Hormones, Oxytocin, and Aging with Dr. Sabrina Fabi of XOMD Skincare

21:57Dr. Ekta Yadav:Why would you apply topical estrogen and think that's going to add even more benefit? That may not be what you need. You may need something else, you know? So I think, I think that maybe just people see things as trends, jump on the trend without consideration that it may not necessarily be what's necessary for you. And listen, I'm an early adopter. Most things, I mean, Steve will tell you like, I'm like, I'll go try this peptide. You know, I mean, of course I do my research with which one might be, there are so many and you should be seen. I mean, as much as I know, and as curious as I am, I don't try to pretend that I know about all of them, you know, and if you're injecting them, you're messing up with the homeostasis of your body.

22:45Dr. Ekta Yadav:You have to be helpful about what you're doing.

22:47Dr. Sabrina Fabi:Don't even get me started on the stuff. Yeah, I completely agree. And also it's like, you know, one of my biggest pet peeves has quickly become this idea that we need to like put everything we can systemically into our bodies like it's like I feel like people like I'm a huge believer in longevity I'll tell you like I really believe I believed it my entire life like since I started starting medicine I believed in the concept of longevity I think any scientist has you know we understand like there's a real value in understanding human biology on that level but then when you get into the realm of like biohacking and all the all that stuff like it has really kind of just cluttered the space and made people think that everything needs to be injected when it doesn't like the literally like the skin is the largest surface area that we have to utilize and to work with and we're not doing it properly and it's not and it just kind of blows my mind how we're so quick to be like well what can i put in my body you know what i mean like yes leave your liver alone it'll thank you i promise Leave your GI system alone.

23:56Dr. Sabrina Fabi:Like just, you know, and that's why I really, I think this is a good segue. And I really want to dive into XOMD because the whole idea, like when I first, when Dr. Diane was first telling me about this, I mean, I was blown away, right? That you guys have really brought this entire concept forward because again, feeding into what you just explained to us about receptors, there is a such, there is such a thing as receptor fatigue. There is such a thing as receptor oversaturation. there are multiple receptors in the body. Why aren't we utilizing multiple pathways, you know, and trying to fix things.

24:28Dr. Sabrina Fabi:So I would love for you to kind of give us like an intro to XOMD and tell us like the science, because I think it's phenomenal what you're doing.

24:35Dr. Ekta Yadav:Thank you. So I would say that XOMD was born from the idea that, you know, there's definitely a connection. And honestly, if you even think of the history we talked about in the beginning, the history of aesthetic medicine, born on the idea of a neuropeptide, right? The most popular neuropeptide that we know we manipulate every day, which is acetylcholine with the use of Botox. We block its ability to bind to the receptor and you no longer have as much muscle movement and voila, you have a facement of a line or a wrinkle, right? And so that's kind of how, you know, Botox Cosmetic works. So that's not the only neuropeptide.

25:13Dr. Ekta Yadav:So this is not like a foreigner concept, right? With the use of neuropeptides, things that reside in our skin, but also, you know, have an effect in the brain. Why? Because our brain and our skin both derive from the same tissue called ectoderm when we were in, you know, in utero. And so there is the thought, and I think Steve may have covered it already, you know, which is if you potentially rev up something locally at the level of the skin? Can you have a benefit? Not because somebody necessarily looks good now because your skin looks good, right? That now they feel more confident, more attractive and their mood's better.

25:53Dr. Ekta Yadav:But is there possibly like an upregulation that happens at the level of the skin that then creates an upregulation, you know, feedback loop at the level of the brain, right? So Steven, you know, like if you really understand medicine, you understand physiology and you understand neurohormones and neuropeptides, there's a lot more at play. And I think, you know, what's inspired me is my patients recognize the patients that look the best always now in 16 years of following them are the ones that are optimized hormonally. I like not just in the way they look, but the way they show up, they're more confident.

