Healing Sensitive Skin by Caring for the Whole Person with Dr. Alexes Hazen, Founder of Zen Essentials

0:00Hey guys, welcome back to Skin Anarchy. Today's episode is very special because we're going to be talking to a true expert in the space of skin health. She is truly accomplished in the obviously the medical field in her practice, but then also has a beautiful line called Zen Essentials, which I really, really love the whole range and I can't wait to dive in. So without further ado, please welcome Dr. Alexis Hazen. Welcome, Dr. Hazen. I'm so excited to host you. Hi, it's so good to be here. And we've been looking forward to talking with each other for a long time. So I'm super excited to be here.

0:31yeah and I'm it's been a long time in the making and I'm glad we're doing this because I have so many questions for you and I love the line and I can't wait to dive into all of it but I really kind of want to start with your your medical journey like where did you know you wanted to be a doctor like at an early age or how did you land into medicine yeah it's such it's kind of an interesting journey because what now when I look back and I put all the pieces together I think I did kind of know but I on some part of me didn't know so I ended up going to college being a history major when I graduated I really didn't know what I wanted to do but I had this vague idea that I wanted to do something in health care but I wasn't really thinking I wanted to be a doctor so I it was 87 and I worked for the New York City Department of Health doing AIDS education.

1:22AIDS was a really big problem then and we were doing prevention education for IV drug users among other things and through that experience I sort of fell in love with the idea of medicine but meanwhile I hadn't done pre-med so I applied to a post-baccalaureate pre-med program and I also applied to the United States Peace Corps and I got assigned to Honduras in the health sector. So I decided it probably wasn't something I was going to do after med school. So I went to the Peace Corps and worked in the health sector and then really got a lot of hands-on experience, worked with local health center, doing everything from like giving vaccinations to doing talks.

2:07I was in Honduras, so it was in Spanish on health and disease prevention. I did a latrine project, water projects, everything with about the most basic health care. And I came back, went to Bryn Mawr for a year to get my pre-med requirements and then went to med school. In med school, I sort of thought I would do something in international health and because that was what my experience was. And then I fell in love with surgery and specifically plastic surgery and ended up doing a residency in plastic surgery and then a fellowship in microsurgery. But what brings it full circle is when I was a kid, very young too, I was burned very badly.

2:53I had an accident and I burned my face, my neck, my shoulder, and I had plastic surgery. I was in the burn unit at New York, what was then, I guess, Cornell. Now it's Weill Cornell. And there wasn't even a burn unit. But so I had experience with plastic surgery from a very young age. And it was always something that I was sort of interested in. And then it kind of circles back to the development of the skincare product line, because I was always interested in scars. And so that's kind of my short version of a long journey. Yeah, no, I mean, it's really inspiring, because I mean, you've been pioneered in merging this idea of wellness as well as plastic surgery and I think that's very rare in the field because it's either one or the other and it's never like this world where we're being truly holistic and we're being multidisciplinary and so I would love to get your take on that in terms of like what truly inspired you to bring that holistic lens into such a technical discipline it's such a great question well I think it is really technical I mean your point is is really well taken because a lot of what we do is very detail oriented and technical.

4:08I did a fellowship in microsurgery, which is literally working under an operating microscope where you're sewing very tiny things back together, like blood vessels or nerves or, or the like. And so there, there really couldn't be anything much more technical than that in, in surgery. But what I noticed, so that always fascinated me and I love that aspect of it. And I also love the creativity of it. But what I noticed is that patients didn't do well if they weren't all, if they weren't taken care of in terms of their whole being. So if someone was really anxious, their pain would be out of control.

4:49If someone didn't have a good like home healthcare team, and I, and I'm not talking about trained nurses, I'm just talking about support, then they wouldn't do well. And so I noticed that just like if you didn't have basic ingredients in terms of stable environment, basic healthy habits, and a way to sort of calm your mind and find peace that you didn't do well with surgery. And especially with the recovery piece, like you might be okay pre-op, but post-op dealing with pain, if you have anxiety, if you don't sleep well, if you don't have a good diet, if you don't hydrate, like all those things are a real problem for people post-op.

