The Optimal Aging Podcast
Millions of people over age 50 represent the biggest consumer market in history for fitness, nutrition, travel, recreation and more. But most businesses don't know how to market to them. We'll interview entrepreneurs, business leaders and innovators to discuss this exciting opportunity.
The Optimal Aging Podcast
Skin Health after 50 Is More than Botox: Not That There's Anything Wrong with That! With Dr. Mary Alice Mina
Why is there still a stigma around Botox and other simple cosmetic procedures? And what role does skin health play in healthy aging?
These are topics I discuss on this episode with Atlanta dermatologist Dr. Mary Alice Mina. You know, it’s funny. We don’t think anything about working out and looking better… but we raise a skeptical glance at the possibility of Botox, fillers, or peels. What’s the difference between them and, say, dying your hair?
I find Botox to be an entry topic for the more relevant subject of skin health, cancer screenings, and the like.
I'd been hoping to have a dermatologist on the show for a while. I know you'll enjoy this conversation.
Well hi, Dr Mina, it's nice to have you here today. Thanks for coming.
Dr. Mary Alice Mina:Thank you so much for having me.
Jay Croft:I'm glad we're here talking on this rare snow day here in Atlanta.
Dr. Mary Alice Mina:I know, yeah, always fun to talk with another Atlantan too.
Jay Croft:Listen, I have wanted to have a dermatologist on the show for a long time, so I'm delighted that you are available for this, because I think the skincare is incredibly important for optimal aging from a few different angles. I'm looking forward to getting into all of it with you for men and women alike. For serious healthcare reasons like cancer screenings, and also for things that might be easily scoffed at by some people, like Botox or just having some cosmetic procedures done to make you feel better about how you're aging. I think it's really fascinating and fun, and so I'm glad that you're here to talk about it.
Dr. Mary Alice Mina:Oh, absolutely yeah. Skin health it's part of your whole body. Health, right? And if your listeners, I know they're into living well and exercising and eating well and taking care of your skin is just one more component.
Jay Croft:Tell me a little bit, before we dive into all of that, about your practice here in Atlanta and what kind of patients you deal with predominantly.
Dr. Mary Alice Mina:Yeah, so I moved here about 13 years ago so it's crazy to think I've lived in Atlanta longer than anywhere else in my life at this point. But I have a practice Bachman Amina Derm Surgery. We have an office in Dunwoody and then Johns Creek and we mostly focus on procedural dermatology. So we do a lot of Mohs surgery, which is the technique to remove skin cancer, so we do a lot of that. We also do a lot of cyst and lipoma, especially big, big things. So I joke, I'm Dr Pimple Popper, atl and then we do a lot of cosmetic procedures devices, inject, peels, things like that just to help people feel good in their skin, erase sun damage, boost their collagen and all of that stuff.
Jay Croft:And do you primarily treat men, women, people over a certain age, under a certain age?
Dr. Mary Alice Mina:The cool thing about dermatology is our patients are all ages, but a lot of my patients who have skin cancers tend to be men and they tend to be 60 plus, although I'm seeing younger and younger, and certainly women can get skin cancers too, but men have a higher prevalence of it, for sure. And then cosmetics both men and women are interested in cosmetics, with a slant probably more towards women, and I would say it usually starts around sort of late thirties but tends to be more like fifties plus.
Jay Croft:Before it gets to the point where you want to talk about procedures. Plus, before it gets to the point where you want to talk about procedures, what about just sort of basic skincare health, like is there something I should be doing or I'm too old to start, I'm 61, but is there something 30-year-olds should be doing? 40-year-olds should be doing all the time so that they can manage what's coming, or not?
