It’s the largest organ in our body and one of the most complicated parts to care for. Our skin changes from season to season and is the first to show our age. So, how can you be sure you’re making the best choices for your skin health? In this interview, Dr. Oz sits down with Plastic Surgeon Dr. Arthur Perry to reveal the vitamin everyone needs right now for a natural glow, and the everyday item that could be wreaking havoc on your skin!
Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
You know, I often laugh at these programs where I see and I'm not going to name any names, but I see a six step morning program in an eight step evening program. Who really does that? Well maybe a model like Lisa over here maybe, but or someone on television all the time. But the average person can't do something like that, nor should they do something like that. Skincare really can be easy. Think of that person. Ten thousand years ago there was no skincare. Everyone. I'm Dr Ros and this is the Doctor Os podcast. So Arthur Periour guest is a post surgeon Extraordinarire's got his own skin Caroline. He's written a book called Straight Talking about cousbic Surgery. Just incredibly bright man who's brought a lot of dignity to the discussion of cosmetics and poltic surgery and the like. And I think reflective of what most of my brother in that field actually do, but oftentimes they don't get the air time. So we're on it to happen with us today. I look like Casperty goes today, Arthur, what's going on? That look pretty good? But because of our respect for Arthur and a wonderfulk that he's done in shedding light on a field that's that's remarkably complex and uh and confusing. We asked Arthur to join us as a co author in our book. It's called You Being Beautiful, the Owner's Manual to inner and Outer Piece. And let's start off by talking about skin. It's structure, uh, what makes it shiny and glow and give it the body you want. And and then I want to transition as once we understand a bit about skin, how to take care of it, and then through the show, we're gonna walk through some of the non invasive plastic surgical procedures and finally culminating something you do a lot of which are the more invasive ones, just to give people a pretty good review what their options are. And along the way, by the way, we'll touch on things like hair and nails and other aspects of your external beauty that actually give us a lot of clues about our inner and beauty. And while one thing about you being Beautiful. We wrote the book because we argue that beauty is not some issue of vanity. You know, beauty is hardwired into us. Because at the end of the day, our ancestors didn't have the access to blood tests and DNA profiles and MRI scans. They had to decide in a quarter of the time whether you're a suitable mate for them, so they looked for beauty. So in fact, beauty reflects health and equally importantly, your ability to procreate, So which is why we search for it all the time. And any of you who think that beauty is some vanity issue don't recognize the fact that people who are deemed beautiful get paid more for what they do, they get promoted more often, they report themselves healthier in their relationships, even maybe happier about the relationships they have, And it seems unfair except if you realize that not only are you looking for beauty, but your ancestors looked for beauty, which means that you're beautiful by definition. So all we've gotta do if you don't think you're beautiful is to help figure out with you why that's so uh, And to help you do that, we actually create a quiz. It's called the u Quiz. Take a look at it. You can actually get your survey results back as you take the quiz. It's also in the book, obviously, but the u Q quiz is very simple. It helps assess your perception of how beautiful you are today and compares it to what you want to be. And the closer you are to where you want to be, the happier you're going to be in life, and the further you are the more you work. You've got to do, and you can do two things. You can change who you want to be and you can change who you are today. Both are doable. Arthur Parry's here to help us on the first part of that. So Arthur, I start off with the skin, walk us through sort of the A b CS of how you think about skin health, and along the way maybe we can touch on some of the creams and the light that a woman faces as a purchase opportunity to when she walks into the average store. Well a moment the skin is our largest organ, right it's it weighs the most, more than any other organ in the body, other than maybe a momentum if you're really heavy. But it's not just a container that holds us together. We're not just people like a gel fish with with skin on it. The skin is a very active organ. Now it's divided first into the epidermist, that's the upper layer of skin, that's what's our waterproofing layer. It's our raincoat. It keeps the water out and it keeps toxins out. It keeps