Welcome to the Episode!
In this episode of Rashmi Shetty’s podcast, Dr. Rashmi, a leading dermatologist, discusses essential skincare principles, busts common myths, and shares personalized solutions for radiant skin. This episode dives deep into the science of skincare and its connection to overall health.

Let's enjoy the transcript

Rashmi:Recently, a patient who came back with severe nerve damage after getting an IV drip from a salon. So if you go to a completely unqualified, untrained person, major things can go wrong. What you may think is just an acne cream or what you may think is just a small laser may actually cause a lot of harm if you've not done in the right way.

If not, you could actually go blind.

Ryan:Is this why it's better to take a face massage at a dermatology clinic rather than one of these spas where that person is like rubbing your face and going at it? How important is nutrition to you?

Rashmi:To me, skin is just literally like a diagnostic tool for what's happening inside.

For example, if there's anemia, skin is pale. If there's excess sugar, skin looks dark. Protein goes down, you can actually see brittle hair, brittle nails. So everything is about what you have put into you is what is seen outside. I think our grandmothers were younger because they also didn't kill themselves to stay lean.

I've stayed, you won't believe, between 50 and 53 kgs all my life. And these days, teenagers are so paranoid about losing their hair. This is huge right now. They are scared to wash their hair. They think washing hair leads to hair fall, which is a big myth. Now what do I do?

Ryan:All of us want to look younger.

What is the difference between Botox and filler?

Rashmi:Yeah, that is a slightly controversial topic.

Ryan:In today's episode, Dr. Rashmi Setty, a top celebrity dermatologist, My friend, and now my confidant for my skin, is here to talk to me about skincare, diet, and how you can have flawless skin. And you know what? All celebrities need flawless skin for their earning.

But what about you and me? I wish I could go back in time and meet Dr. Rashmi Shetty when I was 18 years of age, when I did not have any knowledge, when I did not have any viewpoint on how to take care of my skin. I had pimples, I had acne, I had all the possible oily horrible skin and today I suffer because of it.

I want to share this podcast with you. It looks long. Don't be put off by the long time. Trust me. I want you to watch it till the end. Because if you do, I promise you, Dr. Rashmi Shetty is going to give you bites of wisdom. That is going to make your skin glow when you are her age. And if you want to know where she is in life, then listen in and see all her secrets.

Because I could not stop listening to every word she had. So sit back and enjoy this episode as it brings a glow, not only to your life, but to your skin.

Oh, you're already rolling. You rock stars. Okay. 5, 4, 3, 2, 1. Hey, it's a great day. I've got a celebrity in town and this person makes you and me look more and more beautiful as we grow older. Dr. Rashmi Shetty, welcome to my podcast. Great to have you here today.

Rashmi:Thank you, Ryan. I've actually been waiting for a chit chat with you because I have my own personal questions about nutrition.

Ryan:I know. And you know, I wanted to ask you this question, which is when I came in, I was like, I forgot my biochemistry from Goa Medical College. And my dean would say, Ryan, you need to be better. So my first question was, is skin dead or is skin alive? And I was wondering which part is dead and which part is alive.

Rashmi:So a portion of it is dead, obviously. A large portion is alive. Only the top layer, the stratum

Both:corneum,

Rashmi:is almost a dead layer, is a dead layer. So it's just the keratin that is put out with, let's say, clumped melanin. What is this keratin? Keratin is a protein. So, cells die and become protein. Whether it is here or I'm sure you dive deep into anti aging molecular science yourself.

So if you look at the mTOR theory,

Both:it

Rashmi:is dead protein which is hanging around various tissues which cause the inflammation. So any tissue which kind of stops its function grows and finishes its function and dies. Now in skin, We die and we throw that out.

Ryan:Correct. So we shed a lot of skin every day. Yeah.

Rashmi:You, every day you end up, there was some person, I can't remember the name, said that it was in a movie, controversially said how a whole load of dust in the house is

Ryan:skin

Rashmi:cells. Skin cells. So it, it was in our controversial skin of color movie. So it, it is, it's skin there, which is actually dead, then fallen down.

So the dead part of the skin is the outermost layer. of the outer layer.

Ryan:So

Rashmi:you have the dermis and the epidermis, right? The epidermis is the outer layer. So

Ryan:epi is the outer layer.

Rashmi:Correct, epi is the outer layer. So there is dermis, which is derm is skin. Dermatology comes from there.

Both:So

Rashmi:there is dermis and there is epidermis.

Then there is subdermis also. So these are the pretty much layers of the skin that you feel. Underneath subdermis is usually the fat that you see in the skin.

Both:Then

Rashmi:you have the dermis, which is the layer where there is a lot of blood vessels, collagen, elastin, ground substance, all of that, that makes the bulk of the skin.

Ryan:Is it true that the skin is the largest organ in the human body?

Rashmi:It's enveloping and wrapping the whole thing, right? So it is the largest. If you consider skin an organ, then it is the largest body surface.

Ryan:Dr. Rashmi, tell me something. Is skin also there in our arteries and blood vessels? Could we call that skin or that's something different?

Rashmi:No, that is, that is, that is endothelium, we call it.

Ryan:So that

Rashmi:is different. That behaves very differently.

Ryan:But, you know, if I was like a construction guy and I had to construct the house. I use bricks in the bathroom. I use bricks in the hall. I use bricks in the But you

Rashmi:would do various, the bricks inside the house and the outside, you are making it weatherproof.

So the brick would be different. So outside you may use a slightly rougher material, but you are more Trying to do a barrier. So it shouldn't, you know, put water inside from the rain. Water cannot get absorbed and get into your house. So thinking of various properties for that brick, while an endothelium is a different kind of a brick where you're looking at more, for example, the gut endothelium, you're looking at some kind of Exchange there

Ryan:or the

Rashmi:endothelium of your, let's say the lung or the alveoli.

Ryan:This now explains to me why a dermatologist is not a gastroenterologist. So for everyone out there, the simplest term is a dermatologist is a skin doctor.

Rashmi:So in India, a dermatologist is not just a dermatologist.

Ryan:Our

Rashmi:degree is. Either A DVD or A DDV or an MD in dermatology, our whole body is called as Indian Association of Dermatologist.

The neurologist and

Both:neologist. Okay. So

Rashmi:it's the DV is diseases of skin, sexually transmitted diseases and leprosy. So in India, the degree is all of this put together. Mm-hmm . But a lot of us don't practice everything. Okay. For example. I've never seen leprosy patients after my passing out of college. So if somebody would come to me, it would be disservice for me to say just because I have the degree, I can treat leprosy because I don't know the latest advances or I don't know.

What is medicine at the end of the day? Practice. It's still called a practice, right? So if I haven't practiced seeing venerology or Leprology for this many years, I'm not best at it. So

Ryan:when you say you practice, what is your normal day like?

Rashmi:Oh my god, crazy. It is now. I In practice or in general a day?

Both. In general, I wake up. I was I was joking yesterday with one of my cousins five 57 or 551 is when I wake up, and it will be the same for many, many, many, many days, unless something changes. So I wake up as precisely as that without an alarm. So I wake up at around that 550 ish, and then yeah, I just love to see the sun rise, watch the sun rise.

And I'm lucky that from my home I can watch the sun literally. Come out of the horizon. So I stand there and watch the sunrise and then I have a dog. I play with her for some time. I have my little hot water with some dip in the morning. I do that. I have my thyroid medication. And yeah, so the daily chores of the morning.

I like to do my temple, little temple where I put the flower, remove the flower, do all of that. I like to water my own little garden, whatever little we have in Bombay. So I do all of that. And by eight, I'm on my computer desk where I finish off my emails, blah, blah, blah, all of that. Because I lecture a lot globally, there is something or the other lecture that I need to prepare.

So I'm preparing in the morning. That's at nine. I'm getting ready 945. I'm out to the clinic. Then we see anywhere between a 40 to 45 patients every day. So it's a continuous and I am very particular about seeing every patient myself. We did have junior doctors earlier, Dermatts to take the initial history, do a few things, but somehow I thought unless I gathered the history myself, something is missing.

Ryan:So tell me something for the uninitiated out there who everyone wants to look beautiful today, wants to have great skin. The skin is the largest organ when there are two types of ways to look at it. One is I've got a problem. Like I had adult acne all my life, so I got a problem, but you have clear skin.

Both:Yeah.

Ryan:So I'm assuming that when you're 25 years of age, what would be the reason for you to go and meet a dermatologist from a maintenance point of view? So let's divide into two parts, right? One part is. The prevention, the preventive servicing that we can do. And then there's something which is, there's a problem.

So what's your take on what age should we start looking

Both:at

Ryan:prevention? What are the things that we need to do in prevention? And then we'll go into the people who've got khaddas like me on my face. We have dermatologists on speed dial and like, what can I do, doctor?

Rashmi:Okay. So by and large, I keep telling patients, when you go to a doctor or even look at your own skin and plan what you want to do.

Two main things like you necessarily said. Skin problem and skin goal.

Ryan:Skin

Both:goal. Okay.

Rashmi:Yeah. So you may have, like you said, I have smooth skin, but my skin goal at this age is to maintain my hydration

Both:and

Rashmi:make my skin look as youthful as I would like it to be. So that's my skin goal for the longest time and maybe prevent pigmentation

Both:at this

Rashmi:time in my life.

So these are my skin goals. But what are my skin woes or problems

Both:is

Rashmi:the other thing that I want to deal with. I have an itchy eye sometimes, so I want to prevent that around the eye because I don't want crinkly eye coming. And when, when an itchy eye is there and you scratch it, the black capillaries around the eye is so delicate.

When you do this, it kind of breaks and it may add to your dark circle. A lot of times it's just a topic. I was about to ask you about

Ryan:dark circles.

Rashmi:Allergy, atopy, so called hay fever. What we call your sensitization,

Both:atopic

Rashmi:diathesis, you call to all of these come under a category where you can have early morning sneezing, itchy eye, itchy nose, and you end up doing this to your eye, you're disrupting and breaking all the capillaries, and it leaks the blood and what happens to all that hemocedrin or the pigment in the blood, it just sits there between the tissue.

And as you grow older, your lymphatic drainage from this area becomes poorer and poorer. What is

Ryan:lymphatic drainage?

Rashmi:So lymphatic drainage, so there is blood vessels. There is artery, which gets the good blood from the heart to the rest of your body to function. The

Ryan:vein to pull it back. There is vein. I studied.

I studied a little bit.

Rashmi:Fantastic. So vein to pull it all back for the What we call it the

Ryan:bad blood. Correct.

