ramble [Music] welcome to best friends back all right the show where two high school best friends try the best friend thing again i’m nakin ho mai fad and i’m stevie when levine and this week we are talking about the body’s glove oh the skin the skin [Laughter] the skin the body here love yeah god given glove oh now we’re bringing and here to talk to us about this in a very educated way is one of my dearest friends dr jenna lester who i also call dr lester in all of our social interactions hey what’s up thanks for having me welcome to the show i’m really excited to discuss the bodies glove with you today can i brag a little bit about jenna yeah please just so like just so you guys know that you really should be listening she’s a total expert so a little bit about jenna’s background she is a graduate of harvard that’s where we met and she also went to the warren alpert medical school at brown university and she completed her dermatology residency at ucsf where she now lives and works as a faculty member and is the founding director of the skin of color program that’s my girl i am very proud of you for that you’re in your like early 30s and you’ve founded a program a skin of color program which doesn’t exist in many places right jenna not in many but there are a few there are a few the first the first one that i know was that was founded by i don’t i don’t actually want to know about the first one not yet okay this is going well all right i just need a few few more little bits that i just i’m obsessed about with you before we before we get into the the the deep deep stuff but with the skin of color program her groundbreaking her groundbreaking work there i’m really botching this introduction i’m sorry no you’re not i’m like okay jenna’s groundbreaking earth-shattering work at the skin of color program has been discussed nationally in the new york times npr best friend’s back all right yeah and she was named a ted fellow in 2021 damn what damn you can actually say things like welcome to my ted talk and that’s like actually i didn’t want to hear about the ted talk yet uh if we could say the ted talk part later that would be great thanks jed is one of the smartest people i know and i love and trust her so much that i even let her practice injecting me with botox during her residency how’d it go do you see my forehead moving well i i that was a long time ago so i don’t know what the result was it was great it was great very natural people didn’t notice anything crazy so that was i got what i wanted did you get what you wanted jenna practice and i didn’t like make any of the you know errors that we fear with botox like accidentally injecting it into someone’s lid and then their lid hangs blow for like three months i have no low hanging lids um that’s great that’s great yes you know i wanted to kick off with something that i i’ve posed a theory about uh well about body gloves um in the past 24 hours in preparation for this record that i wanted to just throw out there and i’m sure like scientifically and medically it’s it’s pretty sound but as i get older one of the things that i find very difficult to do is put on body lotion just like after a shower you put on body lotion and i think it is a straight girl thing i think putting on body lotion is what straight women like to do is it like your bones hurt like it’s hard to bend down to put it on my gay gay bones that are preventing me from putting on body lotion so wait like if the actual task is challenging or hard to remember to do it um all of the above so basically what i’m asking you is is twofold i mean i know you should put body lotion on your body especially as you get older your skin might get drier you might get you might get uh crackly but you know my theory is that straight women are are doing this body lotion application more than gay women fact um i would have to see the data on that i’ve never i haven’t seen any studies that have looked at this specifically so i can’t make that comment um that was just a test that was just the test i don’t think there’s anything different about your bones as compared to someone else with your same life experiences same age etc but some people find it challenging to put moisturizer on i think several things you said are correct wow now who’s complimenting who over the years your skin loses its ability to hold on to water and that um is something you have to compensate for by moisturizing yeah sometimes people use heavy creams to moisturize and those are like more viscous or more thick so they are like harder to spread around so if that’s something you were doing i would say maybe try a lotion instead but um your the answer to your original question is we would have to study that yeah well i and i’m i’m gonna i think i’m gonna order one of those studies right up because i do think that people want to know do gay women put on as much as straight women but yeah lots of people do ask that question but i’ve seen it yeah we got some questions from uh our friends our listeners today to take buy you but like i do think generally as i would assume a lot of them are kind of in that self-care type of category what you should be doing for yourself and your body glove on a daily basis and before we get into those questions i did want to ask if there’s one thing that you would recommend that everyone does for their skin on a daily basis what would that one thing be if you can’t bring yourself to do more than one thing which some of us can’t i would say sunscreen and i would say that for several reasons so regardless of skin tone sunscreen plays a role if your skin is lighter it helps prevent skin cancer in addition it helps prevent wrinkles and helps prevent sun spots all of these things that like when you’re in your teens and early 20s you’re likely not thinking about because the the chances are that you’re manifesting these things that you see these things on your skin at that point are a little bit lower so but it’s really helpful in preventing those and any other visible signs of aging because a lot of those come from the sun and as your skin gets dark your skin tone gets darker it doesn’t help prevent against skin cancer because in people with darker skin tones we think skin cancers are often not caused by uv radiation or the light that comes from the sun that’s so damaging not this isn’t 100 true but the data suggests that that is at least partially true what are you laughing at what do you mean it’s not 100 true like this is kind of fake information no it’s not 100 true in everyone like and everyone okay there’s no way you can make an absolute statement for like an entire population of people who respond to like data and statistics and studies which make which makes