The *New* Rules of Skin Brightening, Laser “Stacking” and Why Everyone is Freaking Out Over Xerf with Dermatologist Dr. Tia Paul

21:50Dr. Tia Paul:So I have a ton of patients that are guys and they love this stuff. They're like, wow, I can be read only for like an hour or two and be back to work? Sure, why not? And they are seeing the improvement in the fine lines, wrinkles. Granted, it's going to take them three to six months to see the result. That's why I say go slow. I'm not telling you to do all this stuff monthly. Go slow, but enjoy the process. Yeah. I also really appreciate on your channel that the real talk about the skincare plateaus, Like people will be on like a melasma journey and they're brightening with skincare and stuff.

22:17What is the tipping point where you're like, OK, you should actually dive into a laser or something? What is the plateau, I guess?

22:26Dr. Tia Paul:Yeah. And that plateau might be different for different individuals, too, right? So skincare is very, very important. It's very, very important for prevention. It's very, very important for maintenance. It might not be as dramatic for correction. So if somebody shows you a before and after photo of like dark spots that cleared up, I doubt it's only skincare alone. Skincare is part of the whole treatment plan. But usually there are other procedures like whether it's lasers or micro kneeling or chemical peels that gives you that more dramatic wow factor difference. But even that it's not one magical treatment.

22:59Dr. Tia Paul:Even that you need a series of it. So the classic analogy I give is with going to the gym and getting a trainer. Right. It's not just if you show up to the gym two times a week with a trainer, you're expecting a six pack to show up. You still have to be good about your eating habits, about sleeping and all that. Same thing. Kind of eating clean is equal to doing your skincare routine at home. But when you're going and getting these professional treatments, you still have to do them and you have to do maintenance too. It's not just like a one-time thing. Yeah. Fantastic. So that's where these other products that have skincare brighteners in them do come in handy.

23:32And I know like hydroquinone used to be the gold standard for a lot of dermatologists. What is it now?

23:39Dr. Tia Paul:It is still hydroquinone in terms of like its prescription strength in the United States is very strictly regulated because in a lot of countries like Philippines and India, it's over the counter and misused because people use it there for lightening purposes, not necessarily brightening purposes. And then if you use it for many months, two years in a row, it can cause a paradoxical worsening of the brown spots. That's called okrinosis. So in the United States, we use it, like I only give one prescription refills from time to time, but it works really well, way better than any of the other topicals that we have.

24:06Dr. Tia Paul:But you cannot be on hydroquinone forever. You need to take breaks from it. And when you're taking breaks from it, there's a lot of other alternatives now. Now, the other problem with hydroquinone in some skin tone and skin type, it can cause irritation of the skin. So not everyone can tolerate hydroquinone. So same thing with tretinoin. I know we hear on social media and everything, everybody's raving about retinoin. Not everybody can tolerate retinoin. And then you have alternatives like Spacuchil. You have peptides. Same thing with hydroquinone. You have alternative. You have topical tranexamic acid.

24:32Dr. Tia Paul:You have azelaic acid, niacinamide. So a bunch of other alternatives too. Okay.

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26:02So discover the new Dove Serum Plus Oil Body Wash at dove.com slash CA, now available on Amazon and in stores nationwide. That's www.dove.com slash CA. We'll link to this product in our show notes and on our website. Today's episode is brought to you in part by OneSkin. Okay, I'm going to tell you why OneSkin really stands out as a skincare company. It's not just the hype. The founding team are longevity researchers who set out to target visible signs of aging, wrinkles, fine lines, loss of elasticity by targeting zombie cells. We've talked about this in the past. Those are the cells that slow the aging process right down.

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28:23We're going to get into a whole one-on-one on lasers, everyone. We're just going to pretend And we're starting from zero and that we know nothing. Because honestly, I feel like the word laser gets misused all the time. It's just this umbrella term. It's like, what lasers are we talking about? Incredibly loosely. And like when my girlfriends say, I'm going to get a laser, half the time they're talking about laser hair removal. So how would you actually define a laser? Yeah.