Rashmi:And it will clean it up and it will send it back again from the, from the lungs. And then heart will pump it everywhere else. Correct?

Both:Now

Rashmi:there is one more thing which adds. So all this blood vessels, whether it is vein or artery, can leak away somewhere a little.

And some fluid can be just sitting in your tissue. Microleaks, it's not the blood is leaking, some serum leaks away. There is leak from the, let's say, gut here, there, everywhere. So that leaky fluid which is there, sometimes simply inflammation will bring in fluid to a tissue. All of this will be sitting there and they will also be pulled by other channels, which are lymphatic channels, lymph is a fluid.

Now that is then taken out. So if you see a lot of masseurs, they'll tell you lymphatic drainage. So they will say you massage from here and then massage from here and

Ryan:pump here and pump here. They will have to be really good at that. They'll have to

Rashmi:know the anatomy of the lymph. Otherwise it could

Ryan:damage your skin.

Rashmi:You should know which direction, you should know where your lymphatic, lymph nodes are.

Ryan:Is this why it's better to take a face massage at a dermatology clinic rather than one of these spas where that person is like rubbing your face and going at it very hard?

Rashmi:Yeah, but I must also say in their defense today, if you see the curriculum of a legitimate spa therapist or a masseur, they, yeah, they go through some good training.

Nowadays a lot of

Ryan:spas have a dermatologist as part of the team and everything.

Rashmi:Yeah, that is a slightly controversial topic, whether we should be included in a spa, spa should be included in a dermatology center. All this is now getting very emerging, but you need to be very careful.

Ryan:But if you had to give advice, to me.

And say that okay, doc, I want to go to a spa, but I want to be going to a spa whenever the people are good. Doc, I want to go to a dermatology clinic to maybe prevent pigmentation, acne look younger. What should I be looking for in the dermatology clinic and what should be looking for in the spa as per your expertise?

Thank

Rashmi:you for

Ryan:this question

Rashmi:because I've had recently a patient who came back with severe complications after getting. An IV drip from a salon. Yeah. And I have another patient who came back to me a few months ago, who came with severe facial irritation, not just irritation. She ended up actually having a slight little nerve damage after doing an equipment, energy based equipment in a salon.

So she says, I was sitting doing my pedicure. Oh, you're doing a pedicure? Let's just run a drip. Oh, you're doing a manicure? Let's just finish off your some hypo or some RF on the face. Yeah. So please don't do these things, because as easy as these equipments look, One, it's very difficult for you as a layman to say if the equipment firstly is legitimate or not.

So there is an US FDA, there is a European FDA, which is called a CE mark. There is a Korean FDA, there is an Indian, every company of course has their own FDA for the tool. US FDA is the most stringent.

Ryan:For the uninitiated out there, what does FDA mean? Food and Drug Administration. Correct.

Rashmi:I was thinking for a second, suddenly.

Ryan:Food and Drug Administration. The tools also go through the same. That's what I was about to ask you. Yeah. Is it only the medicine, or is it the tools also? No, it's the medical tools also go through this. So if you're buying equipment for your clinic, We will look at it. You're looking for that as a doctor.

Rashmi:Yeah.

Ryan:But as a, as a layman, I would not know what that equipment would be. And

Rashmi:today, the equipment manufacturers, the MeToo or the copy equipment manufacturers have become so brilliant. They make the outer body look exactly like the original machine. And the name there will be slightly different where you can't even make out that what is different if you, if you really don't know.

So the whole point first is when you go, when you're looking at anything, there are three, four things you need to do. One, look at the doctor and know that, know what her qualifications are.

Ryan:Do you think it's right? Like, I remember I took my dad to a doctor and I said, doctor, if you don't mind, may I know your qualifications?

Rashmi:Does

Ryan:a patient, can a patient ask the doctor?

Rashmi:Your birthright to do that. Like I, so this one very sweet patient from a small town came in and you know how I always get these teenagers or these 20 something and the parents with them. And I can see this dynamics. I have a 20 something at home. So it's like always mother talks, father talks.

Come on, come on, come on, will be happening. Okay. So like, don't embarrass us. Come on, we'll be happy. So here the same thing happens. This mother will be complaining. Something follows it. The children will have eyes open wide. Whatever

Ryan:parents will be disowned. Come on,

Rashmi:come on, we'll be happy. What happened

Ryan:in this incident?

That

Rashmi:parents said, yeah. Doctor, if you don't mind, I want to know your degree. It was so sweet. I was like, I'm so glad you're doing this. And the child was like, come on, what's happening?

Ryan:Like you can't ask a doctor this.

Rashmi:I'm like, no, you must and more people should ask what is the qualification of the doctor because it is very important.

What you may think is just an acne cream or what you may think is just a small laser may actually cause a lot of harm. If you've not done in the right way, medicines today, especially in India, everything is available, OTC

Ryan:and everyone's self prescribing, right?

Rashmi:Yeah, because everything is available OTC.

And there are so many so called skincare experts on the wide space. I want to talk to

Ryan:you about this. No, I mean, we are experts, but then I always tell my team doctors are the true experts. They're qualified.

Rashmi:They're not

Ryan:certain.

Rashmi:Yeah.

Ryan:All these influencers are certified and they're doing these Instagram videos and all.

Rashmi:What certification? Also, we don't know that. Never mind. So, so

Ryan:coming back to the clinic, the lady asked you about your qualifications. So I was very happy.

Rashmi:So I was, I want to say that I ended up, of course, explaining to him this, this, this is my qualification. So I want everyone to be able to ask their doctors and don't shy away from it.

What is it? So if you're going in for, let's say. A hair removal laser, or simply a Botox, a filler, a peel, a facial. You could maybe also go now, I don't know who's going to troll me for this, but you could end up going in for an MBBS doctor who's called as an aesthetic physician or a cosmetic physician.

Aesthetic physician or a cosmetic physician. That physician is a stressful, stressing term here. Now there also you need to make sure there are a lot of doctors who are not from MBBS.

Both:Hmm.

Rashmi:Could be a BHMS or could be something else which cannot be prescribing you certain medicines. So you need to be very careful when you say MBBS doctors, they are bachelors.

So it's not that they don't know any one thing. We also have a small little dermatology posting,

Ryan:but you're

Rashmi:not a master of dermatology.

Ryan:Who would you recruit into your clinic? You are a global speaker, teacher. You have your own. clinic. Yeah. Who would you recruit into your clinic? Because then I know that Dr.

Rashmi is recruiting the right person. So that's the doctor to be going to.

Rashmi:Yeah. So I would only recruit a specialized dermatologist. That's number one. Two in my Hyderabad clinic, I did have one of the doctors who are MBBS because there are times that, and like I said, there are certain things that MBBS can do.

under a guidance of a dermatologist.

Both:They're

Rashmi:just physicians. They're just physicians. So they're still MBBS. They're not non physicians. So they are not a BHMS, which is a homeopath or an Ayurveda doctor. They are best at what they are taught. They can't be prescribing English medicine because that's not the training they go through.

Simple. They're equally fabulous doctors in their stream, not in another stream. It's like, would you want to come to me for homeopathy? No,

Ryan:that's a nice way to put it. That's

Rashmi:all. So it's like you're specialized in as much as I'm an Ayurveda enthusiast and I'm a South Indian grown up. My grandfather was an Ayurveda

Both:Pandit.

Rashmi:I can't prescribe Ayurveda. That's not what I'm trained with. You end up doing. Either an MBBS I would recruit or then I would recruit a dermatologist. Now, so if you're an MBBS, you could do all this, then you need to go to a dermatologist.

Both:If

Rashmi:you're having serious issues, certain pigmentation, hair loss, acne, these are all things which you need a, though it sounds aesthetic, you need a specialized dermatologist to deal with it.

So

Ryan:aesthetic means looking beautiful.

Rashmi:Correct. So it could be anyone from a beautician is an

Ryan:aesthetician,

Rashmi:a spa therapist is an aesthetician, technicians in your office is aesthetic technicians. So these are all people who are ancillary services in aesthetics whose main goal is to get you the outcome of looking your best.

Ryan:Has time changed now wherein more and more people are, are, are taking care of themselves from an aesthetic point of view as compared to maybe a clinical issue? Thank you.

Rashmi:Yeah. Or does

Ryan:that define you as a doctor, like I'm going to do clinical practice or I'm going to do aesthetic practice? A

Rashmi:lot of people ended up thinking initially, I'm a clinical dermatologist and sometimes even look down upon aesthetic dermatologists.

But to me today, everybody has understood aesthetic dermatology is nothing but an extension of a clinical dermatology. For example, how I look at my patients differently and why I have a certain practice and certain treatments. kind of patients who come to me who are much more aware and enlightened about skin care is because if you come to me with a pigmentation, I'm not just looking at your pigment.

We are looking at the health of the skin, the cause of the pigment. It could be anything. For example, you come with a patch on the skin. It is not necessarily every time that it is melasma. Which is the most commonly understood thing, right? So it's not necessary melasma.

Both:It

Rashmi:sometimes could be initiation of a Hory's nevi, a small little thing.

It could be acanthosis on the face. It could be frictional melanosis on the face. It could be LPP on the face, a variant, an ashy dermatosis on the face. It could be any of this. So when you go to a dermatologist, they are able to firstly diagnose what is the pigmentation.

Both:Hmm.

Rashmi:What is the origin of it, etiology of it, which layer is the pigment there, which condition is in both the layers, which is in one layer, all of this, accordingly the treatment can be chosen.

Otherwise, you may have a popular laser, but you may just be firing in the wrong energies and the wrong wrong place. This is why it's important to go to a legitimate dermatologist.

A person who is like more the other day, someone ended up saying that, yeah, every dermatologist can be a hair transplant surgeon, but you can't necessarily. So, which means to say that if you want to do a hair transplant surgery, a dermatologist is qualified to do that. But none of us, or most of us don't have the training in our college days, or in your post graduation days, you'll have to go and super specialize.

Exactly. There's no super specialization degree, but you have to go and do it. Absolutely. Work under someone, train under someone for years to be a specialist hair transplant person. So then you go to them for that. Likewise, maybe for a Botox, a filler, for anti aging, for equipment devices. Some of us had that interest and specialized in it right from the beginning.

So all dermatologists may not be that great in doing. Anti aging treatments. I take pride in doing that because I've always loved it.

Ryan:Speaking of anti aging, my antennas went up the moment you used the word Botox. Okay. And all of us want to look younger.

Both:Yeah.

Ryan:Even us men today want to look younger. Why not?

What is the difference between Botox and filler?

Rashmi:My God, I thought this question has been understood, but I see people asking even now this question. Most people haven't understood it. So simple thing. I mean, I don't know

Ryan:the difference, Sandhya.

