The Intersection of Beauty, Biology & Business with Dr. Zain Husain

In this episode of the Healthcare Nation Podcast, host Rick welcomes Dr. Zain Husain, a board-certified dermatologist and founder of Noor Dermatology. They delve deeply into the multifaceted world of skin health, exploring the psychological and social impacts of appearance, the latest advancements in dermatology, and the intersection of beauty, biology, and business. From personal patient stories to the role of AI in dermatology and the rise of med spas, Dr. Zain Husain provides an insightful look into the industry's future and its current challenges. Whether you're a provider, a patient, or an investor, this episode provides valuable insights into the critical importance of skin health.

00:00 Introduction to the Healthcare Nation Podcast
00:31 Exploring the Intersection of Beauty, Biology, and Business
02:01 Welcome, Dr. Zain Husain
02:34 A Powerful Patient Story
06:27 Common Skin Conditions and Their Risks
08:13 Skin as a Barometer of Overall Health
10:09 Misunderstood Skin Conditions
11:58 Preventative Dermatology and Mental Health
14:34 Beauty, Bias, and Belonging
21:17 Systemic Blind Spots in Dermatology
24:48 Switching Gears: Inside Out Health and Longevity
25:07 Integrating Dermatology with Metabolic Health
27:33 Evidence-Based Approach to Longevity Products
29:44 Addressing the Ozempic Face Phenomenon
32:49 The Rise of Subscription-Based Skincare
37:05 The Med Spa Boom and Its Risks
39:57 AI and Technology in Dermatology
43:56 Redesigning Dermatology and Aesthetic Healthcare
45:40 Final Thoughts and Skincare Advice

Creators and Guests

Host

Rick Gannotta

Health sector executive clinician educator & researcher, RTs/links 🚫 not endorsements, TEDX; https://t.co/51mnBxpPqv @NYUWagner

Producer

Joe Woolworth

Owner of Podcast Cary, the Studio Cary, and Relevant Media Solutions in Cary, NC Your friendly neighborhood creative.

What is Healthcare Nation?

Welcome to Healthcare Nation, the podcast for enthusiasts passionate about the healthcare sector and eager to explore its current state and future trajectory. Join us as we delve into the heart of the healthcare, biotech, and MedTech industries with the help of top thought leaders.

I'm your host, Rick Gannotta, with over four decades of experience in healthcare, spanning from the hospital bedside to the boardroom, C-Suite roles in renowned health systems, advising game-changing startups and established companies, and educating the next generation of healthcare leaders.

In each episode, we'll bring you conversations with distinguished guests, including innovators, scholars, practitioners, and influencers shaping the healthcare landscape. Gain valuable insights from their perspectives and stay updated on the latest developments, trends, and noteworthy news.

Join us on this exciting journey and become a part of the Healthcare Nation community. Subscribe now on Apple Podcasts, Spotify, or your favorite podcast platform to stay in the loop.

49 HCN - Dr. Zain Husain
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Rick Gannotta: [00:00:00] Hey Rick, ADA here today on the Healthcare Nation Podcast. We go skin deep as we tackle the intersection of beauty, biology and business. Let me start with a question.

Have you ever looked in the mirror and felt your confidence shift up or down? Well, you're not alone. Skin is more than what shows. It's how we engage with the world. It's many times the first thing people see, and often the first thing we judge about ourselves. Our culture of selfies, screens, and high definition, everything skin has become both a canvas and a currency.

But let's go deeper beneath the creams, injectables, and algorithms, because today on the Healthcare Nation Podcast, we're peeling back the layers of skin health to ask some hard questions. Why are dermatologic services still treated as elective luxuries by many insurers? What's driving the explosion of med spas direct to consumer skincare brands and aesthetic clinics backed by private equity?

And why are new weight loss drugs like GLP ones raising both hope and concern for how we treat [00:01:00] metabolic and visible conditions alike? We'll explore the intersection of beauty, biology, and business in a conversation with one of the leading experts in the field. Dr. Zane Hussein, board certified dermatologist, longevity and aesthetics expert and founder of Neuro Dermatology.

We'll dig into the science behind skin health, the psychological and social impact of appearance, and how supplements longevity tech and ar ai are reshaping not just our faces but our future. This isn't just about dermatology, it's about what is included in our definition of healthcare. It's about identity, how it's formed, challenged and reshaped by the mirror, the media, and the medical system alike.

Whether you're a provider, a patient, or an investor, this conversation has something for you. Welcome to the Healthcare Nation Podcast.

[00:02:00]

Rick Gannotta: Okay, Dr. Zane Hussein, welcome to the Healthcare Nation Podcast. I'm so glad to have you on here for so many different reasons. Thank you for having me. I got a lot to cover today, but I thought let's start with something, if I could characterize it like this human. What's one patient story or moment in your journey that reminded you how much skin affects, how people see themselves, how they feel about their own self-worth, how they're seen by others?

It could be a health condition, et cetera. For myself, I could think of some things, but tell me about that.

Dr. Zain Husain: Yeah, so one patient that comes to mind was this teenage patient, um, had a long history of really severe cystic acne. She was bullied. She was constantly ridiculed for the way that she looked. She was depressed.

