ZACH MOORE: Welcome to On Health with Houston Methodist. I'm Zach Moore. I'm a photographer and editor here, and I'm also a longtime podcaster.

 

KIM RIVERA HUSTON-WEBER: I'm Kim Rivera Huston-Weber, and I'm a copywriter here at Houston Methodist.

 

ZACH: And Kim, what is your skincare routine?

 

KIM: It's a lot simpler these days. I actually, after interviewing our expert, I am basically washing my face and making sure I'm putting SPF on every day.

 

ZACH: What were you doing before?

 

KIM: I mean, I was always washing my face. I'm not a dirtbag. But…

 

[Laughing]

You know, I think I was probably doing a step above what I think, I don't know. Stereotypically, people think -- men have terrible skincare routines. Like, what's -- what's your skincare routine, Zach?

 

ZACH: I find that an over generalization, but you're absolutely correct at the same time. Before I lived with my wife, I pretty much took a shower and I was like, “Well, like, I'm clean, right? I'm good. Like, soap water. Like, what else do you need.” Now, when I was younger, I did have acne. I had some bad acne when I was younger. So, I mean -- when I had that, I was like doing extra things and whatnot.

KIM: Same.

ZACH: But -- and occasionally I still get a pimple every now and then. I thought that was gonna be over with when I turned, I don't know, maybe 30. But I still get an occasional pimple, unfortunately. But I do do some moisturizer. Like my wife got me onto that. There's other things that she's bought for me that sit in the things that she bought them for me in and I very rarely use them. But no, I don't really have -- I don't get up early and do a whole thing and do a whole thing before I go to sleep. And I don't, like -- I don't wanna put stuff on my face before I go to sleep because like, I'm a night showerer, you know?  So, I wanna be clean, you know?  I'm like, nice and like, I don't want extra stuff.

 

KIM: Yeah.

 

ZACH: ZACH Right. You know what I'm saying?

KIM: Yeah. I'm kind of with you. And I feel like I've started and stopped a lot of skincare routines over time because, you know, being a woman, there's a lot of marketing out there of different skincare trends and things to try that will, you know, take the years off your face or whatever.

ZACH: Take the years off your face.

[Laughing]

KIM: Yeah. Like whatever influencers are saying online.

ZACH: Yeah.

KIM: And, you know, I think that's a big reason why I wanted to do the episode is I think I am a person of a certain age now and I'm inundated with ads about skincare routines and retinol products. So, just things that are supposed to help you age gracefully.

ZACH: Yeah. It's definitely a whole industry.

KIM: Yeah. Yeah.

ZACH: And there's a lot of things out there they wanna make you think you need that maybe you don't need. And this is what we talked about with our expert today.

KIM: Yeah. We spoke with Annie Christensen, a medical aesthetician with Houston Methodist, and she had a lot of good advice for us.

ZACH: All right. Let's get into it.

[ Sound effect signaling start of interview]

KIM: I'm here today with Annie Christenson, medical esthetician with Houston Methodist. Thanks so much for being with us today.

ANNIE CHRISTENSON: Absolutely.

KIM: At least to me, it seems like we're kind of living in this golden age of skincare. You can walk down the aisles of any pharmacy or cosmetic store, and you're just met with any kind of product you could think of in terms of like, “Oh, I wanna focus on wrinkles,” or, “Oh, I wanna focus on skin brightening.” There's just all these different options. And I think with the rise of influencer culture, there's also no shortage of voices out there telling you how you should be doing your skincare, what kind of procedures you should be getting. Just there -- There's a lot to sift through. So, I really wanna talk about anti-aging trends, but I also really wanna talk about how people can just have healthy skin no matter how many times they've been around the sun. So, I'd like to start off by asking, if you were to distill an everyday skincare routine down to its bare minimum parts, what would that look like? And, you know, if you wanna talk about, you know, once you get to the point where you wanna add some anti-aging steps, I'd be curious to hear about those too.

 

ANNIE: You've kind of hit everything that's happening right now.

[Laughing]

 So right now, I feel like the trend is kind of anti-aging versus healthy skin. And you mentioned that. They kind of both go together, hand in hand, of course. So, you know, if you just want healthy skin and to take care of your skin, boil it down to just minimum wash your face every day and put your sunscreen on. That's the bare minimum. You've got to do those things, just to have healthy skin. 'Cause you know, it doesn't matter if you're really thinking about the look of it, we need to be healthy. We keep a healthy body, we eat right, we exercise. Taking care of your skin is part of that. Then if you are looking at kind of an anti-aging sort of look at your skin, and this is for any age, you always wanna start off with washing the skin, using an antioxidant type product in the morning, because that helps to prevent sun damage, moisturizer if your skin needs it, and a sunscreen. And then at night is when you wanna, again, wash, use some sort of an exfoliation, which can be a retinol, a glycolic, a salicylic, something that works for your skin type. And I'll be saying that many times today, probably. And a moisturizer. And that should be your evening routine.

