The Bossticks - Dr. Chris Tomassian On Procedures That Work & Don't & Fact Vs. Fiction On Skincare & Treatments

Episode Date: October 19, 2023

#619: Today, we're joined by Dr. Chris Tomassian, founder of The Dermatology Collective, ensuring cutting-edge dermatology care for all. Beyond the clinical setting, he resonates with a vast online community, with a following of 2.5 million on social media, where he creates content on skincare, demystifying skincare myths, and helping people all over the world achieve their best skin. Today, we sit down with Dr. Tomassian to discuss how to get your best skin. He dives into the skincare trends out there and tells us what could be potentially dangerous for your skin in the long term, how to effectively use retinol, and the rules surrounding sun exposure for skincare. We also explore skincare for men, the links between hormones and skin, and what to look for in a great dermatologist. To connect with Dr. Chris Tomassian click HERE To connect with L'Oreal click HERE To connect with Lauryn Evarts Bosstick click HERE To connect with Michael Bosstick click HERE Read More on The Skinny Confidential HERE To subscribe to our YouTube Page click HERE For Detailed Show Notes visit TSCPODCAST.COM To Call the Him & Her Hotline call: 1-833-SKINNYS (754-6697) This episode is brought to you by The Skinny Confidential. This episode is brought to you by L'Oreal Discover the new Bright Reveal Dark Spot Duo.Visit Target online and in-store to buy yours today. Produced by Dear Media

The following podcast is a dear media production. She's a lifestyle blogger extraordinaire. Fantastic. And he's a serial entrepreneur. A very smart cookie. And now Lauren Everts and Michael Bostic are bringing you along for the ride. Get ready for some major realness. Welcome to the skinny confidential, him and her.

Aha. I think the big misconception is people think Filler does dissolve, like in six months. They're like, it's only last six months. It doesn't. Like they've done studies. They've done ultrasound that shows that fillers in there for many, many more years. I know a lot of plastic surgeons who do facelifts. Interestingly enough, they don't mind the filler as much as they don't like the threads and stuff that people do.

So the filler I'm not too worried about. There's a lot of other worst procedures to do right before a facelift. Then most of my older patients are like, I'd rather do more filler or more like some non-invasive procedure or laser. RF micrnealing, something like that, then go under the knife and spend like $40,000. Dr. Chris Tamassian is on the podcast today. He is the founder of the Dermatology Collective, and he is TikTok famous for all his skin tips. In today's episode, we'll be talking about skincare for men, what not to put on your skin, demystifying toxic skincare trends, how to use retinol correctly, the fix for hyperpigmentation, how birth control affects your skin, and hormones.

This episode is for someone who is a beauty lover who wants to know more about skin. I wrote a book on skin and I learned so much in this episode. I was like shocked. Dr. Chris has a vast online community, a following of 2.5 million. He creates content on skin care and he is a doctor in his practice, the dermatology collective. If you guys are into taking care of your skin and the best practices, listen to this episode. If you guys want to take your skin care to the next level, definitely listen. Dr. Chris tells all. On that note, let's welcome him to the him and her show. This is the skinny confidential him and her. I am reading this book about residency for doctors and dermatologists. It is so crazy.

I will tell you, residency is not like Gray's Anatomy. Oh, it's not. It's not as crazy as that. I would say like the hours and everything is pretty bad. Dermatology, I'll put to the side. You work really hard to get into dermatology, and then your residency is actually not as bad as like surgery residency. Okay, so the one I was reading about, shout out to John Lawrence,

playing doctor, was all about surgery, residency with, doctors. Yeah, it is insane. Dermatology is different, though. How did you even get into that? Why did you want to become a dermatologist? When I first got into medical school, I wanted to be a family doctor, actually. Which is crazy. You got to talk about how you got, you got into medical school right out of high school. Yeah. You got to talk about that. So there's like very few programs that are like six year programs that you actually combine your undergrad and medical school together out of high school. So I had family friends who went through it. I was like, initially I was like, let me do this traditional four years, four years. I know I want to be a doctor. My dad's a doctor.

I know the life. So I was very comfortable with medicine. And I was like, let me try the six year program. I got in 17, went to Kansas City, did my undergrad in two years. So you basically just like, they load you up on credits and no summers basically. So you just do a bunch of school, get in, and then start seeing patients like at 19. So that was the wild part. And why skin? When I actually got into medical school, skin just made so much sense. One, you see the problem.

You know, someone walks into my office. I'm like, I know why you're here. There's either something growing on your skin. You have a big rash. And I could fix it pretty quickly and see an immediate result or a very quick result, which is very nice as a doctor. Many people don't want to go see your doctor, you know. A lot of people want to go see the dermatologist, which is nice.

And then the last thing is it's a very like fast-paced field. I'm able to walk into a room. Either I'm doing a procedure. I'm doing a laser. I'm cutting something out. I'm talking to someone about their skincare routine. So every patient's really different. And you walked in and I said, who has better skin, me or Michael.

And you didn't answer, but you said, well, Michael has some redness. So what is that? Are you just giving yourself a compliment? Kind of. I really work at my skin. So does Michael. Well, I'm learning because I get to talk to people like yourself and come on the show. And I like, you know, you should have seen me before I started this podcast. It was a sore sight. No, you look good. But I want to know what he would do for redness around the nose. Because anyone who's listening who has redness or rosacea or broken capillary. What would you do about that giant growth on Lauren's eyelid? There's no growth on my eye. Go watch YouTube. What would you do? I'm trying to get something for myself here. So redness around the nose is really common. a lot of the times it's from rosacea, you know, so that's an inflammatory condition. It's genetic.