5:39So I just started incorporating it into my practice. And really just the first thing was just like asking the questions, like, are you anxious about having surgery? What are you worried about? And then sometimes it was a simple fix like, yes, I've never been in an OR. I've never been in a hospital and I'm really nervous about doing that. So, you know, we literally would have people go do a tour of the hospital or go take a look at the OR or speak to the anesthesiologist ahead of time. So sometimes it could be something very, very minor. And then in other cases, it would be a whole thing of, okay, I don't have BMI cutoffs.

6:22A lot of surgeons just have like a strict, you know, I don't operate over people, a certain BMI. I don't have that, but I have, do you have comorbidities? So sometimes I, it would take a patient, you know, a year to get ready to be a great candidate for surgery because their hemoglobin A1C, which is a marker of kind of long-term elevated sugar in the blood might be high. And so you want to get that down to a normal level. But then sometimes it was a simple fix, like, okay, we need to get you a post-op pillow so you can be, your head can be elevated. But it really was about noting that people just do so much better if they are healthy going in and supported going in and kind of know what's ahead of them.

7:12Right. No, that's a really, really like such a strong point that you made. It makes me really think about how we are approaching just skin health as well, because there's this whole component of management of expectations almost that doesn't really get addressed. And I always wonder about that because I think obviously from your reference point and you're used to this with your patients you're used to like the like having to explain to patients like what to expect but like a lot of times brands I feel like don't take that into account so like you have people that are expecting results that are beyond a topical solution and then they get frustrated and then we have this like snowballing happening in this industry where it's like you know what I mean so No, no, it's a very good point.

8:01Well, the thing that I think fascinates me about skin and skincare the most is that, as you know, your skin is an organ and it's the biggest organ in the body. And it really reflects your health. If you don't think that, just start looking around at people who you consider to be healthy and look at their skin and then think about people who you know, who are not healthy, who have very bad diseases and look at their skin. And it's just, it's like a, it's a mirror of exactly what's going on in the body. So to your point, if you think that you're just going to buy some topical stuff and it's going to make you look healthy and vibrant, that is erroneous thinking.

8:47And, you know, and I think a lot of people do want a quick fix, but a lot of people really do want to turn their life around and want to be healthy. And your skin, there's just almost no way it's going to look great if you're not taking care of yourself in the most basic, important ways. What are those things? I mean, it's, it's such, it's really basic stuff. It's eating well, it's being hydrated with fluid and it's getting enough sleep and it's managing your stress and if you can do those things then that you're like so far ahead of the game and then the things that you put on your skin will really have the opportunity to make a huge difference and I do believe I mean I think skin care these days and skin products are incredible there's tons of amazing stuff out there that can really make you look much more vibrant and healthy, but you got to do the other stuff as well.

9:50Right. No, that's, I love that. And I love that you said that because one of the big questions I do have is when you look at the field of plastic surgery, I think for a long time, especially back in the day, it was all about reconstructive surgery. And that was like the real heart and the core of it. And I love that. But now when the way the field has evolved, and I mean, you can speak to this obviously much better than I ever could. But the way I'm seeing it with reconstructive surgery, it was more of like fixing a problem. And now it's almost like sometimes I see people who come out of a surgery and then you see their results and it's almost like problems were created that weren't there before.

10:26I just want to hear your thoughts on this whole ethical dilemma that I feel like we're facing in this field, especially with maybe surgeons that aren't as trained as they could be before taking on certain cases. Like, what are your thoughts on that? Well, I mean, I think it's potentially a huge problem. And I think that patients have to be really, really careful in selecting their surgeon. So one of the things that we talk about a lot is making sure your surgeon is board certified. And board certification is a very rigorous process, and it involves training for years, and then a series of exams, usually oral and written.

11:09And then a maintenance of certification that's required over years, which usually means more examinations and taking educational courses. So I think that's sort of one gateway into making sure that you're getting the right person. But then what's the right thing? And I think that one of the problems is due to greed and patient demand, sometimes the wrong thing ends up happening. So that can mean that someone who's not a good candidate for a particular surgery ends up having it because they want it really badly. And the surgeon isn't ethical enough to say you're really not a good candidate and you're not going to get a great result.

