Are You Ready for Your First "Aging Spike”? Plus! “Secret Menus” at Derm Offices and The Skincare Ingredients That Will be Everywhere in 2025 with Derm Approved Podcast Host Dr. Sheila Farhang

0:00The following podcast is a dear media production.

0:07Welcome to Breaking Beauty, the podcast all about the breakthrough people, products, and moments in beauty. We're your hosts, Jill Dunn and Carlene Higgins.

0:20Welcome back to the show, everyone. We're Jill and Carlene, your friendly neighborhood beauty editors sharing the breakthrough people, products, and moments in beauty every single week. Hey, Hey, Carlene. Hey, Jill. I hope everyone enjoyed our damn good holiday gift guide that we served up last week. All the products we want for ourselves. You know, you guys can feel free to share that episode with a friend for inspo or if you want to drop them a hint of something you want, throw it in the family group chat. So it's good. I mean, people just need more than a hint. Some people need to be hit over the head like and so you don't end up with a gift that disappoints.

0:58And, you know, we put that we published that episode nice and early. So everyone has lots of time to shop and hope that you guys had fun doing that. But a quick update on that episode, Carlene, I mentioned the Elf Cosmetics and Stanley Cup. Yeah. Oh, yeah. I remember that. So I actually went in person to Target to see if I could find it because I knew it was going to fly off the shelves. So they have five colors of the Stanley Cup that are like makeup inspired by Elf Cosmetics and they have the lip oil that corresponds. So it's like red delicious Stanley Cup, red delicious lip oil from Elf Cosmetics.

1:35But the missing link, the whole point of wanting this is that they were selling a clip that could clip onto the handle of your Stanley Cup and you could put your lip oil. None of the colors had the clip. Why? What happened? And by the way, that's very road inspired, very road adjacent. 100%. Okay, so what happened to the clips? Well, basically each item was sold separately. So you have the cup, you have the clip, you have the lip oil. So you could buy the cup and the lip oil, but all the clips were sold out. So I think what was happening was people were just like grabbing the clips to put it on their existing Stanley Cup.

2:11Now, I would like to see if any of our audience found one, found the clip and got the whole shebang together. Send me a picture and I'll just drool and be jealous. Yes, I want to see it. Well, of course, our audience loves a damn good episode, but they also appreciate when we hear from bona fide experts as well. And today we're welcoming a dermatologist who is a fellow Dear Media PodFam host. Her name is Dr. Sheila Farang. We were guests over on Dr. Sheila's new show. It's called Derm Approved, and that dropped a few weeks back. You can go back in her feed and check that out. We'll link to it in our show notes.

2:48And the topic of that conversation was all about eye bags and jowls and some things you can do at home to help with those tough to treat areas. Yes. So in this episode, we're asking Dr. Sheila about the groundbreaking research that came out of Stanford around aging spikes this year, which really made a lot of headlines. It suggests that we actually do not age in a linear fashion, but in two major spikes at age 44 and 60. So Dr. Sheila, is going to decode that news, what we need to know and how to get ready for it, along with more timely and topical dermatology matters. And Dr. Sheila is a double board certified dermatologist.

3:28She's also a fellowship trained cosmetic surgeon and reconstructive Mohs micrographic skin cancer surgeon. And she is the founder of Avant Dermatology and Aesthetics in Tucson, Arizona, and she often practices in Beverly Hills as well. You might recognize her name from national media like Good Morning America and the Today Show. So just ahead, we'll get the truth about how we age, according to a dermatologist. Plus, we'll get her, we're calling it prejuvenation secrets. So finding out what we can do now to sort of get ahead of these aging spikes. We also ask her about how to find out if your injector provider is a green flag versus a red flag.

4:09And is there a secret menu at the dermatologist's office that we should know about? All of that, plus the skincare ingredient that will be everywhere in 2025. Welcome, Dr. Sheila.

4:29Hi, I'm Dr. Will Cole. As a leading functional medicine practitioner, I have had the unique position to see so many alchemize their pain and health problems to their purpose. Now I want the same for you. This podcast is the manifesto for a new breed of health seekers, where there is a fresh infusion of grace and lightness into wellness. This is the art of being well. Join me every Thursday for a new episode. This episode is brought to you in part by way. So I don't know how many of you listened to our holiday gift guide episode that dropped last week. We let you know about so many of our favorites that you can pick up in store or online.