 

KIM: You kind of surprised me but it's wash your face and SPF.

ANNIE: Yes.

[Laughter]

If you just wanna do the minimum, you've gotta do those things. Because sunscreen is gonna be your biggest anti-ager that there is. All the other things are great, and they're gonna definitely do something if you wanna do them. If you don't wanna do anything, please put your sunscreen on.

KIM:I mean, I feel like that's like the, the big headline, right?

ANNIE: Yes. Because we're getting damaging rays right here, sitting under these lights. You get 'em from your computer. You get 'em all over the place. So, yeah. You think you're not in the sun, but sitting next to a window, it's bouncing in. So, you really have to protect yourself.

 

KIM: You know, I think I've always thought, you know, “Oh, I'm gonna leave the house, so now I'm gonna put it on.” But…

 

ANNIE: Right. But sometimes you forget. You're trying to run out of the house too fast, or you forget, or you're gonna wear makeup, when you gotta have it on before that. So, when you get ready in the morning, wash your face. If you're gonna do some skincare, put that on. And then after that, put your sunscreen on, and then you're ready. 

[Laughing]

KIM: You talked about the -- sort of, the different steps. I heard you mention retinol, which I'm sure we're gonna talk about a lot. And I've been thinking about it. I saw something online. It was joke about, you know, how younger and younger people are doing these really elaborate skincare routines. Some of them which have retinol and just -- these kind of heavy hitter…

ANNIE: Yeah.

KIM: Skincare treatments at really young ages, like even college age. And, you know, I, I think the joke was –

ANNIE: Or even younger.

KIM: Yeah.

[Laughter]

And I think the joke was, you know, I don't remember drinking water in college, you know? And I'm probably closer to that than the really heavy skincare routine. But if someone's concerned about aging gracefully, is there an age you should start doing this? And is there an age where it's maybe like, well, you know, the ship sailed. Like, there's nothing that can be done. You're gonna have the crow's feet or whatever.

ANNIE: Right. No, there's not a too young and there's not a too old. So, you can always take care of your skin, just like you can always go to the gym no matter how young or old you are. I know this year the big trend for like eight to ten year olds was getting skincare for Christmas. So, I was putting together skincare packages for yes, very young age. But it's a good habit, you know, just like at a young age, it's a good habit to, you know, get out and do your exercise every day, to learn to eat right every day. So, it is okay to start young and do these things. You do have to think about what you're doing, 'cause when you mention retinol, our skin doesn't stop producing collagen until we hit our mid twenties. Now, at that point, it does stop producing collagen, or slow down rather. So, at that point, that's where we do need to get something to rev that up. And that can be with our antioxidants are, which are vitamin Cs and our retinols. 'Cause that's gonna kind of break down the skin. It's like the exercise for the skin is how I kind of put it.

KIM: We really stop making collagen in our twenties?

ANNIE: Yes.

[Laughing]

Sad but true. It slows down. But even if I have someone that comes into me and, you know, they're 55 and they're like, “You know, I've had good skin and I haven't really done anything and I wanna start doing it.” Great. We can still start at any age, and we can rev that up. So even, I mean, again, I will take it back to working out, because that makes sense to a lot of people. But even if you're older and you start working out at an older age, you can tell. You can still build your muscles. You can still get healthy. You can change your diet. You can change your skincare.

KIM: So, you'd mentioned vitamin C, retinol, and I’ve noticed a lot online, 'cause kind of at the top I had mentioned that influencer cultures seems to be so pervasive. I'm getting so many ads for things of people saying, “You should do this. You should not do this.” And one of the things that I keep seeing mentioned is Tretinoin. Did I get that correct?

ANNIE: Yes, you did.

 

KIM: Is that in line with retinol? It really seems to be the “it” ingredient, and I'm sure there's been lots of “it” ingredients over time. But I would just love to hear your opinion on, you know, since so much of this stuff is being touted as like the next big thing, should you start using it as part of your routine?

ANNIE: The prescription is called Tretinoin. So, if you do get a prescription, that's generally what's gonna be on the box. And there are different levels of that. So that depends on, you know, what's good for your skin as well. But over the counter, products with retinol or different derivatives of it, there are so many out there and they are very good. So, I think that we don't need to go to those Tretinoins, which are too hard to use honestly. If you put that directly on your skin, it can be very irritating to the skin. They're just very hard to use. You know, we've heard of sandwiching and, you know, all these different trends on how to use it. Well, why not just get a bottle where you just put a pump in your fingers and put it on? You don't have to do all that. And so, they're out there. Over the counter, you can get very good products without needing that.