Rashmi:Yeah. So it's simple. So basically I know

Ryan:Botox is some enzyme or some poison you put in and the muscles freeze up from the wash.

No, this is, this is my mundane, uninitiated, gawar thinking right now, okay. So what is a Botox and filler?

Rashmi:So Botox basically just put simply Botox is a powder that we turn it into liquid from a little bottle, pull it out and inject into you. Filler is more like a transparent jelly, which we pull it out and inject into you.

Simple. Now, what does Botox do? It, let's say for a simple man's term, it eases your expression lines, which means to say if I have a line when I frown, I use a Botox. If I have these lines when I raise my brow up, I use a Botox. You smile and I have crow's feet, I use a Botox. While, if I have a line here, which is sitting there, etched, right, it is not because I'm moving, it is sitting there, so that I will fill in with a filler.

So filler is an inert substance, like a clay, which I'm putting in, and it is sitting there. If I want a cheekbone, I'm putting in, it is sitting there. If I want to put, give a cheekbone, then I end up putting a little bit there.

Both:If

Rashmi:I want to put in a chin, lip, I'm putting in a filler. Basically anywhere where I want to mold.

is where I use

Both:a

Rashmi:filler.

Both:Now,

Rashmi:how do they act? Filler, like I said, is simply inert. Goes in and sits where I put. Therefore, I always say filler is a job of an artist. You master the science, you get your anatomy right, you know your product right, how then you put these two together to create a beautiful

Both:face.

Rashmi:Yeah, so create a beautiful face. is in the hand of the artist, not the tool. You may have picked the right tool. Then what do you do with the tool is why you need to go early. Do your research when you do the aesthetic treatments because the outcome is not mathematics can't be taught. It can't be taught from a from a teacher to a pupil at all.

It's not painting by the numbers can be taught. So those are the basics. But it's not the same template that you can put on everybody's face. You don't want to create masks. So you're creating Bringing out the best, correcting those little flaws, enhancing the best features in the person that you're treating.

So therefore, that's a huge art. While a Botox can be equated to, let's say, painting by the numbers, because if I decide what is the bulk of my muscle, what is the extent of my muscle, If I know where is the interdigitation with another muscle, then I can calculate and say this many units, these points, and I'm done.

So if you know the anatomy really, really well, and you're able to mark it on the surface really, really well, then Botox is a simple thing. How does Botox act when I inject that into it? So the muscle sends a signal, and when it says I'm angry, you frown. So the muscle said you're angry, the muscle does not end up telling anything.

There's a nerve that's conducting. Now nerve comes and releases acetylcholine, acetylcholine has a receptor in the muscle, that is what muscle responds to a contract, so that's why you frown. Now if I negate the acetylcholine from react, responding the, the receptor from responding to the acetylcholine, it won't respond.

I can keep saying I'm angry, but this will say I'm happy, I'm calm. So that is why Botox is also looked upon as an antidepressant. Do you know that? Yeah.

Ryan:It

Rashmi:makes logical sense. Yeah. There's a scientific paper which says yes, because you look into the mirror every morning and you're not frowning. You're looking happy.

So mind says, ah, I'm happy and it's like a feedback. So that is why Botox is an antidepressant. So basically it nullifies the signaling liquid from the nerve to the muscle. So therefore the muscle action doesn't happen and the frown line doesn't form. That is a basic difference, but there's a lot more we can do with Botox.

And then we can narrow, slim the face down, slim the nostril down, pick the tip of the nose up. All these are very experienced injection techniques. So there's so much more can be done. But this is a basic difference. So while a Botox wears off in three months. Oh,

Ryan:Botox actually wears off?

Rashmi:Yeah, yeah, yeah. Oh, I

Ryan:thought it was a permanent procedure.

Rashmi:Not at all. Not at all. How would I then have my patients keep coming back to me? So every three months you need to do the retouch up. But while a filler goes in and stays textbook wise, Six months to a year, but we have now seen in our own experiences that it stays for a long time. So that one is a boon and a bane.

If it stays for a long time, it's a great job on the face, you enjoy it for a long time. If it's a bad job, Then you're also living with it for a long time.

Ryan:So are there any risks to these fillers or botox? Oh yeah.

Rashmi:Oh yeah.

Ryan:And I think, I think the risk would come in from going to the wrong person also.

Yeah. So

Rashmi:if you go to a completely unqualified, untrained person, major things can go wrong. Imagine you're actually doing things blind. It's not like a surgeon you're opening up and doing, right? So I don't have a vision of, Oh, this is the artery. This is the nerve. Let me avoid this. Let me do this and let me cut here.

Let me cut here. I'm doing it on a face with the envelope intact, so I'm going through it. So I need to know my anatomy like the back of my hand. I need to do multiple cadaver dissections, which I keep even now indulging in to make sure my anatomy is refreshed. And as we are growing older, there are so many more newer papers coming up in anatomy where more dissections are done in the face with a different lens now, right?

Because they're viewing the anatomist also are viewing the face, not just with a simple lens, but saying, Oh my God, these are newer procedures that the doctors are doing. So let me look at it more closely, look at it more differently. So we now know every plane what's happening, any deviation in arteries, what are the percentage of people with the same artery going in the same place.

So you need to know your anatomy and the tissue reaction very well. If not, you could actually go blind. You could actually have a tissue death, you could have a entire nose literally falling off. So we've had cases such as this around the world, not much in India, or at least it doesn't come out much. But there's a lot of very scary things that can happen with filler.

Whatever happens with Botox usually recovers because like I said, it wears

Both:off.

Rashmi:Whatever happens with fillers also mostly recovers because the face is such a wonderful organ. There's so much blood supply. So it kind of recovers, but blindness is irreparable.

Ryan:I'm just seeing you sitting in your clinic and if somebody walks in, you're probably able to within about 30 seconds say whether this person has had some treatment or not to their face.

Yeah, yeah,

Rashmi:instantly. And they'll sometimes they'll sit and say, Oh, I've done nothing to my face and I will know exactly. Then I'll, I'll put my thing pen on paper and say this, this, this, this, you've done your filler. They're like, No, but that was five years ago. I said, but you've done right. When I asked you history, you should have told me that.

So I can just see exactly.

Ryan:So there are a lot of myths about skincare. There are a lot of certified influencers that are there now today on Instagram, which come and troll you and me. And they think they know everything. They just have a camera and then they have a mic and then they're talking about as if they know the world.

They don't have a clinical practice. What are some of the common myths? myths that are out there or hocus pocus stuff that makes your blood boil when you hear about it.

Rashmi:See today I should say the bloggers also read up a lot

Ryan:So they

Rashmi:sound intelligent and they tell you the right thing So they may not be much depth if you really get into it.

So one is

Ryan:to sound intelligent But you don't have the clinical practice.

Rashmi:No depth and no clinical practice, no degrees So that's something which you need to be very clear of who you're listening to or who you're Even as a completely qualified doctor, there are a lot of times people get angry with me because I don't suggest a product.

But I can't. How will I suggest a product online? Which one is the best sunscreen? What kind of a question is that? I can't tell you because I don't know your skin type. I don't know your sun exposure. I don't know where you live.

Ryan:Ryan Fernando, can you recommend a diet plan?

Rashmi:Hello?

Ryan:I don't know your gender.

I don't know your age. I don't know your body fat percentage. And then

Rashmi:I'm angry. You only do it for celebrities. You don't do it for me. You

Ryan:can't do it for me. I'm a poor person and everything. Yeah, same

Rashmi:page. And then something I would have applied. They'll say, which one are you applying? But that's for my skin.

So like that, what boils me is when people end up coming online. So skin is

Ryan:bio individual. Very, very. So one person could use a sunscreen and another person could use a sunscreen.

So if it's, you're like looking at the skin and saying, okay, you can't use this sunscreen, you've got to use this sunscreen.

Rashmi:Yeah.

Ryan:I just thought it was SPF.

Rashmi:SPF is a general thing. There are many factors that you see in a sunscreen. SPF is a

Ryan:little bit about it because you've got a lot of sun, it's going to, it's only going to get hotter.

Heat wave is coming up. Heat wave is coming up. So right from the kids. to older people. Talk to us about skin care routine. You know, the free tips to everyone out there was listening in. We've got Dr. Rashmi Shetty in here. To me, she's this, she's the Virat Kohli of dermatology. So she's like hitting everything out of the park.

Let's get some free tips from her. What, what would you recommend from a skin care routine point of view? I remember her hearing CTM.

Rashmi:Yeah.

Ryan:Cleans my when we started off

Rashmi:in life.

Ryan:Yeah. Yeah. But I'm too lazy to do it. So where would you take skincare routine For all of us.

Rashmi:So like you said, the first thing for skin is hygiene.

I would start right from there. So your scalp hygiene. is included in skin hygiene. So very, very important. So you need to have a clean lot of times. Teenagers come to me with acne. And these days, teenagers are so paranoid about losing their hair. There's also early graying, early balding that we see, right?

So they're all Oh, yeah, big as compared to like 10 years ago. This is huge right now. So therefore, they're scared to wash their hair. They think washing hair leads to hair fall, which is a big myth, not at all, keep your scalp clean. Say that again for me. Washing hair will not lead to hair fall at all. In fact, accumulation of your dandruff, your sebum, your dirt on your scalp will lead to inflammation, which leads to hair fall.

Ryan:That's a sixer right now.

Rashmi:Yeah.

Ryan:Because everyone's saying today, I don't wash my hair, don't wash your hair and everything. No, not at all. The doctor says you got to wash your hair. But how do we do it? So,

Rashmi:depends on scalp type. Okay. So if you have a very dry scalp, how do you know the difference between dry scalp and dandruff is my next, is your next question.

So I'm preempting it. So if you have a dry scalp, you will know that the day you wash your hair. Immediately once you dry it, it starts getting flaky. It starts getting itchy and a little sensitive. And then if someone kind of opens up your hair and sees a scalp, it may feel a little red as well. So now this, you know, is dry scalp flakiness.

So then you don't wash your hair every day. You can wash it alternate days so that some oil can accumulate there. Wait for it to kind of accumulate. But if you have an oily scalp, then you can wash your scalp every single day with your chosen shampoo. Now, if you do have dandruff, then again, you need to wash it every single day, so you're not accumulating the yeast and the fat of your skin, which is with the skin of the scalp is putting out.

That's the food for the yeast. You're going to kill both. So you're going to wash it off every day. This is what you do. Now, if you have, we're only talking about scalp right now. So if you have a scalp a certain way and a hair a certain way, most people end up asking, okay, my scalp is oily, but my hair is dry.

