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This podcast is where your inner work begins. Each season, we skip the small talk and get straight into: nuanced conversations about self-care and inner work where you’ll feel understood instead of overlooked, practices you can try as soon as the episode ends, and reflective prompts that connect you and your experience to the conversation.
Taylor Elyse Morrison:
You're listening to Inner Warmup. I'm your host, Taylor Elyse Morrison, Founder and Author of Inner Workout, ICF certified coach, and fellow journeyer. In 2017, I set out to build a life that didn't burn me out, and I found my life's work in the process. On Inner Warmup, we talk about how self-care and inner work show up in your relationships, your career, your schedule, and then the conversations you have with yourself. We get practical, we get nuance, and we're not afraid to challenge wellness as usual. So, take a deep breath and get curious. This is where your inner work begins. We're continuing our season sitting down with professionals in our self-care support system.
Taylor Elyse Morrison:
And today, our guest is Dr Hope Mitchell. She's an Ohio board certified medical and cosmetic dermatologist with over 25 years of experience in the medical field. She's also the Founder and CEO of Mitchell's Dermatology. Her sub-specialty interest is in hair loss, eczema, hyperpigmentation, skin cancer prevention, skin of color, and skincare consultations. Dr Hope is an advocate for mentorship, education, and diversity in both medicine and dermatology. I love this conversation because I got to ask Dr Hope some of the questions, I wish I would've known before I went to a dermatologist the first time last year. We talk about finding a dermatologist, skin care favorites that you can get from the drugstore, and so much more.
Taylor Elyse Morrison:
I am really excited for this conversation. But before we do anything else, I just wanna say thank you so much, Dr Hope for being willing to be on the show.
Dr. Hope Mitchell:
I'm really excited to be here. Thank you for inviting me today.
Taylor Elyse Morrison:
And this whole idea for this series is like talking to practitioners, talking to experts in their fields, especially people who can support us in our self-care. And I personally knew that I wanted to talk to a dermatologist because I had questions. So, I feel like this in a lot of episodes where I'm like, I kind of selfishly had some questions, but I know that people listening might have similar questions. I went to the dermatologist for the first time last year, and I was like, should I go? Should I not go? Is this the right question to be going to a dermatologist for? So, I'd love to just start with that. Like, I know technically a dermatologist is a skin doctor, but I'd love a little bit more insight. Like, what do dermatologists do?
Dr. Hope Mitchell:
Yeah. You know, the first thing that I want to clarify is the fact that a dermatologist is a medical doctor. So, what that means is that after receiving an undergraduate college degree, we go to medical school, and we receive a medical doctorate degree. After receiving our MD degree or our DO degree, our doctor of osteopathic medicine, then we go on to a Residency program where we have further training. So, we have a minimum of 12 years of training to become a dermatologist. And that means we have 4 years of college, 4 years of medical school, and then at least 4 years of residency, in which that first year of residency training is a 1 year training in internal medicine. Then we go on to have 3 years of training in dermatology. And throughout that training, we gain lots of knowledge about the skin, hair, and nails.
Dr. Hope Mitchell:
And so, we truly complete the program being the expert in skin, hair, and nail health. We are trained to understand, to diagnose, and to treat over 3,000 conditions. And so that's a lot of conditions. And at the completion of our training, we've had up to 16,000 hours treating patients. And so that's always the first place that we wanna to start and we want to understand. We are medical professionals. We're medical doctors. And like I said, we are the expert when it comes to understanding the skin, hair, and nails.
Taylor Elyse Morrison:
Thank you for shedding some light on that. That is so useful. And when I was saying at the beginning that I went to the dermatologist for the first time, and I wasn't even if that was the right doctor. It was because I had these spots where my hair wasn't growing as much. And in my mind, I was like, oh, yeah. Well, dermatologists, you, like, go to a dermatologist. My mom has gone to a dermatologist, for example. We have, like, moles that run-in our family, so you go to a dermatologist for that.
Taylor Elyse Morrison:
I didn't even realize that you could go to a dermatologist to look for things related to hair or to nails until last year. So, I really appreciate you enlightening us on that. And kind of to follow-up on that a little bit more, I feel like in this age where so many people are doing videos about skincare and talking about these things, you also run into aestheticians who are talking about taking care of our skin. So, beyond being a dermatologist, being a medical doctor, what are some other differences between a dermatologist and say an aesthetician?