sort of likely hood statements but not like absolute this is definitely not going to happen to you or definitely is going to happen to you those sun spots that’s the sun damage right that you called out on my face that’s sun damage they’re not cute freckles yeah i thought they were freckles and the funny thing i did i developed these later in life but i remember when i was eight or nine years old my family was visiting our family in iran and i was sharing pictures of my classroom or my like elementary school friends with my cousins and i remember them like pointing at one of the blonde girls and being like why is her face so dirty and she had freckles and it was just not something that they had ever seen before and that was wild to me then and i mean of course i looked around i was like oh yeah nobody here has freckles everyone has like gorgeous olive skin and you were like i want some of those yeah but it turns out you can is it like climate dependent that somebody in one country who doesn’t get freckles can get them if they move to another place like why why do i have freck sun damage i guess it’s not climate dependent in the sense of like temperature like sun exposure causes lentigines which is the plural version of the word lentigo which is a sunspot which can look very similar to freckles um on the face and freckles are something that you are born with likely born with yeah oh my god there are babies with freckles usually not babies but usually around like like toddler years you start to see them they develop yeah fascinating one more question about the sunscreen so in terms of like because i’m trying to like get information out of this podcast for myself is what i’m saying 100 percent yes uh like spv you know is there any yeah is there any rhyme or reason to like spf spv is that what hpv can we switch over to sp svu what what is the um like recommended level um at least spf 30 uh because after at lower than spf 30 so like some moisturizers have like 15 or makeup has 15 in it you get a drop off in the amount of protection that you get and as it is that number is generated in a lab in perfect settings where the perfectly right amount is used and most people don’t use enough sunscreen to achieve that spf level so if you’re going for at least a 30 then the sort of diminishing effect you would have from not putting enough of it on is a little bit less than if you’re starting at a 15. got it but higher actually is better there are some studies that show that higher spf sunscreen helps prevent burns better which burns are risk factors for skin cancer and these like sun spots we’re talking about so i would say if you could go up higher than that you should and there are lots of great moisturizers that have high spf levels in them so i think it’s doable with pretty much a negligible cosmetic difference but there’s not like a high spf uh offering that you’re like it’s not doing anything after a certain number like okay 60 is like the max and if you go above 60 then it’s basically like doing the same thing yeah i think there some people do think there’s a cut off number and i usually don’t i don’t have like a specific one in mind just because of these more recent studies that show higher spf prevent prevent burns but it probably like levels off after a little bit though the higher still seems to be better so i don’t know if like there’s a huge difference between like a 70 and a 100 but i think if you can go a little bit higher you probably should especially if you have fairer skin okay now what about spvs um i’m not sure i think those should be included in your other study you should start a lab before you just have these in your others clinical studies asking interesting questions hard charging questions yes i wanted to google what spv is and it’s absolutely nothing it’s it’s special purpose vehicle by the way it’s uh so we’ll talk about that next time jenna you you think you’ve won you wanted to be a doctor like since you were very young right there was a brief moment where i wanted to be a supreme court judge what yeah we would actually love for you to see that can you switch a book on it in fifth grade about a black judge wow i wrote a book in the fifth grade about uh dorito living inside of my stomach so i think we were on the same page both destined for great things yeah so then so then how why dermatology how did you switch tracks so dramatically well i originally wanted to be an ob gyn and we had that in common didn’t you also want to be an ob gyn at some point i did not um anyways um so i i was interested in like um healthcare access and care for like you know people who become pregnant and children early on in life because i thought that that was like a place where you could impact make a big impact and i started thinking outside of that paradigm um on my med school interviews and i was really resistant to any other suggestion um early on but then my dad was like you know my dermatologist seems to really like her job i really like my dermatologist you should consider this and this was like he’s like i’m thinking about leaving my dermatologist i need a new one well he keeps saying my dermatologist has a job for you did she call you i’m like no i’m not moving back but he made this suggestion i was like home on a break and i had like a snooty answer like i’m never gonna do that like how could i just treat acne and do botox for the rest of my life and here you are and but i i think what i realized is my um desire to care for all people to increase access to care for all people was something that could be addressed from many angles not just from primary care which is kind of how i thought um and i was particularly focused on patients who are underserved or had low resource or you know most impacted by policies that were not fair so i wanted to think of how i could help them and it turns out all people need specialty care and dermatology is a lot of acne which is important to treat because it’s a so it has so many like um psychosocial comorbidities so other other ways that it impacts someone’s life besides just what’s going on on their skin so i don’t make light of that but that’s literally how i thought when i was in med school so yeah and it’s actually one of the questions that our listeners sent in so mary cullen she’s 17. she asked do you thoroughly enjoy stuff like pimple popping now because of doing this stuff so what’s your answer to miss mary collins i like that question and i think i think it comes from this um you know there’s that tv show that everyone now there’s a dermatologist that like explodes cysts and stuff dr pimple popper we’ve had her on good mythical morning yeah you will not believe we did two segments with her one involved