S2 E8: Fruit Acids, Fraxel Lasers And Customized Skincare Through The Ages With Dr. Rose Ingleton

Amy Gordinier:

Total Skin Nerds is brought to you by Skinfix. We're clean, clinically active, and on a mission to deliver healthy skin.

Welcome to Total Skin Nerds. I'm Amy Gordinier, founder of Skinfix. Total Skin Nerds is where I get to nerd out with some of the world's foremost experts in skin. We deep dive into issues related to skin disease, skincare ingredients, diet and lifestyle modifications to support skin health and even spiritual practices and their skin benefits. It's season two, episode eight of the Total Skin Nerds podcast, and I'm excited to speak with Dr. Rose Ingleton. Dr. Ingleton and I are here to talk about psychodermatology, how she came to create her beloved skincare line and why taking care of one skin at different ages and stages of life is something that can be done simply, consistently and effortlessly.

Integrating her medical degree with her background in psychobiology, Dr. Rose Ingleton is absolutely a fellow skin nerd, and you'll find out why she's regarded as a national authority in general and cosmetic dermatology and learn that the key to maintaining your skin's health and wellbeing is all about consistency and sunscreen too.

Before we dive in, I want to take a moment to thank everyone for listening to the podcast, the Skinfix team and I would love to hear more from you. Please take a moment to leave us a review and let us know what you'd like to hear more of. We would really appreciate it. Stay tuned, skin nerds. This is going to be a wonderful conversation.

 

Amy Gordinier:

So welcome Dr. Rose Ingleton. It's such an honor to have you on the Total Skin Nerds podcast. Thank you for joining us.

Dr. Rose Ingleton:

It's my pleasure. So happy to be here.

Amy Gordinier:

So happy to talk to a fellow skincare entrepreneur, Sephora brand as well as an esteemed dermatologist. I don't know how you find time for both 'cause I could barely do one.

Dr. Rose Ingleton:

It is so challenging.

Amy Gordinier:

I can't even imagine. I don't know how you are managing all that's on your plate, but one question that I was really curious about is you went to NYU, yes?

Dr. Rose Ingleton:

Correct.

Amy Gordinier:

Which is so cool. And you studied psychobiology.

Dr. Rose Ingleton:

Yeah. Isn't that interesting?

Amy Gordinier:

Yes. So what-

Dr. Rose Ingleton:

I figured.

Amy Gordinier:

... is that?

Dr. Rose Ingleton:

I think it was a contrived double major that was just specific to NYU.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

I've never heard anyone else in life have that major, but they had it as an actual major and I realized that the prerequisites for that major were basically my pre-med courses with a really heavy helping of psychology courses. So that was a great fit for me. I'm getting both the biology and the psychology aspect, but it taught me so much because I spent a lot of time dealing with the psychology part and learning about how people interact with each other, how all the different diagnoses that are out there that people struggle with in terms of mental health. I just think that it helped me to become more sensitive and intuitive when dealing and listening to patients. It's really served me well.

Amy Gordinier:

Yeah. So psychodermatology is so hot right now and there's so many articles in the media about it and everyone's talking about the connectivity between mental wellness and skin health. At Skinfix, we do a lot of therapeutics. So we treat eczema, rosacea, KP. So I would love to hear just a little bit about in your practice when you are working with patients who have a skin issue like acne or eczema or psoriasis, or rosacea, and it's having sort of a mental health impacts, how do you ascertain how they're doing in their daily life and how do you typically integrate more of a psychiatry psychology approach?

Dr. Rose Ingleton:

I do it seamlessly and it's interesting. I did not realize all this was happening, but during medical school I did several rotations in psychiatry, which is to become a medical doctor of mental health. I was very, very intrigued by many of the diagnoses and just the fact that all these people present in the same way and they don't know each other, but everyone who's schizophrenic presents a certain way. Everybody who's manic, depressive presents a certain way.

I was really fascinated by the mind, but I did not want to make that my specialty. I was more intrigued by the interpersonal interactions that you have when you're taking care of people in a medical setting for health issues related to their body, their skin. I did not even know I wanted to be a dermatologist at that time. I just knew that I loved taking care of people, talking to them, diagnosing whatever their condition was and helping them on a treatment plan that would get them to a better place.