28:45Dr. Tia Paul:So laser is a big, broad terminology. A laser that is treating redness, broken capillaries, or rosacea is very different from a laser that's treating pigmentation, brown spots. or a laser that's stimulating collagen is different from a laser that's done for hair removal. So it is actually pretty fancy. And I almost feel like people don't give it enough credit, maybe because people don't understand it's such a complex thing. And it's also because you hear about every dentist, every meds about having a laser. So it's very vaguely and broadly used, you know what I mean? But it is basically using light technology in a way that can be very targeted.

29:19Dr. Tia Paul:So there are specific targets in our body, such as melanin, the pigment. When you use a laser light to target that melanin, And that's how you treat pigmentation. If you target the blood vessels in our body, that's how you treat redness. If you target water, we call them the target molecule. That's how you get like collagen stimulation. And so it's very targeted. It's actually different from RF microneedling. That's a whole complete different technology as well. So, yeah, overall, just to summarize, laser light is used in a way where if you have a targeted problem, you can use the specific type of wavelength to attack that problem.

29:54I will be honest. I've talked to some people who have said, you know, are lasers dangerous, though, in the sense like how many times can you hit your skin with forcing it to regenerate itself or like taking off a layer? That's the kind of thing that I've heard where people get concerned or they're like, am I wearing down the quality of my skin over time? Can you speak to that?

30:20Dr. Tia Paul:So that's also a very good question. There are, again, like we mentioned, so many different types of lasers. The way I look at it, there's two big categories. There is ablative lasers and non-ablative lasers. Ablative lasers are CO2 and erbium lasers. Those are the one when you see on TikTok or on TV where people have crazy redness, swelling, downtime. because the way these lasers work is they literally ablate, meaning cut layers of the skin. And so they are much stronger lasers. They work for like deeper collagen remodeling. They work for acne scars. But those are the ones that can have higher risk because they are also heating up the skin too much.

30:55Dr. Tia Paul:Then there are non-ablative lasers where it's not that intense. And there's the degree, you know, there is something called fractionated versus non-fractionated. There is a lot of different types of lasers out there. and you truly, instead of just going with the brand, I mean, I know like on social media, like Morpheus 8 got very popular. Instead of just going with the brand, understand, ask your doctor or whoever is doing your laser, ask them what kind of technology is it? What is it targeting? And that's how you proceed with it. So for example, picosecond lasers, they are safe enough to do it at a much, you know, sooner frequent.

31:27Dr. Tia Paul:Like I do it on my skin once every three months and that's totally fine. So that's a non-ablative. Yeah. There's picosecond technology. Yeah, it's completely different. And then if I were to do an erbium or a CO2, I would probably only do it once a year or once every two years. Yeah. That's the one where it's a lot. It's like a week down time. You're slathered in Vaseline. That's the one where I showed you the pictures and I'm like, is this right? Yeah. Yeah. It's like you're questioning your life choices like five days in. You're like, because your skin is gone. Because it crusts over, right?

31:54Well, it depends.

31:55Dr. Tia Paul:Crusting over might lead to infection. I'm not a huge fan of CO2. And I'll say this out loud because of the potential risk. And, you know, I've seen people with darker skin get CO2 laser and crazy hyperpigmentation. They come to me with all the complications. Even on lighter skin, I have seen persistent redness after CO2. Although with any lasers, it's very user dependent. It's not which laser you're using, who is doing your laser? Do they really know what they're doing or are they just plugging in numbers? Ask them a random question. What does pulse duration mean? If they cannot answer that, just walk away.

