can range up to months.
For our clinic, which focuses on lasers
and energy-based devices and aesthetics,
the wait time is multiple months.
So I think it is hard to have access,
but we are involved with education
through our National AmericanAcademy of Dermatology
and the American Society forLaser Medicine and Surgery,
which I sit on the boardare providing education.
(09:19):
If people are interestedin getting more education,
I'd recommend that theygo to these conferences
or take online courses.
There is more and moreinformation available,
which particularly for those of us
who are healthcare providers,
will allow us to deliver better care.
- This gets to a broader issue.
Even when technology is available,
it doesn't guarantee equitable care.
(09:41):
Many patients, myself included,
struggle to find dermatologistswho are trained to care
for richly pigmented skin
and it's not about racial identity per se,
but about clinical familiarityand diagnostic precision.
Our efforts to diversify training
and clinical competencybeing meaningfully integrated
(10:01):
into national dermatology education
and what impact do youthink this is having
on both patient care andworkforce representation?
- These personal stories matter a lot.
They're what matter to us.
As physicians, when we deliver care,
I think specifically
with the American Academy of Dermatology,
they recognize the need toimprove clinical competency
(10:23):
for treatment of people of color,
particularly as the demographics
of the United States have changed.
To be a competent physician
is to know and understand howthese phenotypic variations
affect the diagnosis and treatment
of different skin diseases
and the prevalence of incidenceof different skin diseases.
When we think of laserand LISP space technology,
(10:46):
often these are not covered by insurance
in what's consideredaesthetic dermatology.
I sit at the table withcompanies and nonprofit
or for-profit institutionsand let them know that,
"Hey, this is good for business."
And I know that so they're motivated.
We've seen an advancement in dermatology
embracing things that more people can use
(11:06):
safely and effectively
because they recognize thatthere is financial value in it.
- I'd like to shift gears now
and focus on medical management.
When we think about conditions like acne,
eczema, and psoriasis,
there have been some important advances
in both pharmacologicaland device-based therapies
in recent years.
Can you walk us through whatthe most significant updates
(11:28):
in how we treat these common conditions
and what should cliniciansbe paying closer attention to
that might change the way theyapproach management today?
- We can start with acne,which is extraordinarily common
and is caused by four specific factors,
which is how the keratinocytes
come out of the hair follicle.
When they don't come out normally,they create what's called
(11:50):
a little comedone or microcomedone.
You have increased sebum production,
which is why we see acne,
particularly around the timewhere people hit puberty
because they have upregulationon sebum production
because of hormones.
There's also a proliferationof bacteria, P. acnes bacteria,
and that combination togetherincreases inflammation.
(12:12):
We are aware now that inspecific types of people,
the inflammation is deeper
and so they're more likely to get scarring
as a result of their acne.
We see this particularly in Asians
and African-Americans and Hispanics.
We see a lot more of thosepatients who have acne scarring
as the sequelae to their acne.
Isotretinoin is stillthe mainstay of therapy
(12:34):
for the treatment of acne,
but there's been a majoradvancement in the development
of 1726 nanometer lasers
that specifically target sebaceous glands
and have FDA clearance
for the long-term reductionin inflammatory acne.
They have a 70% reduction at six months
after a series of treatments.
(12:55):
While it's a amazing drug,it's highly regulated,
so this advancement in acnetreatment is a big game changer.
When looking at eczema,
I think biologics are also abig game changer, dupilumab.
It's a dual inhibitor of IL-4 and I-13
and these are the twodrivers of inflammation.
We're even using it inconditions like bolus pemphigoid
(13:17):
and there's more and moredata that these biologics,
particularly dupilumab,
are advancing the treatmentof a lot of skin ailments.
Psoriasis has often been at the forefront
because it is one of thosequality of life conditions
and we know that TNF alpha inhibitors
have been the biologic mainstays
for the treatment of psoriasis
(13:38):
and also psoriatic arthritis.
Their newer interleukin-17, 12, 23s
have also changed the game in psoriasis.
Interestingly, GLP-1 agonistshave also changed a game
in psoriasis,
so we know that there isa significant comorbidity
of psoriasis in coronary artery disease
(13:58):
and oftentimes we will tellpatients to change exercise
or change their diet and those things
are really hard to affect thelevel of patient's weight,
but we know with these GLP-1 drugs
that patients do have a reduction
in their total body surfacearea and psoriasis severity.
For non-dermatologists out there,
it is important to understandthis cardiometabolic effects
(14:22):
with psoriasis,
so if you see a patientthat has psoriasis,
consider asking andpotentially doing workups
to make sure they don'thave hyperlipidemia
or cardiovascular disease andalways refer to dermatologists
because for quality of lifeissues in these patients,
you can significantly improve them
with the advances we have.
(14:43):
- The way you connected pathophysiology
to real world disparitieslike deeper inflammation
leading to more scaring inpatients with skin of color
is an essential contextfor tailoring treatment.
And these new modalitiesfrom biologics like dupilumab
to 1726 nanometer lasers seemto be offering more targeted,
long-lasting options.
(15:03):
The evolution does sound exciting,
but it also raises an important question.
How well do these advances
hold up across diverse skin types?
Are there therapies you've seen
that are especially well suited
or perhaps poorly suited for patients
with richly pigmented skin?
- A lot of the data shows thatwhen diagnosed appropriately
(15:25):
and at an early stage,patients of color do well.
We know that for things likecardiometabolic disease,
it is more common in certainsubtypes of patients.