Dr. Mary Alice Mina:Yeah, yeah Well. So I always say you're never too old to start. Okay, so the best time to plant a tree was 20 years ago, but the next best time is today, right? So, yes, I'll tell people, like, if you want to have amazing skin in your fifties, wear sunscreen in your twenties and thirties, right? So prevention is so key, like with so much in life. Right, it's number one, two and three. But I don't want people to lose hope if they're like, well, shoot, I'm 60. It's all hope loss, there's nothing I can do. It's harder, but there are things to do. You can still make really good changes in your life, right, like, you may live another 30, 40 years at this rate. So there are things that you can do. But, of course, the earlier you can start taking care of your skin and your body, the better, and so it doesn't have to be complicated.
Dr. Mary Alice Mina:I like to say skin health is whole body health. So, especially for those younger listeners, taking learning, the importance of taking care of your body in your twenties and thirties and forties is so critical. I didn't really take care of myself till I was in my forties. I was burning the candle at both ends. I'm trying to grow a practice, trying to raise children, be a wife, a mom all of those things I wasn't prioritizing. Sleep I naturally am thin so I didn't really think I needed to work out and I would eat whatever I wanted. And then it's like 40 hit and I was like, oh, these tactics aren't really working anymore.
Dr. Mary Alice Mina:So learning that by taking care of your body, your skin is going to reflect that health as well. So if I could just impart that to younger people listening, but really all ages, right, but to take care of your body is also taking care of your skin. And don't sunburn, don't tan, wear sunscreen. I would say that's probably the most important skincare ingredient you can be using or should be using at all ages, but especially when you're younger, because you have so much life years ahead of you and you want to prevent all that cumulative sun damage. Because when you're in your seventies and you're having to come into my office all the time to have cancers removed, it's really. It's really discouraging and frustrating and at that point, by the time you developed them, it's a lot harder to reverse it.
Jay Croft:Yeah, it's a lot like fitness. I write primarily for fitness for people over age 50 or so, and yet it's important to start younger than that too, and a lot of people don't. They're raising children, they're working really hard on establishing their careers and saving money for the future. And you know your, your twenties and thirties can be really, really busy time of life. And then by the time you're 50, 60, 70, you don't have these habits. You're overweight, you're deconditioned, you get winded, going to check the mail how are you going to enjoy yourself? Right? So these habits pay off later in life. But it's not too late. So it's not too late for me. I can still start.
Dr. Mary Alice Mina:You can still start, absolutely.
Jay Croft:Well, I certainly hope so. When we're talking about skin health, we don't just mean the face. Should I see a dermatologist twice a year after I turn 40? Should I see him once a year after I turned 60? Like what are some basic guidelines for incorporating skincare into my health?
Dr. Mary Alice Mina:Yeah. So I think it's going to be a little different for everyone. It's not quite as set in stone Like we have. Get a mammogram at 40, get a colonoscopy at 45. But if you're in your 40s and you've never seen a dermatologist, you should get in. I would say probably even your 30s. Particularly if you have a history of sunburns severe sunburns then you want to see a dermatologist, really probably even into your 20s. Also, if you have a family history of melanoma or you have a lot of moles, then you should also be seen when you become an adult, for sure, and then your dermatologist can look at you and decide okay, based on what I'm seeing, you are probably good once a year or sometimes. I'll see people in their twenties. They don't have a lot of sunburns, no family history of melanoma, not a lot of mold, and I'll tell them I'll see people in their 20s. They don't have a lot of sunburns, no family history of melanoma, not a lot of mold, and I'll tell them I'll see you every couple of years unless something comes up.
Dr. Mary Alice Mina:But the reason I think it's important to have that visit, even if you don't have anything you're worried about, is because your dermatologist can help give you important information on what to look for. What does a skin cancer look like? People have heard of melanoma typically and they think of the dark mole, but what is way more common is to get a non-melanoma skin cancer, something like a basal cell carcinoma or a squamous cell carcinoma, and for a lot of people they don't even know those exist. And the other shocking thing is cutaneous squamous cell skin cancers kill twice as many people every year as melanomas and yet so many people don't even know that's a. That's an issue. So I think it's important to see your dermatologist so they can kind of go over what your risks are, what to look for, and and they can guide you on whether you need to come in Now if you've had skin cancers.