She made several suicide attempts, and it was really heartbreaking hearing [00:03:00] her history, and it all stemmed from the way that she looked, how she felt about herself, how others perceived her, and actually actively bullied her. And. It was after a lot of therapy, uh, getting help and support from her parents that she finally went to see a dermatologist myself, um, to really tackle this issue because it was really having severe, if severe impact on her life.

And. I really, you know, I went through all the various, um, you know, treatment modalities not only just to control the acne, but the significant scarring and pigmentary changes that have happened. And you know, we eventually decided on doing Accutane and we had her psychiatrist involved, um, therapists involved because, you know, there are side effects, potential risk effects.

Exactly. Effects. Yeah. So it was not a straightforward case, [00:04:00] but she did beautifully and I just saw her confidence just skyrocket as we saw her skin clear. And by the end of her treatment. I couldn't even recognize her. She carried herself in a different way. She was just so much more confident. Um, she was actually smiling.

I didn't see her smile at all. She was like crying that first initial consult and just to see this evolution and a six month span was absolutely incredible. And she finally felt empowered to really. Deal with some of these bullies that she had been tormented by. And you know, she was thinking about dropping outta high school.

Joe: Mm.

Dr. Zain Husain: And you know, things turned around. Her grades started improving. She started becoming more social. She got a boyfriend, her first boyfriend, and I just saw the impact that [00:05:00] this had on her life. And I could just tell in her eyes she was so grateful. And that meant. Everything to me as a dermatologist, as a physician, and being able to restore that confidence from someone who wanted to take their own life.

She had those, you know, slit wrists and everything, those scars all over. Um, and now, you know, she was this confident, beautiful young woman. Who has such a bright future, and it's been probably seven or eight years since, you know, we did her treatment, we did laser therapy and, you know, treated her acne scars and pigmentation and it was night and day.

So that was probably one of the most significant patient stories I have as a dermatologist, and it's so fulfilling.

Rick Gannotta: Wow. That is a powerful story. You know, it's, it's interesting 'cause I, and I said this in the, in the intro, it really is. How the mirror speaks to you when you see it and for the young person, how much skin affects not only how you're seen by others, but how you feel [00:06:00] yourself and it's so important.

And let's, let's go back and stay on the skin Health of Dermato, really the dermatology side. I wanted to. Start with something you probably see every day in your practice. Perhaps not as dramatic as as what you just said, but something that I think is important. What are the silent skin conditions that people wait way too long to, to see you for, to get treated, and what are the potential risks with that?

Dr. Zain Husain: Yeah, I mean, one of the most common ones that I see that people really don't address is just. Sun damage. Hmm. And the sun. As we know, the UV light is a carcinogen. It leads to changes on the DNA level. There are mutations that are occurring and as. Time goes on and more exposure. Um, we see that these cells start transforming and as dermatologists we can detect these, these are [00:07:00] called actinic keratosis or precancerous.

However, there are a lot, um, of cells that we have not been able to pick up on. They don't have texture changes. They don't have any symptoms yet, but. If they had addressed this earlier on, we can prevent those from even forming, taking preventative measures. We can treat them earlier before they progress into skin cancer, such as squamous cell carcinoma.

So there's a huge population who's had a lot of sun damage, either from they go to the beach, um, without protection or going to the tanning beds and. You can see evidence of sun damage, but they don't know how dire it can be. And many of them don't seek the care of a dermatologist and they wait until a tumor pops up.

Yeah, and then I think it's too late. And then we're kind of working, you know, from the other reverse direction, trying to solve the issues that have already solved rather than preventing.

Rick Gannotta: That's a, that's a tough one. And, and as speaking for myself as someone who's had that in with a family member, it really [00:08:00] could be quite devastating as well.

Absolutely. So that, that is, talk about the basic elementary places to start. I also think it's important to think about how we should help, and this going to my clinical background, help patients understand. Skin as if I can call it a barometer really, of your overall health. Mm-hmm. So, and I, I know you have your own podcast skin side out.

Yeah. Yeah. Thinking about the skin side out, tell us about how it can also be a barometer of other health conditions that might be underlined.

Dr. Zain Husain: Yeah. I mean, the skin. Is an external manifestation of what's going on internally and various organ systems when and dysfunction can lead to cutaneous signs.

So, for instance, um, one of my favorite systems to look at is the endocrine system. So when hormones are out of whack, um, there are imbalances. We see manifestations. So for instance, like a female patient, um, with polycystic ovarian [00:09:00] syndrome, um, has tism, she has hair and growing in other places that shouldn't be.

Um, she's starting to lose hair, um, in the scalp. Um, they are getting hormonal acne on the face, insulin resistance or pre-diabetes. Uh, we see something called aca, those nira cans where there's hyperpigmentation of certain body areas. These are all signs that there is something going on internally and that can be sometimes our only sign, um, before things get.

Further, um, more advanced. So I really do see that the skin has a lot of manifestations of internal health. Same thing with the gut. Um, we see certain rashes with inflammatory bowel disease or celiac disease, if caught early, we can get the patient the proper treatment, um, and reduce inflammation, reduce potential consequences such as colon cancer down the road.

