Well with Arielle Lorre - 458: Rhode Dermatologist Dr. Dhaval Bhanusali’s Guide to Great Skin at Every Age Including Lasers, Barrier Repair and Why Koreans Do Skincare Differently

Episode Date: May 20, 2026

Dr. Dhaval Bhanusali is a board-certified dermatologist, skincare formulator, and the founder behind Hudson Dermatology & Laser Surgery. He’s worked on brands including Rhode and ELM Biosciences and is known for combining cutting-edge cosmetic dermatology with a deeply science-backed approach to skin and hair health.In this episode, we get into the treatments, ingredients, and routines that are actually worth your time and money — and the ones that probably aren’t. We talk about the most overrated and underrated skincare ingredients, the one thing that instantly makes skin look better, why lack of sleep shows up so dramatically on the face, and how overdoing skincare may actually be damaging your barrier and accelerating irritation.Dr. Bhanusali also breaks down adult acne, rosacea, preventative Botox, how to make Botox last longer, hair loss lab markers, hair growth treatments, and the real differences between exosomes, peptides, and growth factors. We also discuss how skincare routines should evolve through different decades of life, why different cultures approach skin differently, the science behind LED masks, and what really goes into formulating products for brands like Rhode.This episode is packed with practical, nuanced advice on how to actually take care of your skin and hair in a way that works long term.You can find more of Dr. Bhanusali on social media at @drbhanusali.This episode is brought to you by:Find Tru Fru’s new greek yogurt product in the frozen aisle of your grocery store now.Go to Hungryroot.com/blonde and use code blonde for 40% off your first box and a free item of your choice.Head to armra.com/WELL or enter WELL to get 30% off your first subscription order.Use code WELL and save 20% on your first order at https://justthrivehealth.com/WELL. Visit livemomentous.com and use promo code well for up to 35% off your first order.Go to Ritual.com/WELL for 25% off your first month.Get 15% off your sitewide purchase and use code well at drinkspindrift.com. This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.Produced by Dear MediaSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The following podcast is a dear media production. This is Well, a podcast about wellness in all its forms. I'm Ariel Lori, and each week I'm sharing unfiltered conversations with people shaping how we feel, live, and look. Come for the substance, stay for the honesty, and leave with the tools to be well, inside and out. I am so excited about today's episode and today's guest. I absolutely adored him and could have spoken to him for hours.

I am talking to Dr. Devil Banu Sali. He is a board certified dermatologist. He's one of the most sought after experts in skin and hair health, and you've probably seen and used his work everywhere without even realizing it. He's worked with major brands, including Road and Martha Stort's Elm biosciences. He is known for being incredibly ahead of the curve when it comes to both treatments and formulation. And in this episode, we get into all of the skincare questions that people People are actually asking right now the most overrated and underrated ingredients, which treatments are genuinely worth the money, how to make Botox last longer, adult acne, rosacea, hair loss, LED masks, growth factors, peptides, exosomes, all of it.

We also talk about why so many people are overdoing skin care and damaging their barrier in the process. We talk how routines should evolve over different decades of life. And the one thing he thinks instantly makes skin look better. This episode is super practical, very nuanced, which is important, and packed with information that will help you make smarter decisions about your skin instead of just chasing trends. So please enjoy this conversation with Dr. Devo Bonosali. Welcome. Thank you for having me.

You have such an amazing career as a dermatologist, and we were just talking about just how well those episodes do, because I think that there's so much noise out there and so much confusion. and on the one hand, there's so much amazing information out there, but it's hard for the layperson to navigate. And then, of course, you also are an amazing scientist when it comes to skincare and formulations and ingredients, and you've been behind some major products. So I can't wait to dive into all of that, but first I want to start with a quick, like rapid fire. Let's do that. I like to do that to get a little context. So what is the most underrated skincare ingredient in your opinion right now? That's a good question. I mean, I always have to. to say SPF. It's by default. It's in my blood. But, you know, I think for me, I like all sorts of

things. I'd say I love niacinamide. I love peptides. I think peptides are interesting because we're just scratching the surface, no pun intended, what they can do. And the world is starting to see peptides in a whole different light. But I think as scientists, as doctors, we've always been intrigued by the potential. What is the most overrated? I have to say vitamin C. Really? Yeah, yeah. Listen. There's just better things now. There's definitely better things. I'm going to give you an When we were younger, we were told we had to drink milk or we'd break all our bones, right? Our parents probably told you that. We all pretty much stopped drinking milk at some point over the last few years and we're all okay,

like everybody's fine. I think vitamin C is an incredible antioxidant, but it's 20 to 30 years ago's gold standard. I think nowadays we have much better antioxidants, more stable. The vast majority of vitamin Cs that are out on the market, by the time you open up the container, they're inactive, they're starting to degrade. So, you know, I think for me it's always been kind of a push-pull because you want people to use good ingredients. Also, a lot of people can't tolerate them. A lot of the vitamin C derivatives are pro-inflammatory.

So if you have a little bit of rosacea or sensitive skin, you might react to it. So as a germ, we've seen a lot of people just get better by stopping the active ingredient. Yeah. I want to circle back on that one because I feel like we're all potentially doing way too much. 100%. So I want your opinion on that. So bookmark that. What is the treatment that gives you the most bang for your buck?

So I'm a laser guy. I think lasers are phenomenal. I think they should be part of your routine. for maintenance, for, you know, longevity is a little bit of an overused term, but I think it's an important way of thinking about the future. I mean, health, you know, the way I define longevity is right now you might go to somebody because something is wrong and you fix it, but you're kind of looking back at all the mistakes. Longivity is looking forward. What are the things you can do today to look better tomorrow or to feel better tomorrow? So I think including lasers, different ones,

depending on your skin type, how old you are, can actually do a ton of good. Okay, we're going to bookmark that one too. Because I think that there's also a misconception that, you can do lasers and then that is like a panacea and you don't have to do anything else, like maintain with skincare. Well, think about working out, right? If you go to the gym, it's part of it. But if you don't eat well, you're not going to see results, right? So if you just eat well and you don't go to the gym, you're probably not going to see results as well.