Dr. Mary Alice Mina:We usually say twice a year for about two years and then we can back off if you haven't had one in that time. And the other thing I say is if you've got a spot you're worried about, do not be shy that. Oh well, what if it's nothing? I'm going to waste their time. We would so much rather have you come in and let us reassure you.
Dr. Mary Alice Mina:That spot is normal, nothing to worry about, and I'll tell you every time that happens one out of two times, I will say, well, while you're here, I'm going to look at your face or I'm going to look at your back and I'll find something that does need medical attention that wasn't even on their radar. So don't ever feel like you're wasting our time or you're worried it might be nothing. You know that's what we're here for, and I think people forget that our skin has really important functions beyond just a pretty face, and so your dermatologist is going to help you with your hair, your nails, all your skin, and help keeping you healthy and and long, you know, having longevity with your skin, and not just coming to see us when a lot of the damage has already happened.
Jay Croft:Yeah, and there there comes a point where your skin tells on you. You mentioned when you turned 40, I think when I turned 50, I started noticing in other people and thinking, wow, his skin is so blotchy. And I realized, well, you can kind of fake it with drinking and smoking and burning the candle at both ends in your 30s, maybe in your 40s, but at some point it shows up on your face.
Dr. Mary Alice Mina:Yes, yeah, that's one of the things I love about the skin is it reflects what's going on internally. So I can see whether someone has, you know, diabetes or prediabetes. Based on some of the skin findings, I can tell whether there's a problem with the their blood vessels by little bumps that may appear, or how their lung function is based on their nails. So our body gives these clues as to what's going on and you just have to be attuned to them to pick up on them. So, again, that's why I say whole body, or skincare, is whole body care, right, how you take care of your body is reflected in your skin. So it's so much more than just putting on a bunch of top of and doing a bunch of procedures like that. That's the final 10%, the icing on the cake, right, that's not going to get you. You know, really taking care of your body is going to get you 90% of the way.
Jay Croft:Okay, that's great. Now let's talk about that 10% Exactly. What's what's new with all of this? Where are we with all of this? What are people coming to you with that's different or that's changing, I guess, in my mind, which is I have a little experience with this personally and with family, but not a great deal, and it seems like the thought of Botox or similar procedures has kind of evolved, sort of in the way that online dating has evolved.
Jay Croft:Like when it first came out 20 or 25 years ago you wouldn't really tell anyone because that, oh yeah, I don't want to have Botox so I don't have to go on the computer to meet a date. But now everybody does it, it seems like Is that true? Yeah, is it less of a stigma or what?
Dr. Mary Alice Mina:I totally can relate to the online dating because I met my husband back in two eight and I remember thinking, never wanting to tell anyone because it was still kind of embarrassing. Nowadays it's like whatever who doesn't meet online. But yes, I think Botox definitely has lost some of that stigma that maybe it used to have and I think sometimes people they get scared of Botox because A it has the word toxin it's botulinum toxin in it, so that can scare people a little bit. But it's been around for so long that we have such great data and safety info on it that I think people now realize it's pretty safe. I find it's a sort of starter or gateway procedure for a lot of my patients. It's nice because it's reversible or I shouldn't say reversible, but it wears off, so if you don't like it you don't ever have to do it again. That being said, most people love it and then they become not addictive, but they want it and because they see the difference it makes in their skin and people don't realize you can use Botox and I'm using the brand name Botox, but there are several of them botulinum toxin.
Dr. Mary Alice Mina:I should be saying right, but Botox, that we can use it for more than just relaxing muscles. We can use it for asymmetry someone may have in their face. Maybe their smile has always been a little crooked and we can help balance that out. Or maybe the tip of their nose projects downward as they've gotten older and we can put a little Botox in to help restore facial symmetry. And so it's more than just making yourself look totally frozen. And if anything, I think the pendulum is swinging to a more natural result.