11:57I think because of all of these sort of TV shows that showed incredible results from a bunch of, you know, really now we're talking cosmetic plastic surgery. People have some very unrealistic expectations about what's possible. And that has been a real disservice to patients and to surgeons. So I think managing expectations, finding someone who's highly qualified, and then sort of even a broader topic. At some point, it's important to accept who you are, the body that you've been given, the face that you've been given, and come to some kind of love and acceptance of your basic sort of structure.

12:51Right. To me, it's sad when people really reject all that because all of our bodies are potentially incredibly functional and could be very healthy and provide us with all that we need. And so it's sad to me if somebody really kind of rejects many of the things that they were born with. Absolutely. And then when it's validated, their rejection is validated, right? By like a professional or something. Yeah. One of the things that kills me is every now and then I'll have a patient come to me and, and they've gone to their surgeons for opinions about let's, let's just say breast or whatever it is, think cosmetic.

13:35And they will sometimes say to me, what do you think I need? And I sort of say, I don't think you need anything. I mean, what do you think you need? It's not, it's not my opinion. It's what, what bothers you? What do you want to be different? And some surgeons literally will have the patients, they'll examine the patient and then they'll tell them what they quote unquote need. And I think that's just such a bad message. Yeah. Yeah. That's not right. Right. Like who am I to tell anybody what, what they, yeah, it's different if you have cancer and I'm reconstructing you, then I can tell you, okay, well, this is what needs to come out.

14:21And this is what's possible. And these are your options. But that's very different than someone coming in and just kind of saying, I'm a blank, I'm your canvas, what would you do to me? Yeah, exactly. Exactly. I love that you said that. That's, that's one of my biggest, I think, annoying things in my mind as this idea of like, there are people out there that are really telling patients, yeah, I think you'd be better off with a nose job. Or I think we can like go this size with your breasts or like, it's like, that is not your role and that's not your lane. And there's no level of medical training that ever teaches you that.

14:58I think it is wildly inappropriate for a surgeon to tell a patient what size breasts they should have. I think what you can say, I don't think we can go larger than this because of these reasons and going smaller than this might not make much of a difference. But to go in and say, okay, you're getting 450. I think it's, to me, it's insane. It's insane. It's insane. I mean, I think that's crazy. And I also don't understand how we don't have a system in place that checks people like that. That's one of the biggest, I think, snowballing things going on right now in aesthetic medicine is that there aren't these checks and balances is put into play is that you normally see I come from the world of trauma and you can't do anything in trauma like there's somebody's going to be down your throat if you even suggest like and and so when I look at aesthetic medicine I'm like what's going on what are we doing I mean I totally agree with you and I think the other thing that and I don't know where where this will end up but there It's really an ethical question, but should we as doctors just be able to charge whatever people will pay?

16:13Right. Yeah. Or should there be some sort of caps on things? And to me, I understand that this country is capitalist and I don't have any real problem with that. But I do think in medicine, even though we may be doing cosmetic surgery, I think there's some obligation to not just charge whatever you feel like. And the world's so crazy now and there are so many incredibly rich people that people are charging just nutty amounts for what are not, they're like simple surgeries. I mean, it's not like a face transplant, which, by the way, I've done. But it's not that. It's things like a facelift. It's a four-hour operation.

17:00It is not a life-altering thing, really. I think a facelift is a great operation. I think people do it very well. I'm impressed with a lot of the results. But should you be charging$250 ,000 for that? To me, that seems like not being a good doctor. I agree. same no i am right there same wavelength with you on this crazy the other day i actually saw this term and it like blew my mind i like had to sit there for a minute and it was literally luxury plastic surgery and i'm like what are you what are we putting like an lv logo on this what are we doing here guys i mean this is this is insanity like exactly what you mentioned like 250 300 000 for a facelift and you're now now they're kind of compartmentalizing it into like oh this is a luxury experience.