watching videos of of different sisters etc which i could not do the other was a game that involved we had a um special effects makeup artist do pimples on retin-link’s faces but filled them with edible things oh so it was a game that involved popping and eating the pimples and it was like wasabi and like all kinds of gross [ ] i’m curious now jenna if you pop a pimple do you know what the flavor of the thing that comes out is it like salty i would think it’s salty um right i’ve never tasted it why do you ask you ask your sister if she smells vaginas and you ask jenna if she tastes pimples and then you try and disguise it aka me wanna know well sometimes you accidental like even pre-covered now we won’t mask clinic but like before that if you were doing a procedure you would put a mask on to prevent a splash which sometimes happens and if things splash i’ve never i still have never tasted it well some you have you have something to look forward to yeah i’ll let you know or this is this could be another experiment for the lab here you go there you go all right there’s a question in here from someone identifying as a female and she says she’s hispanic latino and white so we asked people’s ethnicities or race because that can sometimes provide helpful context for skin care questions so the question was is it normal to get large under the skin cyst like pimples on your inner thighs how do you make them go away so um that’s a great question and this is something i see a lot and while i can’t provide medical advice in this context without actually examining someone and getting their full history and hearing like how often this sort of thing happened what it actually reminds me of is there’s a condition called hedratanitis separativa which is a really long word that i actually the one dr pimple popper episode that i’ve seen she was poppin cysts in removing fatty tumors but also saw um a person who had this condition in this condition um you you can get these big sort of like pimples or cysts or boils a lot of people call them different things in the groin area sometimes under the arms and it’s cons it’s something that sometimes can run in families but because people feel so embarrassed by them and don’t talk about them it’s something that you know you don’t know your sister your aunt or your mom had it um and so i would encourage this person to see um their primary care doctor or dermatologist that they can because if that’s something they have there’s lots of treatments for it and it’s different it’s truly different from acne sometimes people also have acne but the treatments that you would do are much different that makes me think of this question i’ve had which is when do you see a dermatologist versus an esthetician or like you said a primary care doctor like all things face or skin care don’t necessarily require a dermatologist right yeah that’s true um different estheticians and different dermatologists have different areas of comfort there certainly are like licensing things by state that differ in terms of what an esthetician can do and like procedurally but i think there are some dermatologists who really are um focused on skin care and know a lot about products and consider that part of their expertise the main thing is um you know prescribing of medications is something that a physician or someone of the same sort of like level advanced practice practitioner like nurse practitioner or something like that would do but i would say in general if you’re concerned about skin cancer and worried about like moles or something like that that’s definitely something to go to a dermatologist too you also can ask questions about products etc and whether or not you get the answers you’re looking for i think depends on the comfort level of that particular dermatologist estheticians do great work like facials and um are sort of more hands-on about that sort of thing like product questions so i feel like these days like skin care regimens have become like a hobby but yeah like being having a moment it’s having a moment and does does that result in a lot of people coming to your practice with questions about that or how much of it is just like [ ] like how much do you like go on tick-tock and like you’re listening to people and then you’re like that’s so that’s wrong unnecessary yeah the one thing that like one on tick-tock i’ll run into just like very beautiful young women with nice skin going this is what i do and i’m like i’m so tempted to do what you do but then sometimes also it’ll be like doctor so and so and they’re like i recommend xyz and you’re like okay well that’s a completely different thing than the last tick tock that i saw and it just seems like everyone has this like okay well i recommend exfoliating retinol and then this and this and it just seems like yeah what is what is actually real and what’s not and i guess partially i i hearken back to what you said earlier which is like everyone’s not the same so i would assume that you know a lot of things work for some people that don’t work for others but like i guess twofold one do you get pissed because you’re like this is [ ] and why are people following it and then also like what is the most basic level like facial skin care routine that you recommend yeah that’s a really excellent question and i think a lot of people are just so confused about this topic because there’s so much out there that might be well-intentioned but it’s just like confusing because of the sheer volume and there actually was a study done looking at like youtube content around acne and a lot of it is like incorrect we now have these platforms where people kind of have an equal voice to those who are have studied this and they can say whatever and then on top of it you add in like people are getting sponsorships and aren’t always really clear about that so i think there is a lot of it that’s not real i don’t think you need a 12-step regimen anything that puts me puts an hour between me and my bedtime like my bed like crashing into my bed once i realize i’m tired and should go to bed it’s just a no-go for me so um but i also think all the things that are involved in those multi-step regimens are sometimes a little bit redundant i think the perfect scaffolding to a good skin care plan which of course you can like riff on in other ways and add and subtract from is like a good gentle skin cleanser you don’t need something that strips your whole like natural oil away just like you know cleans your skin well a good moisturizer a good sunscreen and then you can add a retinoid or retinol to that which helps with skin cell turnover and helps prevent wrinkles long term for people who get superficial fine wrinkles for photo eight from photo