Now what do I do? So that's when you wash your scalp with the said shampoo every single day and you don't have to shampoo your hair at all. Hair is dry. Hair is not dirty. We are all in AC closed environments. So you wash your hair just so that you get some hydration and shine on it once in a week. With the shampoo, but you shampoo your scalp every day and put conditioner for the hair and come out of the bath.

So this is what you would wash your hair and your scalp separately. Anti dandruff shampoo can only go on the scalp, but a hydrating shampoo can go on your hair. So that's how you look for hair and scalp shampoo. So that is scalp hygiene. Now skin hygiene depends again on your skin type. Now, whatever is your skin, you're having a bath.

I prefer a liquid soap to a solid soap only because you don't keep pulling, applying, putting it back. And again, picking up, applying, putting it back. There is, it's a soap, right? And you're touching it on your skin. There could be germs. There could be dust accumulating. Do we wash our soap before really using?

Two, three people might use the same thing in the house. I just feel it is a little Dr. Ashish has washed his soap. a little unhygienic concept about it. Though the whole world lives on soap. You just got my brain

Both:going

Rashmi:like Yeah, I feel personally, it's, it's, it's not something that I want to touch, put back, touch, put back.

So it's easy to take it out of a dispenser, use it and you're done.

Both:What

Rashmi:is sitting inside is still untouched, right? And if 10 people in a house use one bathroom, for example, not all 10 are using the same soap and putting it back. So you still have the soap dishes sitting. Sometimes I've seen there'll be a soap dish, there'll be a soap with a lot of water in it.

So nobody's even cleaning and emptying it. So I find that whole thing a little unhygienic. So it's easier for something coming out of a tube or a dispenser where you know what's inside is clean.

Ryan:So that's the bathing ritual.

Rashmi:Bathing ritual and bathing how many times? Twice is okay. More than that is not good for skin because you're ripping your own oils off.

Ryan:I have a lot of athletes and they train like three, four times a day. Wow. Okay. So this has been my advice to them. Use the soap once a day on the entire body and in your private parts, underarms and all, all the body folds, all the body folds. You do that for body odor and that is two baths and in third or fourth bath just use plain water.

Is that okay?

Rashmi:That's okay. Maybe if they're athletes, you may still want them to use whatever little soaps, even at their body folds. Each time they have a bath because they're a sweat it out but other than that, yeah, soap only once. Yeah.

Ryan:Is there any of the skincare routine that we now get into beyond bathing?

Rashmi:Yeah. So I think hygiene wise, this is what that you need to be very careful about. And washing the face would again be not more than two times. If you really have an oily skin, then the third time I've seen a lot of people say, Oh, but I'm just washing with water. Now,

Ryan:this is, this is something that I want to.

I want to share with you, because I wrote a book called Wheatless, right? And I had, I had pimples my entire life. And I, as a teenager, had this thought process, if I washed my face more, and I think many of you teenagers out there feel the same that I thought many years ago, which is if I wash my face more, I will not have more pimples.

So can you throw some light on this?

Rashmi:So, by and large, body works on a feedback mechanism.

Ryan:So,

Rashmi:mostly acne patients, that's when you say teenage boys, have oily skin. You're washing the face off every time you feel oily. Even if you don't use a face wash, you are still making the skin dry. What does the skin do when it is dry?

It says, I'm used to a certain oiliness or skin is too dry. Let me throw out some more. Let me throw out some more. So, you're giving a wrong feedback where it is constantly throwing out more oil. So, that is not at all happening. Multiple times washing the face is only bad for you, and if you're using multiple times face wash, most acne patients have face wash which is either a salicylic acid based or a benzoyl peroxide acid based.

Something, even if it is a simple tea tree oil based, to cut out the oil from the top, that is an irritant also.

Ryan:So how if the people are doing their own self skin care? No. So

Rashmi:you end up washing your face with your said face wash, not more than sometimes these things actually be harming your skin. Very much.

Skin is a delicate barrier. Delicate barrier. So don't try and self fix it. No, not at all. Not at all. And don't try doing anything to it if you don't want to. Don't keep touching it. Don't keep doing anything. You see a lot of people sitting for an hour. They have already touched the face 10 times.

Ryan:Yeah, I've got a lot of kids who come into my nutrition counseling and they're like

Rashmi:Yeah.

Yeah.

Ryan:I'm like, don't touch your face. And

Rashmi:they have already touched 110 places. Can you

Ryan:explain the logic why kids when studying, when in school should not touch their face?

Rashmi:One, because all hygiene, like I keep saying, going back to the hygiene rule, you don't touch the railing of the steps because you love to skip on the step and come down.

And then you don't touch your book. That paper has God knows how many things absorbed and sitting on it, how much dust mite sitting on it. And then your pencil, your friend also would have bitten it, you would have also bitten it, that is also in your hand, you would have touched this side, that side, bench, table, uniform, kapda, everything is dirty, your football, your throw ball, everything, shoelace, all that, and kids don't wash

Ryan:their hands in school,

Rashmi:all the shoelace, everything, and then you're sitting like this, or you're touching your face, or you're touching, I am para, I don't touch my face, only if you see, so even as an example, I won't do this, so you don't touch your face, because there is, I am para, I don't touch my face, There is so much in your hands.

I only

Ryan:did that five times in this podcast.

Rashmi:And that's why I told you, even as an example, I don't do it. I'm

Ryan:going to sit like this in this podcast. Hands not on my face. Yes,

Rashmi:totally. So, that's very important for you to make sure that you don't keep touching your face.

Ryan:That's a valid point. That's so valid.

We don't, you know, we don't teach the youngsters these things.

Rashmi:Simple things.

Ryan:Simple things. Don't wash your on

Rashmi:hygiene so much. Wash your scalp. Don't wash your face too much. Don't touch your face at all. These are a few things if you do also, skin is good.

Ryan:Dr. Rashmi, is it true that the face skin is the most sensitive skin in the human body?

That's only

Rashmi:because it is exposed. Like you cover everything up. What is the most exposed all the time is this much. Even if you cover the neck, this much is always exposed. So the sun, wind, pollution, what you apply, cream, lotion, everything is done to this much. Hand is only touching this much. So it's the most sensitive area of your face, more sensitized rather than sensitive.

Ryan:So now that we know cleansing and cleaning and not to touch our face, how do we protect ourselves?

Rashmi:So protection, of course, the minute you say protection, people say SPF, right? Because we are only thinking about protecting from the sun. There's so much more to protect from. But let's start from SPF. So when you pick up sun protection is very important.

In the sunny hours, whether you're indoor, whether you're outdoor, whether there's a cloud cover, you need sun protection if the sun is up and giving you light. If there is day, you need sunscreen. So that's number one. Now, how do you choose the sunscreen right? You need to look at a number called SPF, which is Sun Protection Factor, which means one SPF will give me 10 minutes of safety in the sun, under the sun.

So if it is 50 SPF, ideally, I will get 50 into 10, 500 minutes of safety. Now do I really get that? Maybe not, because to get that, there is a certain quantity of sunscreen that we need to apply, which most of us don't. So every third, fourth hour, you can reapply the sunscreen if you're really out in the sun.

If you're in the shade, maybe not that many times again and again. So that is number one, which is SPF. Second factor you see on the sunscreen is TPA. Which is TAN protection index,

Both:which

Rashmi:is usually triple plus, four plus, one plus, four plus is the highest. So you see what is the TAN protection. That protects you from TAN.

The other indication that you can see is IR protection, which is infrared protection. That is what causes this hot sensation when you're under the sun. The infrared spectrum of the sun, sun rays, is what gives you that heat. So if you have issues like redness of the skin, already irritated skin, skin which is lighter than the rest of them, your burning becomes so much more.

So you need to look at the I. R. If you have acne, any inflammatory disorders, make sure it is I. R. positive your skin care, your sunscreen. So this is your sunscreen. Now there are different types. There is gel based sunscreen. There is fusion technology, which is more like a like a liquid, like a milk, which flows.

There is transparent sunscreens. These million type of sunscreens which are available depending on your skin type. Whether your skin is oily, whether it is not oily, you choose a few brands and you take.

Ryan:You know what's going through my head right now? Sunscreen is like an umbrella for your skin.

Rashmi:Yeah,

Ryan:sun protection umbrella.

Assistant is holding an umbrella for you. Wow.

Rashmi:So that is that. And then you can also end up choosing the form of sunscreen you want. Do you want like a creamy application format? Do you want a powder format? Do you want a stick format, which is so much easier? Do you want an aerosol format, which is even more easier?

Now aerosol not happening. There are certain chemicals which makes it aerosol, which could be eventually harmful for your general health. So I don't usually say aerosols or sunscreen sprays for Children. Stick is very easy for Children because they'll be running or you can just catch them and you can just do the stick and make them run away.

Powder is nice on an oily skin because it also acts as an absorbent. Emulsion is nice for a dry skin or Anybody else who doesn't like too much of a cakey feeling. Silicon based ones are nice for people who want just a matte effect but don't mind applying things. So this is a very large view of sunscreen.

Now above 50 SPF is useless because beyond 50 to 100 you'll only get a protection of some 0. 02 or 0. 03 percent extra even if it's 100 SPF. So after 50 if they're writing something it's mostly just a marketing. It's better to

Ryan:reapply.

Rashmi:It, it is, you should reapply. It doesn't mean 100 means 100 into

Ryan:10.

Rashmi:50 is the best.

After that, it's just a marketing thing that people end up putting more

Ryan:numbers. You mentioned that, you know, I was, in my mind, I'm thinking, okay, I'm going to apply it again. I've applied it once. Do I need to wash my face and then apply it the second time? Yeah. Because I was thinking like layer upon layer of something.

You can, like a lot

Rashmi:of times I end up telling my patients that in, if you're going on a sunny holiday, like a beach holiday, don't put a moisturizer under sunscreen. Firstly, because if it's sticky, then you won't apply enough sunscreen. I want you to apply liberal sunscreen. So don't put moisturizer at all.

Today's sunscreen has hyaluronic acid, Yevo, calming agent, a thousand things in it. So choose the right sunscreen and apply. You can even do double sunscreen. So you apply an emulsion sunscreen, which has all these extra skin friendly ingredients, plus you apply either the powder or the stick or the silicone, whichever you like and your skin likes on top of it.

So you're double layering it. So that's called double sunscreen.

Both:So

Rashmi:that is something that you can end up using. which might be extra protection for you. But if you want to reapply, then you can reapply either a powder or a stick, depending on your skincare, then you don't have to wash off. But if you have sweat and dirt and grime on your face, then it's best you wash off and then reapply anything.