17:50And do your training programs know that you're advertising this? Waiting for the societies to have a problem with it. And I sort of feel like I'm almost like Debbie Downer. I'm always on my high horse about this. And it's not that I don't think that doctors should be well compensated. Of course I do. And it's not that I have anything against, personally against the people who are doing this. But I just think on some level, it's basically wrong yeah it is we did take an oath all of us and the purpose is to help people right that that is the purpose and if your purpose was to make money well you should have gone into another field go into business for for business i mean business is going to make you a hell of a lot more money than than medicine i'll tell you what right i mean no loans yeah exactly among other things and you're making money right from the the get-go as opposed to us who are full-time we're in training or right like losing money essentially no i love you know i love this conversation because this is why i think i have always really appreciated the world of skincare because i think it's a really nice i think it's a nice world because you don't get too crazy and there's not too much that you can really do if you're not doing crazy stuff like diy and all that.

19:09I feel like it gives, it kind of goes back to your point that you made earlier about how people perceive themselves and what they feel like they need. And I think it's just, I feel so much more comfortable knowing if someone's experimenting with things like peptides and growth factors and these things, then like, okay, I'm just going to go get a procedure done and change the whole architecture of my face. And it's like, that's where I feel like skincare really shines is this innovation aspect of it. What are your thoughts on where we're headed with skincare, the entire industry and the innovation?

19:40I think it's kind of a really exciting time in skincare because I think that there's a lot of awareness that we can make a difference in how we look and how we age by taking care of our skin. I think it's something that men and women are realizing. And you can really sort of protect your skin and you can help it along by doing things at a pretty much younger age than what we used to think. And then things like big skin problems that are really debilitating for some people, like acne, there just are better and better treatments for it. And I think there's sort of two prongs. One is the topical stuff that you can put on your skin.

20:22Other is the whole advent of lasers, microneedling, radiofrequency, and the sort of non-invasive types of treatments that can ameliorate a lot of problems. Everything from acne to scarring to rosacea to fine lines and wrinkles or even deep lines and wrinkles. So I think we're going to see more and more young people using topical stuff at an earlier age. And I think we're going to see lasers and sort of the, I mean, they're not really invasive, but the non-invasive skin technology blossoming and becoming more mainstream. Yeah. And again, things like scars will be treated very aggressively right after surgery, which I think is great.

21:21Yeah, I feel like that's a huge white space right now is the scar treatment and like really management of scarring from the very, very early stages of like post-op and stuff. There are a lot of surgeons that do kind of focus on that, but there are tons of surgeons who don't. I think in the world of like cardiothoracic surgery, orthopedic surgery, they're big pockets where they're not doing a lot yet, but more and more they are. And usually found in my practice, the thing that changes the way I do things is mostly patient demand. So, for example, patients know that you can do things less invasively and they know that there are treatments for scars and they know that their friend had the surgery and their scar looks great.

22:12You know, that's really where I think where innovation in a way comes. Patients just demanding and asking questions. No, I completely I completely agree with you. I think that's really the, it's like the foundation of making sure that you're getting what you are actually going to get. If you don't ask questions, I feel like this topic has come up before on the show where it's like, you guys, for all you listening out there, you have to kind of take that portion of your care into your own hands and not be scared to ask questions. Because if there's anyone who's really truly qualified doing work on you or giving you any kind of medical care, they're not going to be scared to answer your questions.

22:50You know, if you are dealing with an educated patient, it's so much easier, such a pleasure, because then you're speaking the same language in a way. Right. They understand the importance of post-op care and all the things that are sort of check boxes for doing well. Absolutely. Now, I want to talk about Zen Essentials. I love your line. I think it's so beautiful. and it's so it's just such a healthy approach to skin care overall and I really like that you've made it the way you have because I feel like the big white space that no one's really addressing in the skincare space right now I mean yeah there's a lot of biotech and crazy stuff out here but like just genuinely good skincare I feel like we're not seeing enough of that where it's like you grab a moisturizer and it does what it needs to do helps your barrier it does all the things so where did the concept really come from for you like when did you realize you wanted to create a line?