Dermatology just ended up being a really good fit for me because I'm very creative, very visual, and it's pretty happy specialty really. People, I see them, I can diagnose within minutes what they have and get them on the road to recovery, if I can. If I can't completely help them, I can tell them. But the way that I see it playing in the practice is there's a lot of what I call talk anesthesia that goes on when you're in my office. It takes a long time to get a first appointment for a reason because when you come in, it is very dedicated.

I want to hear why you're here, what you've been using, what have been your challenges along the way with your skin, and then I can examine you and figure out how I can help you. But if I just walk in the room and I never talk to the person, I just look from across the room and throw them a prescription and leave, which is unfortunately what dermatology has turned into these days, I never get to learn who the person is. I don't know anything about their backstory, what they do for work. Are they going through a divorce? Are they ill with something else? Are they taking care of someone at home? All of that stuff for me plays into how I interpret what I see when I look at their skin and how I administer a treatment plan for them.

Amy Gordinier:

Okay. And are there instances where you will refer to a psychologist or a psychiatrist?

Dr. Rose Ingleton:

Absolutely.

Amy Gordinier:

Or make a suggestion?

Dr. Rose Ingleton:

Yeah. And that's an area where many of us as dermatologists are not comfortable because patients typically will not respond nicely to that. If they come to you for a skin issue and somehow it gets in their minds turned around and moved into the, "Oh, there's something mentally off that you need to address, it's usually not met well." I think that my training as in with a lot of psychiatry and psychology has helped me to figure out how to frame it so that they can understand that it's not that I'm pushing you off and saying, "I can't help you. I want you to understand that what you have not only requires my help, but the help of someone who deals with the conditions of anxiety and depression and obsessive compulsive behaviors and things of that nature.

So it's in the presentation. It's how you present it to them so that they understand that it's coming from a place of care. It's not just being dismissive.

Amy Gordinier:

Incredible. I think it's so fantastic that dermatologists like you are integrating this sort of holistic approach to the patient and getting curious, asking questions, and trying to understand maybe root cause or other symptoms related, not just what's presenting on the skin.

Dr. Rose Ingleton:

What we see, right? We're not really trained in that. By the way, I came to this on my own. It's just trial and error and partly my nature, and then infusing what I've learned along the way. This is not something that we're taught.

Amy Gordinier:

Yeah.

Dr. Rose Ingleton:

You have to actually really be interested to pull up on those tools.

Amy Gordinier:

Yes. Well, I can tell just by meeting you for five minutes that you're very interested in people and you can tell immediately that you have the type of demeanor that I don't think I'd be put off if you were asking questions of a more holistic or personal nature. So I think it's also... The dermatologist themselves has a special skill at that. So it's really nice to see that integrated into a practice. I want to dive in and talk about skincare at different ages, but I also want to ask you a little bit about before we do that, your skincare line, because it's beautiful.

Dr. Rose Ingleton:

Thank you.

Amy Gordinier:

It's so beautiful and I love how simple it is too. I don't feel overwhelmed. I love your calming. Is it the calming serum?

Dr. Rose Ingleton:

Calming hydration booster?

Amy Gordinier:

Love it. I love the sunscreen. The serum sunscreen is gorgeous.

Dr. Rose Ingleton:

No, I don't have a sunscreen yet.

Amy Gordinier:

Okay. You have a serum maybe. It's vitamin C?

Dr. Rose Ingleton:

Yes. There's a complexion brightening one.

Amy Gordinier:

Okay. For some reason I was thinking it had SPF in it and then your-

Dr. Rose Ingleton:

I'm working on it though, Amy.

Amy Gordinier:

Okay. And then the signature moisturizer is great too. Tell me sort of what was the impetus in your incredibly busy practice to become a skincare entrepreneur?

Dr. Rose Ingleton:

You know what it is, my patients directed me there. I have been curating skincare regimens for my patients and writing it down for them. By the way, after talking to them at first and finding out what are you using? "Good, I understand. Now, let me look at your skin. I see the situation. Okay, here's what I think you should do. Keep this product. Maybe you're better served by this product." And I would basically create a little regimen for them. "These are the steps I think you should do in the morning. Here are the ones to do in the evening. It's going to be different from your girlfriend's regimen because she's not you."

Amy Gordinier:

Right.

Dr. Rose Ingleton:

And I'd send them on their way. And of course people did great and they'd come back. "Oh my God, doctor. It was amazing." You're telling me what to buy and what to use and da, da, da and I'm doing really well. Patients would ask me repeatedly, "Why I didn't have a line? Why are you sending me to Sephora necessarily or to Dwayne Reed or wherever to get products or selling it to me in the office when you could create something for me." So they planted the seed.