It's even more importantfor early referral
and early access tocare for those patients.
- What's one common misdiagnosis
you see often in patientswith skin of color
(15:46):
and how can frontline clinicians avoid it?
- Although melanoma isonly 1% of skin cancers,
it has the highest mortality.
We know when diagnosedearly, the five-year survival
for patients is 94%,
but when you look at African Americans
when they're diagnosed with melanoma,
they have a 70% five-year survival,
which is really significant.
We as physicians haveto look at the science
(16:08):
and the outcomes to tailor our treatments
to give the optimalresults for our patients.
- That disparity in melanoma outcomes
is striking and sobering.
The fact that early detection
so dramatically improves survival,
yet Black patients areoften diagnosed later,
really emphasizes how much we need
to expand our diagnostic lens.
(16:28):
It's not just about teaching people
to look in the right places
like palms and souls and nail beds,
but it's also aboutaddressing the assumptions
that lead to delayedcare in the first place.
You've been deeply involved in efforts
to advance equity in dermatology.
How do you balance the use
of standardized treatment protocols
with the need to deliver culturally
(16:50):
and phenotypicallyinformed personalized care?
- We're really fortunate to be at Stanford
where precision care isone of our core values.
This is a basic principleof healthcare, right?
Do no harm and then do good,
beneficence and nonmaleficence.
It's important to be able todeliver personalized treatment.
(17:10):
If I see a patient, for example,who has a hair condition
and I know having done askin of color fellowship,
I can't give the patienta shampoo and say,
"Wash your hair every day with this"
because they don't washtheir hair every day.
I can't tell you how farit goes with a patient
who comes in who hasphenotypically different hair
for me to be able to ask them,
"How often do you wash your hair?
(17:32):
What do you use to wash your hair?"
That improves patientcompliance and patient outcomes.
We can't do more in deliveringthat personalized care
that looks at all of thevariabilities in the patient.
What we see phenotypically,what they do culturally,
what they do every day in and out
to deliver good healthcare.
- I value how you bring itback to foundational ethics,
(17:54):
do no harm and beneficence asthe anchor for precision care.
What I hear in your approach
is that personalized dermatology
isn't about abandoning clinical standards.
It's about applying them with nuance,
whether it's hair careroutines, cultural practices,
or how skin responds tolight or inflammation.
It all matters.
(18:15):
And the outcome isn'tjust better compliant.
It's better care, lowercosts, and more trust.
That principle feels especially important
as we introduce emergingtechnologies into our practices.
One of your core areas ofexpertise is fractional lasers
for scar remodeling.
Could you take us a little deeper
into what's happeningat the cellular level
(18:36):
and how that understanding informs
how you use these tools clinically?
- You'll have to stop me 'causeI love talking about lasers,
but when we think as alight photo biologist,
there are a few different ways
that light can interact with tissue.
At moderate levels, you cancause control destruction.
At low levels, you actuallystimulate biological functions.
We know that people are usinga lot of photobiomodulation
(18:59):
or these red light therapies
to stimulate biological functions.
When we look at fractional lasers,
we particularly look atthose when we target water.
We use what's calledselective photothermolysis
when we target tissue.
So we look at things that willabsorb wavelengths of light.
And so the main chromophoresin the skin are melanin.
(19:23):
That's why it's so important
to be able to know the patient's melanin
and how their skin will respondto light-based technologies.
With fractional lasers, theydiffer from traditional lasers
that target water
in that they have controlled tissue injury
in microscopic areaswith lots of normal skin
(19:43):
around the areas.
Anytime you have controlled tissue injury,
which is often whatwe're doing with lasers,
we wanna spare sometissue for rapid healing
and to reduce the incidence ofside effects like skin burns.
It can lead to blistering,hyperpigmentation,
or even permanent loss of pigmentation,
(20:05):
which we can see really in all skin types.
Fractional lasers revolutionize that.
We use laser and light to either vaporize
or to coagulate small microscopicthermal zones of tissue.
What happens when you dothis is the skin responds
to tissue damage by upregulating things
like heat shock proteins,particularly 47 and 70,
(20:28):
lead to the production of collagen,
and then the other thing that happens
is you have upregulation ofsome matrix metallo proteases.
As the skin heals, during thatprocess, you get upregulation
of both collagen one and collagen three.
What's interesting about thoseratios of those two collagens
is that when we're very youngor in regular adulthood,
(20:49):
the ratio of collagen one
to collagen three is about the same.
As we age, our collagen one goes down
and our collagen three production goes up.
What's interesting with fractional lasers
is they cause upregulationin both of those.
The skin looks better
because it's functioninglike younger skin.
We know when we upregulatethat collagen production,
(21:10):
we're creating normal collagen
where you had abnormalcollagen in scarring.
So you still have collagen in scars,
whether they're atrophic,hypertrophic, or keloidal scars,
but that collagen is not normal collagen.
Fractional lasers helpcreate normal collagen
through those microscopiczones of tissue injury.
(21:30):
- What stands out in your explanation
is how fractional lasersoperate at a regenerative level,
not just correcting the surface,
but actually prompting biological healing.
The idea that controlled micro injury
can stimulate collagen production
and restore the skin's architecture
reframes laser treatmentas cellular therapy
(21:52):
and not just cosmetic enhancement.
Red and blue light therapiesare everywhere right now.
Masks, at home panels, you name it.
And it feels like every skincare company
is marketing some kindof light-based solution.