So, yeah.

Rick Gannotta: Such a marker for so many [00:10:00] things when you think the, the largest organ in the body, right? Yeah. Yeah. It's, I mean, so I mean, it, it's just, it's really very, very powerful. I want you to go into your kind of memory bank. What's the most misunderstood skin condition when you think about it, and, and how do patients' lives change once it's properly addressed?

Is it psoriasis? Is it, is it, as you mentioned, cystic acne? What, what, what kind of conditions are out there?

Dr. Zain Husain: Yeah. I find that acne is often misunderstood. Um, a lot of people think it's a consequence of not being clean enough.

Their skin being dirty for some reason, them just being oily. But it is a very complex disease and people don't realize that there are multiple facets to it. There is a hormonal component, there is a poor clogging component. There is an overactive sebaceous gland component. Um, and. Many times, many of my diligent acne patients are using the right cleansers and they're keeping their [00:11:00] skin properly, um, you know, maintained, but they still have acne and it's partly genetic and hormonal and, you know, they're often, you know, thinking that I'm doing something wrong.

And they're not doing anything wrong. It's just that, you know, the unfortunate combination of hormones and genetics is usually the large driver for acne. And a lot of people don't understand that. Um, you know, some parents bring up, bring their kids to me and they're saying, oh, my kid just doesn't wash their face, or They're using the wrong stuff.

I'm like, that's not it. And then I kind of double a little deeper. I mean, like, did you have a history of acne? Mm-hmm. Husband, um. Yeah. And oftentimes there is a positive, um, you know, family history and people don't understand that there is a genetic component to it, and it's not something that they're doing wrong.

Eating too much chocolate caused that or eating greasy foods, that's not the case.

Rick Gannotta: Yeah. And these, these notions still persist. Yeah. A lot of myths to say, right. The myths are out there mm-hmm. And folks are going down a, a different path.

Yeah. You know, you touched upon this earlier, and I, I wanna revisit it. When you think about. [00:12:00] Certainly the preventative side of dermatology and the intersection with mental health, especially in teens, like the mm-hmm. Incredibly powerful story that, that you told about your patient. What are you seeing with that?

How do you, how do you see preventative dermatology really intersecting with that?

Dr. Zain Husain: It really depends on the dermatologist and whether they make it a priority. Mm-hmm. So for me, I do think about the preventative aspects, um, and how it affects mental health and how it affects overall health.

And especially with my younger patients, they're very impressionable. It's not easy growing up these days, um, just being bombarded with social media messages. Of how they should look, and I find that if I am able to gain their trust and instill knowledge in them that, you know, this is how you should take care of your skin.

It's not only gonna help you now, but in the long run. So this is where I really talk to him about the importance of sunscreen. And sometimes I have to kind of. Turn the message [00:13:00] so it's more relevant to them. Like, Hey, you wanna look good, right? Like, 'cause that's a really important part of being a teenager, like social acceptance.

So, you know, wearing sunscreen is going to help your skin look better, right? Um, you're gonna look more attracted. Um, and they kind of resonate with that rather than me telling, oh, like 30, 40 years down the line, you might get skin cancer. If I can kind of get them to understand how to take care of their skin, knowing what signs.

Are healthy. You know, I love it when parents bring in their kids for full body skin exams, getting them used to that. Mm-hmm. Concept of prevention and surveillance, knowing what to look out for. I can educate them of what to look out for, for melanoma, for instance. Right. How to do a self skin check in the shower so you can catch things earlier and when to seek help.

So I think that's part of the education I provide to my younger patients, and I feel like then I can be an advocate, kind of like a friend on their journey and they really do trust me more when I kind of, you know, take that [00:14:00] approach as opposed to being very pedantic, telling them what they should do and being just very not engaging to what their concerns are.

Rick Gannotta: I think the whole notion of having agency over your own healthcare huge, if you could start. The younger, the better. Mm-hmm. Particularly since they're going to be looking for sources of truth online, et cetera, which is probably not always a wise you know, direction to go if you're looking for treating, you know, a, a particular condition with something that's, that's.

Contemporary cutting edge and what you need to mitigate the issue. Let me switch gears and really think a little bit now about the topic of beauty and bias and even how that impacts, I'd call belonging, whether it's societal, community, et cetera. When you think about, um, how, and you just touched upon this, how body image, how self-perception is really.

Influenced by filters, Photoshops, what we're seeing, especially [00:15:00] as you just mentioned, younger patients. Yeah. But we're bombarded with this, whether it's Instagram, TikTok, look, I'm, I'm an older guy. I, I have a notion of, of how I was gonna look. What I'm older. I'm kind of hitting that mark. Mm-hmm. You're helping me, by the way.

Stay and, and look as young Good as I possibly can. Thank you. Mm-hmm. Uh, but what happens with this generation, and by the way, I don't think it's. Just limited to younger people No. Who are getting bombarded with this and the pressures

Dr. Zain Husain: this has been going on for decades.