So when I created the line at first, I wanted to create it to attack the problems that they kept asking me for help with and I simplified it into four categories of a anti-aging, basically, breakouts, dark spots or discoloration and dehydrate dry skin like sensitive dry skin. I decided I would create serums to target those four common problems and pair that with the most amazing moisturizer I could think of making. I spent the most time with that moisturizer because I wanted it to be the best really. I benchmarked all of those high end names that you know, that $400 creams.

But I knew that I wasn't going to make it a luxury product that was out of reach for people. So the thinking was make it really simple. Everybody can use the moisturizer because it's just packed with everything. I think of it like a multivitamin for your skin.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

It has everything you need in there, plus a ton of ceramides and niacinamide, and hyaluronic acid. And then there's the Jamaican superfruit blend that I put in there, which is fruit extracts. It's like everything.

Amy Gordinier:

Is that the same superfruit that's in the cleanser too, Dr. Ingleton?

Dr. Rose Ingleton:

Yes. It's my secret sauce.

Amy Gordinier:

Cool. I love that.

Dr. Rose Ingleton:

Throwing back to my Jamaican heritage, I realized that I use a lot of fruit acids in my regimens, but I was getting it from different brands. And so my thinking was get it all in one place. Put the concentrations of these items that you want in the product and then just blend in all the other things that you want your patients to have so they don't have to use 14 different products to get those benefits. They can use one moisturizer and know that everything already has been put in there for them. That was my thinking. So you're supposed to use the moisturizer and then pick a serum that targets whatever your special issue is.

Amy Gordinier:

I love it. I love the simplicity of it. I think it's really very contemporary too. I have a Gen Z daughter who's 19, and I think they're moving away from that 20 step skincare regimen, and they want to really simplify. So it's great. So speaking of different age groups and skincare at different ages, I'd love to focus really on the most sensitive skins too because I think that's seems to be a focus of yours, Dr. Ingleton and some of the articles that I've read. And also it's very much a focus of what we do at Skinfix, but specifically just starting with the skin barrier itself, now that we're all becoming more knowledgeable about this, what happens to the barrier itself as we age?

Dr. Rose Ingleton:

Well, we're starting to, it becomes more porous, let's think of it that way. We don't make as much... Well, our collagen is starting to get depleted. Our elastin is starting to get depleted. We don't hold moisture like we did when we were younger. You need to use products that are richer, more hydrating than you needed when you were younger. So as you get older, the barrier is just getting impaired and you have to pay much more attention to protecting it and replenishing those little cracks in the system within your skin rather.

Amy Gordinier:

And just starting at the very youngest, and we'll move through, but when you think about babies and children, what should a mom or dad or caregiver be thinking about when they think about children and skincare? I remember having babies and I always was very careful to bathe them and very gentle cleansers and then moisturize them. But then they get to be beyond that stage where you're bathing them every day. And then I didn't use any skincare on them for a number of years. But what should we be thinking about with children, especially children who might be prone to eczema or psoriasis or other skin concerns are just very sensitive. What should we think about in terms of their-

Dr. Rose Ingleton:

So in babies, we're usually trying to think of very milky, creamy, soap free type products. Things that don't foam up heavily, things that won't sting their eyes if it gets in their eyes because they're all over the place and things end up everywhere. But that whole idea of bubble baths, I'm not a fan of that for little kids. I want things that are more hydrating and soothing.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

I'm usually thinking of very hydrating products for little ones. And then it's super important that when they're in a bath and typically they're doing baths that they're not left in the water for way too long because no matter your age, if you're in there for too long, you're going to start to lose a lot of that moisture actually gets all sucked out and you come out looking pruney.

Amy Gordinier:

Yes.

Dr. Rose Ingleton:

It's super important at the end of a bath to pat, dry and apply the richest moisturizer you can find for a baby and definitely avoid the things that are highly fragranced because so many of the children are actually going to be sensitive to fragrances. So you don't want to add any extra things that could possibly set off eczema where there was no eczema before. You don't need to use products that have any enhancements like fruit acids and urea, and lactic acids, things that you would use on older skin to keep it soft. You just need things that are pretty rich in petrolatum or glycerin, super hydrating, but without the additives, no acids. Babies don't need that yet. Their skin, they're plump.