Dr. Mary Alice Mina:Where people are, they want their muscles softened. They still want to be able to emote, to show expression, but what they don't want is that those scowl lines to be etched into their skin so that when they're not scowling it still looks like they are. I find that's what really brings people in. They'll say everyone keeps telling me are you angry, why are you mad, why are you so tired? And they'll say I'm not angry, I'm not tired, I'm not, I'm not mad, but people think they are because of their expression. And what we can do with Botox, with some units of few little injections, is soften up and make those features go away, and and people just feel so good when you do that, when they're no longer being told you look angry when you're not right, like that's super frustrating.
Dr. Mary Alice Mina:So, I I find that Botox is a great entry starter procedure for people and it really does make your skin just have a nice glow about it. It's really pretty and you don't have to totally freeze yourself. It can be done with the right injector very, very naturally.
Jay Croft:And just for anyone who might not be familiar, we're talking about. You go into a clinician's office and someone sticks a needle in your face and injects this substance. That's it.
Dr. Mary Alice Mina:That's right. Yeah, we so. And I also say you know, everyone's really into natural nowadays and I think Botox is such a cool way that scientists used what's in nature and harnessed it. So Botox is from the bacteria Clostridium botulinum that produces a toxin. It's found in soil. It's the reason we tell parents not to give their babies honey before the age of one, because it could be in there. So it's a totally natural bacteria and we're harnessing its toxin that it produces and using it in very minute, concentrated forms, injecting it into the muscle to relax the muscle so it can't fire, so it doesn't do anything for lines on your face that are there at rest.
Dr. Mary Alice Mina:So if the line is there at rest, it may soften it a little bit, but it's not gonna get rid of it. So if you are thinking about doing Botox, the best time to do it is, again, prevention, right? So when you start to see those lines are getting etched in so when you stop scowling they're still there then that's the time to start if you really want to prevent those lines from forming and for your audience who are into exercise, right, it's like building a muscle the more you flex your bicep, the bigger your biceps going to be. The more we're scowling and pushing those muscles together in our forehead, the bigger those muscles are going to get. And so when you relax them and you can't do that, they soften up or atrophy. And then the other thing people come in for is they just feel like their skin needs a refresh, their complexion's kind of dull. Maybe they've got a lot of what we call dispigment. They might have some brown spots and red spots, maybe some melasma, hyperpigmentation or little warty gross on their skin.
Dr. Mary Alice Mina:And they feel like it's no longer smooth and even and bright and they're looking for kind of a refresh and bright. And they're looking for kind of a refresh and I love doing that because it makes such a big difference to just clean up the background, noise, make the complexion more, even more uniform. It takes years off someone. It's really amazing.
Jay Croft:So what is that? A chemical peel or something?
Dr. Mary Alice Mina:It can be a couple of things. It can be a chemical peel or it could be a laser. So in different laser, depending on how deep you want to go, how aggressive it could be a resurfacing laser or it could be a laser that treats brown spots or blood vessels. So it just kind of depends what your main area of issue is.
Jay Croft:Right, right Now. I've done that. I've had peels a few times and it makes your skin positively glow.
Dr. Mary Alice Mina:Yeah.
Jay Croft:And it's just amazing. You wake up looking so healthy and so rested and in a way that you probably didn't even realize you needed it.
Dr. Mary Alice Mina:Yeah, it's really one of my favorite things to do because the results are so amazing. People just have this refresh to them, and we're not necessarily removing lines and wrinkles per se, but everything just looks better when your skin is brighter. One thing that I'm really loving are biostimulants, and these are things like Sculptra and Radiesse, and I feel like Sculptra had a moment, maybe around 2000, 90s, 2000. And then it was a little complicated to reconstitute it and have it ready to go, and then hyaluronic acid fillers kind of took off. Those are things like your Juvederm, your Restylane, and so then everyone started using those and I think people are now getting a little fatigued with our hyaluronic acid fillers.