26:27Dr. Ekta Yadav:They stand, they sit up straighter. They are, they take control and demand of their life more, you know, their bosses, whether they're 60 or when they, when they were 45 and sitting in my, you know, in my chair. So, and the other women look beautiful, but there's definitely, you know, a difference. If we're talking about longevity, there's definitely no doubt that hormones probably play the most significant role because it's the environment that they're feeding and creating. So if we're looking at hormones, it's not just estrogen. We talked about that one always gets all the, all the glory and praise, but you know, we talked a little bit about progesterone, but there's one called oxytocin.

27:05Dr. Ekta Yadav:This one also declines in menopause. Your ability to recognize it and be sensitive to it declines. And this hormone is of interest to me because twofold. In 2021, there was a great publication that came out of journal Drug and Dermatology by a co-dermatology colleague of ours that showed, she was curious, you know, why do some women also look so much better in their sixties, even if they've had all this sun exposure, than somebody who's 40 and hasn't had as much photo damage. And she did serum levels of oxytocin. And those that were the people that had higher serum levels, in fact, in her trial, the woman that was 57 had much higher oxytocin levels than the woman that was 48, right?

27:52Dr. Ekta Yadav:So you can't say it's age-related. You can't, I mean, you can't say that it's age-related necessarily. And you can't say that it's photo-related. Like, okay, if I go out in the sun, it's going to decline. Right. That woman looked on average three years younger. So it's like we've we kind of brush it off. We kind of think of it as second nature. Oh, like you look so good. You must have had a good night. Or are you in love or what's you know, we say it societally. Everyone knows it. Well, is there science to support it? And so if you you know, you're knowing Steve and I more and more. We're constantly curious and we're constantly kind of challenging like the dogmatic thinking.

28:32Dr. Ekta Yadav:that everyone wants us to adopt. And which is why we love you. Cause you're like, wait, what, what people, what are people just believing and doing, you know, like question things. Cause there's so much learning in the question, right. And we can be better if we question things. So we, we, we saw that we're like, it was interesting. Right. And then around that time, we started kind of looking historically, you could only really leverage oxytocin through a nasal spray. No pills or IV forms or anything like this. And so we coincidentally, you know, we started kind of looking for a neuroscientist to like potentially see if there was a way that we could bind to the piezo receptor.

29:11Dr. Ekta Yadav:This is a receptor that's at the top layer of our skin that if you can bind to it, it intrinsically releases your own oxytocin at the level of the skin. Oxytocin is is created in your skin. This is why when you hug, touch, kiss, it's not like you have to like, just the touch releases it locally. Okay. And then it has a positive feedback loop to make you feel better. So we found a neurobiologist that had created a peptide that could bind to this piezo receptor, which actually received the Nobel prize for being found in 2022. two. And it's a mechanoreceptor on the skin, which is what, for those that are listening, it's when you touch it, like it's something that is a receptor that's activated by touch that releases oxytocin.

30:03Dr. Ekta Yadav:What if you could activate it by binding to it, right? So something sound really good, as you know, in medical school, they sound good in vitro, but then they don't translate into something in vivo, in real life with the human. Right. And so as we're onto this, I get pregnant and I spontaneously get pregnant at 42. I thought that I was infertile truthfully. And so it was like, wow, that's one. And then two, after getting aesthetic procedures for 18 years, well, who was I 18? No, like 13 years. I started when I was 29. I looked younger and better pregnant than I had looked right before getting pregnant with all these aesthetic procedures.

30:43Dr. Ekta Yadav:You had the pregnancy glow. The pregnancy glow.

30:46Dr. Sabrina Fabi:Yeah.

30:46Dr. Ekta Yadav:And it's not because I got so overwhelmingly big that my tissue stretched out, right? Because I didn't gain that much weight actually in the first, you know, two trimesters. It was like, I actually had people coming up to me within about three weeks before I even like had told anybody. And they're like, are you pregnant?