Um. With the advent of Barbie and all these socialized ideals of what beauty looks like, and I think it definitely hits women more than men, but it's there for both sexes. But how women should look to be considered beautiful, um, has been amplified with social media. Like you see all of these images constantly bombarding what's attractive, um, how I should look, and a lot of it's not reality.

Many of these [00:16:00] images are retouched filters. It's incredible what you can do, um, with computers these days. Those deep fakes are it just,

Rick Gannotta: they are. It is. They look

Dr. Zain Husain: so real and I feel so. Awful for these young girls.

I'm a father of three young girls and I constantly thinking about this, and my wife is a pediatrician too, so we're constantly kind of really building up their self-esteem and kinda letting them know that these idealized. You know, visions of beauty are not necessarily real. Some of them are not even attainable.

Mm-hmm. Um, you know, I know like in the past few years, this poreless skin trend among Korean skincare, everyone wanted that. Like completely glass skin, no pores, looks flawless. Porcelain, porcelain, not one, you know, defect. And that's not possible. It's not an ideal you should try to strive for. And there are these little.

Children, adolescents who were trying to. [00:17:00] Emulate that by getting skincare that's not appropriate for their skin type, um, for their age and sometimes doing more damage to their skin. And they're coming to us after they're having reactions to some of these products. These. Beauty stores such as Sephora, I mean, they make it very enticing, like the colors, the strategy, like how they kind of portray their models and photos. Um, I mean, if I were a little kid in that age, that's what I wanna look like. Mm-hmm. And you know, I feel like a lot of people are getting their information, um, and their knowledge about skin health from TikTok and from social media, and a lot of it is not being produced by healthcare professionals, not.

Being produced by dermatologists. Yeah, these are these skin influencers who have no qualifications. Anybody these days can just get behind a camera and say whatever they want. And if you have a good following or some traction, you know, people are gonna listen to you whether it's right or wrong. And there's a lot [00:18:00] of misinformation as we see, um, in society.

So I think. Our role as healthcare providers is to provide the truth, um, and try to let our patients know, you know, what is truly a medical issue and what is truly a cosmetic issue. And there's nothing wrong with having a cosmetic issue, but it has to be within the scope of reality.

Rick Gannotta: Right. Yeah. That brings me to my next question.

Mm-hmm. How do you counsel, how do you guide patients who come to you with. Whether it's body image, stress or some. Level of, of perhaps a distorted perception of themselves that's shaped by these social media filters, if I can call it. Mm-hmm. That and, and even celebrity aesthetics, they're coming to you and saying, I wanna look like X or Can you do this?

Or, I want this almost as a demand. Are you seeing that a lot? And how do you navigate that?

Dr. Zain Husain: Yeah, I mean, we are seeing a lot of this and I think there is a [00:19:00] surge of body dysmorphia. And I think it is being fueled by these images, these messages that people are seeing, um, the obsession with celebrities and how they look.

And I do get requests from patients, Hey, I wanna look like X. They actually show me a picture of what they wanna look like. Can you do this? And you know, when I kind of see these demands and if they're totally outta whack from reality, um, that's a red flag for me. Um, I. Can sense that they have body dysmorphia and no matter what I do, they will never be happy.

And I just kind of say that I am not the right doctor for you. I don't think I can achieve what you are looking for. And I think I save myself a lot of heartache and headaches by avoiding treating these patients. And I think that's the ethical thing to do. Um, as a physician, we take an oath, do no harm, and I feel like there are other.

[00:20:00] Injectors or cosmetic, um, professionals who will treat anyone. I mean, there is a financial incentive. Yeah. Um, but that can nip you in the butt. I mean, I feel like they can be your worst nightmares. Yeah. Um, they need help. They sometimes need the help of a therapist, a psychiatrist, because the body dysmorphia can be.

All encompassing for these patients. They obsess over it. And that pursuit, that pursuit of some, a perfection, perfection. There is no, there is no perfection. No end game. There is no end game. And I feel like if you are treating that type of patient, you're doing them a disservice. Yeah. And it can feed this, you know, constant need to do more procedures.

You've seen those like, you know, the, the male. Kendall and the, the female Barbie doll, they've done so many plastic surgeries and they're still not happy. Right. With the way that they look.

Rick Gannotta: Yeah. It's. Tragic when it's, when you think about the end point to it, because it can't, that, that, that pursuit of [00:21:00] something that's not attainable Yeah.

At the cost of, of your, your physical appearance. Yeah. And in many cases, even the structures, it could be destructive surgery and many

Dr. Zain Husain: times these people are attracted to begin with. Right. They didn't need anything to begin with. So it's, it's, it is something that is a psychiatric illness.

Rick Gannotta: Yeah. Let me, kind of on the same subject, but, but in, in the realm of, of bias in this mm-hmm. Are there still systemic blind spots in dermatology that, that are out there when you think about whether it's our, our usual notion of of of, you know, ethics and, you know, equity and. Being able to have access for different, everything from skin tone, gender, what are you seeing out there with that?

