056. How to Maximize Success with Healthy Skin: Expert Tips for Glowing Success with Dr. Mary Alice Mina

00:05 Dr. Ann Tsung Are you struggling to advance your career and sacrificing time with your loved ones because of endless to-dos, low energy, and just not enough time in the day? If so, then this podcast is for you. I am your host Dr. Ann Tsung, an ER critical care and space doctor, a peak performance coach, a real estate investor, and a mother of a toddler. I’m here to guide you on mastering your mind and give you the essential skills to achieve peak performance. Welcome to Productivity MD, where you can learn to master your time and achieve the five freedoms in life.

00:51 Welcome to Productivity MD Podcast, and I am your host Dr. Ann Tsung. Today I have Dr. Mary Alice Mina. She is a board-certified dermatologist. She’s also a podcast show host of The Skin Real — that’s R-E-A-L — a media expert, a real estate investor, and an awesome wife and a mom to a 9- and 10-year-old. Thank you for being on here, Dr. Mina. The reason why I brought her here is because she’s a skin expert, and we talk about productivity, peak performance, vitality, freedom. And I feel like the skin health is often overlooked, I guess. Then we’re always rushing. We’re always trying to do other things. Skin is the last thing we think about. I brought her on here to talk about what we can actually do that’s actually very simple. Because if you don’t take care of things early on now, you can actually have long-term health consequences in general. And you don’t want that to affect the rest of your life. So again, Dr. Mina, thank you so much for coming onto the show. Can you tell us a little bit more about what you do, and why are you doing your podcast, your experience in the media? Why do you do real estate, and why are you so passionate about skin health?

02:05 Dr. Mary Alice Mina Yeah, Dr. Tsung, thank you so much for having me on. And yeah, you really took the words right out of my mouth earlier about why skin health is so important. That’s why I am doing all these things, I’m juggling a lot of hats. I feel like back in the day, you could just be a doctor and have a practice. You could do that for 30, 40 years and retire. And that’s the end of it. That’s kind of what my dad did and my grandfather’s. But nowadays, the world is so different, right? Medicine has changed tremendously. And what really hit me was the pandemic and not being able to take care of my patients, spending a lot of time at home, a lot of time on Zoom and virtual spaces, staring at ourselves in the camera, right? And it kind of clicked for me that being a doctor is wonderful, and I love it. I find it incredibly rewarding, but I didn’t like how it required me to be going in and seeing patients day after day. I thought I need to be able to reach a wider audience, and that’s really when the idea for the podcast came out.

And also, honestly, out of frustration. There’s a ton of misinformation out there. There are a lot of people who are putting themselves out there as skin experts who, at best, are giving false information and, at worst, are giving dangerous information. And so I just felt like as a dermatologist, as a doctor, I really need to have a loud voice out there to give people really good science-backed skin information. That’s definitely a shift. I’ve noticed that back when I was in training about 15 years ago, doctors weren’t really supposed to do that. Right? It was like, just see your patients in your clinic, and that’s it. But the world has totally changed. This is social media, podcast. This is how people get information. And so that’s really the impetus for why I started the podcast. And it’s been a lot of fun. I love talking about skin. And I find that as soon as people know I’m a dermatologist, no matter where I am — grocery store, bank, party — everyone wants to ask me a skin question. And so, yeah, it’s fortunate that I really like to talk about it. And so that’s why I have the podcast.

04:20 Dr. Ann Tsung Got it. I can definitely resonate with that. Because since working full time at NASA now, I don’t work a lot in the ER and the ICU and learning all these things. That’s why I started the podcast as well. It’s just free resource for people to get to so that I don’t actually have to do one-on-ones in the ER or ICU to actually give some sort of counseling. I wonder and actually, to be honest, I don’t take care of my skin very much. I don’t even think about it very much, except for sunscreen. I put essential oil, and that’s it. So can you tell the audience why they should actually care about it? Most people probably just think, okay, maybe I’ll just age. Like if I put on sunscreen, maybe I’ll prevent some wrinkles, or I’ll have extra wear wrinkles earlier. But are there actually more serious consequences? Why should both men and women care about this?

05:08 Dr. Mary Alice Mina Right. So your skin is so much more than your face. It’s so much more than aesthetics. Sometimes I think we get obsessed with beauty and our skin, our spatial esthetics. But our skin plays so many important roles. Our skin is really a window into what’s going on internally. Sometimes we see skin manifestations as a first sign of an underlying condition. Sometimes that can be from inflammation in the gut and a poor diet. It can also be an internal malignancy causing a rash or itching on the skin. So it kind of runs the whole gamut. Sometimes it can be the first sign of diabetes or insulin resistance on the skin. So I think a lot of people just think, oh, skin is what you look like, aesthetics. They forget that, actually, our skin is its own organ system. It plays many important roles, protecting us from pathogens, viruses, bacteria, all that stuff. It’s important in our immune system, immune regulation. So it plays so many important roles way beyond just aesthetics. And so you really have to take care of your skin.

06:19 And I say skincare is whole body care. Because it’s more than just what cream should I put on my skin, right? It’s more about how can you take care of your whole self, your whole body. Then your skin will reflect that radiance and vitality. That’s really what I think your listeners want, right? I know that’s what I want. I’m not going to fight aging completely. Mother nature is incredibly powerful. There are things that I know are going to happen and changes that are going to come. But what I’m trying to do is stay as healthy as I possibly can, for as long as I can. So I really want a long health span, not just a lifespan.