5:11And I want to give you a hot tip on another great way of shopping. It's at the Waze website. They're doing a build your own bundle deal. And how it works is that you buy three products and you get a mini product for free plus you save 15%. So you start with let's say one of their best sellers. You all know how much Jill and I both love the detox shampoo. I use it once a week to just clarify, get rid of any oil and dirt buildup on my scalp or like dry shampoo left on my strands. And I just find it's a total reset. Also love their leave-in conditioner. So pick your favorite. Step two, choose a scent.

5:52So everybody knows their iconic St. Bart's scent, Melrose Place. You can choose a body cleanser, a body cream, one of their fragrances. And then step three, choose a travel size. So any of your favorites come in minis that you can take with you on holiday, or if you're traveling for work, like the detox shampoo that I mentioned, or the leave-in conditioner. And then step four, you get to choose a mini for free. So any of your favorites, or what I would do is I would pick their Holloway gift bag. It says Jingle All The Way spelled O-U-A-I. So you can wrap up all of these favorites that you've picked and add a little tissue, gift it for someone else, and you are ready to rock.

6:36And the best part is we also have our promo code that we always have for you. It's going to be 15 % off sitewide. Get on your way to save for the holiday. Go to T-H-E-O-U-A-I.com for 15 % off site-wide and enter promo code BEAUTY15. That's T-H-E-O-U-A-I.com for 15 % off with code BEAUTY15. Candles and everything. That's the perfect gift. Just saying. And now back to the show.

7:11Welcome to Breaking Beauty Podcast. Dr. Sheila, I need to ask you about this because you were recently named one of the top 100 injectors in the USA. So I need to know how this comes about. Is there like a competition of sorts? And can I be a guinea pig? You know, with that one specifically, it was, I think, a nomination based. And this is a really good question because it's like, how do you find your provider? Right. Are they on like a top 100 injector list? You know, this one I know was I was nominated by one of the injectable companies. because I'm their celebrity West Coast injector. Okay.

7:45And there are so many different vetting systems. I wouldn't, that one's like a nomination one. There's one that I got nominated for recently and this one's by Peers and it has a board and it's called the Castle Connelly or something like that. Okay. And then there's like Super Docs. And then now there's like actually companies that are vetting their like brokers. Oh. For derms. Have you guys heard about that? Right, yes. Like persona. Yes. Yeah. And like aesthetic, they're kind of like aesthetic concierges. Yes. So I guess you just have to see is this like membership based? You have to pay to be part of this.

8:23And it can get really confusing. I mean, I always get super honored to get nominated for this stuff. But I think when it comes down to patients, kind of beyond that, it's like, look at the credentials, right? See how long they've been doing it. Look at the before and afters, but not so much like on Instagram or anything like that, because you guys know that. Right. It can be edited. Exactly. And see if you vibe, you know, if you get into the place, always do a consultation first. And if things look a little off, red flaggy, maybe it is if everything's very streamlined, everything's very like by the book and so organized and it's easy to schedule.

9:04It's easy to get in touch with someone. If you have something afterwards, if you're bruising or something. And, you know, at my office, we have like a huge protocol to make sure it's not a intravascular occlusion, like filler's not in a big vessel. Those are the things people should really look for. Okay. Okay. What's the name of the peer one? I'm interested in that. Castle Connelly, Top Doctors. Okay. And I think there's a really rigorous process that goes into place because I know I looked at it when I was just a few years out of practice and I was still too, I didn't like meet the criteria.

9:36So I didn't really look into it anymore. And then I just received an email of top doctor. So I think that's really nice if someone wants to do that. I think being fellowship trained, especially in dermatology, of course, dermatology, we get knowledge of cosmetics and we get knowledge of everything. So if you want to talk about skincare a lot, don't go to a medical dermatologist who's only really working on complex like bullous blistering diseases all the time because they are right their mind is a different focus exactly although all derms have that knowledge base of skincare they're not going to sit down and talk to you about peptides and things on tiktok and things like that i kind of do a little bit of all i do all of it because i own the practice but i think that that's another thing to look out for if you want like the best of the best of the cosmetically trained it's like ASDS fellowship trained in cosmetics.