KIM: Is sandwiching like slugging or is that different?

[Laughing].

ANNIE: So, sandwiching is just where you put a layer of a moisturizer on, then you put your Tretinoin on, and then you put your moisturizer on top. I have always, and I've been in this business for a lot of years. So, I have always said, you know, put your Tretinoin in your palm, put some moisturizer in your palm, mix 'em up. Because when I started, that's all we had. There was no over the counter retinols available. So, we did have to use the Tretinoin, and we used it, you know, fine. But now we don't have to.

KIM: So, it's kind of more about finding a retinol that works with your skin.

ANNIE: And, you know, you said the key right there to all of this, what is your skin? That's the thing. You see all this stuff on social media, you read things, and you think, “Oh, I need that. Oh, I need that. Oh, I need that.” You think you need everything. Of course. I do too. But you…

 [Laughing]

You need to then, you know, kind of dial it back and go, “But wait a minute, how old am I? What does my skin need?” Because some of these things you may not need. You know, “I wanna use, oh, this glamorous moisturizer that sounds like it's gonna make me look amazing. But guess what? I have oily skin and I break out. I cannot use that.” So, you have to use what's correct for your skin.

 

KIM: I'm curious to know when someone comes in to see you and they say, “Hey, I saw this thing on TikTok. I saw it on Instagram.” What has been the best thing you've heard come out of that conversation and what has been, you know, the stop this immediately that you’ve encountered in your practice?

ANNIE: I never say stop immediately, mainly because I can go down that rabbit hole too. You know, you just sit there, and you watch, and you watch, and you watch. And so, things do sound fun and exciting. But what I will tell my younger clients, 'cause that is -- I mean, heck, I'm not young, so I'm doing it too. So, I mean, we're all doing it.

KIM: Yeah.

ANNIE: So, you know, it's just that you really have to remember, think about what's -- what your skin needs. So, it is kind of fun to think about what's out there, see what's out there, “What are other people doing? Am I missing something?” So, it's okay to look at it, but you really have to kind of make sure you're getting what you need. You know? 'Cause I do. I have people that come in and, “Oh, I just bought this.” And I'll say, “Oh, where'd you get it?” “Mm. Instagram.” And…

 [Laughing]

 So. Or they'll bring me in what they just bought and say, “Can I use this?” And, you know, normally it's all good as long as it's for their skin type. Now I have had people bring me in or tell me about something, and I'll say, “Yeah, that's a great device, but it's not for you.”

[Music plays to signal a pause in the episode]

 

ZACH: Interested in adding retinoids, AKA vitamin A, to your skincare routine? Whether you use prescription grade or over the counter retinol products, specialists agree that wearing sunscreen is mandatory. Using retinoids can make the skin dry or irritated, which can make getting your average sunburn worse. But the jury is still out on whether retinoids cause sun sensitivity. Many studies have explored whether retinoid use causes photosensitivity, when a drug makes it more likely for your skin to burn when exposed to UV rays. The research isn't definitive either way, so that's likely why the FDA, skincare companies, and experts alike recommend using SPF when using retinoids. And anyone who spends time in a cosmetic shop or pharmacy knows that skincare doesn't come cheap. Catching too many UV rays causes retinoids to break down. So, the active ingredients in your pricey anti-aging products will deactivate, turning that effective treatment into hope in a bottle. To make sure you're getting the most out of retinoid use, make sure you are: Using retinoid treatments at night before bed to get the most from your products. Applying a broad-spectrum sunscreen, minimum SPF 30, every single day, no matter the season, weather, or if you'll be inside all day. Trying to avoid peak sun exposure during the hours of 10:00 AM to 2:00 PM whenever possible. Hanging out in shady spots when you're outdoors. Better yet, consider wearing a hat and sunglasses when outside to protect your face from UV rays.

[Music plays to signal resumption of episode]

KIM: So, there's been a lot of telehealth startups that have popped up in the wake of the pandemic. And I think one of the industries where I've noticed this the most is in dermatology. Dermatology startups are just everywhere online. But maybe that's just because I'm in a certain age group. Many of these startups claim to treat several conditions, whether it's acne or aging. They offer you a quick appointment with the dermatologist and then they prescribe products that are formulated by the startup. These formulations are usually mixed with more than one FDA approved generic drug, or there's a key regulated drug that is mixed with unregulated but beneficial skincare ingredients. So, a lot of these startups are claiming that they're democratizing prescription grade skincare. What do you think about these startups and what could some of the potential risks be?