Dr. Hope Mitchell:
Okay. So, they really are not comparable. Right? Because what we've already said is that we're the medical doctors who have the extensive training. We, however, love to partner with aestheticians who are certified in treating and caring for, basically, the surface of the skin. So, they are trained in skin care, and they are well respected in their roles. They have partnered in many cases with doctors such as dermatologists to provide the best care for patients. And so, they can often provide extra care that dermatologists cannot. And so, they specialize In facials, waxing, chemical peels, etcetera.
Dr. Hope Mitchell:
And so, we see them as being partners who are really needed in order to provide that extra special care that patients deserve. It's almost like thinking about hairstylists. Dermatologists partner with hairstylists very often as well, Because we know that our partnership can bring the best results for patients. And so, an example there could be that we specialize in conditions that cause the hair to fall out, for example. So, we specialize in scalp care, But stylists specialize in hair care. And so, for the overall health and wellness of the hair, we do best when we partner with stylists.
Taylor Elyse Morrison:
Thank you for breaking that down, and I love that example because that's actually how I ended up going to the dermatologist for the first time was I was getting my hair done, and I was talking to the stylist. And she was like, yeah. You've got this spot here that looks like it's thinning. It seems like it's probably a scalp issue. You know who you should talk to about that? A dermatologist. And she actually gave me a referral to a dermatologist and helps educate me on how a dermatologist could help me. And I love this idea of, like, partnership because so often at Inner Workout, we talk about having a self-care support system. And so, it's really helpful for us to know who in our support system is best positioned to help us in each way. For you, as someone who is gone, I mean, you went through the 12 years of schooling, and you've been doing this for so long, so you have this wealth of knowledge.
Taylor Elyse Morrison:
So, some of these questions to you are probably, like, so obvious. But for me, until a year ago, I didn't fully understand these differences, so I really appreciate you breaking it down. And I kinda wanna continue that. I like I said, I sought out a dermatologist because I was having stuff going on with my hair. What are some other instances where we should definitely seek out the support of a dermatologist.
Dr. Hope Mitchell:
Yeah. There are many warning signs that should prompt one to make an appointment with a dermatologist and can include the following. So, for example, if you notice a new spot on your skin that appears different from other spots or if you notice that the spot is changing in size, shape, or color, it's important to seek medical attention. Dermatologists, on a daily basis, we'll screen for skin cancer. We screen by looking at a specific spot that may be of concern to a patient or more excitedly, we love to do full body skin examinations. And so that would entail examining one's skin from head to toe. So, we're going to be looking in the scalp all the way down between the toes and soles of the feet, which is really, really important because a lot of people don't think to look in that area, and melanomas can occur in that area, especially in people of color, specifically black people.
Dr. Hope Mitchell:
Another example could be, as you indicated, losing hair. And I'm an advocate for when you notice that you're shedding more than average, that is the time to see a dermatologist. Don't be afraid. Don't say, well, I don't see a bald spot. I don't think this is important. As soon as you notice it. Because what we'll do is we will take a detailed history, and in that history, we may be able to screen for a condition that could be evolving. Right? And so, we may do medical testing, blood testing.
Dr. Hope Mitchell:
We may find that thyroid numbers are off. We may find that one is anemic. We may find that there are auto-immune markers that could be an indication of thyroid disease, Anemia, or auto-immune conditions. And so, I don't think it's ever, ever too early to see a board certified dermatologist to talk about hair loss. And then one other example could be a persistent rash or persistent itching. That could be an indication of an underlying medical problem. And so, coming in with a rash that doesn't seem to resolve would be definitely worth scheduling a dermatologist to take a look at.
Taylor Elyse Morrison:
Those are all, like, great examples, and I especially love that you called out the piece of especially with black people in melanoma. I don't remember. I was young. I was in high school when I first heard that more melanated people, particularly for me as a black woman. I think of it as black folks, but there are lots of other people. I think of people in India, etcetera, who also have a lot of melanin in their skin. And you, Dr Hope, correct me if I'm wrong on this, but what I remember learning is that We are less likely to get skin cancer, but we can be more likely to die from it just because it's not as noticeable for us to see it. Do you know if that's true?