10:31And there's like a fellowship after dermatology residency that we can pursue. And I did a double one. Okay. Yeah. Okay. Well, we keep learning and we keep growing. Now we wanted to talk to you today about how we age because there was a study out of Stanford Medicine that was released this summer. It made a lot, a lot of headlines and it suggests that there are two kind of births in our aging and one of them happens at age 44 and the other one at 60. I'm curious if you see this theory reflected in your practice and what the takeaway of that news was for you. Did it resonate? Yeah, I'm so glad you are bringing this up because it was huge and it wasn't revolutionary.

11:15We kind of all know we don't age linearly, early, especially after pregnancy, after a stressful time in your life, after, you know, after my, you know, med school or, you know, we kind of have this accelerated aging process based on like stress in our life too. But this one was really specific. Of course, they couldn't control for stress in our lives or anything like that. And they, and this is a really great study. So I know a lot of publications come out there and a lot, my husband's an astrophysicist and PhD. So every time like we see studies, we're like, no, not a good study. Not vetted or this is like industry or something like that.

11:53This was nature, which is the best. And it's actually open access. So if anyone wants to read it, they can. It gets really into the weeds. It's a really long paper and it really gets into the science of it almost like way beyond like what I understand with. Cole's notes. Cole's notes, please. Yes, exactly. But essentially, this is a really great study because it was a cohort of like 108 people, which technically isn't that many. But for such a study that follows them for, I think it was like 6.8 years, almost seven years, they took blood swab, skin swab, saliva swab, all of these things. And they saw these changes over time.

12:35And the two peaks were 44 and 60. And it's funny because I do see that in my office, even like without that study, because it's that it's that perimenopausal. I've said that too. I've said that even from personal experience. I think a lot of people out there think that when they turn 40, their face is going to start changing because they're in their 40s now. But I noticed it when I hit mid 40. And I was like, no, your face and when you're for me, everyone's different, obviously. But when I was 40, I was like, I look the same, if not maybe a bit better because of, you know, the in-depth skincare we do and the treatments.

13:13Like I didn't notice a big difference at 40, but around 45, I was like, oh yeah, yeah. I see it now. It's all falling. And I think one takeaway, and I'll kind of talk about the study a little bit more, but I think one really good takeaway from this is that it's not in your head. It's, you don't, it's, it's not like you all of a sudden felt like you were aging because is there science there to back it up? Because I do have patients coming in and they're like, oh my God, like, and then they feel like this is just gonna be an accelerated aging process. Right. I think a lot of things are gonna come from it because what happened was, so for, you know, of course they looked at cardiovascular, they looked at how you metabolize carbohydrates and fatty acids.

13:54So that weight gain that we get as we mature post-menopausal or what have you is because of that decrease in muscle mass. It's because of how we metabolize things. So I think this is going to be really interesting, hopefully to shift like the lifestyle aspect of everything, going in, getting screened, if you have cardiovascular disease in your family, things like that. So I think as a whole, that was really important as a whole aging factor, but there was also the skin and the muscle. So they saw that for muscle decreases, like actually our muscle mass decreases as early as like 30 years old. and then 60 when it really goes down.

14:32So again, like going in, doing that like weight training and things like that, super important, especially for bones and osteoporosis. And then for skin, which is, I think, what we're really kind of interested in here for this conversation. They saw a dramatic decrease in what we call the extracellular matrix, which is our collagen, our elastin and glyco, like our GAGs, glycans. So this is what gives structure to our skin. You know, we talked about the stimulation of collagen. You guys know all about that. and I think it's really interesting because as far as skincare is concerned as far as in office treatments are concerned as far as at home devices are concerned like red light things like that we do really need to focus on that stimulation of collagen because we lose well this wasn't in the study but from what we know we lose one percent of collagen production each year starting age of 20 and then 30 % of our collagen, like both in five years of like menopause.

