Why is there still a stigma around Botox and other simple cosmetic procedures? And what role does skin health play in healthy aging?
These are topics I discuss on this episode with Atlanta dermatologist Dr. Mary Alice Mina. You know, it’s funny. We don’t think anything about working out and looking better… but we raise a skeptical glance at the possibility of Botox, fillers, or peels. What’s the difference between them and, say, dying your hair?
I find Botox to be an entry topic for the more relevant subject of skin health, cancer screenings, and the like.
I'd been hoping to have a dermatologist on the show for a while. I know you'll enjoy this conversation.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jay Croft (00:00):
Well hi, Dr Mina, it's nice to have you here today
.
Thanks for coming.
Dr. Mary Alice Mina (00:03):
Thank you so much for having me.
Jay Croft (00:06):
I'm glad we're here talking on this rare snow day
here in Atlanta.
Dr. Mary Alice Mina (00:09):
I know, yeah, always fun to talk with
another Atlantan too.
Jay Croft (00:12):
Listen, I have wanted to have a dermatologist on the
show for a long time, so I'mdelighted that you are available
for this, because I think theskincare is incredibly important
for optimal aging from a fewdifferent angles.
I'm looking forward to gettinginto all of it with you for men
(00:33):
and women alike.
For serious healthcare reasonslike cancer screenings, and also
for things that might be easilyscoffed at by some people, like
Botox or just having somecosmetic procedures done to make
you feel better about howyou're aging.
I think it's really fascinatingand fun, and so I'm glad that
(00:54):
you're here to talk about it.
Dr. Mary Alice Mina (00:56):
Oh, absolutely yeah.
Skin health it's part of yourwhole body.
Health, right?
And if your listeners, I knowthey're into living well and
exercising and eating well andtaking care of your skin is just
one more component.
Jay Croft (01:09):
Tell me a little bit, before we dive into all of that
, about your practice here inAtlanta and what kind of
patients you deal withpredominantly.
Dr. Mary Alice Mina (01:17):
Yeah, so I moved here about 13 years ago so
it's crazy to think I've livedin Atlanta longer than anywhere
else in my life at this point.
But I have a practice BachmanAmina Derm Surgery.
We have an office in Dunwoodyand then Johns Creek and we
mostly focus on proceduraldermatology.
So we do a lot of Mohs surgery,which is the technique to
(01:38):
remove skin cancer, so we do alot of that.
We also do a lot of cyst andlipoma, especially big, big
things.
So I joke, I'm Dr Pimple Popper, atl and then we do a lot of
cosmetic procedures devices,inject, peels, things like that
just to help people feel good intheir skin, erase sun damage,
(02:00):
boost their collagen and all ofthat stuff.
Jay Croft (02:03):
And do you primarily treat men, women, people over a
certain age, under a certain age?
Dr. Mary Alice Mina (02:09):
The cool thing about dermatology is our
patients are all ages, but a lotof my patients who have skin
cancers tend to be men and theytend to be 60 plus, although I'm
seeing younger and younger, andcertainly women can get skin
cancers too, but men have ahigher prevalence of it, for
sure.
And then cosmetics both men andwomen are interested in
(02:30):
cosmetics, with a slant probablymore towards women, and I would
say it usually starts aroundsort of late thirties but tends
to be more like fifties plus.
Jay Croft (02:41):
Before it gets to the point where you want to talk
about procedures.
Plus, before it gets to thepoint where you want to talk
about procedures, what aboutjust sort of basic skincare
health, like is there somethingI should be doing or I'm too old
to start, I'm 61, but is theresomething 30-year-olds should be
doing?
40-year-olds should be doingall the time so that they can
(03:02):
manage what's coming, or not?
Dr. Mary Alice Mina (03:04):
Yeah, yeah Well.
So I always say you're nevertoo old to start.
Okay, so the best time to planta tree was 20 years ago, but
the next best time is today,right?
So, yes, I'll tell people, like, if you want to have amazing
skin in your fifties, wearsunscreen in your twenties and
thirties, right?
So prevention is so key, likewith so much in life.
(03:27):
Right, it's number one, two andthree.
But I don't want people to losehope if they're like, well,
shoot, I'm 60.
It's all hope loss, there'snothing I can do.
It's harder, but there arethings to do.
You can still make really goodchanges in your life, right,
like, you may live another 30,40 years at this rate.
So there are things that youcan do.
(03:48):
But, of course, the earlier youcan start taking care of your
skin and your body, the better,and so it doesn't have to be
complicated.
I like to say skin health iswhole body health.
So, especially for thoseyounger listeners, taking
learning, the importance oftaking care of your body in your
twenties and thirties andforties is so critical.
(04:10):
I didn't really take care ofmyself till I was in my forties.
I was burning the candle atboth ends.
I'm trying to grow a practice,trying to raise children, be a
wife, a mom all of those thingsI wasn't prioritizing.
Sleep I naturally am thin so Ididn't really think I needed to
work out and I would eatwhatever I wanted.
And then it's like 40 hit and Iwas like, oh, these tactics
(04:33):
aren't really working anymore.
So learning that by taking careof your body, your skin is going
to reflect that health as well.
So if I could just impart thatto younger people listening, but
really all ages, right, but totake care of your body is also
taking care of your skin.
And don't sunburn, don't tan,wear sunscreen.
(04:56):
I would say that's probably themost important skincare
ingredient you can be using orshould be using at all ages, but
especially when you're younger,because you have so much life
years ahead of you and you wantto prevent all that cumulative
sun damage.
Because when you're in yourseventies and you're having to
come into my office all the timeto have cancers removed, it's
(05:19):
really.
It's really discouraging andfrustrating and at that point,
by the time you developed them,it's a lot harder to reverse it.
Jay Croft (05:29):
Yeah, it's a lot like fitness.
I write primarily for fitnessfor people over age 50 or so,
and yet it's important to startyounger than that too, and a lot
of people don't.
They're raising children,they're working really hard on
establishing their careers andsaving money for the future.
And you know your, yourtwenties and thirties can be
(05:51):
really, really busy time of life.
And then by the time you're 50,60, 70, you don't have these
habits.
You're overweight, you'redeconditioned, you get winded,
going to check the mail how areyou going to enjoy yourself?
Right?
So these habits pay off laterin life.
But it's not too late.
So it's not too late for me.
(06:12):
I can still start.