aging from the sun and those tend to be people with lighter skin so you know people add toners on top of that or like serums of this or that type and i try to remind my patients that your skin has like a micro environment like if we were to get a magic school bus um hell yeah let’s throw it back always i’ve had bastion boys stuck in my head all day today but if we get on the magic school bus and are like driving around on the surface of the skin you see common bacteria that are supposed to be there yeast that are supposed to be there even clutch your pearls like mites and things that are supposed to be there and i think of like the trunk of a tree with moss growing on it like you know it’s a symbiotic relationship so the more you use different things the more you change that micro environment and you it actually can lead to inflammation and things like that so i think that simple is better and there is such thing as acne cosmetica which is acne that is resulting from using a ton of products and one of the first things i do in that situation is get people to simplify and even though they look at me like i have 12 heads many times they come back and things are better from doing less and then you only have four heads uh did you know that lily tomlin was the voice of miss frizzle no really right yes and i asked you is she using body lotion as much as a straight woman would it all comes back around guys it all comes back around do you remember the uh for me the original like multi-step acne routine was proactive yeah yeah do you remember those infomercials that they that they had when we were growing up they had like celebrities on there vanessa williams yeah p diddy bieber everyone um they had like uh uh like one tree hill stars i think like they had some like they had everyone yeah and they look good they look good i actually think proactive works it works you say well it has the ingredient it has the right ingredients that i would recommend for acne anyway so i actually do think it can be quite effective well for 19.95 plus shipping and handling it could be oh i thought you made this a year and i was like yeah approximately 19.95 [Music] this person is from our generation her name is sam she’s 35 and she says i eat really healthily take supplements i’m active i take care of my skin and my skin still is constantly breaking out like i’m 14. i also have unexplained infertility could the breakouts be hormone-related or do some people just have bad skin they certainly could be i think all acne is hormone related and the if i could get nerdy for a second is that okay yeah um yeah testosterone whisperer just whisper it though it’s asmr [Laughter] testosterone is a hormone that all people have um it’s responsible for what we typically think of as like masculinization of different features or like hair growth in some in certain areas of the body but also when it binds to the follicle um like that’s kind of like the pore essentially it triggers oil to be secreted and oil secretion is one of the um things that causes acne so but in essence all acne is hormone related i think what this person is asking is could there be like an imbalance in my hormones that are making this worse and i think certainly if you have unexplained fertility especially within that context something that i think about is um polycystic ovarian syndrome which is you know something that um your sister could talk about a little bit in more depth than i could but it’s it’s one area where ob gyn and derm overlap and people tend to have a lot more acne um you know hair growth like on the chin and on the neck area which is typical and people who sex assigned at birth is female and then you also have cysts on your ovaries and so um that could be a way to connect those two conditions so i would say i would um urge that person to seek further workup um i do think that there is a genetic basis to some of this too but treatment of that condition can be helpful for the acne if that is what’s causing it yeah i did not know we were going to get into the single chin hair uh but let me tell you i it’s real it is real there’s always one single chin here for all you young listeners out there at a certain point keep those always handy yeah always one there’s always there’s one and i don’t remove these things immediately right it’s like you kind of you get you find yourself just touching it and touching it yeah because the texture is different it’s really battery yeah right all right well there’s another pregnancy related question that’s uh this person haley writes has pregnancy slash postpartum made my skin more sensitive i think that’s certainly possible so one thing i mean your skin is a the largest immune organ in the body as well so the immune system which is responsible for fighting off like viruses bacteria a lot of the things that happen on the skin are inflammation which is your immune system like you know responding to something and that can sometimes change a little bit with different you know hormonal changes so i think it’s certainly possible but what i often tell people is like we don’t always have neat and tidy explanations for things human bodies don’t read the textbook so if it’s true for you that like after your pregnancy your skin was more sensitive then it was true then it’s true for you and we should focus on like how to treat it i think it makes sense that we’re in search of answers but sometimes we don’t have like a neat way of explaining it just like we can’t necessarily explain why you have that one chin here you kind of you like kind of pointed at me a little bit when you stop when you said that and i’m noting that i’m noting that yeah all right this next question was really interesting for me this is a 35 another 30 some year old female asian asian pacific islander and she says uh one treatment i see for strawberry legs which is something i had to look up but these are legs that just think of what a strawberry looks like with like the seeds and it’s like that all over the all of the um is there like a red part involved as well the seed part is like the dark part i’ll let jenna explain it but i’ll finish i’ll finish the question so she can explain it should i google it i think it’s helpful to yeah once you see it you’ll see it you’ll get it all right because that’s what happened for me so one treatment i see for strawberry legs is using a salicylic acid body wash but i’ve used one for years and nothing has ever changed is there actually an effective way to get rid of strawberry legs or is that just a beauty myth i should stop falling for the medical word for it is keratosis pilaris which is um it’s a genetic thing um so it’s something that is like like certain people make and and