15:27So I think that now that we know this aspect, 44 and 60, we kind of, I kind of already knew that in my office. I see a lot of, you know, people come in in their thirties. Sometimes I hear like late 30, like for me, I feel like I kind of age like 35 plus and I'm like near 40. So I feel like I'm kind of hitting that, but everyone's so different. So I don't want you to bang on those two numbers. Like, all right I'm not going to do anything until I age at 44 yeah right yeah the prevention and I think yeah doing things like strength training it's never a bad idea um and one thing that was interesting that I took away because I was expecting perimenopause I was expecting them to say women kind of fared worse because of perimenopause but it wasn't the case trust me I was ready to be like patriarchy strikes again but it wasn't it was men and women equally at those ages if that was so interesting so it's like good to keep in mind i think for men yeah it would be interesting to kind of do a side and there was like limitations in the study it was like people around star stanford university so it's like one very specific area yeah sure and then another thing was decrease in testosterone in men muscle loss things like that so it'll be interesting to see i think that was just like the surface yeah we could talk for a whole hour just about that study.

16:45So what can we do beforehand to try to, now that we have this understanding of what's going to happen, how can we use that knowledge to prepare and mitigate, you know, the effects of that the best that we can? What's your advice? Yeah, I think that that's a great question. And first, like lifestyle, obviously, we all know that stress accelerate, you know, that cortisol and that increases like the breakdown of collagen. So decreasing stress, I know easier said than done in my lifestyle. I'm on like adaptogens and things because I know I can't decrease like my career aspect. Right. I might. And I have a doctor who does all of that and helps me with it, even though I feel like I've been doing my own health care forever.

17:28I feel like I needed someone else to run some of those labs, check my cortisol, do all of that. So you want to make sure your insights are good. Right. And then Lexapro guys, adaptogens or Lexapro. Yes. We're both equally fans over here. Yes. Saves me. I'll tell you that much. Yes. I'm so glad you bring that up because the mind, it's all interrelated. Yeah, absolutely. Exactly. It doesn't matter if you have a 10 step skincare routine, if you're a mental and you're my skin is glowing. Yeah, exactly. Exactly. And I think that is so, so important. So what are some things at home and at the in office that we can do.

18:06So as we know, we're decreasing that collagen. Collagen, what gives our skin structure? Elasticity is what gives our skin bounce. And I know you guys are huge into skincare. Surprisingly, as a derm, I'm not really into skincare. I get so much scent to me and I have really sensitive skin. I have like a lot of allergies and I'm acne prone. So I stick to like my few ingredients. Just the basics. The basics. A lot of germs do. Yeah, exactly. But I think that in the world of peptides and of course, retinoids are amazing. They're kind of like the gold standard. Getting skincare down, I think, is really important initially.

18:44So of course, SPF, not even like dousing yourself all with sunscreen, but like sun protecting, wearing a hat, covering up, doing all that when you're like out and about is like super important. That adds up, of course, skincare. And then in the world of in-office treatments, we have a lot of technologies that stimulate collagen. I know there's like some fear-mongering and some other things regarding things that are like heat-based and radiofrequency-based or ultrasound-based that melt fat. But it's only deliberately melts fat when you're at those settings. I think that people really need to embrace this energy.

19:19I think that lasers are a huge part of everything. Botox and filler. I know we may talk about this, but like the fact that fillers are being vilified is I think sad because it does come into place as we've aged because as we're aging, we lose fat. We lose those fat pads go down. We have bone resorption and muscle tone goes down. So I think it's focusing a lot on those things that stimulates collagen. There's a lot of injectables that stimulate collagen sculpture. Hyper Dilute Radiesse is going to be, I've been using it for years, but it's going to be actually approved later this year for stimulating collagen, which is really exciting for the neck, but it opens up the world for like so many other things.

20:03So I think it's really like problem-based too, because even like Caucasian skin types age a little bit differently than darker skin types and the collagen that's there or the hair quality and the hair diameter. So I think it should be very like personalized. Right. Right. What's the single best investment for you to do one thing in your 30s? Oh, my gosh. Honestly, in your 30s. Well, other than sun protection, I would say being on a retinoid. You know, some people are like, oh, my God, I was listening to another podcast and they're like, retinoid has such good PR. I'm like, not really. It's just the gold standard has so much science behind it.

20:39Of course, you can't be on it while you're pregnant. And there is some people that can't tolerate it. But but at a very low dose, there's so many more formulations even on the like aspect of prescriptions like there's a brand that's a prescription called altrino and it's a it's a lotion and it's very tolerable and has like collagen glycerin and anything has hyaluronic acid and this prescription i can give patients and they tolerate it really well yeah and then just like starting off with like a retinol but i think if you want to use one skincare product it's not hyaluronic acid let me tell you that's anti-aging.

