The Ultimate Human with Gary Brecka - 239. Dr. Shawana Vali: Healing Skin from the Inside Out, Collagen Degradation & Skin Aging

Starting point is 00:00:00 If you remove all the things that you use for your acne and stuff like, leave it alone for a few weeks. Your skin will wake up and you won't break out as much. You know the skin. You know what makes it youthful. What makes it healthy. But the vast majority of what you talked about was healing the skin from the inside out. It's easy for us to give you thick hair, perfect skin. But on the inside, we're actually coming first with mood, concentration, performance, sleep.

Starting point is 00:00:21 We're all looking at you on the inside out rather than the outside in. When you walk into most cosmetic clinics, you can get lost in the programs that they're trying. trying to offer you without really having a fundamental understanding of which one of these is actually going to give me real skin regeneration. The skin is one of the biggest organs and what it does every day it repairs itself. Let it do the work. God's giving it the cells for it to work. We just need to tweak it a little bit. I always say this to my patients, less is more. So what does a good basic skincare routine look like for you? I would go back to basics again. And I would say, hey guys, welcome back to the Ultimate Human podcast. I'm your host,

Starting point is 00:01:10 and biologist Gary Breka, where we go down the road of everything, anti-aging, biohacking, longevity, and everything in between. And today's podcast guest is a double board certified cosmetic dermatologist that I actually met when, for the first time, face to face, when we were in Saudi Arabia speaking at a Zeno Cell Summit, I was fascinated by her talk. She was already on my schedule, so I was excited about that. But watching her describe skin care as a dermatologist, As something that happens from the inside out, I found really fascinating. And the plan that she uses to approach her patients to restore healthy, youthful skin, really didn't begin with the topical applications.

Starting point is 00:01:54 It began with rebuilding from the inside out. So I'm really excited to unpack this. Welcome to the podcast, Dr. Shawanevali. Thank you, Gary. Yeah. You really did a great job in Saudi. Well, I was put before you, so I couldn't let you down. Why had they put me before Gary?

Starting point is 00:02:10 like the keynote, why am I straight before Gary? It's better to go before me than after me, I guess. Exactly. But you know, what I found fascinating was the vast majority of your talk, and obviously is a double board certified cosmetic dermatologist, you know skin care, and you know the skin, you know what makes it youthful, what makes it healthy, how it grows, how it ages.

Starting point is 00:02:32 And from a medical perspective, but the vast majority of what you talked about was healing the skin from the inside out. youthifying the skin from the inside out. So can we back up a little bit for the people that didn't have the benefit like I did of attending your talk, which I really found fascinating. And it's so incredible how much of what you do I not only do with my private clients, but I also deeply identify with.

Starting point is 00:03:00 I just never really correlated it to all of these positive skincare outcomes. So I'd love to unpack what a typical, consult with you is like and where you start with somebody's skincare journey. Yeah. You even talked about different personality profiles of people that come to see you. So yeah, I'd love to unpack that. Well, we have the privilege of meeting all different types of people and different types of ethnicities, different types of personalities.

Starting point is 00:03:27 So I think as practicing physicians, you need to be aware of everything and experience and everything. I specialize in cosmetic dermatology, medical wellness, regenerative medicine, and longevity. So we've always looked at everything inside out. We've never been like, oh, you've got some acne, or you've got some rosation. We've always been, what's the root cause? Whole person. Where's the inflammation coming from?

Starting point is 00:03:44 So we've always looked at you. You know, it's easy for us to give you thick hair, perfect skin, contour your body to suit your gender, ethnicity, your silhouette. But on the inside, we're actually coming first with mood, concentration, performance, sleep, libido, gut, health, fertility, immune system, muscular skeletal. We're all looking at you on the inside out rather than the outside in because the problem I've got is if you've got an inflammatory skin condition and I'm just doing some laser and resurfacing you with some exosomes

Starting point is 00:04:12 and some fun stuff on the outside of topically like you mentioned. I'm not fixing the root cause. It's going to come back. You're going to be unhappy and you're going to be a very good doctor. Right. What are the major things in your opinion that cause skin to accelerate? I want to get specific conditions of skin like acne, wrinkles, what have you. But what are some of the just the major offenders of healthy skin

Starting point is 00:04:34 that we do to our bodies from the inside out? I think it's just general lifestyle things, right? So right now we're all living multi-hyphenate lives. We've got multiple roles. Our bodies weren't designed in that manner. So you're a man, you're supposed to be a hunter-gatherer. I'm a woman. I'm supposed to be a protector provider.

Starting point is 00:04:53 But yet we're both entrepreneurs. We're both burning the candle at both ends. We've both got multiple businesses and multiple roles. Right. We're pushing our body to limit that we've never pushed it, i.e. the ultimate human, right? So if our body hasn't caught up with what we're supposed to be doing, then physiologically we have to look at you on the inside and optimize that.

Starting point is 00:05:13 And that's why I always say, when I take a consultation, the first thing I do is diagnosing your skin is easy for me. Diagnosing what's happening on the outside is easy. And the first three questions I always ask is who referred you? Because for me, it's like, what kind of aesthetic are you looking for, right? And you can tell that from their friends? Yeah. But also, what kind of journey have you had?

Starting point is 00:05:34 you know, did your friend refer you to me because you're a paramedopause and so she? We fixed the inside first before we came on the outside. Wow. And then I ask, how old are you? If you're in your 20s, you've got social media pressure, you've got lifestyle pressures going on, you're trying to establish yourself. If you're in your 30s, you might have had just your babies and you want to return back your body or you know, you might be starting a new role as in the C-suite in your late 30s.

Starting point is 00:05:56 If you're in your 40s and 50s, you might start your next phase of life. You might have come out of a divorce. You might have, you know, early nests, empty-servi. something else is happening. So I need to know what stage of life you're in. And the third thing I always says, what do you do? Like what kind of psychosocial pressures are on you? Explain to me what role do you have in society.

Starting point is 00:06:15 What do you do? Are you a mother of four at home and you're running a small business as well? Are you a CEO of a hedge fund that you have to like stay up 18 hours and eight, all the time? And then the key thing is we don't move to it. Let's look at your skin. Gary, the next thing we move to is let's talk about your mood, sleep, energy, immune system, gut health, libido.

Starting point is 00:06:31 We go to the inside immediately. Love that. before we even look on the outside. Now, are these, do you do that by, so first you obviously do the console, you get a profile of what the person is like, how which stage of life they're in, but after that, what kinds of testing, because you can't just say mood, mood, hormones, libido, I mean, we need data, right?

Starting point is 00:06:50 So where do you get that data? What kind of lab tests are you running? And what do you think are key markers to be looking at that might be markers that would indicate that you have accelerated skin aging? Yeah. So my patients are seeking me out. aesthetically on the outside because they might have fine lines and wrinkles, folds in their face that they don't suddenly like loss of definition.

Starting point is 00:07:10 They might find that their hair is thinning, they've got receding hairline. They might find that they've got mid-adominal weight gain, which they didn't normally have. So the metabolism's changed, right? They might find that, you know, aesthetically, they've got some cellulites and stretch marks. They're unhappy in certain places. They're not always taught and tight as they used to be. Right. So their body has changed aesthetically on the outside.

Starting point is 00:07:29 Right. But they haven't identified why it's changed from the inside out. So in terms of markers, we do subjective screening first. Okay. And then we, in subjective screen, you can pick up the clinical symptomology quite quickly in terms of storytelling. Is it adrenal fatigue with estrogen dominant? Is it adrenal fatigue with testosterone deficiency? Is it dopamine fatigue?

Starting point is 00:07:48 Are you perimenopause or is this andropause? Is this dysfunctional gut dysbiosis? Is this just poor sleep or disruptive sleep? So on your wellness screening, we clinically pick up the storytelling. But also, you've already given me signs and signs. symptoms in your past medical history. You've already told me in those three pivotal questions what's happening in your life. I'm recently divorced. I'm dating the world. I'm also a CEO of a hedge funds. You've given me a few key things. And then when I'm asking you about your past surgical history,

Starting point is 00:08:17 past medical history and past non-surgical history, like the ascetic stuff, you've already told me if you're a virgin or non-vergian, I like injectables. I actually have only done one laser in my whole life. So I already know where to move the needle with you. And also in that, we ask your quick medical question. Your wellness question, you do IVs? Have you taken an AD? Have you tried peptides? So you've already told me, are you a biohacker or you're not? Yeah. So all those questions I've got there before I get to that clinical storytelling. If I want diagnosis, if I want objective diagnosis and quantifiable, now my men are driven by data, right? Yeah. If I want objective quantifiable diagnostics, I can run tests, I can do your salivary test, I can do your

Starting point is 00:08:57 DHA, I can do your hormone panel testing. I can do all the fun stuff. If I've clinically already explained to you what's going on, and then I'm trying to learn, are you a virgin or non-virgin when it comes to treatment modalities? Yeah. Am I fixing you on the inside first, or am I coming on the outside? Do you understand me and do you understand the storytelling?

