At 40, Dr. Mary Alice Mina noticed her neck for the first time. She was a dermatologist, she knew the science, and it still caught her off guard. That moment of recognition is exactly what she now builds her practice around.

Dr. Mina is a board-certified dermatologist, host of The Skin Real podcast, and one of the clearer voices in a space crowded with noise about menopause and perimenopause skin care. In this conversation with Dr. Portela, she covers what actually happens to skin during this chapter of life, why perimenopause symptoms are so easy to miss, and what women can realistically do about the changes they are seeing in the mirror.

A few things stand out. The collagen loss that happens gradually in your 30s can accelerate sharply once estrogen drops at menopause, sometimes up to 30 percent in a five-year window. The window to do something about it is earlier than most people think. Dr. Mina and Dr. Portela both practice what they preach: daily SPF, a retinoid, and an antioxidant serum cover most of the ground. Collagen supplements, creatine, and protein intake all come up, with honest takes on what the evidence actually supports versus what sounds good on a label. Everything beyond the basics is diminishing returns unless sleep, nutrition, and stress are also being addressed.

The conversation on topical estrogen and hormone replacement therapy is candid and nuanced. There is promising data and real gaps in the research, and Dr. Mina is honest about both. She also makes a point that tends to get lost: vaginal estrogen is one of the most evidence-backed and underused treatments in women's health, and many women who could benefit from it have never been told it exists.

On the in-office side, she walks through laser resurfacing, microneedling, and biostimulators like Sculptra and Radiesse for collagen restoration, with a clear-eyed take on why patience matters and why the lifestyle foundation has to come first before any cosmetic procedure can do its job.

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Dr. Mary Alice Mina Instagram: @drminaskins Podcast: The Skin Real Perimenopause Guide: hi.theskinreal.com/peri

Skinfluence Podcast Instagram: @skinfluence_pod

Summer has a way of reminding people that their skin has limits.

Every July, the same things land in Dr. Dustin Portela and Austin Lee's clinic: sunburns that crossed a line, back acne that appeared out of nowhere, rashes from sources nobody thought to question. This episode is their honest take on the summer conditions they see year after year, what causes them, what to do, and in a few cases, what not to do.

Sunburns get a proper breakdown, including the biology of why the damage keeps happening after you're already out of the sun, what actually helps during those first miserable hours, and when a burn is serious enough to warrant a trip to urgent care. The conversation on sweat acne and folliculitis is worth the listen for anyone who spends significant time outdoors and can't figure out why their skin keeps breaking out. Tinea versicolor comes up too, including Austin's admission that he deals with it himself every summer.

The diagnosis that tends to stop people cold is phytophotodermatitis. Most people have never heard of it. But if you've ever squeezed a lime into your drink at a backyard barbecue and gone back outside, you've taken the risk. The case stories here are genuinely funny, and the condition is genuinely real. Sea bather's eruption, swimmer's itch, and chiggers round things out in ways that will make anyone reconsider their relationship with warm, still water.

Somewhere in the middle, a 1933 physician decides to let a black widow spider bite his own finger to prove a point to skeptical colleagues. It goes about as well as you'd expect.

Product of the Week

Neutrogena Ultra Sheer Body Mist SPF 70 and Inner Glow Sol Defense Supplements

A water-resistant spray sunscreen for easy summer coverage, paired with a polypodium-based supplement that helps neutralize UV free radical damage from the inside out.

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Austin Lee, PA-C Instagram: @austinleepac

Skinfluence Podcast Instagram: @skinfluence_pod

Your skin is not just your largest organ. It is also, occasionally, a window into something going wrong much deeper than the surface.

Autoimmune disease has a reputation for being mysterious, slow to diagnose, and easy to dismiss. Part of the reason is that the early signs often look like something ordinary: a rash that won't quit, fatigue that sleep doesn't fix, joints that ache without a good explanation. What most people don't realize is that a dermatologist is frequently the first doctor to put the pieces together, sometimes years before a rheumatologist ever enters the picture.