It's a mix of everything, including sleep and all the different factors that get people to where they want to be. And I think aging, skin care, it's all very similar. Everything has its role, but you just have to make sure you do the right steps. Okay. Conversely, what is a treatment that's probably not. worth it for most people. I mean, on Durham side, like those thread lifts and things, I don't, I don't know why. I did that one. Did you? Horrible. I'm sorry. I've seen a lot of complications from them that come into my office. There's not much you can really do. It's very difficult.

And it's just, I think sometimes, you know, again, a lot of times marketing supersede science and our job. The only reason why I'm on social media, to be honest with you, is to do my best to educate because I feel like people need to know. Marketing can get scary sometimes. So we do our best to to help solve those issues. Yeah, I agree with that. What is one thing that instantly makes the skin look better? makeup. No, I mean, it depends. I think sleep is probably the best thing. You know, it's the most underrated thing you can do. And even if it's your fitness recovery, your skin, I know for me, if I don't sleep well for a couple days, my skin doesn't look great. Yeah. There's conditions like rosacea where it's an inflammatory condition. You can have breakouts and

things like that if your body's a little bit off kilter. And sleep does play a role in that kind of stuff. Why is that? Because I haven't been sleeping while the last few days. And I'm like, my skin, it's horrible. Like, it's the first thing to go. So what is the mechanism of that? I mean, there's a lot of direct and indirect reasons for it. I mean, just play the stress card, right? Your body's at a little bit maybe higher stress. Your cortisol might be elevated. Increased cortisol. You have more oil. You're more oil. You're going to have more breakout. It's going to have clog pores. Your texture is going to be a little bit off. Your pore is going to look more dilated. So there's a lot of like downstream effects for not sleeping well. But conversely,

you know, you can try to mask things. I know people do icing and things like that to try to constrict those pores. It's temporary, it does help, but sleep will never not be the most important thing. I agree. Okay. So from your vantage point, I want to talk about what are the main skin concerns that you are seeing a lot of right now? That's a good question. I think in terms of concerns, it's interesting. Adult acne still is a lot more prevalent than people realize. It's a really emotional condition because people feel embarrassed. I feel like after your teens, you're not supposed to have breakouts. Kind of like I said, you know, I think with, you know, as you get older, you might have different reasons. You can have rosacea, right, which is, I always say it's like

acne's frustrating cousin. It's more inflammatory. You're not going to have the oily skin. You might have sensitive skin. You might have drier skin, but triggers like spicy foods, caffeine, alcohol can trigger rosation. You can have little breakouts. Your skin texture changes. And so a lot more people are realizing that. I think because of Zoom, because of all these, like, social media, people are seeing themselves more often, so they're starting to see the difference in their skin texture and quality. We're seeing a lot of people come in for that. But overall, I think, you know, that's been something that's been very common. And I think the other part of it is just aging as a whole. I think people are for the same reasons are more aware that they're aging.

And so they come in a little bit more often now to figure out what to do so they can age a bit better. And do you find that when people come in, they have realistic expectations of what can be done? because I know, like, at least for me, when Instagram stories first came out, that was the first time I was aware of what I actually really looked like. Because prior to that, it was photos. But, you know, seeing your face in movement and whether that's accurate or not, because there's things like different camera lenses and all of that. Like, I don't think we truly know exactly what we look like. But that was the first time that I was like, oh, interesting. And now, of course, I see myself on video every day.

But I remember at that time, whatever that was, maybe six, seven years ago. there was like the inception of, you know, Snapchat filters. And people were going in with their filtered Instagram or Snapchat and being like, make me look like this. Have we moved away from that and people kind of understand like what's in the realm of possibility and not? Or do people still want to look like a filter? Plus or minus.

I think there's definitely that range of people who have unrealistic expectations. They do want to look like a filter. Yeah. I think, you know, for me, the shift has been kind of what we were alluding to before. People now are aware that they should start doing things now. like today to think about a year from now, five years and from now, 10 years from now. You know, we have somebody like a Martha Stewart who looks incredible at 84, but it wasn't what you did yesterday or the day before. It's been a constant stream of things that she's done over

time that's really allowed her to age well. And I think a lot more people are looking at their health, they're aging, everything a lot more seriously and a little bit more analytically and trying to figure out, again, like, what is the plan? Like, what is my, you know, my routine that I can used to get to hopefully a similar place where she is. Yeah. And would you say, because I've had some dermatologists and plastic surgeons and people in the longevity space who have been on the show who have said with all of the advancements that are coming, that are coming pretty quickly, things are kind of compounding because of like AI and just technology and science, everything is moving so fast. If you can hold on for like five or 10 years, there's going to be so many

things that we have available to us, not only when it comes to anti-aging, you know, aesthetically, but also internally. Is that something that you are seeing as well? Yeah, I mean, I was talking to a neurosurgeon friend yesterday, actually, and we're talking about just health and cancer treatments, things like that. Like with AI, the number of breakthroughs are going to exponentially increase, even a simple thought process where they might be doing studies in Europe right now that are important for patients over here. And right now, there's not really great ways of figuring out what happens there. It takes some time from that data to get to us. And it might not even be accepted the same way. I think. with AI technology, the world is kind of together. Now, all the data in seconds will come. Like we have, I get notifications a couple times a week with new studies on certain things from all around the world. That affects how I treat patients, what I learn. I think with hair loss, you're seeing a lot of different, quote unquote, breakthroughs. And, you know, I do hair transplants. I do all sorts of different things. I always tell people in a few years, what we're doing now is going to be so different than what we're doing then. And it's, you know, it might not be