06:59 Dr. Ann Tsung Yeah, I can definitely resonate with that, too. It’s not just about your face, cosmetics, et cetera. Your skin is an outward reflection of your internal body’s vitality. So if you don’t have your health, then you don’t have your wealth. That’s like number one thing. We can see that in burn victims in the ICU when they don’t have their skin, how much dehydrated, how susceptible they are to infection. And we take it for granted, usually. So I wonder what is it like to actually take care — what does that mean to take care of our skin? What kind of results can they achieve? I’m just trying to have the audience get a sense of 10, 20 — I don’t know — 40, 50 years down the line. What’s the difference if they don’t take care of the skin versus they do care for their skin?

07:47 Dr. Mary Alice Mina Well, so it kind of runs the gamut. It partially depends on your genetics, your ethnicity, your background. A huge component is UV radiation from the sun. So sun exposure. For, I would say, 80% to 90% of the aging that we see, especially on the face or sun-exposed areas, is from the sun. So if you do really nothing else, you should sun protect. Because that is going to just be this accelerator to age you and age your skin. And even if you care nothing about what you look like or aesthetics, then you should at least care about skin cancer. This is a very real issue, a real concern. A big part of my practice is taking care of skin cancers. This is from typically cumulative sun damage that builds up over the years. The reason we’re seeing such a stark rise in skin cancers, especially squamous cells and basal cells, is that we are living so much longer than we’ve ever lived before. And so I will get these patients typically 60s, 70s, 80s and they always tell me, “I wish I had known. I wish we knew to wear sunscreen. My parents just sent us out outside, no shirt on, told us to come in when the sun went down.” They didn’t know, and they have a lot of regret over that because they sometimes have to come into my office on a pretty regular basis.

09:12 And while some of these skin cancers act more like nuisances — they’re pretty small. It might be on a part of the body that’s not as visible, and we can manage it pretty well or pretty easily — some of these are truly life-threatening. We’re seeing a rise in mortality, not just an increased incidence with basal and squamous cells but actually increased incidence and mortality from squamous cells, which I think a lot of people think of melanoma. Melanoma is the bad one. The other ones, I don’t really have to worry about. But that’s actually not true. Mortality from squamous cells is growing, and it’s actually surpassed melanoma, which I think would surprise a lot of people. So this isn’t insignificant, and this affects your health. It can metastasize. It can spread. The best way you can prevent that is by taking care of your skin, especially sun protecting as early as you can. Right? If we can get teenagers to do this, even better. But it’s never too late. Start wherever you are. But I would say that would be kind of the number one ramification. If you didn’t take care of your skin, you get a lot of sun exposure, then your chance of getting skin cancer is really, really high.

10:24 Dr. Ann Tsung Got it. So it sounds like you want even as a baby. Of course, as a baby. But even as a toddler, no matter what, you go out, and you put on sunscreen no matter what. That’s what it sounds like. Then I didn’t know that the squamous cell mortality is actually starting to surpass melanoma. That’s surprising to me. And would you say everyone or some audience with moles or large moles really deserve a one-time checkup, would you say, definitely by a dermatologist or maybe a screening by their PCP of their moles to assess, to document? What are your thoughts about that?

11:01 Dr. Mary Alice Mina Yes, so it’s still a little bit debatable. The U.S. Prevention Task Force has not yet said that skin cancer screenings or skin checks are necessary universally. So usually, what I recommend for people, if you have a lot of moles, if you have a family history of melanoma and if you have had a severe sunburn, even one, then a check with your dermatologist is really the first step. If you can’t see a dermatologist, go to your primary care doctor. But if you can get that first check with the dermatologist, then they can sort of tell you: no, the kind of moles you have look very innocent, very benign. I don’t need to see you except maybe once a year or once every two years.

11:41 For most adults, I think a check with a dermatologist is important. Because most of us have had more sun exposure than we realize, no matter what skin type you are. That’s another misconception. It’s that, oh, you only have to worry about skin cancer if you look like me. And if you have darker skin, you don’t have to worry. But that’s actually not true. In general, if you are an adult and you have had some sun exposure, sunburns, and certainly family history of skin cancer, then a one-time check with a dermatologist I think is an order, if possible. If not, your primary care doctor. They can advise you. I mean, I sometimes will see patients and I’ll say you really have no sun damage. I use that time to just counsel them on good preventative measures for now. And I tell them check back in if anything pops up that worries you. So it’s never bad just to have that check. They can reassure you if you’re good or if you need to be seen a little more regularly.

12:38 Dr. Ann Tsung Okay, got it. I’m thinking about all the times where I went high-altitude trekking or by the snow. Lots of sun exposure then. But yes, I don’t think — I wore sunscreen but I definitely didn’t reapply.

12:53 Dr. Mary Alice Mina Yeah, that’s a big problem. I’m guilty of that as well. But yeah, those high altitudes and the snow reflecting, people think, oh, but I’m all bundled up and I’m covered. But you definitely are getting some intense sun up there.

13:05 Dr. Ann Tsung Got it. Got it. I’m going to switch gears a little bit to see what your own vision is. Where do you want to take this? Where do you envision yourself and what you’re doing, let’s say, in 10 or 20 years? What impact are you looking to achieve?

