The Skinny Confidential Him & Her Podcast - 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.

I think the big misconception is people think filler does dissolve like in six months. They're like, it only lasts six months. It doesn't. Like they've done studies, like they've done ultrasound that shows that filler's 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 like threads and stuff that people do. So the filler, I'm not too worried about. There's a lot of other worse 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 or microneedling, something like that. Then go under the knife and spend like $40,000. Dr. Chris Tomasian 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 skincare 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 skincare 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 Grey'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 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 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. Initially, I was like, let me do the 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. 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. A lot of people want to go see the dermatologist, which is very nice as a doctor. Many people don't want to go see your doctor. A lot of people want to go see the dermatologist, which is nice. And then the last thing is, it's a very 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 does that mean? Are you just giving yourself a compliment now?

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 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. Anyone who's listening who has redness and rosacea or broken capillaries. What would you do about that giant growth on Lauren's eyelid? There's no growth. There's no growth. Go watch YouTube. 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. So that's an inflammatory condition. It's genetic. It's environmental. And you get these like broken, basically capillaries or blood vessels around 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 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 skincare, I would say the best thing for redness is the same ingredient that's an afrin nasal spray. That's interesting. I never 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 afrin nasal spray,

spray a couple of 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?

Oximetolazine. Oximetolazine. So you just take a couple squirts of the Afrin, 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. If you're really like a night owl and you're going out at night, I would say do it before you go out at night. But if you're like nine to five 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 730 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, what are the things that you would start that person on? And how has your skincare evolved over time as a man? The first thing I would do is tell them to read your book

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. 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. They have usually more oily skin. So they could tolerate the dryness and irritation from it. Also, I feel like guys' skin is 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? I guess 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? Well, I mean, really where the facial hair is, 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 rhinophymas. So it makes your nose bigger if you have redness around it. You better buckle in. In a few years, I'm going to be looking like a clown. Not always just the redness, but chronic inflammation with rosacea can 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 bulbous bulbous bulbous. You're going to get some bulbous nose as you age and your ears grow. It's a good thing. 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. Well, listen, 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 the far 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. You want to get it to a high normal. 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 the chemicals when everything has a chemical in it. But they'll put lemon and then they'll rub it with turmeric or something, which is anti-inflammatory. Turmeric'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 were 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. That was bulbous nose. But the photo, what's it called? A photo rash? Photo toxic reaction. Yeah. It's brutal. And it lasts so long. It's really common vacationers because they'll drink margaritas at the pool. And then 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 like yeah 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. 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. Okay. One is I could tell when someone's using a heating pad for a long time, you get this kind of spider-like rash that lasts for a while. 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 erythema abigni. 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 erythema ab igni 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 bostick is on the edge of his seat right now because he

got the worst rash anyone's ever seen in history i I've never seen such a bad rash in my life. Oh, shit. My phone's not here. I knew it was there. 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 this day.

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 and the leper that lives in, you know, the old man, he lives in the attic. I was like, that was me for 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 of it. He was itching his back on the carpet because it hurt so bad. He had to itch. I'm going to show you the picture when we started off. It was the worst rash I've ever seen. I took it off my Instagram a while ago because I was just sick of looking at it and I shared it a long time ago.

I mean, I don't know why you shared the rash on the Instagram. No one wants to see that. People didn't really want to see it. Did they figure it out? No. I never figured it out, but maybe you could figure it out. Well, you sound like you're 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 downstairs? And I'm like, no, not here. What the 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 them but i had like these crazy shrimp tacos that your wife insisted 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 it could be family and friends something called erythema multiforme i've never see i've never

heard that one oh did it looks like it was like pretty dusky in the middle sure sure he doesn't want to lose their breakfast my whole body even the penis it was not really there actually it was like torso mostly mouth no face yeah face but not like that anyways people are like what the hell is he showing I'm gonna have to show it now

but the thing you called it what is the thing that you just what is it called that's just what is what is it that's like a 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 so calm down 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 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 a little bit sketchy. And someone was telling me 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 food stuff, you'll have a rash and 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 to answer that,

I think I had more than 1.9 million followers. 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 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 caught 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 the research. They talk about the things that actually make 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 myth busting was a big one and then i recently actually started doing like a couple months ago it's like if you have this use that and that blew up give us give us some of those for example it's like if you have

milia or those like white bumps around the eyes, you should start using a retinol 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 go glance it. Yeah. With a professional.

See, that's the thing. People will do it at home. Don't glance it yourself with a professional. Exactly. But go ahead. So tell me about the retinol. I didn't know that. So retinol speeds up your skin cycle turnover.