32:25No, it's totally true. so when I see those on on tiktok or what have you it's like the crust over the skin the person looks kind of like a burn victim yeah and I will I'll ask people I'm like is this I'm like Jill is this normal is this person okay is that okay well are they okay and people can get infected you know

32:45Dr. Tia Paul:like you're literally getting rid of like top layers of the skin so it's like an open barrier so if you're not taking good care of your skin or if you're going out in the sun you can get hyperpigmentation from it. So that's what I'm saying. Rather, go slow. Do things, you know, slowly, conservatively, maybe more number of times versus doing something so aggressive. Like, I wouldn't be able to sleep at night if I was doing, if I were doing 10, 12 CO2s in a day, versus I do 10 to 12 picosecond lasers in a day and I sleep pretty good at night. Yeah, that's good. I feel like it would be maybe for more extreme cases, like people who have really severe acne scarring.

33:19Dr. Tia Paul:Sure, because sometimes you have to get aggressive to get good results. And also it depends like plastic surgeons, they usually are pretty aggressive because they want really good results. Whereas, you know, again, if you're going to a different place, that's not a, you know, necessarily a physician, they're going to be much more mild with their setting. Yeah. Yeah, that's true. You just mentioned Morpheus 8 there, but I just want to clarify that's not a laser, right? Right. Okay. I can break it down in simple terms. So lasers usually sort of deliver heat from the outside and radiofrequency microneedling, they use which is Morpheus 8.

33:52Dr. Tia Paul:They use microneedles to kind of like punch holes into the skin. And they use the radio frequency energy to deliver energy inside of the skin. So most of the lasers are coming from outside in, whereas the RF microneedling is more so inside out. But they're still like heating up the skin. But with RF microneedling, what you're doing is you're heating up the tissue more like deeper down. So that's why a lot of time it's used for things like tightening of the skin as opposed to superficial lines and wrinkles that most of the other resurfacing lasers target. Didn't RF microneedle, like radio frequency with microneedling get kind of a bad rap?

34:28Yep. What's the story there?

34:31Dr. Tia Paul:Again, that comes down to it's not that RF microneedling is a bad thing. It's who is using it and they really know what they're doing. So if you don't know what you're doing, you can actually heat up the tissue so much deep down, especially the fat layer where there was this concern for fat loss. but it's not because it's a bad technology it's because whoever was using it didn't probably know how to use it and that's why I keep saying this all the time lasers are it's not about plugging numbers it's about truly keeping an eye on your patient how red are they getting what are the end points so there was this whole concern about possible fat loss with RF microneeling but I think it had to do a lot with who was doing it, how they were doing it we've had a plastic surgeon I can't remember who it was now who was on the mic in here And they were saying, they're like, I don't know what people are having done out there.

35:17But when they're actually in the operating room and they get in there, they're like, the quality of the skin underneath is so different now. Like in some cases, it's like meldy, like buttery as opposed to before. And they're like, it just makes our job harder. Like, you know what I mean? What is that?

35:38Dr. Tia Paul:Yeah. Yeah. From some other technologies gone wrong or even fillers gone wrong. But again, it's not a problem of the actual filler or the actual technologies about how they're used. I think one of the problems is, you know, there's such a high demand for aesthetics, right? Yes. And anybody can do aesthetics. Anybody can open up their shop. So the problem comes that, you know, the laser companies or they are willing to sell their laser to anyone. Anyone. You could do like a one week certification and just get it. I was kind of shocked at AAD how many laser. Right. How many lasers existed? I was like, never heard of that.

36:13Never heard of that. It was wild. And they're there, of course, because that's the hub for dermatologists. And it was interesting.

36:21Dr. Tia Paul:And everybody's trying to sell. Everybody's trying to sell something or the other, right? But it almost like taking advantage of people who don't know and they're trusting the stuff maybe. And almost, yeah, it's just like a market where there is a very high demand. And to supply that demand, you're just giving these technologies to the hands of anyone. Yeah. If it's done the right way, who is a good candidate for Morpheus 8? If you're like looking in the mirror and you want to fix this or that, who's a good candidate? Yeah. So again, it comes down to even Morpheus 8 is one of those things I would be careful in darker skin, for example, because I've seen cases of hyperpigmentation.