From your perspective,
where does the evidence actuallysupport red light therapy
and where should we be alittle bit more skeptical
(22:14):
about what's being promised?
- At these very low levels,
you stimulate biological functions.
We know that specificwavelengths of red light
target what's called cytochrome C oxidase,
which is what we have tobuild ATP in our mitochondria.
Through inflammation
and reactive oxygen species,
we basically displace theoxygen in cytochrome C oxidase.
(22:36):
What happens is that with red light,
you can remove that andincrease ATP production
so the cells can function better.
Red light is most studiedin hair growth stimulation
where there is a lot of science
and we see an upregulation ofinsulin-like growth factor.
We see effects similar to the application
(22:57):
of topical and oxidalwith red light therapy,
so yes, there is science.
Now, red light therapy canbe delivered through laser
or it can also be deliveredthrough light emitting diodes.
Laser is coherent lightthat is one wavelength,
so can travel long distances
without losing a lot of its energy.
When we go to things like LEDs,
(23:18):
one is they're less expensive to make
and so that makes it more accessible.
We wanna democratize technology,but it's important to know
that with those light emitting diodes,
that light can scatter.
So if you're using it tostimulate hair growth,
you want something that'sgonna separate the hair
and deliver the light into the scalp.
There are things that are in development
where we can make surethat light doesn't scatter,
(23:40):
which is a long way to say
that there is real science behind it
and there are clinical uses for it.
- That was super helpful
and I appreciate the bit of myth busting.
I'll admit, part of thatwas personal curiosity.
I do own one of thosered light therapy masks
and I've definitely wonderedif it was more hype than help,
but shifting gears a bit,I'd love to come back
(24:00):
to something you touched onearlier about aging skin.
In your experience,
what are some of the changesclinicians often chalk up
to normal aging that actually deserve
more clinical attention,
and what should we belooking out for instead?
- I'm very fortunate tohave taken care of veterans
for a number of years, so I see people
who are in their 80s, 90s, centenarians.
(24:22):
We know that a skin,being the largest organ,
serves many important functions.
One, it's the physical barrier
between us and our environment.
We know that skin frailtycan cause tears in the skin,
which can increase infection.
The skin is responsiblefor vitamin D productions,
looking at also thermal regulation.
Evaporative skin cooling is a major way
(24:42):
that we are able toregulate our temperature.
Those functions decline with age.
There are ways that wecan optimize that skin
to not have that reduction in function.
When some patients say to me,
"Getting old really isterrible, Dr. Rahman,"
I'll say It's better than the alternative.
For countries with the levelof wealth that we have,
(25:04):
it is a privilege to get older,
but your skin doesn't have to get older.
I'm working with one of mycolleagues, Dr. Anne Chang,
to develop a validated skin frailty score
that we can provide to non-dermatologists.
While a lot of these changes may seem like
they are just how the skin looks,
we have to recognize that the skin
(25:26):
also has really importantbiological functions.
- You raise such an important point.
Skin changes in olderadults are often brushed off
as purely cosmetic,
when in fact they reflectdeeper functional shifts
that can impact everythingfrom thermal regulation
to infection risk.
Having a tool like a skin frailty score
(25:46):
in the hands of primary care providers
could be a real game changer.
With all that in mind,
I'd love to hear yourthoughts on skin longevity.
We talk a lot about longevityin cardiology or oncology,
but how do you define it in dermatology
and why is it clinically meaningful?
- When I think of skin longevity,
I think of optimal function of the skin.
(26:07):
Anything that restores theoptimal function of the skin
to the levels of what wehave in mid adulthood,
longevity has a better connotation
than aging becausepeople are living longer.
It's gonna be important forall of us to be able to work
for a long time.
I realized seeingpatients who are coming in
(26:28):
for laser light-based treatments
or neuromodulators in their 20s
and seeing people who are centenarians
and near centenarians at the VA
that I've been treating skinlongevity for a long time.
- That's a refreshingway to think about it.
Framing skin longevity, notaround aging or decline,
but really around maintainingfunction and vitality.
(26:48):
It's so true that as peoplelive and work longer,
keeping our skin healthy
becomes part of stayingindependent and resilient,
not just looking good.
Thinking about that ideaof optimizing function,
especially as the skin changes over time,
what practices or interventions
do you think hold the most promise
(27:09):
for supporting long-term skin health?
- My top three are one, sun protection.
A little trick that dermatologists use,
which other clinicians listening can use
is patients are moremotivated to use sunscreen
to prevent premature aging of their skin
than to prevent sun-related skin cancer.
I'm not telling peopleto go live in a cave.
(27:30):
You still can get sun,
but doing it in a way that'ssafer, so sun protection.
We know that retinoidshave a significant role
in improved skin functioning
because they targetmany cells in the skin,
whether they're fibroblast or melanocytes
or are keratinocytes.
They have lots of benefits.
(27:51):
And the third one turnsout that eating foods
that are high in beta carotene,
which is a vitamin A derivative,
actually makes our skinlook more attractive
because it's functioning better.
There's this 2014 study wherethey took photos of people
and they made them more keratinoid
and they had people evaluatetheir attractiveness,
and it turned out thatthe keratinoid faces
(28:13):
were viewed as more attractive.
So there's something thathappens in our psychology
that shows us that whensomeone's skin is better overall,
that's a reflection oftheir overall health.
We'd see them as being more attractive.
So eat foods that arecarrots, spinach, tomatoes,
sweet potatoes, broccoli,squash, cantaloupe,
(28:34):
and other green leafy vegetables.
