Side Project Podcast 5: Skincare with Sinae Kane

Julie Liegl (02:51.79)

All right, I feel like we have a billion questions for you and we know number one is going to be everybody should be wearing sunscreen. But at a very high level, as we start to age and think about what we should be doing for skincare, how do we sort of balance between, you know, wanting to keep up with the newest latest things and also not wanting to go too far? Like how much should we be interfering with nature versus how much should we just be taking care of ourselves, drinking water, letting things go, or putting needles on our faces.

Sinae Kane, MD (03:23.993)

Absolutely. So this is such an interesting question to talk about. Skincare is such a personal question. You know, I find it’s really similar to questions like, should I dye my hair? Should I care about the clothes that I wear and the way I present myself to the world? Do I want to maintain a certain level of fitness? Do I want to pluck the random hair that grows where hair should not be growing? Do I want to wear deodorant?

Every person is gonna have a different answer to their skincare questions. And when I think about treatments to address the way that the skin ages, it really is the same. There’s some people who are gonna wanna pick and choose certain things and some people that wanna do it all and other people that don’t wanna do any of it. I think a lot of people get trapped into black and white thinking about this. They start to think that if I care at all about how my face looks as it ages, that makes me a superficial person, or that means I’m not aging gracefully, or I’m not letting nature take its course. And I really think it’s much more nuanced than that. Things like arthritis and hypertension, high blood pressure, those are all natural things that happen to our body.

So if you could do things to slow that process down, I really see it in a very similar vein, you know, when I think about the way that the skin ages. Most of the patients who are coming to me and when we’re having this discussion, a lot of people are not coming in saying, I want to look 20 years younger or I want to look like a different person. Most people are saying, you know, are there some low hanging fruit, things that are really safe and relatively easy? Are there some simple things that I could be doing that might make a big difference, make me feel a little bit brighter and look a little more rested? And that’s the way I approach this topic, and I’d say for the patients who are attracted to a similar philosophy, that’s really the way I think about skincare.

Ruthie Miller (05:42.907)

That makes a lot of sense. Well, so going back to the Botox thing a little bit, can we talk about that? Can you help me understand? I mean, I’m not opposed to doing it, but the idea of sticking something external inside my body is just kind of foreign to me. What is the point? And also I feel like Botox has been around for a long time. Are there newer things that people are now doing instead or in addition to?

Sinae Kane, MD (06:10.549)

Yeah, so let’s back up and talk about what Botox is. It’s a neuromodulator that essentially acts as a muscle relaxer. So what happens is that many people, but not all people, age in a way that certain muscle groups on their face start to overact. So it’s like those muscle groups are, it’s like you’re iron, you’re working those muscles out.

And when that happens over and over and over again, the skin starts to say, like, I give up. I’m going to just crinkle when you push me. And again, there’s some people who don’t have that response. And it’s definitely possible that you fall in that category where certain muscle groups aren’t overreacting.

When I am evaluating someone’s face, I often have them make a lot of different motions so I can see how their skin responds to muscle activity. And I’m actually really surprised to see that there are some people who it’s almost like they have natural Botox in them. Their muscles are not as hyperactive. But for a lot of people, especially on the upper part of the face, their muscles are getting stronger and their skin is getting weaker.

So the skin is not as able to resist the movement from the muscle and it results in a lot of lines that people don’t like. And the way Botox works is it relaxes the muscle, which then allows the skin to relax and then the skin can start to unfold or uncrease. 

So, you know, the top three areas for Botox are between the brow, right here on the forehead, and on the crow’s feet. So this kind of area of the face, this upper part of the face is one of the areas that starts to get really mobile and can become hyperactive. And in terms of deciding when or if you should do Botox, I think your face will tell you. Like if you’re someone who’s developing a very deep furrow between your brows and people are asking you like, hey, are you like angry at me or something? Then it’s like maybe you should think about it. Or you could just say, hey, you know what, this is the way my face is and I’m totally fine with it. I’m gonna leave it be.

Ruthie Miller (08:35.507)

What are some of the newer treatments that have come up that may be replacing Botox?