Dr. Mary Alice Mina (06:13):
You can still start, absolutely.
Jay Croft (06:16):
Well, I certainly hope so.
When we're talking about skinhealth, we don't just mean the
face.
Should I see a dermatologisttwice a year after I turn 40?
Should I see him once a yearafter I turned 60?
Like what are some basicguidelines for incorporating
skincare into my health?
Dr. Mary Alice Mina (06:35):
Yeah.
So I think it's going to be alittle different for everyone.
It's not quite as set in stoneLike we have.
Get a mammogram at 40, get acolonoscopy at 45.
But if you're in your 40s andyou've never seen a
dermatologist, you should get in.
I would say probably even your30s.
Particularly if you have ahistory of sunburns severe
(06:57):
sunburns then you want to see adermatologist, really probably
even into your 20s.
Also, if you have a familyhistory of melanoma or you have
a lot of moles, then you shouldalso be seen when you become an
adult, for sure, and then yourdermatologist can look at you
and decide okay, based on whatI'm seeing, you are probably
(07:17):
good once a year or sometimes.
I'll see people in theirtwenties.
They don't have a lot ofsunburns, no family history of
melanoma, not a lot of mold, andI'll tell them I'll see people
in their 20s.
They don't have a lot ofsunburns, no family history of
melanoma, not a lot of mold, andI'll tell them I'll see you
every couple of years unlesssomething comes up.
But the reason I think it'simportant to have that visit,
even if you don't have anythingyou're worried about, is because
your dermatologist can helpgive you important information
(07:39):
on what to look for.
What does a skin cancer looklike?
People have heard of melanomatypically and they think of the
dark mole, but what is way morecommon is to get a non-melanoma
skin cancer, something like abasal cell carcinoma or a
squamous cell carcinoma, and fora lot of people they don't even
know those exist.
(08:00):
And the other shocking thing iscutaneous squamous cell skin
cancers kill twice as manypeople every year as melanomas
and yet so many people don'teven know that's a.
That's an issue.
So I think it's important tosee your dermatologist so they
can kind of go over what yourrisks are, what to look for, and
(08:21):
and they can guide you onwhether you need to come in Now
if you've had skin cancers.
We usually say twice a year forabout two years and then we can
back off if you haven't had onein that time.
And the other thing I say is ifyou've got a spot you're
worried about, do not be shythat.
Oh well, what if it's nothing?
I'm going to waste their time.
(08:41):
We would so much rather haveyou come in and let us reassure
you.
That spot is normal, nothing toworry about, and I'll tell you
every time that happens one outof two times, I will say, well,
while you're here, I'm going tolook at your face or I'm going
to look at your back and I'llfind something that does need
medical attention that wasn'teven on their radar.
(09:03):
So don't ever feel like you'rewasting our time or you're
worried it might be nothing.
You know that's what we're herefor, and I think people forget
that our skin has reallyimportant functions beyond just
a pretty face, and so yourdermatologist is going to help
you with your hair, your nails,all your skin, and help keeping
(09:24):
you healthy and and long, youknow, having longevity with your
skin, and not just coming tosee us when a lot of the damage
has already happened.
Jay Croft (09:34):
Yeah, and there there comes a point where your skin
tells on you.
You mentioned when you turned40, I think when I turned 50, I
started noticing in other peopleand thinking, wow, his skin is
so blotchy.
And I realized, well, you cankind of fake it with drinking
and smoking and burning thecandle at both ends in your 30s,
(09:56):
maybe in your 40s, but at somepoint it shows up on your face.
Dr. Mary Alice Mina (10:00):
Yes, yeah, that's one of the things I love
about the skin is it reflectswhat's going on internally.
So I can see whether someonehas, you know, diabetes or
prediabetes.
Based on some of the skinfindings, I can tell whether
there's a problem with the theirblood vessels by little bumps
that may appear, or how theirlung function is based on their
(10:23):
nails.
So our body gives these cluesas to what's going on and you
just have to be attuned to themto pick up on them.
So, again, that's why I saywhole body, or skincare, is
whole body care, right, how youtake care of your body is
reflected in your skin.
So it's so much more than justputting on a bunch of top of and
(10:43):
doing a bunch of procedureslike that.
That's the final 10%, the icingon the cake, right, that's not
going to get you.
You know, really taking care ofyour body is going to get you
90% of the way.
Jay Croft (10:56):
Okay, that's great.
Now let's talk about that 10%Exactly.
What's what's new with all ofthis?
Where are we with all of this?
What are people coming to youwith that's different or that's
changing, I guess, in my mind,which is I have a little
experience with this personallyand with family, but not a great
(11:19):
deal, and it seems like thethought of Botox or similar
procedures has kind of evolved,sort of in the way that online
dating has evolved.
Like when it first came out 20or 25 years ago you wouldn't
really tell anyone because that,oh yeah, I don't want to have
Botox so I don't have to go onthe computer to meet a date.
But now everybody does it, itseems like Is that true?
(11:42):
Yeah, is it less of a stigma orwhat?
Dr. Mary Alice Mina (11:45):
I totally can relate to the online dating
because I met my husband back intwo eight and I remember
thinking, never wanting to tellanyone because it was still kind
of embarrassing.
Nowadays it's like whatever whodoesn't meet online.
But yes, I think Botoxdefinitely has lost some of that
stigma that maybe it used tohave and I think sometimes
people they get scared of Botoxbecause A it has the word toxin
(12:10):
it's botulinum toxin in it, sothat can scare people a little
bit.
But it's been around for solong that we have such great
data and safety info on it thatI think people now realize it's
pretty safe.
I find it's a sort of starteror gateway procedure for a lot
(12:31):
of my patients.
It's nice because it'sreversible or I shouldn't say
reversible, but it wears off, soif you don't like it you don't
ever have to do it again.
That being said, most peoplelove it and then they become not
addictive, but they want it andbecause they see the difference
it makes in their skin andpeople don't realize you can use
(12:52):
Botox and I'm using the brandname Botox, but there are
several of them botulinum toxin.
I should be saying right, butBotox, that we can use it for
more than just relaxing muscles.
We can use it for asymmetrysomeone may have in their face.
Maybe their smile has alwaysbeen a little crooked and we can
(13:13):
help balance that out.
Or maybe the tip of their noseprojects downward as they've
gotten older and we can put alittle Botox in to help restore
facial symmetry.