13:19 Dr. Mary Alice Mina Well, I really just want to bring back a focus on sensible science-backed real skin health and skincare. I really want to focus to be on more than just what products should I buy, what procedure should I have done? I really want skin health to be seen in a more holistic way. That acknowledging, recognizing that our diet plays a huge role. Exercise, stress management, sleep — these are all components that are so important for not only healthy bodies but healthy skin, and they really lay the foundation. So I would just love to be sort of the go-to, the trusted resource for actual, real practical skincare.

14:03 I find that there are a lot of people promoting skin education out there. Again, they tend to, seem to be marketing something or a product or a device. So there seems to be some sort of angle on it. I find that people are feeling overwhelmed, and they are frustrated. They’re spending a lot of money, and they’re not getting the results they really want. I really think that’s because the foundation hasn’t been set. So I’m hoping to just kind of change the narrative and put really great skin education out there for people. I know it’s hard to find a dermatologist. I know it’s hard to get in with a dermatologist. Unfortunately, I think that’s just going to continue to be a problem as our population grows and the number of dermatologists being trained stays pretty stagnant. And so this is a way for people to get good skin education without having to go see a dermatologist face to face.

14:55 Dr. Ann Tsung Got it.

14:56 Dr. Mary Alice Mina That’s kind of my hope.

14:57 Dr. Ann Tsung And what would you say, with you juggling real estate investing — I know you do it with your husband— your two kids right now, your podcast and other media appearances and your clinic, in terms of peak performance and productivity on the show, what are the top three tips that you can give our audience? If they have a passion for another subject or topic like you and want to venture out and do something else, how can they maintain that balance to make sure that they’re good with their spouse and their kids while they’re trying to change the narrative of whatever topic that they’re passionate about?

15:32 Dr. Mary Alice Mina Well, I mean, that’s the question. That’s the million-dollar question, right? Well, I think we’re in a really cool stage and age where there is a group for everyone, right? There is a group for whatever you’re looking for. You just have to find it. And if there’s not, you can create it. So find some resources. Read books. Attend conferences. Network and meet people. So meeting you, Dr. Tsung, you have given me some great tips on productivity. We have attended seminars together and mindset groups. Really spend the time and the money to invest in yourself. That’s one thing I always thought, well, I don’t need a coach. I don’t need to pay money for these courses and groups. I can figure it out on my own. And maybe you can. But if you enlist experts around you, you’re going to grow so much faster. So I would say: find people who are a little bit ahead of you who are doing something similar to what you’re doing, and have them as mentors or model what they do. Read the books they recommend. Invest in yourself. I think that’s huge.

16:39 This is something I’m constantly learning and struggling with. It’s a balance. One thing I found is delegating. So I don’t need to be the one to make dinner every single night like I had been doing. I don’t love doing that on Tuesday night. I enjoy cooking on weekends. But this way, I can now do my podcast recordings after my clinic. I can come home. I’ll have a warm meal, a healthy meal, waiting for me that I don’t have to be the one to cook it. So if there are things in your life that aren’t really adding value and you don’t enjoy doing it, then outsource that. Delegate that. There’s no reason you have to do everything. That’s one thing I’m really trying to work hard on in this year in 2024. It’s that I can’t really grow and scale my businesses if I’m still the one kind of in the wee needs doing tasks, that really I could outsource to someone who not only wants to do it but could do it better than me. That’s something I think, as physicians or successful, productive people, we have. This mentality that only I can do it, right? I struggle with this with my husband too, where I have to tell him like, no, you don’t need to be the one making those calls, right? Have someone help you. And I know money. Everyone thinks, oh, but I can’t afford that. That’s too expensive. Right? But you have to look at it as, well, I’m already spending that money. My time is that money, right? So you’re already spending. And your hourly rate is probably a lot higher than what you would pay someone to actually do it. So shifting that mindset that you don’t have to do everything. Invest your time and energy on the things that matter.

18:17 Social media and internet and all that, there are so many distractions. That’s something I’m struggling with too. I think you told me this, Dr. Tsung. I have my Gmail app on my phone. It used to be right on the front. It would also tell me how many unread messages I had. I couldn’t look at my phone and see I had unread messages and not click on it. I just could not do that. I have now moved it to a second page. I don’t get notifications on how many unread messages I have. And it’s amazing. I love it. Just doing something that simple has freed up my mind to always see the unread messages and just reflexively have to click on them. So a lot of mindset work, reframing a lot of things that have been ingrained in us. One of the things that I found most helpful is just surrounding myself with people who are doing this kind of work who are entrepreneurial and bouncing ideas off of them. I find that really has been helpful.

19:18 Dr. Ann Tsung That’s awesome. So in summary, it sounds like surrounding yourself with people who are ahead of you because you will pay for the same results. It’s either with your time or your money. Like coaching money, essentially. Right? Coaching is one of the ways where you can actually buy your time back, which is the same reason why we both have coaches. And number two is learning the art of delegation and knowing that you’re already spending your own hourly rate on doing these lower-level tasks. And just switch the mindset to no, it’s not if I can do it. It’s like, how can I not do it?

19:55 Dr. Mary Alice Mina 100% right. You’re already spending that money. But instead of paying $20, $25 an hour, you’re paying what? Like, $300. Right? So, yeah, this whole mindset shift.