36:58Dr. Tia Paul:But typically it's used for acne scars. It's used for overall tightening of the skin. But again, like I said, now technologies like Zerf are coming out, which is much more safer, much more minimal downtime. time. And so, I don't know, man, five years, we can sit down, we'll have a whole different conversation. That's the beauty of it. That's the beauty of it. Did you try Zerf on yourself? Oh, I love it. And I can show you guys. Look, I talk a lot about this PicoShore laser, but I don't get paid a single dollar from the company to make any of these reels. It's just completely transformed my skin.

37:28Dr. Tia Paul:And I do this in clinics so many times. Zerf is my new favorite. So I just, that device just came to the United States last year around August, and we've had it in our clinic since October. We were actually running some of the clinical trials with them, And we still do. Now we're going to come up with a body protocol. Is it a laser also? So it is also radio frequency. But what makes it really good is, first of all, it's very safe. I did one treatment on a patient this morning before coming here as well. It's very safe on all different skin tone. The only folks that you have to be a little careful about is people with melasma because this is heat based, right?

37:57Dr. Tia Paul:So anything that heats up your skin can flare up your melasma. Doesn't mean you cannot do it. You just, again, go to the right people who have experience with melasma. Second, it has no downtime and it's not painful. because the problem with some of the current tightening devices, such as All Therapy, Thermage, is they're so painful. So you're paying a lot of money. You're seeing very subtle improvement because any tightening device is subtle. It's not going to be the same as a facelift. Right. So you're paying a lot of money. You're seeing subtle results. And if it's painful, you're not going to go back and do it again.

38:25Dr. Tia Paul:Yeah, forget it. Definitely. That is why their, you know, Zurf is so promising. Now, again, you have to give it more time to see how good the long-term results are going to be too. I mean, it's looking very promising. I did two sessions, so one in November and then one in Jan. And it takes a good four to six months to start seeing a big difference. The biggest difference I saw was in my jawline. Yeah. The nasolabial folds right here. And yeah, I was somebody who would never put my hair up in a ponytail most of the time. But now almost always I have a bun or ponytail because I'm like, look at my snatch jawline.

38:57Yeah, you're the second derm that's told us they've used it on themselves because Dr. David Kim also did. He did one side and then he didn't do the other side. I'm like, OK, you're committed to the bit. And so you're my second opinion. I'm in. I'm in.

39:09Dr. Tia Paul:I do that a lot in clinics. So all my patients, when I'm doing their ZERF treatment, I do half the face. Then we go and take a set of photos and we compare. And I actually have it on my phone more than 50 before and afters where you can see the difference instantaneously. Although that instantaneous lift doesn't stay. Superficial, yeah. It goes away after a few days, but it'll come back after a few months. But that's how patients love it. And they keep wanting more because they trust the process. Yeah, that's what I was going to say is like, aside from having less downtime and pain, what's the big deal?

39:39Why is everyone freaking out about Zurf?

39:41Dr. Tia Paul:It's because none of the tightening device on the market are like super dramatic. It's not a resurfacing laser where all your brown spots can be gone. All tightening is very much subtle because you have to understand what we are trying to do is stimulate collagen kind of deeper down. The power, your ability to stimulate collagen at the age of 50 is very different from somebody who is in the age of 20. So the responses are very different. So when I sit down with any patient talking to them about ZERP, I keep telling them, this is not one of those technology where you get guaranteed results. In fact, if anybody says that, run.

40:15Dr. Tia Paul:But this is one of those things that's worth a try. Some people get more dramatic results than others because it depends on how your body responds. And again, who is doing the technology, that matters too. But also a lot of people want to do this tightening stuff as a preventative thing. because hands down, prevention is way easier than correction. Yeah. So if somebody comes to me in their 70s and they're like, I want to do ZERF, I'm going to sit down and be like, look, realistically, this is not going to make your nasal labial go away or your jawline tighten up. Maybe a facelift is going to be more dramatic.

