The Habit of Skin Care with Dr. Jennifer Choi

Jessica Honegger [00:00:03] Hey there. Welcome to Going Scared. I'm Jessica Honegger, founder of the world changing brand Noonday Collection. And I'm so glad to have you here for today's conversation. Our Going Scared community gathers here every week for direct and honest conversations that help you live a life of courage by leaving comfort and going scared. Well, by now, I hope you have listened to the very first episode that kicked off this entire series with Gretchen Rubin, where she categorizes four different personality types into how we approach habits. I am a questioner, and I don't think that has become any more apparent than it does on today's episode with dermatologist Dr. Jennifer Choi. Dr. Choi is the chief of the Division of Oncodermatology at Robert H. Lurie Comprehensive Cancer Center. She specializes in providing skin care for patients undergoing cancer treatment. She directs a comprehensive skin care and skin cancer surveillance program for high-risk patients and all cancer survivors. She is co-leader of the Skin Disease Team and an integral member of the Northwestern Melanoma Unit. Dr. Choi also runs a full medical and surgical dermatology practice and is the director of the Division of Medical Dermatology. She received her B.A. degree from Harvard University and her M.D. degree from Yale University School of Medicine. But more than all that, she is a friend. She is filled with compassion and care, and she breaks down all of the myths around skin care. And let me tell you, I laid it on today and I now know what my skin care routine is going to be. And I feel like she really gave me the research and data I needed to start washing my face at night. Here we go. Jennifer, I'm so excited to have you on the show.

Dr. Jennifer Choi [00:02:07] Thank you. I'm excited to be here.

Jessica Honegger [00:02:09] Okay. So, I am a bit of a cynic when it comes to skincare and that is probably one of my most poor habits, is taking care of my skin, washing my face, all of the things. Even though I know sunscreen is essential, I have this I what I hope you all dispel today is a myth that I fried myself as a teen. So, it's too late. Like the damage is done. So, what does sunscreen even matter for me now? So, I. And we are going to walk away today. You're going to just break down the essentials of what we need. We are going to know what we don't need and all of the things. So, I wanted to start with sunscreen because I have a feeling you are going to get on a platform right now and preach and we need it. We're here for it.

Dr. Jennifer Choi [00:02:53] Okay. Okay. So basically, as a background, I am a dermatologist, and my specialty is actually skin cancer. And so, for that reason, yes, 100% sunscreen is one of the things that I recommend the most. And I'll tell you basically why because there are several different benefits. And so, number one, if you look at women who are in their older years and if you compare people who have skin that looks older versus skin that doesn't look older, [00:03:30] actually the number one anti-aging agent is actually sunscreen. So not even yet getting into skin cancer and those fears and whatnot is actually the number one anti-aging ingredient. We have so much evidence now that UV rays, so ultraviolet rays, both in the forms of UVA and UVB, both of which come through from sun exposure, both types lead to aging skin. And so, they've found through numerous basic science studies and biopsies of the skin that with sun exposure, cumulatively you lose college and the quality of your skin. Actually, you start to lose the collagen in your skin from sun exposure and that leads to aging skin that leads to loss of volume. And then we also know that ultraviolet radiation leads to hyperpigmentation and pigmentation on the skin. [53.8s] So that's what's going to also lead to the dark spots. And the freckles and freckles are beautiful, but like more like the dark spots that people start to accumulate over time. And you can definitely see older people who didn't use sunscreen. They just have a lot of dark brown spots on their skin. And so that's number one.

Jessica Honegger [00:04:41] Is there a myth then that I fried myself as a child and it's just too late? Like, I remember just basking in oil as a teenager, putting lemon juice on my hair and getting in like whatever the oil said that it would actually amplify the sun. And so, I feel like, okay, well, it's too late. You know, skin damage has happened. So, what's the point now?

Dr. Jennifer Choi [00:05:03] Okay, so that is an absolute myth. And I'm so glad you brought that up because many people think that they sort of think like, why should I start now? Because the damage is done. It is 100% not true. So, yes, it's true that you have to if you've had damage to your skin, then, you know, there is that that's going to happen. But there is also some evidence that using certain ingredients can help to reverse some of that. And then and we can get into that in a few minutes. But in terms of the benefit of going forward, anything that you do to protect your skin further is going to benefit you going forward, basically. So even if you've had sun damage when you're young, if you start a good sunscreen and just a good regimen now, you can definitely prevent further damage going forward. And a lot of, you know, a lot of further aging, it just all accumulates. So, if you think about it, you know, like say there's a train and yes, the train has left the station. But if you stop the train, then it can prevent further damage as opposed to letting it go off the railing, you know. So, there is yeah. So, it's definitely true that if you do something now, you can definitely prevent further damage from happening.

Jessica Honegger [00:06:13] Okay, I have another myth. Well, I don't know if it's a myth. I'm just super curious. My mother has incredible skin. She's 75. She does not look her age. I've grown up around her saying people saying she has beautiful skin. I actually have her skin like I've got pretty good skin. So, I tend to say it's all genetics. None of this matters because it's so sunscreen and the rest is genetics.