Sinae Kane, MD (08:39.013)

Yeah, so in the same kind of category as Botox, some of the other neuromodulators that are out there, other names you may have heard of are Disport, Xeomin, Juvo, and then very recently there is a new product called Daxify. And in many ways, the first four that I mentioned are very similar to each other. They have small differences in the way that they spread and how kind of, you know, tight they act. I’d say that Daxify is definitely an outlier in terms of the way it works. It is considered to be stronger and to have an effect where it can last a bit longer as well. These are all injectable. So they’re all things that are injected into the muscle group. In terms of your question about safety, Botox has been used safely for a long time. 

And we use the word Botox kind of like the word Kleenex, like most people refer to Botox as all of the neuromodulators. But it’s been around for a really long time. There has been a ton of safety data and the amount of Botox that we are using for the face is minuscule compared to the amount that it’s used for other medical purposes, like to treat larger muscle groups. There’s never been any report of anything that is going to leave you with like permanent harmful effect. That being said, right now, Botox only comes in injectable form. So, you know, there’s some people that are just needle phobic and they’re like, I don’t want anything to do with a needle coming at my face.

Julie Liegl (10:31.232)

Is there anything to the idea of like getting it early, like the concept of prevent the wrinkles from coming in because then your skin doesn’t learn how to wrinkle? I’ve sort of been hearing this, like you shouldn’t wait for wrinkles to appear there. You should get Botox preemptively. Is that a young wives tale, not an old wives tale?

Sinae Kane, MD (10:48.783)

Yeah, that’s actually a great question. there is some degree of truth to that I’ll explain, but the opposite of that is definitely true. Meaning there are certain areas of the face where if you wait too long, you cannot undo the wrinkle. you’re just wrinkle-less over there.

Ruthie Miller (11:06.525)

So I’m screwed.

Julie Liegl (11:08.526)

You can just get a face lift.

Sinae Kane, MD (11:18.83)

Botox type products are designed to treat what’s called dynamic wrinkles, meaning wrinkles that form on the face when a muscle moves. So if you have a wrinkle that is forming on your face and there is no muscle moving, you’re just hanging out with your face there and there’s wrinkles there, sometimes it can be really tricky to have anything undo that because the skin’s been essentially convinced to stay that way.

Now, going back to your question about whether or not preventative Botox does anything, again, there are some people who will never really form a wrinkle there. So I often tell people, like, you know, if you want to be ahead of the game, you can kind of pay attention to the way that your face is moving, the repetitive motions, you know, and if you’re someone who, again, is not overusing that part of your face, then doing preventative Botox may take you nowhere. Now, all of that being said, most people’s faces and their muscles move in a pretty predictable pattern and most people will eventually start to get some overuse of those muscles. So it is true that I think in some patients and small amounts when things are just starting to kind of show up can be really helpful in terms of preventing it going too far.

Ruthie Miller (12:41.969)

As you are talking, I am trying to keep my face relaxed. It is not a natural thing for me.

Julie Liegl (12:44.536)

I know, I’m like if we could only, if we could only go back and not be so expressive.

Sinae Kane, MD (12:45.035)

So this is actually really funny because I actually tell patients, I actually tell patients, you know, people ask me, well, how long does Botox last? And first of all, there’s a huge, it’s like a bell curve, right? Some people will metabolize it very quickly and some people can last a really long time. But in general, you know, we tell patients like three or four months on average, right? For like maximal effect. But I do tell people, there are some people who can do mental Botox, which is when you sort of like remember the way it feels when it’s more relaxed. And it can be kind of an educational experience and help you sort of build like some, there’s a lot of people, mean, it’s like what we call like the, especially this line in here where people are just in such a habit. It’s like their focus face, their concentration face or their mom face, like yelling at their kids. And that muscle is just like, it’s pumping all day long.

So I do think it’s true that when you do Botox there, it does actually help you sort of understand, this is what it feels like to not be constantly holding tension in that area. And I do think there are some muscle groups that you can kind of retrain a little bit.

