Do Hair Growth Supplements Actually Work? Dr. Amy Spizuoco Explains

Are hair growth supplements (referred to as “nutraceuticals” or “trichoceuticals” in this episode) worth the investment? Which ingredients have science behind them, and what do they actually cost?

In this episode of Skincredible, Dr. Lisa Swanson sits down with board-certified dermatologist and dermatopathologist Dr. Amy Spizuoco to unpack the rapidly growing world of hair-loss nutraceuticals. Together, they discuss ingredients in popular products like Nutrafol, Viviscal, Wellbel, and Xtressé. They also discuss the rise and fall of biotin supplementation, and explain how ingredients like saw palmetto, ashwagandha, pumpkin seed extract, and NAD+ may support hair growth.

In this episode, Dr. Swanson and Dr. Spizuoco also explore common causes of hair shedding, including: telogen effluvium, postpartum hair loss, and GLP-1-related hair changes, and discuss practical strategies for supporting hair health during stressful life events. Dr. Spizuoco shares how she incorporates supplements alongside treatments such as oral minoxidil, compounded topical therapies, low-level laser devices, and platelet-rich plasma (PRP).

Plus, stay tuned for a fun rapid-fire round covering New York City life, coffee habits, flying preferences, astronaut dreams, and whether life in Manhattan is really as glamorous as it looks on TV.

In this episode, you'll learn:
• Why dermatologists have become more cautious about biotin supplementation
• The differences between Nutrafol, Viviscal, Wellbel, and Xtressé
• Which supplement ingredients have the strongest evidence for hair growth
• How GLP-1 medications can impact hair health
• What PRP treatments involve and who may benefit from them
• How dermatologists approach androgenetic alopecia and telogen effluvium

Whether you're experiencing hair thinning yourself or simply curious about the latest advances in hair vitamins, this episode delivers practical, evidence-based insights from two highly knowledgeable and board-certified dermatologists.

Keywords

Dermatology, hair loss, alopecia, alopecia totalis, alopecia universalis, alopecia areata, telogen effluvium, hair, skin, nutrafol, viviscal, wellbel, xtresse, vitamins, hair vitamins, glp-1, peptides, prp, platelet rich plasma, vegamour, pumpkin seed, NAD+, ashwagandha, saw palmetto

Links, Attachments

Dr. Spizuoco’s conference: https://dermvipsummit.com/

Dr. Spizuoco’s biography: https://true-dermatology.com/about/meet-dr-spizuoco 

Nutrafol: https://nutrafol.com/ 

Viviscal: https://www.viviscal.com 

Wellbel: https://wellbel.com/ 

Xtressé: https://xtresse.com  

Vegamour: https://vegamour.com/ 

Chapters

00:00 Intro & Welcome Dr. Amy Spizuoco

02:00 DermVIP Summit

03:46 Biotin In the Past

07:03 Any Tricks to Try to “Prevent” Telogen Effluvium

08:48 Four Products With the Most Science 

10:33 AminoMar, Marine Complex

11:06 Saw Palmetto

13:33 Mechanism of Action

15:25 Pricing

16:44 Side Effects

18:09 Monotherapy vs. Multiple Modalities

19:40 Full Court Press Approach

20:34 PRP Platelet Rich Plasma

25:00 Exosomes

28:00 Rapid Fire

The information shared on this podcast is for educational purposes only and is not a substitute for personalized medical advice. Always consult your  physician regarding your health.

Transcript

SPEAKER_00 0:04

Welcome to Skin Credible, where we tell you what you should know about your skin and how to glow. Because your skin's incredible.

SPEAKER_02 0:17

Hello, everybody, and welcome to another fun-filled episode of the Skin Credible Podcast. I'm your host, Dr. Lisa Swanson, and I have a very special guest today, Dr. Amy Spitsuoko. And Amy and I go way back, but our audience might not yet know Amy. Go ahead and introduce yourself to everybody.

SPEAKER_01 0:40

Thank you, Lisa. First, I want to say also I am a Swannaby for all those movies out there. I love that t-shirt. That is the cutest.