Dr. Jennifer Choi [00:06:36] Okay, so there is a genetic component in a way. So, in general, lighter skin types, they are more prone to sun damage over time, darker skin types, you know, they can actually they're protected from their melanin. So, they may not actually have as much sun damage as quickly. So that's that that that kind of genetics. There is genetics in terms of people who are prone to different types of skin condition. So, believe it or not there is a genetic component to acne, so people who are really acne prone, one of their parents may have had really bad acting as a kid, for example. In terms of genetics, in terms of like looking and staying young, honestly, a lot of that is probably sun protection. So, I don't know if your mom actually was really good at sun protection, but honestly, like people who have really great skin. Most of it, to tell you the truth, is actually sun protection throughout their life.

Jessica Honegger [00:07:33] Okay, so let's talk about sun protection. I am curious, first of all, is there a difference between a 20 SPF and a 40 SPF?

Dr. Jennifer Choi [00:07:43] So there is a difference in the sense that SPF is determined they do it in the laboratory setting by determining what level will prevent redness from the sun. And then that gives you like the SPF level. So, for example, if you use an SPF 100 versus an SPF 30, then using that sunscreen will prevent sunburn better than an SPF 30. [00:08:09] Now, having said that, really the minimum that you want is SPF 30. That's going to protect you from 97% of the UVB rays. Once you get up to SPF 50 it's providing 98% protection and then SPF 100 is like 98.5. So, you can actually do that. The number is actually minimal as you go up. But having said that, they have done studies that people who have used SPF 100 versus SPF 30 definitely did burn less. And the reason being is that most people are not using enough, so technically to protect your skin. And let's talk about like all your body. If you're wearing shorts and a t shirt, it should be a full shot glass full. And most people are using half of that, maybe even a quarter. So, if you're using half of an SPF 100, then you're getting maybe about SPF 50. But if using half of SPF 30, you're only going to get SPF 15. So, in that sense, it actually might be better if you're not going to be using the full amount to use a higher SPF. If you're going to use a great full amount than SPF 30 is all you need. [64.4s] I'm just amazed. Yeah.

Jessica Honegger [00:09:17] And I know this.

Dr. Jennifer Choi [00:09:17] Just to mention for your face, it should be two finger lengths. So, a lot of people under apply sunscreen for their face. So, two finger length is a great amount to cover your whole face per application.

Jessica Honegger [00:09:30] Gosh, I had no idea. Okay, then let's talk about this because I feel like brands have caught on. I mentioned, you know, we've had the founder of Supergoop on before and brands have caught on and are putting sunscreen in a lot of things. So, I'm actually feeling very sad right now because I usually just use a little tinted moisturizer and just like a dot and it's got SPF in it. But what I'm curious about is chemicals, because I hear so much time about clean beauty and well, I don't want to use that sunscreen because it's got this ingredient in it. So where do we begin when it comes to ingredients in our SPF?

Dr. Jennifer Choi [00:10:07] Okay. This is a great question. There are different types of sunscreen filters. We call them physical barriers, which is basically technique, it's actually inorganic. So physical titanium dioxide and zinc oxide and then the chemical sunscreens like oxybenzone and octocrylene, these are called chemical filters. And believe it or not, they are organic. So that's one myth right there. Organic doesn't always mean chemical free. Actually, the chemical filters are the organic ones. Now, there is no evidence as of now that chemical or physical sunscreens are dangerous to your health. There really is not. So basically, you know, when they say clean beauty, sometimes they're saying, okay, it's free of the chemical filters. But there is a big kind of controversy around the whole term of clean beauty. It is not FDA regulated. There's actually no regulations anywhere around the use of the term clean beauty. [00:11:07] And if you ask many, many dermatologists, they will actually tell you they are against the whole label of clean beauty because honestly, a lot of it is based on fear mongering and trying to get people to buy their brand because they're saying that it's healthier or safer. And in fact, like there's no chemical that has been shown to be dangerous to your health. [21.5s] This is also somewhat controversial, but there are some also people who really, really believe in looking at the Environmental Working Group list, and they'll list a whole bunch of things that they say could be dangerous to your health. A lot of these studies are based on either like lab or mouse studies where you're getting 10,000 times more in the mice than you would ever get exposed to through a product, for example. And so, a lot of people think that that is not equitable. Like it's not the same as the exposure that we're getting. And so, yes, if you ingested sunscreen ten bottles a day, could it possibly be dangerous to you? But that is totally not in a in a real way relevant. So honestly, if you find a sunscreen that you like to use, that is at least SPF 30. It's absolutely okay, whatever you decide to choose.

Jessica Honegger [00:12:23] Well, I wanted to ask you then and I don't want to name the brand, but I know a brand that has gotten really, really popular. And they even consider themselves advocates that they're going to the FDA and they're going to the government to get regulations passed around chemicals, because they say that in Europe, all of these things are banned because it's like what you would put in your car and it's what you would put in this. And maybe I'm going outside of sunscreen now just into skin care in general. But I guess it's challenging because you are a scientist. You've got Harvard and Yale behind you. Plus, you're the head of, you know, I mean, we're going to get into that later. But I mean, I trust science and I trust when I especially when I know a physician, which I do know you. And I guess there's so much suspicion out there about the FDA and like what you know. So, I guess if you don't believe in FDA, yeah. So, tell me, maybe react to that what I just said.