Starting point is 00:09:15 We don't even treat you on the first day. Wow. We won't treat you on the first day. We send you home with an interactive treatment plan. We phase it, phase one, two, three. Because say you're a 22-year-old female with a bit of acne on the outside, right? and you come in, you're like, common.

Starting point is 00:09:31 Yeah, and you're like, Dr. Tavali, this is what I look like on Instagram. Right. Yeah. Yeah. And you're like, I want him to look like this. Without the filter. I want this to be like this. I want my acne to be fixed.

Starting point is 00:09:42 Also, my body, it's a bit like I face tune it with the apps. And I'm like, are you sleeping? If you have anxiety, do you suffer in panic attacks? What's your mood like? Oh, I used to have depression. I used to be on an SSRI. I'm not on one anymore. I don't, you know, I am overthinking.

Starting point is 00:09:57 In the middle of night, I do check my, like, my, like, my nose. notifications. Right. So we're like, let's think, let's rewire you first on the inside first. Let's work on the inflammatory cause of your acne first before we come on the outside and start contouring when you unnecessarily. Now, how big of a role does stress play in this? Because you're getting to people's lifestyle choices and a lot of us live very stressful lives.

Starting point is 00:10:20 You know, we're constantly on the go, but we're also constantly engaged and entertained. We're also always immersed in something. And that puts a lot of stress on us, right? just to perform, but to look the way that everyone looks on Instagram, to perform at what everyone expects us, the level they expect us to perform. And we talk about, you know, stress being so detrimental, but what is it about stress? What is the link between stress and the skin? Right. Okay. So we can genetically call it stress, but what stress does is it causes something called oxidative stress, so free radical damage.

Starting point is 00:10:55 It causes breakdown of collagen. Okay, so glycation, breakdown of collagen, turns around and gives you fine lines, wrinkles, open pores, oasis, it can inflame your acne, erasation, pigmentation. But if we go back to cellular cause, pathophysiologically, on a cellular level, you've got the beauty layer of the skin, which is the epidermis. You've got the medical layer of the skin, which is the reticular dermis. In reticular dermis, you've got these great things called building blocks, called fibroblasts.

Starting point is 00:11:19 They produce collagen, elastin, hylonic acid, gags, all the good stuff. stays in the medical layer of skin. Right. By the age of 21, this is degradating. This is really going down with, by a gift from God. You're already aging from God. It's the gift that we don't ever want to open. It's a gift that we don't want, right?

Starting point is 00:11:34 So you've already got that. On top of it, you've got a pigment called melanin, right? Which some of us will get pinky-purply, and some of us will get brown pigmentation. So that comes up with sun trigger, hormonal trigger, environmental trigger. So all these things, when you've got oxidated stress and free radical damage going on, this gets enlightening inflamed.

Starting point is 00:11:52 Because this is in the deep layers of the skin. This is a deep layer. So then if you've got fiberblasts, the building blocks breaking down, that means you're going to get the collagen breaking down. You're going to get the good stuff, like the robust, the architectural of the skin breaking down. So you're going to get the laxity. You're going to get the fold.

Starting point is 00:12:08 You're going to get the fine lines and wrinkles. You're going to look dull. The skin's not going to be glowing, right? Things aren't going to be as tight and taught as they used to be. Right. But then also on the beauty layer, there's something called epidermal cellular turnover. God's given. us the best organ, like the human body is the best organ. We both say it open. No doubt.

Starting point is 00:12:26 But the skin is one of the biggest organs. And what it does every day, it renews and turns over. It repairs itself. Right. But when the beauty layer is a bit broken, then that doesn't happen either. So then suddenly you're exposed to environmental toxins coming in. You're causing more inflammation. Yeah. So that's what happens. You know, I very often refer to the skin not as a barrier, but as a gateway. Yeah. Because it doesn't just keep things out. It lets certain things in. And there's a big, you know, discussion going on right now about the types of things that we apply to our skin, phylates, parabins, you know, toxic chemicals that we find in cosmetics

Starting point is 00:13:06 and skincare products. And what kind of damage have you seen over your career and what do you, how do you advise your patients to go out and select cosmetics, skincare products, makeup, lotions because I think we sort of go through the process of our day and we don't realize the amount of toxins that we piled on was actually at a lecture. This was probably two or three years, two years ago. And this woman was walking through a standard day for a female from brushing her teeth first thing out of getting out of bed to removing nail polish at night before she went to bed. And the number of toxins that were applied to the skin, the nails, that hair, the sprays, the things that we're applying to look better and supposedly feel better.

Starting point is 00:13:57 As she broke these things down, I was astounded. It was like 180, 190 different chemical compounds in a very average day, especially for a woman. So what are some must avoids? And, you know, what do these toxins do? What are some of the toxins and what do they do to our skin? And what do they do in the female body to the hormonal system? Yeah. So, firstly you're lucky you're not a woman so you're not going through you're not going through all the pressures that we have to go through but the pressures are coming your way don't worry yeah I know trust me I know but here's the thing so the key thing here is education I'm quite privileged because we've been

Starting point is 00:14:37 educated with a certain knowledge so I can look at ingredients and say this is going to work on my skin or this is not going to work on my skin okay this ingredient's going to sit on the beauty layer and do nothing apart from cause a barrier right or it's going to go down to the medical low skin and it's going to upregulate the good stuff. Right. Or it's going to cause free radical damage and downregulate the good stuff. Right. So that's the key thing here.

Starting point is 00:14:58 Anything that's available over the counter sits on the epidermis. Okay. If it's available here, go to the medical, you need a prescription normally. Right. For it to work in the reticulermis, you need a prescription. Does that make sense? It makes a lot of sense. So everything you're applying topically, you know, and it used to be a lot of silicon-based makeup

Starting point is 00:15:17 and silicon gels that could hide the pore. and stuff like that. A lot of people have gone green in the environment and they've turned around and said, it's green formulation and we want to be natural. The problem you've got is some natural ingredients aren't going to give you a cellular change that you need to work on the fine lines, the open pores, the lax tea, the inflammation, or that kind of fun stuff. Sure.

Starting point is 00:15:35 So you've got to be careful on the ingredients that you're picking. Okay. But what's good in the industry, especially the beauty industry, that they've taken the no nasties out. So there's been a massive movement in the beauty industry in the last decade that the no nasties list has been cleared out. That's good. And there has been a clean, movement, especially with the likes of brands like Sephora and stuff, where they've come in

Starting point is 00:15:53 with a clean list. But then there's also a movement where doctors have come in and said, actually, these ingredients work really well in the medical layer of skin. But if we can get it to penetrate without being broken down up here, then it's amazing. If it just sits here, it doesn't do anything. I'll give me an example, hyalonic acid, right? Everyone talks about it. Highlonic acid and naturally found in my body, oh my God, let me put it in a cereal.

Starting point is 00:16:15 A thousand times it's weight in water, you know. It's amazing. Best marketing PR can. campaign there is. If you have an inflammatory skin condition, if you're acneic and you use pylonic acid, you're actually causing more dehydration. The molecule was too heavy to get down to the medical layer of the skin. It sits up here and it causes something called transepidermal water loss. It actually dehydrates your skin. Wow. Whereas beta glucone is tiny, tiny, tiny speck of hylonic acid. It can go all the way down to the medical layer of skin and reduces inflammation.

Starting point is 00:16:45 It's anti-inflammatory. So ingredients are key. It's called beta-glucon. Beta-glucin, yeah. Beta-glucon. Which is preferential, especially for my acne patients, my rosacea patients would turn around and said, my skin is so dry, I'm like, you're oily. My skin is so dry, I'm using all these emolients and moisture,

Starting point is 00:16:59 and I'm like, please stop using them. Yeah, yeah. Please don't me. You're deafening, you have an inflammatory skin condition. You have cellular turnover, which increases your aging faster. Inflammation causes cellular turnover that causes your cells to break down faster.