- I find it really exciting
how our understanding of skin health
is becoming so much more holistic.
It's not just about topical treatments
or photo protection anymore,but how things like nutrition
and lifestyle fit into the bigger picture.
What really stood outto me in what you said
is this idea of reframing prevention,
(28:55):
not just this avoiding disease,
but as promoting overall health,
confident, and long-term function.
So as someone who reallysits at the crossroads
of academia, innovation,and clinical care,
I'm curious, what areyou most excited about
when you think about thefuture of dermatology?
- I'm most excited abouttechnological advances
in dermatology.
(29:16):
I would say the shift to prevention
and overall health with skin longevity,
the use of advancedtechnologies to improve care,
so the use of lasers, energy-baseddevices, neuromodulators,
artificial intelligence used intelligently
by healthcare providers.
Shifting the mindset for those of us
(29:37):
who have been trainedin traditional medicine
to integrate overallhealth for our patients
with the change of preventionand looking at longevity,
that's something that wouldresonate with our patients
and motivate our patients to do things
that are better for their health overall.
Your skin has no expiration date.
As long as you're alive,
your skin has the ability to improve.
(29:59):
- Dr. Rahman, thank youfor coming on the podcast
and for this incredibly richand wide raging conversation.
You've given us notonly clinical insights,
but also a deeper understanding
of how dermatology sits atthe intersection of science
and technology and human dignity.
From lasers to biologics tothe ethical application of AI,
(30:19):
you'd help to see thatskin health is really
about so much more than what's visible.
It's about vitality,longevity, and equity.
So thank you so much for your time today.
This episode was broughtto you by Stanford CME.
To claim CME forlistening to this episode,
click on the Claim CME link below
or visit medcast.stanford.edu.
(30:41):
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- Welcome to Stanford Medcast,the podcast from Stanford CME
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to stay updated with our newest episodes.
I am your host, Dr. Ruth Adewuya.
Today I am joined by Dr. Zakia Rahman
who is a clinical professor of dermatology
at Stanford University
and director of the ResidentLaser and Aesthetic Clinic.
She's affiliate faculty at theStanford Center on Longevity
and also serves as assistant chief
(00:44):
and co-director of Dermatologic Surgery
at the Livermore Division
of the VA Palo Alto Healthcare Assistant.
Due to her commitmentto advancing precision
and inclusivity in dermatologic care,
she has helped pioneer lasers
and energy-based devices for skin of color
through leading scientific advisory boards
on multiple aestheticmedical device companies.
(01:06):
Dr. Rahman is an invitedlecturer nationally
and internationally on skinof color, skin longevity,
laser and aesthetic dermatologic surgery,
social media, beauty ideals,
and physician burnout and wellness.
She's a media expert and has been featured
in the New York Times,Bloomberg News, Huffington Post,
NBC, CBS, and Scientific American.
(01:26):
She serves in the AmericanMedical Association,
AI Subspecialty Collaborative,
and on the national board of directors
for the American Society forLaser Medicine and Surgery.
Her numerous awards includethe Melanie Grossman Award
for leadership, mentorship, and advocacy
for Women in Medical Sciences,
as well as the AmericanAcademy of Dermatology,
presidential citation
(01:47):
for Advancing Diversity inthe Field of Dermatology.
Dr. Rahman, thank you for being here.
- Thank you, Dr. Adewuya, for having me.
- You have been at the forefront
of laser dermatology equity and care.
I'm curious to hear fromyou what initially drew you
to this intersection of science,aesthetics, and advocacy?
- I credit my parents fora lot of who I am today,
(02:08):
particularly in instillingservice as a core value
really early on in my life.
Growing up, I did a lot of volunteering.
My parents sent me to alocal senior citizen center
where I worked creatingmeals for Meals on Wheels.
So I got to get an interest
and realize how much value senior citizens
have in our lives.
Early on in my dermatology training,
one of my attendingsasked me to be involved
(02:31):
in a clinical study
on a condition calledPseudofolliculitis barbae
using lasers with an extended pulse width
to safely treat those patients.
That was an aha moment for methat sealed my love of lasers
and also in being able to use technology
to treat everybody safely.
Dermatology is the onespecialty where it's so obvious
(02:54):
because you have to go through the skin.
As physicians, we take the oath
to beneficence and nonmaleficence,
the different phenotypes that we see
in skin, hair, and nails.
For me, how important it was
to be able to treat my patientssafely and effectively.
- It's clear how deeplyyour personal values
and upbringing have influenced your work.
(03:15):
That intersection of service,scientific curiosity,
and strong sense of advocacycomes through so clearly
and it's striking that even early on,
you saw dermatology asa field of innovation,
but also as a space where real disparities
could be addressed throughmeaningful clinical work.
That makes me want to zoom out a bit.
(03:36):
Dermatology is evolving quickly.
Technologically, socially, and clinically.
From your perspective,
what do you think has changedthe most in the last decade
and what still hasn't changed enough?
- One of the things thathas changed the most
is the expansion of smartphoneuse throughout the world.
As of April 2025, 70.7%
(03:58):
of the world's population or5.81 billion have smartphones.
These phones that have photos in them,
and we know that 3.2 billion images
are uploaded every single day.
That's about 1.1 trillion a year,
and that number is expectedto go to 2.2 trillion
just by the end of this decade.
There's no organ that'smore image than the skin.
(04:19):
We see our own skin,
we see other people's skin all the time,
and that affects a lot of things,
including our sense of self-worth
from how we evaluate other people's,
mostly in their sense of vitality.
