Dermatologist Reveals: "90% Of Your Skincare Is A Scam. Stop Buying It."

Dr. Nutella Sparings, a dermatologist, and then to be bodybuilding. How did the two worlds collide? So I won the UK Paranormal, which was crazy. Huge. And then at that point, it was, you can either be a pro or you never compete again, because I can't compete as an amateur. Has that impacted how you treat patients in some way, shape, or form? So skincare isn't magic. Most skincare pretty much does nothing. So nobody told me you look like an alien. Not my patient. Okay. These are not my patients. What is the most outrageous skincare scam? It's got to be when one of these people decides to vilify something that's really well evidence-based because they're trying to sell a product when I get really, like, riled up. To just sell your product, you don't need to make... Shit on something else. Yeah, especially if it's completely incorrect, what you're saying. Whether it's textural, whether it's pigmentation, whether it's inflammation, redness. We have treatments for all these types of problems. Redness is a huge problem for people, and it's something that no one ever talks about. partially because... I do want to ask about Botox. I mean, I love Botox. What could you eat to get more lean and have lean muscle mass, especially as a woman in their 40s and 50s where it's harder naturally to just gain muscle mass? What is one uncomfortable truth about skincare that you wish everyone knew about? Dr. Natalie Spearings, Thank you for coming into Biohack It. Thank you for having me. You had such an interesting background. You're a UK-trained consultant dermatologist and a surgeon, best-selling author, and a professional IFBB bodybuilder. Yes. Like, what an interesting dynamic combination of a human you are. Well, thank you. And when my team and I were researching you, the fact that you have a really straightforward approach to how to treat skincare, busting through the meds, And then how you also bring in things like body composition and longevity into your own way of treating people was just an incredible combination. So I'm excited to interview you today. Well, thank you so much. What an interesting background to be a dermatologist and then to be bodybuilding. How did the two worlds collide? It's kind of a weird story because as a doctor, I never did any sports really when I was younger. Like not until I was a medical student. I was a personal trainer throughout medical school to just fund medical schools. It was like my side job just like for fun. And I always liked being in the gym and stuff. And, you know, I did like, you know, cycling. I taught spinning classes. This was all just like to fund my education basically. And I've always liked kind of exercising, but I wasn't big on like team sports or whatever. Right. And I don't come from an athletic family like at all. Like they think I'm a weirdo for like doing anything. So it's not genetic. You're not genetically gifted. No, I'm not genetically gifted at all. Like there is no genetic gift. so um i just kind of you know i've always i was a chubby child so i only got into exercise um when i was a teenager because i was like well i need to be like kate moss skinny because that's how old i am right so yeah so it's all about um the waif look and i was never gonna have that body time because it's just not my body time um so uh basically what happened was i got into bodybuilding because i had a cycling accident um when i used to triathlons which was totally not for me i don't know what i was thinking but i had a cycling accident in my early 30s and then i didn't cycle anymore. So then I wanted to do something else in the gym. And one day, one guy in the gym, I have no idea who this was or where it was said, Oh, you know, you could try bodybuilding. That would be fun thing for you to do. And I was like, yeah, okay. So then I had signed up for a body building competition in 2013. I did very badly. It was a bikini competition, which is not my body type at all. And I just thought it was fun. Like, I just thought it was fun to have like abs. Right. Temporarily. Yeah. And I was like, this is cool. I can do this. And then it just kind of went from there. And then back during COVID time, you know, I decided that if I was going to compete again in bodybuilding, that I was going to do it to win, which I'd never really done before. I just did for fun. Cause I was also a full-time medical student. Then I was a full-time doctor. So I didn't have time for like, I didn't have time. I was doing night shifts and all this stuff. So then I decided I wanted to win. So in 2022, I competed again after prepping for 18 months. I was like, I'm going to really be serious about this. And I told my coach, I'm going to be really serious about it. He's like, yeah, okay. And I won. So I won the UK Arnold, which was crazy. Yeah. I was like, what? So I won and then I got a pro card. And then at that point it was basically you can either be a pro in the IFBB, which is like the biggest federation in the world, or you never compete again because I can't compete as an amateur. Basically at that point. So I was 41. So I was like, right. Okay, well, why don't I just compete as a pro? And then I just decided I was going to go for it. And that was it. And I did it. and how do you is there a link between you being so disciplined with your training you know at you know you got into bodybuilding late but you've been phenomenal at it you basically competing at a world level now has that impacted how you treat patients in some way shape or form yeah i think um i it when i realized what i needed to do to get like shredded and and like lean and shredded for competing and also like muscular it just really like basic stuff and i'd always kind of had that attitude towards dermatology like or medicine like you know we always go back to the basics what science tells us is fact you know we stick with that and that usually works and with with when i realized that was like the key to like having abs and like looking jacked which took me a long time to realize because i tried you know intermittent fasting and i'd done like you know the carnivore diet because i was always trying to be skinnier because i was always a bit too big basically now being big is like the good thing is a good thing but um i did realize that when i focused and was super consistent with what my coach was telling me to do which weirdly i'd not really done that before um i got that result in the end and so i do the same with my patients i'm like i'm gonna give you this plan that's pretty simple right and i just need you to do it exactly how i'm telling you to do it and that's not deviate do not deviate from this okay just do what i'm telling exactly and follow that down to like like a religion religion and that's it and Don't DIY it because I used to do a lot of that back when I was younger. I would DIY my diet a little more and I would just go off piece with what my coach was telling me. And I never got to that elite level that way. So it's like I just need to listen