Dr. Jennifer Choi [00:13:16] I mean, FDA the FDA is important. It absolutely is important because, you know, they are helping to regulate based on science and based on studies what is going to be safe for the general public consumption. So, the FDA is important. And so, on the other hand, it's actually really kind of they have very high standards in terms of what they pass and things like that. So, I you know, I commend any company that is trying to get FDA approval and FDA regulation. And in general, that's a good thing in terms of they are also good about saying like, okay, we're looking at these studies and seeing how really it is relatable to human consumption and human use. And so, I think it's actually hard to get FDA approval. So, in other words, like the efforts are there, I think that's great. But, you know, it's one of those things where there are some things that that may be hard to get past because we don't really have all the firm data there.

Jessica Honegger [00:14:15] So the data, you know. Right.

Dr. Jennifer Choi [00:14:17] Yeah. It's all about the data.

Jessica Honegger [00:14:19] It's all about the data. Okay. I have a question for you because I wanted to kind of move on from sunscreen. I just learned about three things I didn't know. And I'm about to start spending a lot more on sunscreen now just because of the volume. If you were to start a skin care company tomorrow, what are the first five products you would go and create in the lab?

Dr. Jennifer Choi [00:14:42] Oh, that's a great question. Okay. Well, so then that brings us to sort of like what do we as dermatologists think are really the essentials because there are lots of non-essentials. So, number one, obviously sunscreen and then and making it some, you know, an elegant something basically I always say just find something that you like to use and that you're going to use without hesitation. [00:15:08] Number two, the next biggest bang for your buck is going to be a topical retinol or topical retinoid. And what this is basically an ingredient that is based on vitamin A. And when you apply it to your skin, again, based on data and really great science, it has been shown to have really good benefits in terms of renewing your skin. So, it increases cell turnover. So, it helps to make dull skin look brighter and smoother. It helps to actually induce fine collagen formation. So, it actually helps to reduce fine wrinkles and it helps to basically brighten dark spots and smooth your skin. [40.5s] So basically, they're really great benefits to topical retinoids. And so, if there's one ingredient besides sunscreen that you're going to add to your regimen, it would be a topical retinol, which is over the counter. And then the next stronger category is retinoid, which is there are two that are actually available over the counter. And then you get into prescription strength that you can get from your dermatologist or other doctor and that would be applied at nighttime.

Jessica Honegger [00:16:16] I actually used prescription strength retinol for like six years. That's great. It was all in college and high school. I think maybe it was. Maybe they were treating acne with it. I don't know. But I used it. I got the prescription for it, and I can't believe I'm saying this out loud. But whenever I go to Mexico, I think it's not regulated down there is not over the counter. And it is you're knowledge. Yeah. I'm not alone. You're not. So, I might have, you know carried some you know, controversial retinol that but I want to get back into it but the times that I've tried it now, it just does immediately cause, you know, irritation. I don't feel the irritation, but my skin just starts to absolutely peel. So, I think the. Is one of my other myths is because I use the prescription strength for six years. I think prescription strength or nothing.

Dr. Jennifer Choi [00:17:10] Okay. So totally not true also. So especially for people who are listening who you've never used a retinol retinoid or like yourself, if you use a retinoid before prescription strength and your skin can't tolerate it now, it is absolutely a great idea to then go to a weaker strain, start it, building it and slowly again, and then get up to that again. So, for example, you can start with any over-the-counter retinol. There's so many out there or and this is no conflict of interest. But the two retinoids which are which are actually prescription strength but now available over the counter are different and La Roche-Posay makes something called Everclear. So those are all available over the counter. And what you would do is you would start with just a pea sized amount you dotted around on your forehead, your nose, your cheeks, and your chin. I would initially avoid right around your eyes because it can cause a lot of irritation. Avoid the creases right around your nose and in the creases right around your mouth. But otherwise, just gently rub it in, put it on at nighttime, wash it off in the morning, and when you're starting off fresh, only do it twice a week. So, you're only going to do it twice a week. You're not going to jump in and do it every night. The other thing that can really help to help your skin tolerate it is doing what we call a moisturizer sandwich. So, you put a moisturizer on first, put the retinoid on second, and then a moisturizer on top of that. And your skin will be so much happier. And the retinol or the retinoid is still working. So those are great ways.

Jessica Honegger [00:18:42] Are retinol and retinoid basically do the same thing. Are they two separate things? That's where I'm a little confused.

Dr. Jennifer Choi [00:18:47] So the retinol is weaker, but it still gives you benefit. And then the retinoid, it's a little stronger, so it'll give you more benefit over time.