 

ANNIE: First, a little bit on the telehealth. I think that that is amazing in our practices. I do use it, and I think it's very helpful. It's very hard to get into a dermatologist, so sometimes if you can get into see one and you need to, that's a great way to go. So, I do -- just coming from the medical space, I do really agree with that. Now, I have seen some of these companies through my patients that have come in and said, they have, you know, they're thinking about this, or they have already used it. And I'll always just do my little homework with them and kind of look it up and see what you think. And that's just like anything. If you're gonna get a new roof on your house, you're gonna do your homework. So, you've got to do your homework, and just make sure that it is something that does look good and healthy and safe for you to try. And again, that it's for your skin. But if it's helping you to see a physician and you were not able to, because it is -- does take about six months sometimes to get into a dermatology office. And you don't wanna wait that when we're talking about skin. So, this can really help. So, you know, I think it's an okay thing. Prescriptions are a good way to go. Again, as long as it is for your skin type. But do watch out. I mean, you know, with anything you can get taken advantage of.

KIM: This might be kind of a simple question, but I've been around the sun a few times and I've tried and discontinued, I don't know how many different skincare routines. How do you really know when something is for your skin?

ANNIE: Skin changes -- through our life, our skin will change all the time. So, finding something and sticking with it while your skin is sort of in that mode, and how do you know? I mean, your skin feels good. You don't feel dry. It's not sort of causing any texture changes or breaking out or, you know, it's soothing something. Or it's, you know, it's taking care of what you need. So that's how you really know that it’s right for your skin. And some people do have a better notion of what that means. And if you don't, then go to someone that can help you. So, you know, whether that be your dermatologist or an esthetician. I do really promote estheticians because I think they can really help you and spend a little bit more time with you to figure out your skin and what would be the proper products for you. Most of us do have products in our offices. I do have medical grade products in my office that you can only get in a medical office and sometimes that is the case when you're going to a medical office. But I do tend to, you know, stay up on every product that's out there. So, over the counter products, you know, whether you get it at the drug store, at the department store, at an esthetician office that may not be a medical, those are still gonna all be very good products. Depending on your skin. Sometimes you have a more difficult skin that needs a little bit more. And sometimes that can only be for a short amount of time that you're just gonna go sort of learn how to work with a product. You know, a client that has rosacea, that's not going away. You're always gonna have it. But you need to know what it is that's going to make that work on your skin, and then you can build your other skincare around that.

 

KIM: In thinking about working with someone like an esthetician, what are some of the treatments that you can get in-house somewhere versus, you know, I think there's a lot of trial and error that can happen when you're just going to the pharmacy by yourself.

ANNIE: Very true.

 [Laughing]

KIM: I'd love to hear, you know, what that journey of working with an esthetician would be like for someone.

 

 

ANNIE: So, most estheticians have been really trained to, you know, analyze your skin and help you to figure out what your skin type is and then what products and what treatments are gonna be best for you. And I always look at, you know, “What's your goal? Why are you here? What is it that you wanna see different?” You know, are you sort of in your mid-forties and you wanna really work on anti-aging and tightening the skin? So, you know, there's microneedling, there's chemical peels, there's lasers that we use to kind of brighten the skin, work on capillaries and redness in the skin. So those are things that I'm doing all day long. Microneedling treatments, laser treatments, which is like the IPL, to work on dark spots and redness, and chemical peels. Love chemical peels. They're kind of old school, but they're so good. So don’t leave those behind. And then I always help people with their home care. You know, “How often are you able to come in?” So then I can figure out what kind of things I need to send you home with. 'Cause a lot of people don't wanna come, you know? I'm in the med center, it's hard to get here. And Houston is giant.

 [Laughing]

So, you know, someone may take an hour, an hour and a half to get here. So, that may not be a journey they wanna do every month. There are so many things you can do at home. So, whether that be, you know, your own little, microcurrent devices, chemical peeling pads, there’s just great stuff at home.

KIM: Again, I am a person who lives online, so I've definitely seen microcurrent devices as something that is kind of out there in terms of an at-home device. So, whenever I see them, I'm always kind of wondering if you're just low dose electrocuting yourself? Maybe that's not the way to look at it.

ANNIE: Feels that way.

[Laughing]

 Did mine last night.

 [Laughing]

KIM: So, the device can come with a pretty hefty price tag. So, could you talk through the science with it? Is it something worth doing?