to what I'm being told and just do what you're told. Right. And that's what I do with patients now. I'm just like just do what I tell you to do. And follow it down to the T. As someone who's always drawn to wellness products that are simple, effective, and actually help you understand your body, which is why I'm so excited to share the Hormone Zoomer by Vibrant Wellness, a company I love and trust. It's an advanced at-home test that gives you real insight into your energy, mood, and overall balance. That's why I trust Vibrant. It combines standard of care labs with genetics and innovative biomarkers backed by over 400 researchers and more than 40 peer-reviewed studies. I took the Hormone Zoomer myself and finally getting clear answers behind signs and symptoms I'd always blamed on stress or too much travel, which was extremely empowering to me. It measures up to three times the markers of typical hormone panels, including hormones, adrenal and bone health, oxidative stress, and endocrine disruptors and toxins like glyphosate and phthalates. Essentially five tests in one. And with Vibrance Network of over 30,000 trained providers, you get expert interpretation and a plan that makes sense for your body and your needs. If you're ready to understand what your body's been trying to tell you, ask your provider for the Hormone Zoomer or find a Vibrant certified provider at vibrant-wellness.com slash biohackit because understanding your body changes everything. So I want to talk about retinol. Yeah. What's your take on retinol? It's supposed to be this miraculous thing. What do you think? Yeah, so tretinoin, so vitamin A derivative. So I don't like to use the word retinol because that to me is like the over-the-counter stuff that you can buy at like whatever. So I call them over-the-counter vitamin A derivatives. That's what I refer to as retinol, not to be complicated. But tretinoin is what I talk about as the medicine. So tretinoin is the only like topical treatment we have ever that has been shown to reduce the appearance of fine lines, specifically crow's feet has FDA license for that, FDA approval. And it is the only cream we have that's truly an anti-aging cream. So treats fine lines and improves skin texture and appearance over time. So it is the gold standard anti-aging cream. And then the one that you're giving to your, prescribing to your patients, because I stole my cousin's cream basically in the summer. Don't share your medicines. Yeah, I just took it and she didn't really know about it. So it's not her fault. But it was amazing. Yes. And so how do you custom make these, this mixture, tincture? Yeah, so I don't custom make, obviously I don't make it myself. So it's done in a pharmacy and all I do is decide what strength of the different ingredients or the tretinoin, for example, is going to be in that cream within a range, which is kind of allowed. And also like you can make it into a cream, basically. Something is too strong. You can't put into formulation. So basically using the strengths that I know I can use anywhere from like zero to usually 1.1% or higher than that. And then I based it on the patient's skin, basically. We build up from there to a reasonable level of strength. And can people still use it if they have melasma or hyperpigmentation? Yeah, yeah, sure. So tretinoin doesn't treat pigment on its own. It needs to be compounded with something else like hydroquinone to make it effective for pigmentation. But tretinoin is, it should be the basic of all people, women and men, skincare from the age of like 30 onwards. Okay. For everyone. Because it helps protect you from further sun damage. It's not a sunscreen. But it helps your skin have that defense against sun exposure and also to keep your skin looking young and healthy as you age. What do you feel is the biggest skincare lie you wish would get debunked? It's that drinking water is hydrating. Okay. So let's go into that a little bit more. Let's tell people. Everyone hates when I say this. So hydration is water content in the skin, but that's not regulated by how much you drink outside of an extreme. So if you're in intensive care and you're not drinking yourself, then yeah, we can use skin turgor as a sign of hydration. Though in modern medicine, that's never used as a sign of hydration because we have more advanced things like urine analysis, like urine output, blood pressure monitoring, and things like that. So we know about people's status of hydration. So the idea that drinking lots of water is good for your skin or hydrates your skin comes from the idea that your skin will look less plump in an extreme state of dehydration. So maybe if you run an ultra marathon in the desert, right, maybe, you know, then maybe your skin will show signs of that, but probably not to be fair. So it's only really in extremes. So in normal people in day to day life, you're never going to get, God forbid you ever get that dehydrated that your skin shows signs of dehydration. Cause then we're having, you have more problems than skin. Bigger problems. Yeah. Yes. So what kind of water do you recommend people drink or what should they be drinking for their skin? So not nothing in particular. Okay. Okay. You know, you're drinking fluid doesn't impact skin. Okay. Without electrolytes or minerals or all that. No, no, no. For normal, healthy people, if there's something wrong with you, that's different. But for normal, healthy people, which is 99% of the population, really when it comes to this type of problem, just drinking your normal fluid intake, you know, I usually tell people to use their urine as if they're feeling like they're dry, your urine will be darker in color, basically. But that has nothing to do with skin. Is there any foods or drinks or anything that you think is incredible for skin health and patients or you've tried it and said, it really makes a difference? No. No? so it's not about the inside out it is about the inside out okay not well to a point but not necessarily about when it comes to skin appearance you know smoking is probably the number one thing okay which is still external but um and lack of sleep maybe lack of sleep can impact um general appearance and well-being um and also ability to do things that are good for you generally um but smoking is probably is the number one smoking and sun exposure are your are your number the two most important things when it comes to skin health. And when it comes to things like stem cells are becoming a big thing when treating like under eyes and things like that, what's your take on it? There isn't a lot of evidence to support the use of these treatments at all yet. They not FDA approved generally And FDA approval has to do with safety when it comes to devices So stem cell fillers or these types of injectable treatments they not considered medicines they considered medical devices So the FDA approves them for safety only not efficacy So we don't have safety data on these things, which is a worry. In Dubai, the Ministry of Health has approved some of these injectables for use in