Starting point is 00:17:13 If I take you and your twin sister, if you don't have acne and your twin sister has acne, she will age faster. She will see folds in her skin a lot more easily than you. Wow. So when you have an inflammatory skin condition, we have to dry you up. We have to override your inflammation.

Starting point is 00:17:30 So if you're using emolients and moisturizers, you're making my job much harder. So I think there's a massive key piece needed in education. And whoever you're going to your practitioner, your physician, your makeup artist, your beautician, they really need to understand skincare ingredients or makeup ingredients. Is this lipophilic?

Starting point is 00:17:47 Does it, is it lipid soluble? Is it hydrophilic? Is it water soluble? Does it actually get to the right end point to give us a change we want? Or is it just sitting there doing nothing? Listen, there's what I share on this podcast and then there's what I share with my inner circle.

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Starting point is 00:19:10 Now let's get back to the Ultimate Human podcast. Right. Yeah. Now, what are some, you refer to inflammatory skin conditions? What are inflammatory skin conditions? You're talking about sunburns or are you talking about actual skin reactions like a topical dermatitis? Yeah. So most skin conditions are inflammatory base.

Starting point is 00:19:29 And we, you know, this notion of inflammation is only happening in the last five years where everything's inflammatory base. Right. Every condition. Such a buzzword. You know, everything in medicine is inflammation based now, right? Every diagnosis. But actually, skin conditions are inflammatory based.

Starting point is 00:19:43 inflammation per se just in a general term is cellular turnover, rapid, fast and cellular turnover. That's all it is. So for me, when I'm looking at skin conditions, is this a skin condition with accelerated cellular turnover and damage? Or is it not? So things like pigmentation, acne, rosacea, eczema, psoriasis, despite it having an environmental, genetic, autoimmune predisposition. There's also an inflammatory predisposition. So I have to understand what aspect or modality in my working. am I working on the sebum? Am I working on the inflammation? Am I working on the oiliness?

Starting point is 00:20:19 What am I working on before I can give you a treatment plan? Sure. Yeah. And people that have, you see that there's certain races like Latinos, African American, generally more olive and darker-complected populations where they have a blessing and a curse, right? More oily skin, which doesn't age, but it's probably more prone to different things like breakouts and acne and things like that. And you see that. Or pigmentation. Or pigmentation. So it's not a one size fits all because obviously you're treating lighter skin differently

Starting point is 00:20:50 than you're treating darker skin. But what are some of the lifestyle choices that people are doing every day that are accelerating their skin loss? I mean, their skin age. I think in the world we work in, I think the key things that we see is poor sleep. So sleep hygiene, disturbed sleep,

Starting point is 00:21:11 not getting into deep storage sleep. That's causing that. That's causing accelerated aging. Preach about this all the time. And you, exactly, you say it all the time, your body repairs itself at night, growth hormones produced at night, happy hormones produced at night. The microbiome, the gut microbiome, and the skin microbiome is repaired at night, right? Then we've got cortisol.

Starting point is 00:21:27 We've got stresses, daily stresses. We have more stresses now than we've ever had. We've just mentioned that in the beginning. So that's causing accelerated aging, your free radical damage, your glycanation, all the fun stuff that's happening. So that's causing us accelerated aging. Then I always say this to my patients, less is more. I always said, did your grandmother have this?

Starting point is 00:21:46 Like, did she have access? 14 stage skincare routine. All right, your grandmother had Nivia. She didn't have eight to 12 steps, right? Exactly. So, like, less is more. Like, sometimes you want to let the body, the human organ is so amazing.

Starting point is 00:22:00 Let it do the work. God's giving it the cells for it to work. We just need to tweak it a little bit. So my thing is to distill things and remove things a little bit and say, no, take this away. You don't need this. No, an antibiotic will only fix the bacterial element. your acne.

Starting point is 00:22:15 Raractate will only fix a sebum. It's not going to fix the inflammation. It's not going to fix the scarring. It's not going to fix a cellular turnover. There isn't a one pill for a magic cure. Yeah. And it's actually educating that patient in that way. Now, where do you fall on sun exposure?

Starting point is 00:22:31 Because, you know, I'm... Gary, look at me. Yeah. I come on. I think I've answered your question. I'm a vampire. Well, I hope you're taking vitamin D3 then. Okay.

Starting point is 00:22:42 Yeah. Okay, good. You know, I've always been a fan of morning sunlight because there's no UVA and UVB rays. I tell people if they want to get sunlight, the first 45 minutes of the day is a great time to just get out. And blue light is less as well, right? Yes, and the blue light is less as well. And, you know, it's the UVA and UVBs that really kind of damage our skin. But it's still okay to be out in sunlight.

Starting point is 00:23:02 First thing in the morning, I actually make a practice of it. You know, I just expose my skin to sunlight in the morning. You can tell I don't get a lot of sun. I'm not red and I'm certainly not tan. I'm a white boy like you're a white girl. But so where do you fall on sun exposure? And even more importantly, where do you fall on sunscreen? Because, you know, a lot of sunscreens.

Starting point is 00:23:23 I mean, there have been, what, 18 brands or so pulled from the market in the last 12 years for having some kind of indirect cause, either to skin cancer or some. Carcinogen. Yeah. Yeah, carcinogen. So where do you fall in that realm, with sun exposure and sunscreen? Well, the first thing I say to my patients is this skin. has to match this skin, which has to match this skin.

Starting point is 00:23:43 If you're going to have a burkin bag here and you're going to go like, Allah, wakabur to the sun, and you're going to sit there and like get the sun rays in. Birkin bag. You're creating, you're going to cross wrinkling, fine lines, wrinkle, pigmentation. You're going to get that crocodile burkin you've always wanted. You don't need to be put in a weight.

Starting point is 00:23:56 But you're not going to be put on a weight list. Just put a handle on it. Yeah. That's what I say. You go like, are you going to make a burking bag out of your decoditage. Yeah. So the key thing, the problem with sun is exactly it causes inflammation. It causes a cascade of glycation, oxidative stress,

Starting point is 00:24:10 cellular turnover. aging, all the things we've said before, fine lines, wrinkles, it deflates you, it can age you. Your skin is like an organ, it holds everything in place. If I'm burning it, it's burning it down. Yes, yeah, burning. It's terrible. Literally, it goes down here. The other key thing we need to remember is you mentioned Latinos versus Caucasians or Afro-Caribbean versus Caucasians. We've got, and I'm Indian-African, as pale as I am. Indian-African. Yeah, as pale as I am. Practice in London, live part-time in the Middle East, okay. around the world.

Starting point is 00:24:41 Yeah, you got all the bases covered. Basically. But here's the thing, right? I have melan in me. So if you and I went into the sun, you'd burn quite quickly. I wouldn't.

Starting point is 00:24:49 I have a protective melan in me. So Africa-I have skin. I remember there's 28 different types of collagen. Wow. So all of us have different types. We have collagen one and three. Well, I'm only aware of nine, but well, there's 28.

Starting point is 00:25:00 So there's one in three that we really work on in aesthetics, that we really upregulate. That gives you your strength, your volume, the tightness, right? And then there's four, seven and 14 that work on the anchors between the beauty layer of the skin. and the medical lower skin to hold it in place.

Starting point is 00:25:13 But Afro-Caribbean people have different distribution to Caucasian people. African-Caribbean people have more melanin, so they're protected from the side. Whereas you're not. If the UV damages your cells, you get the aging, you get the glycation, you get the fine lines of wrinkles, you get the sunburn, right? But then on the other hand, Afro-Caribbean skin pigments easily, keloids easily. So I think God's been fair to all of us, right?

Starting point is 00:25:38 Yeah, he's been fair in his distribution. Sun protection is key, whether you're indoor, outdoor, I wear SPF all the time. There's different types of SPF 30, I wear SPF 50. And I also wear sunblock, especially in heat like this. So, you know, I do tend to put the sunblock, especially on the tips on my nose, zinc oxide base. Yes, I'm a big fan of zinc oxide. It blocks it completely. Has the industry come out with something better?