all the chemicals out so that when we walk through a farm that's just been sprayed by pesticide, we don't die like an insect. So our epidermist, that's the important layer that really keeps us from the environment. Underneath that is the dermist, and that's our collagen, and collagen is our leather. That's what holds us together. So that's our structure to our skin, and with the epidermist and dermist, that's basically our skin. You know, we hear all the time about the many layers of the skin, but we can keep it real simple. There are two important layers. But the skin does so many things besides holding us together and besides being our waterproofing layer. We make all sorts of hormones and chemicals and things, and the skin interacts with our environment. This simplest way to look at that is the production of melanin. When we're exposed to ultra violet light the light of sun, we make brown pigment to protect us from that damage. Well them ten thousand years ago, how did we take care of our skin, Well, we never went into the water. Ever, when would a human go into the water ten thousand years ago? Fishing? Fishing, that's about it. If we saw something to eat, otherwise we would stay out of the water. And our skin makes important chemicals something called sea bum. Now see bum is a fat, rich mixture of all sorts of things and see them. Uh. It has a lot of functions, and one of the most important functions is it kills bacteria, so that when we have those oils on our skin, we're less likely to get infections. And when we do things like what our modern society has told us to do, like wash our face repeatedly and use all sorts of skin creams and and chemicals, well, we're disturbing the natural function of our skin. And that's why probably there's a lot of exema and a lot of acne and and things of that nature. So some of the things that we teach in the book is, uh, you know what we should be doing to the skin, how we can take care of the skin in a more natural way. And I'm a real proponent of natural ingredients with the skin. So let me go back for a thing, because you mentioned two phrases to two terms that a lot of folks sort of know about but don't know much about. So uh, exema. If we're washing off that cebum all the time, our skin gets desiccated. But what really is exima? What is it represented one of the best ways to treat it well. Exement really is an allergic reaction to something. You know. It's very interesting when you look at fragrances, for instance, Fragrances are very common ingredients in in almost everything you put on your skin. Well, fourteen percent of the population is allergic to fragrance. Four percent of the population is allergic to preservatives. And preservatives are in everything except maybe a bar of soap. And give us a couple of names of preservatives that are commonly out there. Any think off the top of your head. Oh, well, try closen is one of those. Oh, there's fancy medical names. Ben's alconium, things of that nature. All these different preservaves your ea as a preservative, things like that, and they sensitize the skin and they cause allergic reactions. A lot of people tell me as a plastic surgeon that they have sensitive skin. It's usually not sensitive skin. Our skin is pretty durable. What it is is they are allergic to some component in something that they're putting on their body. And that could be anything from their soap to their laundry detergent, to their shampoo to their fingernail polish. And we see it in their skin and the treatments. I know, because we struggle with this within our family. One of our kids, we would give it them Maga three fats. Yeah, because it's not just what you put on your skin that affects your skins. What you put in your mouth too, absolutely, So what else do you tell folks when they have X amount besides O maga three fats. Well, the first thing I want people to do is to stop taking inventory of what they're putting on their skin and try and reverse some of that, some of the allergens. So, for instance, we'll go to a soap that has almost nothing in it, and one of my favorites is Kiss your Face soap. It's got olive oil, water and salt. That's it. Nothing else. But you know, most soaps smell pretty bad because they're made of fat. They're made of large and you can make soap. It's one of the down home things you can do. You can take a Saturday afternoon and make some soap, and you can take any fat you want and make soap out of it, and it smells pretty bad. The only fat that smells good. I don't want to say this in front of Memo Doz, but maybe fat on a grill smells good on your face, that's right. But certainly any other fat doesn't smell particularly good. And that's why fragrance is put into every single soap. For the most part. If you take something like kiss your face, soap doesn't smell real good, but it's less likely to cause an out allergic reaction then other soaps with with an ingredient list that goes maybe fourteen or fifteen