ANNIE: Yeah, so there's several different ones that are out there. Your microcurrent really works on the muscle and tightening the skin. It can help to kind of move the lymphatic system around as well, which is, I really think is very, very healthy for the skin. That's something that I do a lot of is lymphatic massage. I'm kind of taking a little bit of a side note here, but you know, like post-surgical in our office, 'cause we're head and neck surgery, I do do that lymphatic massage. So, a lot of these home devices do help to move your lymphatic or just get it pumped. And so that's something that we don't talk about a lot, but it is something to think about. Your microcurrent tends to tighten the skin so you can help your jawline to look more firm. You can help your cheekbones to stand out a little bit more. And I think they work, I mean they look great. The technology has been around for a long time. We've used a lot of these things in the treatment room for many years. Take the LED lights that you see everywhere now, and those definitely are a little pricey, but they're so worth it. And 'cause people will ask me about that all the time and I'll say, I have been using this LED light on you for years. And they're like, “You have?”

[Laughing]

 

So yes, it's something that is definitely worthwhile. So, your red is for anti-aging, your blue is more for acne. So bottom line, get one that has both of those in it. Then there's some other lights, which -- which are great, but those two are the main ones that you need.

KIM: I remember seeing some -- one of the masks online and I showed the photo of it to my husband and I was like, “Would you be weirded out if I wore this for 20 to 30 minutes a day?” And he was like, “What is that? That is terrifying.”

[Laughing]

ANNIE: It is terrifying.

[Laughing]

KIM But it's good to know because that's another huge thing online, are these various masks. And the prices can really vary. And so you said red and blue? 

ANNIE: And length of time the price sort of goes along with that. So, your less expensive ones you are gonna have to wear a little bit longer because I think they've used less light bulbs in it. The more expensive ones you can actually wear for only three to seven minutes. So, yeah. So, it can make a difference in, you know, say what -- what your pocketbook looks like, but also what kind of time do you have to wear them.

KIM: Yeah.

ANNIE: And they are quite bright, so you have to, you know, wear a little bit of eye cover in them. A lot of 'em don't come with that, so you may have to add that to it.

KIM: Are they LED light masks?

ANNIE: Correct.

KIM: Yes.

ANNIE: Yes. They're all LEDs. Yeah.

KIM: The light masks, the microcurrent, those seem to be kind of worth it?

ANNIE: Yeah, those are the ones that I really like. So, there's a -- there's like a microneedling sort of roller thing. Again, that's been around for a long time and people do swear by it and you can get your products in a little bit better with that. That's something that I personally have not really felt is necessary at home. I think other things can do what that one does. But if you like it, great. I mean, it's not bad. Also, there's like just the plain jade rollers and your gua sha stones. And -- so those again have been around forever, and they're sort of doing the same thing as your microcurrent. You know, they're helping to kind of move that lymphatic flow, but also you’re, kind of working on your jawline and your cheekbones and that sort of thing. So, those are great too. So, it just depends on what you like and what you're gonna use. 'Cause that's it. We can buy a lot of stuff, but if it sits around, it's not doing any good.

KIM: Yeah, tha -- I think…

 [Laughing]

That kind of touches on another thing where -- and I've been as guilty of this as anybody else that, you know, we're all kind of looking for this lightning, magic in a bottle, right? That one product that's just gonna make things work out for us in terms of, you know, whatever we're trying to correct for. So, when you're thinking about embarking on any kind of skincare routine or maybe you wanna try any kind of treatments, in-office treatments, what amount of time should you be giving yourself to see results?

ANNIE: Hmm. Now, that's a good question. I think it depends on what we're trying to work on, because some things can correct much easier than other things. So, I don't know that there's really a timeframe on a lot of those, but you do tend to really see where something may be headed within a few months. So, you can see, you know, either the brightening of the skin or the smoothing of the skin. All of those in a few months. I think four weeks can be a little soon, but a lot of times we think we see it.

KIM: Yeah. Because I do think that there's a lot of hope…

ANNIE: Exactly.

KIM: That wishful thinking maybe that can come in when we're trying something out for the first time. But hearing the phrase, like “it could take months” is important because I -- you know, I think we can all be guilty of, you know, you try something out, it's not necessarily happening as fast enough as you might want to and you're just like, “Okay, I am gonna be done with this.”

ANNIE: I'm done. It's not working.

KIM: Yeah.

ANNIE: Yeah. And it really can be working. Although, I surprise myself so many times. I'll have -- you know, do a treatment on someone and you know, they're scheduled to come back in a month, and they come back in that month, and I have not been seeing them every day. So, that's a big difference when you're seeing yourself every day, you may not see the change, but when I see them in a month, I'm like, “Oh my gosh, that worked so much better than I expected. That was great.”