Julie Liegl (14:03.438)

Well, we started immediately into Botox or the injectables in terms of easy skincare things we can do. But, you know, in that category of easy things we can do that can kind of sort of help us as we age, what are other things that fall in that category that you recommend to your patients?

Sinae Kane, MD (14:20.818)

As a dermatologist, I can’t not mention sunscreen. What I tell patients in terms of topical products, so I think there’s like the category of topical products and then there’s like procedures that you can do, right? So let’s start with the topical products. I tell, you know, pretty much every patient when they ask me about this, that there are three products that are 100% proven by science, not marketing, to help you long-term. And those are sunscreen, obviously. UV radiation does a number on the skin. And that’s why every dermatologist that you know will be seen with their broad brim hat, sunglasses, and their zinc-based sunscreen. And I don’t know if you guys have ever seen the photos of the truck driver. There’s two really great sets of photos, the truck driver one and then the twins who lived in different environments. So the truck driver photo shows a lifelong truck driver where you can see that the left side of the face, the driver’s side window is significantly more aged appearing than the right. And that’s because the side windows don’t have the level of sun protection that the front window does.

And it’s one of those a picture is worth a thousand words. It is really striking. And the other is, like I said, there’s photos of twins who grew up in very different sun-exposed environments and, you know, basically same genetics and they look drastically different, and sunscreen obviously is a huge part of it.

And then the other two are vitamin C or an antioxidant mix, and that’s designed to be worn in the morning after you wash your face and it is the job of an antioxidant or a vitamin C mix is to buffer your skin from free radicals on the surface of your skin. So if you imagine like the sun rays are coming onto your skin and they’re like trying to cause damage in your DNA, the vitamin C is going to help kind of absorb some of that damage and mitigate it. And then the third thing is retin-A or tretinoin and that’s only if your skin can handle it. Not every one skin can handle retin-A because it is it is an ingredient that can be a little irritating and drying on the skin. A lot of people do need to work their way up to it and then there are some people who just can’t their skin cannot tolerate it and in those cases I might recommend something gentler like a retinol or a bucceol or an alpha hydroxy acid. 

I’m also a huge fan of jojoba oil for hydration. So I will often recommend for people to add a few drops of jojoba oils, whatever moisturizer you’re using. Skin dryness is one of the most common skin aging complaints. Our skin thins out; it doesn’t hold moisture as well as it did before. And I find that adding a few drops of jojoba oil is like a really kind of cheap, easy way to boost whatever moisturizer you’re using. It gives people a nice glow as well, which again, a common skin aging complaint is that people notice that their skin looks more dull.

Ruthie Miller (17:57.245)

That’s great. You know, I often hear about sunscreen, of course, and then also retinols and retin-A. But this is the first time that I’ve really heard somebody put a Vitamin-C serum in their top three. Like this is something that you absolutely must be doing. So I’m glad to have that skincare recommendation for sure.

Julie Liegl (18:18.338)

How do you know which ones are good ones though? Like vitamin C, feel like there’s some at the drug store and there’s like $500 ones. Like which ones do you buy?

Sinae Kane, MD (18:21.988)

So you probably have noticed there’s a pretty big divide between the lower end vitamin Cs and the higher end vitamin Cs. In general, the main issue is that vitamin C is a really unstable molecule. It’s kind of in the way it’s designed to work. It’s supposed to be kind of scavenging and finding things. So it can really degrade quickly. It’s very sensitive to exposure to oxygen and to light and air. And in general, I will say that the higher end vitamin Cs tend to have more stability testing. So the idea is that once you crack open that bottle, they’re designed to last longer.

Unfortunately, there’s no great scale. It’s not like you can get a rating, like an SPF number on your vitamin C to say this is a really good one or it’s going to last X amount of time. But I do tell people if a higher end vitamin C is not in your budget, you probably need to be replacing it pretty frequently if you’re going to go with one that’s a lower cost product.

Julie Liegl (19:31.982)

Okay, very good to know. 

Sinae Kane, MD (19:34.582)

And then in terms of sunscreen, I mean, that’s a whole other discussion, there are, in the U.S., the zinc-based or mineral-based sunscreens are the best that we have. There are some other products, especially available in Europe, that have a very similar level of protection, but are not as white as zinc. But in the U.S., zinc is the best you’re gonna get.