20:09 Dr. Ann Tsung Yeah, you basically want to — a lot of times, I tell my audience or my client, you want to be doing the things that you are trained up to your full capability. So you are trained up to be a physician. You’re not going to be like — I’m not going to be the ER stocking supplies and ordering supplies, right? My training is seeing the patients, doing the differential diagnosis, administering the treatments, assessing the treatment. And so another thing that’s super important, like you were saying, that your money freedom or financial freedom will not come until you have achieved time freedom. This is super important in the book 10x Is Easier Than 2x. It’s because when you have the time freedom from delegating, then your mind is freed up to plan, to envision, to be the visionary, to scale. Then more money comes that way. Otherwise, you’ll just be stuck doing the little things, and you can’t expand and scale. The third thing that you have mentioned was, I think you said delegating — what was the third thing?

21:15 Dr. Mary Alice Mina It was like investing in yourself, surrounding yourself with a good network. Yeah, delegating. What else did I say?

21:23 Dr. Ann Tsung Oh, distraction.

21:25 Dr. Mary Alice Mina Oh, I talked about distraction, yeah.

21:26 Dr. Ann Tsung Distraction proofing, yes. I’m so happy that that worked well for you.

21:31 Dr. Mary Alice Mina Oh, my gosh. Yeah, just that simple. It seems so simple. But just not having that on my homepage where I see it every time I look at my phone is huge. We don’t realize. Every time you’re task switching, it sets you back big time. So save your emails for certain blocks of the day. I know you’re good about doing that. I’m even thinking — I saw someone. I emailed her. I got in her signature line that said: I check emails from 9 to 5, Monday through Friday. I thought that’s awesome. So now my next step is, am I brave enough to put that on my signature line and really follow through with it that these are the times I check email. If you need me, it’s an emergency, you can call me. But otherwise, plan to get a response during business hours.

22:18 Dr. Ann Tsung Yeah, you can actually also say: I only check my email twice a day. And that’s it.

22:24 Dr. Mary Alice Mina Yeah, that’s pretty ballsy, Dr. Tsung. I don’t know if I’m there yet.

22:28 Dr. Ann Tsung Or like a shorter timeframe. Because the only time—

22:30 Dr. Mary Alice Mina Yeah. that’s true.

22:31 Dr. Ann Tsung —we talk about deep work, a shorter timeframe, like afternoon only or something like that. So you will not anticipate an email back from me by morning, unless you call me.

22:42 Dr. Mary Alice Mina Right. Yeah, setting that expectation, setting boundaries. That’s one thing. As physicians, we had no boundaries, right? We weren’t supposed to have boundaries. We were supposed to be or still are available 24/7 for anything. I give my patients my cell phone, but I find most people are really respectful of that. They don’t call me for things that are unnecessary. But yeah, that’s something to relearn. Our whole medical training was: you’re available literally 24/7. And so just kind of retraining in ourselves that no, it’s okay to have boundaries, and it’s actually healthy.

23:17 Dr. Ann Tsung Yeah, I do see that a lot of the physicians I talked to. I think I asked a question like, can you just tell your scheduler to not schedule you two weekends out of the month or maybe at least one day of the week, so you can have a set date night with your spouse? They were like, “Oh, I never thought I could do that.”

Because in the ER or maybe as a hospitalist, you just take whatever is given to you by your scheduler in your fellowship and your residency. You don’t have really a say. Not really, except for like big blocks. But you can’t just say, oh, every Monday I want off. Then it’s just so ingrained in us that we don’t think we have a choice to ask for our own personal boundaries essentially. So super important.

23:58 So moving on, I want to talk about for our audience or your patients, I’m curious, for both men and women, what are some basic — we talked about getting checked up by a board-certified dermatologist. Something that’s a routine, that is a must-do, sunscreen in the morning? Anything else that you would recommend? It can be brands. I know we don’t talk about brands. It doesn’t have to be things that you’re affiliated with. But I know people ask a lot like, well, which brand should I use? What kind should I use? What are some basic morning and night routines that should be like the absolute minimum both men and women can do?

24:38 Dr. Mary Alice Mina Yeah, so for men and women, it can be pretty similar, if not the same. The basics are gentle cleanser, moisturizer and sunscreen. Those are kind of the basics. Some people don’t wash their face in the morning. I think if you want to wash your face in the morning, do it. If you don’t, I think that’s okay too. But I would recommend washing your face at night, because you’ve got all the dirt and the oil and pollution and grime and maybe makeup that you want to wash off. So at a minimum, wash your face in the evening. Use a gentle cleanser. I’ve been using — I don’t mind talking about brands. I’m not affiliated with anything. But I’ve been using the Dove. It’s like a beauty bar. It’s a bar of soap essentially. We recommend it for babies. I’ve used it I think for 25 years. People give me new stuff to try and this and that. I’m like, it works so I’m going to keep using it. So it can be really simple. Most of products that I use, with the exception of maybe a sunscreen, are from the drugstore. There are tons of really great brands out there. Neutrogena, CeraVe, Cetaphil, La Roche-Posay. These are all great companies. They invest a lot of money into research, data, science. I know people sometimes say like, oh, you can’t have nice skin with drugstore brands. You need medical grade. Medical-grade skincare is a marketing term, and it is not a reflection of whether it’s going to work better or not.