And so it's more than justmaking yourself look totally
frozen.
And if anything, I think thependulum is swinging to a more
(13:33):
natural result.
Where people are, they wanttheir muscles softened.
They still want to be able toemote, to show expression, but
what they don't want is thatthose scowl lines to be etched
into their skin so that whenthey're not scowling it still
looks like they are.
I find that's what reallybrings people in.
They'll say everyone keepstelling me are you angry, why
(13:56):
are you mad, why are you sotired?
And they'll say I'm not angry,I'm not tired, I'm not, I'm not
mad, but people think they arebecause of their expression.
And what we can do with Botox,with some units of few little
injections, is soften up andmake those features go away, and
and people just feel so goodwhen you do that, when they're
(14:20):
no longer being told you lookangry when you're not right,
like that's super frustrating.
So, I I find that Botox is agreat entry starter procedure
for people and it really doesmake your skin just have a nice
glow about it.
It's really pretty and youdon't have to totally freeze
(14:41):
yourself.
It can be done with the rightinjector very, very naturally.
Jay Croft (14:46):
And just for anyone who might not be familiar, we're
talking about.
You go into a clinician'soffice and someone sticks a
needle in your face and injectsthis substance.
That's it.
Dr. Mary Alice Mina (15:00):
That's right.
Yeah, we so.
And I also say you know,everyone's really into natural
nowadays and I think Botox issuch a cool way that scientists
used what's in nature andharnessed it.
So Botox is from the bacteriaClostridium botulinum that
produces a toxin.
(15:20):
It's found in soil.
It's the reason we tell parentsnot to give their babies honey
before the age of one, becauseit could be in there.
So it's a totally naturalbacteria and we're harnessing
its toxin that it produces andusing it in very minute,
concentrated forms, injecting itinto the muscle to relax the
(15:42):
muscle so it can't fire, so itdoesn't do anything for lines on
your face that are there atrest.
So if the line is there at rest,it may soften it a little bit,
but it's not gonna get rid of it.
So if you are thinking aboutdoing Botox, the best time to do
it is, again, prevention, right?
So when you start to see thoselines are getting etched in so
(16:05):
when you stop scowling they'restill there then that's the time
to start if you really want toprevent those lines from forming
and for your audience who areinto exercise, right, it's like
building a muscle the more youflex your bicep, the bigger your
biceps going to be.
The more we're scowling andpushing those muscles together
in our forehead, the biggerthose muscles are going to get.
(16:28):
And so when you relax them andyou can't do that, they soften
up or atrophy.
And then the other thing peoplecome in for is they just feel
like their skin needs a refresh,their complexion's kind of dull
.
Maybe they've got a lot of whatwe call dispigment.
They might have some brownspots and red spots, maybe some
(16:49):
melasma, hyperpigmentation orlittle warty gross on their skin
.
And they feel like it's nolonger smooth and even and
bright and they're looking forkind of a refresh and bright.
And they're looking for kind ofa refresh and I love doing that
because it makes such a bigdifference to just clean up the
background, noise, make thecomplexion more, even more
(17:10):
uniform.
It takes years off someone.
It's really amazing.
Jay Croft (17:15):
So what is that?
A chemical peel or something?
Dr. Mary Alice Mina (17:17):
It can be a couple of things.
It can be a chemical peel or itcould be a laser.
So in different laser,depending on how deep you want
to go, how aggressive it couldbe a resurfacing laser or it
could be a laser that treatsbrown spots or blood vessels.
So it just kind of depends whatyour main area of issue is.
Jay Croft (17:38):
Right, right Now.
I've done that.
I've had peels a few times andit makes your skin positively
glow.
Dr. Mary Alice Mina (17:47):
Yeah.
Jay Croft (17:48):
And it's just amazing .
You wake up looking so healthyand so rested and in a way that
you probably didn't even realizeyou needed it.
Dr. Mary Alice Mina (18:00):
Yeah, it's really one of my favorite things
to do because the results areso amazing.
People just have this refreshto them, and we're not
necessarily removing lines andwrinkles per se, but everything
just looks better when your skinis brighter.
One thing that I'm reallyloving are biostimulants, and
(18:24):
these are things like Sculptraand Radiesse, and I feel like
Sculptra had a moment, maybearound 2000, 90s, 2000.
And then it was a littlecomplicated to reconstitute it
and have it ready to go, andthen hyaluronic acid fillers
kind of took off.
Those are things like yourJuvederm, your Restylane, and so
(18:46):
then everyone started usingthose and I think people are now
getting a little fatigued withour hyaluronic acid fillers.
While I love them and theydefinitely have a role, they can
be overdone and that's whereyou get that real chipmunk cheek
look, that real stiff look,doesn't look normal, doesn't
look natural, and I think that'swhat people get kind of freaked
(19:08):
out about when they think aboutcosmetics.
They think they're going tolook like that.
Now, that takes a lot ofsyringes and most people aren't
going to go that extreme but togive a more natural volumization
.
I really love things likeSculptra and Radiesse.
They build your own collagen.
So again, for someone who'sreally looking for kind of a
(19:30):
natural approach.
It's boosting your own collagenand the best time to start
Sculptra would be before youreally feel like you need it,
because Sculptra takes timewould be before you really feel
like you need it becausesculpture takes time.
I tell people it takes likethree to six months before you
start to see any difference.
And so starting before youreally need it can be helpful
(19:51):
just for maintenance andmaintaining that volumization
that we know we're all going tolose that volume, it's normal.
Our bone starts to resorb, westart to.
Our face starts to fall.
For women that's acceleratedduring menopause.
So we know all that's coming.
So again, just like working out, like build that muscle before
(20:13):
you lose it, cause we know it'scoming.
So build that collagen beforeyou have that precipitous drop.
Jay Croft (20:20):
The injections you mentioned, I thought of some.
I can't help but think offamous people you know, because
we all know.
We can say their names andeveryone knows what we're
talking about.
But there are some actors andactresses and their cheeks are
out to here.
Dr. Mary Alice Mina (20:34):
Yeah.
Jay Croft (20:35):
And you think you're 45 years old.
You're beautiful.
Why are you doing this toyourself?
It's.
How do you so, how do I, as anordinary person, not go too far?
Dr. Mary Alice Mina (20:45):
Yeah Well, it is tricky, I would say.