Starting point is 00:26:02 Not yet. Right. Are we waiting for it? Watch and waste. Right. But the non-nanosink doesn't actually absorb into the bloodstream, which I'm a big fan of. Because, you know, if you are going to wear sunblock, it should be exactly that a sunblock. It shouldn't be something that actually passes into the bloodstream and starts our, you know, to disrupt our hormones.

Starting point is 00:26:20 And there is a lot of links between different heravans and thylates and fragrances and things that actually do. Hormone disruptors. Yeah, that are hormone disruptors. And so when you talk about getting into this reticular layer of the skin and actually feeding the fibroblasts or helping the fiberblasts or helping the fiberblowers. last do their job. One of the things I've heard you talk about that I am an enormous fan of are exosomes because these are little vesicles. They're about the size of a virus.

Starting point is 00:26:53 They're about 1-800, the size of a cell. They do penetrate deeply just because of their micron size. Some of them carry high molecular weight, high-lyronic acid. Some carry growth factors. So these, I'm starting to see slowly, and I think you even have a skincare line that contains exosomes. And why did you choose exosomes? And for somebody that's not familiar with what they are,

Starting point is 00:27:16 how do they work in the skin? Why should it be something they consider in a skincare routine? Yeah. So I want to step back a little bit. Yeah, step as far back as you want. You're not in my industry. You're not someone who's seeking me out. Right.

Starting point is 00:27:27 So in terms of asate treatments or treating things, you've got virgin and non-vergent. Okay. So virgin treatments are things you might be comfortable. You don't want needles near your face. You don't want anything external put into you. And that could be things like prescription, great skin care with great formulation, you're vitamin A, your retinone, your exorcerns, your epigenetic formulations.

Starting point is 00:27:46 It could be lasers, ablators, non-ablative lasers. It can be skin tightening modalities, radiofrequency, ultrasound. This is all you're comfortable with because you're not putting a needle in your face. Right, and those are looking to do the same thing to provide either micro damage to that layer so that when it repairs, it repairs itself in a healthier way, right? I would probably call that a hormetic stress, like microtrauma. which in a controlled environment done by someone like yourself that understands what they're doing can be a good thing.

Starting point is 00:28:12 Yeah. I also know people that have over derma roller themselves. We're scarring and stuff like that. And gotten scarring. Yeah. Because those needles puncture on the way in. They kind of tear on the way out with a lot of those rollers. Don't do it.

Starting point is 00:28:26 Okay, good. Yeah, you know, because we, Sage and I, when we first started our business, we had a girl working with us, beautiful, early 20s. and she discovered derma rolling, and I'm not kidding you, in three years she had completely destroyed her skin. It looked absolutely terrible,

Starting point is 00:28:44 and she was actually developing these scars. But I want to go back to some of these topicles. I mean, you have a skincare line, but I want to go back to some of these topicals and what exosomes are doing in the skin and why these biologics are. So I'm going to come to the biological formulation in a minute. Sorry, so you've got the virgin-style treatments,

Starting point is 00:29:03 and then you've got the non-vergian-style treatments. And on the Virgin, like you said, it's a controlled inflammation, it upregulates the medical layer of the skin, it tightens you, it cleans up any pigmentation and stuff like that. It works on different modalities. Then you've got non-virgin where we might do intradermal exosomes, where we might inject hylonic acid mixed with exosomes, where you might insert biologic such as PRF, PRP,

Starting point is 00:29:23 your own growth factors. Or we might use biostimulants such as PLLA or calcium hydroxyapotide to regenerate the dermis or even the bone on the periosteal level to tighten you. So these are non-vergium because I'm, I'm using a foreign body into you, right? So when it came to skincare and skincare formulation, there are only certain things that are licensed

Starting point is 00:29:43 of a certain prescription strength that we were allowed to use. But the key thing is here, when you're looking at an ingredient, you want to look at bi-availability. Does this amount actually get to the endpoint or does it go to Pairs Pasoan, does it just sit on my skin?

Starting point is 00:29:56 Does it actually get to that cell we're talking about the fibroclas or the melanin or the keratin side? What cell does it get to and how much of the bi-availability actually gets there? And then what does it actually do? What was the outcome of it?

Starting point is 00:30:08 And I think that's the key thing. I can name exosomes to you. They're exoscelio vesicles. You know, I love them. You love them. Right. We love them in longevity medicine intravenously. We love them in our hair, introscapulet to get hair growth from the effluvian phase, a shedding

Starting point is 00:30:22 phasetis. You're talking about exosomes. Exosomes, right? We love them into germany, to cellular regeneration and grow, right? But what exosomes in formulations do is they create, they give signals to different cells to give you the output that you want. Wow. So they can take growth fat,

Starting point is 00:30:35 DNA, MRNA, RNA, RNA, and they can say, okay, produce more collagen. Really? Make more fiberglass. They can literally send this signal to the, wow, that's fantastic. And that's why it's really, it's going to be, they're not going anywhere, as you can tell. And that's why it's really important in epigenetic skincare that if you are using exosomic formulation, that the bioavailability is actually there.

Starting point is 00:30:56 Yeah. Now, also the, and by bioavailability, you mean that that exosome is still viable enough to perform its function, right? They're not really living things, but they can also be inert because they're destroyed by heat or what have you. Or the delivery system is inept. You know, and I hear the terms collagen, elastin, and fibrin. Yeah. You know, obviously these are all involved in the scaffolding of the skin, the structure of the skin.

Starting point is 00:31:21 For someone that's not familiar, you know, what is the difference between collagen, elastin, and fibrin in the skin? And are there different ways to stimulate each of them and why are they each important? and having youthful looking skin. And then collagen is the main player. Okay. So you've got the building blocks of fibblasts and collagen is actually the main payer. It's a protein, right?

Starting point is 00:31:41 Yeah, and in the dermis, it's collagen fiber one. About 80% of your dermis is collagen fiber one, right? Okay. There's one in three, but it's more one than anything. And then fibrin and elastin, fiberin helps give your fiber in terms of the fibers. So if I stimulate it, you can actually get fibrosis as well.

Starting point is 00:32:00 It can go the other way, right? And then elastin is that, you know, that tensile, do you want it to be loose and lax or do you want to be tight? And you actually want things to bounce back. You want it to be tight, but you want to bounce back. With age, you get the laxity. It's not going back up. So can you remember those days when you used to put on weight and lose weight? Yeah. And the skin never expanded. Right. Or you used to, I don't know if you, you know, if you body training weight and you deep bulk. Yeah. Yeah. You would either, you would either get, you know, lots of guys would get those stretch marks. Stretch marks around their

Starting point is 00:32:29 shoulders and their pecks and stuff because the muscle grew too fast. Exactly. Yeah. So I just say patients, after the age of 35, be very careful of weight gain and loss or muscle gain and muscle loss. Because once you're after the age of 35, you've got significant fibrolast degradation, and your fibroids and lestin is not as strong as it used to be. So it doesn't bounce back. Whereas your collagen, you can keep up regulating it with different treatments that I have. Okay. Most modalities in my industry work on collagen fibers one and three. We don't really concentrate on fibrin and lestin. Okay. So fibrin and elastin, they're going to be, they're, they're being lost at a rate that's commiserate with aging, but the collagen

Starting point is 00:33:09 can make up for that because you're going to increase this protein. So what are some of the ways that you increase collagen in the skin? And then I want to get into some of the topical modalities that people use because I believe some of these are short-term benefit for long-term loss. You know, people are borrowing from their future, if you will, too much burning of the skin, scraping of the skin and maybe you get this youthful rebound. Temporarily. Temporarily. But then you're literally borrowing from your future.

Starting point is 00:33:39 You know, my wife has friends like this that were just laser and derm abrasion and micronealing freaks and skin look great for a period of time. And now it really looks terrible and it's hard to get it back. If you want protein to build lean muscle, but without the caloric impact or need to cut, you need perfect amino. It's pure essential amino acids, the building blocks of proteins in a precise form and ratio that allows for near 100% utilization in building lean muscle and no caloric impact. So we build protein six times as much as way, but without the excess body fat we normally get during bulking. This is the new era of protein supplementation and it's real. If you want to

Starting point is 00:34:24 build lean muscle without having to cut, you need perfect amino. Now let's get back to the ultimate podcast. I think the first thing you said about me was the inside. Yeah. So for me, I don't diagnose collagen degradation because it doesn't present like that. You're presenting with adrenal fatigue or you're presenting with other features, right? And then it's a byproduct of the stress that you're going through. Yeah.