Dr. Zain Husain: Yeah, there are definitely disparities, there is a huge disparity between access to care, as we all know. Um, you know, I think that, you know, minorities and other, um, skin of color [00:22:00] populations have less access. To dermatologists or other specialists, and they're also less likely to seek care from them because they're actually not comfortable seeing, um, most dermatologists because they don't look like them.

Mm-hmm. The vast majority of dermatologists are Caucasian. That's just a matter of fact. It is changing, um, as we are kind of progressing through time. But Caucasian male patient, a male, um, providers were initially what we saw, and now it's moving along more to female. Mm-hmm. But, uh, yeah, a lot of, um, you know, skin of color patients do not have access.

And when they do seek care from a dermatologist, many of those dermatologists were not. Trained to see patients with skin of color. There are nuances, there are differences like, um, you know, how a rash presents in an African American patient mm-hmm. Can be very different than how it presents in a Caucasian patient or a Hispanic patient.

So many times there are [00:23:00] misdiagnoses or they are undertreated. So we do see a lot of disparities and I was fortunate to be trained in really diverse, um, multicultural, um, cities. So I trained at Georgetown in DC so I saw a lot of international patients. I saw a lot of skin of color, um, all types of patients.

Mm-hmm. And different socioeconomic groups too, like very wealthy, affluent, um, patients. And then also the indigent patients, um, who had no access to healthcare. So. I was fortunate to be able to see a whole wide spectrum, um, of skin disease and being taught by some of my professors who specialize in skin of color.

And then I also trained in Manhattan and uh, in New York City, and we treated a lot of diverse patients. So I think that helped me on my journey as a dermatologist. And me being skin of color myself has played such a big role. Many of my patients have sought my care because they feel more. Comfortable seeing me.

Comfortable. Yeah. They [00:24:00] relate to me. Even though we may not be of the same background, African American patients, Hispanic patients, middle Eastern patients, um, I see a lot of these people traveling from miles away from um, you know, like Western and Eastern North Carolina, um, to other states that are looking for someone who can help them.

Rick Gannotta: It's interesting because I, I, I really think look, the access piece, we've talked about it even on the podcast so many times before in previous episodes. But the other side, the medical training piece, particularly now when you're saying the specialty of dermatology and beyond that, yeah.

Really there are gaps that we still need to close. I mean, you mentioned you're fortunate enough to have been trained in Yeah. Urban areas where you had, uh mm-hmm. A level of exposure, different populations, different communities. Not everyone gets that. Mm-hmm. And it, it is so important. Yeah. Let, let me, uh, I wanna switch gears now thinking more inside out health.

Mm-hmm. Another area of specialty for you. Longevity. Mm-hmm. Metabolic, I'll call it metabolic makeover if [00:25:00] I could Yeah. If I could call it that way. And just along those lines of thematically of, of integrating that all together. Your practice, as I said, is more than just dermatology. It's aesthetics, metabolic health, longevity.

What connected those dots for you? What brought that together?

Dr. Zain Husain: They're all related. You know, as we're aging, we're living longer. Um, patients want to maximize the quality of their lives and that intersects with how they look, how they feel, and what they can do to maintain that for as long as possible. So it was a natural.

You know, marriage of these elements to provide them with the best possible care. And you know, as a cosmetic dermatologist, I'm always counseling on how patients can. Slow down the aging process, enhance it, and really maximize and reap the benefits for years to come. And I realized that you can't just do it in a vacuum.

I [00:26:00] can't just be doing injectables like Botox and fillers and lasers. You need to be doing. Other things to help maximize your body and your skin to be at its prime. So that's why, you know, I, you know, talk about longevity and I talk about, you know, what you put in your body, antioxidants, what we can do to help our metabolic processes, and it's all interrelated.

I don't look as the skin as a single organ. It is connected to every other organ and it. Has a very visual effect. So if you can enhance what you can do on the inside with maximizing and you know, really honing in and enhancing what you have for your internal health, it will manifest as healthy.

Rick Gannotta: Really useful saying earlier.

It's almost a barometer with that. Exactly. With, with the, yeah. I see how it fits together. Particularly when you, when you even think about GLP ones mm-hmm. And sticking on longevity. [00:27:00] There's been so many. Yeah. I, I see it whenever I'm online or, or looking at some social feeds. If you think about longevity products, NID, collagen peptides.

Mm-hmm. How do you help patients sort what I would call science from hype, and I think. I, I, it's not a stretch to say marketing from medicine.

Dr. Zain Husain: Yep.

Rick Gannotta: Because it's out there. So when someone comes to you and says, look, I wanna optimize and I've done this myself, I wanna not only look good mm-hmm. But I wanna feel good inside.

Yeah.

Dr. Zain Husain: I go based on the evidence, evidence-based medicine. So if it's something that is backed by science, there have been studies that have shown, um, some type of benefit, then I think that patients should go for it.

However, if it's just hype, someone just making a statement, um, and there's really no evidence to back it up. I don't see any need to kind of go with that intervention. So it always comes back to evidence [00:28:00] and you know, for instance, um, we're looking at the many benefits of GLP ones. We know that it works for, you know, metabolic syndrome.