For most people, it'sincredibly expensive to be doing
the amount of treatments thatthey're doing, and so it's just
simply not possible for mostpeople, the average person, to
spend that amount of money.
That being said, though,there's bad filler all over,
there's bad Botox all over andbad cosmetic surgery right.
(21:08):
So see someone who is trained.
This is not where you want toget the best deal.
This is not where you want toget a buy one, get one free, or
come in with your friend and geta deal Like this is your, your
face, or your body, youraesthetics.
So this is not where you wantto cut corners.
Research who's doing yourtreatments and your procedures.
(21:30):
Sometimes people price shop forthese procedures, and they might
go see one person for theirlips, maybe someone else for
their cheeks, someone else saiddo your chin and it gets very
piecemeal looking, and you don'thave one person just looking at
your whole aesthetics to makesure it's in balance and it's in
harmony.
(21:51):
And then, for people gettingthese procedures done, we get so
fixated sometimes on the flawthat we see the hollowing,
whatever deformity we thinkneeds to be fixed, and so it can
be very hard to remember wherewe came from.
And I think that's where peoplestart going down this slippery
slope of oh well, I need morefiller here and more filler here
(22:13):
and more filler here.
And that's when you start toget kind of bizarre looking.
And then the other thing Iwould say is who's what does the
person who's doing yourprocedure look like?
Because you are probably goingto look similar to them.
So if they, you know, maybe youare going for that overdone
look I mean, there's certainlypeople that's what they want,
(22:34):
right, like the Kardashian lookand all that.
So you are probably not goingto want to come see me because
that's not really what I do.
So, whoever you know, and alsoif someone is doing your
procedures and they've got thosebig cheeks and everything, then
I have to wonder maybe theirsense of aesthetics and balance
(22:54):
is not what I perceive, and so Iwould just be careful with that
as well and so I would just becareful with that as well.
Jay Croft (23:03):
Okay, okay, do you find that it's mostly women who
pursue this kind of thing, ormore men doing it as well?
Dr. Mary Alice Mina (23:08):
Certainly more women, but there are more
men who are getting these thingsdone.
But I do feel like there ismore of a taboo for men.
They usually don't want to tellpeople, they don't want their
family to know.
There still seems to be astigma about getting it done.
But men do care about theirappearance and, you know, my
husband will tell me what.
(23:28):
What do I do about these darkcircles?
Or help me with my.
You know, thinning hair thingslike that.
So I do think men are.
We are seeing more men doing it.
It's just not at the same rateas women, at least in my office.
Jay Croft (23:43):
It's some things, people balk and I think this is
one of them, and I think fitnessis one of them.
A lot of times you'll hearsomeone say oh, you only go to
the gym because you want to lookgood and and maybe, maybe that
is someone's prime motivation.
Maybe it's not their primarymotivation, maybe it's not a
motivation at all, but so what?
(24:05):
Right?
Dr. Mary Alice Mina (24:07):
At least they're going right.
Yeah, I feel that way.
I have people who will tell meI'm never doing Botox.
You know they are, they're verylike the crunchy granola
natural and and.
And they'll say I never wantBotox, I'll do laser, but I
don't want Botox.
Or I don't want anything in mebut I'll do.
I'll do a laser treatment butyou know they'll color their
(24:29):
hair but they won't.
They won't do this Right.
So you know, everyone's entitledto whatever they want to do.
You don't have to do anything.
My mother could do any.
I do any procedure on her thatshe wanted.
She wants nothing.
She has never tried anything.
I can't even get her to use aretinoid and she looks great,
she looks amazing.
She wears sunscreen and shewears a hat when she gardens,
(24:51):
but it's not her jam.
She does not want to do it.
And then I have other people whowant to try everything.
They want to do everything andyou can do whatever you want.
But yeah, I see that too, wheresort of on the side, people
will pull me.
My friends will come over andsay you know, don't tell anyone,
but I do want to come see youfor Botox, like they're.
They feel almost ashamed orembarrassed that you know now
(25:13):
that they're 45, they really dowant to try it, but for so long
they said they wouldn't do itthat they feel like they're a
phony or a fraud to get it done.
So I think everyone should beable to do whatever they want
without feeling guilt about it,and I think also to celebrities
(25:33):
need to stop saying they haven'thad things done when it's so
obvious they have, just just ownit, Say I mean, what's the big
deal you got you?
you get Botox and filler, it'sokay.
Jay Croft (25:45):
Now you have your own podcast and you have something
you want to share with us, soplease tell the folks about that
.
Dr. Mary Alice Mina (25:54):
Yeah, so my podcast is called the skin real
R E A L, so if you arewondering, you know what's?
What's the truth about this orthat or different things.
Definitely check it out.
My topics we cover are usuallythings my friends and patients
and family asked me about andhopefully it's just a way to
give people some good science,fact, actual skin health
(26:15):
information.
So definitely check that out.
And then, if you're wondering,you want to take a fun quiz and
find out am I more of a NicoleKidman or Dr Mina's mom?
You can check that out attheskinrealcom forward slash
style to see what your aestheticstyle is.
Jay Croft (26:31):
Oh, that sounds like fun.
Yeah, I'm at Dr Mina's skin.
Put all of that in the shownotes so people can access that.
I'm going to take your quiz tosee if I'm more like Nicole
Kidman or your mother.
I think I'm probably more likeyour mother.
I think so too A little Nicole,maybe a little Nicole.
Dr. Mary Alice Mina (26:53):
And that's okay.
Jay Croft (26:55):
Yeah, absolutely, it's all okay.
You know, the name of the showis Optimal Aging and for me that
means whatever you want it tomean, and if you need to dye
your hair or go to the gym orwear expensive clothes or makeup
or whatever the heck you wantto feel good about yourself and
enjoy your life, go for it.
(27:15):
That's what I say, yeah.
Dr. Mary Alice Mina (27:17):
I love it, your mental health matters too,
is what I say.
Yeah, I love it, your mentalhealth matters too, right?
Jay Croft (27:21):
Absolutely, absolutely it does.
This has been a delight.
I want to thank you.
I could talk to you about thisall day, because I'm just
fascinated by all of this.
I have three older sisters andthey do a lot of this and I've
done a little bit and it'sreally interesting to me.
So I want to thank you for yourtime today.
Dr. Mary Alice Mina (27:41):
Absolutely.
This was a lot of fun.
Thanks for having me.
So I want to thank you for yourtime today.