It's environmental. And you get these like broken, basically capillaries or blood vessels are on the nose. I've had those forever. If you have access to a dermatologist, go get a laser. It's the fastest way to get rid of them. There is multiple types of lasers, light-based devices like IPL, KCP laser, which is just a more, you know, targeted to the blood vessel. And then PDL, which is like the gold standard for red spills.

spots on the face. And that actually will like almost instantly remove the red spot, which is really satisfying for a patient when they walk in and then leave when it's gone. But in terms of skin care, I would say the best thing for redness is the same ingredient that's an afrinasal spray. That's interesting. I've heard that. If I'm telling people to be on a budget, because the prescription version of it is very expensive. Okay. I tell them to basically go get aphra nasal spray, spray a couple pumps into their moisturizer and put it on their face. And it usually compresses all their blood vessels and gets rid of the redness temporarily. Chris, that is why we have you on the skinny confidential, him and her show. That is a really good

tip. What is the actual ingredient that does that? Oxymetoletolazine. Oxymotolosin. So you just take a couple squirts of the aphrine, put it in your moisturizer and rub it around your nose. How many times do you have to do it? Well, it depends on what type of lifestyle you have. You know, if you're really like a night owl when you're going out at night, I would say do it before you. go out at night, but if you're like 9 to 5 working, I would say do it in the morning. And if you're at home, you don't need to put it on. What if you go to bed at 7.30 and you read your Kindle for fun? In the morning. Do it in the morning. And you probably have a very healthy lifestyle if you're doing that. We used to be going to bed at 7 a.m. Now we're going to bed at 7 p.m. Kids kind of...

Kids turn that off. I need to get on that routine. No, your skin looks so glowy. Is there a specific thing that you do for your skin? If someone's listening and they have a boyfriend or a husband, Like, what are the things that you would start that person on? And how is your skincare evolved over time as a man? The first thing I would do is tell them to read your book. Oh. And put your sunscreen on. That's the first thing.

I think everybody wants to get the ingredient. The first thing is like, oh, let me get a new active ingredient. I'm like, if you're not going to protect yourself from the sun, you're just wasting your money. Like, we all know this. Like, sun protection is the number one thing. It prevents from fine lines and wrinkles, dark spots. all these things. So you could keep trying to build collagen,

but you'll never build it faster than the sun takes it away. I always tell people that. So first thing's protection, and then add in some active ingredients. A couple of my favorites, obviously, retinol, probably number one. It helps boost collagen, helps with acne,

helps with fine lines and wrinkles, dark spots. So it does a lot. And it's a pretty easy ingredient, I think, to add in, especially for, I would say for guys more than girls, because they have usually more oily skin,

so they could tolerate the dryness and irritation from it. Also, I feel like guy's skin is like thicker and so it can handle it better than women's. Like I noticed there's sort of like this waxy sheen on women who have used retinol for a long time. And while the skin does look clear and beautiful and glowy, there's a waxiness to it if you overuse it on women specifically. But is that actually true? Like I get, or maybe you can't fully answer that. But in your practice, do you typically see men with thicker skin than women? Usually their skin's a little bit thicker.

Why is that, dude? Well, I mean, really where the facial hair is, you know, you have a lot more sebaceous kind of oils where you're having hair growth, especially around the nose, too. I would say, for example, for rosacea, more men will get enlargement of their nose from rosacea than a female would, like that oil enlargement or rhinophymos. So it makes your nose bigger if you have redness around it. You better buckle in a few years. I'm going to be looking like a clown. Not always just the redness, but chronic inflammation with rosacea can't lead to it.

When I explain it to a patient, I'm like, look at what Santa Claus looks like. You know, like the big boggy nose. He's like a red. Bulbis? Bulbis. You're going to get some bulbous nose as you age and your ears grow and your balls hang and your dick shrinks. Oh, geez.

I can't wait. Those are the four things I get. Well, it's a good thing that you're not with me for my looks, right? I only stick with the skin stuff. So, no, he's good. You can take care of him. He's good. Yeah.

Okay. Listen, you know, people ask all the time, like, we talk about testosterone on this show. And I'm like, listen, not yet, but probably when I'm like in the late 50s, hopefully making up our 60s, I'm going to jack myself up on that testosterone and I'll be good. Don't worry. Don't do too much. I know. But I think there's a point where older men, it makes sense.

Not now. It's too early. Yeah. You want to get it to a high normal. Yeah, yeah, yeah, yeah. What is the craziest thing that you've seen on TikTok that people are doing with their skin where it makes you want to just cringe? Everything is so bad. Like, give us some examples.

Okay. One is just using cleaning supplies on their skin. What? Like, what kind? What? Like, I've seen people use, like, baking powder and mixing it with, like, detergent stuff that you would, like, clean a table with to, like, remove the bacteria off your skin. I'm like, that's just in general. I've seen those videos.

That's always bad. And then it gets to like people wanting like a reaction on their face. So they'll put something really basic and then really acidic and then be like, oh, it's fizzing on my face. Something's working. And I'm like, nothing's, you just neutralized. Whatever. Like that's what you did.

Good job. You know? For example, lemons are huge. I don't know why everyone wants to put a lemon on their face or in their hair or something. You know, many times they'll do that to. fade, especially dark spots. And it's really used, I think, overseas. People love to use like more natural ingredients because they're scared of like the chemicals when everything has a chemical in it. But they'll put lemon and then they'll like rub, rub it with like turmeric or something, which is

anti-inflammatory. Tumric's okay. But it will give you a nice orange tint to your skin. And then they'll go outside and then usually you'll get a photochemical reaction from the lemon, which will leave you with a big burn reaction that leaves you with a terrible dark spot. Oh my God. That happened to me with antibiotics. Doxycycline? Ugh, the worst. Do not take doxycycline and go in the sun.

That's exactly what happened. We're saying with the lemon. Remember I got that rash in Palm Springs? Boy do I ever. How could you forget it? But that was bulbous nose. Yeah. That was bulbous nose.

But the photo, what's it called a photo? Phototoxic reaction. Oh, it's brutal. And it lasts so long. It's really common vacationers because they'll drink margaritas at the pool. And then like there's lemon and lime in it and it gets on your hands and it usually drips because you're a little intoxicated. And then they'll come back from their trip and be like, I have this like streak of dark. And I'm like, were you having margaritas?

And I'm like, I'm a fortune teller. What are other things that you see in your practice all the time that are so weird that people who are listening maybe are like, what is? that, but you know right away. Instead of Margarita Hand. It's a TikTok. Margarita Hand. If you haven't done that, you guys, that's a TikTok. I'll make it TikTok.