26:05 Anyways, I kind of digress. So a simple moisturizer. If you tend to have dry skin, you’re going to want to go with a thicker moisturizer, maybe even more of like an oil-based moisturizer. If you have more oily skin, you want to stick with something a little lighter like a lotion. And then sunscreen. And really, sunscreen for everyone. No matter what skin type you are, no matter what your complexion is, everyone needs sunscreen. And just kind of getting in the habit of doing it every single morning just like you brush your teeth. I think most people listening, they don’t debate whether they’re going to brush their teeth in the morning or not, right? They just do it. So put your sunscreen right next to your toothbrush. Put it on in the morning. And that’s really it.

26:45 Now, if you want to get a little bit fancier — maybe you’re mid-40s like I am and you’re like okay, things are changing — you could add on a vitamin C serum in the morning. That works great. It’s an antioxidant. It helps fight free radicals that we get from pollution and the sun. If you’ve got some pigmentary changes in your skin, maybe some discoloration, some sun damage, then it also helps lighten with that. Again, there are tons of products out there. There are very expensive ones out there. I get mine from the drugstore. I think it’s RoC and La Roche-Posay are very nice ones. Great price point, and it worked fine.

27:25 Before I go into that, in the evening, I really like a vitamin A cream. So that’s going to be your retinol or retinoid. I think that’s a great option for someone who’s kind of playing the long game. Like, I don’t want to spend a lot of time or energy on my skin, but I do want to look as good as I feel and I want my skin to reflect that. Using a tiny little pea of that at night before you go to bed is a great way to build your collagen, even out your complexion. Again, it’s not an overnight fix. It’s not a quick fix. It’s like eating a healthy diet, right? You just got to stick with it, and you’ll reap the benefits. I use some prescription strength one. I kind of feel like if I’m going to do it, I’m going to go big and really get the biggest impact. But if you tend to have sensitive skin, then look for an over-the-counter product. Again, drugstore ones are totally perfect. So, you know, I think that’s really as complex as you even need to get. I don’t use an eye cream. I don’t use peptides. I don’t use all these other additional things. And you don’t have to.

28:27 Now, if you’ve got eczema, or you have acne, or you have some other, rosacea, particular skin concern, then you’re going to adjust your products accordingly. I mean that’s kind of like all you need for an anti-aging routine if you want. So it really can be simple. And since this is a productivity podcast, why would you waste 30 minutes of your life every day or twice a day, morning and night, with a complicated skincare routine? It’s not necessary. Who’s got time for that, right?

29:02 Dr. Ann Tsung Yeah, there’s like 5-steps, 10-steps, toners, et cetera. I wonder, I do use like jojoba. Because yeah, I just do sunscreen, jojoba oil. And that’s it. What are your thoughts about those organic essential oils as moisturizer? Then you talked about vitamin C at day, vitamin A at night. Is there a difference where layering — because I’ve seen that you have to do this versus first, before the other. Otherwise, they won’t absorb. Does it matter, the sequence?

29:30 Dr. Mary Alice Mina It does. Usually, we say go start with the thinnest to thickest. And so a serum usually comes in a dropper. And so it’s really liquidy. You just need a couple of drops. I would recommend putting that on your skin right after you wash it and then doing — depending on how thick your sunscreen and moisturizer, then layering those on. Then at night, you want to use your vitamin A or retinoid on clean skin. I would let it dry a little bit, because sometimes it absorbs too well if it’s wet. You can also layer on a moisturizer if you tend to have really dry skin, or you want to kind of dilute it a little bit. But if you tend to have oily skin, you can just put it on straight. But yeah, the order. And again, that’s why I’m like keep it simple. You don’t need five different products to layer on. It gets complicated. What goes first? What goes second? But in general, the thinnest to thickest is a good way to think about it.

30:25 Then your question on essential oils, I’m not a huge fan of essential oils. I think that they can lead to a lot of allergic contact dermatitis or rashes in people. There is this notion that, well, it’s natural so it must be good. It must be safe. That’s not always true. Usually, we’ll give the analogy of poison ivy is very natural. Arsenic is very natural, mercury. These are not things you would want to put on your skin. You know, if you like it and you haven’t had any problems with it, then fine. Enjoy it. I don’t see any problem with that. But in general, it’s not something that I’m recommending.

31:02 Dr. Ann Tsung And you have mentioned that for vitamin C, it was RoC. There was something else. What was the—

31:07 Dr. Mary Alice Mina Yeah, I’m a big fan of La Roche-Posay. I think they make products at a good price point that are also still elegant. I think that’s why some people gravitate towards these more expensive brands. The packaging is a little sleeker. Sometimes the formulation can feel a little bit better or lighter on the skin. But I find La Roche-Posay and really a lot of these brands make really nice ones. Skincare is so personal. So I really hate the feel of a lot of stuff on my skin. I really want things that are light. You may want something that’s a little thicker or has a different kind of smell. So everyone is different. So just because I like La Roche-Posay doesn’t mean you’re going to like it. Some of it is just trial and error. The good thing is that your dermatologist’s office, we get tons of samples. And so I’m always giving out samples to people. So grab those samples. Try them out. See what you like. Because really, people say, well, what’s the best sunscreen to use? I’m like the best sunscreen is when you put on. So I’m less concerned about which brand, whether it’s chemical or physical blockers. I just want an SPF 30 or higher that you actually wear. So that’s really the most important thing.