Starting point is 00:34:47 So I'm not focused on collagen, collagen, collagen, I'm focused on getting the inside correct first. I love that. So if we've got adrenal fatigue, then I'm working on that. And is it NAD? Is it peptide program? I can I move the needle? What do you find some ways that people recover from adrenal fatigue? Because we do see women whose cortisol is floored out.

Starting point is 00:35:06 Yeah. They're just not producing cortisol. I've burned out twice in my career. Have you really? I've had a significant burn out twice in my career. So how did you get your cortisol back? Yeah, so I've been completely flawed. I was Eastern dominant with adrenal fatigues.

Starting point is 00:35:17 Oh, dude, the worst. I had to go through, I had to go through rewiring myself. I had to do my routine NAD. I had to turn around. I went on peptide programs. I didn't just go on ACTH-139 and the adrenal fatigue ones. I went on Semak and Selang as well to optimize my mood and cognitive resilience. Yeah, yeah.

Starting point is 00:35:33 So I went on those. And the anti-anxiolytic, that's a peptide. Yeah. So I went on those. And then I went on a microdose on estrogen as well. But now I'm coming to perimenopause. So I'm now changing that up a little bit. So we work on the inside first before I'd work on the outside of your collagen degradation.

Starting point is 00:35:49 On the outside, like I've said before, it's always virgin or non-vergent tools. What are you happy with? in my industry, everything is inflammation basis. It's me causing microtrauma to up, to upregulate the cells to wake them up. So it's either that. But there's a neuro medicine which we spoke about in the Saudi conference called regenerative aesthetics.

Starting point is 00:36:05 That's where your biologics come in. That's where your exosomes are coming in. That's where things like polynucleitides are coming in. That's where profilis come in. That's where your biostimates have now come back again. They used to be out of afatish fashion because like calcium hydroxyapit or PLA used to grow your face uncontrolled biostimulation.

Starting point is 00:36:23 so you'd get that look. And you're like, no, no, I haven't had any treatment. I promise you for two years, it's still growing. Still going. But they've changed the mechanism of action. They've told us to inject much deeper and over dilute. And, you know, they've changed the molecule, right? So they've worked on it's changed the mechanism of action.

Starting point is 00:36:37 So we've got different modalities now in terms of regenerative aesthetics and cellular regeneration that are not focused on just micro trauma, but work on a biological front on the front end, on the outside, but also on the inside we've got regenerative modalities, such as your exosomes, your meson, or stem cells such as your peptides or just natural things like therapeutic plasma exchange or ibup or ibupon. Oh, I love that you're saying all these things.

Starting point is 00:37:02 That's great because, you know, these toxins build up not just in our bloodstream, but in our tissues. And our skin is also a secondary route of waste elimination. Lots of waste is sort of excreted through the skin. And if you're full of toxins, they're going to come out that way. You know. And what happens? Do you remember the days when I don't, you do, you must do intermittent fasting?

Starting point is 00:37:22 You do 24-hour fasting from, I remember. 24-72 sometimes. You're like a legend in fasting. And you notice that your skin just glows. Oh, it's unbelievable. The whites of your eyes, they're bright. And your skin changes in three days.

Starting point is 00:37:36 You know, which is fascinating to me. And that's why sometimes I say to patients, you know, you can't get access to me, but you can get access to my knowledge. You can go on intermittent fasting. You can go into autophagy. Your body can start repairing itself. It can start reducing the inflammation on the inside.

Starting point is 00:37:48 Your skin will start glowing and repairing itself. Yes. You can do a detoxification, remove all these creams that you're putting in for the next seven days. And you'll notice that your skin barrier function will start waking up again. Wow. And your skin will start repairing itself. If you remove all the things that you use for your acne and stuff like, leave it alone for a few weeks. Your skin will wake up.

Starting point is 00:38:08 Yeah. And you won't break out as much. Stopping. Even if you don't come and see me. Yeah. You know, it's funny. I have one teenager now, but I have one just recently turned 21. Both of them struggled severely with acne.

Starting point is 00:38:20 One went on a very short course of acutane. We took him right off. But one of the interesting things, much to your point, was in both of their cases, when we applied the less is more theory, not over scrubbing their face, not always using these facial cleansers. A lot of those are heart benzoyal peroxide and all those pads. Acids. And yeah, the acids.

Starting point is 00:38:46 You know, I found that it really inflamed. the skin, they would go from having acne to really red and inflamed acne. You could tell the skin was super, super irritated. But in both of their cases, both my youngest son and my youngest daughter, their skin changed dramatically when we started skipping days washing it, when they just used warm water, when they actually didn't use any. And they had a little bit of sun exposure, not a lot, but just a mild amount of sun exposure. It actually really started. And, and, and, We focused on hydration and good nutrition. And internal.

Starting point is 00:39:24 And internal. It really started to change him. Well, my wife, who's been very public about this, you know, just recently went through menopause. Yeah. And on the way in, we noticed dramatic changes, mood, emotion, typical hot flashes, but also to her skin almost overnight. Yeah. And, you know, I've been deep down the rabbit hole. of female hormones and their relationship to, you know,

Starting point is 00:39:54 estrogen's relationship to skin elasticity. You know, and when these hormones floor out, the skin very rapidly loses its elasticity. But what was fascinating is after hormone therapy, her skin bounced right back. It was unbelievable. I mean, I think menopause is like if you could sort of design the perfect torture chamber for a woman,

Starting point is 00:40:16 you know, it's like weight gain, water retention, loss of skin elasticity, no libido, sleep detruption, brain fog, and mood swings. There you go. And by the way, we're going to toss in a little frozen shoulder. Cognitive decline. And we're going to maybe toss in some frozen shoulder, just really complicated things.

Starting point is 00:40:34 A couple tonne was really. Exactly. Fun times. And, you know, as we really, I mean, when I got this test back on her, which is called a Dutch test, it really gave me so much insight into how so much could go so wrong so fast

Starting point is 00:40:51 because these things floored out and I really would implore women to really, if you're perimenopause or you're going through menopause, you know, get a functional medicine doctor to do a hormonal evaluation on you. So what have you seen with hormone replacement therapy in men and women and having effects on their skin? Yeah.

Starting point is 00:41:10 So men, again, never come for, I look tired. I've got folds, wrinkles, can you fix that? They don't come. men come, my wife sent me to get refreshed. Yeah. So men never come to me because I've got wrinkles on my face or folds here. Yeah, we're fine with it. You're quite chilled, right?

Starting point is 00:41:27 You throw some jergins, you know, 299 CBS lotion on. I just borrow her moisturiser. I don't care what I pull in my face. But it's the wife that pushes the man. It's so true. And then when you take the history from, and like I said, we always do inside out, and then I'll find out you're wide and tired, you're running on empty, you're not sleeping, you've got loss of libido,

Starting point is 00:41:45 you've got middle abdominal weight gain, You don't have that drive that used to have. And I'm like, okay, let's do a testosterone test. We've got a little bit of testosterone deficiency. Are we in andropause? Do we even have adrenal fatigue on top? Are we just in andropause? Right.

Starting point is 00:41:58 So what happens in men is that the testosterone declines over a long time. Right. And then with the collagen and in terms of skin, you notice you get the bony resorption. So you get lots of definition of your jawline. You suddenly have that sharp jawline used to have. Right. You also get folds and wrinkles in your face.

Starting point is 00:42:15 It doesn't really bother you because, you know, should look like they've lived. Right, right. It doesn't really bother you, but you look a bit weathered, right? You might get recession of your hairline, and you get the middle of the abdominal weight gain. And like men, again, are always metric-driven. If I change you on the inside, outside is five minutes, you're like, done. Thank you. Goodbye, I'm off.

Starting point is 00:42:33 And I've got different modalities. Again, is it virgin, non-virgin? Do I stick to just pet ties? Do I stick to IV and AD? Simple stuff. Do I do TP, Uber, all that kind of fun stuff? Or do I go on testosterone and replacement therapy? Sure.

Starting point is 00:42:45 Are you ready for that? Yeah. My women will literally take the pencil and they will consult themselves. I need this. I've got this more. I've got this five. I literally woke up this morning and this is a classic line in perimenopause. I woke up this morning and my jails were here.