31:05Dr. Sabrina Fabi:Yeah.

31:05Dr. Ekta Yadav:Good. So you see people know what that looks like, but we just haven't been able to measure it or like quantify it. Right. So that like we were onto something. So we worked on a formulation because as you also know, right, like if you even have an active, if you have a peptide, it sounds really good. We've learned a lot actually from CNE. Acorbic acid is an excellent example. If you put it in the wrong vehicle, it's inactive. If you put it in like, you know, it has to be like in a dark glass, otherwise it gets oxidized, right? So even if you have an amazing active, if it's not in the right formulation, it's going to be inactivated or it may not even be active by the time you apply it on somebody's skin.

31:55Dr. Ekta Yadav:So there was a lot at play. So it took about two years for us to formulate this. And then we put it to the test because Steve and I really don't need, we just did it out of more like curiosity, intellectual exercise to prove our thought than to even think that we were ever going to commercialize this. Okay. And we did a randomized placebo control trial. So for those that are listening, this is kind of what we use in aesthetic medicine with, you know, the use of devices or drugs. Like this is the highest level of rigor in that half the group was randomized by a randomization calculator to receive the active in the vehicle that we formulated.

32:42Dr. Ekta Yadav:and the other group blinded to the investigator and to the person received the product, just the vehicle alone without the OX factor, which without that blend of peptides that bind to the receptor. And we followed them for four weeks. In as early as four weeks, what we found, because people want results fast. I mean, that's the reason I'm in aesthetic medicine, because otherwise, you know, I would have done medical germ because that's one of the hardest things people want, especially now. I mean, that was 20 years ago. Now it's like people want, they won't wait for an Uber for more than seven minutes, right?

33:18Dr. Ekta Yadav:Right.

33:18Dr. Sabrina Fabi:Yeah. Attention span has gone down. Yeah.

33:21Dr. Ekta Yadav:Yeah. So attention span in patients have gone down. So in as early as four weeks, we saw a significant difference in metrics like redness. Why? Because we know that oxytocin is mother nature's own anti-inflammatory peptide. It decreases inflammation almost to prime you for the inflammatory physiologic state that pregnancy is. Improved skin dryness significantly. And this is like in the winter of Chicago, which the study was conducted between November and February. And so here we found that they, and why is this happened? Because oxytocin draws in water into the dermis, into the second layer of the skin.

34:06Dr. Ekta Yadav:So that's the reason why women look so dewy when they're pregnant. This is the reason why I didn't need aesthetic procedures when I was pregnant, because your skin almost plumps up a little bit, even if you haven't gained the weight, right? So improvement in dryness, radiance, dewiness, redness, and then skin tone evenness, because we know that redness contributes to pigment. A hypervascular face is going to feed pigmentation, right? So if you can minimize the red, you can minimize the brown. And so we saw an improvement in skin tone evenness. And as a sanity check, we also looked at fine lines and wrinkles, which we didn't expect would improve yet because we don't expect fibroblasts to still have an improvement or respond in as early as four weeks.

34:54Dr. Ekta Yadav:We've learned that from the retinol trials. So there was no difference in fine lines and wrinkles as early as four weeks, but in all the other metrics, there was improvement. At eight weeks, there was even greater improvement in those that continued on the topical. So we know that if you're gonna use topical skincare, be consistent because people only reap a better benefit. And the people that were on it for eight weeks looked better than those that were just on it for four weeks. Because at four weeks, we crossed over the placebo group and we put them on the XOMD. Wow.

35:31Dr. Sabrina Fabi:that's yeah quite a long time there no that's amazing i'm just listening because i'm just thinking about all the different parameters that are like you're kind of targeting here i mean i think this is incredibly fascinating because when you look at conventional dermatology like solutions one of my biggest complaints has always been the amount of inflammation that we're inducing in people you know and like the amount and the damage that is actually doing and the real aging that's occurring because of that and so this really makes you think because you you touched on so many important parameters.