32:16 Dr. Ann Tsung And you did mention that for sunscreen, you don’t get that from the drugstore. Where do you get it?

32:21 Dr. Mary Alice Mina Well, I do. I also like EltaMD, and so we do have that in our office. I ran out, and so I’m using my La Roche-Posay that I have. So I’ll change that around a little bit. I tend to be a little more particular on my face, which is what I put on every single day. If I’m going to the beach, I’m less worried like if I’m putting on my arms and legs, the feel of it isn’t as critical to me. But for something I’m wearing every single day, I really want it to absorb well. I want it to feel like — I don’t want it to be sticky. I don’t want to feel like I’m wearing something on, caked on. And so I find Elta products are really elegant. I like the La Roche-Posay. But people like Supergoop. That’s another popular one. But again, trial and error. And I’ll tell people like, really, your sunscreen doesn’t need to cost a lot. I think $30 to $50, you can get a really, really nice sunscreen. And you know, it doesn’t break the bank.

33:17 Dr. Ann Tsung Yeah, I use one that’s purely zinc oxide. It has like maybe four ingredients. Do you have any thoughts about that? And that’s okay, really.

33:25 Dr. Mary Alice Mina Yeah, so I love zinc oxide. Zinc oxide and titanium dioxide are physical sunscreen blockers. The thought was that they’re not absorbed, and they act as a shield and block. But a lot of these cosmetic chemists on Instagram and stuff like that will say they actually do absorb as well. But they work really nicely at blocking UVA wavelengths, which some of our chemical sunscreens don’t block as well. So if you struggle with melasma, then that’s a great option. Because a lot of times, you’re getting that UVA through car windows and sitting by windows in your office that you don’t realize. So physical blockers are also great for babies because their body surface area to weight ratio is a lot higher. And we don’t want that absorption of chemical sunscreens into the bloodstream.

34:15 Chemical sunscreens are great as well. I use both. It’s kind of like whatever I have on hand. Sometimes the physical sunscreens can leave a little bit of a white cast, or at least historically. And so, again, it’s like trial and error. There are so many great brands nowadays, so I think you certainly can find one. But I don’t feel strongly. But if you’re worried about using a chemical sunscreen, then stick with the zinc or titanium, and you’re totally set.

34:40 Dr. Ann Tsung So you don’t need both really. If you have physical, you’re good. If you have chemical, maybe not as much UVA but it’s still fine.

34:48 Dr. Mary Alice Mina Exactly. La Roche-Posay actually has one that does get more UVA. So I would say, really, unless you struggle with melasma or you’re an infant, then those are really the only groups I would say a physical blocker may be better for you.

35:04 Dr. Ann Tsung Okay. Got it. Yeah, my son uses the same sunscreen as I do.

35:06 Dr. Mary Alice Mina Yeah. Well, here’s a little tip. Everything, I feel like they label things like baby or for women and then they jack the price up, right? Babies’ sunscreen is just zinc oxide, titanium dioxide, right? So you don’t necessarily have to get the one that says baby. Just flip it around. Make sure the only ingredients are zinc or titanium, and you’re set.

35:26 Dr. Ann Tsung Awesome. Thank you. Thank you. Then I think with the last thing regarding the vitamin A, you said you do like, is it a 1% or a .5% that’s prescription strength? But it will cause some — it depends on the strength, right? Because I know some people, it will cause some peeling. If they can tolerate it, they can do that. But if not, it will be the lower strength one over the counter.

35:47 Dr. Mary Alice Mina Yeah, so over the counter or the retinols, they’re not as strong. I don’t think they necessarily write the percentage on there. Adapalene, which is also a different brand name, different as an over-the-counter vitamin A, that’s a little bit stronger. Then the prescription strengths, there are different levels: .025, .051. I usually say start low. Start slow. You can start with a .025. You can mix it with a moisturizer. But I usually will try to counsel people that it’s okay to get some flaking. And in fact, that’s almost like my end goal. It’s just a little bit of flakiness and dryness because then I know it’s doing what it’s supposed to, right? It’s increasing cell turnover. It’s help removing the stratum corneum and boosting your collagen. And so I’m okay with a little dryness and irritation. I just combat that with a little moisturizer in the morning, or I don’t do it every night. So starting off, doing it maybe just two nights a week is totally fine. But I think where people run into problems is they overuse it. They use more than just literally a tiny pea. They don’t mix it with moisturizer, and they do it too frequently. So again, it’s like playing the long game low and slow. I do think most people can handle a prescription strength retinoid. They just need to know how to use it and properly.

37:06 Dr. Ann Tsung Got it. They cannot do the over the counter in pregnancy and breastfeeding, or they can?

37:10 Dr. Mary Alice Mina Well, you know, I would probably say just steer clear of it for pregnancy and breastfeeding. The data is not great for it. But we certainly know what the oral form of vitamin A, which is isotretinoin. Not safe at all. So when you’re pregnant or breastfeeding, just avoid a retinol and just don’t use it during those times.

37:31 Dr. Ann Tsung Okay. Got it. Yeah, I’m just asking for myself, selfishly.

37:35 Dr. Mary Alice Mina I know. Right.

37:37 Dr. Ann Tsung Yeah, right now, at the time of this recording, I am pregnant. 32 and 4 weeks right now. So I’m just trying to figure out my own regimen. Because definitely, I don’t use vitamin A. I have tried it. I have tried vitamin C. But then after I ran out, it just ran out. Now I will go back. Because you’re right. It’s confusing. I don’t have time to research the brands. My friends, they do a lot multi-step, and they research the brands. But they’re like $100 to $200 for a bottle. I’m just like, do I really need that?