Ryan:So we've completed cleansing, then protection. Now is nourishment. What's your take on nourishment?

Rashmi:Simple moisturizer. So it could simply be that. If your skin is, for example, mature and you need more, then you can look at ceramides, you can look at peptides, you can look at all of this to nourish it even further, or if you're looking at simply, my skin is feeling very dehydrated, then you look at more hyaluronic acid, what gives you that water.

So you look at the necessary ingredients in your nourishment. Nourishment is mostly like quenching the skin, feeding the skin. Certain vitamins like C, B5, B3, niacinamide, all this

Ryan:can go in. You know, doctor, I'm smiling because once I went shopping with my wife, and I was in this beauty store, and I was looking at a shampoo bottle, and it's niacinamide, collagen.

Arginine, B1, B2. I was like, I can drink this. So nourishment even happens externally. Is there a way that skin scientists when they do the research, they're able to see the nourishment on the skin matrix? Do you look at it as a hydrometer or something to check? There are,

Rashmi:there are, there are a lot of things.

There are hydrometers that you can, you know, see how, how are you reading these?

Ryan:Studies and then saying, okay, I want to give my patient ceramide. I want to give my patient peptide. No,

Rashmi:you know, reading each patient becomes honestly difficult. There are a lot of cameras now I can't even remember the name.

So you can see that there are so many that you can put your face in.

Both:Yeah. And

Rashmi:they will tell you where is the pigment, where is the UV damage, where is this, where is that? All of that. But honestly, with a naked eye. Yeah. These are all more and more fanciness to. Kind of make it all look, Oh, my God, all this is happening, but a lot of times you can look at them and you can say, like, for example, if you want to see a genetic gene for diabetes, you don't need to necessarily do a gene testing,

Both:you can

Rashmi:ask the blood test, simple, or you can say family history, blood tests also don't want family history, look at him, he's obese, central girth is high, BMR is different than you, so I'm predicting you're going to be diabetic in some time.

He's eating patterns like that. You can make clinical as simple as that is or as complex as you want. When should

Ryan:nourishment start?

Rashmi:When should nourishment start? Again, the day you're born, the oiling that is done to you is nourishment to the skin.

Ryan:I've seen most families after the baby, the kid is five, six years of age, then there is no skin care routine.

Both:I

Ryan:keep shouting at my son, I can go put moisturizer. I can go put moisturizer. Otherwise you're going to suffer like papa with, with bad skin and you can't rejuvenate it in your forties and fifties. So teenagers, how important is it for them to nourish? Because where I'm going with this talk is we'll come back later, which is how people eat today.

Both:Yeah,

Ryan:but I want people to also understand is that skin care routine is so important. So for teenagers, the nourishment routine, what would you advise?

Rashmi:So you're so right, you know, when the kid is born till it is under our control, we're putting oil, whatever, whatever, whatever. After what, when it is out of our control and says, do not touch me, then the skin care is gone for a toss till they start Instagram.

And they start looking at various other people looking now I want and then they go and do all the wrong things that. After around 13, 14, depending on which family gives Instagram at what time. So that interim, which is actually the very crucial period because everybody's also going through hormone changes.

Maximum sun exposure happens, then correct dust wind happens, then you're expanding in your body. So there's growth of everything happening, then your nutrition. is formed in your head as your pattern, your palate is being formed.

Both:So

Rashmi:it's very important that everything is affecting you, the hormones, the nutrition, your growth spurt itself, your exposure to everything.

So therefore, at that time, skin care. Inculcated into a person like brushing your teeth is very important. Hygiene, like I say, small skin care at that moment could be hygiene. Make sure your scalp is clean, make sure the kid is actually having a head wash at least alternate days. Making sure kid is changing their bedsheets, pillowcases, innerwear is washed a particular way, changed a particular way.

Moisturizing the body, maybe not a long hot shower. These are small, small, small things that

Ryan:destroys teenage skin. Correct. I know so many teenagers and parents complain to me that they are in the bathroom and when they come out the bathroom, like a sauna,

Both:you

Ryan:know? So, okay. So everyone out there, Dr. Rashmi, skin expert, dermatologist, the guru of skin is saying.

Youngsters don't have hot showers for too long.

Both:Tepid

Ryan:water, room temperature water. And speaking of temperature of water I see sometimes people talking about ice bowl and putting your face into the side of your pole. What's your opinion on that?

Rashmi:It just, it's like, again, shock to the skin, right? We don't

Ryan:want to be shocking the skin actually.

Rashmi:If you shock, there are certain protective mechanism which actually comes alive in you. So it's okay to shock, but please beware. I myself did a reel once, said that, you know, with easier way, we all don't have hot, you know, ice buckets to dip in after the workout. So you finish workout, come in, have a hot water shower and immediately turn the thing to cold.

And that time it was Jan, I think, or December when I did this reel. You got a catch? No, I'll tell you what happened. Then I did the ice cold immediately. And I said, have a shower and that's done. You go through, right? So that's your shock and you've got what you have to from the ice and you're done. Then I got a DM from a.

From one of my followers saying, Doc, I think you should put a disclaimer in this reel because I did this once much before and I ended up fainting, passing out there. So that shock can be that extent of vasoconstriction that if you are a low blood pressure patient, you can fall in the shower. So please, when you listen to things, understand these things that we give out on Three seconds, because you all don't have patience to listen to long format.

Now, thankfully to all of you, podcast has become a thing that people want to listen to. Otherwise, oh no, attention span, 30 seconds, talk, finish in 30 seconds, finish in 30 seconds. You're like, how do I give everything in 30 seconds? You say something so it's fully out of context. It's not generalized. Then you end up doing it and things may go wrong.

So My whole point is I believe in shock. I believe in icing, but has to be done by the right people, right context. After the physician has looked at you and said you're generally a healthy person and can take that shock. Others will fall into your ice tub, something else might happen.

Ryan:So speaking of correcting what people should not be doing, the fourth pillar comes in, right?

Correct. Which is correction in skin. Talk to us about correction.

Rashmi:Correction for me is when you have a problem. You have an acne, you go to your dermatologist, she'll give you a correction. That is your correction. You have pigmentation. You've gone to your doctor. She's given you. Mostly, I like doing correction at night, nourishing at night, morning just protection.

Makes sense. Yeah. Makes real sense.

Ryan:The face is the soul to the world, right? And you are what you eat. Very much. So, I wanted to bring you in the guru of the skin, which is how important is nutrition to you?

Rashmi:Everything. To me, skin is just literally like a diagnostic tool for what's happening inside. For example, if there's anemia, skin is pale.

If there's excess sugar, skin looks dark. If there is let's say, vitamin upheaval, certain vitamins make you look very cracked and very dark and protein goes down. You can actually see brittle hair, brittle nails. So everything is about what you have put into you is what is seen outside. There is this zero fat diets people do instantly.

You end up looking at the skin, getting, looking very aged and crinkled and dry. So literally what you put in, how, how good is your core? Is how the skin glows. So skin, hair and nail are, but simply byproducts of wellbeing.

So, having said that, Ryan, I want to ask you, how do you end up, you know, I've seen a lot of dieticians who eliminate no sugar at all or no fruit at all, or let's say no oil at all, which is more sinful. What is your take on elimination diet, or are you all inclusive but in a limit?

Ryan:For me, over the years of practice, I've seen bio individuality works and no one size fits all.

Both:So,

Ryan:there are people who You know, when you turn the skin from outside and put it inside, it becomes your gut and they have very resilient skin inside. The gut is really strong. So the elimination diet actually cures up certain of the issues and then they can get back to eating normally. But then there are some of us who have got very sensitive guts or sensitive skin.

I believe that when you put food inside and it sits inside your stomach, your skin sometimes can show what you've done. Of

Both:course. And

Ryan:so from that perspective. I do the blood test. I do the nutrigenomics

Both:in

Ryan:the nutrigenomics. I'm very fond to look at the caffeine sensitivity, the lactose sensitivity and the gluten sensitivity.

Now, if a person tries to say that, no, but you know, I've eaten wheat my entire life and there's no problem, then I do a food intolerance blood test. So if I get enough of signals coming to me saying that, Hey, this is not working. Then I try and begin to counsel the client saying that, Hey, let's try three to six weeks on a nutrition plan and let's see if there's any improvement now within the first three to five days, the gut feeling.

Is there and within 10 to 15 days, 90 out of 100 clients will say my skin has cleared up, of course. So from that perspective a lot of people one of the side effects of a great diet, I won't call it a side effect. I'd say a good effect, a good effect of falling bio individualized diet is that your skin begins to glow.

Rashmi:Yeah, so true. So I also keep telling my patients to end up doing like a food dairy. I tell them just start writing down everything, do a journaling of food. So you yourself can understand the day you're feeling burpy, bloated, and you will see very next few days maybe there's an acne which will erupt out.

So you know what to eliminate that way.

Ryan:So as a dermatologist and a skin guru, In my department of nutrition, are there any supplements or botanicals that over your years of experience, you kind of use them as your best friends?

Rashmi:Yeah, lot of them. In fact, I believe in micronutrition re plugging because there's one macro nutrition, of course, which experts such as you really take care and understand what carb, which carb, how much carb, for example, what protein, which protein, how much protein all of this is, and the oils.

All of this is taken care of. Then as much as we may eat right, we may eat healthy. The produce itself is not like before, right? There's not enough nutrition in the produce itself, so you need that little micro plugging of nutrition to happen. So that's when I believe in supplementation, and in supplementation, I've realized that I not only look at English medicines, or not medicines, let's say vitamins and minerals and amino acids, et cetera, but I also like, for example, milk thistle.

It's a fabulous anti inflammatory, and it just comes from English intelligence, like curcumin comes from our intelligence. So, like that, I like to mix these little things. Shatavari, for example, comes from our Ayurvedic intelligence. So, I like to mix the English and the other traditional and plug them together towards a goal.

Either it is an antioxidant or an anti inflammatory or it is, let's say, something which calms down the hormonal upheaval just before a menstrual cycle. So, these are things that I like to put together and I believe in them as micronutrients to support. The functioning of the body

Ryan:when people walk into a clinic, I'm just thinking if I was a fly on the wall, how much of you look of you looking at them, you would say that is it because they're eating too much and therefore they have bad skin.

Rashmi:Yeah, every, every single person in my clinic. I asked him about their diet. It is very important for me, everybody. So we ask them about their diet and I just tell them, I'll send you an elimination list and an inclusion list. I'm not a dietetics expert, so I can't give you a diet chart and what to do, nor will I be able to monitor you because I don't have that kind of time and bandwidth through that subject.