about holding out, but it might be just, you know, again, doing the right steps. Like, again, small differences now might prevent a hair transplant for a few more years where you have a whole different kind of slew of opportunities for you to get treatment. You probably know that I have a sweet tooth. I have to have something sweet after dinner every single night, sometimes even during the day. And I love a sweet treat moment, especially in the summer when it's hot out and you want something refreshing, but not something super heavy that leads you feeling gross after. and that goes for at night as well. And lately I am so into the new Greek yogurt line from Truefrew because it hits that balance perfectly. It is real frozen fruit covered in Greek

yogurt so it has that creamy, satisfying dessert vibe, but it still feels lighter and fresher. And what I like is that it actually feels like a good little protein forward snack or post-workout treat. Instead of just eating something sugary for the sake of it, the texture is so good because you get the cold fruit inside with the cream. me Greek yogurt coating. It's one of those things that genuinely satisfies cravings without making you feel like you totally overdid it. They have strawberry, raspberry, which is my favorite and banana. And honestly, they are perfect for summer for that midday snack, that late night sweet craving for something cold after a workout, even just keeping a bag in the freezer when you want a lighter

dessert option on hand. It's sweet and refreshing without being overly rich or heavy. And I also love that it is made with real fruit and frozen, so it feels a little more elevated than your typical freezer aisle dessert situation. So you can find true fruit now in the freezer aisle of your grocery store. One thing that I'm always trying to balance is eating in a way that supports my goals without spending my entire life grocery shopping, meal planning, and cooking. Especially when things get busy, it's so easy to either skip meals, order takeout, which I am very guilty of, or just grab whatever is convenient. And usually that doesn't leave me feeling my best. And this is why Hungry Root is so amazing. It takes so much mental load off because it basically handles the planning

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make such a difference. So you're going to love a hungry root as much as I do for a limited time, get 40% off your first order plus a free item in every box for life. Go to hungry root.com slash blonde and use the code blonde. That's hungry root.com slash blonde, code blonde to get 40% off your first box and a free item of your choice for life. When it comes to gut health, one thing that I think is really important that so many experts have stressed on my podcast over the years is that it's not about taking random probiotics and hoping for the best. Your gut is connected to so many things, digestion, obviously, immune health, energy, even how you feel day to day. And with how much we are exposed to now between processed foods, stress, travel, environmental toxins, all of it, I think

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Listeners who have been listening to me for a long time are going to know what I'm going to ask right now, I think. Is there anything that is coming down the pipeline when it comes to like actually reversing the age of skin? I always say my biggest regret is like being a tannoholic when I was a teenager and in my 20s. And that's something like, yes, we have lasers and thankfully, you know, I'm diligent about SPF and all of that. But like, where are we moving in that direction? So I'll give you two answers. One is, yes, lasers are helping. And they're actually showing that you can undo some of the sun damage and photo damage you have with fractionated lasers.

So even if you're not coming up for rejuvenation, there's more and more evidence that just to prevent the sins of yesterday, as they say, doing a laser is a good idea. And I look at it medically, like if you have a chance of getting a skin cancer and things like that down the road. And if I can slow that process or prevent it, I'm always going to recommend that, right? Yeah, because they sloth off potentially pre-cancerous cells, right? Exactly. And so that I do think we're getting more and more insight into it. So we have a lot of patients who come in, not for aesthetics, but just to like prevent hopefully, you know, some bad things that might happen.

I think with skincare now, we're starting to measure things. We did a study, we haven't published it yet, but it's coming soon. Where we look at advanced objective imaging, utilizing AI, epigenetic studies. We can figure out your cellular age based on, you know, independent lab work and actually see are we reversing your skin age? And again, this whole idea of senescence and cell death and preventing that or slowing it down, it's now becoming top of mind. Before it was kind of theoretical, now it's like, hey, we can actually measure this. My hope is at some point we can do the same with hair. I think it's fascinating because 100% of people are losing hair over the age of, let's say,

21, then how do we slow that process down? So I think, you know, again, as a collective medical group, we're looking at things a bit differently. And it's coming very, very rapidly. When it comes to things like senescent cells is the most effective way to approach that topically for skin or like internally with a supplement or something? It depends. Supplements I think are having their moment right now. I think the science needs to catch up a little bit. You know, we worked on a supplement and it was interesting because we have for one of our projects for Elm, we have 350 plus dermatologists. Everybody has a lot of different opinions on things. And so it was really difficult to kind of understand what everybody was thinking. So we started creating conversation. And I think

the idea becomes everybody has different reasons for recommending different things, but there are certain ingredients that most germs do like or recommend for their family, their friends. But measuring that's a little bit tougher. And so we have to use a little bit of our clinical like expertise or experience to figure out like what are the right things to put in there. How much should a skincare routine change from like 20s to 30s to 40s to 50s and beyond? So I'm a big believer. They should change quite a bit. Let's get into that. I think, you know, in your 20s, it's all about kind of setting the stage. You see like this whole college and banking idea is getting a little bit bigger. If I can go back in time, I probably would have started a retinoid when I was like 18 years old and never stopped.

It's probably one of the single best things you can do for your skin over the long term. Can I interject there? Why do we see like in Korea, for example, they have a totally different approach, right, where they're not really using retinoids. Is it just because they have different skin than we have here? I think it's interesting. We did a study. I did one of back, I think, in med school where we looked at skin concerns. We looked at a sense. We looked at a South Asian population. They don't care about aging. They care about pigment. It's something called dyschromia, which is this uneven skin tone. I think based on where you are, you have different genetics, different concerns. You know, they always say with like African American skin, it tends to

age a lot slower. They have deeper crevices when I have wrinkles, but fewer of them, right? So everybody has different exposures, different, you know, again, makeup. So it does vary, but I do think retinoids are one of the best things you can do. And I think the issue is, and, you know, with the Korean market, they're not against retinoids. They just don't like the, exfoliation, things like that as much, they're like more hydrating, which is a great idea. Yeah. I think you'll see the next iteration there of maybe retinoids for sensitive skin because that evolution is happening in real time as well.