23:42I wanted to for a really long time. And I wanted to kind of, I mean, it sounds like we're similar in that we've both been fascinated with skincare and products for a long time. Yeah. So I was always trying out new stuff and just love to mess around with finding new products and masks and what works and what doesn't work. But I never had time to really dedicate to doing this because it takes a long time to actually develop products and packaging and all that. But I developed debilitating skin rashes. Oh, no. Like about five years ago. And I had just sensitive. I always had sensitive skin. But suddenly I had these rashes all over.

24:27And I went to every kind of doctor. I finally ended up with an allergist. And turned out I developed allergies to a lot of ingredients in your basic skin care stuff and your household cleaning stuff. like Tide, I couldn't use even toothpaste. And it probably was like a cumulative stress response. And I probably had a little sensitivity and then over time it just got worse and worse. So I literally had to start developing my own shampoo, everything, and everything had to be super clean and so I decided that I wanted to start a skincare line that actually works because the things there are lots of clean products out there that are one ingredient product so you could find something an oil that I could use or I could but but I couldn't find anything that had a retinol in it that I could use because suddenly there's perfume in it or there's linaloon in it or there's a preservative that I'm allergic to.

25:32So basically I couldn't find a sensitive skincare line that was non-toxic that actually works. So, and maybe there are a couple, but they smelled so bad and they were so unluxurious. And when I say luxurious, I don't mean exclusive. I mean that it feels great and smells great and looks good. And obviously it's not free, but it's also not at the luxury price point. So basically it was really personal need. And then I'm, I've just always been fascinated with like what ingredients actually work. And I wanted something that everybody could use young people old people different skin colors different skin types and one of the things that i found in all my research is that basic it's kind of like diet and recovery from surgery like everybody needs the same thing if you're a woman or a man you don't need different things different amounts of them but you we all kind of our skin requires the same stuff and to the extent that we think that that's not the case it's just marketing strategy because it's hard to market to men and women all skin colors and so what companies do is they they pick a market that they're going to target and so then they say okay this is for post-menopausal women because you need exactly this yeah we kind of all need the same stuff you know yeah no i mean that's such a solid point though that's something we don't really discuss i feel like now seeing how cluttered the space has become, right?

27:16I mean, everybody's got a skincare line these days. And it's like, I'm here for it. I think, okay, if you think you have an innovative idea, like definitely come out with what you think is missing. But at the same time, I think you and I were speaking about this before the recording where people chime in every day. I know with us, you know, in our email inbox, and we're getting these questions of like, well, I've got five products that do the same thing. Right. Which one do I layer first? And I'm like, pick one. I pick one. But yeah, it doesn't matter. And also it's more so like, where do you draw that line of, this is what you need.

27:50This is what your skin will actually utilize because it's skin mimetic versus this is just made in outer space and we don't know what this even does. So that's where I feel like I get very frustrated, obviously as a consumer, but then for a consumer. It's sort of like if you tackle any topic in the health and wellness arena and you kind of do a little bit of a deep dive on it sometimes it becomes so overwhelming that you end up throwing up your hands and saying you know what i i don't know what supplements to take because they're telling me a million different things so i'm not going to do anything yeah to some degree skin care there are so many products out there and there's so many people saying talking out of the two sides of their heads that it is overwhelming.

28:41And so for a lot of people, especially people who are new to it, if you're like 40 year old woman who had a mother who had a skincare routine, you've probably figured something out that works. But if you're like a guy and you're, you're embarking on this or young girls, they don't know what to do. And there's so much being thrown at them via TikTok or Instagram suddenly you're like putting oatmeal masks on your face and raw eggs and I don't know you don't know no it's a scary I don't know if you've seen it and I hope you haven't because I feel like you're gonna have nightmares I did I went on to the dark side of TikTok once and it was the DIY skincare TikTok oh it's bad oh my god i swear to you i had nightmares for a week i was like this is some crazy stuff going on here and like now what is it there was like a health advisory issued about at home botox or something crazy like that yeah what is going on and that's where that but that's the thing that's the downside i think of having all these brands come out here it's true and and on the one hand it's great that there's so much opportunity.