humans as injections. They haven't been approved in countries like Australia or the United States. You can derma roll them, but you can't inject them, but you can here. yeah I think now they're starting to so stem cells are now going to be available in Florida that's where I live I live in Miami and exosomes are now starting to be allowed so those are kind of coming in too potentially not for injection so people are derma rolling them in or like for example doing something else and then putting them on the skin like you can microneedle and then you can microneedle over the treatments and so on it depends I think in the United States also each state has their own thing going on but I mean I am using certain types of things myself in my clinic but I'm only currently using for under eye treatments for dark circles and under eye rejuvenation but it's for me it's still very much at the beginning of using these things because they become more commercially available but yeah it is a very unknown area in aesthetics and what do you love to treat under eyes with because a lot of women listening to the show they're in their 30s and 40s sometimes and they're like, what do I do for my under eye? I want to look bright and I want to look awake again. So what is your favorite treatment for under eye? So my favorite treatment is not something I do for people, but a blepharoplasty for your under eye. If you have a displaced fat pad or you have a lot of hollowness, then the best thing you could possibly do is do corrected surgically to rejuvenate the air in the long term. If you just have a bit of like kind of mild hollowness or mild tear trough, then I would put filler in there very carefully. and then maybe do some CO2 around the CO2 laser if you have the right skin type. So the under eyes is one of the most tricky areas to treat in dermatology or in any type of aesthetic thing. So Botox, if you don't have that, then Botox can really improve that area as well. So yeah, it's multifaceted. Yeah, depending on the patient. So I'm back in the day, let's say like 10 years ago, the first time I ever got like fillers, I had filler put in my under eye and it completely blocked my lymphatic pathway. And so basically later down the line, I broke my nose and I had to get surgery. And my recovery from surgery was so bad because I didn't have any lymph movement in my under eye. And so, and then, you know how you can go in with a scan and see old filler kind of trapped in the nose? I was like, I'm never touching this stuff ever again. Did you have an MRI of your under eyes? Yeah. Because you could see. And it was all there? It was all there. And it'd been years. And so, you know, there's now evidence to show that kind of filler doesn't fully ever leave. It does not ever dissolve. Yeah, correct. Okay. so my whole thing is and how do we find people that we know are going to inject in the right way and not cause what happened to me which is basically a blockage of my lymphatic system under my eyes you find too much filler in a place too high up um yeah that's tricky i think going going to see a properly trained dermatologist as opposed to um it depends on where you live someone who's perhaps not a trained injector or they've done like a weekend course in filler because in the UK you can do that. The guy who injected me was a plastic surgeon, by the way. And he did a terrible job. Yeah, I don't know. It's just tricky. People ask me all the time, how do I find someone to do Botox? I'm like, I don't know. I don't know what to look for. I don't know. I mean, I've seen plastic surgeons do terrible filler. I've seen plastic surgeons do terrible Botox. Just because you're a plastic surgeon doesn't mean you know how to use injectables. Just also with dermatologists, though. A lot of dermatologists in the UK, for example, where I trained, don't ever have training in aesthetics. So they don't know how to do Botox either. You know, so I don't know. It's hard. I don't know. Actually, I can't answer that very well. What worked for me really well was a fat transfer. So what's your take on that? Great. Yeah. I love surgery. I don't do that kind of surgery. I wish I did. But I do think the more permanent types of procedures for this kind of problem, you have great under eyes. I mean, I'm like trying to examine them. Thank you. With the light here. I'm like looking. They look great. I mean, fat transfer is a brilliant treatment for many people as opposed to using filler. Right. Because it's a totally different thing. Because I did it for my full face and the things that I saw because I have a really skinny face and I was like, I don't want to put anything in it. I just wanted to do fat transfer. What I felt after the fat transfer was my skin texture improved. I've always had good skin texture, got better. Obviously it looked plumper, more hydrated, more fuller. And I think it comes down to the natural stem cells that go in when you have a fat transfer. Yeah, possibly. I don't know enough about fat transfer to know that. but it is I have seen some beautiful results from fat transfer yeah that's when my I'm really close to the surgeon who did it and that's what he told me he's like when you're taking your own fat and just putting it back into your body it has all healthy tissue it's like doing like PRP essentially right from the inside and he's like so obviously like your skin has better turnover it's hydrated I actually my hyperpigmentation improved a little bit so it was just all these like amazing benefits that I got from it versus trying to just walk into the office and getting something done and being more sustainable. Yeah, no, totally. I mean, I do, I think I try to move my patients towards surgery wherever that's appropriate as opposed to doing filler. So whether it's for like mid, like cheek volume loss or mid cheek volume loss, like just have it corrected endoscopically. Right. You rather than have anyone put filler in there, you'll end up looking like a chipmunk because what happens is the volume moves from the upper cheek down to the mid, to the lower cheek, which creates a nasolabral hole. Yeah. And that's a displacement of volume. So if I just put filler, which I wouldn't do, But if let's say someone puts filler just here, then that's when you start ending up having this kind of weird face, weird face, triangular. You know, I mean, seeing that a lot in the eyes, these people who have these like triangular, like, like, like jaws that come out, their cheekbones are out. I'm like, I said, nobody told me you look like an alien. Not my patients. These are not my patients. They look like, like literally an alien. Yeah. Yeah. It looks really weird. It's because it's a loss of like, I don't know. There's a, there's a look here that some nationalities go for. Totally. And they'll go with their own, like people from their, like as in the injectors from their country. This is like, I'm trying not to say anything totally wrong here. And then there'll be that look they're going for. And that injector will always do that look because it's