often times it runs in families but it has to start somewhere so i often will see people like well no one else in my family has this and um i’m like maybe you’re the first one yeah so so it’s you which no one ever wants to hear that in this particular context but um but you want to exfoliate which is what salicylic acid is can can do that but it’s something that unless you’re constantly treating it um it doesn’t go away there are other ways to do that like lactic acid containing lotions i think lotions probably work a little bit better because with a body wash you’re just washing it away the medicine doesn’t necessarily have enough time to be in contact with your skin to do what it’s supposed to do but the moral of the story is um you know it’s something that you constantly have to treat one of my colleagues says the keratosis pilaris brigade is not coming oh that’s so sad yeah it is but it’s like a way to just be um just let people know but there are ways to like you doctors are so cool [Laughter] i don’t say that but um you have like a wedding coming up yeah i guess i just did say that in a larger context honestly you said it to a larger audience than you’re a colleague doctor ever has so it’s just to say that it’s a it’s a not harmful thing it doesn’t mean it’s not bothersome but me what i would suggest is like concentrating treatment around times when the when your legs are exposed or some people get it on their arms and their arms are exposed like the back of the arms yeah if like spring or summer is coming like folk and you live in an area that gets warm then like focus on treating then and then maybe taking like winters off so you’re not worrying about it as much i also like to talk about radical self-acceptance in these contexts too serious i’m really curious about this because i want to know how much of your job is is helping people build confidence and just ex like you said acceptance of whatever they have i talk a lot about um self-acceptance and we talk a lot about um chronic conditions in dermatology and i think maybe my colleague who makes this joke is like trying to get a laugh and then we sort of delve further into what does it mean to have a condition that we don’t have a cure for um and when you’re dealing with people with skin conditions who are experiencing this so publicly it’s not an easy thing all the time like i have patients with hair loss that are coming to terms with this but also dealing with public responses to their condition so but there’s a there’s a movement that i’ve seen online about people who don’t want to treat their acne at all and just sort of like live in the skin that they have and um and that’s empowering to them and i think you know with keratosis pillars we talk about how to manage it but that it’s not going to go away and what does that mean yeah we we dealt that a lot and i and i often you know i think all adults should have therapists but that that is sort of where i feel like i’m out of my league a little bit because i do think that there are therapists um licensed mental health professionals who deal with this specifically like how to live a life with a chronic medical condition and that can range in any you know area of severity so um so i usually direct people on that i was going to ask when we had dr nazan we were kind of poking holes a little bit in i guess the the industry that she works in and like how it you know there’s it needs to evolve in a lot of ways and um i have the same question for you like there’s obviously a lot of ways that i think in all medical fields we need to evolve in terms of you know the how patients are dealt with or like what other you know lanes kind of overlap in the same way that you just mentioned um you know psychologically how that has so much to do with what you do i mean obviously a lot of what you do is trying to push the bounds of of your industry but can you talk a little bit about that like what what is lacking kind of on a widespread level and and what change are you pushing to see thank you for that question i this is like what i think about this is what i notice all day um and and this is kind of what um i noticed one day when in residency and that got me in this area of interest within dermatology to begin with um and that is like as a black woman sitting in lectures i usually only saw my skin tone when we were talking about sexually transmitted infections so i’m and it’s and it’s very stigmatizing and i’m like is this my imagination it’s something i’ve noticed since med school and once delving into it more it’s something that other black dermatologists had brought up in the past and we i actually did an analysis of some of our common textbooks and literally counted photos and categorized what skin tones were appearing with what disease processes and it’s actually true that overall we we almost never see dark skin and so it’s hard to learn how to diagnose certain diseases that could appear different in different skin tones and sort of exude that confidence when you’re in front of a patient um and many dr 47 percent of dermatology residents in one surveyed once they were graduating did not feel comfortable caring for patients with with dark skin which is like a huge problem that’s a huge part part of your future patient population but to notice also that certain skin tones were over represented when you’re talking about sexually transmitted infections and how that stigmatizes people and how that limits what conditions you’re considering when someone comes in and you don’t really know what they have that was disturbing to me and so i one of the first things that i did when i was on faculty was talking about changing our educational materials and how we need broader representation of all skin tones so that learners know what things look like in their skin tones and i think what trickles down from there is that people searching on google or you know whatever search engine they use to say like googling you know bumps on arms or strawberry legs like something that looks like themselves because that is really important and surprisingly or maybe not surprisingly i got a lot of pushback when i tried to publish that article and i ended up publishing it in a journal outside of the us because i was told this is not a problem this is something that is up to individuals to solve like why are you talking about this you should be careful trying to publish i saved that email that i got from someone you should be careful trying to publish on these topics wow so i got a lot of pushback and whenever i get responses like that i’m like i’m on to something yeah let me push push harder like whenever someone is like triggered i’m like you know this means i’m onto something so yeah