Amy Gordinier:

Yes. They are. So much collagen.

Dr. Rose Ingleton:

You're just trying to peeling.

Amy Gordinier:

Exactly. Okay. So then into teens and 20s. I think about my daughter, and she's bought into all the TikTok shenanigans and had the retinol eye creams, and I'm like, "What?"

Dr. Rose Ingleton:

How old is she?

Amy Gordinier:

19.

Dr. Rose Ingleton:

Yeah. Okay. There we go.

Amy Gordinier:

19 next week. And this is happening in 15, 16. So really, what should they be thinking about in their late teens and 20s in terms of skincare?

Dr. Rose Ingleton:

You see in the teens and 20s, they're very similar. Skin has become very oily. If you're going to get acne, that's when it's starting to show up. So the face is going to have either whitehead blackheads or those cyst and pustules, depends on your genetic makeup, but you tend to be oily, clogged up, pimply, all of those things. So the focus should be on correcting for that. So most of my patients in that age group will be recommended to use some kind of cleanser that helps with oiliness.

So if they're actually breaking out a salicylic acid based cleanser would be a great idea. And they will use the ones that are foaming. So unlike the baby, their cleanser can be foamy because the foamier cleansers tend, generally speaking, to be a bit more astringent. It'll remove a little extra oil that's sitting on your skin. So a salicylic acid cleanser, even a glycolic acid cleanser. By the way, my skincare line has an amazing cleanser that has fruit acids in it as well. It's good for every age, but I just thought I'd mention it there. It'll be better suited for the later age group when we talk about them.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

But in the younger kids, I would say something that's a bit foamy and has some fruit acids in it like salicylic or glycolic acid. I also spend a lot of time educating that age group about the importance of wearing sunscreen because the earlier they get that to become part of their regimen. So it's so much easier for them later on. That's when the damage is being done, right, really.

Amy Gordinier:

Oh, yes. I wish I had known, Dr. Ingleton.

Dr. Rose Ingleton:

I know. If only.

Amy Gordinier:

If only.

Dr. Rose Ingleton:

And they get small rolling of the eye. I get all of that too when I say sunscreen, but I'm going to tell them and explain to them how important it is that they are setting themself up for success later.

Amy Gordinier:

Yeah. They'll thank you someday, if they're compliant.

Dr. Rose Ingleton:

If they're compliant. And then most of my teens and 20s will have some degree of acne so they'll probably end up on a prescription grade retinoid.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

And I'll teach them how to use that. A retinoid is just a vitamin A derivative. And the prescription grade ones are typically targeting the follicles and the pores that get clogged and lead eventually to acne. Most of my young people are going to have something like that in their regimen.

Amy Gordinier:

Now, what if someone is listening to this podcast and is in their teens, 20s and is struggling with some oiliness and acne and can't access a dermatologist for some reason. I live in Canada. It's very difficult to get in to see a derm in Canada. Would you recommend an over-the-counter retinol in that instance for an acneic sort of teens, 20s, something?

Dr. Rose Ingleton:

I actually do that often. Okay. Many times my patients, the grownups, the parents, they come in and they'll describe their child to me. "Oh, here she is 18." They're getting a few pimples. I'll give them a recommendation on what to try. And then if that doesn't work, you come in. Oftentimes I'll tell them, get a salicylic acid cleanser. Every brand makes one, I think.

Amy Gordinier:

Yes.

Dr. Rose Ingleton:

I recommend getting some kind of toner. I recommend the exfoliating tonic that's in my skincare line because it has the right balance in there for most people's skin type. And that will help to unclog and remove the excess oil. I recommend the sunscreen. And then I say over the counter, we now have adapalene available, which is what different is. I don't know if you have that in Canada.

Amy Gordinier:

Yes, we do.

Dr. Rose Ingleton:

But that's very good. We used to prescribe that and then suddenly it was no longer prescription. So I'm like, "That would be great for them." Benzo peroxide products are available over the counter, and oftentimes in the dermatology practice, we're recommending that as well. So I would say maybe give them a little benzoyl peroxide topical. There are many brands right now. I don't know if Oxy-10 is still being made, but things along that line that have benzo peroxide, put it on in the day and then at night put on the different.

And that's a nice combination. If you come to me as a dermatologist saying, "This is what I've been doing and I've only gotten this far with it, it's very good for me to then take you to the next level because you've already tried some of the really good stuff that should have helped if you just had a mild case."