Jay Croft (27:44):
Absolutely, this was a lot of fun.
Thanks for having me All right.
Have a good day.
Stay safe in all this crazyAtlanta snow.
Dr. Mary Alice Mina (27:48):
That's right, stay warm.
Jay Croft (27:51):
Okay, bye.
Well hi, Dr Mina, it's nice to have you here today
.
Thanks for coming.
Dr. Mary Alice Mina (00:03):
Thank you so much for having me.
Jay Croft (00:06):
I'm glad we're here talking on this rare snow day
here in Atlanta.
Dr. Mary Alice Mina (00:09):
I know, yeah, always fun to talk with
another Atlantan too.
Jay Croft (00:12):
Listen, I have wanted to have a dermatologist on the
show for a long time, so I'mdelighted that you are available
for this, because I think theskincare is incredibly important
for optimal aging from a fewdifferent angles.
I'm looking forward to gettinginto all of it with you for men
(00:33):
and women alike.
For serious healthcare reasonslike cancer screenings, and also
for things that might be easilyscoffed at by some people, like
Botox or just having somecosmetic procedures done to make
you feel better about howyou're aging.
I think it's really fascinatingand fun, and so I'm glad that
(00:54):
you're here to talk about it.
Dr. Mary Alice Mina (00:56):
Oh, absolutely yeah.
Skin health it's part of yourwhole body.
Health, right?
And if your listeners, I knowthey're into living well and
exercising and eating well andtaking care of your skin is just
one more component.
Jay Croft (01:09):
Tell me a little bit, before we dive into all of that
, about your practice here inAtlanta and what kind of
patients you deal withpredominantly.
Dr. Mary Alice Mina (01:17):
Yeah, so I moved here about 13 years ago so
it's crazy to think I've livedin Atlanta longer than anywhere
else in my life at this point.
But I have a practice BachmanAmina Derm Surgery.
We have an office in Dunwoodyand then Johns Creek and we
mostly focus on proceduraldermatology.
So we do a lot of Mohs surgery,which is the technique to
(01:38):
remove skin cancer, so we do alot of that.
We also do a lot of cyst andlipoma, especially big, big
things.
So I joke, I'm Dr Pimple Popper, atl and then we do a lot of
cosmetic procedures devices,inject, peels, things like that
just to help people feel good intheir skin, erase sun damage,
(02:00):
boost their collagen and all ofthat stuff.
Jay Croft (02:03):
And do you primarily treat men, women, people over a
certain age, under a certain age?
Dr. Mary Alice Mina (02:09):
The cool thing about dermatology is our
patients are all ages, but a lotof my patients who have skin
cancers tend to be men and theytend to be 60 plus, although I'm
seeing younger and younger, andcertainly women can get skin
cancers too, but men have ahigher prevalence of it, for
sure.
And then cosmetics both men andwomen are interested in
(02:30):
cosmetics, with a slant probablymore towards women, and I would
say it usually starts aroundsort of late thirties but tends
to be more like fifties plus.
Jay Croft (02:41):
Before it gets to the point where you want to talk
about procedures.
Plus, before it gets to thepoint where you want to talk
about procedures, what aboutjust sort of basic skincare
health, like is there somethingI should be doing or I'm too old
to start, I'm 61, but is theresomething 30-year-olds should be
doing?
40-year-olds should be doingall the time so that they can
(03:02):
manage what's coming, or not?
Dr. Mary Alice Mina (03:04):
Yeah, yeah Well.
So I always say you're nevertoo old to start.
Okay, so the best time to planta tree was 20 years ago, but
the next best time is today,right?
So, yes, I'll tell people, like, if you want to have amazing
skin in your fifties, wearsunscreen in your twenties and
thirties, right?
So prevention is so key, likewith so much in life.
(03:27):
Right, it's number one, two andthree.
But I don't want people to losehope if they're like, well,
shoot, I'm 60.
It's all hope loss, there'snothing I can do.
It's harder, but there arethings to do.
You can still make really goodchanges in your life, right,
like, you may live another 30,40 years at this rate.
So there are things that youcan do.
(03:48):
But, of course, the earlier youcan start taking care of your
skin and your body, the better,and so it doesn't have to be
complicated.
I like to say skin health iswhole body health.
So, especially for thoseyounger listeners, taking
learning, the importance oftaking care of your body in your
twenties and thirties andforties is so critical.
(04:10):
I didn't really take care ofmyself till I was in my forties.
I was burning the candle atboth ends.
I'm trying to grow a practice,trying to raise children, be a
wife, a mom all of those thingsI wasn't prioritizing.
Sleep I naturally am thin so Ididn't really think I needed to
work out and I would eatwhatever I wanted.
And then it's like 40 hit and Iwas like, oh, these tactics
(04:33):
aren't really working anymore.
So learning that by taking careof your body, your skin is going
to reflect that health as well.
So if I could just impart thatto younger people listening, but
really all ages, right, but totake care of your body is also
taking care of your skin.
And don't sunburn, don't tan,wear sunscreen.
(04:56):
I would say that's probably themost important skincare
ingredient you can be using orshould be using at all ages, but
especially when you're younger,because you have so much life
years ahead of you and you wantto prevent all that cumulative
sun damage.
Because when you're in yourseventies and you're having to
come into my office all the timeto have cancers removed, it's
(05:19):
really.
It's really discouraging andfrustrating and at that point,
by the time you developed them,it's a lot harder to reverse it.
Jay Croft (05:29):
Yeah, it's a lot like fitness.
I write primarily for fitnessfor people over age 50 or so,
and yet it's important to startyounger than that too, and a lot
of people don't.
They're raising children,they're working really hard on
establishing their careers andsaving money for the future.
And you know your, yourtwenties and thirties can be
(05:51):
really, really busy time of life.
And then by the time you're 50,60, 70, you don't have these
habits.
You're overweight, you'redeconditioned, you get winded,
going to check the mail how areyou going to enjoy yourself?
Right?
So these habits pay off laterin life.
But it's not too late.
So it's not too late for me.
(06:12):
I can still start.
Dr. Mary Alice Mina (06:13):
You can still start, absolutely.
Jay Croft (06:16):
Well, I certainly hope so.
When we're talking about skinhealth, we don't just mean the
face.
Should I see a dermatologisttwice a year after I turn 40?
Should I see him once a yearafter I turned 60?