the look of their nationality or whatever. It's a very scary look at times. It's a very scary look. Yeah. So I'm sure the people listening to this will know what I'm talking about. It's shocking. And sometimes over here also I'm noticing certain women in the region just have overly done lips. like they can't even move their mouth oh yeah no that's that's it that's yes so somebody comes to your office yeah not and they're like hey natalia dr natalia can you please do my lips and you're like what would you'd be like no no so the answer is no i don't get a lot of patients like that anymore because people know what i do and do not do aesthetically yeah so my aesthetic look my aesthetic kind of sensibility is not that um so yeah i'm not the i'm not the doctor for those people they don't see me if you want to live longer and heal naturally you are going to love the Dr. Josh Axe show hosted by my dear friend, Dr. Axe. Every week, he shares how to balance your hormones, restore your gut, boost your energy, and slow down aging without relying on harsh medications or quick fixes. He shares both ancient biblical practices and the latest breakthroughs in nutrition, herbal remedies, and lifestyle medicine. And he sits down with world-renowned experts to have a real unfiltered conversation you won't hear anywhere else. If you're ready to take control of your health, renew your energy and transform your body, mind and spirit, tune into the Dr. Josh Ack show every Monday and Thursday, wherever you get your podcasts. What are some of your skincare do's and don'ts that most people overlook? I think I had a good answer to this. Using thinking that, okay, thinking that skincare is magic. So skincare isn't magic. most skincare pretty much does nothing like i would say 90 plus percent of it um you know it's just gonna temporarily maybe smooth the skin and make you feel like there's a little bit of glow but the minute it kind of you know evaporates it's gone um so believing that skincare is magic and but it's sold like that it's marketed to be this hope in a bottle yeah yeah like we can do this magic with this cream the majority of skincare that you buy is not magic i mean i'd say most of it isn't. I think Vaseline is the closest thing to magic. Really? Yeah. Just try it because it's properly hydrating. It's not irritating. It reduces redness. It's very, very bland and benign. And it does what we want it to. Almost every moisturizer you buy on the market has Vaseline or petroleum jelly in it anyway. You know, you might as well just use the good stuff, just getting the yellow pot for four pounds. Easy. Just use it. What about all the skincare now that has like peptides and exosomes and stuff added to it and other things? I mean, these are just marketing gimmicks. It's like putting gold dust and caviar into skincare. Like it doesn't really do anything. It doesn't. So for anybody listening, they're like, we want to have beautiful glowy skin. What do we do? What do they do? Deal with the problem. So if most people will have, when they feel like they don't have glowy skin, there'll be something that's an issue that's causing that problem. So whether it's textural, whether it's pigmentation, whether it's inflammation, redness, something along that line, that we have treatments for all these types of problems. And I think that's often forgotten in the world of skincare marketing is that when someone has, for example, excessively enlarged pores, we have a medical treatment that will beautifully correct that. You don't need like six different clay masks and like a pore minimizing serum, you know, that this is not going to do it. because enlarged pores are due to a number of different pathological reasons, which then we can correct that. So when someone comes to me and says I lack glow, I look at their skin, I'm like, okay, well, what is it that is causing that? And it's often a textural problem or a pigmentation problem or a redness issue. And then, like I said, we can correct those problems. And what about things like chronic inflammation in the body and stuff? Yeah, so I don't know how that – so, yeah, people ask me that too. I'm like, I don't really know what that means, how that impacts skin. Because if I can't see an inflammatory problem on skin, then I can't treat that problem. So the chronic inflammation systemic thing is kind of something I don't really manage. Because if I can't see it on the skin, then I can't see it. Then you can't manage it. Yeah. Yeah. Like psoriasis is a chronic inflammatory systemic disease. Psoriasis. So when we treat the external, you know, what you see of the psoriasis on the body, then we know we're also reducing that systemic. inflammation inside yeah and does diet play into it at all to having like how your skin should look and feel like how people eat i mean you would you would imagine that yes so generally speaking if you eat total crap all the time your skin may reflect that but in reality that doesn't really happen which is odd i know that sounds odd and it's hard to believe that okay obviously living a healthful lifestyle not eating crap all day um you know and all these things that we know are good for you like sleeping enough not smoking etc etc that's going to impact the way you look generally does it have a direct impact on skin probably not which is difficult because everyone wants to know that you know i'm eating almonds and i do my omegas and i have my salmon and i do this i drink enough water and i don't drink caffeine and therefore my skin should be glowing but when it's not glowing then it's like why is it not glowing right you know and i get that a lot with patients like i do everything right and so many people do because they they know what to do yet my skin's i still have acne or I still have this problem with my skin. Why is that? I'm like, well, that's because they're not related. Right. They're separate. So what about eating enough fat? So one of the thing is like we went through this phase in health and wellness that, you know, we were told like fat is bad for you. Right. And so our cells are essentially made up of fossil lipids and fats. And so now people are reintroducing healthy fats, whether it's butter, ghee, avocados, all back into their diet. Yes. How much do you think that can affect like the plump list or like the look and texture because it it health on a cellular level Yeah I think the only evidence base for anything to affect skin in a positive way would be supplementing with omega fatty acids So that basically what you saying So the only thing, if anyone ever asked me what supplement should I take for my skin, I'm like, well, maybe consider taking some omegas or just eat more salmon or whatever. Right. As the evidence is supporting that concept. If you don't eat any of that, is that going to negatively impact your skin? Probably not because your skin will still function and do what it needs to do. Will it look better if you do? Possibly. Though. Yeah. you know, it's generally not a bad idea. So I'm like, well, it's not harmful. So go for it. And