Yeah. One is, I could tell when someone's using a heating path for a long time, you get this kind of spider-like rash that lasts for a lot. It's usually really common in people's backs, and they won't even notice because they can't see their back. And it's like this, it's called Aerithiba Abigny. It's a really long name. But from chronic heat exposure, you get this, like, spider-like rash.

And they're like, oh, what is this? And I'm like, oh, do you have back pain? And like, yeah, I'm like, you use a heating pad. They're like, yeah. And I'm like, it's from that. Michael Bostic is on the edge of his seat right now because he got the worst rash anyone's ever seen in history. I've never seen such a bad rash in my life.

My phone's not here. I knew. In this rash, you have to show him this rash. Carson, my phone's in my office on my desk. Well, you can use my phone. No, no, I need the picture. But anyways, while we're talking. No, no, no, this was like.

I bet you he knows what that rash is. I shared this years and years ago and it used to be on my Instagram. And we still talk about it to the same. Well, it's going to be a while. We can maybe jump back to this because Carson's going to check my phone. But it was like a full body. I was like, you know, have you seen the movie Braveheart in the leper that lives in, you know, the old man? He lives in the attic. I was like, two months. Two months? I don't know if I ate something bad, but I had to go to like the hospital about because it was it's going to go. I had to it's eating his back on the carpet because it hurts so bad. He was it. I'm going to show you. I'm going to show you. I'm going to show you. I'm going to show it. I'm going to show. I'm going to show. I'm going to show. I'm going to show. I'm going to watch. I'm I never figured it out, but maybe you could figure it out. Well, he sounds like, you sound like you're like really savvy with seeing something random and diagnosing it. It's a great party trick. Yeah.

Except when someone's like, could you take a look at something down? And I'm like, no, not here. What the fuck is that? We should pop it up on YouTube so everyone can see it. I went to this restaurant. I won't put the restaurant on blast because I don't want to kill him. But I had like these crazy shrimp tacos. That your wife insisted you ate.

But it lasted for two months. That lasted like that for probably like a week and a half, but it took a while for that to go away completely. Like once the skin was discolored, it took a while. I thought I was done. I was like, well, this is it. Better start, you know, saying my goodbyes and farewells to family and friends. Something called Aerithema multi-formy. I've never heard that one.

It looks like it was like pretty dusky in the middle. Sure, sure. Yeah, wow. He doesn't want to lose their breakfast. My whole body. Front and back. Even the penis. No, it was not really there.

actually. It was like, yeah, torso mostly. Mouth? No. Face? Yeah. Yeah, face. But not like that. Anyways, people are like, what the hell is he showing? That's a gnarly rash, right? I'm going to have to show it now. Yeah. God. But the thing you called it, what is the thing that you just, what is it? So, that's like an auto-reactive condition that's either from a viral infection. It's commonly with like a herpes outbreak.

Oh, great. On the entire body? Like a cold sore. No, you've never had a cold sore. No, but it wasn't. That's what freaked me out. is like they took me in and they were like asking what it is and it was like they couldn't figure that out. I've never seen him have a cold sore. I remember the day I went, I had these shrimp tacos and they were like a little bit sketching them. Someone was telling me like sometimes the sediment that a shrimp can have if you don't clean it out properly from the bottom of the ocean or wherever it was. The body may just freak the fuck out being like what is this in the system?

It's just weird that it lasted that long. Yeah. Because usually like food stuff, you'll have a rash and it'll maybe last a week. So that's interesting. That was a fun diagnosis on air. Maybe I'm a mutant now. Why do you think that your TikTok blew up the way it did? You have 1.9 million followers. What are the videos that you see go viral and why? If I had an answer to that, I think I had more than 1.9 million dollars.

I mean, that's a very impressive amount. It is. I started TikTok during the pandemic. So like most people. And I was making videos, one, on like, how to treat conditions that you could treat at home. without seeing a dermatologist. Because most of my practice went to telehealth or virtual visits. And most people couldn't come see a dermatologist during that time.

So I was like, go buy this at the store and see if it works. And in the meantime. So I started making those videos. Those did really well. And then I started myth busting. And that really did well. It caused a lot of controversy because there's a lot of people on TikTok who are like skincare experts without the degree.

And they'll post a lot of stuff on there. that really doesn't have any science behind it. So you have to be a little careful. Because there's a lot of skincare experts without a degree that are very smart. And they actually do their research. They talk about the things that actually makes sense. They put the publication behind it. And then there's some who will tell them to put like baking soda and lemons on their skin.

Mythbusting was a big one. And then I recently actually started doing like a couple of months ago. It's like if you have this, use that. And that blew up. Give us some of those. For example, it's like if you have milia or those like white bumps around the eyes, like you should start using a retinal around your eye. That's a good tip. I've never heard that.

I've just heard pop it. No. Not pop it with your fingers, but like go glance it. Yeah. With the professional. See, that's the thing people will do it at home. Don't lance it yourself with a professional. Exactly.

But go ahead. So tell me about the retinal. I didn't know that. So retinal speeds up your skin cycle turnover. Right. So usually if you do that, it will treat a little bit of the millia you have. If they're small, if they're really big, Milia, you will have to get a lance. But the beauty of using a retinol is it will prevent further milieu from popping up.

Which is really helpful. And then stopping, like, don't use like vassoline or aquifer around the eyes. What about if you have dark circles around the eyes? Hence me. What would you do that? He doesn't have any dark circles. Really? Well, yesterday was a little rough.

And then we got two kids under three, so the sleep's a little dicey. Dark circles are tough. That's actually one I made. If you have dark circles, use this. The reason is tough is there's so many causes of it. Lack asleep, genetics, actual hollowness. Like if you have a hollowing underneath your skin, the only way to do that is to put some sort of a volume filler, right?

Or something like that. There is pigment. Most of the time, what I tell people that will target, I think, three out of the four is I would use retinal. I would use vitamin C and I would use sunscreen. And then honestly, maybe like a caffeine or niacinamine. because caffeine will help tighten any of the vessels. Niasinamide is going to help with skin texture, skin barrier, help with dark spots.