Okay. Okay. So you would go back and you would start a retinoid. What else do you like in the 20s? We know you don't care so much for vitamin C. Yeah, yeah. Well, no, I do like antioxidants. I'll take that back.

I think obviously SPF in all age ranges is the most vital thing. If you do like a laser, something like a laser genesis, which tends to be more for toning, for pigment, for acne. It's a light treatment. I think it became popular for red carpets, you know, for gala, things like that. Because it's less downtime. Less downtime. You can go out that night and you'll just, your skin will look better, just your texture and your tone. And within a week or two weeks, it'll keep getting better and better and better. You know, the idea about Botox, prevent under Botox, I'm actually, I'm a fan of it. Again, I don't think you should be doing it in your early 20s or even mid-20s. In your late 20s, if you have a predisposition for

having, you know, some people just have more, you know, deeper wrinkles or earlier onset, It's a good idea to just prevent what we call static wrinkles, right? Dynamic wrinkles are normal, healthy. They're incredible. I love them because it gives you character. But if you start having those kind of, you know, those wrinkles forming when you're not moving your face, then the goal is to create an intervention as quick as you can. Yeah, I started Botox when I was 29.

Yeah. So that's a depending on the person, because some people, like some of my South Asian patients or Asian patients might be into their mid or late 30s when we started. It depends on the patient. I think there's a lot of nuance there. But it's not uncommon for us to have people in their late 20s coming in. And some of them we've been seeing for almost 10 years and they look incredible. And I think it made a big difference.

Do you think that people should fully let their Botox wear off before they go back for injections? I do. I mean, or at least pretty close to it. I like structure. So I just put a, what I have people do is I have them do their Botox. And then I do disport the second time. I like to see which one lasts longer. I like to literally have them come in at three months the first time or four months,

whatever it is, figure out where they are and then set a schedule. And then we put it in their calendar. It's in their Apple, whatever it is, get their Botox, get their disport. And we set it and forget it. And it becomes just part of their routine as opposed to you look bad one day. Because that could be lighting. That could be stuff. I think a lot of times people, I hate to say this, but pray on insecurity.

For sure. Especially in the city, you give them a credit card. They'll swipe it. And so I think you have to, again, have a situation just like working out. Like you can't sway from the process. You have one bad day. You can't change your routine, do all these things. Just keep the routine.

Have patience and trust. the process. I do find that there's a bit of a different aesthetic in New York than in L.A. Yeah, for sure. Whenever I come here, I'm like, oh, I just, I don't know, I see myself differently almost because I feel like there's more of a natural aesthetic here. And I do think hopefully overall people are moving or it's trending more towards natural. Yeah. And moving away from like tons of filler and tons of volume, tons of like freezing your face, you know, like you were saying, dynamic wrinkles, I think are so attractive. Yeah. Being able to move your face and everyone's embracing the 90s now.

Yeah. Listen, I love it. It's the best. I live part-time Miami and it's a different world over there. It's certainly a bit more, I would say, filler maxing over there. Miami and LA are more similar, I think, than New York. Yeah. I love New York because we, I don't do as much cosmetics as I used to do nowadays, but when

we were doing a ton of it, we treated a lot of people who would never expect to get anything. And I love that. Like I love that nobody would expect, you know, this person to do it, but it's, they look it is maybe it's part of their job, maybe it's part of their life. They just want to like maintain. I think that idea of just like aging gracefully is again the most it's like aging is a privilege. I really believe that. And you should embrace the process. I think like I always joke like with smile lines. You don't want to erase them because think about why you get them. It's like joy, right? So you don't want to not have those, but you maybe maybe not want to have them as deep or whatever it is.

Right. So I think the aesthetic is more with what I like, which is understated. I think there's truly art there. Even with Botox, people don't realize. It's not about putting 20 units in your forehead or you can put eight to 10 units very specifically. And literally you want to maximize certain expressions that make somebody who they are, maybe minimize certain other ones. And that way, it's like a palette. You want to make sure that it comes out perfectly. Yeah, and you want to balance.

I feel like a lot of people go and say they just want to freeze their forehead, right? But then there's a lot going on in the lower face. And sometimes like the lower face can affect the upper and midface. 100%. Yeah. We're lucky, I think, in our office. We have all of our doctors are pretty, we're all similar. We never really just like to do a certain area.

It's like, again, it's like, again, a painting. You can't just pick one side and color it in. You have to look at the whole thing. Yeah. Okay, so when we move into 30s, so 20s are what, retinoid, SPF, some kind of antioxidant. Yeah. Right. 30s, what does that skincare routine look like?

So I might, depending on what your skin type is, I might add it a little bit richer of a moisturizer. I start focusing more in the skin barrier. There's a lot of conditions that occur because your skin barrier is compromised. What products do you like for barrier? So I'm a bit biased, but the road barrier cream I do love. And a couple of those products have always been staples. The glazing milk, obviously, I love it.

Those are fun formulations. So it's been incredible to see those out in the world. For me, the antioxidant, obviously we use Elm. For me, Elm is a, it's a very interesting. So I'm a formula. I'm a science guy, right? I'm not a marketing, as you probably can tell. I just kind of like to state the facts.

And for me, when you're using an antioxidant, think of it as like your shield, your protection against everything. Again, with vitamin Cs or whatever traditional antioxidants, it was only a singular role. I love to minimize my routine. How many things can I get in there? So, you know, with that formula, for example, we put squalane, hyluronic acid. So I'm thinking about the hydration aspect. We do something like blue tanzi, which might be a little bit more calming.

We have a very anti-inflammatory kind of cocktail in there as well. And then obviously the antioxidant part of it is a bit more stable than you would otherwise expect. All of these things come together. We also have a little bit of like a tint in there, right? We do that because as you get older, if you think about infrared, all these different things can cause pigment, the issue that people get melasma, stuff like that. So we put iron oxides in the formula to help prevent it. So if you see tinted sunscreens, it's really for people with pigment.