Dr. Mary Alice Mina:While I love them and they definitely have a role, they can be overdone and that's where you get that real chipmunk cheek look, that real stiff look, doesn't look normal, doesn't look natural, and I think that's what people get kind of freaked out about when they think about cosmetics. They think they're going to look like that. Now, that takes a lot of syringes and most people aren't going to go that extreme but to give a more natural volumization. I really love things like Sculptra and Radiesse. They build your own collagen. So again, for someone who's really looking for kind of a natural approach. It's boosting your own collagen and the best time to start Sculptra would be before you really feel like you need it, because Sculptra takes time would be before you really feel like you need it because sculpture takes time. I tell people it takes like three to six months before you start to see any difference.
Dr. Mary Alice Mina:And so starting before you really need it can be helpful just for maintenance and maintaining that volumization that we know we're all going to lose that volume, it's normal. Our bone starts to resorb, we start to. Our face starts to fall. For women that's accelerated during menopause. So we know all that's coming. So again, just like working out, like build that muscle before you lose it, cause we know it's coming. So build that collagen before you have that precipitous drop.
Jay Croft:The injections you mentioned, I thought of some. I can't help but think of famous people you know, because we all know. We can say their names and everyone knows what we're talking about. But there are some actors and actresses and their cheeks are out to here.
Dr. Mary Alice Mina:Yeah.
Jay Croft:And you think you're 45 years old. You're beautiful. Why are you doing this to yourself? It's. How do you so, how do I, as an ordinary person, not go too far?
Dr. Mary Alice Mina:Yeah Well, it is tricky, I would say. For most people, it's incredibly expensive to be doing the amount of treatments that they're doing, and so it's just simply not possible for most people, the average person, to spend that amount of money. That being said, though, there's bad filler all over, there's bad Botox all over and bad cosmetic surgery right. So see someone who is trained. This is not where you want to get the best deal. This is not where you want to get a buy one, get one free, or come in with your friend and get a deal Like this is your, your face, or your body, your aesthetics. So this is not where you want to cut corners. Research who's doing your treatments and your procedures.
Dr. Mary Alice Mina:Sometimes people price shop for these procedures, and they might go see one person for their lips, maybe someone else for their cheeks, someone else said do your chin and it gets very piecemeal looking, and you don't have one person just looking at your whole aesthetics to make sure it's in balance and it's in harmony.
Dr. Mary Alice Mina:And then, for people getting these procedures done, we get so fixated sometimes on the flaw that we see the hollowing, whatever deformity we think needs to be fixed, and so it can be very hard to remember where we came from.
Dr. Mary Alice Mina:And I think that's where people start going down this slippery slope of oh well, I need more filler here and more filler here and more filler here. And that's when you start to get kind of bizarre looking. And then the other thing I would say is who's what does the person who's doing your procedure look like? Because you are probably going to look similar to them. So if they, you know, maybe you are going for that overdone look I mean, there's certainly people that's what they want, right, like the Kardashian look and all that. So you are probably not going to want to come see me because that's not really what I do. So, whoever you know, and also if someone is doing your procedures and they've got those big cheeks and everything, then I have to wonder maybe their sense of aesthetics and balance is not what I perceive, and so I would just be careful with that as well and so I would just be careful with that as well.
Jay Croft:Okay, okay, do you find that it's mostly women who pursue this kind of thing, or more men doing it as well?
Dr. Mary Alice Mina:Certainly more women, but there are more men who are getting these things done. But I do feel like there is more of a taboo for men. They usually don't want to tell people, they don't want their family to know. There still seems to be a stigma about getting it done. But men do care about their appearance and, you know, my husband will tell me what. What do I do about these dark circles? Or help me with my. You know, thinning hair things like that.