Retinal does all of it. So like fine lines and wrinkles, dark spots, collagen boosting. Because that's like super thin skin. So you want to kind of thicken it up too. And then vitamin C also just supports collagen and fades dark spots. Can you overuse retinol for the, I'm using some of it right now, but I'm like I was told only like maybe three nights a week? In reality, you should use it every night.

All the studies on retinal are like every night use. But we always tell you'll start three times a week because if you overdo it, you'll get too irritated, then stop using it for like two weeks, and then you'll restart it. And the whole point of using retinal is like long-term success, right? So like you're not going to see any benefit for a week a month. You'll start seeing it like six weeks in, three months in. So the best is to just stay consistent. So if you could only tolerate it three times a week, that's perfect.

So it's maybe like they're testing to see if three nights a week gives me some kind of reaction. Yeah. What if you have hyperpigmentation? That's what I struggle from. Melasma and hyperpementation. What are some things that you would say to try? So first thing is sun protection. Okay.

Because if you don't, I mean, like I said, you can't outwork the sun, really. Like the sun's always going to beat you and make more hyperpigmentation, especially you have any of your prone to it. What are usually your hybrid pigmentation from? Is it melasma? Is it? I think it's a mixture. It's a hybrid of being on birth control when I was younger. Just know if you go on birth control and you go in the sun. I don't know. You probably could speak more eloquently on it. Like there's something that happens where I got like a sun mustache. Everyone in TikToks and be mad about that take. What do you mean? They just, I know, I know the TikTok's now. How is everyone going to be mad about that? And then watch. Everyone's mad about everything. You know what I realized. You know what I

realized this is just like a little tangent. I've been trying to think of what the internet's like. And I'm like, you know what the internet's like? Did you guys ever play the game Operation? Yeah. Hey. Well, Chris is probably fucking good at this because he's a... But the internet is like operation, the game.

How you deal with it? You have to go in with a very specific angle of your hand to get the kidney to pull it out without it beating the side. Yeah. Anything you say white, trigger something. Yeah, the internet's operation. It's 100%. That's a great analogy. Thank you. I think so too. I thought of it while I was driving it today and I was like, that is like what it is. Okay, hyperpigmentation. I think it's from birth control. I think that it is from maybe like sun exposure. I also think, and this is I think an important thing to know is when you get a peel or a glycolic peel, you cannot even go in the sun for one second. And what I mean is like even, walking from your car to get into your car after you get the peel, you have to be protected. And I think people don't realize that incidental sun exposure really can activate something

if you have had a peel or a glycolic. 100%. You actually, like, you nailed it right there. Because one, birth control definitely triggers melasma. So it's the hormones and the birth control that usually do it. If you want to do not get melasma, do a non-hormonal birth. control, but that mustache is like classic. And everyone, everyone comes into my clinic and they're like, I have hair and I'm like, there's no hair. This is dark. So melasma is that like ill-defined

almost sheets of brown and it's like forehead, cheeks around the mouth. That's due to hormones, pregnancy is a big one, thyroid irregularities. And then you can get it for medications, but they're pretty rare medications. So that's not a big one. That's a very big one. That's a very very, very, very, very, very tough condition to treat. You could do all the treatments and get it perfect, and then you'll go out in the summer for one day and it will all come back. What I've realized about it is, number one, if I spray tan, you think that that'll even it out, but it brings it out more on the face, so I don't spray tan my face anymore,

which is weird. Because if you think about it, the spray tan clings to the dark spots on the face. So I don't spray my face anymore. I never think of spray tan on the face looks good anyway. You don't like neither does my facialist either. Stacey does, Stacy's like, oh, yeah. How could you spray tan your face? Yeah. I don't like the spray tan at all. Even on the body. No, he doesn't like the spray tan. No, because I don't like the smell. You do aggressively check out my ass though when I get a spray tan. No, no, no. I mean, listen, like I.

Aggressively, I notice a huge difference. I don't know. I mean, I'm not joking around about that. You do. Maybe, but I don't like the smell. Now all the spray tanners are be mad at me. Another thing to be mad. But, you know, it's just like, it's just like it's really strong. and then the sheets get everywhere and then you touch my shirt and it's all over the shirt. But you just got to avoid them for like a day. Yeah, but that's,

you know, what's one of that? Let it all settle it. I feel like you kind of do like the smell. You just don't know that that's the smell. Here's the thing. We should be like, hey, Michael,

don't use this cleaning supply or don't burn this candle and then she comes in with like a paint, like a car paint brush and sprays her whole body. It's all about balance. Bullshit, you know? Like how can you say don't like use the,

you know, the cleaning supply. They put a tent around her though, right? Yeah, but it's like it's all over the house. Do you like a spray tan for the skin? Oh, I'm pro it's spray tan. Because you like that we're out of the sun. Exactly.

Like, I'm all about it. Fake it until you make it. Anything you will do to not get in the sun and get a tan, I'm happy about it. But what about like, if you just wanted like a decent amount of like daily sunlight? Will you do it like, will you do it at all if the UV's light or will you just avoid the sun completely? Listen, I go out of the sun. Like, you need to enjoy your life.

life. There's a very, like, I think there is extremes in both worlds. Like, I'm not the dermatologist who walks around with an umbrella outside. Like, I just put my sunscreen on and I go and enjoy the sun. If I'm at the tropical place, I'm by the pool. I'm in the water, but I just protect my skin. And yeah, you're going to have like a natural kind of tan that your body will make from protection. If I'm burning, I'm doing it completely wrong and that's not good. But I think there is a fine line because you need to enjoy your life. There's a lot of things outside that require you to be in the sun. Well, I mean, and listen here, you have like a nice dark complexion, right? It's like a nice color. For me, if I don't get a little sun, I'm going to look like this fucking table, right? You're going to look

like a sheet of paper. You're not going to be, I'm going to be translucent. I'm going to be translucent. He's saying, though, it makes your skin like, it degenerates. Is that the right word? Yeah. It's like degenerates your skin. Like it takes the bouncy plump collagen out of your skin. You know what? I have this little thing I do. I think you're going to be proud of me. I downloaded or my sister did it. Shout out to Mimi. The UV, but she put it on my home screen with my steps. The UV index. So every time I pick up my phone on it is how many steps I've walked, my UV and how hot it is outside. So what I do is I look at the UV when it's zero, which is for us in Austin, it's in the morning around 8 o'clock.