21:14It's going to just plump up your fine lines and pull in water. You want to do something that's actually stimulating collagen and boosting that cell turnover. And that's a retinoid. Yeah. Yeah. Retinoid. And it's interesting you said peptides, because I do think that that's risen to popularity this year, even though it's not new at all. Do you have a favorite peptide formula? Because that's not going to be by prescription. So give us something we can buy. Yeah. You know, peptides, I think the only thing about what's going to be difficult for that is good peptides are so expensive. So I think that unless they like mass, you know, are able to do something like that, they're nearly, you know, I think good peptides are like over a hundred dollars.

21:55So then these products are luxury products. Yeah, they end up being expensive. Yeah, there's a new one from SkinCeuticals that I really like that we've talked about. PTOX. Oh yeah. And it's supposed to be, I mean, I can't believe they're saying it, but it's supposed to be kind of Botox. Botoxish in a bottle. And I'm like, I can't even imagine that skin suit of poses. Well, it's called PTOX. Like obviously that's where they're going. But it's not Botox in a bottle, guys, but it is a very good peptide serum. I have been using it and it has a very gentle exfoliator in it, which I think is actually what gives you the glass skin effect and encourages you to keep using it.

22:36But yeah, it's going to be over a hundred dollars. The Allies of Skin And peptide is really good. That's really good. Which one? Allies of Skin. Oh, OK. I've heard of that one. And it's growth factors and multi-peptides in one serum. It's very unique in the market. It's like still expensive. Medicaid liquid peptides is quite good and more affordable. Oh, yeah. So there's some RECOs. Now, I want to ask you about, we know you're one of the top 100 injectors. So fair enough. We've talked about filler fatigue this year. Is there anything in your opinion that has changed since when you started your practice and now in terms of your approach?

23:15Or what's your thought on this backlash? I think that nothing really major has shifted because I'm not really like trend based in a way. You just have to go in to the patient individually. And if it's like sometimes I'll use one syringe and do the entire face. and like little micro droplets here and there just for like shadowing and things like that. And then there's like another injector I saw who only takes patients if she's only doing like seven syringes at once. And these are younger patients. These are like patients in their 30s. I know. And so and she like that's her branding. Yes. It's like$12 ,000.

23:52Yeah. That's insane. So there is a lot more expensive than Botox. I don't know if people know that. Right. Exactly. So for something like Botox, it's by units and it really depends on where you go. I would say anything under than like$10 unit is a little bit of a red flag. I'm just going to ask you to pause for a second. So you know of somebody who will only take clients if they do seven units minimum. No, seven syringes. Syringes, sorry. Yeah. Of filler, meaning that this is kind of like I don't wake, I don't get out of bed for less than$5 ,000 a day kind of mentality. And that's like her, and I don't like know this person personally, but I saw that branding and the seminars they were doing online.

24:29Wow. And I was just blown away. I was like, this is bizarre to me. I feel like this person needs, I'm sorry, I'm like getting a reaction right now because I think that this person needs to be dragged straight down. I'll go on Reddit after it's an idea. Because I have, like, you know, I have a 13-year-old daughter and it's like, I'm not against fillers. I've had blepharoplasty. We've talked about this before when I jumped on the air. Like, I'm all about interventions, but that's just such a mentality that like forcing young people to overdo it because they're not willing to to go smaller to minimize to give a natural look and accept less money is just kind of evil this is not women supporting women guys yeah yeah or they could be injecting men too absolutely i think in your very and you have to think about if you're doing that many syringes your body's having like a kind of like an inflammatory response to it right with all of that it's pulling in water things can migrate then so i will usually if I have a mature patient over 60 that has a lot of volume loss, fine.

25:34If we're going to go temples, cheeks, mid cheek, mesolabial, jowls, that will end up being like four or five syringes. And that's like usually where I cut it off. Wow. Yeah. It seems like a lot, but it's like each one is a blueberry size. I just mean that's so much less than seven and you're doing it on a young person. That just puts in perspective. Exactly. I'll send you the page. Yes. Perfect. Okay, guys.