SPEAKER_03 0:48

Oh my gosh. I can't believe you heard about that.

SPEAKER_01 0:51

I think it was on one of the social medias or something. It is the cutest.

SPEAKER_02 0:55

Isn't everything? Everything's on social media.

SPEAKER_01 0:58

Yes, it is. It is. So I'm Dr. Amy Spizwoko. I am a board-certified dermatologist and dramatopathologist in New York City. I did my dermatology residency in Arizona, where I had the pleasure of meeting Dr. Lisa Swanson while she was doing her PEEDSDRM fellowship at Phoenix Hospital with Ron Hansen. Yes. Yes, and I've had the pleasure of getting to see you speak at so many conferences. And you did me a huge, huge, huge favor by coming to speak at my conference in May during VIP Summit. So thank you so much for having me. I'm so happy to be here.

SPEAKER_02 1:31

You and I met wow gosh, 17 years ago when I was a fellow and you were still in your residency in beautiful Scottsdale, Arizona. Yes. And then have seen each other every year at least once or twice or three or four times at conferences and stuff. And then you embarked on creating your own conference, which is a huge endeavor. Yes. And it's it's kind of tackling almost all things derm, but especially alopecia, especially hair.

SPEAKER_01 2:00

Right. So we we had the idea being that I was president of the AOCD for one year, but I was on their board and I helped run those conferences for so many years. Another dermatologist, Dr. Peter Friedman, in Rockland County, New York, does a lot of research and a lot of things with hair loss. And I do a lot of hair loss lectures, treatments. I see a lot of patients with hair loss. So we came together and said, we don't have a conference in New York City that just focuses on being a New York central meeting. You know, NYU has a meeting, Mount Sinai has a meeting, skin of color, but we wanted like a main state New York meeting. And we both had this interest in teaching and treating hair loss. So we focused on that. And we did about a 50-50, I think, conference based on hair loss conditions, scalp conditions, hair loss disorders, and then also inflammatory conditions, which centered around the scalp as well as the body and such.

SPEAKER_02 2:54

It was so good. It was so fun. I was so excited to be involved. To be that close to Central Park was a real joy for me because I don't get out there very much. And it was at that conference that you did a beautiful talk about all the kind of nutraceuticals out there marketed for hair loss and hair regrowth. And I was like, oh boy, this would make for a great episode of the podcast because I think so many people really wonder about these things.

SPEAKER_01 3:24

Yes. Yes.

SPEAKER_02 3:25

So I thought it would be good to have an episode where we give the facts as we know it. And we're going to talk about a little bit of the limitations because sometimes some of these things aren't specifically studied the way we normally like to see things studied, but we do have some science to back up and support their use. And so I wanted to break it down for the audience. The first thing I wanted to talk about was biotin. We used to hand out biotin to anybody who expressed any sort of concern about their hair. Things have changed. Go ahead and tell the audience what happened that prompted that change.

SPEAKER_01 4:01

Right. So I think before we had any of these nutraceuticals or uh trichoceuticals, or as some people are calling it. Trichoceuticals. Yeah. Cute, right? Uh Neil Sadek said that. I'll I'll let him have the credit. Yeah. I love it. Very cute. So yeah, we didn't really know too much. We didn't really have anything for these people. I really didn't do blood work because if I did blood work, I'm like, what am I looking for? You know, maybe thyroid tests or whatever, you know, things like that, which were always negative in my patient population. So yeah, someone came along and said biotin is helpful. So I was dosing it about like 10,000 micrograms a person. And what I first saw was patients were getting acne. So I had to step back. Almost all my patients were complaining of acne. So we stepped back. Well, biotin is really only meant for people who have biotin deficiency. It's so rare to have a biotin deficiency. So that's one where we should be more appropriate when we're dosing or giving out biotin. And two, it can skew lab tests. So some patients that are taking biotin and have a lot of it in their system, it can alter their thyroid function tests and it can alter their troponin levels. So troponin levels, as you know, are what we monitor when patients may complain of chest pain and heart attack. It's the enzyme that's released when patients are actively undergoing a heart attack or a myocardial infarction. So if you have high levels of biotin or any biotin in your system, it can skew those results and you may not be treated appropriately if you are going into myocardial infarction or, you know, sudden heart attack.