36:03Dr. Sabrina Fabi:The inflammatory response alone, downregulating inflammation is one of the hardest things you can ever do in the body. It's one of the hardest things to target. Everybody knows this. For the skin especially, I feel like this conversation recently only has emerged where we've defined what the inflammatory aging word even means. That's really fascinating for me, I think even from that perspective is this idea that if you are using other stuff, like if you are on TRET, for example, and I'd love for you to speak on this because there's so many women, you know, and men, I mean, everybody's on TRET these days, you know, we, everybody who goes to a dermatologist, you're getting some sort of prescription.

36:44Dr. Sabrina Fabi:And so being on TRET, knowing what TRET does to the skin, it is going to, it causes inflammation. How do you feel about someone pairing XOMD's moisturizer with TREP or like something like that? I mean, do you think that's where like synergy is really like happening? I mean, do you feel that there is like, you know, positive synergy there?

37:04Dr. Ekta Yadav:Oh, a hundred percent. I mean, and the reason why is I couldn't agree with you more. For anyone that wants to understand aging at the most simplistic level, aging is an inflammatory process.

37:16Dr. Sabrina Fabi:Yes.

37:17Dr. Ekta Yadav:Like the more inflammation, the more you're aging. That's the reason why, like, if you have too much, if you're high, have chronically high cortisol levels, you're definitely going to age more. It breaks up your collagen and elastin, no matter what procedure or how much filler you put in. If you're stressed, you're kind of working, you're working against yourself. Right. Right. So, so it's an inflammation. Aging is an inflammatory process. And so then to be able to potentially, you know, and the reason why oxytocin is used in the plastic surgery space is because it reduces the inflammatory mediator interleukin-6.

37:56Dr. Ekta Yadav:So you can control, like you need a little bit of inflammation. There's the concept of hormesis or, you know, a controlled or good stress. Yeah. A little bit of stress, which is like, then that becomes the hard question to answer. like when is too much stress bad, right? But if you're in a wound, in this case, they were looking at like lower, you know, ankle ulcers. They used oxytocin and it reduced inflammatory media interleukin-6, which had reduced inflammation. It reduced free radicals, which form from, again, stress, from external factors, from eating too much sugar, from a lot of a host of things.

38:36Dr. Ekta Yadav:And then this promoted wound healing. So that just shows you the power oxytocin has. Now, our product doesn't have oxytocin. It is a botanical-based peptide that binds to a receptor that releases your own intrinsic oxytocin to give you an oxytocin-like effect that we see, right? Right. So that's the concept on its anti-inflammatory properties, which is probably the reason why we saw a decrease in redness. Now, my TRET users, right? I'd say 50 % can really tolerate it every night. I don't know. Maybe they're more sun sensitive in San Diego. I treat 30 % of my patients have rosacea and really sensitive skin, so I can't even tolerate it.

39:25Dr. Ekta Yadav:So that's the type of person where I might use the XOMD serum first because the beta glucan in it, the vehicle that it's in draws in water to make you a little bit more moist. And then the OX will help with that decrease in inflammatory response. And then you can tolerate that pea-sized amount of TREAT. You don't need a thin layer to get the effect of your TREAT, right? Then you can put your moisturizer. I like Arouse because it's a glycerin-based moisturizer. It's a sugar-based moisturizer. It's not in a dimethicone base, which can sometimes prove occlusive. And if it's too occlusive, now you're trapping your tretinoin in your skin.

40:07Dr. Ekta Yadav:And even it's almost counterintuitive. You're like, but I'm moisturizing. Yeah, but you're like in an occlusive, an occlusive-based product is trapping. It's not moisturizing. So it might trap the drug that you're putting in there. So caution, you know, is probably what I'd say. But yes, it absolutely helps my more sensitive skin folks.