We just put into our everything because I just feel like as we get older, you're going to see those spots and sun damage. So if we can prevent it, I think it's really, really important. The only other difference is now I like to also add lasers and things like that too, right? So beyond the genesis, a clear and brilliant I love, it's a pretty moderately powered fractional laser. I recommend that at least once a year. If you're in your early 30s, maybe twice a year when you're at your mid 30s, just as maintenance to make your skin look good, the texture. Again, your retinoid, you might increase it a little bit in strength.

You know, I think that's important if you can tolerate it. And then you kind of look at the big picture and see if there's any active thing to treat, whether it's again, acne, rosacea, malasma pigment, anything specific, and that's where your active serum can go in. Fiber is one of those things that people know is important, but most of us still probably aren't getting enough of it consistently. And when your digestion or gut health is off, you really feel it from energy, bloating, recovery, cravings, all of it.

The more I've learned about gut health, the more I've realized it impacts basically everything else that you're trying to do for your health and performance. That is why I've been using momentous fiber. Plus, what I like about it is that it's not just a basic fiber supplement. It is a triple action formula with soluble fiber, insoluble fiber, and prebiotic resistant starch. So it's supporting digestion and gut health more comprehensively instead of just checking a box. And honestly, I think a lot of fiber products just haven't really evolved. They're loaded with fillers or artificial ingredients and don't actually make you feel that great. Momentus takes a much

cleaner approach, which is really important to me. It has minimal ingredients, no unnecessary fillers. It's NSF certified for sport. So it's third party tested for purity and quality. I also think people underestimate how much better everything works when your gut is functioning well. You have to attack it from a lot of different angles, from your nutrition to your workouts, your recovery, even blood sugar support. It all becomes more effective when your digestion and gut health are in a good place. So support your gut health and overall performance with Momentus Fiber Plus and get up to 35% off your entire first order at LiveMomenus.com promo code well. I feel like we are in a time now where there is definitely a shift toward more natural, glowy, healthy looking skin. Skin is very much in, especially for summer.

So less heavy makeup, less full coverage, more bare skin. And honestly, when your skin looks hydrated and healthy underneath, everything else just looks better. Your makeup sits better, your skin has more radiance, and you don't feel like you're trying to cover things up all the time. And this is why I love rituals, Hyacera. I think people focus so much on topical skin care, but supporting your skin from the inside out makes such a difference, especially when it comes to hydration and that healthy glow. Hyacera is designed to support moisturized, smoother-looking skin with clinically studied ingredients that work internally to support skin hydration and elasticity. and what I like is that it's not just about temporary glow. In a clinical study, Hyacera led to a significant increase in facial skin smoothness within 90 days. And participants also reported

improvements in elasticity, glow, and radiance. It's one of those things that really complements your skincare routine instead of trying to replace it. I also appreciate that ritual keeps their standards so high. Their products are vegan, GMO free, and tested for heavy metals and allergens, which is so important when it comes to supplements that you are taking every single day. So start high as serra to support your glow without compromising on clean science. Save 25% on your first month at ritual.com slash well. That's ritual.com slash well for 25% off your first month. I feel like once summer hits, I automatically want something cold and refreshing in my hand

at all times, especially during the day when it's hot out or if I am outside a lot, which I am, and I've really been on a spin drift kick lately because it actually tastes different from most sparkling waters. You can genuinely taste the real squeezed fruit in it instead of just vaguely hinting at a flavor, which to be honest, it just makes me nauseous. My personal favorite is the blood orange tangerine. It has that really crisp citrus flavor that tastes so good, ice cold, especially in the afternoon. I've been reading outside a lot in the afternoon when the sun is strong and it's just so refreshing. I also also love that they have so many good flavors depending on your mood. The raspberry lime is really

refreshing. The new cherry is amazing. Island Punch feels so summery. The Nohito flavor is so good if you want something that feels a little elevated without actually making a cocktail. I also appreciate that the ingredients are really simple and transparent. Spindrift is the only sparkling water in America made with real squeezed fruit and you can actually tell the difference. It's lightly bubbly, it's unsweetened. It just feels like a better option when you want something flavorful without a bunch of extra stuff added in. And honestly, it's become one of those things that I always keep stocked in my fridge because everybody loves it. It's great on its own. It's great for entertaining. And it just feels very summer coded to me. So right now, my listeners can get 15% off their next

order of Spindrift. Visit Drinkspindrift.com and use the code well at checkout for 15% off your sitewide purchase. That's D-R-I-N-S-P-N-D-R-I-F-T.com. And the code. as well for 15% off your next order. When you're seeing acne later in life, like 30s, 40s, maybe even beyond, is there a common cause? I mean, obviously hormones, I would imagine. Hormones are going to go awry. For sure, yeah. Hormones are definitely there.

I mean, stress happens. Again, I think rosacea is incredibly underdiagnosed. Spicy foods, caffeine, alcohol, all the good stuff in Earth can trigger. I think there's also a problem with too many products. A lot of my patients, I still remember one. And if she watches, she'll smile. She's on air, on TV, pretty much every day. And she came in with this package of products.

And she's like, she's coming from L.A. And she's seeing me in New York because she was on, I think she was filming here. And I literally told her, we're not going to prescribe you anything. We're just going to stop everything. And she's like, what do you mean? Just stop everything. I'll see you in a week. And she's like, no, like I need something.

I'm like, no, no, like just, you know. And because she was exfoliating like two, three times a day. She was using crazy masks because she thought she was supposed to. A week passes by. her skin is 80 to 90% better. We kind of reestablish. I have something called a two-week rule. We start very, very slowly, and every two weeks will add a different active if we need to.