Starting point is 00:43:03 They weren't there yesterday and they're suddenly down here. I suddenly look like I've aged 10 years overnight. This is what happened to this age. So women, they'll take their pencil and they'll mark it all and say, and I just sit back and relax and I check my WhatsApp. You know like I've been here before. Yeah, yeah, I'm like, here's your charge for the consultation. You've diagnosed yourself.

Starting point is 00:43:21 But the good thing about women is they'll tell you everything and the picture's a lot easier and they're very transparent. Yeah. So the picture's a lot easier. So again, on the inside, are they sleeping? What's their mood like? So we can diagnose perimenopause just on clinical symptomology like you mentioned with their symptoms, yeah?

Starting point is 00:43:36 And they already had that in clinic because they spoke into their friends. We talked to each other all day long. Oh, yeah, yeah. Women just, they're flat out with their friends. And they'll come in. Yeah, they'll come in. I'm going, I'm perimenopausal, right? And you're like, you're 308.

Starting point is 00:43:47 I'm perimenopausal. It starts early in Dr. Wally. Did you not know. You're like, okay, no, not a problem. Yeah, yeah, yeah, yeah. Did you not know. I was like, okay, cool, not a problem. Eastern decline in women just happens overnight, over the cliff.

Starting point is 00:43:59 Right. And it just drops by 30, 40%, overnight. Collagen degradation happens, fine lines, wrinkles, open pores, owing, more inflane conditions. So say you had moderate erasure, you just drank a glass of wine in your 30s. Now in your 40s, you're noticing

Starting point is 00:44:12 broken capillaries, working skin thickening, You've got pores. Your face looks a little bit grubier. The solanness is there. It doesn't look as bright as it used to be. Yes. So you're noticing changes that you didn't see before.

Starting point is 00:44:23 Your skin's thinner. The seramites have gone because the estrogen dries are seramites. The serramides have gone. So you're feeling dry everywhere. You've got hair thinning. So this is what's happening. And then suddenly you're getting the middle abdominal weight gain. You are not eating at all, but you're still putting on weight.

Starting point is 00:44:37 Yes. Retaining water. You're retaining water. So women will come in. And again, do you want to stay in virginaline or non-vergulineine? Some of my women are still. not HRT ready. They're not identical hormone replacement ready either.

Starting point is 00:44:49 So I have to still, I just have to use the tools I have, whether it's peptides, NADs, whatever it is, just to optimize their mood, get them to sleep with the Delta Sleep Indus peptide. What is it that I can do in a natural way that they're comfortable with? And on the outside, it's easy. I've got loads of modalities to thicken their skin, tighten their skin. You know, do they want a biostimunate to lift on the bony level? So they got a jawline definition back.

Starting point is 00:45:10 Do they want an emblaidive laser with exosomes to continue regeneration? Yes. But if I can convince them to go on bi-identical hormone replacement therapy or HRT, a lot of women are now going on it much younger because of positive outcomes. I think so many women are suffering unnecessarily because they have this fear of getting on bioidentical hormone therapy. And I've seen miracles happen for women that are suffering overnight. My wife being one of them, and I'm a big fan. And I've been deep down the rabbit hole in the research.

Starting point is 00:45:37 And some of the studies that linked hormone therapy to breast cancer actually debunked that link. in the very same study just after it was carried on for a longer period of time. I think it was the women's health initiative was the big one that really got a lot of... It's been debunked, right? Yeah, it's been debunked by the women's health initiative. So, you know, if you are listening to this podcast and you're one of those women, you know, don't be scared of seeing a functional medicine doctor and getting on bioidentical hormone therapy. I would they go on it.

Starting point is 00:46:03 Yeah, because it can be... So you've mentioned peptides a number of times. What are some of your favorites for skin? I mean, like the GHKCU copper peptides, do you like BBC? What are your, what are your go-toes? I don't really, I don't use peptides for the skin because I've got so many different modalities already. Gotcha.

Starting point is 00:46:19 So I don't really need to use peptides. I've got better things that can work for it. Okay. But GHKCU is a popular one. Thymosin BET is a popular one. You can do sub-dermal injections or you can just microneedle it in. It's up to you how you want to take it.

Starting point is 00:46:30 For me, I use peptides for the internal stuff. Yes. I don't use peptides for skin. I don't use peptides for hair either. I use exosomes for hair because the cellular regeneration is much stronger. Right? So the outcome is therefore, my patient because if I promise you something, I don't deliver some game over.

Starting point is 00:46:47 Yeah. Like, again, I'm the worst doctor in the world. Especially in dermatology. Yeah, yeah, I'm the worst doctor in the world. So your reputation matters, but also you have to do good by the patient. So I have to say these are the modalities you've got. If it was my hair and my hair follicle, this is what I would use. So I want to talk about the new breed skin technology.

Starting point is 00:47:04 Tell me about that. How are you using that for your clients? So for me, like I've always mentioned, and probably for you as well, biovailability is important. formulation is important. And one thing I didn't understand, I'm a practicing doctor. Yes. I'm a derm, I'm a practicing doctor.

Starting point is 00:47:18 But what I didn't understand is how one skincare brand can work on all of us the same way. I couldn't agree with you more. We're eight or nine billion different types of people. If we're doing personalized medicine, why are we not doing a personalized approach? So then when I was looking at formulation, I'm like, what do I like in practice that is prescription-grade strength? And can I get it over the counter? So I was like, okay, most of the skin products sit on the beauty layer.

Starting point is 00:47:39 So it's not even going where we need it to go. Right. How do I get my 12 favorite ingredients to go to the medical layer of the skin without you need a prescription? Yes. And then how does it treat open pores, oinas, fine lines, wrinkles, pigmentation, rosace, I think all the common things we suffer from, right? Inflammation. But it works on you differently to me because we're different ages, we're different sexes. We have different skin conditions.

Starting point is 00:48:04 Right. So then I wanted an epigenetic formulation. So I took the 12 prescription rate actives. I shrink wrapped it in Japanese technology. I spent about seven years and we lab and formulation in clinical trials and studies. And we proved that it goes to medical leather skin, the meticulermist. Wow. And it upregulates your fibroblasts or your melanin or your inflammatory cytokines or whatever

Starting point is 00:48:25 it needs to do differently to mine. Wow. So if my problem is pigmentation and yours is rosacea, it acts on you differently to me. Wow. Regardless of gender. By it uses cell signaling or something. Self signaling, epigenetics, formulation, that kind of thing. Wow.

Starting point is 00:48:39 So we've done that in our pasted molecule, biomeatine. magnetic, adaptive complex 12. So that's an adaptive skincare. Okay. And that's why you call it adaptive skin care. Adaptive, because it adapts to you. Okay. And then the reason why we call it New Breast Skin Ternel is because I wanted something fun,

Starting point is 00:48:53 you know, like Rihanna Fenty, I wanted something fun. I wanted to be just as cool. Yeah. Yeah. Well, you are pretty cool. I mean, look at your boots. Yeah, thank you. I got styled.

Starting point is 00:49:02 Yeah. And then on the other side, devices, over-the-counter devices. So, you know, your LED mask, your microcurrent devices, you know, does it actually lift and tighten. Right. How do I get my hands on you over the counter without you having to come to me? So I was like, well, Michael Caron

Starting point is 00:49:19 only goes to the beauty layer and the dermis. It doesn't go to the muscle. It doesn't go to the bone. It doesn't go to where we restructure it. When we age from the bone, do you remember grandma, you said, these big, wide eyes, in pictures, and now they're like tiny, beady rhomboidi.

Starting point is 00:49:33 And like the cartilage of the nose is grown and the ears are growing, and the doorlines move forward or backwards. The eyes are beady. Yeah. That's your skull are sore. as you age. Wow.

Starting point is 00:49:42 So we age from the skull and everything else slips off. Wow. And that's why you get the fat parts coming here. Never really thought about it that way. Yeah, and then the balloon deflates, the skin deflates,

Starting point is 00:49:52 so it doesn't hold it as much. So you've got the perioste and the skull resorbing and the balloon resolving. So in between everything slips. Right. So I wanted a technology that doesn't need a transducer gel that doesn't need, you don't need to be like,

Starting point is 00:50:06 use my creams. Yeah, it doesn't need a current. It doesn't, and I don't need to be, you might not like my cream. So don't use my creams. Right. But it was also, I wanted you to be able to take a technology that goes to the bone and it lifts and contours.

