What “Efficacy” Actually Means in Skincare with Jack Jia of Musely

29:10Even we don't take insurance, we took the high standard of security and then compliance and all that has to be learned. So that was kind of the first battle. The second battle was really making the drug inexpensively, right? So the compounding was, and there were some compounding shops, but mostly our mom and pop shops. There are a lot of them actually in the U.S. Like over at the time, it was over 10 ,000 compounding pharmacies. But they're just doing compounding drugs for neighborhoods. And so the model we use is called 503A, which is you write, the doctor write a prescription first. Based on the prescription, the pharmacist will compound the medication for you, right?

29:52It's not like going to CVS, there's manufactured drugs available. So it's very manual, very custom made, personalized. You would think that's very expensive. It is very expensive when we first started out. But it's still relatively inexpensive compared with the big pharma drugs. But then once we start to scale, we realize that entire industry was just too old. We have to use technology to reinvent it. Give me an example, right? The standard, this 10 ,000 compounding pharmacy, the standard dispensing software they use for compounding is written in Microsoft DOS. So in order to have our machine running there, we had to find even DOS to run.

30:39And then we put the software on it. That's crazy, right? So that means we have to reinvent that. So our engineering team had to learn how the dispensing model works and rewrote that software in modern stack of software. And so we initially written in Java, then we first further modernize it. And then the entire process, right, because every single drug has to be compounded, started with pharmacists telling the technician how to do it, and then all the drugs made has to be checked. Every single bottle has to be physically checked by a pharmacist, right, with their names on it, on the label, right?

31:20So it's very, very personal down to it. So that's a very manual process. So in order to increase efficiency and scale, we have to make software help in that process. So we introduce, for example, QR code scan so that the technicians and the doctors and the pack and ship people can work in a very similar way. We have to introduce many, many lines of production, right? Because these are not factory kind of thing, but we can still, when we fill the pills, right? We have some hair pills. We have the longevity pill called the Age Well pill, and they are individually made. And those pill machines are very miniaturized for technicians to work on this small line, right?

32:09So because they were literally prescription already written. So today we have, let's say, 100 bottles of the Age Well pill for 100 different patients, right? They can still automate this with technology, but at a very simple, customized, personalized fashion. So this whole notion of, then all of these are freshly made. So therefore, the medications are more potent when they're fresh. So we have this notion of from farm to table, from farm pharmacy, farm to individual homes. So even in that farm-to-table model, we can make it so much cheaper, so much more affordable than the big pharma, you know, massively produced with billions of pills produced at the same time, right?

32:58You know, we're still probably a thousand times, a hundred times, ten times, depends on what drugs, cheaper than those kind of… I think that's what blows me away is that everything's so affordable on Muesli. Like it's, it's really, really amazing. Pretty much everything we try to keep it a dollar a day, right? A dollar a day is, is sort of the, the mantra. And we used to compare with the, you know, it's a cup of coffee, but now you can't get a cup of coffee for a dollar. The coffee is now three, four bucks of coffee. I don't think they're selling coffee anywhere for a dollar anymore. No, I know.

33:34That was kind of what changed in the last seven years. Yeah. No, this is, I mean, it's really fascinating to me. I think for so many reasons, right? Because the price point thing really matters at the end of the day. And I think this is where, you know, when I look at Muesli, I don't just see, okay, you know, these are like skin health solutions. I also, from my perspective, I'm looking at it from like, if a physician is looking at this model, this makes the job of a physician, I think, a lot more simplified. You know, if you're a new dermatologist, for example, you want to give your patients the most access that they can get.

34:08And it's a hard conversation to have. I've had that conversation, you know, both on the patient side as well as the other side, where it's like, when you know a prescription costs$500, like I know the classic example of this was Ozempic, right? When Ozempic first came out, people were being quoted like$500,$600, you know, for one pen, like, you know, or more than that, I think. It was like, yeah, like$1 ,200 or something Like crazy. And then to have that conversation for any, I think, practitioner is very disheartening. Because you don't go into medicine trying to sell people ridiculously high prescriptions.

34:43Nobody wants that. There's not a single medical professional that's like happy about that scenario. I mean, Ozempic is a great example. It's the traditional big pharma across the line to a consumer wellness business almost. Right. That's by accident. Right. It was definitely a diabetes drug, right? It's almost out of patent. It's been there for a long time, right? It's been there for 20-some years. And for some country like China, Olympic patents already expired. All right, so it's been that long, right? And just was recently, the last few years, all of a sudden, oh my God, this for weight loss is great.