Dr. Dustin Portela and Austin Lee have both sat across from patients who had been to doctor after doctor without answers. In this episode, they talk openly about what those cases actually look like, what they're thinking when a rash doesn't behave the way it should, and what separates a routine skin condition from something that warrants a much closer look. Lupus, dermatomyositis, bullous pemphigoid, and gout all make an appearance, not as a checklist, but as real conditions with real presentations and real consequences when they go unrecognized.

There is also a case that has nothing to do with autoimmune disease and everything to do with why the gut microbiome deserves more respect than it gets. A man was pulled over, failed a breathalyzer at twice the legal limit, and had not touched a drop of alcohol. What his body was doing instead is one of the stranger things documented in modern medicine.

For anyone who has been told their labs are inconclusive, their rash is probably nothing, or their symptoms don't quite add up yet, this episode is for you.

Product of the Week

Avene Thermal Spring Water Spray and Avene Cicalfate+

Fragrance-free, sterile formulas for barrier repair and inflamed skin. Links in the show notes.

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Austin Lee, PA-C Instagram: @austinleepac

Skinfluence Podcast Instagram: @skinfluence_pod

Two in three Australians will be diagnosed with skin cancer by the age of 70. That statistic is the backdrop for everything Johanna Young does.

Johanna is the founder of Solbari, an Australian sun protective clothing brand now distributed in over 160 countries. What started as a solution for herself and her fair-skinned husband on the golf course has grown into a company of 35 people, a warehouse in California, and more than 800,000 customers worldwide. In this conversation, she joins Dr. Dustin Portela to talk about UPF clothing, why most people dramatically underestimate the sun protection their everyday clothes provide, and what the US could learn from Australia's decades-long commitment to sun safety.

The conversation opens with something most people don't know: a standard white cotton T-shirt offers roughly the same protection as SPF 5 sunscreen, and when wet, that drops even further. UPF 50+ clothing, by contrast, blocks at least 98% of UVA and UVB rays and maintains that protection throughout the day without reapplication. Johanna breaks down what actually determines a garment's UPF rating, from fabric composition and weave density to color and stretch, and explains why Solbari tests every color in every product to ensure that rating holds through at least fifty washes.

Dr. Portela and Johanna also get into the broader cultural question of why sun protection is non-negotiable in Australia while it remains a hard sell in parts of the US. The answer involves school policies, government-subsidized skin checks, a national ban on tanning beds since 2015, and a public health infrastructure built around prevention rather than treatment. It's a candid and genuinely interesting comparison between two countries with very different approaches to the same problem.

For anyone who loves being outdoors but has felt caught between protecting their skin and actually living their life, this episode is worth your time.

Product of the Week

Solbari UPF 50+ Sun Protective Clothing

Lightweight, breathable, moisture-wicking UPF 50+ clothing designed for all-day outdoor wear. Use code SKINFLUENCE15 for 15% off at solbari.com.

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Johanna Young / Solbari Instagram: @solbari

Skinfluence Podcast Instagram: @skinfluence_pod

Not everything trending on your feed deserves a place in your routine. This week, we're sharing a conversation Dr. Portela had on the Derm It Trotter podcast, hosted by board-certified dermatologist Dr. Shannon Trotter, where the two broke down some of the biggest skincare trends circulating online right now and separated what's worth your attention from what isn't.

The conversation covers a lot of ground. Red light therapy gets a fair but nuanced take: there's real potential there, but the people most likely to benefit are also the ones already doing everything else right, which makes it hard to know what's actually driving results. Exosomes are generating enormous buzz, with search interest up thousands of percent in a matter of months, yet the science on sourcing, purity, and efficacy hasn't caught up. K-beauty earns some genuine praise for its innovative textures and formulations, though both doctors agree that 10 steps is a hard sell when two or three solid products do most of the work.

Dr. Portela also addresses the anti-sunscreen movement that reliably resurfaces every year on social media. He traces where it comes from, why the studies people cite don't hold up in real-world human use, and why sunscreen remains the most evidence-backed thing anyone can do for their skin. Supplements follow a similar thread: the industry is larger than pharma, largely unregulated, and too often marketed as a shortcut around the lifestyle changes that would actually help.

The episode closes with practical advice for anyone trying to find reliable skincare information online: cross-reference your sources, be skeptical of claims made on social media that the brand itself won't make on its own website, and when in doubt, get face time with a board-certified dermatologist.