long. The other thing you mentioned besides eczema, well, acne is caused by a combination of factors. It's caused by clogged up pores by our own skin. So the epidermist is an active, actively growing part of our body, and we're continually shedding skin. And that's why everybody exfoliates. We do that in the shower, we do that with all sorts of methods. But if we don't exfoliate, and that means if we don't get rid of that dead layer of skin that's constantly growing. It can clog the pores. So the combination of clogged pores, the oils in our skin and bacteria can cause acne. And we know that the oils have a real good purpose. There's all sorts of reasons for it. We we talked about the the antibacterial properties of oils, but you know what else oils do? Oils attract mates. And it's interesting that the skin has an cidic pH so it's around five point five. I don't I don't want to board the listeners, but remember that hydrochloric acid is zero and and lie is fourteen in water is seven. So when we have a five and a half, we've got an acidic skin. Well in two areas of the body a moment, we have a more alkaline skin, and that's our under arms and the volva of women. And the reason it's alkaline is because it allows the proliferation of bacteria in those locations. And why do we have bacteria in those locations Because the bacteria act on the oils of the skin and they create a very characteristic smell. We all know that when you go into an elevator with someone who hasn't bathed, but they send signals to our mates or potential mates. And we talk a little more about that in the book, about these things called pheromones, which are acted on their oils that are acted on by bacteria to create these smells that attract a mate. I love this stuff. It's so cool. A is A And by the way, well you talk a little bit about the fact that puberic care and axillary hair has two primary functions. One is to trap these smells so it gives you a bigger surface area so people around you can smell it. Because some people will love you. I wanted to have that scent near them. It reminds them of you, and they're attracting to a biologically. And the other reason is it probably prevents chafing. But but it's I didn't realize that the pH is different there. It's a very cool insight. We have a lot more to talk about, but first let's take a quick break. So you've got the epidermist to sort of shield on the outside, keeps things out, the dermost being our leather sort of keeps us in. Uh. If you have to give me sort of the a b cs of how to take care of the skin. And it's a complicated area that you know, when if you walk into any store in America, they'll give you their perspective on it, but you probably won't walk out with a lot more clarity than when you walked in. And you you've written a great book, um, straight talking about cosmetic surgery. Which so we've used these but we did our best, and you being beautiful to to knock this out of the park as well, so look us through, Um, how you explain this to people? Well, skincare doesn't have to be a difficult concept. And uh, you know, I often laugh at these programs where I see and I'm not going to name any names, but I see a six step morning program in an eight step evening program. Who really does that? Well maybe a model like Lisa over here maybe, but or someone on television all the time. But the average person can't do something like that, nor should they do something like that. Skincare really can be easy. Think of that person ten thousand years ago there was no skincare and for the most part they got along just fine. I'm not sure we'd want to be in an elevator with that person now, YEA and they probably looked like they were seventy five when they were twenty four. Well, remember, ten thousand years ago, our life expectancy was twenty years old, and in fact, skin and uh, if you were twenty years old, your skin, if you survived to that age, would have been pock marked because the only people that survived to age twenty where people that already survived smallpox or milk maids. Right, milk maids were the people that that actually got naturally inoculated against smallpox. So we look very different than movies. Don't depict people from ten thousand years ago? Is what they really were like. But they weren't pretty as we know them now, but they had skin that was protected by the sebum as you mentioned, and the epidermis and dermas. So what if you would give someone a five step program, And that's what we do in the book, and it was thanks to you that we sort of designed it on these lines. Well, walk it, walk them through it. Okay, Well, skincare requires three things, a bar of soap and a morning protector cream. And and if you were asking me to what the single most important skincare ingredient really is, it's sunscreen. It's sunscreen because the number one determinant of our aging other than our genes, and if you smoke, of course it's all out the window. But the number one determinant is sun