Like what are some basicguidelines for incorporating
skincare into my health?
Dr. Mary Alice Mina (06:35):
Yeah.
So I think it's going to be alittle different for everyone.
It's not quite as set in stoneLike we have.
Get a mammogram at 40, get acolonoscopy at 45.
But if you're in your 40s andyou've never seen a
dermatologist, you should get in.
I would say probably even your30s.
Particularly if you have ahistory of sunburns severe
(06:57):
sunburns then you want to see adermatologist, really probably
even into your 20s.
Also, if you have a familyhistory of melanoma or you have
a lot of moles, then you shouldalso be seen when you become an
adult, for sure, and then yourdermatologist can look at you
and decide okay, based on whatI'm seeing, you are probably
(07:17):
good once a year or sometimes.
I'll see people in theirtwenties.
They don't have a lot ofsunburns, no family history of
melanoma, not a lot of mold, andI'll tell them I'll see people
in their 20s.
They don't have a lot ofsunburns, no family history of
melanoma, not a lot of mold, andI'll tell them I'll see you
every couple of years unlesssomething comes up.
But the reason I think it'simportant to have that visit,
even if you don't have anythingyou're worried about, is because
your dermatologist can helpgive you important information
(07:39):
on what to look for.
What does a skin cancer looklike?
People have heard of melanomatypically and they think of the
dark mole, but what is way morecommon is to get a non-melanoma
skin cancer, something like abasal cell carcinoma or a
squamous cell carcinoma, and fora lot of people they don't even
know those exist.
(08:00):
And the other shocking thing iscutaneous squamous cell skin
cancers kill twice as manypeople every year as melanomas
and yet so many people don'teven know that's a.
That's an issue.
So I think it's important tosee your dermatologist so they
can kind of go over what yourrisks are, what to look for, and
(08:21):
and they can guide you onwhether you need to come in Now
if you've had skin cancers.
We usually say twice a year forabout two years and then we can
back off if you haven't had onein that time.
And the other thing I say is ifyou've got a spot you're
worried about, do not be shythat.
Oh well, what if it's nothing?
I'm going to waste their time.
(08:41):
We would so much rather haveyou come in and let us reassure
you.
That spot is normal, nothing toworry about, and I'll tell you
every time that happens one outof two times, I will say, well,
while you're here, I'm going tolook at your face or I'm going
to look at your back and I'llfind something that does need
medical attention that wasn'teven on their radar.
(09:03):
So don't ever feel like you'rewasting our time or you're
worried it might be nothing.
You know that's what we're herefor, and I think people forget
that our skin has reallyimportant functions beyond just
a pretty face, and so yourdermatologist is going to help
you with your hair, your nails,all your skin, and help keeping
(09:24):
you healthy and and long, youknow, having longevity with your
skin, and not just coming tosee us when a lot of the damage
has already happened.
Jay Croft (09:34):
Yeah, and there there comes a point where your skin
tells on you.
You mentioned when you turned40, I think when I turned 50, I
started noticing in other peopleand thinking, wow, his skin is
so blotchy.
And I realized, well, you cankind of fake it with drinking
and smoking and burning thecandle at both ends in your 30s,
(09:56):
maybe in your 40s, but at somepoint it shows up on your face.
Dr. Mary Alice Mina (10:00):
Yes, yeah, that's one of the things I love
about the skin is it reflectswhat's going on internally.
So I can see whether someonehas, you know, diabetes or
prediabetes.
Based on some of the skinfindings, I can tell whether
there's a problem with the theirblood vessels by little bumps
that may appear, or how theirlung function is based on their
(10:23):
nails.
So our body gives these cluesas to what's going on and you
just have to be attuned to themto pick up on them.
So, again, that's why I saywhole body, or skincare, is
whole body care, right, how youtake care of your body is
reflected in your skin.
So it's so much more than justputting on a bunch of top of and
(10:43):
doing a bunch of procedureslike that.
That's the final 10%, the icingon the cake, right, that's not
going to get you.
You know, really taking care ofyour body is going to get you
90% of the way.
Jay Croft (10:56):
Okay, that's great.
Now let's talk about that 10%Exactly.
What's what's new with all ofthis?
Where are we with all of this?
What are people coming to youwith that's different or that's
changing, I guess, in my mind,which is I have a little
experience with this personallyand with family, but not a great
(11:19):
deal, and it seems like thethought of Botox or similar
procedures has kind of evolved,sort of in the way that online
dating has evolved.
Like when it first came out 20or 25 years ago you wouldn't
really tell anyone because that,oh yeah, I don't want to have
Botox so I don't have to go onthe computer to meet a date.
But now everybody does it, itseems like Is that true?
(11:42):
Yeah, is it less of a stigma orwhat?
Dr. Mary Alice Mina (11:45):
I totally can relate to the online dating
because I met my husband back intwo eight and I remember
thinking, never wanting to tellanyone because it was still kind
of embarrassing.
Nowadays it's like whatever whodoesn't meet online.
But yes, I think Botoxdefinitely has lost some of that
stigma that maybe it used tohave and I think sometimes
people they get scared of Botoxbecause A it has the word toxin
(12:10):
it's botulinum toxin in it, sothat can scare people a little
bit.
But it's been around for solong that we have such great
data and safety info on it thatI think people now realize it's
pretty safe.
I find it's a sort of starteror gateway procedure for a lot
(12:31):
of my patients.
It's nice because it'sreversible or I shouldn't say
reversible, but it wears off, soif you don't like it you don't
ever have to do it again.
That being said, most peoplelove it and then they become not
addictive, but they want it andbecause they see the difference
it makes in their skin andpeople don't realize you can use
(12:52):
Botox and I'm using the brandname Botox, but there are
several of them botulinum toxin.
I should be saying right, butBotox, that we can use it for
more than just relaxing muscles.
We can use it for asymmetrysomeone may have in their face.
Maybe their smile has alwaysbeen a little crooked and we can
(13:13):
help balance that out.
Or maybe the tip of their noseprojects downward as they've
gotten older and we can put alittle Botox in to help restore
facial symmetry.
And so it's more than justmaking yourself look totally
frozen.
And if anything, I think thependulum is swinging to a more
(13:33):
natural result.
Where people are, they wanttheir muscles softened.
They still want to be able toemote, to show expression, but
what they don't want is thatthose scowl lines to be etched
into their skin so that whenthey're not scowling it still
looks like they are.