So then I tell them either you can go to your nutritionist and show them this elimination list and double check with them. We also have a nutritional supplement list that I will give them to support. So that to me is very important, a starter point.

Ryan:So this comes under the nourishment part of one of your pillars.

Yeah. Can any of the nutritional products help in the correction part?

Rashmi:Yeah. Yes. A lot of them. Simply, for example, a vitamin. Yeah. So a lot of them come with very. fulminant or very infective acne, which is looking red and angry. Then I do ask them, let's say, for example, for their hormonal issues, which I ask clinically, is their breast tenderness?

Do you have a headache? Do you have mood swings? Do you have flushing on your face? Then if all of this, for example, they say yes, then I already know clinically, the prolactin may be high. Then we end up looking at their hormone testing to see prolactin is high. I won't simply go and give a drug to bring the prolactin down, but I will also check their vitamin D.

Because I know the minute I correct the vitamin D, prolactin will automatically start coming down a little. Or if they're on antacids, then I know that can also increase the prolactin levels. So I'll tell them to cut that. So the nutrition and what you put into your gut becomes so important the way the hormones behave.

There are a lot of pro estrogen Nutrition elements such as let's say flax seeds, soil, all of these are very pro estrogenic, right? So if you're already high on estrogen, if you're already getting a lot of, let's say, oily skin, acne, prone skin, I am not going to load you more with that. So these are a few things that I work with and balance it out.

Ryan:What is Dr. Rashmi's nutrition schedule like? So, You have beautiful skin, so I'm, I'm, Thank you. So you're like doing stuff on yourself and doing the pillars of cleansing, Yeah. What was the second one?

Rashmi:Protection, protection, nourishment,

Ryan:and

Rashmi:correction when necessary.

Ryan:So from a, from a nutrition point of view, what does your day look like?

Rashmi:So I think I'm pretty much a South Indian. Yeah. And I've stayed, you won't believe, between 50 and 53 kgs all my life. All my life, from being a teenager to now. Only last two months I've put on. After the podcast, I'm going to ask you tips, free tips. So put on some two to three kgs. But what I have always lived with is three meals a day.

So I have my breakfast, my lunch, and my dinner, and it is always, I know intermittent fasting has become a style now or a theory that most people are talking about, but that's how I led life. My mom always served dinner by around 6. 37, so even today I have my dinner by 6. 37. And you continue to practice after that?

No, I finish practice by 7.

Both:Okay. So

Rashmi:sometimes it's 7. 30. So it goes a little delayed. Otherwise, that's, that's how I practice. So I have my breakfast at nine, lunch sometimes because of practice gets up and down, but I'd like to have it at two and I have my dinner at seven and I'm done. I don't snack in between.

If I feel very hungry by around 12 ish, if I know my lunch is getting delayed, I have a half a peru, which I remove the seed, but I don't remove the skin. So I just have half a peru or one orange or one. Citrus fruit. That's all is what my diet is. What I've learnt and observed, why I have a constant weight and my skin also is good and nourished, I take one size of, let's say, this much.

This is my salad, this is my soup, this is my vegetable, this is my chicken, fish, whatever, and this is my rice. Okay, so what I do is, very unconsciously I've seen over the years, My carb is not very big. Carb is equal to my vegetable, equal to my protein, which could be either a black dal gassi or something like that, or it is the chicken or the fish of the day.

So just that much. If there is a salad or a soup, it is just that much. So I'm not binging on a carb as a natural thing, but I don't eliminate carb because I know You should tell us, please tell us about not eliminating carbs, and I want to ask you more. So that's been what I eat and a few of my supplements that I like and change according to the season and my age.

Ryan:What are the supplements that you take? So

Rashmi:I make sure primrose is something that I like. So evening

Ryan:primrose? Evening

Rashmi:primrose with the flaxseed. With with a vitamin E. Now, that, as a combination works best for you in terms of all the omegas that you need.

Ryan:But take advice to the Omega take, take advice from your personal dermatology doctor.

Yes. Or a qualified dietician. When you take a nutritional supplement, a lot of people do sell prescription, so this is your prescription to yourself. Like,

Rashmi:for example, I see everyone. Taking glutathione, vitamin C, effervescent tablet. In effervescent, there's so much soda by cup which you don't need. You're

Ryan:actually killing, you're destroying the glutathione, but that's another story.

Rashmi:Exactly. You're destroying the glutathione too. You're changing the pH of the entire gut. Why would you do that? You should tell us more about that. Or you take gummies because everybody is saying so. There's so much cellulose and sugar in it, you just don't need it. So yeah, self medication not happening about nutrition, the right format is important.

There's so much science behind it. So I take BRITE, which is a set of antioxidants, with of course the popular glutathione in it and many more. Then I take a hydrate, which has collagen in a tablet form. So I don't have to mask the smell and the taste of collagen in a liquid form or a powder form, so it's more in a tablet form with edible hyaluronic acid, with lutein, all of that, to hydrate.

So I take something to hold the water, I take something, which is the omega oils, which I told you to hold the oil, and I take something which is an antioxidant and an anti inflammatory. So these are something I'm quite regular with, and I definitely see the difference that those micronutrient plug in will do to you as you grow.

And

Ryan:if you had to choose five of your favorite foods? Rice, rice, rice. From a skin perspective,

Rashmi:you know, I also say from a skin perspective, there's something called the gut skin access. Scientifically, there's so much more towards the microbiome, the absorption, all of that. But for me, gut skin access only means eat the food that quenches your soul.

For me, it's curd rice and the day I eat something which quenches my soul, my fish curry and rice. This makes me happy and when you're happy, there's so many more happy hormones releases, stress reduces, skin automatically looks good. So one is the whole nutrition perspective, which is elemental knowledge and science.

Ryan:The physiological part and then the psychological part.

Rashmi:Psychological happy part. So I'm like, take something which soothes your gut, soothes your memory, soothes your mind. So you're like very happy with it. So that glows on the skin.

Ryan:So Doc, you're stuck on an island. And you can take only five foods with you.

Both:Aiyo.

Ryan:And none of your medical equipment or your clinic, your skin therapist, nobody's there with you. What are the five foods you'd carry with you to that island?

Rashmi:Water.

Ryan:Mm hmm.

Rashmi:Rice.

Ryan:Mm hmm. Remember your skin.

Rashmi:Haan. Then can I, can I take veggies and grow?

Ryan:Yeah, you can take veggies and grow.

Rashmi:So I'll take some veggies and then sow there and then start growing them.

Some veggies. Okay, lots of veggies. The fish is there in the island.

Ryan:Yes, so that's my omega 3. So I'll

Rashmi:catch the fish. How good

Ryan:is omega 3 for the skin? Very good.

Rashmi:Very good.

Ryan:So my

Rashmi:fish has come.

Ryan:Last one. You can't take sweet.

Rashmi:No, I won't take sweet. Why won't you

Ryan:take sweet?

Rashmi:That's because it's going to kill everything that is going to firstly, my perspective of now I want to stay youthful on my skin, right?

It's going to make my collagen brittle

Both:and it's

Rashmi:going to break the collagen and kill it, make the elastin brittle. So I don't want it. It speedens the end glycation of anything. So the protein becomes brittle. I don't want sweet

Both:for

Rashmi:multiple reasons. If I'm if I'm eating sweet, increase the Glucose and therefore including insulin.

Is that

Ryan:why our grandmothers were much younger than the current generation in terms of their skin and their looks because they didn't have that much access to sugar?

Rashmi:I think our grandmothers were younger because they also didn't kill themselves to stay lean. There was a lot more subcutaneous fat, which is very important.

It is not just a source of nice coating under the skin.

Both:It is

Rashmi:also that coating holds back. Even the skin's collagen really well holds a little bit of estrogen there for a longer time. There's a peripheral conversion and estrogen there. So that is why they looked a lot younger and they were less stressed.

There was less pollution, less sun. So there was multiple factor. True.

Ryan:True. Wise words. Yeah. You know, you talked about glycation. So, this is basically, in my opinion, sugar going and slapping. Correct. So, we have HbA1c. Correct. Is that the same process, glycation of hemoglobin?

Rashmi:Yeah, that is a cumulative three month analysis of how your body is behaving with

Ryan:sugar.

Correct. So, basically, the sugar is slapping hemoglobin and you can see that three month period. Does glycation happen for your skin?

Rashmi:Yeah. So glycation is nothing but hardening of the protein there. So that makes it, makes the skin

Ryan:kadak. That's why you're saying don't have sugar.

Rashmi:Aha. And also what happens is when you have sugar.

That spike of sugar gives you a spike of insulin. Every time you spike sugar, insulin keeps spiking car. Car insulin sits there because it's spiked out so much and the body doesn't even work with insulin the way it should work.

Ryan:So Doc, what you're saying, so insulin resistance doc, what you're telling me is, I mean, when we say sugar, people think holy table sugar.

Both:No.

Ryan:But our insulin spike goes up with the carbohydrates that come from our food.

Both:Yeah. And

Ryan:so if you're eating too much, you have these constant spikes of insulin, which is actually aging. You.

Rashmi:Yeah,

Ryan:so would fasting also

Rashmi:making you darker, also making your skin thicker, not the good thickness of skin that you want with collagen, but bad thickness of elastosis kind of hard thickness that you don't like.

So skin simply goes bad with sugar. Also, there's insulin like growth factors that it stimulates.

Both:So

Rashmi:acne increases. So sugar is a

Ryan:So I get a lot of teenagers. So like, they're like, they buy all of these products and they do the skincare, but they're forgetting their diet.

Rashmi:Very important. And when I say sugar, like you rightly said, they only think tablespoon of sugar.

They'll simply be having an ice cream. They'll have a cookie, which is sugar and dairy and maida, which is processed food, which is which is lethal. That combination is lethal. So a cookie, a cake, an ice cream, a processed cheese, a processed meat, all these are lethal because they have all the three.

Ryan:So when you say lethal, I get a lot of teenage girls who are overweight, skin is bad.

PCOD is a new condition. Yes. Yeah, for the last decade, polycystic ovarian disorder. Do you see a lot of PCOD cases and what are the skin care issues associated with this condition? So

Rashmi:PCOS is literally a lifestyle disease is what I call it. Starts off by wrong eating, by stress. These are two things which if I can narrow down are the triggers for this.

Ryan:Does it happen with these teenage girls when they're finding the identity early teen years? Mom, don't correct me on eating. I want to eat whatever I want. I'm stressed out. Do you think that could be a starting point?