Dr. Hope Mitchell:
Oh, absolutely. I think that the reason for that can be two or even three-fold. Right? So, I think one reason can be that we ourselves have not been taught that we can get skin cancer because we have, over many years, have even been told that the melanin in our skin protects us even from skin damage or sun damage, right. Which is not accurate. And so, I think that we just have been raised to think that that is not a condition that affects us. That conditions that affect us are hypertension and high cholesterol, etcetera, diabetes. Right? But we've not grown up to know that. And part of that could be there has been an evolution in understanding melanin and the sun And how much protection we actually get.
Dr. Hope Mitchell:
And so, we know today that the melanin in our skin probably provides an SPF of equivalent to 13, and the current recommendations is that we wear a minimum of SPF 30 to 50. So, there is evolution. There is a better understanding, but I think we just never thought we could get it. We don't believe. I still see patients who believe that skin cancer doesn't affect us. Then we have our primary care physicians where we may be visiting with them, and we may bring up the fact that we have a spot. And I think that their sensitivity is not as high even to the fact that it could be skin cancer as well. So, putting it into our mind that we should follow-up on that spot, They may be more likely to reassure us than not.
Dr. Hope Mitchell:
So, I also think of that being part of why we are where we are today. But we know that things are changing, and that's a good thing.
Taylor Elyse Morrison:
Yeah. Thank you for shedding some light on that. I remember as soon as I heard that, I went from thinking, oh, I don't need to be that worried about sunscreen to you from a relatively young age being like, nope, I'm gonna be on my game about putting sunscreen and also partly my mom too. My mom has amazing skin, but she told me she was like, I didn't really start taking care of my skin until I was 27 or 28. So if you start taking care of your skin at this age, imagine how you're gonna look. So, shout out to my mom. She shows me that, hopefully, I will age as gracefully as she does.
Dr. Hope Mitchell:
Yeah. Our moms are really smart. Right? And so, we get so much wisdom from them, so shout out to our moms.
Taylor Elyse Morrison:
Absolutely. And we've already started to pull in a little bit of this nuance. I can only speak from my own experience, and the experience that I have is an experience of being a black woman. And something that I've been mindful of is that even though dermatologists go through all of this training, these years, and years of medical training, some are more maybe equipped or more interested in being mindful of the differences that can exist in skin, especially skin that has more melanin. So, I'm wondering what tips you have for everyone in looking for a dermatologist, but especially people like me who have more melanin and are mindful of the fact that maybe people won't be able to handle my skin as well. And also feel free to tell me, like, actually, no, every dermatologist is perfectly equipped to handle my skin. I would be happy to hear that too.
Dr. Hope Mitchell:
Well, honestly, I believe every dermatologist should be equipped, right, to manage any skin type, any Fitzpatrick skin type, and any condition, right, that we should all be trained equally. Very similarly, one could make the argument that all hairstylists should be able to take care of all different hair textures, etcetera. I am of the belief that the training should be the same. I know that we have been talking about this for the last few years, right, how we're all being trained, how we should be trained, and there are changes being made. We have to understand that there are some programs where the training takes place where we don't see a lot of black people or people with darker skin types. Right? And so that training may not be the same as someone who trains in an area where there are more different skin types. And so, I think we're working on that. I think it's really important.
Dr. Hope Mitchell:
But what's important is that every patient, regardless of their skin type or skin tone, skin color, be comfortable with the doctor that they're seeing. And so, I think that it works on both sides. I think that doctors should be transparent about their experience. And I think that we, as the CEO of our own bodies, Should be comfortable asking questions about the experience of the doctor. I think that if we're entering into Any procedures or anything like that, we should vet the doctor. Right? And so, I think that the doctor should not be offended by questions, and I think we should be comfortable asking. Some of the questions could be, you know, how long have you been treating patients with this procedure, what are some of your outcomes? We can also take a look at photographs to see what those outcomes are like. I also think that, and I do this myself.