Julie Liegl (20:00.206)

All right, that’s the topical stuff. Let’s go back to non-topical stuff. So what are beyond Botox, the sort of next set of things that we should be doing?

Sinae Kane, MD (20:02.633)

So there’s a long list of other skincare treatments we can do. And there’s definitely no one size fits all. I would say that there are some common categories in terms of how people’s skin ages. For some people, they start to get very speckly on their skin. They get a lot of brown spots, or they get more redness, and their skin starts to get really uneven in tone. So we often will talk about procedures to try to even out the skin tone. So that could be, you know, kind of lower key things like chemical peels, which can help to even out skin tone and create a little bit more luminosity to the skin. Two lasers that specifically target pigment in the skin or specifically target blood vessels in the skin. So, you know, for patients with rosacea, they’d start to develop a really ruddy texture. They start to notice those little red lines on their face from the dilated capillaries we would use, you know, maybe a laser like a V beam laser or KTP. A very popular laser is the IPL laser. You might’ve heard of that, Intense Pulse Light. A branded version of that is BDL. It’s just another type of IPL. And that is a really common laser because it’s a little bit like a jack of all trades. It does, it has a bunch of different filters within it that allow you to target multiple things at once. And so, I know for people that are like, I’m just starting to notice like all these different colors on my skin and I want to even them out. It can target multiple. You can address red, you can address brown. So it’s not like the most powerful at any one of those things, but it kind of does all of that at once.

The one thing it doesn’t do is it doesn’t help with skin texture. So that kind of moves us into the next category, which is, you know, for other people, they might notice more aging in terms of like losing collagen and elastin in their skin, like everything falling or melting or crinkling. And essentially what’s happening in your skin is your collagen fibers are kind of like bunching up and they’re not acting in that nice, juicy, bouncy way that is in youthful skin.

Sinae Kane, MD (22:34.902)

And there are some skincare treatments that are designed to try to help stimulate collagen production. These are lasers like a fraxel or a Morpheus laser, you know, a CO2 laser. Those are all kind of like different ways of trying to trick the skin into thinking it has a very controlled injury. And, you know, the way I describe it to patients is: if you got a tiny scrape on your skin, your body can heal it completely without a scar, right? So you have the ability in your skin to regenerate new, fresh skin. So all of those lasers in the collagen regenerative category are trying to take advantage of that machinery that you have in your body to get your skin to, instead of losing collagen, to like grow collagen and elastin and actually help to turn skin cells over and create newer, healthier skin. Some of these lasers are even used to treat medical things on the skin. So things like pre-cancers or skin cancers can actually use some of these lasers to make your skin healthier in a medical sense, not just in a make it look beautiful sense.

Julie Liegl (23:59.95)

So when you do things like this, I assume you’re doing it, is it like you have to do it every couple years? Like you don’t just do it once. Just like you have to get Botox every, say, four months. Is it like you get these lasers, you get this Morpheus and then you have to go do it every couple years or what?

Sinae Kane, MD (24:12.944)

So for a lot of these skincare treatments, what I tell people is if I put you, if I stopped the clock on your aging and I put you in a cave where you weren’t exposed to any sunlight, then your results would last super long. But, you know, most of these treatments are not temporary. So a lot of people are like, well, if I do this laser, how long does it last? Does it last like four months or six months or how long? And, it’s not that it’s a temporary effect. It’s more that your skin continues to age and that you might be continuing to get exposed to things that might contribute to skin aging as well. So for a lot of these treatments, to see the best results, generally you’re gonna need to do a series of treatments initially, maybe something like three to five sessions to get the results you’re looking for. And then for a lot of people, we would come up with a plan of like, maybe let’s do a maintenance or a touch-up session every one, two, or three years, we kind of figure out what I think based on all of those other factors. If there’s someone who has, they grew up in Hawaii and they play golf and tennis all the time, they’re probably gonna need treatments more frequently than other people that are like, people like me maybe who I grew up in partly in Kentucky and went to tanning beds, but now I’m a dermatologist, so I’m really on it. So I do think that, yeah, there’s going to be some variability. But in general, you might need a little bit of a maintenance schedule.