38:10 Dr. Mary Alice Mina I tell people save your money for other stuff, right? The products don’t need to be expensive, right? Save your money. Maybe you want to do some other procedures, or save it to put a down payment and invest in real estate, or your coaching, or whatever. But yeah, you don’t need to spend $100 plus on your skincare product. So hopefully, that’s a testament that you really don’t need it.

38:32 Dr. Ann Tsung And for those of you guys who can’t see this, I would go on YouTube because Dr. Mina’s skin looks great right now.

38:39 Dr. Mary Alice Mina Well, yours says too, Dr. Tsung.

38:42 Dr. Ann Tsung Thank you. Thank you. I do want to touch on a little bit of — I don’t know whether it’s a biogenetics or basically increasing your own collagen turnover. I heard it on your podcast, and then the red light therapy mask. For anybody who wants to take it further, who will be the right candidates for those?

39:00 Dr. Mary Alice Mina Yeah, so I’m a little bit skeptical on a lot of the devices and things out there. There’s so many. It’s so overwhelming. It’s hard to keep up, honestly. If you are looking to do something at home, then the red light mask have been shown to be effective. The main issue is: they’re super expensive, and we don’t have a lot of good data showing how much energy should they be emitting. What’s the exact wavelength and power that they need to have, and how long do you need to use it? And if you have patience and you’re going to stick with it, you really need to wear them like 10 minutes every single day for a year plus to really see the benefits. So if you’re willing to commit to that and invest in it, then there’s certainly no harm to it. Studies are promising. I mean, we use red light in in-office procedures, so we know it works. But it’s just a question of which at home device is really the best. I don’t love at home derma stamping and rollers and stuff like that. I think anything where you’re puncturing the skin, do you really want to be doing that in your bathroom by yourself without sterilization and all that? So I would say stick with seeing a professional, like a dermatologist or a plastic surgeon for those things.

40:14 But you had asked me about collagen boosting and stuff like that. That’s definitely all the rage. As I get older and older, I’m more and more interested in that. Because our collagen starts to decrease even in our mid 20s. Then when women hit menopause, there’s this dramatic 30% reduction in your collagen. That’s why many women in their late 40s, 50s, or whenever menopause happens for them, they feel like they wake up one day and their face has just fallen. That’s because of that really drastic collagen loss. So, again, things we can’t do. We can’t totally stop that, right? It’s a normal, natural process. But it doesn’t mean there aren’t things we can do to lessen the severity. Some people, I get asked a lot about like collagen supplements and stuff like that. There’s a little bit of data. I think we really need more data before I will just routinely recommend it to everyone. Because again, it’s expensive. But collagen supplements may help increase collagen in your face. But what I love is actually just putting the collagen there. And so there are things called biostimulants. Brand names are Sculptra and Restylane. People think of them as fillers, but they’re really not fillers. What they do is they stimulate your own collagen. So you inject these little particles, and it kind of revs up your own collagen. And so I love that because I know I’m actually getting the collagen where I want. I think it’s a great option for someone, again, who’s playing sort of the long game. They want to still look like themselves. They just want to maintain their collagen as they go along. So I think that’s a great option. Using a vitamin A is also boosting your collagen by about 300%. So again, that is like super cost effective, especially if you can start it before you really need it. That’s a great option.

42:02 People have shown that even doing resistance training, weightlifting can boost — well, they they’ve shown that your dermis, which is the second layer of your skin, is actually thickened. And so there’s some thought that actually weightlifting, resistance training can boost your collagen as well. I think that really goes back more towards just taking care of your body in general, right? Weightlifting, exercise, we all know that’s going to help give you just healthy muscles and a healthy body. But it may also give you some collagen boost in your skin as well.

42:35 Dr. Ann Tsung Wow, I did not know weightlifting can boost your collagen. I’ve been weightlifting for like, I think, 11, 12 years. That’s exciting.

42:42 Dr. Mary Alice Mina Yeah, that’s why your skin looks so good.

42:46 Dr. Ann Tsung I wonder why. Is it because of increased cellular turnover process from weightlifting and resistance training somehow builds it up?

42:55 Dr. Mary Alice Mina Yeah, maybe like boosting the mitochondria, ATP. It’s still debatable. Again, the study I’m referencing just looked at the thickness of the dermis. And so we’re hypothesizing that that is because of increased collagen, which is the main component of our dermis. So again, more research has to be done. But I think there’s plenty of health reasons to suggest weightlifting and resistance training. Anyways, if the only thing that gets you to do it is that it might boost your collagen, then yeah, it does.

43:24 Dr. Ann Tsung At what age should they begin if they are interested in biostimulants? Is there a certain age or as early as possible to talk to your dermatologist?

43:32 Dr. Mary Alice Mina Yeah, for most people, I would say you start to notice the changes of aging, I would say, in your late 30s. Now, there are some people who may have some asymmetry from congenital things and stuff like that. But for the most part, people start to notice these changes in sort of their late 30s and then into the 40s. Again, I’m all about prevention and maintenance. So if we can tackle it earlier, like I was talking with a girlfriend yesterday. I was saying like one vial for her every maybe two years is going to do her great because she’s getting in early. But then I do see people who are maybe in their 50s, and they’ve already gone through menopause, or they’ve already had that a lot of collagen loss. And so for them, we’re going to have to play catch up a little bit. So it’s going to be a little more intense in the beginning. They’re going to need more vials kind of spaced a month apart. But then, they’ll reap those benefits later.