Often people thoughtdermatology is a vanity field,
but it isn't.
I like to use a differentV word, which is vitality
because we know that how people view us
(04:42):
affects things like if they view,
if we're intelligent,
if they view that we're guiltyor innocent on jury trials.
People wanting their skin to look the best
has even become more at the forefront.
Dermatology is also a fieldwhere because of these images,
use of artificial andaugmented intelligence
is something that we cando in skin cancer diagnosis
(05:04):
and in the diagnosis andtreatment of disease.
That gets me to wherewe haven't gone enough,
which are these disparities.
We still see majordisparities in diagnosis
and treatment of skin ailments
because how light reflects on the skin
affects how we're able to diagnose things
like pigmentary disorders, melanoma,
(05:24):
which we know that there'sdifferences in morbidity
and mortality at diagnosis,
So I think that there'sa lot more opportunity
where we haven't gone far enough.
- The distinction you madein saying dermatology,
as a field of vitality rather than vanity,
is especially resonant today.
Visibility has clinical implications.
(05:44):
We know appearance related concerns
can influence everythingfrom mental health
to how others assesscredibility or competence.
At the same time, theexpansion of tools like AI
raises the stakes for accuracy,
especially given the visualnature of this specialty.
Foundational disparities still persist,
particularly in how skin conditions
(06:05):
are diagnosed across different skin tones.
What recent advances in laser technology
do you think have truly changed the game,
not just in improving outcomes,
but in shifting how we thinkabout treatment itself?
- Talking about this ideaof vitality in dermatology,
think of lasers andlight-based technologies
and energy-based devicesas just another tool.
(06:28):
Lasers change the game in terms of
being able to effectivelyand safely treat people.
One is the advent of fractional lasers
that improve the accessof people who could safely
and effectively get laser treatments
for conditions like pigmentary disorders
or acne and acne scarring,
(06:48):
which we know has differentincidents and prevalence
depending on your racial background.
I still, to this day, see alot of people for complications
of laser-based technologiesthat they've had,
people with permanent loss of pigmentation
with lasers that don'tincorporate those new features
like fractional lasers.
(07:08):
When you look at traditional lasers
that were targeted at water,
they basically wouldbe able to treat things
like wrinkles or photodamage or acne scarring,
and they would treat ahundred percent of the skin.
That would mean that you're dependent on
the pilosebaceous unitsas well as the stem cells
and the edges of thewound to re-epithelialize.
(07:30):
That re-epithelialization
took anywhere from seven to 10 days
in ideal wound conditions,
which we know patientsoften will have a hard time
doing at home.
When you look at fractionallasers, that gets reduced
because you have thesesmall microscopic areas
where you either ablateor coagulate tissue.
You can quickly heal thatskin from the wound edges,
(07:52):
which reduces that risk ofpermanent loss of pigment
or hyperpigmentation, whichis often when you break
that epidermal dermal barrier,
you get pigment dropout andyou can get hyperpigmentation
in all people, butparticularly those of us
who have more pigmentation in our skin.
- The way you describe lasersas part of an expanded toolkit
(08:13):
and as biologically active toolswith broad clinical utility
underscores how the field is evolving.
As these technologiesgrow more sophisticated,
the convergence betweencosmetic and medical dermatology
seems to become moreapparent for clinicians
outside of academic centers.
That raises a question about access
not just to equipment, but to training.
(08:35):
How accessible is thiskind of laser technology
to the broader medical community
and what role does education play
in ensuring its used safely and equitably?
- That goes to access,
which is a major issuein healthcare all around.
Dermatologists are 1.2% of physicians.
The average wait time,
at least throughout thecountry is about 38 days,
(08:57):
but it can range up to months.
For our clinic, which focuses on lasers
and energy-based devices and aesthetics,
the wait time is multiple months.
So I think it is hard to have access,
but we are involved with education
through our National AmericanAcademy of Dermatology
and the American Society forLaser Medicine and Surgery,
which I sit on the boardare providing education.
(09:19):
If people are interestedin getting more education,
I'd recommend that theygo to these conferences
or take online courses.
There is more and moreinformation available,
which particularly for those of us
who are healthcare providers,
will allow us to deliver better care.
- This gets to a broader issue.
Even when technology is available,
it doesn't guarantee equitable care.
(09:41):
Many patients, myself included,
struggle to find dermatologistswho are trained to care
for richly pigmented skin
and it's not about racial identity per se,
but about clinical familiarityand diagnostic precision.
Our efforts to diversify training
and clinical competencybeing meaningfully integrated
(10:01):
into national dermatology education
and what impact do youthink this is having
on both patient care andworkforce representation?
- These personal stories matter a lot.
They're what matter to us.
As physicians, when we deliver care,
I think specifically
with the American Academy of Dermatology,
they recognize the need toimprove clinical competency
(10:23):
for treatment of people of color,
particularly as the demographics
of the United States have changed.
To be a competent physician
is to know and understand howthese phenotypic variations
affect the diagnosis and treatment
of different skin diseases
and the prevalence of incidenceof different skin diseases.
When we think of laserand LISP space technology,
(10:46):
often these are not covered by insurance
in what's consideredaesthetic dermatology.
I sit at the table withcompanies and nonprofit
or for-profit institutionsand let them know that,
"Hey, this is good for business."
And I know that so they're motivated.
We've seen an advancement in dermatology
embracing things that more people can use
(11:06):
safely and effectively
because they recognize thatthere is financial value in it.