Dr. Hope Mitchell:
If there is a condition or a patient who presents with a concern that I'm not comfortable treating. I'm honest and I will say I think that it could be a better fit for you to see someone else. And I will help coordinate that care. And so, I think there's nothing wrong with wanting to connect with a dermatologist who you share a cultural background. Right? I think that's across the board. And I think that we need more dermatologists who are of different ethnicities so that we have the ability to gain access those doctors, and so we're working on that as well. Because you can only teach culture to a certain degree. Right? Like, you can train and train and train, but, you know, until you have hair like that, or you experience those hairstyles, you don't quite connect a 100%.
Dr. Hope Mitchell:
And I don't think there's anything wrong with wanting to work with a dermatologist where you feel a 100% connected with. It may not be feasible all the time, but I think there are a lot of factors that will help us to get to that point that we're working on in the field of dermatology.
Taylor Elyse Morrison:
I appreciated all of what you shared, but I especially appreciated some of those questions that you gave us, and that's already becoming a theme for me this season is we are allowed to ask questions. And I think a lot of times as a patient, I have been I either wasn't sure what questions to ask or I'm worried about seeming difficult. And so, I just really appreciate hearing from a doctor like you that, yeah, we can ask questions. We should be able to ask questions, and that's even something to monitor too. Like, if a doctor is uncomfortable with us asking questions, Maybe they're not the right fit for us for the long term.
Dr. Hope Mitchell:
Absolutely. Because what's most important is the patient. Right. So, our feelings, that feeling of offense, none of that should enter into the room. We should always want what's best for the patient.
Taylor Elyse Morrison:
Yeah. And it's like, that's so simple, but sometimes that is so hard to find in a doctor. But like you said, there's a lot of change that's happening, and we're really lucky to live in a time where the tides are turning. Absolutely. Absolutely. So, you just really broke things down. I'm like, yes. Okay.
Taylor Elyse Morrison:
I get what a dermatologist is, that it's not just the skin, it's also the hair and nails. So, I guess that's another question I have is now that we're like, I have a sense of what to ask when I'm in the dermatology room in the doctor's office, but I'd love to know a little bit more about where I can go to find a dermatologist. Like I said, I got lucky, and I got that referral from my hairstylist, but what if people don't have a referral?
Dr. Hope Mitchell:
Sure. If you are looking for a dermatologist who understands the specific needs of your skin tone or if you prefer a dermatologist of color, there is a great resource to be able to find one. The resource is blackdermdirectory.com. It's a wonderful resource because what you can do is you can put your ZIP code into the app, and dermatologists in your community, you will find them through that app. There are other wonderful resources for finding dermatologists in your community. Our academy, the American Academy of Dermatology, and the Skin of Color Society also are valuable resources for finding dermatologists in your community.
Taylor Elyse Morrison:
Lovely. Thank you for those. And for people We'll make sure that those are added in the show notes so you can find them super easily. So that kind of covers what we can do when we're working with a dermatologist. I am curious since we have you here to talk about some of the things that we can be doing at home. Because even if we are working with a dermatologist, the vast majority of the time that we're taking care of our skin, it's gonna be us washing our face, doing those types of things. So, what are some things that we can be doing to care for our skin?
Dr. Hope Mitchell:
There are so many things that we can do to take care of our skin, which is the largest organ, which protects us from the environment and infections, etcetera. We should be excited to take care of such a wonderful organ that takes care of us. First and foremost, it is advisable to refrain from smoking. Smoking accelerates the aging process of the skin, and it will lead to a more mature appearing skin with wrinkles and fine lines. A lot of people who live in urban areas are dealing with pollution. And so, it's extra important that you take care of the skin through proper cleansing. There are some sunscreens on the market which can protect the skin from pollution. And so, I know that's a whole different podcast, but you can look for that on the sunscreen labels.
Dr. Hope Mitchell:
Always handle your skin with care. I know a lot of us love to exfoliate, but believe it or not, you can over exfoliate. You can excessively exfoliate, and we don't want to remove the skin barrier that protects our skin. Right? And so, the more that we over exfoliate, we can make cracks in the skin, and that provides for leakage of moisture, And it provides for entryway of pollution, right, and irritants. And what will that do? That will cause the skin to become unbalanced and go on and on to really put us in a position where the skin is uncomfortable and itchy and red, etcetera. So don't over exfoliate. It's important to moisturize the skin. A lot of people who have oily skin believe they shouldn't moisturize.