40:45Dr. Tia Paul:But then there are people that don't want surgery, right? So everything has its own place and you just have to pick the right candidate. But people are freaking out because they're seeing more visible results with ZERF. Especially because the instantaneous one. What I understand, correct me if I'm wrong, is that it's so difficult to get your jowl snatched back. And I think that that's what the beauty is. And then over time, it's going to be better because you are getting more collagen, right? And then you just have to, so in the beginning, it's supposed to be two sessions, six to eight weeks apart.

41:12Dr. Tia Paul:And then after that, once every six months. I'll tell you, at least in my clinic, because we've been doing this since November of last year, most of my patients want to do the every six month thing because they can see some difference. I'm seeing very good results on the abdomen. Skin tightening on the abdomen. Again, you have to pick the right candidate. So not somebody with too much excess fatty tissue. It's more so somebody who's very skinny, but has that excess skin. Right. And you can crank up the... The GLP people. Exactly. Calling all GLPers. Crank up the setting. And again, we have to still establish a body protocol, which I'm working with a company on.

41:45Dr. Tia Paul:But in clinic, I've been able to see pretty good before and after. But again, you have to pick the right candidate. Yeah. So I don't tell anyone and everyone to do it. I look at their skin. I analyze them. And I'm like, I think you're a good candidate. Huh? I gotta take you to another. You're like, I've had two kids. So from my chin to my clavicle is like a 45 degree angle. Well, that I think. Where are you based again? Newport Beach. It's like an hour. We're going. Dr. Kim already sold me on that thing. And we made a clip of that episode. And so many people commented like, I'm in, I'm in. I'm in because I was literally contemplating a lower facelift.

42:21So I mean, I did it on my mother-in-law.

42:24Dr. Tia Paul:I've done it on my friends. I'm about to do it on my husband. them so I wouldn't do it if I didn't believe in it and I did it on myself two times so far and I am saying again the company's not paying me to say any of this. Thank you for the disclosure by the way. Well because the way I look at it is I believe in who I am and instead of telling the way I work with somebody is based on if I truly believe in their products. Of course yeah. So I truly believe in the picosecond laser technology. I truly believe in Zerf so far. Yeah. Again Zerf is a little bit like, you know, early stage. Yeah. I need to ask you, because I'm sure inquiring minds are wanting to know what sort of the cost, the budget you should be allocating.

43:01And you don't need to say yours specifically, but a range. And it can vary. Yes.

43:06Dr. Tia Paul:But again, if it's too good to be true, ask why is it too good to be true? Because I'll tell you behind the scenes what's going on. So typically, I think it's going to range in the two to three thousand. Preserve? Yeah. Per treatment, I would say it's around, yeah, two thousand ish. And then if you do a set of two, some places will have some sort of a deal or whatnot. Now, I've heard some places that are doing way cheaper for like a thousand or not. But what they are doing differently is instead of doing the whole face, they're only focusing on a certain area. Because Zerv has pretty high consumable cost.

43:38Dr. Tia Paul:So per treatment, the doctor's office also have to pay for the consumable handpiece. For those, sorry? For the consumable. Consumable means like tips and stuff that you use. Okay. Which obviously you're going to be using different. for like sanitary reasons. Yes. Yeah. And that, because you have to, they expire. You have to keep using new tips. I see. So if some place is only charging a thousand, it almost like doesn't make sense. Right. So what they are doing is it kind of like the whole concept of Botox, right? If a place is charging you $8 per unit, it's probably diluted or it's probably a different brand.

44:11Dr. Tia Paul:So same thing with Zerg too. Maybe they're not doing the recommended amount is 600 shots for the whole face. Maybe they're doing half of that. Yeah, exactly. So ask them some of those questions. Like if it's too good to be true, why is this place charging half the price of the other places? Yeah, it's very, very likely not happening. I want to get back into something that is your specialty, which is doing lasers on people or skin of color. Because that I feel like is not talked about enough. There's not enough experts out there and it can lead to really serious bad outcomes sometimes. So let's talk about if all skin tones can use lasers safely and walk us through that.