Please support Dr. Trotter by subscribing to Derm It Trotter: Don't Swear About Skincare wherever you listen to podcasts.

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Skinfluence Podcast Instagram: @skinfluence_pod

Most people who want to become a dermatologist know it's competitive. Few understand what it actually takes to get there when nothing is handed to you.

Dr. Wallace Nozile is a board-certified dermatologist, social media educator, and someone who came very close to choosing a career in R&B over medicine. In this conversation recorded in studio, he and Dr. Dustin Portela trace the full arc of what it takes to match into one of the most competitive specialties in medicine, from a rocky undergraduate start and a student advisor who laughed at his ambitions, to a grueling step one prep schedule and a mentor who changed everything.

Dr. Nozile is candid about the role discipline played, or didn't, in his early years. He was pre-med from the start but largely coasting until a dismissive advisor put a chip on his shoulder. That moment, he says, did more for his trajectory than anything else. He went from Cs in organic chemistry to a 4.0 in a master's program alongside first-year medical students, then into medical school, and eventually into dermatology, one of the hardest fields to match into in the country.

The conversation gets into the emotional weight of that process in ways a checklist never could. Dr. Nozile talks about skipping his best friend's bachelor party to study, becoming temporarily socially awkward after weeks of 12-hour study days, and the unexpected mentor who turned out to be his greatest advocate. That mentor, Dr. Stanton King Wesson, was a Vietnam veteran and program director who told Dr. Nozile plainly: "The only difference between you and that person is time." It's the kind of line that stays with you.

They also look ahead, discussing personalized medicine, genetic testing for treatment response, and what role physicians will play as AI reshapes dermatology. And in a field where social media has become its own form of medical education, Dr. Nozile reflects on why reaching patients who might never see a dermatologist matters as much to him as anything he does in clinic.

Product of the Week

Avene Tolerance Foaming Cleanser

A gentle foaming cleanser Dr. Nozile recommends for dry, sensitive skin patients who thought foaming cleansers were off the table.

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Dr. Wallace Nozile Follow on social media (links in show notes)

Skinfluence Podcast Instagram: @skinfluence_pod

Your skin at 37 is not the same organ it was at 22. Collagen is breaking down faster than it's being replaced. Fat pads are shifting. Cell turnover is slowing. And one morning you wake up and wonder where your face went.

Dr. Dustin Portela and Austin Lee break down the biology of aging skin in a way that's actually useful, covering the collagen and elastin loss that starts in your 30s, why the dermis gradually thins, how fat pads descend over time, and how cumulative sun damage eventually overwhelms your skin's antioxidant defenses. It's a slow process, mostly invisible, until it isn't.

The episode then turns to what you can actually do about it. Sunscreen and sun-protective clothing are the foundation. Vitamin C serums help neutralize free radical damage. Retinols, on both the face and body, can slow collagen decline and improve texture over time. Diet matters more than most people realize: chronic sugar intake accelerates the breakdown of collagen, while inadequate protein makes it harder to rebuild. Sleep, cardio, and resistance training round out the picture, with real data showing that weightlifting can improve skin thickness, not just build muscle.

For those already seeing changes, the hosts get more specific. Topical pigment inhibitors like hydroquinone and thiamidol can address sunspots, with the important caveat that not every dark spot is the same. Microneedling, chemical peels, and CO2 laser resurfacing each have a place depending on the severity of concerns. Dermal filler can be transformative for volume loss when used correctly, though Dr. Portela is candid about what happens when it isn't.

The episode closes with a reminder that aging is not a problem to be solved. It's something to be managed thoughtfully, with realistic expectations and a little grace.

Product of the Week

Activé Restore Body Firming Cream — Dean Skincare

A retinol body cream with hyaluronic acid, ceramides, and caffeine formulated to improve skin resilience and support collagen production. Available at shop.drdustinportela.com.

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Austin Lee, PA-C Instagram: @austinleepac

Skinfluence Podcast Instagram: @skinfluence_pod

What if getting expert acne treatment didn't require months of waiting, multiple office visits, and endless trial-and-error with products that never seem to work?

In this guest episode, Dr. Dustin Portela is joined by Michael Chang, founder and CEO of Clear Health, and board-certified dermatologist Dr. Aaron Farberg to discuss how telehealth is changing the way patients access acne treatment.