it can make your skin look better. Fabulous. The only problem is like anything in this industry, you know, 95% of fish oils in the market are rancid by the time they get there. So there are very few fish oils that are actually in their truest form, not rancid, stable enough to take in and stuff. So that's why it's always better to take in. Yeah. Eat the caviar, be bougie, eat the salmon, you know, yeah, exactly. Just take it. I've been having tins of caviar, like while I've been here staying with Mariam and she's just looking at me. She's not like heavier. And she's just like, that is gross. I'm like, think about how good my skin's gonna look. It's like a food bill. Yeah. Exactly. I've been having them all the time and she's just looking at me in my face. She's like shaking her head. But I think it makes a difference. Yeah, I mean, that's the thing. So I always say to patients too, if you feel like it's helping you, making a difference and you feel good about it, then there's no harm in that. Well, except to your wallet perhaps, but, or Mariam's wallet, but there's no- Both are wallets. Both of yours. There's no harm in that. So I'm like, well, you know, and it's generally going to be good for your general well-being, for your cholesterol, for other things. I mean, we do know factually that taking statins does impact skin hydration, dryness. Yes, yes. Right? So not because lipid membrane doesn't function as well. And that tends to occur in older people who take statins for many, many, many years. And that contributes to skin dryness as you age. So statins aren't great for skin. But of course, we have to work with that because you have to take them for other reasons. I love that you have a really straightforward, no bullshit approach to life and skincare. So I'm going to ask you that what is the most outrageous skincare scam and influencer or ploy you've seen that completely shocks you? You're like, what the hell are these people doing? It's got to be when one of these people decides to vilify something that's really well evidence-based because they're trying to sell a product for that problem. Like, for example, hydroquinone in the treatment of melasma pigmentation. This is super well evidence-based. We've had hydroquinone as a cream for 60 plus years. It's super safe. It's never lost its license. But then I hear these influencers and these influencer doctors or whatever you want to call them, who go on and start saying, Hatchquin is dangerous, blah, blah, blah, blah. Why? Oh, just because it's irritating and whatever. It causes all these other problems, which it doesn't cause. You know, we know it doesn't cause problems. But just to then say, but I sell this amazing or Eucerin or whoever company sells this amazing depigmentation cream that's so much safer or this peel that's so much better or this laser that's so much better. So I'm always like, you can't don't just sell your product. Don't try to like provide crap loads of misinformation. about something that we know is super safe. And as a doctor, and it really pisses me off when it's a doctor. As a doctor, you know, unless you've never read a paper in your life, you'll know that what you're saying is incorrect. And they deal with minoxidil as well. I see doctors doing it with minoxidil. Minoxidil is the only FDA-approved evidence-based treatment we have for female hair loss. It's super safe. It's super effective. And then the amount of complete crap people spew about how minoxidil is dangerous or unsafe or whatever in order to sell another product, that is when I get really riled up. You don't need to just sell your product. You don't need to make it. Especially if it's completely incorrect what you're saying. We don't need this kind of misinformation. We already deal with enough of it. I also want to pivot to like we were talking about hormones influence skin and body composition so much. When women, when we go into our 20s, 30s, 40s, 50s, estradiol, testosterone kind of dips and it starts changing not only your mood but how your skin texture looks, how your body holds muscle mass, all that stuff. How often do you recommend HRT, not synthetic, bioidentical, HRT to your patients? So, okay. So I try to be very factual about HRT because it's not my area of specialty. Okay. So I don't prescribe it myself, but right. Yeah. So what I, when patients say to me, should I take HRT for my skin? My answer, my standard answer is no. Okay. Because HRT should only be used for two reasons. One for bone health through menopause, And the other one is for the symptoms of menopause. It is not a treatment for skin. Okay. So as at the moment, okay. As, as it stands. And I say, that's why. Now, if you take it and it helps your skin, bonus. If you take it and it causes skin problems, I can fix skin problems. Okay. So if you need to take HRT for other, for those two issues and you start getting acne or something, then I can correct that problem. But I don't ever recommend it for skin because it's outside of what it's licensed to do. Okay. so it's all about like when you look at something from the perspective of so you're more about like it has to be licensed for that exact condition you're not in the mindset of being like i don't want to experiment with it it's yeah both but for me because it's not my specialty if it was my specialty area like with a lot of dermatology stuff i use things off license all the time okay because it's not your area it's not my area that's the thing it's not my area and i hate it when people don't stay in their lane okay so i'm like just stay in your lane this is not your people do a dermatologist everyone yeah because skin is visible and it's easy so i'm like no you don't know what you're talking about stay in your lane so i try to make sure that i do what i say other people should do which is stay in my lane right when it comes to this and keeping yourself to the same standard what is your take on estradiol creams so that's interesting um it's um an interesting concept um i think that it'll have its place within anti-aging medicine or anti-aging health skincare, if you will. But I don't think the evidence base is strong enough to support it. And in the formulation that it needs to be in used, like used, because most women are using their HRT creams for their, like their, for their faces, which it's not made to be used on faces. There are issues with systemic absorption through the skin and how that impacts general hormones, which hasn't really been well elucidated. At least I'm not aware of it being well understood yet. so on balance right now i do prescribe it to some patients um but it's not something like i talk about a lot because i only do it on a on a patient by patient depending on that person i don't think it's going to be like tretinoin where you can use it for everyone because tretinoin can basically use for everyone um it's an interesting area and i'm very open to seeing how that can be used yeah but at the moment because of the systemic absorption issues um and how that can impact female health, I'm kind of being very