I find that's what reallybrings people in.
They'll say everyone keepstelling me are you angry, why
(13:56):
are you mad, why are you sotired?
And they'll say I'm not angry,I'm not tired, I'm not, I'm not
mad, but people think they arebecause of their expression.
And what we can do with Botox,with some units of few little
injections, is soften up andmake those features go away, and
and people just feel so goodwhen you do that, when they're
(14:20):
no longer being told you lookangry when you're not right,
like that's super frustrating.
So, I I find that Botox is agreat entry starter procedure
for people and it really doesmake your skin just have a nice
glow about it.
It's really pretty and youdon't have to totally freeze
(14:41):
yourself.
It can be done with the rightinjector very, very naturally.
Jay Croft (14:46):
And just for anyone who might not be familiar, we're
talking about.
You go into a clinician'soffice and someone sticks a
needle in your face and injectsthis substance.
That's it.
Dr. Mary Alice Mina (15:00):
That's right.
Yeah, we so.
And I also say you know,everyone's really into natural
nowadays and I think Botox issuch a cool way that scientists
used what's in nature andharnessed it.
So Botox is from the bacteriaClostridium botulinum that
produces a toxin.
(15:20):
It's found in soil.
It's the reason we tell parentsnot to give their babies honey
before the age of one, becauseit could be in there.
So it's a totally naturalbacteria and we're harnessing
its toxin that it produces andusing it in very minute,
concentrated forms, injecting itinto the muscle to relax the
(15:42):
muscle so it can't fire, so itdoesn't do anything for lines on
your face that are there atrest.
So if the line is there at rest,it may soften it a little bit,
but it's not gonna get rid of it.
So if you are thinking aboutdoing Botox, the best time to do
it is, again, prevention, right?
So when you start to see thoselines are getting etched in so
(16:05):
when you stop scowling they'restill there then that's the time
to start if you really want toprevent those lines from forming
and for your audience who areinto exercise, right, it's like
building a muscle the more youflex your bicep, the bigger your
biceps going to be.
The more we're scowling andpushing those muscles together
in our forehead, the biggerthose muscles are going to get.
(16:28):
And so when you relax them andyou can't do that, they soften
up or atrophy.
And then the other thing peoplecome in for is they just feel
like their skin needs a refresh,their complexion's kind of dull
.
Maybe they've got a lot of whatwe call dispigment.
They might have some brownspots and red spots, maybe some
(16:49):
melasma, hyperpigmentation orlittle warty gross on their skin
.
And they feel like it's nolonger smooth and even and
bright and they're looking forkind of a refresh and bright.
And they're looking for kind ofa refresh and I love doing that
because it makes such a bigdifference to just clean up the
background, noise, make thecomplexion more, even more
(17:10):
uniform.
It takes years off someone.
It's really amazing.
Jay Croft (17:15):
So what is that?
A chemical peel or something?
Dr. Mary Alice Mina (17:17):
It can be a couple of things.
It can be a chemical peel or itcould be a laser.
So in different laser,depending on how deep you want
to go, how aggressive it couldbe a resurfacing laser or it
could be a laser that treatsbrown spots or blood vessels.
So it just kind of depends whatyour main area of issue is.
Jay Croft (17:38):
Right, right Now.
I've done that.
I've had peels a few times andit makes your skin positively
glow.
Dr. Mary Alice Mina (17:47):
Yeah.
Jay Croft (17:48):
And it's just amazing .
You wake up looking so healthyand so rested and in a way that
you probably didn't even realizeyou needed it.
Dr. Mary Alice Mina (18:00):
Yeah, it's really one of my favorite things
to do because the results areso amazing.
People just have this refreshto them, and we're not
necessarily removing lines andwrinkles per se, but everything
just looks better when your skinis brighter.
One thing that I'm reallyloving are biostimulants, and
(18:24):
these are things like Sculptraand Radiesse, and I feel like
Sculptra had a moment, maybearound 2000, 90s, 2000.
And then it was a littlecomplicated to reconstitute it
and have it ready to go, andthen hyaluronic acid fillers
kind of took off.
Those are things like yourJuvederm, your Restylane, and so
(18:46):
then everyone started usingthose and I think people are now
getting a little fatigued withour hyaluronic acid fillers.
While I love them and theydefinitely have a role, they can
be overdone and that's whereyou get that real chipmunk cheek
look, that real stiff look,doesn't look normal, doesn't
look natural, and I think that'swhat people get kind of freaked
(19:08):
out about when they think aboutcosmetics.
They think they're going tolook like that.
Now, that takes a lot ofsyringes and most people aren't
going to go that extreme but togive a more natural volumization
.
I really love things likeSculptra and Radiesse.
They build your own collagen.
So again, for someone who'sreally looking for kind of a
(19:30):
natural approach.
It's boosting your own collagenand the best time to start
Sculptra would be before youreally feel like you need it,
because Sculptra takes timewould be before you really feel
like you need it becausesculpture takes time.
I tell people it takes likethree to six months before you
start to see any difference.
And so starting before youreally need it can be helpful
(19:51):
just for maintenance andmaintaining that volumization
that we know we're all going tolose that volume, it's normal.
Our bone starts to resorb, westart to.
Our face starts to fall.
For women that's acceleratedduring menopause.
So we know all that's coming.
So again, just like working out, like build that muscle before
(20:13):
you lose it, cause we know it'scoming.
So build that collagen beforeyou have that precipitous drop.
Jay Croft (20:20):
The injections you mentioned, I thought of some.
I can't help but think offamous people you know, because
we all know.
We can say their names andeveryone knows what we're
talking about.
But there are some actors andactresses and their cheeks are
out to here.
Dr. Mary Alice Mina (20:34):
Yeah.
Jay Croft (20:35):
And you think you're 45 years old.
You're beautiful.
Why are you doing this toyourself?
It's.
How do you so, how do I, as anordinary person, not go too far?
Dr. Mary Alice Mina (20:45):
Yeah Well, it is tricky, I would say.
For most people, it'sincredibly expensive to be doing
the amount of treatments thatthey're doing, and so it's just
simply not possible for mostpeople, the average person, to
spend that amount of money.
That being said, though,there's bad filler all over,
there's bad Botox all over andbad cosmetic surgery right.
(21:08):
So see someone who is trained.
This is not where you want toget the best deal.