35:20And they're really adjusting. If you look at the stock price for Novo Nordisk in the last few years, Even with this massive adoption, acceptance, consumer wellness usage, their stock didn't go up that much because this is not their business model. Selling it cheap, right? It's not that cheap right now. Even the pills are still$200 a month, right? The shots, the needles are still$400,$500. And still they're having a hard time making a lot of money. Even they are making a lot of money. But relatively to their business model, it's not the best business cases. But this is one of those crossover happened, right?

36:03It's kind of like, you know, that's why this fundamental business model for wellness is not really, generally speaking, they don't exist. And that's why we have to learn how to vertically integrate, in our case, with dermatologists and OBGYN doctors since we got into the HRT, menopausal conditions, and even longevity, functional medicine, and that kind of a discipline medical. And then with the pharmacists who can compound chemists who can formulate. Then we have to also understand chemical industry. That's also a very old, very inefficient business. I mean, you're talking about like traditional wholesaler, reseller.

36:46Like I remember in the 90s, like, you know, to get car fixed, you have to buy some parts. You know, there was no direct to consumer business. And you have to go through these layers of complexity. Same thing happening still in the chemical industry. So we have to break through all of that layers to get the chemical dirt cheap, right, ourselves. right and then by vertically integrating these and you can create the best cocktail and you can improve the best cocktail and and and never done right that's kind of the uh and that that we now you know certainly start to especially for the menopausal conditions given our woman you know naturally gets into age our our you know the aging condition happens the middle age anyway so that That was already squarely in that demo where just most women didn't know HRT should be considered.

37:37It was a taboo topic until years ago. And so thank God that that change, you know, in realization of this faulty study from 25 years ago, this women's health initiative that was just wrong, right, misguided the entire society and the women and who are not seeking treatment for these conditions. That's massive, massive conditions, right? The menopausal condition have 20, 25, 28 symptoms that we've been tracking, right? Yeah, it's a huge, it's a whole area of study just figuring this out. I know, I know. And the top few actually turn out to be dermatological related, right? It's a skin, it's a hair, it's nail change.

38:23Of course, the mental health and hot flush and you name it, right? And now we know why. I mean, actually, our medical director for this field, HRT, is an OBGYN doctor from Stanford. She'd been wanting to help her patients for 20-some years also. Even when this WHI study came out, she knew it was wrong. But she couldn't say anything because that's NIH study. So therefore, we have to follow. And so now for the last few years, she's just on a mission, right? So thank God we got a platform. She now can formulate the best HRT treatments and most affordable treatments. And for women to really treat these conditions, you know, these conditions that shouldn't be there, really shouldn't, women shouldn't be suffering in their, you know, 40s and 50s.

39:19And that's really the, that's a shame. Well, that's also why I think a platform like Muesli and this level of accessibility is so profound on multiple levels. So even let's move past just the fact that we're getting access to prescriptions. Let's move past that, right? And talk about how we're getting access to information that's indirectly coming out through interventions like this that are now accessible. I mean, women didn't even know for the longest time that this could help me. You know, like that information wasn't even out there. Like now when I see the social media conversation around hormone replacement, anything, right, skin changes that you go through in menopause, perimenopause, it's a brand new conversation because it's like almost like discovering a new field of medicine.

40:05That's what it feels like. And when you look at it from that lens, it's like, oh my God, these things were right in front of our face and we never even considered them as options for women. And so, I mean, also, I want to say this about, you had brought this up, like the compounding part of it, like tretinoin, for example, right? Tretinoin, I use muesli's tretinoin. That's my choice. And I love it. Absolutely love it. Mine is compounded with niacinamide and hyaluronic acid. It's amazing. The problem that that solved for me as a consumer was it gave me the ability to stick to it, the consistency part.

40:39And I think that's a huge conversation as well, right? Because most people, when you talk about them like Tretinoin, their biggest complaint is it spreads very thick. I can't get it on my face. And then they don't stick to it. So they believe that pharma is failing them. You know, drugs are failing them because these aren't old or dated or in whatever. But that's not true. It's that we have to rethink that. And so I'm kind of superimposing the examples, but it's the same thing with women's health, where it's like, I feel like for the longest time, we felt like these are inaccessible treatments, but they're not inaccessible.

41:13They just need to be framed in a way that you feel comfortable approaching a doctor wanting to get them. So, you know, I want to get your opinion on that because I think that requires a cultural shift to happen, you know, in the consumer space. What are your thoughts on that? What do you think is blocking that cultural shift from really taking place in a very robust way where we are all doing our work? Yeah, that's a great, great question. And it's something we talk a lot about also internally because traditionally medication has been considered. Again, as I said, the traditional model has educated the consumer is for illness.