and you know talking to my mentors this is this is a sort of a cyclical problem that had been brought up before um and i’m hoping now this time that we are developing some sustainable solutions there have been curriculums developed that are that are focused on broad representation of skin tones and this is an issue that is being discussed i think in a more sustained way than it had been in the past so let’s see what happens um i think that’s one major thing that needs to change about durham though yeah what about getting you know getting people who have historically not had you know accurate experiences or helpful experiences when they’ve gone to a dermatologist people with darker skin tones you have this history of you know it’s not working so how do you have people like that to come visit doctors like you who are newly trained to recognize skin conditions that’s one of the main reasons why i think it’s important to have a program called the skin of color program a lot of people also ask me like why are you starting that why do we need that why do we want care that’s different from for for you know black and brown people and there actually is research to support that um you know small study but i think one that lays some convincing groundwork that certain patients who have been excluded from medical care like an explicit sign that they’re being welcomed into this particular into a particular space right okay there are community clinics of all types you know clinics for trans people clinics for people who are hiv positive clinic like this this maybe not everywhere but these are clinics we have all at ucsf so these people who tend to get poorer health outcomes i think lose faith in the medical system and i i think that’s totally justified and so when they see a space that centers their concerns just based on off the name i think they take some comfort in that and that’s been my experience well you come from a long line of medical professionals stevie one thing i failed to mention to you was that jenna grew up in syracuse oh it’s real cold stevie went to syracuse oh no it’s okay you didn’t have to know that yeah it’s it’s like ringing a bell because i think nikki had told me about that sometime oh it was so cold i could not wait to move out to los angeles where it’s just the opposite opposite weather well if you had stayed if you had stayed in syracuse you may have come across jenna’s mother who is a doctor and the chair of the department of geriatrics [Laughter] and i don’t think that timeline would work out actually yeah but jenna’s grandmother was also a medical professional she was one of syracuse’s first black nurse practitioners one of new york state’s first black new york states jeez okay so even be impressive or maybe like she she used to argue with one of her friends whether she was the first her friend was the first i love it impressive and yet still petty [Laughter] but you were you were practically born a doctor yet you were told by your pre-med advisor that you weren’t going to get into medical school and i’ve seen you post about this topic before and i wanted you to talk to us a little bit about the kind of racism and gatekeeping that exists not only for for patients but for people of color who are trying to come and go into the field of dermatology and what that looks like yeah well i think it’s medicine in general my mom was also told the same thing by her pre-med advisor and this recently came up because i was talking to a colleague who was also a dermatologist and he was told by the same pre-med advisor as i was told i wasn’t going to get in med school that he wasn’t getting into med school he went to an excellent med school and is doing really well and um so it’s it’s like why so what’s the deal is this like is this like an old white dude like is he gonna like retire or pass away soon it’s it’s a woman um who is a woman of color wow but this isn’t just this one woman this is how this this is happening across across the field of pre-med advisors yeah it’s really a weird thing that people feel like they need to be the one to tell someone no rather than rather than thinking of like how we can open gates and like see barriers as something to be overcome you you erect them yourself and i don’t know why that is i honestly don’t i would never want to be the one to tell someone you can’t do something i would want to think of all the ways that they could do the thing and like to be clear my i had tons of experience like i had really good grades i have no idea i got into tons of med schools most with scholarships so it’s weird yes you did it’s weird like that that was a thing that she thought of and it was and i feel quite fortunate that i had my mom who literally i think it was the second time i heard her swear where i told i came out of this meeting and i’m crying and i caught i’d call her and tell her this pre-med advisor said i’m not going to get in and my mom was like said all sorts of things what did she say exactly i want to know i don’t exactly remember but there was an f-bomb which oh it’s just like nails on the chalkboard when she said i will still tell her like you can’t swear it doesn’t just doesn’t work but um but i did it anyway and i think there are a lot of people who didn’t because they didn’t have that support and in moments where you’re feeling insecure you remember all the people who told you no yeah and you think about like sort of satisfying their wish that that it’s not going to work out and i had to have voices one of whom was my mom’s my dad my great aunt like all these people were like you could definitely do this and my mom when i graduated from intern year which is the year right after med school she’s like you need to email that pre-med advisor and tell her what you’re up to this is right before i was moving out to san francisco and i found her email in my box and along with the ones where she said yeah you’re not going to do that well i was like by the way i hope you replied look at me now replied to the email saying right the chain i didn’t have that level of petty in me and me at the time because i was after interneuron was so exhausted but like i replied and i was like you know i’m doing all these things and you should think about that the next time you make a move to discourage someone when you really have no basis of doing so that’s awesome so that is so freaking awesome did she reply it felt good she did and she it was a very like you know those like she was like i’m sorry you felt that way yeah that is the interpretation kind of apology it’s a non-apology it’s a non-apology wow so do you find yourself in the position are you like do you mentor a lot of a lot of med students i do and i um it’s one of the