40:31Dr. Sabrina Fabi:That's exactly why I asked you, because I feel like this is why to me, I love what you're doing with XOMD, like at large in this industry, because of this exact question that I had for you about TRET. Because it's not that we can't use drugs or like harsher actives, right? Right. They're proven. There's data. OK, you know, we know the benefits. But it's also about like educating consumers on you need to also know how to pair things, because if you have too much inflammation and Dr. I think you already spoke on this. If you have that much inflammation in your skin, in any tissue, it doesn't matter what you're putting on.

41:14Dr. Sabrina Fabi:Like that inflammatory burden, you know what I mean? That inflammatory burden is going to just completely clog that microenvironment and not allow normal receptor binding. It's not going to allow for normal signaling to happen. Like that physiology won't take place. And so that's why I asked you that because so many people chime in and ask this question of, well, I'm using TREC even if they're using it every night. You know, even if they're using it three times a night, what else can I put with this? And so that, this is your solution. This is the kind of product you need, something that's going to calm down that inflammation and actually let your, the drug work, you know, like and do its job.

41:54Dr. Ekta Yadav:So I think that without irritating you in the process, a hundred, a hundred and 50%. I, you're, you're absolutely right. I mean, and that's the reason why we, you know, it's like a laser's excellent, right? Like let's say a CO2 laser, right? The most aggressive laser that you potentially do to yourself. But this is the very thing. If it, if it's uncontrolled, then that injury is now shifting into too much injury, which can call scarring, right? Like too much injury is not good. Right. So it's a delicate balance when you are playing with stress, when you're stressing your tissue in order to try to get the response of, cause you know, your tissue gets sleepy.

42:35Dr. Ekta Yadav:And so the thought here is to kind of wake it up with a controlled stress response, which is a play on hormesis. But the problem is if you create too much stress, then you can actually have a negative consequence like scarring.

42:53Dr. Sabrina Fabi:Yeah, no, that's very real. And that's, I'm glad you're saying that because I think that's really, I mean, truthfully, if you ask me just as someone who's been observing the space of skincare, I think that's what we've been doing. And we've been using 10 products for like literally how many of you out there exfoliate five times a week? You know, like I've heard this time and time again, people are using unnecessary.

43:18Dr. Ekta Yadav:Yeah. Unnecessary. Right. You see it in the 17 year old teenager that's scrubbing their acne and using salicylic acid on top of an alpha glycolic acid. Yeah. Like what ends up happening? They'll tell you that they're acne flared. They look more red. I mean, because your C your sebaceous glands go nuts. And they're like, wait, I need to produce more oil to protect this barrier that's been disrupted. So it's, you have, it's a controlled manipulation, right? And so that requires expertise. And if you're going to play with an aggressive laser, let's say just like, because that's a controlled, you know, thing that we know exists, then it's like, you then have to do things to counteract the inflammation so that you get the desired outcome without the potential side effect.

44:03Dr. Sabrina Fabi:Exactly. And, you know, another thing I really want to kind of point out here, just for our listeners, because I think this is like why I really love your approach with XOMD so much is because I'm a huge believer in like cell biology and molecular biology, like before any other like medical subdiscipline. Like for me, that was my first love in medicine, you know, like cell signaling. And when you think about the amount that you can accomplish with proper signaling and sending the right signal in the right dose in the right amount with consistency to any tissue in the body is profound. The results are profound.

44:39Dr. Sabrina Fabi:I mean, all of oncology medicine will show you that. You know what I mean? It's like people need to understand that. And I really feel like consumers will stop spending ridiculous amounts of money if we just wrap our heads around this biology concept. You know what I mean? Just like using a product that is telling you, like, you use this every day, okay? Every day you do this, every single day, you're training your skin, you're training your organ to respond. every day on cue that's going to go way further along for you than like okay well two days i'm doing this third day i'm going to go get a laser treatment fourth day i'm going to exfoliate the crap out of my skin like you can't do that you know and and unfortunately that's where we are because there's so much misinformation out there you know and there's so much like conflicting information so what i mean i'd love to hear your thoughts on that in terms of like these like multi I don't know, like multimodal routines people have.