29:57And on the other hand, it's just completely overwhelming. And then the DIY stuff can be, you know, there are obviously some really incredibly practical tricks to reducing cost and figuring out how to do things on your own. And then there's some really dangerous stuff. It's hard to sort of siphon out what's good and what's not good. But I think one one take-home message that I got from developing this line and from my own personal experience having these terrible rashes is that your skin it's it's not like a raincoat yeah your skin is an organ and it absorbs things and it absorbs toxins so if you put if you look at the back side of your moisturizer and there are 10 ,000 ingredients in there, half of which are chemicals, your skin's going to absorb those chemicals.

30:55And they, a lot of those things are toxic. Is it going to kill you? No, but it might make you sick. It might make your skin very itchy, rashy, unhappy. And so I think we really have to think of our skin as something that, that takes stuff in and can, and that can make you either healthy or unhealthy. And so it's really important to think about, you know, what you're putting on your skin. And I think a good rule of thumb is if something doesn't feel good, if something smells toxic, it probably is. Yeah. You know, it's just like when you go into a place where they've just done industrial cleaning, yeah or or where they've sprayed for bugs or something like that and you smell and you're like this doesn't smell healthy because it's not it's not healthy you know right so you should anything that's like that you should definitely not put on your skin i mean i've had like literally i've had founders tell me forever like well we had to fix the smell of this because it smelled terrible when we first formulated it and i'm like that's not good this big take-home lesson i learned is so parfum yeah f-u-m so that is a compound of a bunch of different chemicals it's not actually perfume but what it does is it covers up the toxic smell of products and if you look on the back of probably 75 % of the skincare products, it contains parfum.

32:36And it's, like I said, it's not a scent, it's a chemical that reduces the chemical smell of these products. And so you're absolutely right. If you're creating a product that has a terrible chemical scent, it's because it's full of terrible chemicals. So you don't want to be using that stuff. I have either the fortunate or unfortunate, I'm allergic to parfum. So I can't use any product that has that ingredient, but actually that's probably a blessing because I don't think anyone should be using these things. I agree with you. I completely agree with you. My products have a pleasant smell or no smell, but it's from essential oils or the actual ingredients.

33:19So in the cleanser, it smells like coconuts. Like you, people always say, Oh, I always feel like I'm on vacation when I use the cleanser. And it's because it's from natural coconut oil, which is a great way to prevent drying out when you use a cleanser. Because one of the problems with a lot of cleansers is they really, they take, they strip too much. And so then they dry you out. And then any aroma comes from the actual ingredients rather than covering up the ingredients. Right. No, I actually, I wanted to say to you when I knew you created a beautiful line was when I used it with a retinoid.

33:55When I put and i i don't know if anybody else has this problem but for me when i use my tretinoin well it doesn't layer well i get like that weird where you take your hand and it's like the moisturizer is like rolling off yes the pilling the pill yes it's so and also not only that it stings for me like bad stings and i was like when i first tried the moisturizer i remember it was my on a tretinoin night and i was like i'm really gonna put this to the test and i put it to the test i felt nothing no pain nothing it was beautiful didn't pill amazing and i was like oh my god i love this i was like so happy really good point it's a really good test of products because yeah because we and we were talking about this earlier that it's so confusing for consumers and patients like what what do i put on first if i'm wearing sunscreen when do i put that on right and if products don't layer well it's like a total nightmare because then your last product like pills and and you can't smooth it out and so the whole it's almost like all for not yeah and it's like occluding there's so many products now that they're all they're so all in one that they occlude everything else so if you put on i know a lot of people chime in and they ask us about the sandwich method for example with their tretinoin and it's like okay if your dermatologist told you to do it by all means do it but like if you're putting on your favorite random super occlusive cream before that tretinoin you're not getting any benefits of that vitamin a we don't even the skincare industry doesn't address this and i feel like there are ways to do it without directly doing it too you create brands and products that are just genuinely good for the skin they're gentle they they really marry with the skin's physiology you avoid all of that And I think a big thing now that we're going to see more and more is, so in our cleansing drops, there are probiotics.