Obesity helps with diabetes and it helps with a lot of other cellular proses, cardiovascular health. So we know that it has a lot of benefits and there are studies to back it up. Even addiction now we're saying it is incredible seizure disorders. It is incredible what it does, and I have a feeling that we just only scratch the surface and there is more evidence to come for the benefits.

Same thing with Metformin, that is also a. A very old drug, but we are seeing so many benefits from it. Um, and I treat some of my, um, my patients with metformin who have inflammatory diseases, um, such as acne, hydradenitis, um, and it also has a lot of metabolic, um, you know, benefits and we're seeing longevity from the studies.

So, you know, we do see benefits even from drugs that have been [00:29:00] around for a long time. It's just. Now we have the evidence to back it up so that I can recommend it to my patients. You

Rick Gannotta: know, it's really interesting that, that the common denominator seems, seems to be these metabolic conditions, right? Think about metformin or even GLP ones.

They're for diabetic patients. Exactly. And you know that there's a tell in that, right? A hundred percent.

Dr. Zain Husain: Um, I mean, we know that. Metabolic syndrome. I mean, it stems from, you know, being sedentary, being obese, and that leads to hormone disruptions. And those hormones are chemicals that are going through your whole body and have effects.

Right. And. If we don't control them, that's what leads to these imbalances and can lead to a lot of health problems.

Rick Gannotta: Yeah.

Dr. Zain Husain: Let me

Rick Gannotta: on, on the GLP one side. I, I think this comes up so often and we see this, again, I hate to keep bringing up social media, but with respect to what's happening to the skin clinically and aesthetically.

Yeah. When people rapidly lose weight with GLP ones, what do you do both clinically [00:30:00] and empathetically to treat things like I, I would. Assume we call it ozempic face,

Dr. Zain Husain: this was such an unintended consequence that we saw from the GLP ones. People were losing weight rapidly, they were feeling better, you know, the diabetes was clearing up, but they noticed that.

They were looking older, they were looking hollow, and we found that not only because they're losing weight rapidly, um, their fat pads in their face were atrophying or getting smaller, but the actual GLP ones actually have an effect on the skin that's preferentially targets like facial fat and its elasticity and collagen, and that accelerates that.

Aged appearance, and that is what we call Ozempic face. When we saw this phenomenon happening, we actually got bombarded with many patients who were coming in with the same issue, hollow face. They were looking older and [00:31:00] they didn't wanna go off their GLP ones because of all those benefits that we just talked about.

They were feeling great. They were off their medications. You know, they're not taking blood pressure medicines or diabetes medication. They were feeling great, but they weren't. Feeling great about how they looked. Yeah. And their faces, especially because, you know, they almost looked sick. Some of them looked so gaunt.

And what we found as a community of cosmetic dermatologists is that we can use the science to help these patients look better without sacrificing the benefits of being on a GLP one. So we were looking at, um, variety of ways. To replenish volume. So one of the key, um, treatments that we did were bi was bio stimulation using, um, biostimulatory fillers such as Sculptra or Radis, to really help build up that reservoir of lost fat and really help to make patients look more healthy [00:32:00] and restore those fat pads.

And, you know, we were combining with hyaluronic acid based fillers. Mm-hmm. Um. Light and energy based devices to stimulate collagen using growth factors, PRP. So a variety of different modalities to help enhance volume, help with skin integrity, help with skin tightening so that patients could enjoy the benefits of their GLP ones while also looking good.

Rick Gannotta: Yeah, that is a great great segue to our, our, our next segment. You know, Joe, Joe, our producer, and I often say we can't go through a podcast without also addressing the markets, capital, markets, venture capital and innovation. Mm-hmm. And there's a lot happening out there. You know, also on the regulatory side with scope of practice laws and, and, and other areas.

Let me start with this. We're seeing a surge in subscription based skincare. Direct to consumer. Yeah. Dermatology. Really online. I mean, a lot of this, I don't know how, how regulated or not regulated it [00:33:00] is. Yeah. How does this shift, uh, both access and expectations and are you seeing this in your practice? I mean, either the demand for it or folks who've come in and said, oh, I go online for that.

Dr. Zain Husain: Yeah. We're seeing a lot of it, and especially for conditions such as acne. Hair loss, um, and, you know, a variety of other, um, skin conditions. Who are they getting treatments from? That is the question. I don't know who these people are that are providing these recommendations.

Is it just based on an algorithm? 'cause people are filling out these questionnaires. Are they really seeing someone? There are platforms where you just, you know, filling out a questionnaire and there's an algorithm and it just kind of spits out a regimen that's kind of generic. And a

Rick Gannotta: prescription. And prescription.

Dr. Zain Husain: Yeah. Yeah. And I feel like that is, that is a scary, slippery slope because these patients. A are not being properly evaluated by a professional who is trained to treat those conditions. We are also kind of seeing [00:34:00] a one size fit all kind of treatment model, which may not be appropriate for their skin, may not be treating the skin properly or making it worse.

Many of these patients who bring up that they've used these subscription models have kind of come in frustration because their treatment has failed. They're not seeing the benefits or. In fact it's getting worse and now they're seeking help. So, and sometimes I have to reverse some damage. Like some patients, like, you know, like they were using an inappropriate medication and it actually harmed their skin, so.