exposure. So ultra violet light will prematurely age our skin. So number one, if you're going to buy one product, just one product to take carere skin other than that bar soap, then it's sunscreen. And everybody should have sunscreen on. And it's a level of about fifteen that you should be wearing pretty much day in and day out because a moment you go skiing and veil, and what happens when you when the sun goes hits the snow and comes at you at a an oblique angle. That means it hits your right in the face, and uh, and here it is three months after your your tan has disappeared, so you can get a real sunburn in the winter. So it's sunscreen year round. So that's what you need in the morning. In the evening, I like a vitamin A type cream. Now vitamin a we know it as retina. That's the prescription form, but there are other forms of vitamin A that are almost as good, probably as good, such as retinal which is in a lot of Johnson and Johnson type products. Uh, there's retinal appropriate a, which is a storage type of vitamin A. There's right now to hide. There's all sorts of different vitamin vitamin A, and our skin has the ability to turn one into the other, so we have the enzymes in our skin. So it really probably doesn't matter which form of vitamin A you put on your skin. And vitamin A is a wonderful drug. It's really the only thing that can reverse some of the signs of aging other things. Kind of hold it at bay. You cut open a vitamin capsule and rub it on your face. Probably not, Probably not, because well those are usually in the vitamin A capsules. Those are esther forms. I mean you might get some absorption. Um No, I'm intrigued that vitamin A is so popular, But the most common antioxidants in our skin are actually vitamin C and E. So why is it they're giving the Putting a creamon with CN is not smarter than putting a cremon with A. Well, I think C is probably the number two ingredient. Vitamin A is the most well studied cream ingredient. It's been around for over thirty years now, and we know that it does all sorts of things. It's the first line drug for acne because it decreases oil production in the skin, It decreases that dead layer of cells on the surface of the skin, It fades brown spots. Overall, it just makes your skin look better. But it's interesting moment because if you look at the data behind even retin A only of people that use retin a daily see in the mirror a decrease in their wrinkles. Now everybody, if you take a biopsy of their skin, their skin will look better and younger under a microscope. But the gold standard to you is not what it looks like under a microscope. It's what it looks like when you look in the mirror and and the skin creams that all say, well, you know this helps wrinkles, and this does this and that. Many of those are not backed by real studies in scientific journals. But again, why would you support an A over C an E. If AN is a more common antioxidant than A is, why why why do we even start looking at A more than C and E. Well, A does more, it's more than just an anti accident. Really reprograms the cells to do things differently and to look better. Now, Vitamin C is great because it stimulates collagen formation of the skin. In collagen, as we said earlier, is that structural layer of the skin that thins as you get older. So the child has really thick, nice skin, and the seven year old has almost translicent skin. That's because collagen has declined. Well, vitamin C will not only protect your skin as an antioxidant, but it will also directly stimulate the formation of collagen, and it does that actually better than vitamin A. So I'm not saying one over the other, but if I were to choose one, you know, vitamin are there creams with all three with A, C and E. Well, E is something that we probably don't have to put into our skin creams because the body is very efficient at taking oral vitamin vitamin E that we eat in our foods and it sends it right up through the sevum and and but that's one of the problems with over washing your skin, because when you wash your skin, you're removing the natural oils of the skin, and that means you're removing the vitamin E that your body has placed in the skin. The Vitamin C is so light sensitive that we can't get a lot of very high levels of vitamin C in our skin even by eating it, and it's destroyed probably within an hour or two of going out into the sun. So that's why in my skincare program, we put vitamin C on at night, and when we see vitamin C and skin creams in the morning, doesn't make much sense. It's destroyed. Vitamin E is also destroyed by light, but it takes longer. So once you've sort of gotten your basic program down, your antioxidants on the skin at night, you have a moisturizer with SPF fifteen or greater, usually titani resinc oxide, right, because then it's not being absorbed by your skin. Absolutely very important moment and something that's not been Uh there's not been enough publicity about maybe the dangers