Right? So usually if you do that that it will treat a little bit of the milia 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 milia from popping up huh which is really helpful and then stopping like don't use like vaseline or aquaphor around the eyes what about if you have dark circles around the eyes? Ahem, hence me. What would you do then? He doesn't have any dark circles.

Really? Well, yesterday was a little rough and 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. Okay.

The reason it's tough is there's so many causes of it. Lack of sleep, genetics, actual hollowness. 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 retinol. I would use vitamin C and I would use sunscreen. And then honestly, maybe like a caffeine or niacinamide because caffeine will help tighten any of the vessels. Niacinamide is going to help with skin texture, skin barrier, help with dark spots. Retinol 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. Okay. All the studies on retinol are like every night use, but we always tell people start three times a week because if you overdo it, you'll get too irritated, then stop using for like two weeks and then you'll restart it. And the whole point of using retinol 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 hyperpigmentation. What are some things that you would say to try? So first thing is sun protection. Okay. Because if you don't, I mean, 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 if and if you're prone to it if you what are usually your hyperpigmentation 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

it there's something that happens where i got like a sun mustache everyone on tiktok's gonna be mad about that take what do you mean they just i know i know the tiktok how is everyone gonna be mad about that and then everyone's mad about everything you know what i realized it's 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 okay well chris is probably fucking good at this because he's 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 might

trigger someone 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 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 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 from medications, but they're pretty rare medications. So that's not a big one. That's a 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 need that as my facialist either. Stacey does.

Stacey'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 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 the smell like now all the spray tanners would 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 gotta avoid them for like a day yeah but that's you know let it all settle in 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 paintbrush

and sprays her whole body. And I'm like, this is bullshit. You know, how can you say don't like use the, you know, the cleaning supply

and then 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 spray tan. Because you like

that we're out of the sun. Exactly. Like I'm all about it. Fake it till you make it. because you like that we're out of the sun exactly like i'm all about it fake it till you make it anything you will do to not get in the sun and get a tan i'm happy but what about like like if you just wanted like a a decent amount of like daily sunlight will you do it like will you do it at all if the like if the uv is light or will you just avoid the sun completely listen i go out of the sun like you need to enjoy your life there's a very, like I think there's 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 look like this fucking table right you're gonna look like a sheet of paper you're not gonna be i'm gonna be translucent with her first i'll be translucent you'll be like oh

yeah he's he's saying though it it makes your skin like it degenerates is that the right word yeah it like degenerates your skin like it 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.

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 eight 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 chris is 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 stressful yeah i don't want to look at the stocks that's probably a little more stressful yeah 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 carotenoid carotenoid carotenoid think about like a carrot you, 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

and then get an orange tan. Interesting. Which, to be honest, like 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 suntan. But I think it's like either you're going to have to take a lot of that supplement. It can be dangerous to some people. It's like any, like if it's vitamin A derived, that stores, it's a fat soluble vitamin, so it stores in your fat. So I don't recommend it, to be honest.

I think spray tanning is better. So continue with 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 classy. It's like we 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 I even walk in the room.

It's pretty. What did they say? What's the staff say? There's good. Yeah. There's a code word. There's code word. Yeah.

Yeah. Because I don't want to walk in surprised. Oh, it's that surprising. It's 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 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.

Here's 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, out,, long, long, long, long, whatever, wherever you place the filler. And then you go in and you get, 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. Cause 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 jawline 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 only lasts six months it doesn't like they've done studies like they've done ultrasound that shows that filler's in there

for many, many more years, especially under the eye filler. That lasts 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 like 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 the fat, the superficial fat and the dermis, then you can definitely stretch the skin. There's a lot of other worse 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 if microneedling 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. 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 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 canthal, like the lateral part of your eye, the canthus, should go up.

Okay. And that's like more attractive. Okay. And a lot of people are using this filter and it'd be like negative tilt. They're like, dang it, I'm like unattractive. So you don't want

your face to look this way. Oh, great. Yeah. Perfect. You're good. You're good. Trust me. How's my cantilever tilt?