Dr. Mary Alice Mina:So I do think men are. We are seeing more men doing it. It's just not at the same rate as women, at least in my office.
Jay Croft:It's some things, people balk and I think this is one of them, and I think fitness is one of them. A lot of times you'll hear someone say oh, you only go to the gym because you want to look good and and maybe, maybe that is someone's prime motivation. Maybe it's not their primary motivation, maybe it's not a motivation at all, but so what? Right?
Dr. Mary Alice Mina:At least they're going right. Yeah, I feel that way. I have people who will tell me I'm never doing Botox. You know they are, they're very like the crunchy granola natural and and. And they'll say I never want Botox, I'll do laser, but I don't want Botox. Or I don't want anything in me but I'll do. I'll do a laser treatment but you know they'll color their hair but they won't. They won't do this Right.
Dr. Mary Alice Mina:So you know, everyone's entitled to whatever they want to do. You don't have to do anything. My mother could do any. I do any procedure on her that she wanted. She wants nothing. She has never tried anything. I can't even get her to use a retinoid and she looks great, she looks amazing. She wears sunscreen and she wears a hat when she gardens, but it's not her jam. She does not want to do it.
Dr. Mary Alice Mina:And then I have other people who want to try everything. They want to do everything and you can do whatever you want. But yeah, I see that too, where sort of on the side, people will pull me. My friends will come over and say you know, don't tell anyone, but I do want to come see you for Botox, like they're. They feel almost ashamed or embarrassed that you know now that they're 45, they really do want to try it, but for so long they said they wouldn't do it that they feel like they're a phony or a fraud to get it done. So I think everyone should be able to do whatever they want without feeling guilt about it, and I think also to celebrities need to stop saying they haven't had things done when it's so obvious they have, just just own it, Say I mean, what's the big deal you got you?
Dr. Mary Alice Mina:you get Botox and filler, it's okay.
Jay Croft:Now you have your own podcast and you have something you want to share with us, so please tell the folks about that.
Dr. Mary Alice Mina:Yeah, so my podcast is called the skin real R E A L, so if you are wondering, you know what's? What's the truth about this or that or different things. Definitely check it out. My topics we cover are usually things my friends and patients and family asked me about and hopefully it's just a way to give people some good science, fact, actual skin health information. So definitely check that out. And then, if you're wondering, you want to take a fun quiz and find out am I more of a Nicole Kidman or Dr Mina's mom? You can check that out at theskinrealcom forward slash style to see what your aesthetic style is.
Jay Croft:Oh, that sounds like fun. Yeah, I'm at Dr Mina's skin. Put all of that in the show notes so people can access that. I'm going to take your quiz to see if I'm more like Nicole Kidman or your mother. I think I'm probably more like your mother. I think so too A little Nicole, maybe a little Nicole.
Dr. Mary Alice Mina:And that's okay.
Jay Croft:Yeah, absolutely, it's all okay. You know, the name of the show is Optimal Aging and for me that means whatever you want it to mean, and if you need to dye your hair or go to the gym or wear expensive clothes or makeup or whatever the heck you want to feel good about yourself and enjoy your life, go for it. That's what I say, yeah.
Dr. Mary Alice Mina:I love it, your mental health matters too, is what I say. Yeah, I love it, your mental health matters too, right?
Jay Croft:Absolutely, absolutely it does. This has been a delight. I want to thank you. I could talk to you about this all day, because I'm just fascinated by all of this. I have three older sisters and they do a lot of this and I've done a little bit and it's really interesting to me. So I want to thank you for your time today.
Dr. Mary Alice Mina:Absolutely. This was a lot of fun. Thanks for having me. So I want to thank you for your time today.
Jay Croft:Absolutely, this was a lot of fun. Thanks for having me All right. Have a good day. Stay safe in all this crazy Atlanta snow.
Dr. Mary Alice Mina:That's right, stay warm.
Jay Croft:Okay, bye.