Starting point is 00:50:19 It goes to the fat pads and repositions them. That goes to the lymph nose and decongest you. Right. That goes to the frontalis muscle here and releases tension and gets rid of headache. Or goes to the massacist and your teeth grinding tension. It releases it. So this is called transons. It's one called oscillations.

Starting point is 00:50:35 It's vibration technology. So everyone's like, oh, you're based on a sex toy. I'm like, no. We did clinical studies, and we made different sonic wave patterns to go to different anatomical planes to give you different outputs. So we made QTIS, which gives you the perfect bone structure. But each sonic wave pattern gives you different outputs. What does this look like?

Starting point is 00:50:54 Like a handheld device? Yes, a handheld device. It looks a little bit like a sex toy. Oh, it does. But it's in a really cool charging case. It's right. Most women are not scared of those. Let's just be honest.

Starting point is 00:51:02 But it's in beautiful colors. It's like your hormones and your bone. And you're like, throw. Can you use it in public? You can use it in public. And no one's going to say anything to you. Okay, good. It was like, that looks cool.

Starting point is 00:51:11 Yeah, that's cool. She just whipped that thing out on a bus. Yeah, yeah, yeah. Exactly on the plane, you're depuffing. Yeah. You know I'm all about optimizing performance, and lately I've been using the ion weighted vest during my workouts, and it's been a game changer.

Starting point is 00:51:24 It isn't your average weighted vest. It's designed to fit like a second skin, activating your core, improving blood flow, and even helping you with recovery while you train. What I love most is that the weight is perfectly distributed. It doesn't pull on your shoulders or throw off your alignment. whether I'm doing strength training or cardio or just taking a walk, I'm burning more calories, building muscle and pushing my endurance even further.

Starting point is 00:51:48 If you're serious about leveling up your training and unlocking your full potential, check out the ion weighted vest at iongear.com. That's A-I-O-N-gear.com. And you can use code Ultimate for 10% off and start training smarter today. Now let's get back to the Ultimate Human podcast. But what it actually does, the study shows that it changes the cells. There's no point, it's not temporary. With use, you can readdicate.

Starting point is 00:52:13 It's like going to the gym and the muscle. So it reposition, re-educates yourselves. So what you've got, it's a horseshoe shade and then it's got a connecting wire. And some people are really putting force in it to the connecting wire braids. You're like, dude, it's not going to give you a facelift. Just like calm down with the tension,

Starting point is 00:52:29 let the device do its own work. Right. Lifts and contours your face. Repositions a fat pat. It can relieve tension. It can depuff your pace depending on the protocol. And is it using microcurrent or is it using sound wave? No, it's using sonic waves.

Starting point is 00:52:43 Sonic wave. And it's called trans anatomical. So each anatomical plane oscillation technology. Ah. So you know that different tissues respond to different wavelengths. So muscle is going to respond differently than connective tissue than bone. So you actually provide different wavelengths to stimulate those different areas. And we've never really heard of somebody starting with skincare from the bone now.

Starting point is 00:53:05 But that really makes a lot of sense. I never really thought about, you know, skull resorption because you are having osteopinia osteoporosis. These are, you know, de-mineralization of the bone. Why would you not have it in the skull? It makes perfect sense. But it's like when we assess you in the face and you know, you want contour and anything like that.

Starting point is 00:53:25 Some people want their lips done or they want their cheeks down, something like that. The first thing someone looks at is your eyes. Yeah. Next thing is your teeth. Yeah. Fix that first. Yeah.

Starting point is 00:53:33 Forget your lips. Yeah. Get your cheeks. No one's looking at that. Right? So true. So it's understanding. And the reason why we went in and around is because of the journey that we've both been on,

Starting point is 00:53:43 we understand internally what's happening pathophysiologically and histopathologically on each cell, that we can now understand what happens on the outside. Yeah. Yeah. And so is this used in conjunction with a skincare routine? Because I have seen as many as 14 steps in a skincare routine. And I'm like, how can anyone stick to that kind of program where you literally have 14 things? You have an enzyme puncher, then you have a cleanse.

Starting point is 00:54:07 Then you have the, you know, dermatology, you know, the, what do you call it? What's the sandy things? Microdermibration, you know, exfoliation. That's the way I was looking for. Exfoliation. Then you have something that you put on right after that. Then you have a toner. So what is a good basic skincare routine?

Starting point is 00:54:25 Okay, so let's go back to basics. Yeah, let's go back to basics. Regardless of gender, and I always do this, regardless of gender, heritage, age, regardless of the way, like, you know, the 21-year-old sitting in the room, There's 16-year-old syndrome. Then there's me, there's you. 30s, 40s, 50s, whatever it is. Regardless of gender and ethnicity,

Starting point is 00:54:43 there's something that's going on in our skin for all of us the same thing. There's only two things that are happening that we're synonymously feeling the same. We all have fibroblast degradation from the age of 20s, early 20s. Your collagen, elastin, your hylonic acid, your gags are all going down.

Starting point is 00:54:56 That gives you fine lines, wrinkles, open pores, oasis. Then all of us, regardless of ethnicity, have some form of pigmentation. So in me, it's going to be brown and you it's going to be pinky purple or vascular. So fair hair, fair skin, pinky, purple, vascular. Brown hair, darker skin types, brown. So if I'm only just treating those two things, I'm going to be together with that, I'm going to give you the perfect canvas.

Starting point is 00:55:19 So that's just two creams. Obviously, they're my creams, but they're just two creams with my formulation. But if I was going to say to you that you're not going to bother with my skincare, and you're going to go and use two, three products, the only thing I would say to you is use an SPF, use a beta-glucon-based serum. Beta bleakling weight. And I'd actually say to you, wash your face with water. Yeah. That's why I would say to you. And if you can tolerate a retinae or retinol or something vitamin A durative base, because that's the strongest ingredient has the mass and the amount of studies. There isn't anything that's been studying more in our industry. In retina. Yeah. Retinae, retinae, retinal, retinal, whichever one you can tolerate, right? Once a week, twice a week, just to upregulate the fibrogloss. And that's it. That's all I would start with. Really? So, so washing your face with water, applying one of these creams. So just wash and then apply the cream. There's not a multi-step.

Starting point is 00:56:11 You're not a big believer in taking those abrasive things and scrubbing off the layers of the skin. You just gave me the stories of not just your kids, but also one of your ex-employees or colleagues. Oh, yeah, she dermal over-stimil. It was terrible. I mean, she started at 24 by the time she was 20, last time we saw her, she was 27, maybe 28 years old.

Starting point is 00:56:29 And there was a noticeable, you know, scarring on her skin. and she was actually going for laser to try to correct what she said less is more. Because once you've damaged certain cells, you know when you've got the stretch marks? You know when you've got the stretch marks? We can't get it back together. We can't get these borders back together. Have you ever seen anyone fixed stretch marks properly? No.

Starting point is 00:56:49 Even if we do CO2 blazer, if we do carboxy therapy, even if you've got exosomes in there, really tough. You can lighten them a little bit. You can change the pigmentation, but that's about it. And you can bring the borders slightly together, but it doesn't go back to Nuba skin. No. So once you've damaged certain skin, it's really. really hard to bring back. Yeah.

Starting point is 00:57:05 So you've got to be careful. And that's why I talk about the Birkin bag. This skin is thin. The skin under the eye is super thin. The skin around this area is thin and the neck skin is thin. These are the areas you don't want to damage. Yeah, very true. So are there any different, I mean, are there any topical modalities that you think

Starting point is 00:57:22 are great practice? Are there any particular lasers that you're a huge fan of? Because I know there's CO2 lasers, there's ablation lasers. There's class one, class two lasers. There's so much that when you're, you walk into most cosmetic clinics, you can get paralysis of analysis. You can also get lost in the programs that they're trying to offer you without really having a fundamental understanding of, okay, which one of these is going to borrow from my future,

Starting point is 00:57:48 which one of these is actually going to give me real skin regeneration? And changes. Yeah, and real changes. So I would go back to basics again. And I would say, let's first put you on a skin prescription-grade skin program. Okay. Let's re-educate the cells. You've had your skin your whole life.