45:32Dr. Ekta Yadav:I mean, you know, what are you, you know, this is the deal, right? And it's like, it's, I love hearing you because, you know, I, I'm like, I am, you know, I'm in the more aggressive camp, you know, but I've been humbled. Right. And then I have the, I've been humbled by the body and I've been humbled to see, you know what, that's a little too much. And I've also, I put it to the test. Like we do trials. If we do this on top of this, do I get a better outcome? Sometimes no. You know, if I do it alone, it actually, in some cases, when we've done studies with one modality versus combining modalities, we find that the singular modality were just as good as the combination.

46:16Dr. Ekta Yadav:And in other studies, like we did an IPL clear and brilliant, let's say half the face IPL alone on the other half. I clear and brilliant alone on the other half we ran. So I, I actually, I'm curious about this. Like I try my, so it's like test it, right? Like do a study, run it, run it through the IRB, you know? And we found in that study that the combination did work. So I think it's the right amount of intermittent stress, you know, that then creates the adaptive response that you want in the tissue. but if it's severe stress, the tissue may not like it. So it's like, it's like creating chocolate chip cookies, right?

46:58Dr. Ekta Yadav:It's like a little bit of salt. Sometimes it makes some taste good, but if you put too much, then it's like it ruined it. So, you know, but we don't know what the effect of these combinations are sometimes because they're studied and they're approved as singular treatments and modalities. Then people sometimes try to layer it or come up with their proprietary combination for marketing purposes. And there's no doubt that sometimes the combination can absolutely give someone a more desirable, complete, effective response. But sometimes it may not be necessary. Right. Because more doesn't always mean better.

47:43Dr. Ekta Yadav:And so I think it's like asking your doctor or provider, has this been looked at or investigated? If you combine it, is it necessary? What's the right sequence? And why are you doing it this way? Try to get an idea of whether they're thinking about what they're doing, not just doing it because the place down the street is running a special for some competitive other combination. but there's actually a scientific medically based reason as to why they're combining something i think that that just simple question can give insight on whether they're thinking well just

48:25Dr. Sabrina Fabi:also like i love that i i love that you're saying that because i want to really circle back real quick to that you know that conversation we first had about the you know perimenopausal menopausal years, you know, and the skin changes. I mean, really, I think this is so applicable, what you're saying, especially during that time period for women, because we are so quick to jump the gun. And we're so quick to be like, well, if it's, hey, if there's any data, I'll do it. You know, I've seen this, like, I've seen so many of our listeners chime in about that. But like, what are the latest treatments?

48:57Dr. Sabrina Fabi:What are the, you know, and it's like, guys, like, you've got to pause and you got to really think like, what is going on with my body and why does this matter? And how do I actually get to the bottom of this? And so, you know, I guess like, I just want to round out the interview and really get some words of wisdom from you for that demographic of our listeners, right? About like, how should you, like, what should they be pausing on and how should they really be like, I guess, re-strategizing when it comes to their skincare, you know, strategy or their skincare approach, like what are some things you would suggest like a good starting place?

49:34Dr. Ekta Yadav:Yeah. So, you know, going back to that survey, because I like to kind of lead always with some type of evidence, right? You know, like let, let, let us kind of anchor in that. And then we can, I can extrapolate based on my experience. When we went back to that survey of like 4 ,300 people, and this is the largest menopause survey that I'm aware of, you know, globally conducted when women were asked what they're doing to combat their symptoms, the number one were food supplements, right? It's like, based on what, right? Like, how do you know these aren't even approved or even usually have studies to support their claims.