careful with it. And when you're talking about systemic absorption, can we break that down a little bit for people? Yeah. So it's effect on breast cancer. Okay. So, um, so estrogen dependent cancers, um, we don't know yet enough. At least I'm not aware of that. Um, I'm not a hormone specialist, so I am using estrogen creams is on the periphery of kind of hormone stuff. Um, the creams that are used for HRT for estrogen, if you're using estrogen type cream, they are made to be absorbed systemically. So you're not just giving it to your skin. So we need to have creams that are made for skin. What bothers me right now is that a lot of these estrogen based creams are being done without prescriptions. So they're not prescription creams, which means that we have no regulation over how much is in there and how much we don't know how much is being systemically absorbed because when it's a commercial product or a cosmetic cream, these aren't tested for anything. A prescription medicine with an Easter dial in it or Easter, Easter oil in it is tested. And we know if it's how much is being absorbed. We have, we have to have all this information before the FDA will approve a cream like this for safety and efficacy. So, and that's the other issue is that you can buy them over the counter in the United States, definitely, which is a bit of a worry. So like I said, I prescribe it. And when I prescribe it, I'm very careful with how it's done. You know, my pharmacy I use here for compounding doesn't do it for skincare yet. And that also stops me from, if they're not happy to do it, then you're not giving it. And then what's your take on things like Botox and the different types of Botox that's being offered? I'm not even going to ask you about the face taping because I know you think it's bullshit. Face taping, yeah, it's bullshit. Yeah, we're not talking about face taping. Yeah, I see people doing it and I'm like, what? Like, are you seriously taping your face and hoping a muscle will stay given all the movements you make throughout the day you're hoping that the tape that you wear at night to sleep is going to help you like no no no no i've given up yeah but i do want to ask yeah about botox i mean i love botox it does what it says it's very safe trustworthy reliable trustworthy reliable been around for a long time it it does prevent the um you know the development of lines over time um it's it's like the closest thing to magic you can get for wrinkles it's temporary which is also good yeah you know because it's done badly a lot of times and people mess it up so thank god it's temporary um but you know it's temporary fine you do three times a year whatever um but i love it i love botox i've been doing it for myself since i was like 30 um and i you know i think it's magic is there anything in the holistic or alternative space that you think is good for skincare so whether it's dry brushing for the face or lymphatic drainage or you know gua sha or anything like that anything is there anything i'm gonna look over there anyone is it anything that you think okay it works oh god um or you're like i haven't tried enough to say make up my mind about well i mean i don't really try these things yeah kind of things um i can't think of anything that kind of like the popular kind of stuff that people talk about. Yeah, no. I mean, I definitely am not like, I'm even not a fan of facials. Like I just don't. Really? Yeah. Yeah. I think those are. Mariam had told me that. Yeah. Why do you not like facials? It's just, you're irritating the skin. You're playing around the hair follicles. You're messing about. If you have any sniff of a skin problem, you'll almost certainly make it worse. Right. I mean, we know that it stimulates acne, but it takes a long time. It takes four to six weeks to see that happening. And that's been well evidenced based. We have trials of this. We've looked into it. Like all this kind of stuff is like research, but no one knows that because they're like, oh, you have my facials. So, you know, scrubbing, facials. I mean, I would definitely not dry brush your face. I always tell patients, you know, treat your face like a baby's bottom, like, or baby's skin even, not just the bottom. Right. Any part of their skin, you know, what you wouldn't do to a baby, don't treat your face. So you probably don't like peels. I only, right now, I only do peels for tretino and hydroquinone for pigment. So that's, but I've just started doing that recently. So I'm not a huge fan of peels, but I do CO2 laser. Okay. So I am a big fan of things like that if you're looking at acne scarring treatments and overall skin resurfacing. Are there any other lasers that you like and like the results from? I like anything that has to do with a vascular laser because I like to treat redness. Okay. Redness is a massive—redness in vessels, blood vessels, are a massive skin problem. Right. That's really, I think, under-talked about. Under-talked about? Yeah, under kind of like— Yeah, underestimated that redness is a huge problem for people. And it's something that no one ever talks about. partially because it's difficult to treat. You need the right type of device for that. Correct. And it tends to recur. So you do need to kind of stay on top of it. What is your best treatment or what you recommend for people who have hyperpigmentation and melasma? So the gold standard is the triple combination treatment, which is tretinone, hydroquinone with a steroid in it. Okay. And is that what you put in your formula? Yes, compounded. Yeah. It's compounded. And then using hydroquinone. So hydroquinone is your mainstay of treatment. topical treatment for pigmentation, whether it's melasma or sun-induced or anything melanocytic, like comes from melanin. And then hydroquinone compounded within that type of formulation is the absolute 100% gold standard. It will clear the pigmentation every time when done correctly. And what is the duration that you have to take this for? For the treatment, like until your pigmentation is clear or at least close to 100%. So that's usually three, six, eight months, depending on the patient, how bad it is. And then you maintain that clearance with continuous use over time. I want to switch over a little bit to body composition and all that stuff. Why is it that so many women fail to change their body composition despite lifting weights Well I mean I can always talk about things like you know you not lifting heavy enough you not being consistent blah blah blah I do think that part of it that there this fear of getting bulky or, you know, being a little scared of kind of pushing yourself. No one likes to feel pain. You don't have to feel it. Yeah, of course. Yeah, no one wants to, none of us want to work excessively hard, you know, and it's understanding that threshold, you know, how hard Can I push myself? And it's taken me years to understand how I can do another rep. Don't be a wimp. You know, don't be a wuss. I'm not saying all women are wimps, but I think it's having that fear of not knowing where your own limit is