most rewarding things that i do it’s very it’s you know i’m pretty busy and have like a lot of things going on but mentorship is something i try to always make time for i knew you’re gonna get me for saying that and um and so but it really reminds me like how hard people are working to do the thing that i am doing and like it helps me remember like sort of where i came from but also i am trying to encourage more people who not even have a similar path to me but who i could see really improving our field and you know a lot of it is young women of color but you know men to anyone really who emails me i try to get back to and try to be a source of encouragement so i being in this position now it makes me even more it’s more puzzling to me like why someone would ever tell someone no it’s it’s not your job to make a decision for someone it’s your job to help them on that path and um you know help them make the decision that they come to themselves i would imagine i mean i know we briefly talked about this but i did think it was a really good point when you were talking about kind of the psychological aspect of dermatology and i would imagine that some old school doctors just don’t have that in their tool box and that it is very like you know cut and dry like this is this big medical word that i’m gonna say and then take this for it and there’s no acknowledgement of like okay psychologically this is what you might be going through um is that part of kind of the new curriculum or is that something that’s like you know being more talked about or recognized yeah 100 and i think the larger concept you’re referring to is bedside manner and like empathy like even if you have no idea what someone is going through if you’re an empathetic person you make space for them to tell you and you don’t just you know hand someone a prescription and walk out the door you try to give space for them to be a human um in that interaction in addition to understanding like what conditions might be affecting them and that’s not something that was always taught in medical school and i do think that there’s some part of that that comes from within and i think that’s why a lot of people there’s certain people are attracted to medicine but it’s certainly something that can be taught to people even if they don’t have that as part of their like toolbox when they walk in and that’s something that there is explicit curriculum for in medical school now and is not something that there has always been curriculum for so that’s awesome um and i also just think our generation and generations that are coming up after us just have like higher capacity for emotional intelligence and that is a really important part of this too it’s an intersection of a lot of things and i i if i were to ever open my own practice i think i would want like a therapist and a psychiatrist in my office too yes also can i suggest and i did i suggest this for dr nas um i i think lighting is very important uh for for the doctor’s office so jenna can you work on that i understand you need some you need some bright lighting when you’re looking at certain things but if you were to open your own practice i soft a soft warm yes lighting situation um and i i need to follow up with dr nas because i did offer to send some kind of lighting gels for her office she was um marginally offended when i i don’t i hate fluorescent lighting that’s like well let’s make a change here let’s make a change i think yes doctor wide we need to make a change sometimes use my cell phone flashlight is that bad i think that might be i think that’s probably you use your cell phone flashlight like with a patient it depends it depends on what’s because i don’t have a i don’t have a flashlight that i like keep in my pocket the battery died like something oh you know what you should get a headlamp you should get a head lamp i have colleagues who use a headlamp i think a headlamp is cool my head doesn’t fit into that’s so anything so i don’t think they make a headlamp this size as my mom frequently comments still about my head everyone listening is like holy [ ] how big is her head yeah she does not have a big head everyone she does she does not have a big head well it feels kind of large i mean it’s a little bit big it’s a little bit big okay gosh as a fellow big head person i’m a size large in all hats i’m a 5 2 girl with a size large hat okay so i understand anyway well jenna thank you so much for canceling a bunch of patient appointments to come onto this show trying to get me fired that’s not what happened yeah this is not happening during work hours it was great having you on the show thank you so much for joining us and we’ll get those lighting gels over to you asap okay okay thank you [Music] that was so fun that was great i just feel like i just feel like i always learn so much whenever i talk to jenna i genuinely i do find myself like getting sucked up into these tick tock like this is what makes me have good skin videos so like going back to the basics because that’s what i i had heard was that like the only proven thing for like wrinkle prevention or like you know making your wrinkles less wrinkly is retinol um but like everything else like reinforced i think what the medical community says versus like there’s this [ ] girlfriend there’s this girl who like her like pre-bed routine is it winds up making her look like she has like a forehead patch the eye patches oh right yeah i’ve seen this thing thing i like thinking like a thing that like holds her lips together so because like you’re not supposed to like breathe out of your mouth at night time for wrinkles like all this [ ] and i’m like well you look good but i’m also like but you’re 23. so did you see the one where you also have to like stuff your nostrils just so they don’t sag oh god i haven’t even started worrying about sagging nostrils i just made it up it’s not a thing it would kill you if you closed your mouth and stuffed your well if you did both you could alternate every other night um okay awkward moment of the week i was out for a friend’s birthday for lunch oh i love a good lunch party yes everyone loves lunch uh it was uh it was on the beach and not on the beach it was in santa monica and uh it was a nice restaurant and um me and and a friend or i would i should say like a friend of the birthday girl that i also know and an acquaintance we went to went to the bathroom together and i’m wearing like first of all i mean we haven’t we haven’t talked about like fashion in a hot minute but i am lost i am very lost i don’t know if it’s that i don’t have the will to try and like put an outfit together um but i’m going like really with the the basics lately but i’m wearing you know a