This is Dr. Robert Frankel. I’m an emergency medicine and anti-aging physician and welcome to the Modern Man Podcast. In this podcast, we talk about important topics for men, which include male aesthetics, health and wellness. But most importantly, we try to remove the stigma of male aesthetics because I think that it’s important to understand what men can do for aesthetics and how important it is … for their social and psychological well-being, and ultimately just to feel and look good. So, take the journey with me. It’s going to be okay. It’s going to be fun. So enjoy it. I think the next episode will be really interesting and informative, so take a listen, hope you enjoy it. Again, this is Dr. Rob Frankel. Enjoy the episode. Thank you.

So, today’s topic, we’re gonna be talking about medical skin treatments for men. This is a pretty important topic, and I talked to a bunch of my male patients and we discussed like, what are the most important things that we worry about as men as far as what things bother you? And so I picked out five different problems that occur, and I’m gonna list them out. And then we’re gonna talk about these problems. We’re gonna talk a little bit about skin. We’re gonna talk about why things work and why things don’t work. We’re gonna talk about the medical approach to skincare because it is different than things that you’re going to pick up at the pharmacy, things that you’re going to see on tv, things that you’re gonna see on the infomercials late at night because of the fact that, to create true change, a lot of times you have to work on the permanent area of skin. And so that’s what we’re gonna talk about today.

So, the five things that … in skin that most patients were worried about were, one was scarring and acne scarring. And so this was, you know, years later, you could still have, you know, scarring or acne scarring. Pore size and this happens later in life. You notice that your pore has become enlarged. Texture of your skin and this creates fine lines and even wrinkles, which is also, you know, with age. And we’re gonna talk a little bit about the different cells and collagen that change … that cause this. The tone of the skin, which means that … so as we get older, the tone of the skin is very important because you start to feel that the skin might sag. You might not be as fit, you know, in …. on your face. Just like … as we go to the gym, we notice that we’re not … having that six-pack, if we ever did have that six-pack in our mid-section. But we’re not having that tautness around our jawline, around our cheeks, around their eyes and so all those things occur and the reason why they occur is a couple of reasons.

The first thing is that you can develop collagen damage. Now, collagen, I’m gonna talk a little bit about, and we’re not gonna go, you know, deep into a skin lecture here, because that will take hours but I’m gonna go through some of the kind of important things to understand, but we will discuss it. So you can just from, you know, environmental issues, sun, if you know, smoked in the past, even excess, you know, taking sugar in, caffeine, all these things can increase your risk of having collagen damage and also elastin. Which is another cell, and elastin actually creates the … just like what it says, the elasticity of the skin. So the ability for your skin to kind of snap back is really important as well, because this gives you the ability … your skin, the ability to have that kind of tautness that we start to lose over time. And so the tone of your skin also … is important to a lot of patients and pigment. Now pigment means that you can over time develop uneven pigment in your skin. So regardless of what your skin tone is you can have often hyperpigmentation changes in pigments, browns and reds. Meaning like, you can develop, you know, brown spots, darker spots where you have hyper melanin, regardless of your skin tone. You can develop extra melanin in, you know, specific areas and so it creates an unevenness in your skin. And this of course is going to create, you know, something that is not what, you know, not what patients want. And so there are ways to improve this as well.

As well as, you know, broken blood vessels, which you can see as reds or you know, sun damage is … another problem that happens over time. So these … issues are all kind of the major kind of five problems that I’m going to target when we talk about skincare for men. And of course, they transcend to women as well. But we’re gonna focus on guys because this is the Modern Man odcast. So and a lot of times guys are going to be less diligent about what they do with their skin. You know, I’ve had talk … I’ve had discussions with some of my patients and they’ve told me that, ivory soap does really well for them and so we’ll discuss. We’ll discuss, we’ll go through it, we’ll get you where you need to be. So why are the things that you see on late-night TV or at the pharmacy, not the best things or not… are wasteful? As far as like I … I saw this on tv, I saw this advertising, they said it’s great, it’s gonna get rid of all my lines, and it’s not. And so why does that happen?

So we didn’t go through kind of like some of the basics of skin and it’s important to kind of understand because if you understand that, then you understand why a lot of the things that you might do might not actually work. So skin has, you know, three kind of important layers, that we’re gonna kind of discuss. The first is the outer layer, and it’s called the epidermis. It’s the outermost layer. So the epidermis sheds usually every 28 days. Now, the fact is actually as we get older, it can take longer for it to shed. Now, as we’re much younger, it actually sheds sooner. It could shed up to 14 days. But for some patients over 50, it could take up to 80 days for the epidermis to shed. So that’s why when we talk about things called peels they’re useful because of the fact to get rid of that outer layer of skin, some of that dead skin, and you know, that outer layer is useful.

But the reason is, is that the epidermis, like when you use a lot of the lotions and potions that you see on TV or at the pharmacy, those materials that you’re putting on your skin are being placed on the epidermis and they’re being sloughed off, you know, over that period of time. Meaning that they’re not making permanent change on your skin because whatever you’re putting on the surface of your skin at some point, eventually is going to be … is going to eventually be sloughed off. Now, if you’re doing it every day, then you can develop change, you know, you’re going to see changes, because there is melanin in your epidermis. So things like retina and tretinoin, which we’ll discuss a little bit here. I mean, a lot of what we’re gonna talk about today is kind of a more of a general idea of skin.

I’m going to go, you know, over the length of these podcasts into specific issues. And we’re going to kind of focus in on, you know, more kind of specific ways that you can fix problems, because I realize that like you can … I could sit here for three, four hours and I don’t know if anybody’s gonna wanna listen to me for that long. So instead we’re gonna break it up into … more general kind of approach to just looking at skin today. So, the epidermis, the size of the epidermis is 1.5 to two millimeters. Now, why is that important? The reason why that’s important is that when you have … you could buy things online that say that they pierce the skin that are less than two millimeters, and that is, you know, that is kind of the kind of FDA approved, you know, purchasing. Then anything below that is only going to be in the epidermis. So that means that you’re not going to get into the second layer of the skin, which is what we call the dermis.

Now, the dermis is a more permanent part of the tissue now. So the reason why, like, we have tattoos that never go away, because the fact is that when they put the ink into the skin, they’re putting it into a deeper layer, the dermis. So every time that the epidermis is sloughed off, it doesn’t affect the ink that’s already in the dermis or scarring that’s in the dermis. So the scars stay there, you know, because of the fact that it’s in the deeper layer. And so this is really important.