And I'll walk my son when it's zero. I'll still wear a hat and driving gloves. I wear driving gloves. The whole thing. But it's really nice to know that it's not super strong and it's right on my phone. That's actually genius. It's easy. I should do that.

Make sure I do that. Chris has two TikToks to film. Margarita hand and put the UV. Michael's looking at his. Michael has the stocks. That's probably a little more stress. I don't want to look at the stocks. Markets up today, feeling good.

Anyway, I think the UV, like, just to look at it, because sometimes it's, like, eight. Yeah, I mean, we're in California. It's, like, always high, I feel like. It doesn't matter when. What are these pills that people are taking to get tan? The cratinoid. Pratenoid.

Cratenoid. Think about, like, a carrot. You make, so there's basically you just make yourself a little bit more orange looking from eating too much of it. Like, you could have too much carrot juice than they get. an orange tan which to be honest they've actually been doing studies

on this that I was reading that people do think like that orange if you do it the right amount it can look attractive they were like looking at the attractive scale compared to like a sun tan but I think it's like either you're not to take a lot of that supplement

it can be dangerous to some people like if it's vitamin A derived that stores it's a fat soluble vitamins that stores in your fat So I don't recommend it, to be honest. I think spray tanning is better. So it continues your spray tan. I'm going to continue with my spray tan.

They harvest that stuff from the Jersey Shore. Calm down, New Jersey. It's going to be all right. As a dermatologist, I think that you are probably seeing filler fatigue. A lot of people coming in with too much filler in their face, they went way too gnarly. They didn't sort of keep it classic. It's like way, it went way overboard. What do you do when someone comes in with an overfilled face and they're young?

Usually my staff will tell me before even walk in the room. It's pretty. What did they say? What's the staff say? They just go. Yeah. There's a code word for it? There's code word.

Yeah, because I don't want to walk in surprised. Oh, it's that surprising. Sometimes. Oh. Because I think a lot of people are getting filler way too young. Yeah. You know? Yeah, it's too young.

And I have a, like, so I'm Armenian. So we have a lot of, I have a lot of like Middle Eastern patients too. And they go overseas and they'll get filler too. And it's much cheaper there. So they're more prone to getting a lot more done. I would say most of my patients, I'm actually talking to them out of getting filler than putting filler in or talking about dissolving some filler. And I think they are aware of it too.

They're like, they're like, it's a little much. I don't recognize myself anymore sometimes. two, I think that as you age, a lot of people will get a facelift. But if you keep filling your face and filling your face and filling your face, you're stretching the skin. And I think the dermis out, out, out, out, or long, long, long, long, whatever you place the filler. And then you go in and you get a, if you get a facelift, then you're pulling the skin over the thing that you've stretched. So to me, filler doesn't really make sense a lot in the face because if you are going to go and get a facelift, it almost negates, like, I don't understand why you would do that.

It depends on where you put the filler, right? So a lot of the times, like, for the cheeks, it's on the bone, for the chin, it's on the bone, for the jaw line, it's on the bone. Okay. And I think the big misconception is people think filler does dissolve, like in six months. They're like, it's only the last six months. It doesn't. Like, they've done studies, like they've done ultrasound that shows that fillers in there for many,

many more years, especially under the eye filler, that last years, I would say, for people. I know a lot of plastic surgeons who do facelifts, and interestingly enough, they don't mind the filler as much as they don't like the threads and stuff that people do. And that's because there's like a lot of scar tissue that gets built in. So when they're cutting, it's like basically resuspending scar tissue rather than healthy tissue. So the filler, I'm not too worried about, especially if it's on bone. I feel like if you put a lot in the fat, that's superficial fat and the dermis, then you can definitely stretch the skin.

There's a lot of other worst procedures to do right before a facelift. And I've realized now that a lot of people don't even want to pay for the facelift. That's the thing. I think the prices of facelift has gone up so much that most of my older patients are like, I'd rather do more filler or more like some non-invasive procedure or laser or of micrneedaling, something like that. then go under the knife and spend like $40,000. I would rather, if I was older, I would rather do the opposite.

I would rather save for a really great facelift than do a bunch of filler because I have this theory when you overfill the bottom of your face. It brings the eye down, which I think can be aging. So I don't get why you would keep filling the bottom of your face over and over and over because you're bringing the eye down. when as if you, I mean, maybe I should be a dermatologist in my other life, but you want to bring the eye up, right? Yeah, the canthal tilt. Can you talk about that? Yeah.

So this was huge on TikTok. Did you do it? No. There's like a filter, the canthal tilt filter. No. So you should have like a neutral or positive vector to your can't, like the lateral part of your eye, the canthas should go up. Okay.

And that's like more, more attractive. Okay. And a lot of people were using this filter and it would be like negative tilt. and they're, dang it, I'm like unattractive. So you don't want your face to look this way. Oh, great. Perfect. You're good.

You're good. Trust me. How's my cantal tilt? Neutral or a little up, actually. Oh. Yeah. You say good carriers again. Don't look at me.

I'm hideous. Your cantle tilts a little off. Is the cantle tilt where the temple is? It's right here, like this part. Okay. But a lot of times when you fill the temple and fill like under the eye, you support it and it will raise it up a little bit. Okay, but here's my other thing because we're just getting so detailed.

I don't like under eye filler at all. I've never done it. But I don't like it because I don't like how it presses the eye up and makes the eye look smaller. That's my theory. These are my weird theories. I'm not saying my theories are right. I'm just saying like this is... I think under eye filler is overdone.