- I'd like to shift gears now
and focus on medical management.
When we think about conditions like acne,
eczema, and psoriasis,
there have been some important advances
in both pharmacologicaland device-based therapies
in recent years.
Can you walk us through whatthe most significant updates
(11:28):
in how we treat these common conditions
and what should cliniciansbe paying closer attention to
that might change the way theyapproach management today?
- We can start with acne,which is extraordinarily common
and is caused by four specific factors,
which is how the keratinocytes
come out of the hair follicle.
When they don't come out normally,they create what's called
(11:50):
a little comedone or microcomedone.
You have increased sebum production,
which is why we see acne,
particularly around the timewhere people hit puberty
because they have upregulationon sebum production
because of hormones.
There's also a proliferationof bacteria, P. acnes bacteria,
and that combination togetherincreases inflammation.
(12:12):
We are aware now that inspecific types of people,
the inflammation is deeper
and so they're more likely to get scarring
as a result of their acne.
We see this particularly in Asians
and African-Americans and Hispanics.
We see a lot more of thosepatients who have acne scarring
as the sequelae to their acne.
Isotretinoin is stillthe mainstay of therapy
(12:34):
for the treatment of acne,
but there's been a majoradvancement in the development
of 1726 nanometer lasers
that specifically target sebaceous glands
and have FDA clearance
for the long-term reductionin inflammatory acne.
They have a 70% reduction at six months
after a series of treatments.
(12:55):
While it's a amazing drug,it's highly regulated,
so this advancement in acnetreatment is a big game changer.
When looking at eczema,
I think biologics are also abig game changer, dupilumab.
It's a dual inhibitor of IL-4 and I-13
and these are the twodrivers of inflammation.
We're even using it inconditions like bolus pemphigoid
(13:17):
and there's more and moredata that these biologics,
particularly dupilumab,
are advancing the treatmentof a lot of skin ailments.
Psoriasis has often been at the forefront
because it is one of thosequality of life conditions
and we know that TNF alpha inhibitors
have been the biologic mainstays
for the treatment of psoriasis
(13:38):
and also psoriatic arthritis.
Their newer interleukin-17, 12, 23s
have also changed the game in psoriasis.
Interestingly, GLP-1 agonistshave also changed a game
in psoriasis,
so we know that there isa significant comorbidity
of psoriasis in coronary artery disease
(13:58):
and oftentimes we will tellpatients to change exercise
or change their diet and those things
are really hard to affect thelevel of patient's weight,
but we know with these GLP-1 drugs
that patients do have a reduction
in their total body surfacearea and psoriasis severity.
For non-dermatologists out there,
it is important to understandthis cardiometabolic effects
(14:22):
with psoriasis,
so if you see a patientthat has psoriasis,
consider asking andpotentially doing workups
to make sure they don'thave hyperlipidemia
or cardiovascular disease andalways refer to dermatologists
because for quality of lifeissues in these patients,
you can significantly improve them
with the advances we have.
(14:43):
- The way you connected pathophysiology
to real world disparitieslike deeper inflammation
leading to more scaring inpatients with skin of color
is an essential contextfor tailoring treatment.
And these new modalitiesfrom biologics like dupilumab
to 1726 nanometer lasers seemto be offering more targeted,
long-lasting options.
(15:03):
The evolution does sound exciting,
but it also raises an important question.
How well do these advances
hold up across diverse skin types?
Are there therapies you've seen
that are especially well suited
or perhaps poorly suited for patients
with richly pigmented skin?
- A lot of the data shows thatwhen diagnosed appropriately
(15:25):
and at an early stage,patients of color do well.
We know that for things likecardiometabolic disease,
it is more common in certainsubtypes of patients.
It's even more importantfor early referral
and early access tocare for those patients.
- What's one common misdiagnosis
you see often in patientswith skin of color
(15:46):
and how can frontline clinicians avoid it?
- Although melanoma isonly 1% of skin cancers,
it has the highest mortality.
We know when diagnosedearly, the five-year survival
for patients is 94%,
but when you look at African Americans
when they're diagnosed with melanoma,
they have a 70% five-year survival,
which is really significant.
We as physicians haveto look at the science
(16:08):
and the outcomes to tailor our treatments
to give the optimalresults for our patients.
- That disparity in melanoma outcomes
is striking and sobering.
The fact that early detection
so dramatically improves survival,
yet Black patients areoften diagnosed later,
really emphasizes how much we need
to expand our diagnostic lens.
(16:28):
It's not just about teaching people
to look in the right places
like palms and souls and nail beds,
but it's also aboutaddressing the assumptions
that lead to delayedcare in the first place.
You've been deeply involved in efforts
to advance equity in dermatology.
How do you balance the use
of standardized treatment protocols
with the need to deliver culturally
(16:50):
and phenotypicallyinformed personalized care?
- We're really fortunate to be at Stanford
where precision care isone of our core values.
This is a basic principleof healthcare, right?
Do no harm and then do good,
beneficence and nonmaleficence.
It's important to be able todeliver personalized treatment.
(17:10):
If I see a patient, for example,who has a hair condition
and I know having done askin of color fellowship,
I can't give the patienta shampoo and say,
"Wash your hair every day with this"
because they don't washtheir hair every day.
I can't tell you how farit goes with a patient
who comes in who hasphenotypically different hair
for me to be able to ask them,
"How often do you wash your hair?
(17:32):
What do you use to wash your hair?"