Jessica Honegger [00:18:56] And those are the two brands you name that actually are over the counter now that used to be prescription strength, correct? Okay. Yeah. Okay. Well, that's good to know. Okay. What's next?

Dr. Jennifer Choi [00:19:05] So, okay, so then the next thing I would consider, the next ingredient would be vitamin C. So, vitamin C is like the next one after retinol or retinoid. That also will give you benefit. And I will also just kind of say it out there. Not everyone can tolerate these ingredients. So, some people, no matter what vitamin C, they try it will irritate their skin. So, you just kind of have to say these are not necessary, but these are kind of good, effective products. [00:19:31] So vitamin C serum, again, there are many out there. Typically, you put it on in the morning and it's a great antioxidant. And so, number one, it helps against it does actually help against damage that your skin gets from ultraviolet radiation. It helps to prevent or treat dark spots, sunspots, and it helps to brighten your skin. [20.1s] So vitamin C is another great one. There are different qualities of vitamin C. So, into in general, you want to find one that's going to be in a dark bottle because it does oxidize easily and once it oxidizes, it's not going to be as effective.

Jessica Honegger [00:20:06] So are you saying this is literally vitamin C like you're just putting out like, okay, like is it in like an oil or so?

Dr. Jennifer Choi [00:20:13] It depends sometimes that some of them are most of them are going to be like a light, like it's like a light serum. Basically, there are some vitamin C that come in creams and so they come in different formulations. It is also ascorbic acid. There are other there are different types of vitamin C, so it's not the same as just putting like we don't say just put an orange or lemon on your face because so especially lemons, they can be acidic and actually can cause damage to your skin. But these vitamin C serums are really well formulated, and they actually are a great antioxidant.

Jessica Honegger [00:20:45] Okay. What's next?

Dr. Jennifer Choi [00:20:47] So the next thing after that, I would say is a good, gentle cleanser. So, cleansers are great for our skin. And if there's one habit that you want to also form is just wash your face every night.

Jessica Honegger [00:21:05] Oh, my gosh. I was about to tell you; you're going to be so disappointed. I do not wash my face at night. And that is one of the reasons I thought if Jennifer, Dr. Choi can convince me of this today, I'm going to start washing my face at night.

Dr. Jennifer Choi [00:21:19] Yeah. So. Okay, so similarly, when I was younger, similarly, I was like, why is it so important? But then of course, I started dermatology residency and then I went there and now I know all the benefits, but there are a couple of reasons why. So, number one, there is such a thing as like, you know, grime and the daily things and like whatever products you put on your face, it all kind of is just sitting there. It really is just sitting there on your skin. So, when you wash your face at night, you're getting all of that off. You know, it's a total myth that pores can be removed. Like there's no such thing as removing pores. But the pores are like the opening of the hair follicles on your skin. And so. But there are different ways that you can minimize the appearance of pores. But washing your face is actually one of those. So, like, if you can imagine if you have all these products and things and you know, honestly like dirt and stuff from the outside, that's just kind of like even microscopic bits on your skin. You can actually be, you know, kind of it's in your skin, it's in the hair follicles. It's all just kind of on there. So, when you clear it, it really just helps. It helps all of that. So, it clears your skin. It helps in terms of like other conditions. So, like if you're acne prone 100%, it's so important to clean your skin because it can actually make acne worse. Although it's a myth that cleaning it more and more and more is actually going to clear acne. That's that totally a myth as well. So that's a whole nother conversation. But you want to at least wash your face every night and with a gentle cleanser, it shouldn't, you know, it doesn't have to be anything harsh or stripping. And you don't want it to be you just want to be a gentle cleanser. So, number one, it helps with skin conditions like that. It clears your skin from the grime and the dirt and all that stuff from the day. And it allows whatever you're going to put on at night to then work more effectively. Okay. So, you know you're going to. Yes. And then you just clean your face, put on the retinoid or retinol or even if it's moisturizer, and then it's just going to work so much better. And then I also think it really helps with just your mental kind of, you know, it just helps to disclose is your day out? Yeah, it does. It really does. And you can create this. It doesn't have to be complicated at all, basically just kind of wash your face and if anything, put on a moisturizer and then just go to bed. Like it just helps mentally. Just tend to close the day and you can make it something that you that that's enjoyable to you.

Jessica Honegger [00:23:49] Okay. You've said moisturizer. I'm assuming that's going to be your next one.

Dr. Jennifer Choi [00:23:52] And that's my last one, so it'd be a moisturizer. So basically, you know, it's another myth that oily skin doesn't need moisturizer. It actually does need moisturizer. All types of skin need moisturizer. I would have I would say, you know, you don't absolutely have to use a moisturizer every day because it's not like something that if you don't use one, your skin's going to go crazy or bad. It's one of those things where basically, you know, especially if you are washing your face, you can actually get rid of the natural, ceramides and hyaluronic acid and things like that that are in the skin. That helps to that helps to keep a healthy skin barrier. And if you wash it a lot or strip it a lot or your skin tends to be really dry, then those ceramides are proteins that are in your skin that really help to create this healthy barrier. So, you don't get things like eczema and like acne and things like that. So, a moisturizer is really good just to kind of renew all of that to trapping moisture. And it also helps the appearance of your skin so it doesn't look so dry, and you know, it actually can plump your skin and make it look better. So, moisturizers are wonderful thing to incorporate into your regimen as well.