44:48Dr. Tia Paul:Yeah. So first of all, it's an absolute myth. If people say lasers cannot be used on darker skin, I would say come spend one day with me and I'll show you how many lasers I do on darker skin. Second of all, you have to go to a place where they have the right technology. Like I wouldn't use IPL on on darker skin. For example, you have to have the right technology and be the right expertise. Pick somebody who does this on every single day basis. If I'm only seeing darker skin patients, like five darker skin patients in my entire week, that's very different from somebody like me who is seeing 15 darker skin patients per day.

45:22Dr. Tia Paul:So pick somebody who truly knows, because it's not that complications doesn't happen. I mean, I have had a bunch of complications too, but I know how to manage complications. Because if anybody says I've never had complications, boy, you have not done enough cases. But if you need to pick somebody who knows how to manage those complications and where the complication rates are hopefully much lower. Yeah. Is there a specific question that someone can ask at a at a office to know if you're in the best hands? Yeah. Asking for before and afters on, you know, darker skin. Like, can you show me or how much experience do you have?

45:55How often do you see patients with my skin tone? Right. Right. So and what are some of the complications potentially that maybe we should touch on that? Yes. The number one thing is risk of pigmentation or hyperpigmentation.

46:07Dr. Tia Paul:So a patient with darker skin is just way much higher risk of hyperpigmentation or even worst case scenario. If you go too aggressive, they can get burns and scars from it. It's also much more unpredictable. I see why a lot of germs probably don't want to focus on skin of color is because there's much more handholding involved. Like I could treat five different darker skin patients the same day with the exact same protocol, the same setting, the same laser. And two people can have different outcomes because so much of it depends on did they go out in the sun? Like their skin, our melanin, you know, just reacts differently.

46:39Dr. Tia Paul:Like if I get a mosquito bite, I know I'm going to get brown spot for the next several months from that. So our skin just reacts differently. But again, that doesn't mean you cannot do all these procedures. Just go slow. Yeah. One big takeaway from this today's podcast, Dr. Paul said, go slow. Yeah. Love it. Got it.

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48:54Let's talk about laser stacking.

48:56Dr. Tia Paul:What is that? I was actually having a conversation about that earlier today. So that's when you're combining different technology. And personally, I think that's where you get the best outcome. There is no one single laser that's going to get you the best. Like I actually make a lot of posts about this too, where I talk about how, So first of all, again, the skincare transformation journey is a journey over several months to years. And a lot of times I start off patients with one specific technology, say like the picosecond lasers to help with their brown spots, fine lines, pores. But then if they have much deeper lines underneath the eyes, I combine it with like an erbium resurfacing laser.

49:30Dr. Tia Paul:And I can even do it same day. And that's ablative? Well, it depends. You can have ablative mode or not. It is ablative, but you can make it fractionated or non-fractionated. But my point is you can even do it same day. So I do a lot of acne scar treatments where I will do the picosecond laser. And then for the specific areas where people have the more pronounced acne scar, I will do a little bit of erbium on top of that. But again, carefully because it's much higher risk, but it can be done. But I think that's how you get the best outcomes by combining different technologies. Even this morning, I have one patient where we were treating redness and I used two different lasers.

50:01Dr. Tia Paul:Each one of them were meant for redness, but I combined them to target their redness. just because you have to understand, like we were talking about earlier, there is no one magical laser out there that's going to treat everything. And why do you think so many derms keep investing in more and more laser? It's because the combination is where you get the best outcome. Yeah, because we haven't really touched on vascular lasers, which is the ones I think Carlene was talking about, the broadband light, BBL, right, that you did. And I know that when I've been in that type of setting, like a derm setting where they're like, you're a great candidate, do Moxie, then do Genesis, this and then do BBL.