and fearing injury. And also getting this whole thing with like, I'm going to get too bulky, blah, blah. What I do think is a main problem, though, is that you don't know if you're changing. Right. So, you know, I'm a huge fan of body composition, dexascanning. I'm bringing a service like that to Dubai when I open my clinic in a few months time and I want to be able to have women be able to track it because weight doesn't track it no one does calibers correctly so we'll forget about that impedance, bioimpedance is because it doesn't give you any information you need a gold standard which is the body composition dexascanning which will also tell you your bone density but that will tell you factually what your body composition is your fat and your muscle and if you don't know what that is and you don't monitor the change you'll never know whether you're actually gaining muscle right so that's the only way to really know and i think without knowing that you you just give up because your weight perhaps will stay the same you know or it'll go up and then you're like why why is it going up i'm doing everything right and this is the most common thing i hear i'm doing everything right i don't understand i'm doing everything right yet my weight's not going down or i don't feel like things are changing or whatever but if you can somehow monitor that in a way that is actually factual right and that's the only way to do that was with a body composition dexaminer, then women will be more likely to get to that end goal. What is your take on injectable peptides? Oh, for body composition? For body composition, like epamorlin, tessamorlin, CGC, all this kind of secretes natural growth hormone, helps you have more muscle mass. I have no answer to that question. Okay. No, I'm just wondering. I know people do it. I just, I've never thought about doing it myself. Yeah. No, I've seen people have amazing results from it. So I'm wondering like in the bodybuilding world yet, have peptides made an entry point? Probably, but I'm not big on injectable supplements. So I don't really follow, like, I don't know. I don't know actually. I'll ask, I have to ask my trainer. In terms of like food wise, right? What could you eat to get more lean and have lean muscle mass, especially as a woman in their forties and fifties where it's harder naturally to just gain muscle mass? Yeah. So, I mean, obviously everyone's protein, protein, protein. I think that's very obvious. Like you need to eat more protein. It's, but it's the day to day. How are you going to achieve that? Um, while having your busy life and not wanting to eat, just chew chicken all day. So, um, and that's, yeah, that's. I cannot eat the same thing every day. Yeah, I know. I would be deeply bored. Some people can't do that. Definitely. I mean, I, I have no issue with that, but some people can't do that. So what I always just say is like with, with my patients who come and say to me, I'm really struggling to get my protein. And I'm like, well, just have one good protein shake a day and that'll probably get you halfway there or more. and then you have to worry about it so much. So I'm a big fan of whey protein shakes. I drink like one or two myself a day. I don't think there's anything wrong with that. And it's an easy way for me to make sure I'm all, because I have a huge, my protein target's 212 grams a day. How do you get that in? Everyone's like, exactly. How the hell do you do that? Walk us through your daily, what do you eat in a day, Natalia? What do I eat in a day? Yeah. Well, I have like, because I also have 179 grams of carbs right now. So I do like, everything's pre-measured though in my life. like everything i buy everything in sachets okay my the environmental impact yes um so i have like the pre-done like oats and i mix them with my own milk um i usually have two protein shakes a day and mine have like 50 grams so i do like um whey protein greek yogurt and all measured um and then that's i have two of those that's 100 grams yeah and then i have my i order my meals ready made with like a chicken type pasta thing or whatever beef whatever i feel like having and each of those has about 45 grams in there. Okay. And then I usually have like an extra Greek yogurt. So then that ends up being my 212. Yeah. It's hard. It's hard. It has to be really well planned. Do you like cottage cheese? I do, but I don't eat a lot of it. Yeah. What is better? I have to look into this. I should know this being in the health and wellness space, but what has higher grams of protein? Is it cottage cheese or Greek yogurt? I think it's Greek yogurt per calorie. Per calorie. Yeah. Because I look at calories. Obviously I have a calorie limit as well. So I look at calories. And so I have to fit the 212 grams into my... 1,998 calories. Right. And that becomes, that's where the problem starts. That's part of it. Yeah. So then the protein shakes are a really easy way to max out the protein with the calories staying low. And most women have that issue as well. They want to get it within the calories. So I'm like, just hit the protein shake. And just, you know what? That's so funny you're saying that because so I want to start my day with protein. Yeah. And some days I'm just, most of the time I'm just tired. I just want to get on with it. So every morning when I start my day, I have a protein shake with about 35 grams of protein powder in it, two raw eggs. Oh, ugh. So you're getting like, yeah, 40 something. Yeah. 40, 50 grams. And then sometimes I put Greek yogurt or cottage cheese or whatever in there and then just blueberries, whatever it is. And then creatine and all that stuff. Creatine stuff, yeah. So I'm trying to get all my protein bulked up right in the beginning, which is technically when you get into your forties, which is where I am because insulin sensitivity and stuff, it's better to start your day with a high protein load right at the front and then taper it in. Yeah. And so that's what I'm trying to do. I think the easiest thing for me was start with protein. Start with a protein shake. Start with the protein. Because sometimes I don't want to eat an omelet first thing in the morning. No, or ever. Yeah. You front load it, and I usually have a protein shake before I go to bed. But that's, for me, that's because I'm overnights when you build, you know. So I do that as well. So I usually have one in the morning, one in the evening. How, like, how much, how many hours before you go to bed do you have it? So I go to bed really early, like between, like, usually before 8.30. Okay, amazing. I know. Because your human birth hormone is being secreted just fine. It's just fine. So I also get up really early, so I don't have children or anything. So for me, I can go to bed like 8, 15. No one cares. So I have it like 7, 37. It depends. That close to before you go to sleep? Yeah, because I don't have a huge window between coming home from work and then sleeping. Right. So I kind of squeeze it in there. Why do you go to bed so early? Oh, because sleep is like so the most important