of the chemical sunscreen. So I like a physical sunscreen that does not get absorbed into your into your body. All right, So, uh, anybody, we have your own cosmetic line? Is it for sale to stuff yet? You know? Yes, I have a night Skin which is an evening program thanks for the plug, Day's Skin which is the morning skin protector, and a sunscreen and people can buy in stores. I get it free from you, so I've never actually gone and gotten I keep you supply. They can go to night skin dot com alright, and they've used the cleansers to be clear that you prefer the bars because there's less chemicals in them. Uh. And something like kiss your face uh is nice because it's it's only olive oil, water and that's it. That's it, alright, water salt, and so it's very very simple, no preservatives. All right. That's the last part of the program that is exfoliation. Exfoliation is important. Otherwise those of you who have had a cast on know what exfoliation is all about. If you have a cast on for six weeks, you take it off of your leg and you've got that filmy extra skin that just washes off the first time you get in the shower. Well, every single day we exfoliate. We exfoliate for a reason. We look better, our skin looks smoother. And exfoliation is an important part of a good skincare program. It will decrease acne and you do it once a day, once a week, well, once a day with a washcloth. That's all you need. A loopop had a washcloth. Some people like glycolic acid, which is a wonderful chemical exfolian doesn't really matter which way you do it. The issue I keep hearing women complain about UH and when I walk into stores by the way and try to figure out what the advisers are telling people, it always seems that the advice depends on what kind of skin you have, So it's very difficult to generalize. And so someone, for example, has really skin versus dry skin, UH, the the the amount that they would exfoliate would vary, perhaps to kind of moisturize that they would use with very Is it really possible to create a cookie cutter model for this or is it too too complicated? No? I think most people's skin are are fairly similar. Sure, there are differences in oil production of the skin, and different people have acne and and other problems such as rosasia, But for the most part, UH skincare doesn't need to be diffical and and a lot of what we learn about skincare is incorrect and pushed by an industry that makes an awful lot of money. And one of those topics is moisturizers. Why do we use moisturizers. You know, ten thousand years ago, we didn't need a moisturizer. And you know, most men don't use moisturizer now, and most women, certainly when their children, they don't use moisturizers. Why do we use moisturizers Because in eighteen seventy Vasileine was invented. It became the biggest selling moisturizer in the world in eighteen seventy and continued for many, many decades. And people are programmed by the media, by a lot of outside influences that they need a moisturizer. Well, the fact is, you don't need a moisturizer in most cases unless the humidity is very low under and interestingly, by the way, if the humidity is underwent like in Phoenix, the oil content of your skin actually is increased. As compared to someone who lives in New York and then moves to Phoenix the next week, they have very dry skin, they feel because we adapt, we acclimate, our skin is very good at doing that. So why do we want to put moisturizer on? I don't think it's necessary in most cases, being this into the ground. But again, one more time, so you use a cleansing agent that doesn't have a lot of chemicals in it. Then you use a a some type of a cream that has antioxidants in it at night, some type of a cream that has some block in it during the day that morning, and then you use you do some kind of an exfoliation could be chemical, mechanical, whatever in the evening. Uh, that's pretty much. Do you exfoliate every day or once a week or does that bury based on your type of skin. I think exfoliation daily is probably appropriate and keeps your skin looking good, and but it can be done as simple as a washcloth, and so it doesn't have to be fancying. Okay, so we're doing all this stuff and father time is still creeping up, and your skin doesn't look like it did when you're sixteen, and it's starting to hang off your bones a little differently. Then we call you up and what do you get us to do? That's what I'm interested in. You know, plastic surgery has really been revolutionized in the last decade. When I trained at the University of Chicago, we're back in the dark ages. A couple of decades ago, plastic surgery was really surgical, and we've evolved now, so think operations like facelifts are actually going down in relative numbers compared to tummy tuck. For instance, facelifts are less popular now than they were ten years ago because of things like botox and things a wrinkle fillers like high uronic acid rest a lane for instance. Uh, those type