I am always of the mindset that you get what you pay for. And with a dermatologist, you know, there is a standard of education and training and we took an oath. We need to make sure that we help our patients and not hurt them. And these online companies, I mean, they don't have any regulation. It's really sketchy on like some of the platforms and what my patients have said.

And you know, many of these patients. Have wasted [00:35:00] hundreds, if not thousands of dollars on some of these subscription models with no benefit.

Rick Gannotta: And even, I mean, I've heard about this myself in, in, in different communities, states that I've lived in, folks having parties where it's come over and we'll do it.

The Botox party inject an injection party, a Botox party, no. Uh. Compliance. No. Oversight, no. Even understanding of whether this person is qualified or whether what they're injecting in your face is something real. Yeah, it's,

Dr. Zain Husain: it's wild. Some of the stories that I hear, um, you know, professionals who aren't even trained, right?

Like medical assistants injecting, they're also getting product from overseas that may be counterfeit. So we've seen that there was a case in New York, like, you know, counterfeit Botox being used, um, you know, fillers, they, everyone thinks that, oh, it's just a filler, but they're. Are dire consequences that can occur.

People can go blind, people can get skin necrosis. There are a lot of nuances. That's why we go to medical school. That's, that's why we do years of training. The anatomy is complex. It's not just [00:36:00] sticking a needle because there can be very serious consequences that can occur.

Rick Gannotta: Yeah. Let me, let me shift more, uh, deeply on the kind of the venture capital.

Mm-hmm. Pe, private equity side. Yeah. Yeah. I think of it as technology plus incredible exponential scale. Great returns equals a really good investor climate and a lot of interest. Yeah, a lot happening out there. A across the board, um, the aesthetic medicine market growing super fast. It's gonna hit, I think 136 billion in the US by 2033.

From your perspective. What clinical and consumer trends are really driving this. I mean, I could think of some off my mind, but, but you're, you're an expert here. What's, what's driving this incredible growth? And by the way, I look at this a lot. It's one of those areas in, uh, not only clinical medicine, but you don't need much clinical validation if you're doing a private equity pitch or mm-hmm.

Or working with you know, a startup. If they're [00:37:00] going down this road, if they've got something good, there's probably gonna be some traction.

Dr. Zain Husain: Yeah. I mean. With the rise of the med spa, I mean, we've seen an exponential growth in this in the past decade, and you know, with the scale they can. Attract patients at a very good price point and still make a considerable profit.

And they have the scale to also market, um, direct to consumer like they're flooding your social media and bombarding. And like every other week, it seems like a new med spa pops up and. Patients really are just very fickle. They see a deal, they see a Groupon, um, and they just come and it's kind of scary because they don't really do that much research and they're really drawn to sleek advertising and the basement bottom pricing, and they're attracted to that.

And. [00:38:00] Like I said, you pay what you get for, you don't know necessarily what you're getting sometimes and the level of training of who is doing the procedure, and that is such a big thing. I mean, in terms of the aesthetic landscape, we see that patients at Medi Spas. Have a lot of complications. I see them weekly in my office.

Weekly and even some reputable places. But the medi spas for sure, like burns from lasers. Number one thing I see, um, as a complication, and you know, these are usually skin of color patients. They had a treatment done by someone who's not experienced, use the wrong technology and boom. That is serious because it can cause long lasting pigmentary changes, scarring.

It only takes one time. Takes time, right. And then same thing, like I was talking about the injectables, like one wrong move and you can get blinded, you can have skin necrosis and that is sometimes irreversible. [00:39:00] So I think that, um, you know, these consumers just. Aren't really doing the research they should be.

Um, there are some really savvy consumers who will do research. They will only see, you know, board certified dermatologist or plastic surgeon for their treatments. And I applaud them because they at least know there's a minimum right level of training and you know, they're gonna be playing by the rules.

But these MediSpa it's like the wild, wild west. Yeah. And it's scary and I see complications all the time and it makes me so upset because I really do think it's due to greed. They're not really thinking of their patients. These are clinical procedures. I mean they're, yeah,

Rick Gannotta: they, even if it's an aesthetic, uh, injection. Yeah, it is. Still when you're putting something right. I mean, bot,

Dr. Zain Husain: I mean, Botox is bot botulinism toxin. So like you can Wrong spot.

That's it.

Rick Gannotta: Yeah. Yeah. Wow. One, one other shift we've gotta talk about. Technology and I wanna go down the as I have to Yeah. In almost every podcast, the ai [00:40:00] rabbit hole are there. Diagnostic tools advances AI that is now being applied in, let's say, real world dermatology aesthetics, even the longevity side that we actuarial tables or algorithms that are really leapfrogging.

Some of the outdated norms that you worked with?

Dr. Zain Husain: Yeah, I mean there are a lot of AI driven devices that, um, are using. Image-based technology to diagnose patients, because as you know, dermatology is a very visual field. Mm-hmm. And you know, the thought is, is you can train AI to recognize these patterns and potentially make diagnoses.