Yeah. I think everyone thinks like a filler's going to fix it and it causes swelling. It can cause... If it's done too superficially, it can cause it. a lot of that blue discoloration under the skin, which even makes their dark under eye circles worse. Like when we're learning about under eye filler and how to do it on patients, you want to go for like a 70% improvement. Everyone tries to go for like 100%. But if you don't have an under eye or tear trough, you look like a cat. Right. A minks. Yeah. Like you need a little bit of a hollow

there. Like that's just a normal structure and a face. And I think people are trying to get rid of, like even like the laugh lines. People were like, I want my laugh lines gone. And I'm like, if I get rid of your laugh lines, you're going to look like a monkey. I don't want my last lines gone. You look artificial. Also, it brings the eye down if you get rid of them. Again, we don't want to bring the eye down.

We're bringing the eye up. I have a more basic question because Lauren's going to go like into a deep rabbit hole, which I know. I have 21 deep rabbit hole question. But we were talking to Steph Shep yesterday on the show and she was talking to like one of her biggest skincare tips that she says she has a great term. And she was basically. saying that people should go and find a great germ like yourself. But if you are somebody,

like say that I'm coming in and I get to learn a lot on this show so I get access to people like you. But if I was going to ask for my first consultation, like the first four things or first three things that you should ask for your, for your skin, like what would those things be for anyone that's just starting their journey and just meeting a dermatologist? That's a great question. I would say first four things. When I'm looking at someone's skin, it's skin quality. then texture, then hollowness, right? Like if you're coming, this is for like cosmetics, right? So those are probably the top three.

And when I look at someone, I go, what's your skincare routine? Basics, right? Are you on the things that need to improve your skin? Are you on a sunscreen? Are you on a moisture? Is there vitamin C, your retinol? Those are the number one, right?

And then I'd go, what is the number one complaint you have? So for you, it would be my redness, right? I'd say, all right, let's fix the redness and the texture. It'd be let's do some sort of either get you on a good skincare cream that will help fade the redness, or let's do a procedure or a laser or light device that will improve your skin texture, improve the discoloration, improve the redness. If you improve your discoloration and redness on someone's face, they could literally look the same.

The hollowness could be the same, everything looks the same, someone will look at that person be like, you look night and day different. You should go to Chris and get the laser, he's saying. No, I will. Yeah, come tell you. You should go and get the laser. That's, I mean, that's a quick one, right?

What I like about what you're saying, and we could keep going, is that, you know, it is so individual for each person. Yeah. And, you know, there's some things that we will recommend on this show that I think are like blanket recommendations, right? Like, one of those is I think everybody,

man, woman should weight lift. We don't have to go on that tangent. but I'll say that confidently. I think that is a good application for everybody. It doesn't have to be the main thing. But with stuff like this, I'm a little bit more careful because I think what would work for me may not work for Lauren and what might work for Lauren may not work for me.

Does that make sense? 100%. And I think a lot of times, for example, when you were coming in, I think patients come in with one complaint and it's an end result of another problem rather than that's the problem. What do you mean? For example, if you do have like really deep lines here and they're like, I want to fix this.

I'm like, actually, you're falling from here. We need to support here. And then we need to support your, we need to support your bone rather than your skin. Yes. No one's ever said that like this on the podcast. Go off. Right. So like you can't.

And imagine someone's listening. He was saying that the cheekbones is actually where you need to be filled, not the folds. I rarely ever fill the folds. And I'm telling you like 95% of the time my patient leaves. And I'm like, my fold looks so much better. I'm like, I didn't touch your fold. Because you, if you look in an aging face, it folds inwards. And like your bone retrues back, your facial bone.

So it comes backwards and your skin falls down. So almost like collapses in on itself. Can't wait. Thanks, Chris. No, but it's like, no, hold on. Look forward to aging. So what you want to do is really support the bony structure, the deep structures on the cheek where you're,

lifting up here. And when everyone's like, oh, you lift up to skin with a cheek filler, you know, it's not dramatic, right? You're not like, oh, my God, I just put, you have a whole new face, but like millimeters count on the face. Millimetres count on the face. Like, if you raise your eyebrow three millimeters

and don't tell anyone, people are going to be like, what's wrong with your eyebrow? Right? So that matters. So first you want to inject on the bone here, and then you really want to go, there's a deep puriform space. It's like this hole. right next to your nose. And a lot of people don't realize that,

like, you have actually a great example of what it isn't. So if you look at like your line, your nose is actually really, like almost like doesn't dive into your nose at all. Your nose and your line are almost together. Is that good? That's great. Because a lot of people will have this deep like crevice right by their nose

and their line, their laugh line, dives into that crevice. So do you feel the hole? you fill the hole. So you put a lot of filler right on the bone right here and it plumps that back out. And then you still have this line, but it ends like naturally with your nose and people are like, wow, my laugh lines look so much better. It's kind of like building the foundation of a house. It really is. It's like it's not, you're right. It's not just like what is the symptom coming from of why you do that. Well, no, but I think like part of the problem of the world we live in now is you is people jump right to effect. And what I mean by that is they will see. something online or they'll see a picture of their face or they'll see someone else. And instead of going to the root cause of whatever is causing that particular issue, they'll jump right to the effect and they'll try to fix what's on the surface and they won't go to the root of what the problem is. I'll give you like a strange, stupid example. There's a lot of people that complain about back pain,

especially young adults, which you should not have back pain if you're a young adult. The reason you probably have back pain is because you're set anterior and you probably have no hamstring strength. So people think like, I need to go and fix my back. It's like, no, you need to go build muscle. and your hamstrings to build proper posture. Does that make sense? 100%. And so then they go and they start doing all this stuff on their back when that has nothing to do with their back.

It has to do with their leg strength, their hamstrings. And same thing here. It's like you're going and trying to fill a problem that is being caused from something else. Yeah, you have to work your way back. It's always work your way back. There's something that's causing this problem, not just fix the problem.

But I think that's where we're getting in trouble now. I'm probably fault of this myself when I make videos. I'm like, if you have this, use that, people think it's going to go away the next day. Right. I try not to do that. And I try to make videos in between all these things. Like, skincare takes time. Procedures.