41:49I don't take meds unless I'm sick. Yeah. Right. That is right for certain kind of conditions. But it's not right with the modern science understanding. Right. So this is what, you know, what we do. Right. The science behind this is, I mean, I would say, to be fair to a lot of people, a lot of the science really behind this thing is matured in the recent 10, 20 years. So a lot of this stuff was not available, right? We didn't understand DNA. We didn't understand the cellular structure. We didn't understand a lot of the interactions. There were not a lot of studies. You know, MUSELE have done a lot of meta studies.

42:36We don't do original study. That takes too long. But we've done a lot of meta studies on, you know, really what has truly worked, what doesn't work. So the fundamental shift is that we need to treat medicine like the true supplement for our health, right? Not just to treat illness, right? If you draw this square, half of them is for life-threatening conditions. That's fine. You have cancer treatment. The other half is wellness. And this is the sign, right? The fundamental sign is we peak produce every chemical we need as a healthy person in our 20s, right? Late 20s is we, every chemicals we need to keep us healthy is produced 100 % at that age.

43:24Right. From that there on, we're on a very slow downhill decline, right? Of producing these chemicals. So, for example, the muesli medications out of these 130-some formulas, most of the medications are either 100 % bioidenticals or very close to bioidentical chemicals. And therefore, these are the things we, as we age, we start to lose a lot of them, right? Then we would talk about HRT was a great example, right? The estrogen loss for women starts at late 30s, early 40s, around 40 years old, plus minus, depends on individual. That estrogen loss will go through a 10-year cycle from 100 % down to 1 % left, 99 % loss in 10 years.

44:19Imagine the change of the human, you know, within, with that chemical gone, right, completely, right? That's why there's so many conditions, side effects, you know, produced. And it's not necessarily a healthy thing, right? You know, why we would lose estrogen, why women would lose estrogen? I mean, there's a biological reason, evolutionary reason why that happens, but it's not healthy, right? And the same thing with hair loss, right? For hair thinning, women don't lose hair completely, like men, because the hair follicles are largely killed by testosterone. And women have smaller amounts, so therefore about 10 % of the men's testosterone.

45:08So therefore, it's not potent enough to kill all the hair follicles. But why would testosterone kill hair follicles? What's the reason? Nobody knows why that happens, but it's just one of those things. It's a mystery of life. But to prevent that from happening, right, you need protections. You need DHT kind of chemicals to really help to protect the hair follicle being killed. So there are chemicals. We naturally produce them when we're really young. We start to lose them. Both men and women start to lose them. And so therefore, you know, we can add them, you know, whether it's topical hair solutions or eat pills, and they will protect from hair thinning or hair loss in a woman's case.

45:54And the same thing goes into longevity, right? Longevity, we start to lose. I mean, I'm in that age now, right? You know, that you massively lose almost all the chemicals that to keep you healthy. That's why the last 20 years of Americans or anybody, right, but at least American, you can quantify the age, right? So 80 years old is kind of the lifespan. But from 60 and onward, that last 20 years, 80 % of the Americans are not healthy anymore, right? They are no longer. Why they're not healthy? Because the lack of these basic chemicals to keep them healthy. These chemicals are not your supplements.

46:33You can't just take vitamins and to get them back, right? These are by law medications. These are bioidentical chemicals that we need to keep us healthy, right? And so we recently introduced the longevity pill. One of the first one is called the Core Foundation. It's really about energy production. It's called the Age Well Pill. I have had this back pain, right? Just like typical older people since I was 50 years old, right? For over 10 years, you know, if I sit on the chair for half an hour, an hour, if I stand up, I just can't stand straight, right? I'm bent a little bit, right? And you see a lot of old people, they walk kind of bent it.

47:18I start to feel I'm going to become that if I don't do something. But I couldn't. I run. I exercise. I do all the healthy things. I still cannot reproduce some of the chemicals that I have. And so I'm going to kill this pill, right? The pill basically have chemicals to help you to increase your mitochondria cellular energy production. So it's at the core, at the furnace level, right? You end up having more energy, and therefore everything else becomes better. It has anti-inflammatory chemicals. It has, you know, helping your metabolism. And so all of that makes your core better, right? So this is, you know, our doctors, our scientists basically said, first, we need to cure the core.