Starting point is 00:58:03 I'm going to happen overnight. It's going to take me three to four months to give you a good skit. And I always promise you 70% improvement and we aim for 90. Wow. So what we do is we re-educate, we might resurface you. We might use a partial ablative, not full ablative. A full-oblative laser such as CO2, I'd only do my 40s up. Okay.

Starting point is 00:58:21 Post like a facelift or something like that. But I do a non-oblated laser such as fractal, which is less damage, but I'd combine it with exosomes for regeneration, right? How would you apply the exosomes? I could do intraderminally. No, topically or interdermally, one or the other. And then, because that will cause cellular regeneration. Okay.

Starting point is 00:58:39 So you either do microneedling like your colleague did, prescriptory in micrneedling, or you can do a partial laser such as a fractal, which is a baby laser, right? But not an ablative. Fraxel is a light laser, right? It's a light. It's not ablative, it's a lighter version,

Starting point is 00:58:52 not a CO2. You don't need that yet. Okay. And then what happens, we put you in a prescription-grade skin program, just creams for the next six to eight weeks, morning and evening, two minutes and morning,

Starting point is 00:59:01 a couple of minutes in the evening, you yourself within four weeks, you're not wearing as much makeup, pores have gone away. The skin feels tighter. Because we're working on the reticular dermis. We're getting your cells to start behaving again and start upregulating,

Starting point is 00:59:14 to regenerate again, right? Yeah. And if you need another, if you need another booster, we might do another booster. And the first phase of the skin changing, it takes skin cells six to eight weeks, the keratinocytes eight weeks to change their behavior.

Starting point is 00:59:27 Wow. To 12. So the first eight weeks is what I call transformation. And the second phase, and this is the most important phase, I'll call permanence. We want the skin to permanent behave like that for six to eight weeks. And in this program, we increase the active. So we might increase the dose of the retinate. We might increase the dose of the prescription rate actives.

Starting point is 00:59:44 And they're just creams. By the end of it, you have perfect skin. Wow. You turn around and you continue it. And say you started with inflammatory, acety, yes, and scarring. It's a breakouts. I say to you, you know what? In three to four months, you're going to tell me often you're going to complain about one or two spots.

Starting point is 00:59:58 It's like your whole face. because literally if you can go on a steady level and retrain the cells slowly rather than attacking them and blasting them because you don't want to borrow from your future in your own words. Yes. You want to re-educate them slowly and you want them to behave in that way

Starting point is 01:00:13 for the rest of their lives. And that's the key thing. Slow and steady wins the race. I totally agree with that. Is there anything that you know of to actually increase the density of these fibroblasts? Yeah. So the neocogenesis,

Starting point is 01:00:28 that's most of them. Cologenesis. Most modalities are based on something called neocoologenesis, neocologenesis. New collagen formation, right? And what we call it, it's a fibroblast upregulator that increases the density of the fibroblasts. Perfect. If we're increasing the density of the fibrolast, we're increasing everything else. And what increases the density? So it depends. We can do inflammatory-based modalities, or we can do biologics, or we can do virgin or non-vergion, or we can just do prescription-grade ingredients. It just depends what you're comfortable with. That's phenomenal. And then just winding things out, you know, you, you, I won't take you

Starting point is 01:01:02 deep down the private hole of peptides, but I'm a huge fan of peptides and we use them internally for what do you use? BPC 157 for wound healing and repair, something called TB 500 for wound healing and repair. So like post-surgical recovery, anytime someone has like a knee, hip, shoulder, rotator cuff injury, low back, especially if it's chronic and persistent. You do it subcut. Yeah, yeah, You can do it sub-Q. PPC is probably one of the few peptides that's tolerated well orally because it's a gastric peptide. But we find the combination of those two works really well.

Starting point is 01:01:34 GH-C-C-U copper peptide, NAD. I know you're a fan of NAD-D-2, 50 milligrams a day in sub-Q injection or a transdermal patch. In full disclosure, I'm a partner in a peptide manufacturer called Peptual by Vysalius lab sciences. and I chose these guys because they manufacture in a CGMP certified lab. They don't source ingredients from China, and the peptides really work. A lot of the over-counter peptides have all kinds of nasty things in them,

Starting point is 01:02:08 heavy metals, fillers, binders, and very often they're not even peptides. And it's hard for a consumer to know because, I mean, how are you going to evaluate whether or not this white capsule is, you know, rice brand or a peptide, other than, by the fact that it either worked for you or didn't work. But, you know, not being a dermatologist, but having seen the, I would say, the greatest shift in what we see by treating the inside showing up on the outside is when we balance hormones.

Starting point is 01:02:40 You know, you see a noticeable, youthful appearance in both men and women that get their hormones balanced. You know, when their estrogen dominant or the progesterone is deficient or the cortisol is floored out or like you said, stress and inflammation has just fatigued their adrenals. You know, we see it. You see it in the skin. They just look and feel tired.

Starting point is 01:03:04 And in a few weeks, you know, they seem to really, really bounce back. So, Dr. Valli, I, first of all, I'm so appreciative that you came on the podcast because And it's so interesting that we saw each other in Saudi and now we're here in the Middle East. I think this is one of the most fascinating regions of the world because they are growing so fast. And they're so hungry as well. So hungry. Yeah. And they're innovating.

Starting point is 01:03:32 And they're, it's like they want the brightest minds. They want the best food. They want the most educated population. They, you know, they're really thirsty for knowledge in this area of longevity, anti-age. you must be a very popular human being walking around here. I saw you get mobbed after your talk. You got mob too. We both got mobbed.

Starting point is 01:03:52 Yeah, we sure did. So I wind down all of my podcasts before we go into the VIP and we have some questions for my VIP community by asking all my guests the same question. What does it mean to you to be an ultimate human? For me? For me, I'm perimenopause at a moment. So for me...

Starting point is 01:04:13 Full disclosure going on there. If you ask me in two weeks time, it would be a different answer, right? So for me, at the moment, it's just... Yeah, I might be completely different. For me, it's just contentment. For me, the ultimate human, because I've got access to everything. And you're like, you're on a peptide stacking program. I want a peptide stacking program.

Starting point is 01:04:31 I have access to everything. As soon as I see the first red flag of, like, I mean, caused the overdrive, I know what to do. So I'm quite privileged in the industry to have that access. Yeah. So for me, at the moment, it's just contentment. I want to get to that phase where the highs are high, but I don't feel it high.

Starting point is 01:04:44 and the lows are low, but I don't feel them low. I'm just streamlining and, you know, just getting through like content and happy. Yeah. What will be will be and what won't be, won't be, kind of thing. Yeah, you know, I think there's a lot of genius in that, you know, letting go the things that we can't control. Yeah. You know, I've focused a lot on that as I've gotten older or more mature,

Starting point is 01:05:04 whatever we want to call it, you know, frustrating yourself with the things that you have no control over is just, that's only on you, you know. but getting frustrated about the things you can control, it's a little different. But so often things just knock us off our stride during the day that we have zero control over. I don't get frustrated in traffic anymore. I'm just like, that's what it is.

Starting point is 01:05:29 You know, so I'm going to be late. I feel like, especially because you're an entrepreneur like me, we go through such high highs and we go through such low lows that you have to get to a point where you're just like nothing, nothing. Our emotion is so tied to our outside environment, How well did this meeting go? How bad did that mean to go? What are they saying about social media?

Starting point is 01:05:45 Was I validated? Was I not? Yeah. It is. And that's why I say I'm perimenopause at the moment. So ask me on another day, I'll give you a different answer. Yeah, I know. It depends on my cognitive resilience.

Starting point is 01:05:57 All right, Dr. Vali. We're going to go into the VIP room. For those of you that are interested in becoming a VIP, you can head over to the Ultimate Human.com forward slash VIP. This is the community that I am pouring myself into. We do private podcasts. We do live Q&As. I have a Gary AI in there.

Starting point is 01:06:12 that you can ask anything to. You can feed it your labs. You can feed it your genetic testing. You can ask you questions about supplementation, diet, lifestyle, travel hacks. Anything you'd like, I think you'll find it fascinating to interact with the Gary AI. But for the rest of you guys,

Starting point is 01:06:26 until next time, that's just science.

The Ultimate Human with Gary Brecka - 239. Dr. Shawana Vali: Healing Skin from the Inside Out, Collagen Degradation & Skin Aging

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