44:30 So again, it’s always like — I don’t want to say no 20-year-old needs it. We don’t need like Sephora babies coming in for biostimulants. But I would say when you start to notice some fine lines that stay on your face even when you’re not moving or starting to notice some loose skin, some Halloween of the mid face, then that would be time to kind of start talking to your dermatologist about it.

44:55 Dr. Ann Tsung Got it. After this conversation with you, I’m going to go buy a bunch of drugstore brands, like you said. I mean, I think my dermatologist probably booked out like months ahead, but I’m going to start now.

45:07 Dr. Mary Alice Mina Yeah, get that appointment locked in.

45:09 Dr. Ann Tsung Yes. And that goes into the action steps. Then if they were to take like a top three takeaways or action, what would you say it would be for the audience?

45:20 Dr. Mary Alice Mina I would say think about skincare as whole-body care. So it’s not just, what do I need to put on? What procedure? What device do I need to buy? Think about really your skincare as whole-body care. Get that sort of locked in and get that foundation set. Make healthy lifestyle choices. Not drinking too much alcohol, not smoking. Getting enough sleep, stress management. It sounds like well, yeah, yeah, yeah. Like, give me what really helps. But really, that is the foundation, right? All the stuff I can do and the procedures and devices, they’re really going to just put a Band-Aid on it if you don’t have that foundation set. So thinking about your skin is more than just what you put on it and thinking about taking care of it from the inside out. That’d be number one.

46:06 Number two would be to trust real experts. I think nowadays, it’s so easy to have so many followers and have a large presence, which doesn’t necessarily mean you’re an expert. There are people putting out advice and messages about skin and health, and I feel like it’s not always the best. Sometimes it’s actually dangerous. A lot of times, it’s really steering you to buying their product or buying something they’re endorsing. And so I don’t really know if they have your best interest at heart. So I would say just be mindful of who you’re listening to, who you’re trusting. Do they really have the expertise and credentials?

46:49 Sometimes I’m amazed, where people will come to me and they’ll say, well, I got Botox at my dentist, or my podiatrist, or my chiropractor, all these people. I just think like we research. On Amazon, people will research the heck out of a light bulb. But people have no problem going and getting these cosmetic procedures from just anyone or anywhere. I’m like, how much research really went into what you’re getting, what it really does, and who’s performing that? So I think just really trusting the experts, trying to eliminate the noise around you, which is hard, right? All those distractions, all those people telling you buy this or buy that. Then my last thing is: just keep it simple. People have really overcomplicated skincare. Again, a lot of it is because they want you to buy this, do that. Spend money on that. It’s a lot of marketing. And so take a step back. Keep it simple. I know your listeners, we’re busy people, right? We have a lot going on, a lot of things vying for our attention. And a complicated skincare routine does not need to be one of them. So that would be my three tips.

47:54 Dr. Ann Tsung Thank you so much. Where can people find you in terms of like podcast, social media, your website? Or if they want to see you in person, where can they find you?

48:03 Dr. Mary Alice Mina Yeah, so I practice in Atlanta, Georgia. I tend to have more of a procedural-focused dermatology practice. My handle on social media is @drminaskin. My podcast is The Skin Real. We’re theskinreal.com. You can find it on that. And if people are interested in learning and sort of like, well, what kind of skincare habits do I really need, you can get a free PDF from me at theskinreal.com/habits where I kind of break down the first step is really knowing your skin type and your skin needs. So that’s available for any of the listeners interested.

48:37 Dr. Ann Tsung And that’s Skin Real. R-E-A-L. Correct?

48:41 Dr. Mary Alice Mina Exactly. Yep.

48:43 Dr. Ann Tsung Okay. Not R-E-E-L. R-E-A-L. The real talk. All right?

48:46 Dr. Mary Alice Mina That’s right. That’s right.

48:48 Dr. Ann Tsung Awesome. Well, thank you so much again. I mean, this podcast was basically for me. I just asked you all the questions I’ve been meaning to ask. But I’m sure, yes, a lot of the woman probably have the same questions. So I hope the audience got — I’m sure they got a lot out of it. And I really appreciate you sharing how you do things, the journey, and to simplify things for us. Because there’s just too much info out there, like you said.

49:17 Dr. Mary Alice Mina Yeah, it’s distilling it and cut through it. I would say that’s one of the perks of being a podcaster. You get all this like free information with your guest.

49:26 Dr. Ann Tsung Yeah, I’m scratching my own itch. So for the audience, please go check out Dr. Mina’s podcast. Go to her website and then just get that PDF. Okay? Then it doesn’t take any more time. If you just take one action after this, maybe just pick out one product or just find the nearest board-certified dermatologist near you, and just book an appointment. And again, thank you so much, Dr. Mina, for your time and for the audience for your time and attention. And just remember that everything we need is within us now. Everything that we talked about, the brands, the links, it will all be in the episode show notes on productivitymd.com. Thank you.

50:06 Dr. Mary Alice Mina Thanks, Dr. Tsung.

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