Long story short, within a month or two, her skin was flawless. And I probably saved her thousands of dollars in skincare products. So I think less is more with a lot of this stuff. Yeah, I wanted to ask you, because you probably see so many, you know, skincare routines and trends and everything online. Are there any that stand out to you as just being like very frustrated? in the position that you're in. I mean, 12-step routines, like, over-exploitation. I mean, come on. You probably hate mine if you've ever come across. It's tough because the issue is

you want people, like I love that people are being educated or at least trying to educate themselves. I think that is a great thing. When they come in with a baseline understanding of what is going on, I love it. We can have really good dynamic conversation. I think this whole idea of trying things, like hair loss, for example, is one of my most frustrating things. There was one rosemary oil publication that wasn't that great. And now people are trying to make rosemary oil in their bathrooms or God knows where. And that was compared to monoxidil 2% that no derm actually recommends. We want 5% once a day if you're female or twice a day if you're male. That's like the standard. So if you're going to go below the standard and create something in your bathtub or whatever it is,

like why? Like why not just go buy the relatively affordable product that you know, was going to work versus spending probably more money on all these different things to get some weird concoction that might cause more harm than good. So I think for me, the most frustrating thing is just I think people try to follow trends a bit more than they should rather than actual expert advice. What about dexteride? I mean, I like dexteride. You know, side effect profile looks like it's not perhaps as as worrisome as people thought it was. There's always side effects with everything. I like topical dexteride. We built a company called skin medicinals. It has topical forms of like high dose monoxide like six or seven percent topical finestriide topical

detestriide there's belief that you have less systemic absorption we've seen really good results but i think it depends on the person like i don't always skip to the top you know i always like to do the smallest intervention and then i like to see what happens for as long as i possibly can and then i'll go stronger if i have to i don't i don't think you have to go all the way here because then you run out of options yeah but you can and your body always kind of likes to adjust to things so you know again a slow and steady process we've done probably more hair patients than i can count But again, the slow and steady wins the race. Yeah.

Okay. So when we get into 40s and 50s and beyond, how are we changing our skincare? Because I think that there is probably a tendency to keep adding more, kind of like what you were saying. Obviously, we know that our skin gets thinner. We lose collagen and elasticity. So is that kind of counterproductive to be like exfoliating more, using more retinoids? Or does it kind of depend on the person? Yeah, it's actually the opposite.

In terms of exfoliation, you have less oil as you get older, right? So your skin might be a little bit more sensitive, a little bit more dry. And so I think the idea becomes that you want, like I think at that point, at least what I've seen with my patient, they want things that work. You know, you start seeing this trend now of more scientific products, brands, starting to do really well. It's because I think the average consumer, by the time you're 40, you kind of like have seen all the marketing.

Like, okay, great, what actually works? I'm willing to spend the money, but tell me what actually works and show me the proof. And, you know, I think that's, you know, that's my favorite. thing because I think we should hold that standard to everything. But we start looking at, you know, again, retinoids, again, stronger ones, peptides. This is where, like, a lot of the actives do make a difference. And the R&D behind them, which might be a little bit more difficult to do, I think it's worth it. And the price might be a little bit more elevated, but again, the people who do it the right way, it's not cheap, but I think it's worth it. Can we get into, like, we're mentioning peptides

a lot, peptides versus like exosomes versus growth factors? Because I think a lot of, you know, people get confused. Yeah, so I'm going to say something and I'm going to humble myself. I did not believe in exosomes. I genuinely did not. Mostly because I'm sure you're familiar. So really think of it as like a package or sorry like a bag. There's a package in the bag. Nobody talks about what's in the bag, but everybody just talks about these exosomes. They're just moving things. So I don't know, like where it's derived from. There's so many questions. So people are marketing exosomes. Like it's the end-all be-all, but nobody really knows what they're doing, right? We actually did a recent study in our office not paid. It was literally for my curiosity. We just got it from a biotech

company. And I wanted to see if we can help with hair loss. And it was monotherapy, so no monoxid, nothing else. And we actually saw some pretty interesting results that were positive. The question now becomes, what is the concentration of exosomes? Again, where are they derived? There's still a lot of questions to be answered before I can be like, yes, these things work. I think any good doctor likes to go on a scientific discovery journey. They have to make sure because, you know, I could be recommending something to you or my mother or, you know, any one of my loved ones. It's, it's all the same, right? I have to make sure I believe in what I'm recommending and it helps you. And so I think we have an obligation to do it the right way. So right now, we're in, I would like to say,

fact finding, where we're, there's signal. There's something potentially there. I can't tell you all the specifics yet. I don't think anybody can. And people who are claiming they can, I think they're just guessing. And so this is where, you know, I'm, you know, I'm. I'm a big, a certain bias, but I'm a big advocate that all these brands out there should have some sort of like scientific or dermatological lens with which they look at things. Because again, you can't just market these like hard-earned dollars that people are spending. They're human beings on the other side of it. So you want to make sure that you're doing it the right way and you're, you know, giving them

your trust and vice versa. They're trusting you. And does that apply to growth factors as well or peptides or is that more just exos? So peptides, I think, have been established for a while. You know, it's something that, you know, early on the road, obviously, we looked at peptides probably before most people had. It actually led the name, you know, some of the names of the products that we had. And, you know, I think you've had, you've seen good results, good data.

I think as you evolve, more and more peptides will come to market. You know, I think they're looking at peptides now for hair loss and for hair growth and all sorts of other things. Growth factors, you know, it's interesting because it feels like kind of a garbage, you know, pale term of so many things. Again, where are they coming from? What are they doing? You know, your body can create natural growth factors.

A lot of these things are, again, people use terms sometimes that aren't really represented of what they're doing and they do it just so they can convince people to buy products. So you have to be careful. Yeah. What would be the ideal morning and nighttime routine if you could build one? Or what's your morning and nighttime routine? Mine? Yeah.

So mine is always changing because I'm always playing with formulations all day, all night. So I'll give you general things. So I cleanse every morning. And again, depends if I'm in New York, Miami, L.A., Europe. Miami is the best. Miami's the best. Everything gets plump and juicy and hydrated. Miami is great for the skin. Usually I start with a nice cleanse. Actually, one hack I do is, so I help with Therbody. I don't know if you've heard of Therbys. They have this depuffing wand. There's an ice, like a cold feature. I like to do that under my eyes and the morning just to wake up. It's really good. And then I'll cleanse. I usually add my antioxidant my own serum. For a moisturizer, I still use my road, usually glazing milk. I use that as a moisturizer if I'm in Miami. I might use the glazing. fluid if I'm in New York or depending on how cold it is, it might something a little bit more rich. I use my SPF that varies quite a bit.