Michael shares his personal journey through years of persistent acne, multiple dermatologists, restrictive diets, and frustration before finally finding success with Accutane. That experience ultimately led him to create Clear Health, a telehealth platform focused on connecting patients with board-certified dermatologists and expanding access to evidence-based acne care.

The conversation explores common misconceptions about Accutane, why so many patients wish they had started treatment sooner, and how telehealth is helping remove barriers that often delay care.

They also discuss Isoclear, a new topical isotretinoin treatment designed to deliver many of the benefits associated with isotretinoin without the monitoring requirements of oral Accutane. Dr. Farberg breaks down the science behind topical isotretinoin, how it compares to tretinoin, and why this approach could become an important option for acne and anti-aging treatment in the future.

Whether you're struggling with acne, considering Accutane, curious about telehealth dermatology, or interested in the future of personalized skincare, this episode offers an inside look at one of the fastest-growing areas in dermatology.

Guest Info

Michael Chang Founder & CEO, Clear Health

Dr. Aaron Farberg Board-Certified Dermatologist and Mohs Surgeon Medical Director, Clear Health

Learn more: helloclearhealth.com

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Skinfluence Podcast Instagram: @skinfluence_pod

Shaving, waxing, laser hair removal, sugaring, electrolysis... with so many options available, what's actually the best way to get rid of unwanted hair?

This week, Dr. Dustin Portela and Austin Lee break down the most common hair removal methods, who they're best for, and the biggest mistakes people make that can lead to irritation, ingrown hairs, burns, and long-term skin damage.

They discuss the pros and cons of shaving, waxing, depilatory creams, electrolysis, and laser hair removal, along with what makes someone a good candidate for treatment. You'll also learn why skin tone and hair color matter, how to prepare for laser hair removal, and why "permanent hair removal" isn't always as permanent as people think.

The conversation also covers pseudofolliculitis barbae, hidradenitis suppurativa, acne keloidalis nuchae, shaving bumps, razor burn, and dermatologist-approved tips for preventing ingrown hairs and keeping your skin healthy.

Plus, Austin shares one of the most questionable hair removal decisions of his life involving a Taco Bell parking lot, Axe body spray, and an open flame.

If you've ever struggled with unwanted hair, ingrown hairs, razor bumps, or wondered whether laser hair removal is worth it, this episode is packed with practical advice to help you choose the right approach for your skin.

Product of the Week

Dean Skincare Botanical Calming Serum

Designed to help calm irritation, reduce visible redness, and support the skin barrier after cosmetic treatments, shaving, and everyday skin stressors.

Use code SKINFLUENCE20 for 20% off.

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Austin Lee, PA-C Instagram/TikTok: @austinleepac

Skinfluence Podcast Instagram: @skinfluence_pod

What if the best plastic surgery advice is how to avoid plastic surgery in the first place?

In this guest episode, Dr. Dustin Portela sits down with board-certified plastic surgeon Dr. Tony Youn, known to millions online as "America's Holistic Plastic Surgeon." Together, they explore a different approach to aesthetics, one that prioritizes lifestyle, nutrition, skincare, and overall health before ever considering surgery.

Dr. Youn shares how a life-changing patient complication reshaped his philosophy on medicine and why he now views surgery as a last resort rather than a first step. The conversation covers longevity, weight loss, GLP-1 medications, skincare, social media, and the growing overlap between plastic surgery, dermatology, and preventive health.

They also tackle one of the most confusing topics in aesthetics today: the difference between a board-certified plastic surgeon and a cosmetic surgeon. Dr. Youn explains what patients should know before choosing a provider and why training, credentials, and complication management matter more than ever.

Whether you're considering cosmetic procedures, interested in healthy aging, or simply want to understand how the aesthetics industry is evolving, this is a fascinating conversation with one of the most influential voices in plastic surgery today.

Guest Info

Dr. Tony Youn Board-Certified Plastic Surgeon Host of The Dr. Youn Show Podcast

Instagram: @tonyyounmd TikTok: @doctoryoun YouTube: @tonyyounmd

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Skinfluence Podcast Instagram: @skinfluence_pod