Ruthie Miller (25:51.783)

Okay, so talking about skincare treatments, Julie told me a couple of weeks ago about something called a vampire facial and I was intrigued and perplexed and she told me kind of what it is and it sounds absolutely insane – Yet something I kind of want to try. So please can you enlighten us all on what exactly is a vampire facial and why should we or should we not try it?

Sinae Kane, MD (26:13.421)

So the vampire facial uses stem cells in your blood. It’s really cool science. It is using a treatment called PRP, which stands for platelet rich plasma. And it is where blood is taken from your body, just like you were going to a lab and doing a lab test, and that blood is drawn out. It’s filtered and essentially your red blood cells and white blood cells are removed from it, which is why vampire facial is a little bit of a misnomer because it is not even red what you’re injecting into there, right? But it is your platelets floating in your own blood plasma. And what was discovered is that your platelets have growth factors. They have sort of like stem cells that can go in and rejuvenate whatever it’s injected into. So it originally started in orthopedic medicine. People were injecting PRP into joints to help with joint recovery. And as happens in science, we were like, it works for that, let’s try it for something else. It started being used in other areas and we commonly use it for the skin and also for the hair. We actually inject it into the scalp for certain types of hair loss. It can help stimulate hair growth. So the vampire facial is when you combine that liquid with a treatment called micro needling. And the micro needling is essentially creating little entry points into your skin. Ruthie’s eyes are like, oh God, needles. I know, and ironically, it’s actually like one of the least, I’d say it’s essentially pretty low in terms of pain control.

Julie Liegl (27:53.39)

I’m like Ruthie, it’s not for the faint of heart, but I have done it.

Sinae Kane, MD (28:05.29)

The device kind of vibrates and distracts and they’re really tiny. Of course you use numbing cream. But yeah, the liquid is essentially applied to the skin as you’re micro-needling. And the idea is that you’re delivering this really nutrient rich plasma into your skin. Is it a treatment that’s gonna make you look 20 years younger? No. 

Ruthie Miller (28:31.187)

Okay, cross that one off my list.

Julie Liegl (28:33.698)

Wait, which one is?

Sinae Kane, MD (28:35.19)

You know, but it does, does it give you luminosity? Definitely. I mean, people really love the glow that they get from it. 

Ruthie Miller (28:46.151)

That’s why it’s called a vampire facial. It’s not the blood, it’s the glow.

Julie Liegl (28:51.128)

Do vampires glow?

Sinae Kane, MD (28:50.292)

Yeah, and it’s a super safe treatment and it’s also one that’s pretty low on downtime. Generally people look a little pink and dry for a couple days, but they tend to bounce back very quickly and you don’t need to go in hiding. And as I mentioned, we use it for other areas like into the scalp.

Ruthie Miller (29:12.979)

I use a product at night and it has stem cells and growth factor in it. I always say I’m putting dead babies on my face. But my dermatologist here recommended that and she said it’s kind of her holy grail. So is putting it on topically going to help me just as much as using the needles or do you really need to have it injected?

Julie Liegl (29:40.174)

Should she stab herself in the face before she puts it on?

Ruthie Miller (29:41.971)

Should I be microneedling myself before?

Sinae Kane, MD (29:44.788)

So I think no one really knows the answer to that question. This is a topic that is like a big area of research and you’ll start to hear more about, for example, there’s this new category of growth factors called exosomes, are being, a lot of the companies are actually being researched, they’re not actually approved yet. We’re all trying to find the holy grail, right? Of the thing that’s gonna make your skin look way younger that’s very effortless. I think the answer is that no one will really know yet. We don’t know the answer to that question yet. But essentially you’re kind of in the same category. mean, obviously the idea is if you’re penetrating the skin a little bit more with creating channels, you’re probably gonna get a better effect. But with a lot of those products, I often recommend patients, it’s like, try them for a while and see if your skin seems to be responding. I think there’s a huge variability in how people respond. It’s kind of like I was talking about before with we’re trying to take advantage of the machinery that’s in your skin. So some people, their machinery is going to be like, yes, I am on board with this and I am going to give you what you want. And other people are going to be like, their skin is going to be like, meh, I don’t know. So I do think there is, I think it’s a little bit of trial and error in terms of things out and trying products out.