Amy Gordinier:

Okay. Now entering into our 30s, and I don't know if you would group 30s and 40s together, Dr. Ingleton.

Dr. Rose Ingleton:

No, I [inaudible 00:21:13].

Amy Gordinier:

No. Okay. So what would you do then differently in your 30s?

Dr. Rose Ingleton:

So 30s, I think of as that the transitional time. Things really do change tangibly between your 20s and your 30s. The big thing is dullness like the skin suddenly stops turning over its cells the way it used to. So that vibrant, glowy skin you had in your 20s and your teens to maintain that now suddenly you have to do work because the skin just starts to take on this dull appearance.

If you are lighter complected, you might see little lines starting to appear where there was not a line in sight when you were in your 20s, but suddenly little crow's feet start to show up around the eyes in some people. So you'll see that you start to see little sun spots. So it's telling you, "Oh, you should have paid attention when you were 16 and when you were 20 to wearing sun protection and not lying in the sun and baking because now 10, 15 years down the road, these little spots are starting to show up."

So a lot of that happens in the early 30s. So I think of that as a big transition from the carefree years of things just happening naturally and easily to now suddenly you have to step in and start doing a bit of the work to maintain your skin, to keep it looking great.

Amy Gordinier:

So what are the sort of key products that you would introduce to someone's regimen at that age? Would it be an exfoliator and some sort of a discoloration product?

Dr. Rose Ingleton:

Absolutely. I'm big on antioxidants, so I almost always have my patients in their 30s introducing an antioxidant, something with a vitamin C type base in it. In my line, I have a complexion brightening booster, which is something that will help with brightening your complexion and it's because it's taking advantage of a lot of vitamin C and fruit acids in there. So things along those lines that are going to help with repairing some of the damage, but also correcting for some of what you're starting to see. You're going to still continue your sunscreen. That never goes away.

Amy Gordinier:

Always a sunscreen.

Dr. Rose Ingleton:

And then you're going to introduce a retinol. This is a time that you introduce retinols because the lines adjust starting to show up. And a retinol will be great to help repairing your collagen and can tangibly reduce the lines that you are seeing, or at least the appearance of those lines.

Amy Gordinier:

Now, what if you're someone who is really sensitive, Dr. Ingleton, or I'm now in my early 50s prone to rosacea. I've been trying a lot of products lately in development, and I've got a breakout on my cheek. What about retinol for someone who's really sensitive?

Dr. Rose Ingleton:

I'm super sensitive to retinols myself. And so I can't use any of those prescription grade ones which is what prompted me to create a retexturizing retinol booster in my line. So you can get a serum that has a good enough strength retinol in it, but it's not irritating. So I usually direct my patients with sensitive skin to starting small. Start slowly and as your skin acclimate, and then you can move on to maybe in a higher grade of retinol and ultimately to a prescription grade retinol.

So just step yourself up. Don't start at the top and then freak your skin out, and then think that you can never use a retinol. So starting small is best and starting with a product that touts that it is for sensitive skin or for introductory people using retinols, something along those lines. You want to look for that kind of wording on the packaging of the product you're buying. But there should be some strength that you can tolerate.

Amy Gordinier:

Okay. All right. Now, we're getting into our 40s.

Dr. Rose Ingleton:

40s. How do we think about all the things that could be happening and what products should we start to swap out or introduce in our 40s?

So think of things as progressing now to where the lines are going to be a bit more prominent. So you will want to have the higher grade retinol if you can tolerate it. You want to introduce some peptides into the mix. You think of building collagen. Anything that's available that can help build a collagen, we want it.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

So vitamin C products, again, are super helpful for that. Hyaluronic acid products are great for that because you're starting to tend towards the dryness now. So you're no longer that teenager who's greasy all the time. Suddenly you need extra moisturizer. The glow is continuing to fade. You want to keep using your fruit acid products. You want to do procedures in the dermatologist's office that help you along because sometimes the products by themselves are not enough to get you that result that you're so accustomed to. If you've been taking care of your skin all the way up until your 40s, what am I forgetting? Your sunscreen. That's that's a given. Products that help to speed up cell turnover, so fruit acids. I adore fruit acids. I use it for their entire life.

Amy Gordinier:

Fantastic. Except when they're babies. But once they've gotten into their teens... Now, what about growth factors, Dr. Ingleton? What is your perspective on growth factors?