That improves patientcompliance and patient outcomes.
We can't do more in deliveringthat personalized care
that looks at all of thevariabilities in the patient.
What we see phenotypically,what they do culturally,
what they do every day in and out
to deliver good healthcare.
- I value how you bring itback to foundational ethics,
(17:54):
do no harm and beneficence asthe anchor for precision care.
What I hear in your approach
is that personalized dermatology
isn't about abandoning clinical standards.
It's about applying them with nuance,
whether it's hair careroutines, cultural practices,
or how skin responds tolight or inflammation.
It all matters.
(18:15):
And the outcome isn'tjust better compliant.
It's better care, lowercosts, and more trust.
That principle feels especially important
as we introduce emergingtechnologies into our practices.
One of your core areas ofexpertise is fractional lasers
for scar remodeling.
Could you take us a little deeper
into what's happeningat the cellular level
(18:36):
and how that understanding informs
how you use these tools clinically?
- You'll have to stop me 'causeI love talking about lasers,
but when we think as alight photo biologist,
there are a few different ways
that light can interact with tissue.
At moderate levels, you cancause control destruction.
At low levels, you actuallystimulate biological functions.
We know that people are usinga lot of photobiomodulation
(18:59):
or these red light therapies
to stimulate biological functions.
When we look at fractional lasers,
we particularly look atthose when we target water.
We use what's calledselective photothermolysis
when we target tissue.
So we look at things that willabsorb wavelengths of light.
And so the main chromophoresin the skin are melanin.
(19:23):
That's why it's so important
to be able to know the patient's melanin
and how their skin will respondto light-based technologies.
With fractional lasers, theydiffer from traditional lasers
that target water
in that they have controlled tissue injury
in microscopic areaswith lots of normal skin
(19:43):
around the areas.
Anytime you have controlled tissue injury,
which is often whatwe're doing with lasers,
we wanna spare sometissue for rapid healing
and to reduce the incidence ofside effects like skin burns.
It can lead to blistering,hyperpigmentation,
or even permanent loss of pigmentation,
(20:05):
which we can see really in all skin types.
Fractional lasers revolutionize that.
We use laser and light to either vaporize
or to coagulate small microscopicthermal zones of tissue.
What happens when you dothis is the skin responds
to tissue damage by upregulating things
like heat shock proteins,particularly 47 and 70,
(20:28):
lead to the production of collagen,
and then the other thing that happens
is you have upregulation ofsome matrix metallo proteases.
As the skin heals, during thatprocess, you get upregulation
of both collagen one and collagen three.
What's interesting about thoseratios of those two collagens
is that when we're very youngor in regular adulthood,
(20:49):
the ratio of collagen one
to collagen three is about the same.
As we age, our collagen one goes down
and our collagen three production goes up.
What's interesting with fractional lasers
is they cause upregulationin both of those.
The skin looks better
because it's functioninglike younger skin.
We know when we upregulatethat collagen production,
(21:10):
we're creating normal collagen
where you had abnormalcollagen in scarring.
So you still have collagen in scars,
whether they're atrophic,hypertrophic, or keloidal scars,
but that collagen is not normal collagen.
Fractional lasers helpcreate normal collagen
through those microscopiczones of tissue injury.
(21:30):
- What stands out in your explanation
is how fractional lasersoperate at a regenerative level,
not just correcting the surface,
but actually prompting biological healing.
The idea that controlled micro injury
can stimulate collagen production
and restore the skin's architecture
reframes laser treatmentas cellular therapy
(21:52):
and not just cosmetic enhancement.
Red and blue light therapiesare everywhere right now.
Masks, at home panels, you name it.
And it feels like every skincare company
is marketing some kindof light-based solution.
From your perspective,
where does the evidence actuallysupport red light therapy
and where should we be alittle bit more skeptical
(22:14):
about what's being promised?
- At these very low levels,
you stimulate biological functions.
We know that specificwavelengths of red light
target what's called cytochrome C oxidase,
which is what we have tobuild ATP in our mitochondria.
Through inflammation
and reactive oxygen species,
we basically displace theoxygen in cytochrome C oxidase.
(22:36):
What happens is that with red light,
you can remove that andincrease ATP production
so the cells can function better.
Red light is most studiedin hair growth stimulation
where there is a lot of science
and we see an upregulation ofinsulin-like growth factor.
We see effects similar to the application
(22:57):
of topical and oxidalwith red light therapy,
so yes, there is science.
Now, red light therapy canbe delivered through laser
or it can also be deliveredthrough light emitting diodes.
Laser is coherent lightthat is one wavelength,
so can travel long distances
without losing a lot of its energy.
When we go to things like LEDs,
(23:18):
one is they're less expensive to make
and so that makes it more accessible.
We wanna democratize technology,but it's important to know
that with those light emitting diodes,
that light can scatter.
So if you're using it tostimulate hair growth,
you want something that'sgonna separate the hair
and deliver the light into the scalp.
There are things that are in development
where we can make surethat light doesn't scatter,
(23:40):
which is a long way to say
that there is real science behind it
and there are clinical uses for it.
- That was super helpful
and I appreciate the bit of myth busting.
I'll admit, part of thatwas personal curiosity.
I do own one of thosered light therapy masks
and I've definitely wonderedif it was more hype than help,
but shifting gears a bit,I'd love to come back
(24:00):
to something you touched onearlier about aging skin.
In your experience,
what are some of the changesclinicians often chalk up
to normal aging that actually deserve
more clinical attention,
and what should we belooking out for instead?