Like, if I'm doing a laser to remove rounds off people's skin and that takes two weeks, you cannot expect your cream to treat something in two days. It's sort of like that quote about like, show me your routine and I'll show you your life. Like the little habits that you do every single day. whatever that is, whether it's wellness or beauty or whatever, really do add up if you do them every day. I've found that with all the things that I've tried, sort of like as a beauty guinea pig, that the skincare routine of doing it every single day and showing up for myself every single day is what really over time is the most effective. I love IPL. You said you like that too. I did

IPL for brown spots and I felt like that really worked. It's amazing. Yeah. And, I think it's a great entry level procedure that's not going to break the bank for a lot of people. And it does so much. Yeah. It treats browns. It treats reds. It can stimulate collagen. But you have to be the right skin type, right?

You can't be like really dark skin because then you'll get burns. And there's bad videos. If anyone wants to like see what the downside of an IPL has type in IPL burns. And you'll see people with like skin type 6 or like really, really dark skin. And they just get burned from the IPL because there's so much heat. and it targets dark. And everyone has different skin types. It's like we're not all the same.

You can't just prescribe one thing fits all. Yeah. You said you don't like threads. I do not like threads either. I've never tried them, but I've interviewed a lot of people who hate them. Are you like so passionate that you hate them? I tell people, if it was my money and in my face, I would never do it.

Yeah. And the reason for that is I really, I've seen people do threads. I've had family members do threads. And I tell them don't do threads. And just don't listen to me, which hurts my feelings. So listen to me. But you're really causing a lot of scar tissue. And the result is, oh, I'm building collagen by creating inflammation in the skin from putting in this thread.

But you could do that with micronealing PRP. Or with sculpture. There's so many other things. Right. Right. You could do. And then they're like, oh. And they'll leave the appointments like crazy lifted.

They look like the Joker. I don't know. Like, it's like it's a little scary. And I'm like, you've seen it all. And I'm like, okay. And then it falls in like six months. And it's like back to square one. And it's a big fall you would think.

Yeah. I mean, you're trying to like, they always do these videos where they'll pull on the skin. And they'll be like, wow, I'm pulling up on the skin so much. And yes, temporarily you're going to have a lifting effect. You will build some collagen. However, I've seen many cases of threads being put in way too superficially. Some people try to do the eyebrow lift with threads. there's great videos also on social media for this, but they put the thread in too superficial.

You literally see the thread on someone that's like going up their forehead and you just see like this barb. And the only way to take care of that is to cut it, cut the skin, obviously give you a scar now, and then pull up the threat. And if they're barbed, they're like really like stuck into the skin. What are some plastic surgery things that you're seeing celebrities do that like people just don't know about that you think are like so crazy, that like maybe we would never think of. Or maybe there's none and we know them all now. A lot of people are posting more about procedures than they ever have. Thank God because who cares.

Yeah. And I think it's almost a flex. Like, oh, I got this done. Yeah. It's like the new car that you got, but not. But not. Yeah. That's what me when I get a new laser, I'm like, like my new lasers.

You know what else people do that with? We were laughing yesterday is they do it with like cold plunge sonnas. They'll be like, well, look at my cold plunge. When you do that, you are one of those people. I think it's cool to have a cold punch. Like, I don't care about the car. A cold plunge? You would love it.

I feel like you would love it. It's so like it has to do with sin. Listen, you put me in a cold shower for like two seconds. I'm jumping out of there. No, no, no,

I feel like you'd like it. I feel like you'd like it. You'll just get, you get so much energy. We don't have to go into tango. We talked about it. I brought you an ice roller. You can start out with this.

I needed this earlier. I want to know if you like ice, if you like how you use ice as a dermatologist. Okay. Is there any way that you, Like you like it after Botox. I mean, you obviously don't want to roll over Botox. But like, how do you use ice as a dermatologist?

It's great for like while you're doing filler. You put ice on the areas to help prevent bruising. Yeah. I love it for mornings. I think ice. There's a difference. Like people like get an ice bath and like shove their face in there for like five seconds and then come out. I'm like, that's not really doing much.

But having ice in the actual massaging motion of it is really good because many, like, it's like, It's like guasha. Like, that was a huge thing, right? Guasha is not going to give you a jaw line. However, temporarily it's going to reduce a lot of inflammation. It's going to drain your lymphatics. It's going to tighten up some of the skin. And this is amazing for the under eyes.

There's actually an eye serum by L'Oreal that I like a lot. It's the H.E.I. It has like these steel balls on it. And you could literally massage your under eye with it. So that's what I do. And it has nice end of mine and all these other things in it. But ice or cooling sensation and it actually mechanically aiding in lymphatic drainage, you're going to look tighter. Your skin is going to look

a little better. What is a drugstore product that you think is so incredible for the skin? Like if someone could go find something and walk in and grab something, what would it be? It really depends. This goes back to what you're treating. It's really easy to spend a lot of money at a drugstore, buying things that really, one, are not going to help your skin. But for example, like if you have dark spots, the way I tell people to use dark spot to treat with dark spots is you need to hit it from multiple angles. Okay. So one protection, sunscreen, right?

Anything SPF 30 or higher, broad spectrum, make sure you're wearing it every two hours. So like this one's perfect, SPF 50. And this one's really good. The reason I like this one is it's actually a chemical sunscreen. I don't know what your thoughts are on chemical versus mineral sunscreens, but for darker skin patients who are the ones who really struggle with dark spots, especially P.I.H or post-inflammatory dark spots from acne and stuff because they are. already have melanin, you need a sunscreen that's going to blend into their skin or they'll

never use it. So if you use like that really, you know, old school white casty sunscreen, like they'll never put it on, right? So you need something chemical. I think it just blends in really well. And then in the morning, vitamin C, at night, nice and night and retinal. So you'd use this one at night, this nice and mind, the dark spot serum. Yeah. That one you could use actually twice a day. There's a big like, the reason you could use this one with, vitamin C and there's like a lot of controversy on social media of like can you use nicosinamide with vitamin C? You can. You got to be careful because there's a lot of niacinamides on the market that are really high percentages. They're like 20% niacinamide. And with any high

percentage, anything, you cause irritation to the skin. So what is this? L'Oreal ones 12%? So this is 7%. I want to tell me the exact one that you can get at the drugstore. It's Loreal Paris Bright Reveal, 12% niacinamide and it has frulec in it. Borlix, so it's antioxidant and amino sulfonic acid, which is actually an exfoliant. And then you use it with bright reveal SPS-50. You like SPF-50. Most people don't use enough sunscreen. Okay. So I tell them, if you have dark spots, you should use SPF-50.