Which do you like? There's a bunch. It really depends. I love LTAMD. I love Nutri Gina has this new like invisible sunscreen. It's like that matifying kind of effect. So as a guy, it's the best if you have a beard. Even if you're not a guy, but if you like to go running, you know, like for me, I run almost every day.

I love it just because I forget it's there. LTAMD makes some great ones. And there's a lot of great options there. A Venn has some really good ones. Same with ISDN. So I like to mix and match depending on where I am, what my skin's like, what the temperature is like. I take supplements in the morning. So I take, I mean, I help formulate it. So I'm biased, but I have to have my vitamin D in there. There's something called Polypodium leukatomies. I don't know if you've heard of it. So polypodium is a really interesting

germ ingredient. Only the derms really talk about it. It's not like a quote unquote sexy social media thing. But we've been recommending it for years to our pre-cancer patients, cancer patients, talking about skin cancers, people who might have pigmentation. Think of it as an oral antioxidant, and photo protective. And this is not exact, so forgive me. But if I were to simplify it, let's say you go to the beach and you get a sunburn with sunscreen in an hour, it might take now two hours to get that sunburn. So it actually can extend a little bit of that protection that you have. And so it's an ingredient that, again, we've been recommending for years. It's one of the ones we put in our Elm supplement. I always make sure vitamin D is good. I do a lot of hair loss.

A lot of people, whoever's watching this, if you're losing hair, check your vitamin D, check your ferretin. Those things are very, very important. So I make sure my multivitamin has everything. That's pretty much it in the nighttime, pretty basic, light cleanser. I use a retinoid at nighttime. It depends. You know, if it's summer, I might use, we have Lerm retinoid that we worked on because I want something lighter. If I can tolerate a prescription, higher strength in the wintertime, I'll do it if it's a richer cream.

A lot of times I just can't because the air is so dry, so it all depends on kind of where my skin. is that? What can you tell us about formulation when it comes to something like road or elm? What does that process look like for you? Do you start with what you want the end result to be? And then you kind of work backwards or are there ingredients that are intriguing to you and then you build around that? So let me flip this a little bit. So think about, we have Martha, right? So think about cooking. You give her and I the same ingredients. You can make two different things. Hers will be an incredible masterpiece. Mine probably won't be edible. You know, one of my biggest frustrations with social media I think was with people critique formulas. Like, well, this has

this in it, this has that. This is low on the inky list. Now, if you look at a recipe, if I were to put salt at the top of, you know, the recipe and it was the most into something, you'd be like, well, that tastes terrible. A pinch of salt is all you need. So with certain ingredients, a pinch of something is all you need to stabilize a formula or to get the efficacy. Also with a formula, a one or two percent might work differently than a five percent of some ingredient. So even like an oral medication, for example, like doxycycline, it's an antibiotic, right? We use it for all sorts of anti-inflammatory things. At a very low dose, we use it for rosacea. So, you know, excuse me, so antibacterial stuff, if you have like an infection,

for rosacea, it's anti-inflammatory, a lower dose. So depending on the percentage of something, it does different things. It might be sometimes that you actually combine two different ingredients where it's like a one plus one equals three. So you can add these two ingredients and kind of complement their roles and you get a much better end result. So formula to me is, again, it's like, it's a, it's truly like art. And combining different ingredients might take forever to get the exact right texture, exact right result. That's why not every, you know, vitamin C, vitamin A, whatever it is, is exactly the same. And don't look for the highest percentage, look for the best formula. And, you know, I think anybody, even exports, I love my Durham colleagues, I love the chemist colleagues, but sometimes they'll

call out formulas. I'm like, how do you know, you don't even know what the active percentage is. Like, how are you saying that this is good or bad? Like, I, you'll never see me critiquing anybody's formula mostly because I don't know what's in there and I don't think anybody does, right? So that's been something to me that's been a bit frustrating. But formulas are beautiful. And it really is like creating a masterpiece. That's why I get so humbled whenever I see somebody with something that I've made or they're posting it. I know on TikTok, I'll swipe through and somebody has a product.

And I just, I think it's like your baby out to the world. It's an incredible feeling. But it is marrying art and science. and I love it. Yeah, and they're trusting you and the formula to use it on their body. I mean, that's huge. Yeah, it's one of my projects is something called, I mentioned skin medicinals. It's a pharma tech platform, but we've worked on prescription products.

People use it for everything from eczema to psoriasis. It is incredible. People have that trust. And when they send results, it's the single best thing. Again, when I see one of those things, my eyes light up, like it is something I cannot describe. And I love seeing patients in my office. But there's only so many patients I could see per day, per week, per year in those four, you know, four walls in my room.

So getting to extend a little piece of my, like, soul to the world is, again, a very humbling thing to do. And I love, you know, the opportunity. Yeah, it's such a massive scale, too, because you've been involved in so many massive brands. I've been fortunate. So far. Sure. You mentioned, like, Martha, she has amazing skin rate. She's in her 80s.

And it's been kind of a confluence of things that she's been doing her whole life. Yeah. What gets somebody to that point? I mean, obviously, sun protection is one. She's very diligent about her sun protection. She actually talked about it. And she came and spoke to the American Academy of Durham Conference. She had Vitiligo.

So Vidaligo, those patches of white skin. She never had publicly talked about it. And she still doesn't, you know, I don't think it's out there too much. But she has to be used photo protection. Right. She's a higher chance of having, you know, certain skin cancers, things like that. She's outside all. Like if you ever go visit her, which I highly recommend,

she'll probably be out on her farm when you go there. should be on her tractor trailer doing God knows what. So she needs more photo production than anybody. She technically should be the exact opposite of where she is. Yeah, that's what's so surprising to me. And she is really, like she's truly, you know, outside farming, gardening, all the things. I know, I saw the documentary. Incredible, by the way.