Jessica Honegger [00:25:07] So can we combine the SPF and the moisturizer? Can that be just one product?

Dr. Jennifer Choi [00:25:12] Yes, it totally can. So, there are lots of moisturizers out there that say SPF. And again, what I always tell people is just find something that is doable for you. If you make yourself this whole regimen that just seems completely not sustainable, then you're not going to do any of it. So, find something that you like. So, these moisturizers with SPF. Yes, it does help. You can put it on there. Again, though, the main thing is that you're using enough. So even if you're using a moisturizer with SPF, you want to try to do two finger lengths. Otherwise, you're not getting the full SPF that's listed on the bottle of the moisturizer.

Jessica Honegger [00:25:48] Let's face it, I don't even wash my face at night, so I'm not going to be the one that's reapplying sunscreen during the day. So how long does that protection last?

Dr. Jennifer Choi [00:25:56] Okay. So, it lasts only about 2 hours.

Jessica Honegger [00:25:59] Oh, that's depressing.

Dr. Jennifer Choi [00:26:01] Right now. So that's our general rule is you want to try to reapply every 2 hours. Now, how am.

Jessica Honegger [00:26:07] I going to. I don't know anyone that does that.

Dr. Jennifer Choi [00:26:10] I know. And so, I think once you learn the benefits of reapplying, then you do get into the habit more of doing that. But let's say, for example, you're going you're starting your day, you're cleansing your face, putting on moisturizer and then putting out sunscreen, and then you go to work. And so, let's say you go to work and some people, they're kind of not really near windows and whatnot. So, then you don't have to reapply every 2 hours. That's fine. Like you're just like indoors and working and then as you're leaving the office or whatnot that you're driving home, that actually would be a good time to reapply because we get a lot more ultraviolet exposure through windows of the cars than you realize and so that would be a good time. So, either you have a small sunscreen bottle that you keep in your purse or your work bag or even in the car, although we kind of generally say don't in the summer, don't let it sit and get to really high temperatures because that could actually affect the quality of the sunscreen. So maybe keeping it in your purse and either reapplying at that time. Sunscreen powders are wonderful. There are many different great sunscreen powders, and that's a great way to reapply. So, you basically reapply. It goes on nice and matte. It's almost like a foundation brush, like a powder. And that's a wonderful way to reapply.

Jessica Honegger [00:27:26] So there are different ways that exist. Wow. Yeah. Okay. Wow. I can. I didn't. That's blowing my mind. One habit that we talked about in this Habit series is finances and planning your life.

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Jessica Honegger [00:29:24] Okay. So, let's talk about money because there is such a wide range of costs out there. And now that you're saying I mean, my sunscreen slash, you know, tint that I like to put on almost wear it as my foundation. If I did two finger fulls like I would if you spend like a hundred bucks a week or something. So yeah. So, I'm going to have to make some changes here. What is the difference between a high-cost product and a, you know, lower cost product? Like because Target has such I mean, the beauty industry has exploded in the last few years. And you can see that by the store spaces that retail spaces are now giving to beauty. And I mean, the Target space is huge and there's so many products there. What do I do about that?

Dr. Jennifer Choi [00:30:10] [00:30:10] I love this question because there it is also a total myth that more expensive means better quality. That is totally not true. So, there are wonderful effective products that you can get from Walgreens, CVS, Target, all kind of products that you can find in those stores can be extremely effective because they still have great active ingredients. And so, if you again, you can just find a sunscreen that's actually not that expensive, one that you like to put on. And that's your thing. Like, you don't you don't need anything that's super expensive. And so, I actually also incorporate like drugstore products all the time in my daily routine that I love. There's so many, so many great brands out there that you can get that are affordable. [46.0s]

Jessica Honegger [00:30:57] Is there a certain brand that you use for sunscreen that feels pretty light?

Dr. Jennifer Choi [00:31:01] Yeah. So basically, I like so drugstore brands Cerave, Cetaphil, la Roche-Posay. These are all great ones. La Roche-Posay actually makes a really nice mineral fluid that goes on like a light fluid and it's a great effective one. Yeah. So, I mean, if you look for maybe like mineral fluids or ones that usually if you if you get one that says facial, it's going to be on the lighter side compared to the ones for the body. So, then you can just kind of try some out here and there and see if you like them.

Jessica Honegger [00:31:35] Okay. And what about can we put the can the vitamin C be combined with the sunscreen and the moisturizer? I'm trying to get rid of the five products and get them down into two.