[Laughing]

So, yeah. Things do work. It's just how we visually see it sometimes.

KIM: Yeah, so you kind of have to commit to the vision, and probably there's an element of we're all sort of our own worst critics sometimes.

ANNIE: Absolutely.

KIM: Especially with maybe those tiny things that no one else notices but bug us.

ANNIE: But us. Yes.

KIM: So, in terms of other devices, could you walk me through what epidermal planing is?

ANNIE: Yes. That is one of my favorite things. And I do that with every single treatment I do. So, no matter what you're coming in for, I start off with that. And I've been doing that for many, many, many years. It's amazing for the skin. So, it's a light scraping of the skin where I get off a dead skin layer, but it also takes off a little bit of the sort of peach fuzz to say, on your skin. So, your skin just feels so soft and smooth. Your products can penetrate really well after it. And then over the past few years, there are many home devices that have come out, and they are actually very good. So, from a $5 one that I thought, “I'm gonna pick this up and just see how well this $5 one works.” It was great. And that's what I personally use at home every day is that one that's just over the counter, that I got at the drugstore for five bucks. But now you can get some that are, you know, you have to plug in and they're a little easier to use and they feel good in your hand. And those are great too, ‘cause people are scared of cutting themselves. Neither one of those can you really cut yourself. So, that's what's nice. But I think that is a great anti-age product because it exfoliates the skin from the top and it also gets off the fuzz and it doesn't make it come back heavier. People think, “I'm gonna grow a beard if I shave it off.” No, you're not. We would all be rich if we could do that because there would be no bald people. There would be…

 [Laughing]

 So.

KIM: No, that’s – yeah.

ANNIE: It's an old wives' tale.

KIM: Oh yeah. No, I think my -- I think my mom even told me that at some point.

ANNIE: Yeah.

KIM: Something that you mentioned as an in-office treatment, microneedling. So, what is that and --'cause I'll admit just the phrase…

ANNIE: The word needle.

KIM: Yeah, it kinda scares me a little. So, could you walk me through what that is?

ANNIE: Yes. Microneedling is a really great treatment. Again, it's something that I've been doing for many years. It's anti-aging, yet it can also break up, say acne scarring, can help calm down a --an acne once it's sort of, started to heal. So, I use it a lot in that sort of realm. And now we have microneedling with radio frequency. So, at the tips of those needles, once those needles deploy into the skin, they shoot off a radio frequency, which also works at building the collagen. So, it's very anti-aging as well. So, the original one, which I still use as well, depending on what I'm working on, because we're causing micro injury to the skin, when the skin gets injured, it says, “Oh, I'm being injured. Let me build new skin, build, you know, grow more collagen or build more collagen in the skin.”  So, that's really what we're doing. And again, back to the working out, you know, you use weights to kind of break down that muscle to build up the muscle. So, it all kind of works the same way. So, the skin does the same thing. So, that's why we're constantly kind of breaking down the skin. That's what your retinol is doing, your Tretinoin is doing. It's breaking down the skin so that the skin says, “Oh, I'm being traumatized. I need to create more skin.” So, that's what we're doing. But back to the microneedling. The microneedling helps to firm the skin 'cause it is building that collagen. It's a really great treatment. I, you know, work with several doctors that do, you know, facelifts and brow lifts and neck lifts and all of that. But they're -- do, in the beginning they'll say, you know, “Let's do this instead. Let's see if we can get you to where you wanna be. Maybe we don't need to go the surgical route.” Because we can get such good results with it. And also, say you have had surgery done, this is gonna help to kind of protect your investment. So, we're gonna keep that skin firm and tight afterwards. So, it’s a really good treatment for all skin types and any age.

 

KIM: So, you broke my heart earlier by saying that we stopped producing collagen so much earlier than I would've imagined. And so, another thing out there that you see quite a bit are collagen supplements, whether it's powders you can put in a smoothie or just supplements that you take in pill form. Is…

ANNIE: Yes. 

[Laughing]

Yes.

KIM: Do these work? Are they worth the money? 'Cause some, depending on the type you get, you know -- I guess in terms of everything, you know, there's a scale. But...

ANNIE: Yeah, they can be expensive, you know, depending on what route you go. You know, you can get them in little liquid daily shot forms. You can just go to, you know, like a Big Box store and get like a powder form that you can put in your smoothie or your coffee every day. I do one of the powder ones in my coffee every morning, and yes, I do believe in them. And two, as we get older, you know, they're helping out with your joints and, you know, other things. So, it's not just your skin that they're working on. So, I do really think that they're valid. So -- 'cause we have collagen everywhere in our body. So, it's not just our faces that we're seeing it help. So, those, I think are very valuable.