Rashmi:Stress and eating are the two starting points. That's your lifestyle. So the mothers intervene

Ryan:at that point?

Rashmi:Yeah. So when I have PCOS patients coming in, I have the mother, the father, and when the girl is sitting, I tell them, you can't tell the child not to eat XYZ. I can't tell the child, you better lose that weight that you've gained when both of you are this on the weighing scale. It

Ryan:has to be a

Rashmi:family.

Ryan:Parents need to lead by example. Exactly.

Rashmi:You have to be a family. together to help the child to look a certain way, be a certain way. It's not about looks. It's about health. So you have to end up having what the family eats is what shows on the kids and you all together. So it has to be a food habit in culture.

If you as parents are going out every day, partying and eating and expect a teenage child to sit down and eat, it's not going to happen. And at home, if you have this much cooking and that much happening, it is, it has to be a discipline. That's in the family. So that's important. Now cut the question of PCOS in my practice.

It's a big chunk of practice these days because they present one with acne. Two, because there's insulin resistance also associated PCOS, there's a lot of skin pigmentation, especially on the neck, on the forehead, on the temples, on the cheeks that can happen. You could end up having excessive hair growth on the face.

So very male like terminal hair. Yeah. Hirsutism is what can happen on the face. You have hair fall from the scalp. All of this is part of PCOS. Sometimes their periods might be very regular. So today also, when I saw the results and I told the patient, oh, you're marginally PCOS, we'll have to do this. She says, but my periods are regular.

Periods can still be regular. You can still have PCOS. You needn't be obese or overweight. You can still be PCOS, which is a lean PCOS, we call it. It could be either a source from the ovary. which is kind of driving it wrong or it could be adrenals which is driving it wrong. So we'll do some blood tests to figure out what is driving your PCOS and treat it accordingly.

Very important for us to also correct the nutrition.

Ryan:A doctor said correct your nutrition for PCOD condition and parents you need to lead by example. Now, speaking about you know, parents, I remember when I went to study my mom told me don't drink tap water when I went to Scotland. Now, when I went to Scotland, You know that in Europe, water can be drunk from the tap, but some of this Indian mentality mindset says you can't drink it.

So then I found out that bottled water was really expensive and orange juice was really cheap. So I ended up drinking orange juice for

Rashmi:Insulin spike and how? I

Ryan:ended up drinking orange juice for nearly four to five months and then suddenly my nails started going yellow. And I got scared and I went to the doctor at the NHS and he says He did all the questions, the doctor, and he just said, are you drinking too much of orange juice?

So I think there was this case

Both:of

Ryan:people having too much of nutrition.

Both:As a

Ryan:doctor, have you seen cases where eating too much of carrots or orange juice or for that matter, any food in your career, like you can look at a person like orange jello. So are there things that you can tell people out there that, which is like, Oh, I know you're doing.

This nut and you have a skin problem or your skin is orange in color. So share with us some of the secrets that you get out of it.

Rashmi:I think the only thing I say is everything, even though probably nectar is good in a limit, you over drink it. God knows what happens. So you need to be. In limit, everything, like you would say as a nutrition, carb is good in a limit.

You can't eliminate. This is good in a limit. So likewise, for me, everything is good in a limit. So especially vitamin tablets that you keep popping, be very careful. So there are, to simplify it, there is a set of vitamins. Let's say ADEK, which is fat soluble vitamins. You end up having them without the doctor's prescription.

You're going to end up with toxicosis. So likewise, a lot of food substance in excess, but honestly, right now, I don't see much of people in food binging, which becomes excess, except glucose, insulin.

Ryan:Okay. Which are the foods that a teenager or anybody who has oily skin that they should avoid? What do you tell them?

Rashmi:I usually generally tell them fried food. Not because fry exactly oil comes out on the skin because fried food is highly inflammatory, especially if it is refried with oils, which are all

Ryan:the street food that we get today is really bad.

Rashmi:And somebody the other day told me you will know the answer that.

There is a way, a certain oil that they use, which is apparently the cheap oil.

Ryan:The palm oil.

Rashmi:Yeah, where you can't say which oil it is or the flavor you don't get.

Ryan:So we did a costing of oils, okay?

Rashmi:And

Ryan:so if you and I look, look at pure ghee, it's in excess of 700 rupees a kg.

Both:Okay.

Ryan:Whereas the other oils will come down the range.

And palm oil comes in at the cheapest. So if you and I opened up a restaurant, And imagine cooking our food in ghee, how expensive the dish would be. So you're looking at the profitability of the restaurant.

Both:Yeah. So

Ryan:restaurants are not looking at the nutritional element

Both:of foods,

Ryan:they're looking at the financial element or the profitability return.

So the palm oil is something that I think the fried food on the streets is what is slapping us. But that's the inflammatory markup. Is there any other foods that you, sugars we said already? Yeah.

Rashmi:Sure. What are the foods that needs to be avoided if you have an acne prone oily skin? One, of course, is anything that is fried and fried in the wrong oil.

Two, you could also stop anything which spikes your glucose, therefore your insulin. So anything that is sweet to the tongue has to be avoided, not just tablespoon of sugar. And third will be inflammatory. Which means to say, whatever makes you feel bloated, burpy, you know, the next day, skin is feeling red and irritated.

It could be different for different things. For one, it could be maida, for one it could be wheat, for one it could be milk. So whether it is dairy or maida or gluten, I leave it to you to decide. If you're so keen, you could go to you and do a food tolerance test and do all of that to figure out which is it.

Ryan:You know, one way when people don't want to do the testing. I just asked him to check their resting heart rate for 10 days. Then I tell them, you eliminate these basic kujjili foods.

Both:Yeah.

Ryan:And we invariably see a drop in the resting heart rate.

Both:Really? By 3

Ryan:to 5 points. But that's significant enough to convince my client that there does show a link between the food

Both:Wow.

Ryan:And your inflammatory markers, a simple, a simple dipstick test that you can do because many people do not want to do a food intolerance test. Many people are in denial that food could be the causative condition.

Rashmi:So now I want to ask you for PCOS. If I can ask you to give me a free diet for all my patients of PCOS.

Ryan:So, so number one is what I feel is that, you know, and you laugh at this, but I, I call the cysts in the ovaries, the pimples inside the ovaries.

Both:Yeah. Right? Yeah. Okay.

Ryan:Now, why do we get pimples? Yeah. It's because some food you're eating that is wrong.

Both:Yeah. You

Ryan:already told me that don't eat too much of sugar.

Both:Yeah.

Ryan:And PCOS is insulin resistant. Correct. So we have this whole cascade that comes back.

Both:Yeah.

Ryan:I have identified it as a logical conjecture that between the ages of 11 and 15, as the girl is growing up, she's forming her identity, her menses and hormonal structure starts in. So there is the mood fluctuation, there is a behavioral change, she's moving into adult mindset of thinking.

And therefore, I believe that food represents one independent adult choice making decision, not when you're 18, but at a much younger age.

Both:Hmm.

Ryan:So now what happens is most of the fathers don't interfere. And I think A lot of the mothers are also working, so the conversations are not at the dinner table or at the lunch table anymore.

So, the girl now is exposed to media,

Both:which

Ryan:says I need to have this slim trim figure. And a lot of girls understand that by starvation, you get there, I get there, and they stop eating. So, nutrition now suddenly drops. And when they do eat, they're eating from a craving perspective.

Both:Yeah. And

Ryan:when you are stressed out, research has already shown people who are stressed will gravitate to high fat and high sugar foods.

So now we come back into the whole behavioral mechanism of the limited food choices in a week, in a month, in a year, are bombarding your hormonal system.

Both:Yeah.

Ryan:And coupled to the fact that we are so focused on academics in today's day and age for the woman to be contributing, she has to lead, she has to become powerful focusing so much on academics.

Physical activity is being lost. So as a result, you're putting on weight. And I think by the time three years have gone, 13 to 16, 10 standard, we have got that 5 8 kg fat gene. And I think that's where the PCOD condition begins to start flaring in and coming in. And then we have the insecticides, pesticides, the pseudo estrogen molecules from plastic, from microwaving.

So I always tell people, Don't fry your food because trans fat goes and kujles you, so no fried food. So I see teenagers look at me like, not even french fries? I say, specifically not french fries. Right. And, and so, I spend a lot of time educating the girl child that she needs to walk. Walking is one of the best fat burning exercises because many girls have anemia and can't do these high end sporting activities.

Both:They're out of

Ryan:breath and then they say, this is not for me. Whereas walking is a sustainable activity. And then we're looking at elimination of the high glycemic index carbohydrates. I don't say grain free, but I choose a more intelligent grain. Which could be based on if the parents give me a permission to do the food intolerance test.

If they don't, what I do is I do a simple thing. One week, one week, eat this grain. Tell me how's your potty? Do you have gas? Does the wing scale go up? So a lot of times we find out then people, let's say for example, eat only maida chapati, or wheat chapati, or whole wheat, or quinoa, or brown rice, or ragi.

We begin to able to form a pattern.

Rashmi:So you're not against maida?

Ryan:Anybody, like you said, no, even a poison taken a little form is okay. I'd like to behave like a judge. When Maida comes in front of me, I don't say guilty or I let it go free. I ask, what are you appearing before me as a petition? So if it's a croissant you're in Paris, enjoy it.

Right. But if every day we're going to sit in our clinic at four o'clock in the evening or we're in school coming out of the canteen and ordering those cakes and pastries, or I'm having, I have the choice to ask for a healthier roti and I don't have the knowledge because the maida releases a sugar spike immediately because of the refined flour and my saliva mixes with and gives me the pleasure sensation.

So then I'm like, dude, I got to educate you. Okay. And therefore, once you get educated, you will realize that Maida without its fiber is going to be bad for you because it's a nuclear bomb getting into you. So when you put all of this together, I think the PCOD diet is driven more from behavioral consequences and lack of information on what to eat.

And how much to eat with these younger girls, they're eating too little

Both:and with the

Ryan:girls who have now gone into college or their first job in college, they're like, can I hang now my body this way? I can't do anything about it.

Both:So there's

Ryan:this I don't care whatever attitude and they don't realize that they could control it with the proper nutrition.

And then comes the, you. I can't exercise either. I don't have the scheduled time. It's not a belief in my family or I'm too body conscious to go out and work out because I'm getting trolled or shamed on the internet because I'm of a heavier weight. So I sit in a counseling room and I hear all of this.

People break down

Both:and it's

Ryan:not about the diet. It's about just that the stigma associated with eating too much, eating unscientifically or eating not at all. And then when they get into this, yeah. I work in my first job. I've got to prove that I'm a girl. I'm a woman in this workplace. So I will work longer hours than anybody else.