SPEAKER_02 5:35

Yeah. Yeah. It's so interesting. It falsely normalizes certain labs like cardiac enzymes and thyroid tests. Yeah. Yeah. And so I tell patients, like, if they're going to take biotin, because of course it's over the counter, make sure they tell anybody, any doctors they see who are going to do blood work that they're on it because they'll probably want to be off of it for I've heard three, four, or five days off of it before you would theoretically be okay to check labs.

SPEAKER_01 6:06

I I say a week. I say a week just to be safe. You know, it's it's easier to remember a week, you know.

SPEAKER_02 6:12

I don't know about you, Amy. I was never like blown away with its efficacy for hair. I think that biotin can make your nails stronger. Like I I observed that.

SPEAKER_01 6:23

Yeah. The the patients that I did see do well with it are telogenefluvium patients because they're gonna do well anyway. You know what I mean? It's just a matter of time. So it was almost like a placebo effect.

SPEAKER_02 6:40

You mentioned telogen afluvium, and my mom recently called. She had listened to a couple episodes of the podcast. She had some notes for me. She's always full of full of thoughts and feedback. And she has had some stressful things happening in her life, health-wise. Everything's okay, but she had she had a kidney stone and she she like fell down and stuff. And so she's like, is there a way to prevent a telogen of fluvium? Like, if you know it's coming, like you just had COVID or you just had surgery, is there any way to prevent it? And I was like, gosh, I actually I don't know the answer to that. Do you do you ever recommend anything for maybe a mom that just delivered or somebody who's recovering from something? Is there a trick?

SPEAKER_01 7:26

Well, yeah. So a mom who just delivered, I say stay on your prenatals. Yeah. Just don't stop. Or a mom, you know, who maybe, you know, someone who delivered six months or eight months, and you know, they're saying anything about their hair. I'm like, do you have prenatal vitamins left over? Don't stop taking them. But also these nutraceuticals can be recommended for that as well. They have all these um ingredients in them that are meant to be stress relievers and help, you know, minimize that cortisol effect, specifically like ashwagandha. So things like that can be really helpful for even any kind of stressful event if you're not worried about telogene fluvium, if you're just worried about any kind of stress on the body. The normal doses you should take is 30 micrograms a day. And we'll talk about these nutraceuticals. A lot of them have cut back, but you only need 30 a day.

SPEAKER_02 8:13

Because sometimes people think, especially with the vitamin, they think more if a little bit is good, more is better. Everything.

SPEAKER_01 8:19

With topical retinoids, you know? Yes, yes, yes, yes.

SPEAKER_02 8:23

There are so many products in your presentation. You covered all of them, but I thought that might be just a little bit too much for the sake of the pod. So I wanted you to hone in on maybe the three products that you feel like have the most science to back up their use. Yes.

SPEAKER_01 8:45

Definitely. So the there's there's probably four, I'm gonna say. Right. I'll allow it. I'll allow.

SPEAKER_02 8:51

You can have you can have an extra.

SPEAKER_01 8:52

Thank you, Your Honor. Um, really, because they're the the first three I'll mention are kind of cousins in a way, and they've they have good data, but the newer one is a little different. So, of course, Neutrofol was the first one that came to market, and then Viviscal, and they have the most data, the most studies. Neutrophil probably has about 80 different clinical studies, mostly with women because they came out as a women's brand. They're focusing more on postmenopause and perimenopause. So they have a lot of data on that. Viviscal came out around the same time, probably too, maybe less marketed at the time, but very similar, just a couple different ingredients, but they both do have biotin, but their biotin levels are a lot lower. I think neutrophil is about 300 micrograms, and I think Viviscal is probably around 500. Another one that came out a few years ago is Well Bell, and again, some similar ingredients, some different ingredients. It's more affordable. They they drop their price a bit. Yeah. Nice. Good for that. And then number four is the extressy gummies that was started by our dermatology colleagues, and they don't have biotin, and they also have something called NAD plus, which is helpful for like mitochondrial health and just activities of the cells. So those are my top four that I recommend. Absolutely. Yeah.