48:03If you have a good foundation, good bones, then your health will improve. Then we can individually target other parts of the body, right? And I don't know when this podcast is going to air, but we will have a skin pill, an oral pill for skin health from within, right? Literally repairing your cellular damage from UV, right? Yeah. It's unlike like a, you know, sunscreen, you protect UV from damaging. But what will still get UV in, right? There will be damaged cells and the skin pill can repair that and make your skin better within, right? So that's kind of the one area, right? Certainly we'll have pills for heart, for brain, for guts.

48:52I mean, those are all chemicals we need, especially we need as we age, as we become older. We just don't have them anymore. And therefore, these cells start to become malfunctioning, right? Yeah. No, it's a very, very compelling argument that you've made here. And I think that's so, so well-rooted in the science and the physiology of it, because no one really wants to talk about this. I personally love longevity, you know, and I've been very up to date on reading all the papers that come out. And one thing that I keep seeing that we're missing the point on is kind of what you alluded to just now, which is there are certain chemicals, molecules that are naturally depleting.

49:29But then also we are also failing to replete them in the standard ways. So, like, for example, I'll tell you vitamin D is a big one. You know, I don't know what the stats are right now, but I do remember a few years back there was some data about like the percentage of people in the United States that have a deficiency in vitamin D. And then that led to all sorts of theories and people were blaming sunscreen and, you know, all sorts of crap. And, you know, so it's like, but that is a prime example, right? Because vitamin D is at the center of so many cellular functions, but we don't get to focus on that.

50:05We focus more on, well, you know, what could have caused this? No, it's just your body's natural way. Like, that's what happens. Yeah, yeah. As we age, we start to lose our ability to, you know, produce vitamin D. You can argue, yeah, you should go into some more, but the problem is the sun can cause a lot of damages at the same time while maybe producing a little more vitamin D, but still not enough. That's the problem, right? That's the problem. Still may still not be enough. And a lot of these other chemicals are very difficult to reproduce because just the clock is ticking, right? And, you know, a lot of the mechanism of action is very interesting, very unique.

50:44And, you know, there have been a recent study on this. I mean, this study is pretty well known now, right? Even as we get into the old age, 60, 70, 80, our DNA itself, right, is still fully intact. It's really the epigeno that controls the DNA on and off that goes haywire as we age. That's right. And how to make the epigeno function healthy again, reset it, reboot it, is really part of the trick. We're doing a lot of the biohacking is all about that. But really figure out what's working, what's not working. So when we introduced the age well pill, there's only five ingredients in it. And we started with probably 150 chemicals that people claim that has worked.

51:38But when you chase it down to the actual study, is this a placebo-controlled study? Is their sample large enough? Are the impact truly are noticeable? When you put all those filters and clon into it, there's less and less chemicals. That's why we ultimately, we only need these five. And for me, my pains are, I mean, after, you know, suffering for 10 years, it was gone after really just a few weeks of taking it. And I had foot pains. I used to play a lot of soccer and I just couldn't do it anymore. And I ended up only playing golf. I even walking start become painful. I don't want to ride a car.

52:19I was like, when I'm going to, how long can I hold on to this? My foot pain, right? It's like, all of a sudden I was completely gone, right? Like completely gone. It was just like, oh my God, this is like, for me, this is the miracle pill. I may be less caring about the skincare, like my wife, but this is for me, it was like, okay, I'm going to get young again, it feels like. No, but it's amazing because that's the definition of preventative care is what you're describing. I mean, this is really the, this is, in my opinion, the future of preventative care. It doesn't have to be complex. It just needs to be efficacious.

52:53And we have to understand the molecules that are at play and what they do. and how they reset your body. You know, I had this, Jack, I had this conversation. I don't remember, it's been a while, but the idea came up of physiological feedback loops, you know, and that was an important conversation because when you look at physiology and the way it functions, we lose the capacity of these loops to do what they're supposed to do, which is tell ourselves, hey, you're lacking this, make less or, you know, or make more or whatever, right? So the feedback loops themselves get completely hijacked as we age.

53:24If we are able to introduce certain molecules and certain things that can replenish that system, you're replenishing the whole machine at the end of the day. Yeah, they create a whole feedback system. That's why I'm not a big fan of the functional health thing, right? But I think there's absolutely some truth to it, right? Even just I experienced, I feel like I'm young. When I'm walking now, I want to run because I feel like I've got the energy. I want to bounce now all of a sudden. That feeling, I haven't had it for, again, 10, 20 years, 10, 15 years. Wow. Well, I love it. And I'm such a fan of what you've created.