I know we were going to talk about supplements kind of along the same vein. In general, there’s not a lot of data behind taking oral supplements to benefit the skin. It’s kind of like when people ask me, if I hydrate a lot, does that hydrate my skin? A lot of times the answer is no. Like if you’re very dehydrated, your skin might look parched, but if you’re just like, okay hydrated and you like super hydrate, your skin’s not necessarily gonna show like the extra hydration. 

So in terms of supplements, there has been a lot of research and it is an area that’s really challenging to study because it’s hard to know. There’s so many other factors going into it, right? But I’d say one of the supplements that’s gotten the most attention lately has been collagen or collagen peptides. And, you know, it kind of makes logical sense. Like we want more collagen, let’s take the collagen. But again, like, you know, it is a protein molecule and, you know, a long time ago when this discussion sort of first started happening the answer was, no, that doesn’t make any sense. You could just eat any protein source. Like what’s so special just gets broken down into peptides. And, you know, maybe they’re not necessarily like gonna get absorbed into your skin. But there have been some studies that show that ingesting collagen peptides might help a little bit with skin hydration or with wound healing. So I would say that the answer, it’s a mixed bag. There’s kind of data in both camps.

So again, when I talk to patients about them, like you can try it and see. I personally don’t take collagen peptides because a lot of people add them to their coffee and I must have like a super taste bud or something because it completely ruins one of my favorite moments of the day. So I don’t use collagen peptides. 

The only supplement that I use on a regular basis is vitamin D and that’s because I am a religious sunscreen wearer. And most people that wear sunscreen religiously are gonna be low in vitamin D. 

And then the other supplement that I use periodically is an oral sunscreen plant. So this is pretty incredible. It started with a supplement pill called HelioCare. And it was a pill that was tested and shown to be equivalent to an SPF of like six to eight. Not as good as sunscreen, but it goes everywhere and lasts for hours. Yeah.

Ruthie Miller (34:00.787)

It’s not nothing. That’s great. So you can take a supplement, like a pill.

Julie Liegl (34:02.646)

Yeah, I’m like that’s more than more than my tween is wearing on a normal day leaving the house. I’ll shove that pill in them.

Sinae Kane, MD (34:07.086)

Yeah, it’s a so the original one’s a pill and now there’s a gummy. Yeah, now there’s a gummy. Yeah, so there is a company called inner glow is actually created by a dermatologist and they have a product called Sol Defense. And it’s a gummy bear form of this plant. So the plant is an Amazonian fern called Polypodium leucotomus. And it was originally discovered there is a tribe that eats, Amazonian tribe that eats this plant. It’s part of their rituals and ceremonies. So they eat this plant and they noticed that they had fewer sunburns. And that’s what kind of sparked the original research studies. Anyway, now there’s this gummy bear form. Again, you take it like an hour before sun exposure and it lasts for four hours. You can top it off. I personally use it. We do a lot of tropical travel and I take it with me on all of our trips and pass it out. We call it the sunscreen gummy.

Ruthie Miller (35:18.941)

That is brilliant. I love it.

Julie Liegl (35:19.406)

That’s amazing. Okay, I have to ask. I, because I’m on Instagram too much, see way too many things for light masks or lights I can hold in front of me or zip zap devices. Talking about data and stuff like that. Does any of that stuff work? Is it worth investing in? And if so, how do you know?

Sinae Kane, MD (35:38.613)

Yeah, that’s a great question. Most of those devices that you’re seeing are red light devices or LED type devices. There are some that are very weak IPL machines. So that’s like the laser hair removal devices that you’ll see. And I’ll just touch briefly on those, because those have been shown to be effective. are, you do have to be careful with those because you can burn yourself.