Dr. Hope Mitchell:
But long story short, if you don't moisturize consistently, it makes the skin even oilier. I've already alluded to this in no particular order of importance. In my response, it's important to wear sunscreen on a daily basis, a minimum of SPF 30. We usually recommend this dermatologist between 30 and 50, And it's important to reapply it, especially when you're out with recreational activities. And increase your water intake. Moisturize on the outside as well as on the inside. And one more thing, maintain a healthy diet. It does make a difference.
Taylor Elyse Morrison:
All of those are such good reminders. I will say I am definitely SPF wise. An SPF 50 girly, I don't mess around even when it's cloudy, even in the winter. I love making sure my skin is protected in that way, and that was an interesting insight for me too. I'm like, Oh, when we get off this call, I need to go look at my SPF and see if it's also protecting from pollutants. Because I do live in the city, and there is all of this stuff that's coming into my skin. And I don't honestly know how well protected I am from it.
Dr. Hope Mitchell:
We're talking about it more and more because we are finding that the damage that pollution can do can be pretty significant.
Taylor Elyse Morrison:
Yeah. That's a really important reminder. Okay. I've got a couple more questions for you. So, I was thinking when we were talking about these questions, I was like, I could ask you about, like, the most luxurious product that you recommend for people if they wanna splurge, but I actually decided to go in the opposite direction. And I'm wondering, like, what's a product that you can get from the drugstore that actually works really well for your skin?
Dr. Hope Mitchell:
So, some of my favorite products are in the CeraVe brand. I love the hydrating facial cleanser formulations. I think that a lot of people think that they need to use an exfoliating cleanser or cleansers that are marketed for oily or for oily skin. But what we find is that we want to do so much to our skin that if we use a cleanser that strips the oil, it's really hard for the skin to tolerate or to handle those products. So, 9 times out of 10, I usually recommend to my patients, just go for the hydrating cleanser because I know that they want to apply their retinol, their vitamin c. They want to exfoliate. In this way, we keep a pretty basic foundation to the skin, so that the skin is comfortable in the application of the other products. So, love that.
Dr. Hope Mitchell:
I love No 7, Advanced Retinol. I think that it's a great drugstore product. I think that it's well tolerated. So, I love that product. You can also look for retinols that contain ceramides. And CeraVe has a product that also has ceramides in it, and that's gonna be really good for people who have extra sensitive skin. So maybe people who have Rosacea. Ceramides help to protect the skin barrier.
Dr. Hope Mitchell:
And so, by adding that into the retinol, you're less likely to get erythema, redness, irritation, etcetera. I love, love, love La Roche-Posay's SPF 60 and SPF 100 melt-in milk. I love that product because it goes in well to all skin tones, including people with darker skin tones, including black people, without leaving that cast or that white looking appearance or on the skin. So that's probably one of my top recommendations for an over-the-counter sunscreen. And then Ambi, who has been out for a long time, I grew up using Ambi soap. They have a wonderful formulation. It's their fade serum retinol, and it's one that helps to do all the things that retinol does, including help to even the skin tone. And a lot of times, people with darker skin tones, we have hyperpigmentation after trauma to the skin, trauma like an insect bite or trauma like acne, and so that product works really well for that.
Dr. Hope Mitchell:
So those are just a few of my favorites.
Taylor Elyse Morrison:
Oh my gosh. I feel like I'm like writing this down mentally, even though I know this is being recorded so I can go back listen to this, but that was so helpful. And the hyperpigmentation, that is something that I struggle with, that my husband struggles with. And so, It's nice to hear some recommendations. And this is a whole other conversation, but even when you were talking about La Roche-Posay, when I was in Europe and getting to go to the drugstores there or the pharmacies as they call them and seeing, like, all of the different things that they had available. Man, they've got some good drugstore products, but we're keeping it to the American ones since most people who are listening live in America.
Dr. Hope Mitchell:
Yes. I agree with you. I've had a chance to go to Europe as well, to France, and the drugstores are amazing there.
Taylor Elyse Morrison:
Yeah. I was like, I don't need a bag that says Paris on it or, like, the typical touristy Souvenirs. I came home with, like, skincare and soaps and those different things. Okay. So, I've got one more question left for you, and you've already kind of been myth-busting throughout this conversation. But I wanted to give you a chance. What's a skincare myth that you would love to correct for people?