And they've been using, especially for like pigmented lesions or, you know, trying to determine if this, you know, this is skin cancer or not. And. We are seeing that, um, you know, although there is some benefit to it, there is also a lot of [00:41:00] discrepancy, right? So it's not perfect. And I have seen advertisements for primary care to start, you know, screening patients with these tools.

Um. I don't think it's a bad thing because we often hear about access being an issue, especially for dermatology. Like people are having six month waits to get in and you know, sometimes you can't wait that long, especially like if you're concerned about skin cancer. So if we are able to equip, you know, primary care providers.

With tools that can help them, but also having further training like in how to do a skincare, uh, a skin um, exam and do an assessment and referring those patients that are higher risk to the dermatologist. I think that's a benefit to society. Like I can't tell you the number of patients I see are like the worried, well, they really don't need to be in my office for a skin check, but they're there every year and I'm happy to see them, but they're low risk.

They really don't have anything going on with them. So I'd rather see people who have [00:42:00] acuity issues, Hey, this is a skin cancer, treat them and you know, be done with that. And I think that that could be a possible benefit for the future. But AI is not there yet.

Rick Gannotta: Right. But

Dr. Zain Husain: it's

Rick Gannotta: probably two ends. I think, you know, first with the access piece with primary care and I really think there, there's probably is a role there.

Yeah. For a primary care provider to, you know, leverage some advanced technology to help them with. You know, some differential diagnosis where at least if it has the sensitivity, specificity to a point where, well, I'll, I'll be cautious and refer. Mm-hmm. Yes. It's certainly better than directional and gonna keep you outta trouble on the other end.

There's probably a lot of high-end technology. That you could use just on not only the aesthetic side, but I would think in the reconstructive side that are Oh, yeah. That are coming. That must see all the time. They

Dr. Zain Husain: actually have programs that are AI driven. Like say you have a cosmetic patient, um, and kind of.

Focusing on the [00:43:00] areas where there are, say, certain deficits or defects or certain areas that can be enhanced and they can do a model of what can be done, how they would look, and you can customize your treatment based on that. So that can help with that consultation and kind of showing the patients what can be done.

And on the reconstructive side, so I'm a MO surgeon, so I do skin cancer reconstruction, and there are programs that you can take a look at, a defect after the skin. Cancer is clear with MO surgery. What are the options for reconstruction? And they can actually look at the lesion, give you the different possibilities of what's gonna be the best possibility, and you can help educate that patient and being empowered with that knowledge to make a decision that can have a serious consequence on the reconstruction.

Rick Gannotta: Yeah, that's, it's amazing. I'm sure much more to come on the technology side. I wanna close up with a couple of questions. One I'll, I'll kind of say is for you and one will be for the benefit of our listeners. Mm-hmm. The one for you, if you could redesign how [00:44:00] healthcare, how the health sector treats your specialty of, let's say, dermatology and aesthetics.

Longevity, where would you start?

Dr. Zain Husain: That's a great question. I think. That there is a misperception of dermatology that we're just simply pimple poppers and, you know, just injecting Botox. Um, very superficial, not real medicine. And that was reinforced by the media, by the way. Yeah. And, and. And the house of medicine too, like we're always knocked on like, Hey, you're not real doctors, or You guys are out like playing golf like half the week.

Um, you know, and it's just that stereotype and I think that there is a lot of serious skin disease that is out there and there's just not enough information about that. And I think a lot of patients are suffering in silence. So I think that. Showing the wide breadth of what we do as clinicians in dermatology, I think would be [00:45:00] very helpful so that I'm not asking for more respect from other specialists or the public, but just to really showcase that we can really help.

Patients with really serious disease, and we are the experts at hair, skin, and nails, and we can really help enhance patients' quality of life, whether it being medical, surgical, cosmetic. We do do it all.

Rick Gannotta: Yeah. And as I said earlier, being the barometer with skin is mm-hmm. The largest organ of so many other issues.

Okay. For our listeners, what's one skincare habit, or even I'll say mindset shift that you believe? Could or would make the biggest difference for our listeners today?

Dr. Zain Husain: It sounds cliche, but wear your sunscreen. There you go. And honestly, this simple task will save you so much money from aesthetic standpoint.

You are gonna slow down the aging process because the sun really does prematurely age you. And second, it's going to help prevent skin [00:46:00] cancer. Um, I love doing skin cancer surgery, but if we can prevent that, that's way better.

Rick Gannotta: Fantastic. Dr. Hussein, thank you so much for a fantastic podcast. So much information.

I know our listeners are going to benefit from this powerful stories, fantastic prognostication with respect to where things are going. And also the notion, the idea that, you know, the skin really is more than just skin deep, you skin what we're looking at. Skin deep. Skin deep. Mm-hmm. So, um, for our listeners out there, what's your skin story?

Drop us a dm, call into the show, drop me an email. We'd love to hear about that and feature it in an upcoming podcast. So for now, thank you. From the Healthcare Nation podcast. Thank you, Dr. Hue. Thank you. It was

Dr. Zain Husain: a pleasure.

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