KIM: So, we've talked a lot about the trends that happen online, but let's take it in real life for a second. So, there are tons of spas and places that you can go to get skincare treatments, facials, like what have you. If someone is interested in kind of exploring a skincare journey and they're looking for a place to go, what are some of the red flags and what are some of the green flags when you're look -- researching somewhere to go?

ANNIE: Yeah, so we've got a lot of different areas that you can choose from. So, I think it kind of boils back to what's going on with your skin and what do you need. So, I love going to a spa and getting a facial and having a, you know, a massage and doing the whole thing. Am I expecting them to fix whatever's going on on my face? No. But it feels amazing. So, you know, so those are fine. Now, if you do have a concern with your skin, say you have acne or rosacea or a sensitive skin for some other reason, that may not be the best thing for you, if it's just kind of what I call, you know, a fluffy facial. Because that can irritate your skin. But you know, in saying that, there's so many other things you could do at the spa. So, if you are going, you know, have a good time.

 [Laughing]

 But if we need to work on our skin, then you gotta do your research, you know, talk to your friends, you know, we can go online and kind of, you know, Google around and find out what's out there that can work on your specific skin needs. And interview the place where you're going, okay? I see people all the time for a consultation. And I, myself, I don't charge anything for my consultations. You come in, we get about 20 minutes, we talk about your skin, I talk about what we're gonna, you know, what I think is gonna be good for you, what your skin type might be and what we can do. And then you can decide, you know, is this the right place for you or not? And that's really what you should kind of look for, someone that's gonna really be interested in your skin type and help you with your skin needs.

 

KIM: I think there is a lot of pressure to consider what we look like as we age. And I feel there's another camp that's, you know, they want to age naturally or as low intervention as possible. While I think a lot of this stuff sounds cool and I'll probably be talking to you after about, “Oh, you know what's up?” Maybe I'll make an appointment with you. But for those who are listening to this and thinking, you know, “I don't know that I wanna be doing all of this stuff. I just wanna approach it from as natural as possible.” What can that look like for a person?

ANNIE: Yeah. Aging gracefully and naturally is actually what I prefer to be honest. As I said before, I work with some amazing plastic surgeons. I don't think I really wanna do that. But that being said, you know, you never know what you're gonna think of in 10 years or whatever. So, yeah, we have to look at what do we think today? How do we look? Everyone is on sort of a different journey on what they kind of wanna do. You know, some people wear makeup, some people don't. Some people wanna have this big, long skincare regime and some don't. You know, that's just being you. So be you. That's what you wanna do. Find out what it is -- because I do, I see people from all, you know, from just, you know, keeping it natural. They come in just for a nice healthy facial once a month, to people that are doing all sorts of things and are on their third facelift and still doing, you know, all these things. There’s everything in between. Just find your lane and enjoy it. You know, there’s so many things that you can do out there. And I think that it is -- we have come to a time where you -- it's okay to say, “I don't wanna wear all that makeup. I don't wanna have my lips filled. I don't wanna do all that.” Then don't.

 [Laughing]

Because you look great no matter who you are.

KIM: Yeah.

ANNIE: So, yeah. Yeah.

KIM: Finding a way to make it work for yourself.

ANNIE: Exactly. Yeah. You still need to wash and put your sunscreen on, but you know.

 [Laughing]

KIM: Annie, thank you so much. I feel like I've learned so much about the spectrum of what exists for skincare and especially with anti-aging treatments. So, this has been wonderful. Thank you so much.

ANNIE: Thank you for letting me do this. It's so much fun. And I'd love to get the information out there. I think there's so much information and I think everybody deserves it.

[Sound effect signaling end of interview]

ZACH: So, Kim, I feel better that Annie recommended, you just gotta wash your face, right? I mean, I've been doing that.

[Laughing] 

So, I’m good. I don't need all those extra products, right?

 

KIM: Yeah. You know, I think her message about you can engage with skincare as much as you would like to or as little as you want to, really encouraging. Because especially I think for women, we are constantly being marketed to, to have like, “You need to have a 15-step skincare routine.” And, you know, you don't to have healthy skin.

ZACH: Well, I think another factor is, and correct me if I'm wrong, I don't wear makeup, women wear makeup, right?

KIM: Yeah.

ZACH: And you're putting all this stuff on your face. You gotta take it off anyway. You gotta do a wash and then you're adding other extra things. So, it requires an extra level of cleanliness to remove everything, 'cause you don't want stuff there too long. And it's just -- there's a lot that goes to it, right?

KIM: Yeah.