And would you bring the UV sunscreen onto your hands and your chest? 100%. Yeah. You know that. I mean, I just want to make sure that everyone knows that. I scream it from the rooftops. Take it to your tits, take it to your toes. My facialist tells me, Stacey Christie, she says,

your skin, Lauren, is from your forehead to your toes. And she looks fucking incredible. There are so many videos of people, like old farmers. Have you seen these? Yeah. And then it's like and then their thigh. It is ridiculous.

Like if you, and this is the thing, like sunscreen's not sexy. I tell people this all the time. I'm like, sunscreen's not sexy, but it's like the best thing for you. Because you'll never be like, oh my God, my sunscreen is doing so much for my skin. But like in 10 years when you see someone else who's not wearing sunscreen, be like, my sunscreen did so much for my skin, right? But yes, hands, neck. And the neck is super hard to

treat too. By the way, like down the line when you're using all these laser and light devices, it's harder to treat than your face because it's thinner skin. This is why if you're already at your facialist, I'm like, just to have or do it, then I have my facials do my arms. I've had my arms microneedled. Like if I'm already there and I can slap on an extra, listen, I know that like some people like they're saving money so that's not cost effective. But my point is, is if you're doing your skincare on your face and you have extra, put it on your arms. Put it on your hands. Like use it where you can use it. Don't just wash it off. I do nice and I'm out on my hands. I do vitamin C in my hands. I do retinal in my hands. Actually, any of my actives that I use in my

skincare routine that build collagen, improve your skin barrier, help with dark spots, goes in my neck, goes to my hands. And it's game changer, I think. I got a different curveball question for you because I know we're getting close on time. For obviously, you have a skincare routine and I now have a skincare routine. But a lot of men are resistant. Even like friends of mine, now they're like, you know, they're looking like old dusty. One of his crust bucket friends brought no moisturizer or sunscreen on a trip that we were on for two weeks. And I go, what's going on with your skin?

He goes, I forgot a moisturizer. I'm like, you need some of my claustrum serum right now. I dragged him downstairs. This is not okay. You can't just go away for two weeks and be like. Can we talk about crust bucket? Like what? That is a...

A lot of my guy friends now are coming to me and they're like, you know, they've seen a drastic change, right? And they look like old weathered saddles. And it's still, even with that, it's hard to convince men to do a skincare. Do they think it's like maybe they think it's feminine or they think it's like weird to have a routine? But the more people I've talked to and the more I've learned about skin, I'm like, you know, you lead with your face. You want to have healthy looking skin. You don't want to look sickly, right? You sound like I robotically went in your body and made you say that you leave with your face.

But anyways, it's taken a lot of drumming into me. And again, I have these conversations. But for men that come in. Like, what is the easiest way, in your opinion, to get men to develop a skincare routine and think about taking care of their skin? It's with men, I love using combination products. I'll be honest. Like, get a sunscreen with, that's moisturizer sunscreen combo. But I mean, what do you tell them to get them?

No, he's saying like multitask like how this has niacinamide and the vitamin C. They can just use that. What do you tell them when they're resistant to even want? to implement it. Because again, like I said, a lot of men for whatever reason, they feel like uncomfortable having a skincare routine. Well, first I find out why they're uncomfortable with it, right? Like a lot of people, if it's like image wise, but they're like, I don't want to like look like I'm doing makeup and stuff. They think it's like not manly. Exactly. So then I'm like, your skin is dry, right? And most of the guys are the ones with beards. You're a crust

bucket. And I don't say that, but I might start using it. But most of the time I look at someone's beard. This is what always gets them. I'm like, I look at their beard. I'm like, you're like really flaking in your beard. Yep. I was just going to. And then they get so like, it sounds like bad, but they get like more self-conscious about that. And I'm like, you know, you should really moisture your skin's really dry. You should moisturize it. And I'm like, you should just use this one as sunscreen knock out two steps in one. You don't need dead skin. If I was a dermatologist and I saw a guy in my office that was resistant, I would do exact. I would be like, you know, you're a little crusty. just to call someone crusty and like it's done.

No one wants to be crusty. Cresty the clown. No one wants to be crusty. Just be like, you know, there's a, the flake thing is great. A little flaky, a little crusty. There's a little crust hanging off your eyebrow that would go away with moisturizer. Done. It's done.

That's all you do. So that's one way. And the other way is the scare tactic where like I have authorization from some patients that I've had really big skin cancers remove off their face. And I'll literally show them like a face flayed open. and I'd be like, you could have that if you don't wear sunscreen. Carson is logging on to L'Oreal to buy the Bright Reveal. SPF 50 right now.

I'm going to leave the link for the product that you recommended and your TikTok in the show notes so you guys can just go shop. Maybe you can send us some of your tips. We'll put them in the show notes. The products that you recommended. The passive multitasking products that you recommended. I think it's so smart to find products like you said that have multiple ingredients. people don't get overwhelmed. Where can everyone find you,

pimp yourself out if they want to book with you virtually or in person? Social Dr. Tomasian on Instagram and TikTok. My clinic is the Dermatology Collective. I'm in Glendora, California. I do virtual appointments. I do in person. You could do those appointments at the dermatology collective.com or just linking my bio on Instagram. And your TikTok is off the charts. If you guys want to go, Watch some super interesting myth busters, ingredient information. I think it's really cool what you've built. We'll link it all out.

Thank you for coming out. Thank you for coming up. Thank you. Thank you. Discover the new bright reveal dark spot duo. Visit Target online and in store to buy yours today. All the info is linked in the show notes.