Dr. Rose Ingleton:

Yes. I knew I was forgetting something. So the epidermal growth factors are great. I actually start talking about that in the 30s.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

'Cause the lines are just starting to show. I encourage people to introduce the epidermal growth factor type products at that time and continue them as time goes on. So we have a lot of options for building our collagen. You don't have to use every single one of them, but you have to be on something that is targeting the collagen. You have to be on something that targets the moisture retention and replenishment. And you need something that protects you from further sun damage.

You need the antioxidants that are your... I think of them as those... They're blocking all of those free radicals in your skin that are trying to form and age your skin. Antioxidants are taking care of that. So you do need a targeted approach where you're hitting various aspects of what's happening as you get older. But it doesn't have to be a million steps.

I like multifunctional products so that you can get something that has peptides and hyaluronic acid and maybe even epidermal growth factors in there. If you can do combination products, it makes it easier. And then you can be more consistent if it's a simple regimen.

Amy Gordinier:

Yes, definitely. I think that's it, right? If it gets too complicated and too many steps and too many processes, people sometimes struggle. So now we're in our 50s and I think I'll sort of say 50s plus because we could go and I'm thinking too... You talked a bit about derm procedures being introduced in your 40s, but in your 50s, what else do we have aside from the topical skin care to support that dullness and help with the collagen? What do you like to use in the process?

Dr. Rose Ingleton:

So procedures, right?

Amy Gordinier:

Basically, yes.

Dr. Rose Ingleton:

So what's happening in your 40s and 50s is you're starting to lose volume. So think of a balloon just slowly deflating. So the fill isn't like it was when you were 20, 25 or even 30. So we end up introducing fillers into the skin artificially. What's the word I'm looking for? To reestablish where you may have been before. So areas where you've lost volume. We try to replenish that. By strategically injecting hyaluronic acid fillers under the skin, sculpting it in place so that it looks like it was always there and you keep it moving.

Fillers are trying to replicate what we had naturally, but as time goes on, as I was saying earlier, we lose some of our understructure, the collagen, the elastin layers. Everything is kind of wasting away with the estrogen that you're losing as you get into menopause. These things progress. Also, there's some bone resorption that happens. Our faces literally change in architecture. The jaw line. You start to lose some of the bone support there. Your chin sometimes you lose some of that bony support. You lose some of the cheek. I think of this as a scaffold on your cheek that holds everything up. You start to lose bone structure and things are sagging, right? Because you're losing the under surface that would normally keep things plump.

So we try to correct for all of that and we do a lot of it with fillers. There's so many types of hyaluronic acid fillers now available. There's one to lift. There's one to fill. There's one to plump. You pick and choose based on what you're dealing with.

Amy Gordinier:

I didn't realize the bone... I mean, it makes sense, but I hadn't really thought about that. Is that sort of an osteopenia kind of?

Dr. Rose Ingleton:

It is. What happens is you notice the result of not having that bone structure that is usually serving as a scaffold. And that's why you see a sagging jawline where you used to have a nice straight line. Suddenly you have sagging there because your cheek that used to hold everything up, things are thinning out there and it's just a hot mess, isn't it? It's a hot mess. And then in terms of lasers, I read an article that you were interviewed in, I think it was... Maybe it was the glossy podcast that you did where you talked about lasers. I personally have been thinking about Fraxel, but terrified of Fraxel. And you had mentioned that there are others that can be done repetitively that could give you the same results. So how do you feel about laser resurfacing? And if somebody was particularly sensitive or prone to things like rosacea, how would you approach that?

Really good question. We do so much resurfacing in this office and I'm talking about starting from in your 20s where in your 20s the resurfacing is not with a laser. I'm doing it with a chemical peel. I do so many chemical peels because that's also renewing skin cells, right? In their 20s, I'm doing chemical peels that target the acne, the big pores, the oily skin. So salicylic acid peels are done repeatedly in our practice.

No downtime, keep it moving. When you get into your 30s, we can keep doing salicylic peels or we can edge up a little to maybe doing Jessner's peels or TCA peels which are a little bit deeper because your issues are now more prominent and your glow is running away like I mentioned earlier, so that can help you. But we start introducing a laser that is fractional. We do the clear and brilliant laser in our office which is a fractional laser, which it doesn't leave you with much downtime. It causes this pixelation of energy delivery to your skin where you start to see after about two or three days that the skin just feels really dry when you touch it and gritty like sandpaper. But nobody can tell that anything is going on. About four or five days later, it's, "Oh, wait a minute, it's smooth now. Where'd it go?" Those are the dead cells that we zapped and they dried and they came off, but nobody saw it happening.