ZACH: Now, to that point though, if you do have a certain skin thing you're working on, right? If you want to try and remoisturize or rejuvenate your skin, then you absolutely should look out for some skincare products that could help you achieve that goal, right?

KIM: Oh yeah. And what I really loved was she talked about how we're -- we start losing collagen basically when we're in our twenties.

ZACH: Mm.

KIM: And it just -- you keep losing it...

 [Laughing]

 ...but it's not over, you know?

ZACH: Right. It's never too late to start. Like, I like how you guys mentioned that, where it's like the gym or a diet where it's like, yeah, it’s-- if you start now, you can turn the ship around…

 [Laughing]

Right?

KIM: Yeah. Yeah. And the idea that you can start as young as you want to, but it's more about having a routine, right? Like going to the gym. Because, you know, I think sometimes skincare gets lumped in with being more luxurious or perhaps something that is, I don't know, self-care, wellnessy.

ZACH: Yeah. Yeah.

KIM: But, you know, it is your skin and it's taking care of yourself and your body, and so it's time well spent too.

ZACH: Yeah. I don't wanna call it a stigma, but I know what you're talking about.

KIM: Yeah.

ZACH: Or it's like, “Oh, skincare, I'm not one of those people.” Right? I think some people might feel that way. And no, it’s like…

KIM: It's a luxury.

ZACH: It’s like, brushing your teeth or getting your hair maintained. Like, it just -- it's a part of your body that you need to keep up with.  And we take it for granted because it's there, but it's just something that definitely in the long run you will see the benefits of it. And again, we had a whole podcast with Annie about sunscreen before, and you guys touched on that as well. But she again reiterates, wear a little sunscreen every day, which that's a struggle for me. But I did find, you know, speaking of all these moisturizers and things, like having a moisturizer and sunscreen combination, like sometimes I know -- especially if I'm gonna be outside, I know -- like for whatever reason, for however amount of time, like I'm gonna put some of that on. And I have noticed a big difference because I've noticed that when I don't, and I don't know if it's because I'm losing collagen or whatever the combination is with my skin, because, you know, everybody's skin is different as you guys discussed. But like, if I don't do any of that, I'll come inside and I'll be outside for just an hour or two and I'll be red, like, not like a burn burn, but a little something. And then I'll have flaky skin because, you know, everybody knows how the sunburn works. And you can avoid all that just by putting a little bit of sunscreen moisturizer on before you go outside.

KIM: Yeah. I know, you know, we talked a lot about using retinol or retinoids to kind of “reverse time” as it were. I think it's really telling that SPF, if anti-aging skincare is important to you, SPF is always going to be your most important tool in your toolbox.

ZACH: Yeah. And I, I feel like I've always had kind of a baby face. So, I mean, kinda shy to like, “Oh yeah, let me put on stuff that makes me look even younger.” No, no, no. I'm gonna wait till like, “Oh, are you starting to look old now? Oh, maybe I'll stay in the space for a little bit.” And then I'll try to reverse that. I don't know if that's the right approach or not, but that's just where I’m coming from with it. But I am kind of getting that age where like, yeah, this stuff does start to affect you. You see the side effects of it all. And let's, you know, like everything else we talk about here, be preemptive about it.

KIM: Yeah. I think men get a little bit more of a pass than women do. Like, I don't know. Are, are you seeing lots of ten step routines on your Instagram feed?

ZACH: No, I am not seeing that. No. I get targeted on other things.

KIM: Okay. Well, that’s good.

ZACH: What those things are, I’m not gonna tell you.

[Laughing]

And then, wrapping up, I did wanna mention, I was rather surprised, and it sounds like you were too in your conversation with Annie about the age of kids now that are getting skincare routines. Like, she’s saying that she’s making packages, or you know, Christmas presents for kids who are like eight, nine, ten years old. Right?

KIM: Yeah. And I think it’s just how pervasive wellness culture is. And it’s kind of why I wanted to explore this topic. And you know, I – we talk about it in other episodes this season where influencer culture is starting people young on these different messages. And whether those messages are good or not is to be seen. But, you know, with Annie saying that you’re never too young for a healthy skin care routine is positive. But, you know, maybe those eight, nine, and ten year olds don’t need to be using anti-aging skincare.

[Laughing]

ZACH: We’ll draw the line there, right?

KIM: Yeah, right?

[Laughing]

ZACH: All right, well that’s gonna do it for this episode of On Health with Houston Methodist. Be sure to share, like and subscribe wherever you get your podcasts. We drop episodes Tuesday mornings. So, until then, stay tuned and stay healthy.

[Music ends signaling end of episode]