This is not where you want toget a buy one, get one free, or
come in with your friend and geta deal Like this is your, your
face, or your body, youraesthetics.
So this is not where you wantto cut corners.
Research who's doing yourtreatments and your procedures.
(21:30):
Sometimes people price shop forthese procedures, and they might
go see one person for theirlips, maybe someone else for
their cheeks, someone else saiddo your chin and it gets very
piecemeal looking, and you don'thave one person just looking at
your whole aesthetics to makesure it's in balance and it's in
harmony.
(21:51):
And then, for people gettingthese procedures done, we get so
fixated sometimes on the flawthat we see the hollowing,
whatever deformity we thinkneeds to be fixed, and so it can
be very hard to remember wherewe came from.
And I think that's where peoplestart going down this slippery
slope of oh well, I need morefiller here and more filler here
(22:13):
and more filler here.
And that's when you start toget kind of bizarre looking.
And then the other thing Iwould say is who's what does the
person who's doing yourprocedure look like?
Because you are probably goingto look similar to them.
So if they, you know, maybe youare going for that overdone
look I mean, there's certainlypeople that's what they want,
(22:34):
right, like the Kardashian lookand all that.
So you are probably not goingto want to come see me because
that's not really what I do.
So, whoever you know, and alsoif someone is doing your
procedures and they've got thosebig cheeks and everything, then
I have to wonder maybe theirsense of aesthetics and balance
(22:54):
is not what I perceive, and so Iwould just be careful with that
as well and so I would just becareful with that as well.
Jay Croft (23:03):
Okay, okay, do you find that it's mostly women who
pursue this kind of thing, ormore men doing it as well?
Dr. Mary Alice Mina (23:08):
Certainly more women, but there are more
men who are getting these thingsdone.
But I do feel like there ismore of a taboo for men.
They usually don't want to tellpeople, they don't want their
family to know.
There still seems to be astigma about getting it done.
But men do care about theirappearance and, you know, my
husband will tell me what.
(23:28):
What do I do about these darkcircles?
Or help me with my.
You know, thinning hair thingslike that.
So I do think men are.
We are seeing more men doing it.
It's just not at the same rateas women, at least in my office.
Jay Croft (23:43):
It's some things, people balk and I think this is
one of them, and I think fitnessis one of them.
A lot of times you'll hearsomeone say oh, you only go to
the gym because you want to lookgood and and maybe, maybe that
is someone's prime motivation.
Maybe it's not their primarymotivation, maybe it's not a
motivation at all, but so what?
(24:05):
Right?
Dr. Mary Alice Mina (24:07):
At least they're going right.
Yeah, I feel that way.
I have people who will tell meI'm never doing Botox.
You know they are, they're verylike the crunchy granola
natural and and.
And they'll say I never wantBotox, I'll do laser, but I
don't want Botox.
Or I don't want anything in mebut I'll do.
I'll do a laser treatment butyou know they'll color their
(24:29):
hair but they won't.
They won't do this Right.
So you know, everyone's entitledto whatever they want to do.
You don't have to do anything.
My mother could do any.
I do any procedure on her thatshe wanted.
She wants nothing.
She has never tried anything.
I can't even get her to use aretinoid and she looks great,
she looks amazing.
She wears sunscreen and shewears a hat when she gardens,
(24:51):
but it's not her jam.
She does not want to do it.
And then I have other people whowant to try everything.
They want to do everything andyou can do whatever you want.
But yeah, I see that too, wheresort of on the side, people
will pull me.
My friends will come over andsay you know, don't tell anyone,
but I do want to come see youfor Botox, like they're.
They feel almost ashamed orembarrassed that you know now
(25:13):
that they're 45, they really dowant to try it, but for so long
they said they wouldn't do itthat they feel like they're a
phony or a fraud to get it done.
So I think everyone should beable to do whatever they want
without feeling guilt about it,and I think also to celebrities
(25:33):
need to stop saying they haven'thad things done when it's so
obvious they have, just just ownit, Say I mean, what's the big
deal you got you?
you get Botox and filler, it'sokay.
Jay Croft (25:45):
Now you have your own podcast and you have something
you want to share with us, soplease tell the folks about that
.
Dr. Mary Alice Mina (25:54):
Yeah, so my podcast is called the skin real
R E A L, so if you arewondering, you know what's?
What's the truth about this orthat or different things.
Definitely check it out.
My topics we cover are usuallythings my friends and patients
and family asked me about andhopefully it's just a way to
give people some good science,fact, actual skin health
(26:15):
information.
So definitely check that out.
And then, if you're wondering,you want to take a fun quiz and
find out am I more of a NicoleKidman or Dr Mina's mom?
You can check that out attheskinrealcom forward slash
style to see what your aestheticstyle is.
Jay Croft (26:31):
Oh, that sounds like fun.
Yeah, I'm at Dr Mina's skin.
Put all of that in the shownotes so people can access that.
I'm going to take your quiz tosee if I'm more like Nicole
Kidman or your mother.
I think I'm probably more likeyour mother.
I think so too A little Nicole,maybe a little Nicole.
Dr. Mary Alice Mina (26:53):
And that's okay.
Jay Croft (26:55):
Yeah, absolutely, it's all okay.
You know, the name of the showis Optimal Aging and for me that
means whatever you want it tomean, and if you need to dye
your hair or go to the gym orwear expensive clothes or makeup
or whatever the heck you wantto feel good about yourself and
enjoy your life, go for it.
(27:15):
That's what I say, yeah.
Dr. Mary Alice Mina (27:17):
I love it, your mental health matters too,
is what I say.
Yeah, I love it, your mentalhealth matters too, right?
Jay Croft (27:21):
Absolutely, absolutely it does.
This has been a delight.
I want to thank you.
I could talk to you about thisall day, because I'm just
fascinated by all of this.
I have three older sisters andthey do a lot of this and I've
done a little bit and it'sreally interesting to me.
So I want to thank you for yourtime today.
Dr. Mary Alice Mina (27:41):
Absolutely.
This was a lot of fun.
Thanks for having me.
So I want to thank you for yourtime today.
Jay Croft (27:44):
Absolutely, this was a lot of fun.
Thanks for having me All right.
Have a good day.
Stay safe in all this crazyAtlanta snow.
Dr. Mary Alice Mina (27:48):
That's right, stay warm.
Jay Croft (27:51):
Okay, bye.
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