50:04Dr. Ekta Yadav:And so that was an interesting thing. Some women, the third was dietary change. Okay. Interestingly, HRT, only 17 % of women even used to try to combat the cutaneous changes that they were seeing. And aesthetic treatments, only 15 % were doing to combat the skin dryness or the lines and wrinkles they complained about. So that was interesting. A lot of women don't even make the association that the changes that they're seeing are caused by hormones and that what they need to do to address those skin changes are not found in food supplements, right? So that was like an interesting learning for me.

50:43Dr. Ekta Yadav:And so when they were asked, took it a step further, what are the things that made their symptoms that they complained about, what did they find the most satisfaction with? The number one thing were specialized aesthetic treatments. So the treatments that we do, do definitely play a role in this demographic in making them look better and feel better. There is no doubt. Okay. Actually, in fact, it did it more in a short-term basis than even HRT in satisfaction. Okay. But what I will tell you then this is a snapshot of a group of women that don't, they just know they're having these symptoms. They know that this is what they've done and they're happy.

51:26Dr. Ekta Yadav:Okay. It's not following them out for the longterm. What I'll, what I'll finish with, I guess, is that then in my experience, seeing these women, the trajectory of their, of their hormonal, you know, journey is that there is definitely, aesthetic treatments play a role. What you apply every single day absolutely plays a role. In fact, if you apply the wrong thing, like an apricot scrub that was super popular when we were probably kids, it can make it worse, right? And that if you're being seen by someone that treats you as the holistic human that you are, that you will not only feel better, but look better too.

52:11Dr. Ekta Yadav:That there's a role for the hormonal environment that can support. You can't just lean on one thing to do all of it. But it needs to be managed and cared for by somebody who's not following the latest trend, but by someone who fundamentally understands the practice of medicine and you as a human being.

52:31Dr. Sabrina Fabi:I love that. Multidisciplinary.

52:34Dr. Ekta Yadav:Yes, it is. You know so much about what you do. I know so much about what I do. I don't try to pretend I am like a hormonal health specialist that should be prescribing that for you, but I sure will find the best person to do it.

52:48Dr. Sabrina Fabi:Right. Right. I love that. I'm so glad you said that. And I couldn't agree with you more. I think for anyone listening out there, like really take this advice to heart, you guys, because honestly, yeah, I mean, you got to figure out, first of all, where you're getting your health care, you know, like real care. Like that's what it is. Like medicine isn't just techniques, it's care. It's somebody who wants to help you. And yeah, I couldn't agree more, Dr. Fabi. I think you're absolutely spot on and absolutely brilliant insights. I am a huge supporter of XOMD and I am because I understand how amazing the scientific like logic that you guys have employed here is.

53:28Dr. Sabrina Fabi:I mean, this is really, really cool to see. And I'm really like hats off to you and Dr. Dayan for like coming up with this concept and like bringing it to life because I wish more people would invest in this like deep, deep science, like go deeper. You know what I mean? Like go further. I think we, I think we will.

53:46Dr. Ekta Yadav:I think people are, I have hope, you know, I think that people are seeking information. That's why, you know, people come to listen to you and you're doing such a great service to so many by, you know, seeking, you know, people that might be experts in whatever field or discipline they're in to try to bring the most credible scientific backed information to an audience. Right. And so this is what we learned from this survey. So many women wanted more information and were disappointed with the information they had, but they wanted it. So people are seeking it. And so I have hope that it's going to become something that's mainstream and understood.

54:29I love that.

54:30Dr. Sabrina Fabi:And I can't wait for the entire category of skincare to evolve in the years to come honestly i feel like this is so cool to watch like we're you know like i think i had a conversation a long time ago early on the podcast where we talked about how it's like skin care and skin science is one of the only medical like like special disciplines of science that you can see so much being adopted you know from like very very rigorous scientific disciplines like like regenerative medicine oncology you know like translational medicine coming to life like it's such a beautiful field and it's so ever evolving that like it's just it's wonderful watching you know and yeah so I'm very excited about the future I am too thank you so much for having me thank you so much this has been such an amazing conversation