Neutral. Or a little up actually. Oh. Yeah. You'd say good carriers again. Don't look at me. I'm hideous. Your cantilever tilt's

a little off. Is the cantilever tilts a little off is the cantilever tilt where the temple is it's right here like this part right okay so a lot of times when you fill the temple and feel like under the eye you support it and it will raise it up a little bit 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 is going to fix it and it causes swelling. It can cause if it's done too superficially can cause 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 minx. 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 are 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 laugh lines gone. Yeah, you look artificial. Also, it brings the eye down if you get rid of them. we don't want to bring the eye down we're bringing the eye up i have a more um basic question because lauren's gonna go like into a deep rabbit hole which i'm i know i have 21 deep rabbit hole questions but for we were talking to steph shep yesterday on

the show and she was talking like one of her biggest skincare tips that she said she has a great derm and she was basically saying that people should go and find a great derm like yourself. But if you were 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 skin, 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 and those are probably the top three and 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 moisturizer? Vitamin C, retinol? Those are the number one, right? And then I'd go, what is the number one complaint you have? So for you, it'd 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 onness. 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 and be like, you look night and day different. You should go to Chris

and get the laser, he's saying. No, I won't. Yeah, come tell her. Yeah, you should go and get the laser. I mean, that's a quick one, right? What I like about what you're saying and we could keep going is is that, you know, it

is so individual for each person. 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 weightlift. 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 yeah so like you can't and imagine someone's like they go right to the effect he was saying that the cheekbones is actually where you need to be filled not the the folds i rarely ever fill the folds and i'm telling you like 95 of the time my patient leaves 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 protrudes back to 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 the skin with a cheek filler, you know, it's not dramatic, right? You're not like, oh my God, I just put your, you have a whole new face, but like millimeters count on the face. Millimeters 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 piriform 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 because of that hole So do you fill 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's causing that particular issue, they'll jump right to the effect and they'll, they'll try to fix the, what's on the surface and they won't go to the root cause of whatever's causing that particular issue they'll jump right to the effect and they'll they'll try to fix the 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 like 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 all 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 in 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. Yeah. 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. Like there's always, there's something that's causing this problem, not just fix way back. It's always work your way back. Like there's always there's something that's causing this problem not just fix the problem. But I think that's where like 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 browns that. And I try to make videos in between all these things like skincare takes time, procedures. 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, like 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 treats it can stimulate collagen. But you have to be the right skin type. Right. It treats browns. It treats reds. It treats, 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 is, I've been like IPL burns. And you'll see people with like skin type six or like really, really dark skin. And they just get burned from the IPL because it'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. What do you 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 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 they 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 microneedling PRP. Or with sculpture. There's so many other things, 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, 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 superficially. You literally see the thread on someone's, it'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 out the thread and if they're barbed they're like really like stuck into the skin so 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. I did that. 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, look at my new lasers. You know what else people do that with we were laughing yesterday is they do it with like cold punch saunas 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 just because I could tell like you're a go-getter.

You'll just get you get so much energy. We don't have to go on a tangent. 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 it after Botox? I mean, you obviously don't want to roll over Botox, but like how do you use ice as a dermatologist. Okay. Is there any way that you like it after Botox? I mean, you obviously don't want to roll over Botox, but how do you use ice as a dermatologist? It's great for 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. People get an ice bath and shove their face in there for 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 like it's like gua sha. Like that was a huge thing, right? Gua sha is not going to give you a jawline. 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 a hai one 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 niacinamide and all these other things in it but ice or cooling sensation and 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. Like 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 spots, to treat 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. It's 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 PIH or post-inflammatory dark spots from acne and stuff, because they 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 niacinamide and retinol so you'd use this one at night this niacinamide and retinol. So you'd use this one at night, this niacinamide, 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 niacinamide 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 one's 12%? So this is 7%. I want to tell them the exact one that you can get at the drugstore. It's L'Oreal Paris

Bright Reveal 12% niacinamide, and it has ferulic in it. Ferulic, so it's antioxidant and aminosulfonic 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. 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 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 like my sunscreen did so much for my skin right but, 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 have her do it. Then I have my facialist 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 niacinamide on my hands. I do vitamin C on my hands. I do retinol on 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 in 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. Obviously, you have a skincare routine and I now have a skincare routine, but a lot of men are resistant. Even friends of of mine. Now they're like, you know, they're looking like old dust. 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 colostrum 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 that that is a well a lot of these guys 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. You sound like I robotically went in your body and made you say that. No, no, no. But anyways, it's, 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 this 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 wanting 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 look at their beard and I'm like

you're like really flaking in your beard. Yep. I was just going to manipulate it. It sounds so bad but they get like more self-conscious about that.

And I'm like, you know, you should really moisturize, 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 coming out of your beard.

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. Crusty the clown done no one wants to be crusty 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 that's one way and the other way is my the scare tactic where like i have authorization from patients that have had really big skin cancers removed off their face and I'll literally show them like a face

fillet open and I'll 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 like send us some of your tips we 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 so 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 dermatologycollective.com or just link in 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. I appreciate it.

We'll link it all out. Thank you for coming on. Thanks for making the trip. Thank you. Appreciate 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.