Amy Gordinier:

Amazing.

Dr. Rose Ingleton:

So that's my favorite laser for the working woman. Right? So people in their 30s, 40s, they're busy. They don't have time for a laser that's going to leave them with cornflakes on their face basically.

Amy Gordinier:

Right.

Dr. Rose Ingleton:

We do the fractional laser of the clear and brilliant sort a lot during their 30s and 40s. And then the Fraxel is what we step you up to. So I think of [inaudible 00:32:59] as a baby Fraxel. But once you're in your mid 40s, 50s, or if you can allow time for the shedding that's required for that, then we move you to the Fraxel laser where it's the same kind of idea. The energy is being laid down in a pixelated pattern, but it's a higher energy device. More heat is being produced. It can penetrate a little deeper into the skin. So the result is that you do get visible drying and shedding that has to occur. It does occur over about five days.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

So you can schedule accordingly.

Amy Gordinier:

You have to hide out for five days. Have your camera off.

Dr. Rose Ingleton:

Most people like doing a Thursday 'cause the peeling doesn't really start until the third day.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

They do it on a Thursday. Friday you theoretically could go to work and nobody really knows anything happened. You look a little flush. But Saturday and Sunday you're like-

Amy Gordinier:

Godzilla.

Dr. Rose Ingleton:

... cornflakes coming off your face. And then Monday it's like, "Oh, look at me. Look at my clear skin underneath."

Amy Gordinier:

Baby skin. And what about microneedling? Are you doing any of that, Dr. Ingleton?

Dr. Rose Ingleton:

A lot. I usually think of microneedling as my go-to for people with large pores, oily skin, acne scars. Like those indented acne scars.

Amy Gordinier:

Yes.

Dr. Rose Ingleton:

Even the fine lines and wrinkles that you get in your 30s. It's great for that.

Amy Gordinier:

Okay.

Dr. Rose Ingleton:

I use it a lot for indented scars. Even if you had surgery and the scar healed and then kind of puckered inwards.

Amy Gordinier:

Yes.

Dr. Rose Ingleton:

Very good to elevate that kind of scar. We're using it for stretch marks a bit to help the appearance of those marks. We don't have a perfect treatment for stretch marks yet, but microneedling does get you close. It helps with the texture of the scar, so it's not so indented. Okay. The stretch mark. Sorry, I said scar. We do a lot of microneedling. And also microneedling can be combined with radio frequency as your skin is sagging over time. So 40s and 50s.

The microneedling is helpful with some of the tightening, but we also do radio frequency treatments to help tighten the skin up because like I was saying, "As time goes on, the elastin and the collagen are kind of running away." They start to sag and nobody wants a facelift. Everybody is like, "Oh, I just want to do this without being cut." So we do a lot of skin tightening using the microneedling device and the radio frequency device in our office.

Amy Gordinier:

I mean, at some point we're all living to be a lot older than our ancestors. We're getting into our 90s and in some cases early 100s. Do you think that at some point in time we'll just win over? Or could some of these non-invasive procedures keep skin looking... Obviously, we're going to age, we're going to wrinkle, we're going to sag to some degree, but do you think that they're going to be able to keep skin looking better and healthier than it has in generations past?

Dr. Rose Ingleton:

I think it can and will because I do have patients who have been seeing me probably for the 20 plus years I've been in practice. So I've seen them age. They started seeing me in their 50s back then. They're 70 something now. And the people who started early, especially with things like Botox, which most of my patients are starting in their 30s with that because that's when the lines are starting to show up.

Those women and men are so much well better preserved as it goes on. They don't have a lot of the lines that would've been caused by repetitive movements which is what Botox helps you with. Doing fillers, you can tell they're getting older, but they're not looking haggard. They look refreshed, and they look like a good version of a 75-year-old or 68 year old, whatever.

Amy Gordinier:

Yeah. Okay.

Dr. Rose Ingleton:

I think with the use of a lot of this technology, we are going to be able to delay the onset of many of these symptoms and signs. The tightening of the skin. You're not going to ever tighten the skin enough with a device to make it look like you had a facelift. But it can make you look pretty refreshed and tight enough that you don't feel like, "Oh God, I'm aging so fast."