of less invasive I hate to call him noninvasive mement because if someone sticks a needle in your skin, is that really noninvasive? But those type of things like botox and rest a lane will will really buy a number of years for you, and the facelift is being put off later and later. I like doing lippos suction on next. People in their forties can have Lippo suction as opposed to a facelift, and the skin retract and the neck looks more youthful just from removal of fat. So that's a nice way to do it as opposed to a facelift. I think in ten years we're not gonna be doing too many face lifts. Right before you get into at least's favorite topic, it was one last thing that I think I'm washed in my face once a day and putting on screen on it, and I'm using antioxidants and they we're gonna go to botox. I promise you just wait the way it's coming. Tell me what rosa is about. One of the best ways to treat because there are a lot of folks that have rosatia and the treatments, you know, they're fifteen of them, which means none of them are perfect. Well, rosasia is characterized early on by kind of a blush, a red blush on your cheeks and nose. It's in what's called a butterfly pattern on your face. And in the beginning it's usually just that blush. As it progresses, acne forms in that area. So the real name of rosatia is acne rosatia. And as it gets even more developed, when we get into our fifties and sixties, the skin begins to thicken and it can create Remember Jimmy Orranti, remember that guy in uh in Hollywood, Well he had acne rosatsia and something called rhino feima, which is the extreme of that where the skin really thickens. You know, I've actually removed thickness of skin as much as a half an inch off people's nose. It's it's amazing. We shave that off, but we want to prevent that from happening. So in the early stages of rose atia, where it's really just a red blush, things like vitamin A. You asked me about retina and and vitamin A, well, that's one of the things that can help rosasha, and vitamin C can also help rosasia, and niacin vitamin B three can remove some of the blush from rosasia. Well, bacteria are part of it, and so as the disease develops, a dermatologist, usually not a plastic surgeon, will prescribes something like metro gel, which is a very common antibacterial and it's a combination of factors that contributes to rose asha. So we want to head it off when I get involved. Often besides the skin creams is to laser those red blood vessels. Is it contagious, No, no, not at all, but we'll catch it from somebod. What's the difference between acne and actnemization, because acne, if I understand correctly, is when the pores get blocked off by oil of secretion whether and again the reason it's probably because you're making a lot more oil and unable to clear it like you should. So when does it become actually a rosatia. Well, acne can occur anywhere on the body. Acne rosatia is classically on the face. Uh, And it's characterized by those red blood vessels. Often by the way, those red blood vessels really stand out with spicy foods and alcohol and cigarette smoking things like that. So those, uh, those dietary things and and behavioral things contribute to acne rosatia, whereas with normal acne usually they're not. I'm not to leave the question about botox asking about botox. I'm I'm interested in any kind of plastic search in the eye the beholder. If you think you need it, you can get it pretty straightforward. You taught us also when we were writing The Being Beautiful, that the skin is attached to the muscles. So I did more. You bend it like a coreboard forms increase. So botox helps stop that bending process, so actually allows creases in the forehead, for example, between the eyes to resolve. Yeah, botox is wonderful. I think it's distinguished. Well, see the art of good botox, though, Lisa is to leave some lines and and leave some animation of the face and not make it so. So the art of good botox is not making you look like you've really been paralyzed, but reducing the wrinkles without making it look funny. Well, your eyebrows are going up and down like very animatedly, which means you probably haven't at it yourself. It's very difficult to do in the mirror. Arthur Perry, I guess that he's a very animated person. He's a co author with us and you being beautiful the last board to come after the break. We're not talking just about external beauty about inner beauty as well, because it turns out that you're out of beauty is in many ways reflective of your inner beauty. So pain and depression and relationship problems, financial headaches, these are all part of the inner pain you may feel that hinders your external beauty, but there and creates worry wrinkles, worry lines, and the names of those lines by the way between your eyes until Lisa's been torturing you. In the break about botox, so there us a quick walk through about the non invasive plotic surgery procedures. So botox wrinkle