high-waisted pair of levi’s and a tank top and actually my high-heeled boots it was a high heel boots lunch because i just you know i wanted to show out santa monica only have one pair of high heel boots but okay and so i went to the bathroom with uh this girl girl happens to be a straight girl and in the bathroom we’re leaving i mean we peed if you want to know what we did in the bathroom like one of us wasn’t you know taking a [ ] we encountered a woman in like the wash your hands counter area okay and um she’s wearing a black like spaghetti strap cropped number uh with some black jeans and then like like stilettos that have like um you know fake diamonds all over them yeah and she’s like oh my god can i stop you for a second and i’m like this is to you yeah i’m like there’s no way i can tell that she is a fan or knows who i am in any way just by what’s happening and she’s like i thought i didn’t know this restaurant was at the beach and i just i should have worn a dress and i just don’t know what you think about my outfit and i’m like [ ] i am gay like do you not under do you not see on me that i am are you are did you want a gay woman opinion to the situation that’s happening it’s so awkward to me to have that type of interaction with a woman i just like logan’s nodding logan i understand how weird that is because is it because it’s like a you don’t want to i just think it’s so it’s a little truthfully i think it’s a little artificial and and it’s a total straight girl thing the like whole like oh there’s a stranger in the bathroom and i’m gonna talk to them about like you know my outfit or whatever is going on i’m like i’m here to do one thing and anyway so my friend that i’m with goes into the straight girl thing like because i’m like deer in headlights at this this point and she’s did you have an opinion i mean not for her like if that’s her vibe i wasn’t thinking yeah you should have worn a dress like i don’t care like you know whatever live your life i wasn’t you know like i’m not gonna judge what she’s wearing um and of course my friend is like girl you look great you are right i’m like okay thank god just do it yeah and um she and then my friend’s like do you feel good and the girl goes no i don’t and then the friend that i’m with because she’s wearing these you know black pants and it’s like not it’s kind of sunny and hot outside and she’s like my friend’s like well i have a knife if you want to cut those pants into shorts and i’m like you have a knife she takes her switchblade out she freaking takes a knife out she does she really has one yeah she really is not like the granted she’s like no she’s like she’s a bartender and she like has like a knife that she uses to like open things or whatever and she was like talking to me about the utility of it but i was like please never whip out a knife like in a restroom with someone ever again but of course this other straight girl was like girl yeah let’s cut my pants into shorts and i’m like oh my god this this entire entire interaction is freaking me out um and i didn’t really say i cut up anything no no no she she put the knife away um she was also at least two drinks ahead of me when she whipped out the knife um and the funny thing the additional funny thing was is i like went to exit the restroom but someone was coming in on the other side and there was like a struggle with the handle situation and my friend that i was with goes go go go go go and i’m like we’re five feet away she can hear you she can hear you saying i’m not prepared to answer any more questions yeah this has been the worst bathroom experience to be approached with the outfit question to have this knife whipping out and then the the no no no on the way out yeah i don’t know it seems like it wouldn’t have been you you were practicing the in the straight girl arts including putting body lotion on so it’s so interesting i i i’m learning a lot i will say because i i didn’t think about like the straight or lesbian approach to giving an opinion about an outfit yeah i think do you think concerned right yeah if you and i agree then everyone agrees yes [Laughter] why would you be honest with someone like i don’t oh no it’s totally not about no girl when somebody asks when somebody’s in a public place they are not close to their own closet and they ask how that looks you have to find something good right to say the only thing to say is like what’s possible yeah what i love what i love is that this acquaintance of yours whipped up a knife solution oriented yes i love a solution-oriented woman because she was like i can’t give a compliment so i’m just going to help her fix it oh my god i’m just glad that the other woman wasn’t as deep into her drinks as my friend was because then we would have been in the bathroom with a stranger with her pants off cutting her pants into shorts and i was not tired for that i mean it would make a better story for this podcast though totally totally thanks for listening to best friends back alright you can catch brand new episodes every friday make sure to follow so you don’t miss an episode if you’re enjoying the podcast leave us a review you can follow at mythical pods on tick tock for clips to share with family and friends you can follow nakeen at nagine and me everywhere at stevie w levine and of course you can hear me every monday through friday i’m good mythical morning with brettonlink at youtube.com good mythical morning i’ll see you there adios hello friends if we don’t talk enough about sex on this show do i have some news for you because ear biscuits with rhett and link is bringing back sex timber again this year that’s right a whole month filled with rhett and link talking about sex two sex experts two mythical beasts who have sex questions last year they talked to their wives i don’t know everything they’re going to be talking about listen i don’t need to know everything that they’re going to be talking about but maybe you do so go check out ear biscuits wherever you get your podcasts sex timber is running now through september 19th so get on over there you horndogs if you’re liking what you’re listening to now then you might just like listening to me trevor from trevor talks too much and i just recorded an epic episode with guess who it’s me oh my god it’s nicole hey hey guys so we talked about some great things we talked about being friends with your bosses yeah um our relationships with food yeah and creation crayshawn was the most important part of the conversation i agree it was a great little chat but it was very fun and you should all go listen to it and check it out and don’t forget to like and subscribe and make sure to check out trevor talks too much wherever you get your podcast you