Yeah. And so I think with somebody like her, you know, for us, even bringing Elm to life, she had been using, like she had asked me to make some products for her because she can't tolerate most retinoid. So most things were because of our relationship, right? She hated retinoids for the longest time because most retinids. because most retinoids are irritating to dry out your skin. You have that two to three weeks where your skin gets red and kind of raw.

She just didn't want to do that. And as you get older, again, you can't tolerate that kind of irritation because your skin is already so dry. So she's like, well, why can't you make one that feels hydrating? And I was like, well, let me work on it. It took me a long time to figure it out, but you get there. You know, with the antioxidant, again, she needs photo protection. She had been using this for a couple years before she said, we have to bring this. We have to bring it to the world.

And so I think with somebody like her, I mean, she's been great. I mean, she's been open about, she's used Botox, but she doesn't do it very often. She doesn't like Botox, honestly. She does the occasional laser. She's been open about that. But I think, you know, again, her regimen of just doing things the right way, caring for her skin, carrying for herself, eating well is the biggest contributors of why she is how she is not just how she looks, but how she lives. Yeah. Yeah.

And that's something that drives me crazy. And I mentioned this in the beginning is when you see somebody who has amazing skin. and they've done things, Botox, lasers, maybe even surgery. But that doesn't give you good skin. Like people conflate the two all the time. Yes, lasers and things like that and Botox can help with, softening lines. But, you know, I believe, this is my non-expert opinion, it's what you're doing 99% of the time that's going to really show. And then the other things are just kind of like the cherry on top.

Well, a lot of times we have patients come in who are wanting, you know, very aggressive things like Botox fillers, all these things. And I'm like, let's just do a IPL or BBL, like the BBL laser or BBL, sorry, the broad-based light. It just clears up the noise. And we've had patients look five, 10 years younger by just removing all the sun damage and that like, you know, again, like that, I would say like the Florida kind of texture. Yeah, yeah, yeah. And that sometimes does more than the wrinkle. The wrinkles are, like I said, it's not as bad as people think. I think a lot of this stuff is based on just caring for your skin and its most holistic way. Yeah.

And you'd be shocked at how well people look by just doing little things. Again, I've had many patients who I just put on a retinoid for like, you know, I always tell people, and this is, again, a little tip, if you start a retinoid, my joke in the office is for the first two weeks you'll hate me, because we might have some texture, some, you know, some irritation. By four weeks, you won't hate me, but you're like, probably assume it doesn't work and you're probably dislike me a little bit. By six weeks, you're convinced it doesn't work and you probably hate me. And by eight weeks, you'll never not use it again because the texture, everything just looks so much better, almost like a Paris filter on your face. And it just looks incredible.

And, you know, again, little things like that for years compound over time. And they're just part of, you know, like eating well when you're working out. It makes a difference. Okay. I want to close with this or that. Let's do it. So quick answers. Retinoid or chemical exfoliation.

Retinoid. Botox or lasers. Ooh. Lasers. Nyacinamide or bar. peptides? You're making me like choose with my children. Peptides. Morning or night routine? Morning routine. LED masks or microcurrent? LED mask 100%. Okay. I'm actually going to go into that one. We have like one minute. So those are legitimate in your opinion? Okay. Yeah. So I actually didn't

think so. So I kept asking everybody for the science. Some people can deliver. Some people didn't. The whole Theribody partnership actually started because I asked them, like show me the science. because I'm not recommending a single thing to my patients that I can't stand behind. There's some really good data. I think nature just had a big piece on it, which is our gold standard publication. It's there. You just have to ask the real questions. How strong is this?

How many LEDs? What is the power of all of it? Are you using it enough? Anything on earth can be useful if done correctly. And conversely, it can not work if you're not doing it the right way. Yeah. Okay. Good to know.

Ice rolling or guasha? Ice or your ice device, your cold device? A cold device. Yeah. eye cream or just take your face cream around the eyes? Eye cream. What's your favorite eye cream? It always changes.

I don't know if I have one. Rock has a really good one because there's a rock mall in it. A really good one. Skin Sudocles has a pretty good one because it has like a little bit of this perlest kind of look. So it actually just looks better. It's actually on my formulation list of things to play with. So at some point I'll probably just make one that I like. But I think a great eye cream, it's a different type of skin.

So I think you have to be mindful of it and it makes a difference. In office treatments or at home consistency? That's a tough one. I would say controversially at-home consistency. I love it. Well, thank you so much for coming on. Tell everybody where they can find you. My office is here in New York and Hudson Yards on social media at Dr. Bonasali. But honestly, like I said, I try to do educational content for any Durham out there who's providing value and education to their patients. All of them. Like I said, it's a privilege to be in this field and to help educate countless people out there. Amazing. Thank you. Thank you very much.

I hope you enjoyed that episode. If you liked the episode, and if you liked the show in general, please take a second to rate, review, and subscribe. It goes such a long way in supporting the show. Follow the show over on Instagram at well.pod. You can also follow my personal Instagram at Ariel Lurie. I'm always sharing great clips from the episodes, and we also have full episodes on YouTube. YouTube as well if you want to watch in entirety. Thanks for listening. Hi, we're the sports bitches. And no, we're not actual bitches. Yes, we are. Like, I'm for sure a bitch. Okay, fine, we are, but that doesn't define us. Yeah, we also love

sports. We don't just love sports. We, like, love sports. Yeah, we're like sports sickos. Sports addicted. Get these sports into my veins. You could call us a couple of sports perverts, which was the other name for our podcast.

Speak for yourself. I'm Rachel Beneta. I'm Sarah Tiana. I'm Megan Galey. And we are the sports bitches. Listen to new episodes of the show every Wednesday, wherever you get your podcasts. Please note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.