Dr. Jennifer Choi [00:31:45] Yes. Yeah. So, vitamin C in general, you're going to see as it typically they're going to be a separate product, although there are some products that combine the vitamin C with, you know, with other actors and with other serums and whatnot. But your basic routine that I would say it's nice and basic. So, in the morning just wash your face, you can use a cleanser or even just water, really. I just wash my face with water in the morning because there's nothing else except my cream from the night before that's on there. I put on moisturizer and any again, any moisturizer does not have to be expensive at all. And then I'll put my vitamin C serum and then I put on sunscreen. So that's just like that's like four basic simple steps that take literally seconds to do.

Jessica Honegger [00:32:31] How come you decided not to combine your moisturizer in sunscreen? I'm just curious.

Dr. Jennifer Choi [00:32:36] So, I mean, that's a great question. I maybe it's just again, it's habit. It's a habit of mine that I found that I've used sunscreen for years now and I just use it as a separate product that I just I just put it on and I sort of feel like, you know, knowing that it's a straight up sunscreen, it's going to give me, like, all the great protection I need if I if I'm putting it on. So, I just out of habit, I just do it separately. But if you want to, you can absolutely put it on moisturizer with SPF.

Jessica Honegger [00:33:05] Okay. I want to move on and ask you about how often we need to be going to the dermatologist to get our moles and such checked out that.

Dr. Jennifer Choi [00:33:15] Okay. So that's a good question. [00:33:17] So not everybody necessarily needs like a full skin check every year, but there are some people who would benefit from doing that. So, if you have lighter skin and you're more prone to sun damage or you've had a history of sunburn and history of blistering sun burns, if you have a lot of moles. So generally, if you try to estimate of 50 to 100 moles or more, that that in itself is a risk factor for melanoma skin cancer. So, you should definitely at least get a once-a-year skin check if you have lots of moles. If you have a family history of skin cancer, in particular melanoma, then absolutely you should be going at least once a year. And then if you have other kind of factors that may not. Oh, and history of tanning bed use. So, we know that even a single use of a tanning bed under the age of 35 will actually increase your risk of skin cancer. And then many people have done more than that. So, if you have a history of tanning bed use, you should also see a dermatologist for skin cancer screening. And then rare, more rare factors if you're on medications that suppress your immune system and things like that. So, if you if you have any of those risk factors, once a year is a good time to get checked. [79.4s] And then if you do go and stay, the dermatologist says, okay, you actually have a few moles that we want to really keep a close eye on. I think you should come back in six months. There are some people who come in twice a year and then rarely. We do have some people who come in every three months because they've either had a history or they have a lot of lot of atypical moles. And if you've never had one, it doesn't hurt to just get a baseline, because then the dermatologists can say, listen, your skin actually is really good and I'm not actually seeing anything from worry about. You can come back in like three years. You can come back in five years. So, if you if you've never had one, you just want a baseline. It does not hurt to just go get it. Baseline.

Jessica Honegger [00:35:13] Yeah, that's a good idea. I just realized I forgot to ask you a question or set up kind of a point that I'd love for you to make that routine, that skin care routine that you discussed. We do. We apply that to our necks and our hands and our arms. Like how extensive do we get on our body range?

Dr. Jennifer Choi [00:35:31] Yes. So, in terms of just going back to sunscreen, you want to make sure you're covering areas that are chronically exposed to the sun. So that includes your face. Don't forget your ears around your neck, like on your neck and behind your neck and then the tops of your hands. And that should be like year-round. A lot of people forget their ears, their necks, and their hands. And believe it or not, we're seeing a lot of skin cancer in those areas and aging. You know, people will start to get brown spots on their hands, and they don't like the appearance of that. So those are all areas that you should do sunscreen on moisturizer, same thing. All those areas can get moisturizer. You don't have to do like moisturizer behind your neck or whatnot, your ears if they don't feel dry. So, your face and your neck are great places for moisturizer in your hands if they're dry. And then in terms of like vitamin C, you know, your face, your neck, you can put on your hands. Although some people would say, okay, if you're if you're going to try to save your product, you don't need it there. And then the retinoid or the retinol, you know, face, neck as well, although neck, you want to be careful because it can be more sensitive. So, some people will develop like a really, you know, a dermatitis if they use it on their necks. If you're going to do it on your neck, I would only do it say like twice a week for sure, and then maybe just keep it at that minimum level. And that retinoid on the hand is a hidden secret. So, a lot of people won't put it there, but if you actually put it there, you can actually keep your hands looking younger for decades.

Jessica Honegger [00:37:02] Oh, my gosh. I'm because I, you know, jewelry. I model jewelry all the time and my hands are looking 50 right now. Not that I'm you know, anyway, I don't want to be a just at all, but I just look older than I am on my hands.

Dr. Jennifer Choi [00:37:17] Yeah. So, I need to put it. Yeah. If you put a drop a retinoid there start off only twice a week, slowly increase it tonight you will notice a difference in 3 to 6 months.

Jessica Honegger [00:37:26] That is crazy. Okay. I got to be consistent, though. This is my this is my issue. I got to be consistent with all of this because you're not going to see the benefits unless you actually apply it over time.