fillers. Peas, you had a good way of doing botox that a lot of people don't do that. I wanted to hear about. Okay, well, the first time I do botox on a patient, I like to see them two weeks later, and I'll adjust the botox because everyone does react a little bit differently to the botox. And if you've chronically lifted your brows, then what happens after the botox since it's been a habit, Often you will lift the outer portion of your brows and you'll have the joker type of parents, right right, Nicholson. Look, so what I do is that first time I'll go a little further out with the botox, will touch up with just a little bit to relax that so you don't look funny. And then after time your brain retrains itself. And usually the second time I do botox, you don't get that reaction. So so you gotta wait six months before you look good. No, no no, no, We're gonna fix it with our touch up botox at two weeks. Wrinkle fillers tell us about it, well, wrinkle fillers, we're in a new generation of wrinkle fillers. You know, we had collagen since nineteen seventy eight, I believe, But collagen wasn't that good because our bodies made antibodies against college, and that means we attacked it. And you know, there are probably hundreds of cases of rheumatoid arthritis, yeah, from people who have gotten lots and lots of college. And I'm not talking about one or five or ten injections. I'm talking about the people that I've had hundreds of collagen injections over the years. So about five years ago now, highly uronic acid was introduced. Now that's a much more natural type of substance that we inject into wrinkles. It's a it's a sugar, and it's identical in the test tube to what's in our body. So we don't make antibodies against hig uronic acid. The most common form is restlane and it really revolutionized the treatment of wrinkles because before that I would try and dissuade my patients from having collagen. I really didn't think it was a good idea. Why would you do botox in your far ahead instead of injecting something like resting in those wrinkles. That's a great question, and it's that pesky little complication of blindness that I just think. So what happens is there have been at least fifty cases of blindness from injecting all sorts of things from collagen and fat and and and pretty much any filler that is a solid or a gel. If it's injected around the eyes, it can connect with what's called the retinal blood vessels. Those are the blood vessels that go behind the eye. And a lot of people think, well, the blood vessels around the eye just run with the skin. That's wrong. And if you study anatomy, those blood vessels that come right up to the skin go into the skull and connect with the eye. And that's why there can be cases of blindness. So I don't inject anything like wrestling or Juba drum or anything around the eyes. We had dinner the woman who was not not actually blind, but could not focus because of botox um so that her her you couldn't construct her pupils. Her eyes are actually paralyzed. And she was an older woman, but her her children who are age had to lead her around because she couldn't see for you know, however long the botox is going to work. Well. The nice thing about botox is if you don't get a perfect result, or you get blurred vision, which is a known complication of botox. Well, it does go away relatively soon, four months. It's not that's usually those things go away sooner than the long term effective botox, which is at the maximum six months. This is very interesting. Peels finally, peels, Okay, well, there are all sorts of peals. There are different peels. There's a lunchower peal. You could go today down on Fifth Avenue and get your glycolic acid peel, but you're really not going to see too much. And it takes six glycolic peels spaced about three or four weeks apart to even see any sort of result. But it's good for people who have no down time. They can't take time off at work, so it's better than nothing. Glycolic acid is a nice exfolian and will help fade the skin and even out the skin toime. So what is an effective peel then? If that's not really going to do anything, what what if you really wanted to lighten your skin and get rid of fine lines, what would you what peel would you do? The t C A peel is a great peel. Now that's try chloroacetic acid and and that's a chemical that we put on the skin. It's also called the Obagi peel out in California after a dermatologist who popularized it. But it's a great mid level peel. And what it does is it removes the upper layer of skin, and with it it removes the pigments. So if you've got melasma, which is the mask of pregnancy, or if you've got freckles of your face, you know when your child, freckles are are cute, but their age spots when you become an adult. And so if you've got those things, the t C A peel is the quick way to get rid of those and I'm a big fan of that. A lot of people like to use the lasers now, and I know why they're using the lasers