Let my food go for a toss. And then I'm living in PG's. I'm going to this big city. I'm no longer eating mamma ka

Both:khana.

Ryan:So the tiffin box is coming in. So she's working really hard now. She's stressed, stressed, stressed. She's trying to prove herself out. You know better than anybody else as a doctor how stress affects your hormones.

So now you've got another 3 4 kgs of weight gain. So what do we do now? We have nutritional deficiencies. We have the stresses. So I'm drinking copious amounts of tea and coffee and suddenly because my brain needs that spot of energy I had 2 3 teaspoons of sugar. And so now the PCOD rears itself even more, and then we get another 3 4 kgs, weight gain.

Before you know it, this teenage girl, who was of the right BMI, is suddenly 20 kgs heavier. And then she comes to marriageable age. Because she's going to get married, and she wants to look good in that wedding gagra. Or gown. Please stop. She calls her Brian Fernando. Ha! Can I, can I lose weight in three months?

And something that has taken almost three to ten years cannot be lost in, in, in three months. So at that point, you know, you, you look at the symptoms, the skin, little bit of hair. Or you just guess intelligently by looking at the HOMA score

Both:or

Ryan:the insulin resistance and the high average blood sugar levels.

And like, I think you should go and see a dermatologist. You should go and see a gynecologist. These two doctors you have to be because you're going to be getting married. So you want beautiful skin and you want to know that all your female reproductive system is in the right

Both:place.

Ryan:And then suddenly they get this thing about PCOD like hitting them.

So that's another place we diagnose it. And then the last stage is where you know, You're trying for kids.

Both:Yeah.

Ryan:And that's where it's not detected till now, which is the skinny PCOD. In fact when I married my wife we, we had a, we had a late marriage, both of us. And my mother in law's a gynecologist.

And the moment we got married, the first thing my mom, mom in law said to me is like, don't delay. You have to make babies. And I was like, we just got married to each other and stuff like that. And my wife says I have PCOD. Yeah. And I knew the condition and everything. I said, don't worry about it. And I remember my mother in law saying is you start fertility treatment right now itself.

I was

Both:like,

Ryan:no, we won't do it. Let's get into diet. So my personal experience is that PCOD is a reversible condition.

Both:Completely.

Ryan:And nutrition is tantamount because you can take all the hormones, medication, do all the high end weight training and exercise and run marathons. But if you want that ovary to reset itself, get rid of those pimples, as I call it, you got to go with nutrition.

Rashmi:So true.

Ryan:So, Dr. Rashmi, you are the skin goddess, the guru, the teacher, the doctor,

Both:I

Ryan:am the nutritionist.

Both:Yes.

Ryan:Your domain is skin care.

Both:Yes.

Ryan:My domain is nutrition care. I will choose five things that everybody out there needs to do for better skin.

Both:Wow.

Ryan:What are the five things that you say are the top priority for them to do for their skin.

So you go first.

Rashmi:So the five points for skin, which is super important. One, of course, the first one is skincare, which is the four pillars that we discussed earlier. So start with a good skincare. Better you go to a dermatologist, understand your skin and start that. Most important. Number two, There's a try and understand what is nutrition, because like we said before, what you put in is what shows on the skin.

Very important. People think that you go to a nutrition only when you're either obese or you want to put on weight, either want to lose or put on weight. For me, just go to a nutrition in general to understand what you should eat, understand the healthy food. So that's one thing. Third, very important thing is mobility.

So exercise, whichever is yours, whether if it is sports, if you're a young kid, you don't have to do one walking and running and Jimmy, you do sports mobility. See how you expend the energy that you're putting in. Fourth is a lot of hydration to the skin. So again, excessive water drinking will only drain out the nutrition.

So you need to know exactly what is the hydration you're taking in, how is your lifestyle and how you consume that. What could the fifth one be? I am thinking. Don't self medicate is the fifth one, I would think. Actives. Don't overdo the actives. Lot of them are looking at internet.

Ryan:Don't self prescribe.

Rashmi:And so many actives you are putting in on the skin. Because you can't

Ryan:undo some of the damage.

Rashmi:Yeah.

Ryan:Okay, so go with the fifth one.

Rashmi:That's it. So the fifth one is too many actives getting educated online, internet, self education and putting in the actives, which might actually lead to long term damage, maybe difficult even for a derm to then correct it.

It's not, everything cannot be erased.

Ryan:Yeah. You don't paint your house today. You don't service your own mobile or your car yourself, but you know, your diet and your skin, everyone, everyone's there. Everyone's an expert on it. The

Rashmi:best part is they come to your clinic and they say, we've done our research.

From where? Why did I study so many years? So now these were my five points.

Ryan:What's yours? My first point is walking. Most of India has a heavier BMI, especially urban India. Walking is one of the best fat burning exercises on the planet. In fact, yesterday I found somebody running in the gym and I went up to her and I said, Ma'am, what's your goal?

And she said, I want to lose five kgs of fat. I said, walk, because when you walk, your heart rate is in a zone where in your substrate utilization of energy is 70 percent from fat and 30 percent from carbohydrate. When you run. You utilize more of your muscle glycogen, which is carbohydrates. So the first thing for great skin care, and you also agreed with me that people when they run, the face does get affected to a certain extent from an aging point of view.

Rashmi:Now, there's two things in a runner's face. If you're running and you're running at a certain pace and you're not running every day like a marathon runner, and you're of an optimum weight, then that will give you that glow, that fresh blood into your face, that little flushing and make you feel lovely.

While it can be the other edge of the sword, where you've run so much, you're so lean right now, and you're at an age where the face can go fully gaunt. So that's called as a runner's face in a not so positive way. So you need to be very careful which age, how is your skin, how is your bony structure when you really decide to run to be that lean.

Ryan:Which is why I'm going to be now walking like this. Because. I'm going to get fat burning. Yeah. It's going to be good on my skin and I'm not going to get the gaunt look. But

Rashmi:you see you have a very lovely bony structure of the face so you will never age badly. And you have a very lean face. I'm sure you being the nutritionist have the exact fat percentage, which is right, not low.

I know you may never have high because you're a nutritionist, but you won't even have it low. So that keeps your skin nice. And three, your acne has been your blessing. The scars because of the acne is actually holding your skin tight and not kind of letting it go down. And scarred tissue has so much collagen, elastin in scar tissue.

It just holds the skin there.

Ryan:Doctor, I feel like taking you for an ice cream. I would say I can't give an ice cream. Let's go get some sugar. That's the best news I heard this century. My second tip of nutrition would be hydration. And, and not only because the skin, 70 percent of the human body is made up of water.

The brain has water, the kidneys have water, skin has water, everything has water. So I am very focused on people hydrating more responsibly. And in today's world, everyone wants to not have plain water. They want to have beverages. If he rewound 1000 years, there were no beverages, we just drank water. So I think that would be my second tip.

Bring water back as a fashionable element into your body. Third would be, as you said, you would take to your island vegetables. Fruits are my fourth. Between these two, if you're looking for weight loss, I'm looking at vegetables being my best friend. And fruits is like your side friend. Okay? Yeah. But if you're looking at weight gain then I would say, Hey, get a little bit more of the fruits as your best friend.

The final point over here is I would And I might be trolled a lot for this is, I would look at the grain control better, G R A I N. You see, you and I today are DJs. What's that? Dash jockeys. Okay. Yeah. So our ancestors moved and walked and worked a lot. So their calorie requirement was very high. So, which element in the food chain gives us higher calories?

It is the carbohydrates and fat. Now, fat technically comes in the added fat from our vegetable oils and all. So, I tell people that's a given to reduce. But carbohydrates, because we are brought up by our ancestors, our dadis and our mothers, we want to eat more of grain. We are taught to eat more of grain.

India is a culture where we celebrate food as an expression of love. So, if I can reduce the grain. Or improve the grain. So white rice, maybe get brown rice, red rice. If there is wheat, go towards the old kamut wheat or kapli wheat. If you're gluten sensitive, then go to the gluten free grains.

Everything from jowar, bajra, ragi, amran. But again, check your bio individuality. Like I'm allergic to ragi. Even though even ragi is a great game because when I have ragi, I get loose motion. So I've got a hypersensitive gut, but there are a few things like quinoa, buckwheat, kuttu, my stomach likes. So my advice to people is begin to understand that your body is the most expensive real estate.

Rashmi:You keep saying that, right? And

Ryan:are we living in it as a landlord? What is a tenant and to me you are like when like you would be like my nutrition architect that I would go to because my house needs to be constructed. It's the most expensive real estate and the skin is the face to the world. So I've got in touch today with the nutrition.

Expert skin architect, expert and the guru. So we've got these few tips together. In case you want to reach out to Dr. Rashmi, we will be sharing her links in the description below. And doctor, where do you practice?

Rashmi:So I practice in Bombay. I used to practice in Hyderabad as well, but I'm planning to wind that up because simply lack of time.

So Bombay it

Ryan:is. Awesome. So we can find Dr. Rashmi Shetty in Mumbai. And if you have any comments, Please list them below and me and my team at the headshot podcast will reach out to you to get you. Younger, healthier, fitter, stronger. So Dr. Lakshmi, thank you so much for being here today with me and sharing your skin secrets and how your skin glows and everyone's gotten some of the secrets.

I'm going to invite you to Bangalore to our podcast studio. Invite you to have an ice cream, which is most of the people are going to say, no, no, you can't have sugar, but we're going to do an ice cream. We're going to. Pick your brains further on how we can better our skin care routine.

Both:Sure.

Ryan:And you can also enjoy Bangalore traffic when you visit us.

Rashmi:Oh my God. Okay.

Ryan:Pleasure having you today.

Rashmi:Likewise. Likewise. Thank you so much. And I must say. I gain so much from this podcast myself. So thank you for having me here and I'm going to pick right back and get more out of you of nutrition as well.

Ryan:Let's go off camera right now so that you can ask all the secrets.

Thank you for watching this far. It's been an amazing episode and I'm so grateful to have you till the end. If you like this video, please share this video with your loved ones. Better still, give me a subscribe, a like, or even a comment and we'll come back to you.

Mentioned Tools and Techniques

• Customized Routines: Tailored skincare regimens for cleansing, nourishing, and protecting your skin.

• SPF Knowledge: Proper sunscreen application for all-day protection.

• Micronutrition: Essential supplements like vitamin D, ceramides, and antioxidants to support skin health.

Resources

• Dr. Rashmi’s Clinic: Book consultations and explore her recommended skincare solutions.

• Follow Dr. Rashmi on social media for daily tips on skincare and wellness.

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