53:59I honestly can't rave enough about it. I think I've recommended, like I said, before we even decided to do this podcast, I've been recommending Muesli. Thank you. Appreciate it. Yeah. I mean, it's deserved though. It's like people ask the questions, right? Every day you're getting the most basic questions of where can I go get a prescription for my hyperpigmentation? Where can I go and get solutions like here you go it's right here yeah you know i don't know if you know this um i was surprised who got a notice um three weeks ago from usa today i won the most trusted brand in the u.s i mean uh actually it's a global brand voting by by the americans right and was like 20 30 000 people participated in this uh completely independent study right with no brands be involved right we're ranked number seven in the health and beauty space right and in our space so it's really the all the other brands were very old you know your CeraVe your Neutrogena brands right because the way they had the consumer surveyed it right you know 23 ,000 people being surveyed it and it's just asking two important questions would you buy this yourself again and would you recommend refer this to people you care right friends and family right those are the 40 40 percent weight on each and and then somehow musli's got surfaced right i don't think we we technically were too young to belong to like oakley is actually one of the beauty brands listed there um but it you know what you said is true yeah when when you focus on really what makes the efficacious medications and for wellness, everything else would just follow.

55:49We have this internally, we have this principle. Our drug is not cancer treating because for them, life-threatening conditions to even 30 % efficacy is fine because if someone is dying from a cancer, 30 % chance is better than no chance. We have an 80-80 rule. Minimally, you need to be 80 % efficacious for 80 % of the people. Otherwise, we would not introduce a medication because it's not universally accepted. No, I love that. I think this is the future. I think what you've created and what your team is doing, I mean, this is the future. And I see skincare merging more into this understanding that we cannot lie and we have to stop following the marketing.

56:37We have to follow the science. There is no substitute to that, you know? Absolutely. This is not a fashion business. This is not color cosmetics, which is fine. You can, you know, whatever you feel good, look good, right? This needs to have results. That's the only thing that matters. And that's the thing is like, we are having this conversation in the cosmeceutical space where we're talking about things are merging with dermatological science, you know, cosmetics is coming. But at the end of the day, the efficacy has to speak. That's the bottom line. And if we ignore that, we're going to keep spiraling in this gray zone that we've been in with cosmetics.

57:14That needs to stop. I mean, if you ask my opinion, it needs to stop. Yeah, it needs to stop. I mean, the funny thing is that because we created a whole ecosystem through this DIY model, we have our own healthcare system, patient record system. We have our e-nurse. We have collect, you know, recently we actually use AI to further harvest the data that we have, right? We have, you know, 10 million data points from these patients, right? 1.2 million patients gave us data, what works, what doesn't, which formula, down to every single formula. If you look at each formula, the number of, I mean, this is not even like a traditional clinical trial study.

57:54You survey them. They literally are using the nurse to help their treatment. So they're using their action to tell us, is this improving, not improving, right? They're not even answering a question for us. They're just helping themselves along the way. Yeah. Even the most least used, actually the least used formula have thousands of people behind it in terms of efficacy, impact. At what point? At day seven, day 30, day 60, day 90. What are the impact? How much impact? We have all the data. Right. This is in some sense, I don't think there is another place with this much data for skin care. And now with hair care and, you know, hair care for women mostly.

58:39And then, you know, HRT is catching up quickly and longevity is kind of the new frontier. And yeah, we I think the Stanford, you know, which is the five minutes away from my home, their dermatology department is probably smaller than us. in terms of how many board-certified dermatologists practicing, and they're also participating in the medication development and improvement at the same time. So the practitioner is not just using the tool, they're improving the tool. Yes, that's huge. That's really huge. I mean, I could talk to you for hours about this. I mean, it's truly a breakthrough in skin science, and I have not enough words to praise what you've created.

59:22Oh, thank you. I mean, it's the truth. I really think this will change this industry. And, you know, I for all of our listeners, you guys got to follow the follow the efficacy. That's why I try to tell everybody, you know, follow results oriented, result driven skin care. That's when you will be voting with your dollars and you will stop buying marketing, you know, at the end of the day. And so thank you so much, Jack. This has been an honor to host you and to learn from you. Yeah, thank you, Elka. Really appreciate your program. I always love your program. Thank you. Thank you so much. If you guys want to get 28 % off your Muesli order, use the code SKIN, S-K-I-N 28, all one word, at checkout.

1:00:00But make sure that you have selected the two-month refill or the three-month refill option, and it's your first initial order of the Muesli product. Again, that's SKIN28 at checkout.