Dr. Hope Mitchell:
I think if I have to pick one, I'm just going to beat down sunscreen, that sunscreen myth that people with darker skin tones don't need to wear sunscreen. Believe it or not, I still get that statement from patients in my office. Over the years, I've been practicing for over 25 years. I hear it less and less, and I know that is because social media has done such a good job educating, but I still hear it. So, everyone, regardless of skin tone, regardless of how darkly melanated the skin is, everyone needs to wear sunscreen because all skin tones can be subject to skin damage from ultra-violet light. And so, what that means is that that ultra-violet light can cause enough damage to maybe put us at risk for skin cancers to put us at risk for pre-mature aging. And I always tell my patients, I'm like, you know, I am vain. I'm a dermatologist.
Dr. Hope Mitchell:
But just to hear that I could pre-maturely age, that to me is, like, right there with skin cancer. Like, it's just as urgent. I don't want to ever look older than what my numeric age is. And so, I think understanding in black people, our biggest concern that is an indicator of aging is uneven skin tone. That is the biggest reason why black people see me that are aging, it's not because of fine lines and wrinkles and uneven skin tone, hyperpigmentation, dark spots. That is directly related to sun damage. That is because the skin has been damaged by the sun.
Dr. Hope Mitchell:
There was not adequate protection against the sun. So, if we start to wear sunscreen, we could decrease that risk of hyperpigmentation or even melasma as we age. So that's my myth. I only got one. It should be worn by everyone all year round, regardless if it's sunny or if it's cloudy, because sun damage can occur on cloudy days as well.
Taylor Elyse Morrison:
Thank you for reminding us of that and the other piece that you mentioned earlier too is, like, reapply. I think sometimes I'm good at putting it on in the morning, and then I'm out all day and don't think to reapply it even if I'm out in the sun. So, like, that's my challenge to myself It is okay, you've got it down putting it on in the morning, but make sure that you're reapplying. So, anyone else, feel free to take that as a challenge for yourself too. I just wanna say thank you so much. I learned a lot.
Taylor Elyse Morrison:
I feel like this clarified a lot for me. I haven't been to the dermatologist in a while, so, this is also helping me think about, do I wanna get like a full skin? This is I just turned 30 this year, and I've noticed that I have more little - my mom has these too, like but these little, tiny moles that come up. And I'm like, oh, maybe I do need to get like a head to toe thing with a dermatologist. So, I learned a lot. Thank you for being so, so generous with all of your wisdom. Where can people go to stay connected with you and to keep learning from you?
Dr. Hope Mitchell:
Well, I would love that. You know? I'm actually excited to hear that you will consider a full body skin check because even in that check and we don't find concerns, it's a win. Right. We love giving good news. As I tell my patients, I think what you come out of that appointment with is understanding what you have and having a better understanding of what to look for. So, kudos to you for wanting to do that. I love to educate, and I would love to stay connected through my Instagram. My handle is drhopemitchell, and so I find time to educate there.
Dr. Hope Mitchell:
I am the founder and owner of my own private practice In Ohio, Mitchell Dermatology. And I definitely see patients there. I am in a town called Perrysburg, but what's interesting about where I'm at is it's very close to Detroit and Ann Arbor, about 45 minutes away, Cleveland, Columbus, Cincinnati, Dayton. So, I have lots of people who can come in very easily. I just saw a follow-up patient. I've seen her for years out of Cleveland, and so it's not a bad drive. You can find me by phone, 419-872-hope is the phone number in case you want to schedule an appointment.
Taylor Elyse Morrison:
Awesome. And all of that will be in the show notes too. Thank you again for being on the show and thank you to everyone for listening.
Dr. Hope Mitchell:
Thanks for having me.
Taylor Elyse Morrison:
Inner Warmup is a collaborative effort. It's hosted by me, Taylor Elyse Morrison. Danielle Spaulding provides production support, and it's edited by Carolina Duque. If you enjoyed this episode, share it with a friend. And if you're looking to continue your inner work, our free Take Care Assessment is a great place to start. On that note, take care.