50:35And I'm like, what are you even talking about? Because it's like shorthand of the actual device. And they're using brand names versus I try not to do that. I try not to do that because then it overwhelms you.

50:44Dr. Tia Paul:The whole point is don't overwhelm people or their skin. Exactly. So what would you say the difference is for a vascular laser, what you're treating versus... Yeah. So there is quite a few different types of vascular lasers out there. I don't want to just throw random acronyms and names, but the point is they are targeting blood vessels, right? So if you're trying to treat like those broken capillaries, there might be a laser that does that, treat the broken capillaries really well, but the overall diffused redness, you might have a different laser for that. And it comes down to the wavelength, the particular wavelength.

51:18Dr. Tia Paul:Now, BBL is interesting because BBL and IPL, they're essentially broadband light or intense pulse light where you're mimicking the actions of a laser. You're using different filters and you're making it. So they're not as targeted. So that's actually one of the reasons why I'm not the biggest fan of those technologies. BBL can help with both red as well as brown and also to some extent, you know, help with skin texture. But it's not going to be the same as like a laser, like a PDL that is targeted for red as opposed or like a picosecond laser that's targeted for brown. So it's a more generalized technology.

51:51Dr. Tia Paul:That's why you find those more in med spas versus like, you know, advanced derm offices, especially they're truly cosmetic like Durham Heavy, they're going to have more targeted devices. Okay. At my dermatologist's office, I was getting BBL, broadband light, and then I was also getting XLV. XLV is more targeted. What is that? Yeah. What is the generic name for XLV? It's a 532 laser. So it just comes down to, yes, what wavelength? Because remember our earlier conversation we had, the way lasers work is it targets specific molecules in our body. Either it's melanin, which is pigmentation, blood vessels, which is redness and water.

52:30And so XLV can be used for, you know, redness, but much more targeted than like a BPL. Exactly. So I think that's why they had me on both. So one was for overall redness and one was for my capillaries along my nose. And so now I always know because people will ask me, what can I do about broken capillaries? And I'm like, XLV, that's the only thing that I know, but that will target it. And it works, man. It does.

52:54Dr. Tia Paul:But now every damn year, the technologies keep changing. So now there's this thing called DermaV, which is super cool because it has inbuilt cooling with it. Because some of the problems with some of the redness laser is that if it overheats your skin, you can get blisters from it. So now DermaV comes with its own inbuilt cooling. So the risk of getting any blister or any complication is much lower. So on my darker skin population, I feel so much more comfortable with the DermaV. and these poor dermatologists are like, how do we get this big... I know. It's like moving a... Landfill. I know. And then every year I'm like, these lasers are expensive.

53:29Dr. Tia Paul:They're like a couple hundred thousand bucks. Every year I'm like, should I buy another one? Where do they end up? Oh my gosh. The question that we're asked constantly is about the Lima or Lima laser. It's one of these at-home devices. Are you familiar with it? And it's very, very, very pricey. I think it's about$5 ,000 for at home. Where do you land on it? So again, it's one of those things. I think it's gotten too much celebrity hype. It's not a bad product. It's just not going to compare with an in-office laser treatment. It's one of those things, kind of like red light therapy, where you can use it as an adjunct therapy at home, but it's not going to give you the same results as doing Moxie or BBL in office.

54:11What would be the number one at home skin device that you think is actually could make some kind of a different or just measures up the best amongst all of them out there? And which one would you say, like, please stop using this?

54:25Dr. Tia Paul:Again, it comes down to the efficacy, how good something is versus safety. My biggest thing is just don't do something where you have a higher chance of causing harm than any good. Rely more on skincare. That stuff we know can work well if you're consistent with it. And again, remember, every company wants to sell their product, at-home product, because they're trying to say, oh, don't go to an in-clinic. You don't need to go to a clinic. I don't know personally what I do. I can tell you that. I do use one of the red light masks. You do. But I don't think it's a red light mask that's making my skin glow.