for that. It's a higher fee. It really is, is as effective as a laser for sample Usually it is. It's certainly my first line. Sometimes there are some refractory, some very difficult brown spots that we then go to the laser. I'm gonna spill the beans here on my wife. I did a t C apel on my wife and we went up to Montreal the next day because we figured no one would uh would see us, and of course we ran into neighbors in Montreal neighbors. I had to tell them that she didn't have smallpox at the time, but usually hid for five to six days. After t C A peel, everything is downside? What are the big downsides of these peels? If you get this done, can you do it again in five years? Well, t C A peels we used to think we're kind of one shot or maybe every couple of years, but the trend now is to do them more often, so I do repeated peels. Now we can begin to treat wrinkles with t C A peals, whereas twenty years ago we were taught we had to go to those deeper peels, phenel peels or laser peels, which are very invasive required general anesthesia and uh, and they're good, they're effective, But how many people really want to take two weeks off and have a weeping face that looks like a pumpkin. So we're going into more or rather less invasive peals like a t C appeal and repeating them. The question I think a lot of America is wondering though, is if I have one of these peels done, and let's see, I'm fifty and I'm thinking about having it at forty five versus waiting to fifty five. Is it like a facelift where you can sort of got one or two in your system? Where do you think you can repeat these peels every five years or even even more often than that moment? Most people really do get t c a peel at one to two years, every one to two years, depending on what you do to your skin. So if you use sunscreen and you have a good skincare program, you'll probably get more out of the peel and a last longer, but certainly they're repeatable. Now let's go to hair. So the problems with not enough hair, problems with too much hair. For the folks that have a lot of hair, you know they're going through menopause, for actually getting more of facial hair, what are the kinds of therapies they are practical to offer these women? Okay, well, the first thing for a woman who is growing hair, let's say on their face. First step is to see an into chronologist because one of the most common problems is called polycystic ovary disease and or stein levinthal disease, and it's very important. I have lots of patients that come in for a laser hair removal and uh. And if they've got a little hair around the mustache area or or on the chin, well that's okay. But if they've got a full beard, an intochronologist really needs to examine them once they've been cleared by an into chronologist. The best way in two thousand and eight to take care of hair on the face for a woman is laser hair removal. It's wonderfully effective. I've seen so many women women who have had electronics us and have had scarring from electronlysis. And I've had women come into my office who have literally been doing electronlysis for five years. You know, the weekly visit there that they're electrologists is their best friend. Unfortunately, electrology is now in the realm of electric typewriters because laser hair removal is very effective. So that's a great way to get rid of hair. But aren't there problems with laser hair removal if you've got very light hair or if you're a dark skinned individual. Absolutely, the laser is just a tool and it needs to see dark hair, and it does it best by looking at a contrast between the dark hair and the light skin. So I always say, you remember the phrase get them while they're hot, you know, for the hot dogs, while get them while they're black, because that's when you have to get the hairs. If the hairs turn white, I can't get it with a laser. And that's when we go to electronlysis. And how about these other chemical peels near shaving, how do they all compare. You're talking to the near expert of the world. I did more or near on rats than anyone else, for right when I was at Columbia twenty something years ago. Near works wonderfully. Rats are vain, Yeah they are. That was in the skin grafting experiments. But we have to remove hair from rats, and we can remove it very effectively, but it's an irritant to a lot of people. Many people get kind of red skin after using their So I think it's much less popular than it was back in the rat here twenty years ago. How does it remove the hair by the way it dissolves it. It physically dissolves the hair. I like that. You know, we we we're talking to Arthur Parody day. Obviously you knows everything. It's certainly about the skin and a lot of other things. Um he's a co author with us and You Being Beautiful has his own book as well, called Straight Talking about Cosmetic Surgery and his own cosmetics line. Even where can they find that? But the easiest way for listeners is to go to night skin dot com