Dr. Jennifer Choi [00:37:38] Yes. [00:37:39] And so and that's another thing, you know, a lot of people can feel overwhelmed and be like, I can't do this. You know, all of a sudden coming out of nowhere, I'm going to do this whole regimen every single day. So, I always tell people, you know, like, if you can get yourself to do it with any regularity, even if it's once a week, like That's great, you start there. And then for that, oh yeah, seriously. And then you go to twice a week, you know, and then if you can, you go to three times a week and then as you sort of slowly get into the habit, anything you're doing will provide you benefit. [31.8s] And then I think what happens is that people may actually like, you know, you just kind of stay with any consistency and then once you get into the habit, you'll do it a little more. And then once you start seeing the benefit, then you're going to be like, okay, I really like this.

Jessica Honegger [00:38:26] Okay, okay, okay. I wanted to end with more invasive things because I think there's a lot out there, like all these new med spas that are popping up that are promising this, that and the other. What are some of the things that are most effective if you are wanting to, you know, get rid of age spots or I guess more about youthfulness, tightness of skin, etc.?

Dr. Jennifer Choi [00:38:47] Yeah. So, I mean, there are you're right, many different procedures out there. The number one thing I'm going to start with is saying if you are going to consider doing a procedure, I would really stick with somebody who, you know, has all the proper training and is sort of like really either you get a personal recommendation from somebody who's had good results and I would not try to get a Groupon coupon somewhere just to save money because we have seen horrible cases of mistreatment if you just try to get it done cheaper and then people end up with terrible scarring from either lasers or micro needling or whatnot, because it's not done appropriately, it's truly awful. [00:39:36] So first thing is, if you are interested in, you know, the people who are most well trained and this is going to be dermatologists and plastic surgeons, bottom line, because that is where we are trained in the skin and in skin care. You know, there are a lot of doctors out there now who say they provide this. And honestly, they're not fully trained. They haven't had a residency in terms of understanding the health of skin. So really, I think that those are your best bets. And then there are aestheticians who are wonderfully trained, but again, there are some that aren't. So, you just really want to go to somebody who's like truly vetted and then in terms of procedures, [37.9s] so facials can they're not necessary at all, but they can be helpful. So, for example, if somebody wants to try to lighten their sunspots or, you know, get some brightening, there are some facials that will contain what you call active. So, like either glycolic acid or other types of acids that can if it's done appropriately and gently, it can really it can provide benefit, especially if it's repeated kind of intermittently throughout time that can provide benefit. And then you have things like Micro needling, which is totally safe and effective. I have actually got this done myself and one of my colleagues did it for me. And basically, it's where they take this electric needle. It's like tiny, tiny needles that look like an electric pan. And they go over, they call it the vampire facial because it does induce slight bleeding. And then they can actually combine it with something called platelet rich plasma, where they actually take your blood, they spit it out, they get the plasma out and they actually put it on your skin while they're doing the micro needling. Oh, my gosh. That cannot I. Yeah. And it actually has shown benefit in terms of like stimulating fine collagen people with acne scars. It can actually help to smooth the scars, you know, things like that so that that can be effective. And then you have things like, you know, like Botox and fillers and lasers. And there are many different types of lasers out there. There's like full, full thickness resurfacing and then there's fractional resurfacing that only makes like tiny, tiny, like channels in your skin that stimulates collagen. All of these are actually totally safe when it's done in, if it's done by well-trained hands.

Jessica Honegger [00:41:53] And so safe and effective.

Dr. Jennifer Choi [00:41:56] Yeah, yeah. Safe and effective. They all have great uses for different, different things.

Jessica Honegger [00:42:01] So whether it do the micro needling, don't you have to get several treatments?

Dr. Jennifer Choi [00:42:06] So most of the time they say for best benefit, it's better to get multiple treatments. They may space them apart like every 2 to 3 months type of thing. But a lot of people will get like one or two or three and then just be done for a while. So, any of these can provide benefit and then some people will get maintenance and some people won't and they can. Whatever you get done can provide you some benefit. And again, the best thing to do if you're interested is first have a consultation with somebody who knows like all the possible options and just say, okay, here are my goals. Like I want to lighten my sunspots, or I want to try to reduce my wrinkles, or I want to whatever. And then if you go to somebody for consultation first, then they'll give you all the options. They'll kind of go over the cost with you, and then you basically come up with a plan and say, okay, I'm going to start with this, and I'll do this, you know, so it can be like you don't have to like to do this whole big package. You can do one thing and then try something later or you can do none of it. You know, it's all just kind of its extra, you know, it's all just extra stuff. If you have certain goals for your skin.

Jessica Honegger [00:43:09] It probably, yeah. And where do we get goals from our skin is often from media and from maybe the society that we are in? And you know, yeah, I'm in Austin and I barely have any friends that get Botox. But when I go to Dallas, it's like everybody's got it. And I, I've gotten Botox a couple of times for the last couple of years, and my dermatologist is so light handed. I love her so much. And then she's retiring, but she's still going to stay active in her practice. So, I went to one of her colleagues for the first time. She looked 21, but I asked her she'd been at Sinai for five years to do it. So, I was like, okay, you're legit. But she was like, well, let's put a little bit more in, you know, because it's been so light handed and so she did and I'm like.