Amy Gordinier:

Yeah, like I have to have a facelift. What about topicals? Do you feel like we know more now about ingredients and formulations? Do you think we're getting better with the topical products also and will also be benefiting from better topicals in our generation?

Dr. Rose Ingleton:

I will say absolutely, yes. Even in the three short years since I launched my skincare line, I've already gotten to the point where like, "Oh my gosh, I want to include this ingredient in there now because it wasn't available before." So we are learning a lot about ingredients that help to get you the result you're looking for, better delivery systems for these chemicals. The kinds of lasers that are being developed.

Right now, they're getting better and better and better every time. So as technology improves, I think our results are going to continue to improve. Products are being better formulated. The impetus right now is to get rid of all the things you don't need in the products and just really give us most of what is going to do the work, which is how I thought of my line as I was creating it. I'm like, "I don't want any perfumes. I don't want any unnecessary fillers. Any preservatives that are not going to serve us well they need not be in there. I want it to be clean."

Just thinking about all the things that bother people. No parabens, none of that stuff. So as we learn more and we make adjustments in the way we are developing products, I definitely see where we're going to get to a point where we're going to be able to have more people using products because they're not allergic to it or sensitive.

Amy Gordinier:

Interesting.

Dr. Rose Ingleton:

And they're going to get better results because we're making the products more powerful.

Amy Gordinier:

I love that. I know you have a very busy practice, but I really enjoyed this conversation, Dr. Ingleton, and appreciate you taking the time to be on the podcast. I was so excited to meet you.

Dr. Rose Ingleton:

It was such a pleasure and thank you so much.

Amy Gordinier:

You too. Take care.

Dr. Rose Ingleton:

Bye-Bye.

Amy Gordinier:

Bye. You can read more about Dr. Rose Ingleton at rosemdskin.com, ingletonmd.com, and you can follow her on Twitter and Instagram @rosemdskin and on TikTok @ingletondermatology.

Brilliant. What an inspiring and informative conversation that was. I want to thank Dr. Rose for nerding out with me and for sharing her insight, expertise, entrepreneurial spirit, and impressive work. Here are three things that really stood out for me in our conversation. One, psycho dermatology is a hot topic right now and a fascinating subject to explore because our mind, our mental health, is connected to everything including our skin.

It was tremendously interesting to hear how Dr. Ingleton studies in both medicine and psychobiology at university taught her to become more sensitive and intuitive now as a doctor when she sits in and listens to her patients. Two, it was also great to listen to Dr. Ingleton's meaningful targeted approach on how to specifically care for skin through the ages from newborn to more mature skin.

We spoke about the importance of skin barrier health, which as you know, skin nerds is our love language here at Skinfix. Three, Dr. Ingleton has built a flourishing practice based on her medical knowledge and dermatological expertise as well as the communication and interpersonal relationships she has cultivated with her patients. And it was those patients that inspired the acclaimed doctor to create her beautiful line, Rose Ingleton MD Skincare.

It was wonderful to learn more about her holistic philosophy towards skincare and the secret sauce she uses in her line, a Jamaican super fruit blend that connects to her heritage, her history, and her family.

Thank you for listening to the eighth episode of the second season of Total Skin Nerds. We'd love to hear from you and would be so grateful if you could take a moment to leave a review and please subscribe to the show on Apple Podcasts and Spotify or wherever you listen to your podcasts. Total Skin Nerds is produced by Rob Corso, Casey Kahn and Howie Kahn for FreeTime Media. Our theme music is by John Palmer. Special thanks to Cohen Bay, Rochelle Gomez, Lauren Fonda, Megan Collins, and Karen Talae. And I'm your host, Amy Gordinier. Till next time, skin nerds.

Speaker 4:

Total Skin Nerds is a podcast created to educate. It is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical advice. If you are looking for help with a skin concern, we would encourage you to seek the advice of a board certified dermatologist, functional medical practitioner, or other qualified healthcare provider.

You can find a registry of board certified dermatologists in the US at find-a-derm.aad.org, and in Canada at dermatology.ca. For a registry of qualified functional medical practitioners, you can visit ifm.org. Thank you so much for joining us on this episode. We hope that you enjoy listening to Total Skin Nerds as much as we enjoy making it.