- I'm very fortunate tohave taken care of veterans
for a number of years, so I see people
who are in their 80s, 90s, centenarians.
(24:22):
We know that a skin,being the largest organ,
serves many important functions.
One, it's the physical barrier
between us and our environment.
We know that skin frailtycan cause tears in the skin,
which can increase infection.
The skin is responsiblefor vitamin D productions,
looking at also thermal regulation.
Evaporative skin cooling is a major way
(24:42):
that we are able toregulate our temperature.
Those functions decline with age.
There are ways that wecan optimize that skin
to not have that reduction in function.
When some patients say to me,
"Getting old really isterrible, Dr. Rahman,"
I'll say It's better than the alternative.
For countries with the levelof wealth that we have,
(25:04):
it is a privilege to get older,
but your skin doesn't have to get older.
I'm working with one of mycolleagues, Dr. Anne Chang,
to develop a validated skin frailty score
that we can provide to non-dermatologists.
While a lot of these changes may seem like
they are just how the skin looks,
we have to recognize that the skin
(25:26):
also has really importantbiological functions.
- You raise such an important point.
Skin changes in olderadults are often brushed off
as purely cosmetic,
when in fact they reflectdeeper functional shifts
that can impact everythingfrom thermal regulation
to infection risk.
Having a tool like a skin frailty score
(25:46):
in the hands of primary care providers
could be a real game changer.
With all that in mind,
I'd love to hear yourthoughts on skin longevity.
We talk a lot about longevityin cardiology or oncology,
but how do you define it in dermatology
and why is it clinically meaningful?
- When I think of skin longevity,
I think of optimal function of the skin.
(26:07):
Anything that restores theoptimal function of the skin
to the levels of what wehave in mid adulthood,
longevity has a better connotation
than aging becausepeople are living longer.
It's gonna be important forall of us to be able to work
for a long time.
I realized seeingpatients who are coming in
(26:28):
for laser light-based treatments
or neuromodulators in their 20s
and seeing people who are centenarians
and near centenarians at the VA
that I've been treating skinlongevity for a long time.
- That's a refreshingway to think about it.
Framing skin longevity, notaround aging or decline,
but really around maintainingfunction and vitality.
(26:48):
It's so true that as peoplelive and work longer,
keeping our skin healthy
becomes part of stayingindependent and resilient,
not just looking good.
Thinking about that ideaof optimizing function,
especially as the skin changes over time,
what practices or interventions
do you think hold the most promise
(27:09):
for supporting long-term skin health?
- My top three are one, sun protection.
A little trick that dermatologists use,
which other clinicians listening can use
is patients are moremotivated to use sunscreen
to prevent premature aging of their skin
than to prevent sun-related skin cancer.
I'm not telling peopleto go live in a cave.
(27:30):
You still can get sun,
but doing it in a way that'ssafer, so sun protection.
We know that retinoidshave a significant role
in improved skin functioning
because they targetmany cells in the skin,
whether they're fibroblast or melanocytes
or are keratinocytes.
They have lots of benefits.
(27:51):
And the third one turnsout that eating foods
that are high in beta carotene,
which is a vitamin A derivative,
actually makes our skinlook more attractive
because it's functioning better.
There's this 2014 study wherethey took photos of people
and they made them more keratinoid
and they had people evaluatetheir attractiveness,
and it turned out thatthe keratinoid faces
(28:13):
were viewed as more attractive.
So there's something thathappens in our psychology
that shows us that whensomeone's skin is better overall,
that's a reflection oftheir overall health.
We'd see them as being more attractive.
So eat foods that arecarrots, spinach, tomatoes,
sweet potatoes, broccoli,squash, cantaloupe,
(28:34):
and other green leafy vegetables.
- I find it really exciting
how our understanding of skin health
is becoming so much more holistic.
It's not just about topical treatments
or photo protection anymore,but how things like nutrition
and lifestyle fit into the bigger picture.
What really stood outto me in what you said
is this idea of reframing prevention,
(28:55):
not just this avoiding disease,
but as promoting overall health,
confident, and long-term function.
So as someone who reallysits at the crossroads
of academia, innovation,and clinical care,
I'm curious, what areyou most excited about
when you think about thefuture of dermatology?
- I'm most excited abouttechnological advances
in dermatology.
(29:16):
I would say the shift to prevention
and overall health with skin longevity,
the use of advancedtechnologies to improve care,
so the use of lasers, energy-baseddevices, neuromodulators,
artificial intelligence used intelligently
by healthcare providers.
Shifting the mindset for those of us
(29:37):
who have been trainedin traditional medicine
to integrate overallhealth for our patients
with the change of preventionand looking at longevity,
that's something that wouldresonate with our patients
and motivate our patients to do things
that are better for their health overall.
Your skin has no expiration date.
As long as you're alive,
your skin has the ability to improve.
(29:59):
- Dr. Rahman, thank youfor coming on the podcast
and for this incredibly richand wide raging conversation.
You've given us notonly clinical insights,
but also a deeper understanding
of how dermatology sits atthe intersection of science
and technology and human dignity.
From lasers to biologics tothe ethical application of AI,
(30:19):
you'd help to see thatskin health is really
about so much more than what's visible.
It's about vitality,longevity, and equity.
So thank you so much for your time today.
This episode was broughtto you by Stanford CME.
To claim CME forlistening to this episode,
click on the Claim CME link below
or visit medcast.stanford.edu.
(30:41):
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