Dr. Jennifer Choi [00:43:53] I hate it. I can't move my eyebrows. So. Right. And you know, yeah, I mean, you bring up such a good point because honestly, that is one of the things we have to actively fight against is like all the input we're getting in from social media and whatever because that is we should not be dictated by what other people think is beautiful. Like, I know it's hard not to do that and we're all susceptible to it, but I think it's something we have to actively fight against. Which is why I love on social media people who like to show their real skin because that should be the norm.

Jessica Honegger [00:44:27] Right.

Dr. Jennifer Choi [00:44:27] So yeah, I mean, [00:44:29] I always say don't have unrealistic expectations and don't try to like to have no one has perfect skin and no one should try to have perfect skin. We should just, you know, just kind of honestly. Number one is healthy skin. [13.1s]

Jessica Honegger [00:44:44] It's so hard, though, because you look at like the new standard or for, let's say, 50, you look at Jennifer Aniston, Reese Witherspoon, Jennifer Lopez, and they don't tell everyone, but they've most definitely had surgery. At least they've had some eye lifts. I mean, there's just. Right. There's just no way you can. Right. Yeah.

Dr. Jennifer Choi [00:45:01] Yeah. Yes. There was this whole thing about I love Jennifer Lopez, but, you know, she came out with her own skincare line, and she said the secret was using olive oil. And everyone's like, yeah, you sure about that? So, in other words, they're yeah, there are probably a ton of things that you're not aware of that people get done and all this stuff. And again, it shouldn't be our goal. It shouldn’t be our goal to like look like that.

Jessica Honegger [00:45:27] Like health sparkle in the same way dieting, you know. But I feel like the dieting industry and the beauty industry are a little bit similar in that they make these big promises without a lot of data. And at the end of the day, it's just about like being consistent and taking care of yourself.

Dr. Jennifer Choi [00:45:44] Yes. Yes, exactly.

Jessica Honegger [00:45:46] Okay. Before we go, I keep thinking of all these things while I have you hydration water. Does that matter for your skin?

Dr. Jennifer Choi [00:45:54] Though? Not really drinking. Okay.

Jessica Honegger [00:45:56] Okay. That's a big myth and it's a huge myth.

Dr. Jennifer Choi [00:46:00] I mean, hydration is so good for our bodies, but you will see people who come in and they're like, I am drinking like two gallons of water a day and my skin is still dry. And it's because the hydration from drinking is not necessarily actually getting into your skin, like your skin is a barrier that protects you from the outside so it can get dehydrated from the heater that's blowing. It can get dehydrated from the wind outside. And no matter how much you drink, it's not going to necessarily all just go into your skin and hydrated. So, you need. So again, another reason why you should use moisturizers for your skin, especially if it's dry. Water itself by drinking, it's not going to do it.

Jessica Honegger [00:46:45] Okay. All right. I mean, I might have to do part two and three because. Yeah, I'm going to I'm going to start where I'm in it. We'll have you back on in six months. And I'm going to take pictures of myself now and I'm going to get out my I am going to go get that LAROCHE And then I'll move into because I have a prescription strength retinol that I. Did get in Mexico a couple of months ago. So. Okay. Oh, goodness. Oh, well, thank you so much. I know that what listeners don't know is Jennifer helped me during a time when my dad was having an adverse reaction to his immunotherapy for his kidney cancer, because the same immunotherapy that's used to treat melanoma is used to treat kidney cancer. And my dad was having a rare, rare adverse event. And my dad's cancer doctor was actually not believing me and would not administer to him the steroid that he needed to reverse the reaction. And I had to I got on the phone with Jennifer. I found a specialist at Duke who ended up writing me right back. I mean, I'm in the ICU, the neurological ICU with my dad, who's now cannot say my name, doesn't know what day it is. And I and this researcher got right back to me and said, he's got to get on steroids, and I had to demand it. And within hours, he was he was himself. And I'm happy to report that he's he is now on chemo them you know, therapy helped him for about a year and a half. Now he's on two chemo pills, but it’s holding steady. So, I love the work that you're doing because truly it is it is saving lives. But this conversation around sunscreen, that really is the most preventative thing we can do for skin cancer.

Dr. Jennifer Choi [00:48:21] Yeah, it is. It is. Thank you.

Jessica Honegger [00:48:23] Thank you. Thank you for the work that you do.

Dr. Jennifer Choi [00:48:26] Yeah, no, thank you for saying that. Yeah. I love what I do. And I and I know, like, all of this is so important for people to help.

Jessica Honegger [00:48:41] I am so relieved to know that I can just go to Target. I'm going to be getting this Cerave cleanser, Cerave Moisturizer, the LaRoche retinol thing. But I'm also going to eventually be using the contraband retinoid that I got in Mexico. So much goodness, but more than anything, I'm just going to start washing my face at night, guys. That's what I'm going to do. The music for today's episode is by Ellie Holcomb. And I'm Jessica Honegger. Until next time let's take each other by the hand and keep going scared.