54:56Dr. Tia Paul:It's still the PicoSure laser. But the red light mask in between is helping me for sure. Which one do you like? I like the one from Current Body. Oh, yeah, yeah. But even like maybe if I didn't use the mask versus I use the mask, I would probably see a difference. I don't know. I don't know. But part of it, I also like using it because it makes me feel good. Also, it's a time. It's a alone me time. My kids know they can stay away from mommy during that time. So is it life changing? No, but it is a good addition to my skincare routine. Yeah. PicoSure. How do you spell that? First of all, P-I-C-O is just like Pico Second Laser Technology.

55:33Dr. Tia Paul:And PicoSure is P-I-C-O-S-U-R-E. That is one particular type of picosecond laser from the brand Cynosure. Oh, okay, okay. So if you're going in and you're just asking for that service, what do you ask for? First, you can ask, do you have any picosecond lasers? And then if they are like, yep, which particular one do you have? Is it the PicoSure? And not to confuse people, but now they even have Pro, which is the newest generation. but the PicoSure Pro is like the most advanced picosecond lasers they have right now. Okay. And I forgot to ask you, how much is that one approximately? That too can vary.

56:10Dr. Tia Paul:I can't tell you how much I charge in my clinic. So we charge$9.50 per session for the entire phase, or I think it's$2 ,700 for a set of three. And then, you know, people add on their neck, chest. Oh my God, I have patients that add on their arms, but you name it. I probably treated every area you can think of. But, you know, I mostly started off with my face, had very good results from it. Yeah. And then but I'm also the believer in be careful, go slow. Yes. Rather than trying to see overnight transformations. Yeah. What's your favorite sunscreen right now for you personally? I'm a big fan of the Supergoop Glow Screen Sunscreen because that's what gives the glow on my skin.

56:46Yeah. OK. Looks great. Yeah. No conflict of interest. Yeah. Yeah. I love the disclosures. You're the best. You're the best. Our last question, if somebody were to visit you, so you have your, you're in Newport. Now, I understand that you're also chief medical officer at a place called Blue Sunil. Yeah. What's that? It seems like it's maybe more of a concept.

57:07Dr. Tia Paul:No, so I'm very excited about that project too. So Blue Sunil is basically a combination of wellness and aesthetics, but more so from like a regenerative medicine and longevity standpoint. So again, it's how can you age gracefully from inside out, not just fixing brown spots with a laser, but also taking care of underlying, you know, maybe cellular inflammation. So it incorporates certain wellness treatments, whether it's red light therapy, like red light bed, or whether it's like infusion of NAD, along with aesthetics, meaning lasers and microneedling for overall, you know, well-being of your health and your skin.

57:47So it almost is giving me like spa. Is it like destination spa kind of thing?

57:53Dr. Tia Paul:So it's not exactly a med spa. That's the whole point. It's about using medicine. So it's medically backed. It's me and then another fellow physician. It's using medically proven procedures where, again, you're combining wellness with aesthetics. So it's not just a med spa. But it's also like, you know, other technologies where you're kind of slowing down the aging process more so intrinsically. Thank you, Dr. Paul. where can everybody find you on Instagram and TikTok? So it's Dr. Tia Paul, D-R-Tia Paul on both Instagram and TikTok, as well as my practice is balanced skin dermatology and aesthetics in Newport Beach.

58:25Dr. Tia Paul:And yeah, I'm excited to be here and this was great. Thank you so much. Thank you. This was great. Thanks for listening. You can find details on every product mentioned in today's episode, along with our exclusive promo codes on our blog at breakingbeautypodcast.com. While you're there, be sure to sign up for our newsletter. Every episode will be delivered directly to your inbox so you won't miss a single thing. And get social with us. Let us know what you think of the episode. You can follow us on Instagram at Breaking Beauty Podcast. And did you know we also have a private Facebook group? Just search Breaking Beauty Podcast chat room.

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