So that’s the only thing that I would tell patients is like, you’re not, you know, make sure you’re a good candidate for them, meaning that your skin’s on the light side and not gonna have a bunch of pigment that’s gonna react to those lasers. In terms of the face masks, they are, they do help with some things a little bit. They don’t help with all of the things that the companies want you to think that they’ll help with.

So one of the things that they help with the most is redness in the skin. So for patients who are really prone to rosacea, they can be helpful in temporarily calming down some of that redness. Again, they’re not gonna reduce it as much as like a laser treatment where you don’t need to continue to use it. They’re generally much more of a temporary effect, but they’re now available for use at home and pretty easy to put on.

So I’d say that redness is definitely an area that’s been shown to be helpful for. There are a couple of other skin quality improvement areas that it may help a little bit with, but there’s, I’d say, less data on some of those other areas. Some of these companies are trying to do some bigger studies now to look at, if it can. For hair loss, there have been some kind of these low-level light-based devices.

that can, again, help a little bit. The question really becomes, you know, is it enough to see a difference, right? Like if they show like, it helps a tiny bit, but you’re not really, it’s not enough for the naked eye to detect, then is it actually worth doing? You know, maybe not. I do caution people about patients who have melasma, which is, you know, a darkening that can happen during pregnancy, but it happens all the, we see it all the time outside of the scenario of pregnancy, the mask of pregnancy where,

Sinae Kane, MD (37:58.066)

People get dark patches on their face. That is a condition where your skin can be really sensitive to light and heat. So I would be really careful if you’re someone who has that with using these masks, because they are delivering a lot of heat to the face as well.

Ruthie Miller (38:16.851)

Sinae, we are running out of time, but I want to ask one final question that is probably top of mind for everyone. Do you have any holy grail products that you recommend or brands that you really trust? A big thing for me is trust. And so if I can learn what brands are really trusted by people who know and expert dermatologists, then I can kind of look out for those. So can you list some of your favorite products and brands?

Sinae Kane, MD (38:42.024)

I definitely can. In general, it’s rare that any one brand has the best of everything. Often I’m picking my favorite one or two products from different brands. And it is a little trickier these days, because there’s so many, like the skincare industry has exploded. I mean, if you look in my bathroom cabinet, I’m constantly trying different products on and I can’t even keep up with how many different products are out there. In general, I tend to favor brands that have done more clinical trial testing in terms of safety and efficacy. I am a mom of two kids, I work as a dermatologist, I’m busy. If I’m gonna take the time to put products on my face, I want them to be worth it. I don’t just want to hear a friend say, hey, I like this product, use it. I want something where they’ve done testing on people and they know it has a good chance of actually helping. So in general, I prefer brands like SkinCeuticals, SkinMedicinals, EltaMD, and brands that have done a little bit more in terms of research. Skin Better is another brand that I really love as well.

Julie Liegl (41:49.526)

Actually, I know we said we were wrapping, but I do have to ask, because this is relevant to some of the other experts we’ve talked to, is topical estrogen something that dermatologists are looking at? Because obviously, estrogen is affecting everything that’s going on. Is there a chance that that’s one of the things that could be helping our skin?

Sinae Kane, MD (42:07.747)

So this question has been a hot topic in the dermatology community because there are some studies that show that using estrogen or just having more estrogen in general can make your skin look a little bit more youthful. However, we take an oath as physicians to first do no harm. And that is the biggest issue here is that it is really hard to know. 

Estrogen sort of moves around in the body. It’s like, how do you control it? If you’re slathering estrogen on your face multiple times a day, how are you measuring how much estrogen your body is seeing? And, you know, breast cancer is one of the most common cancers that women have. And there are a whole subset of breast cancers that are estrogen receptor positive. That means that adding more estrogen is like pouring gasoline on them, right? So, you know, do you, at this point, I would say that most dermatologists would not necessarily recommend applying topical estrogen willy-nilly. It’s something that might be considered in the future, if there’s a way to do it in a safer way, but it’s definitely something that is still being investigated.

Julie Liegl (43:30.382) Wow, really interesting stuff. OK, you can find a recap of everything we talked about on our website at sideprojecthq.com.