thing in my life. Yeah. It sounds insane. Well, it should be in most people's lives. Yeah, it should be more important for most people. So without eight hours sleep at night, I'm like, I'm not functioning. So I just, and I get up really early. So I get up at five or five. Yeah. Cause I'm better in the morning. I function better in the morning. So I just go to bed early and I just get up early. Is there any longevity or anti-aging hacks that excite you most when it comes to skin or overall wellness? I mean, it's not a hack, but for, I mean, I guess this is a personal thing too. It's like having the, having body composition monitoring, that's not a hack, but getting people to understand that and utilizing that in a way to help them reach their goals and their targets and having actual knowledge and information that's not a hack. But like for me, because I'm used to getting them in the UK and I haven't been able to get them in Dubai since I've been here, I basically bought my machine for myself pretty much. Okay. If I could put my living room, I would. So I'll be getting my own body composition test every like eight weeks, which is for me, it's gonna be a huge game changer to be able to have it so accessible for myself. Absolutely. And I feel like that's why I did it for me. But if other people can benefit, bonus. Yeah, exactly. But I think for me, that's just giving people that, because when you have that information, it sounds so lame, but that gives you like so much power. Like information is, you know, knowledge is power and all that stuff. But if you understand so much about your own body conversation and then you can see it changing through what you're doing, that's empowering. Yeah, you know you're on the right track. You know you're on the right track. Everybody wants to see results, right? We're also living in a place of, in a time and a place that instant gratification is a thing. So if you can track it and measure and be like, okay, these last two weeks or last month, I increased my training by another day. I increased my protein intake. I add in this new supplement or I added in this additional protein shake and you see the result. Then your brain automatically goes, okay, we want to do more of this because this felt good. Yeah, exactly. And that's what I think the most, I mean, it's a huge motivator. And then because these scans give you so much information. They're not expensive. They're easy to do. They're safe. You can do one every minimum eight weeks. and like that every eight weeks if you get that feedback to say yeah that protein shake you added or that extra day of working out that's actually increased your muscle mass by you know uh one kilogram i mean one kilogram is a massive amount of muscle yeah especially especially for women and if it's a you also see okay my my body fat's actually also gone down in my arms by because that's how specific it is by 0.25 of a kilogram or whatever it is i mean we can because i'll be able to show you where your muscle is gained which arm it went into whether it was your abs or your arms and where the fat went as well. So it's compartmentalized on the scan. So it's like that, for me, that information has always been really important over the past 10 years. But I mean, if you had that information, you're like, oh my God, the change I made, or the other way, the change I made where I wasn't sleeping so much this month or these past eight weeks and now I've gained two kilograms of body fat and lost muscle. And it's like, okay, hold on. It'll keep you accountable. Information keeps you accountable. So for me, that's really exciting to be able to offer that to people here. But it's not really a hack. But yeah, that's my, it's kind of a hack. It is a hack. I think it's totally a hack because if you know more and you can make educated decisions based on real data and research on yourself, then you know you're on the right track. So it is hacking yourself. It's hacking. It's a hack. I was going to ask you, in a world overwhelmed by beauty standards, marketing hype and quick fix promises, what is one uncomfortable truth about skincare health or wellness or body transformation that you wish everyone would face and know about? And how has embracing the truth changed your own life? I think it has to do with like, um, the simple stuff, the simple stuff works. I think that's, we don't want to, we want, I mean, this all goes against the hacking concept, but the simple stuff done consistently is what's going to get you there. So there isn't always going to be a quick answer to your skin problem or your body composition problem or you're, I don't know, you're not sleeping well, you're going to have to work at it. And there's no, there's not always going to be a simple solution or there generally isn't. So like you said, we all want the quick fixes and we want the immediate gratification. Most things worth having in life don't happen like that. It happened overnight. And it only gets harder with age. And I hate to be busting everyone's balls on this show and being like, it gets harder with age, but it does. It gets harder with age. Because the hormone makeup and your body composition that you have in your 20s, that's why they say it's start healthy habits sooner, eat better sooner, start lifting and building muscle mass sooner. So when you get older, it's easier to sustain and maintain that. Yeah. But it's never too late. No, absolutely. It's like you, you, you started. Yeah, I started late. Yeah. And looking, yeah, hardly. And look how amazing you look. Oh, thank you. But some of the top bodybuilders in the world are in their forties and fifties. So, cause learn muscle, muscle density and gaining that size and stuff that takes years. Like it's years and years of work. So, um, you know, I'm in a sport where at least I'm not like a ballerina or a gymnast. You know, I'm in a sport where, you know, I can, I can, like a fine wine. Correct. Get better with age. And you are only getting better with age. I have loved interviewing you. I thought you had such a fascinating background and just your no bullshit, straight to the point approach to skincare, which now I need my own retinol cream. I need to stop stealing from my cousin. Yeah, no problem. You stop stealing from your cousin. Yeah, exactly. She didn't even know I went missing. My cousin's the nicest put in my bag. She's like, where's my cream gone? Yeah. She got back to the vine. She's like, did you take my cream? I was like yeah we were sharing it when we were staying together it was so great sharing is caring yeah sharing is caring so I was like I need to go see Natalia and get my own batch done yeah I'll get you your cream but thank you so much for coming on educating my audience because there's all these hypes right there's products that are being sold to you on Instagram there are creams that are being sold to you on Instagram it's like what is real and what is bullshit so thank you for coming into Biohack It and you know letting my audience get to know you thank you so much for having me thank you I'm