SPEAKER_02 10:10

Now, if I absorbed some of the information from your lecture appropriately, the profile of ingredients in neutrophil and viviscal, which are probably the two biggest trigosuticals on the market, they are different. Like Viviscal, it's something about like murine, like fish proteins or something.

SPEAKER_01 10:29

So they have they have something called amino mar marine complex. Marine complex. And that is just, yeah, and that's just kind of a building block of keratin and proteins. So that's what they use. But neutrofol has marine collagen peptides, which are like, I think, based out of like shark collagen or something like that. So they both have a little bit. The main thing that Neutrofol has that Viviscal doesn't is that Oshwagon. Viviscal actually doesn't have ashwagandha. It has other things that can help reduce cortisol and cortisone. But then also neutral has saw palmetto. So what salt palmetto is, is like a very mild, mild, um, like a finasteride where it can help uh inhibit that five alpha reductase enzyme to help stopping the breakdown of testosterone. So not as strong at all as like a finasteride or a deutasteride or that kind of molecule, which is FDA-approved medication, but to a certain level, it can help with that. Gotcha.

SPEAKER_02 11:27

And, you know, I've read there have even been articles in our dermatology literature about ingredients like saw palmetto, ashwagonda, pumpkin seed. Um, and it's nice to see that some of these products contain little bits of that. So you don't have to go online and buy, you know, 12 different vitamins. You can buy something like a neutral or a viviscal, and it includes a lot of them. Right.

SPEAKER_01 11:52

Exactly.

SPEAKER_02 11:53

Isn't Viviscal, is that the one that's like four pills a day?

SPEAKER_01 11:59

Well, for sure, neutrophil is four pills a day.

SPEAKER_02 12:01

Well, maybe that's the one I'm thinking of. That could be the one I'm thinking of. Yeah.

SPEAKER_01 12:04

Yeah, Viviscal might be two. I think Wella Bell is actually four also.

SPEAKER_02 12:08

Okay.

SPEAKER_01 12:09

They're all they're more than one. They're definitely more than two. Yeah. Exactly. And then the extrassi are two gummies.

SPEAKER_02 12:16

Yep. Okay. And that one is special because it was formulated with the help of a dermatologist-led team. Exactly.

SPEAKER_01 12:22

Yeah.

SPEAKER_02 12:23

And remind me of the ingredients in extrressi.

SPEAKER_01 12:27

It's gonna have that NAD plus, which is uh um really helpful for like mitochondrial um health and for cellular activity and anti-aging activity, but it also has saw palmetto and ashwagonda. It does. It has a lot of vitamins. Yep, it has a lot of vitamins in it, and it also has that pumpkin seed extract that you were mentioning. Gotcha.

SPEAKER_02 12:46

Okay, but no shark.

SPEAKER_01 12:49

But no shark.

SPEAKER_02 12:51

So if you're shark, if you're a fan. If you're a fan, if you're a fan of the shark, extressy might be a good choice for you. Yeah. Right. Exactly.

SPEAKER_01 13:00

And they also do, you know, there's also one called Vagamore that some people had also preferred because it was vegan. All of these have vegan formulations as well. Neutrophil has a vegan formulation, Vibiscal has a vegan formulation.

SPEAKER_02 13:13

Is the main culprit that would make the formulation not vegan the shark cartilage? Yeah. Gotcha. Okay. What do we know about the mechanism of action of some of these things? You mentioned that saw palmetto kind of works like a phenasteride, five alpha reductase inhibitor. Do we know anything else about how these things work? Is it is it magic or what? That's magic.

SPEAKER_01 13:36

Well, you know, Wellbell has MSM in it. That's methyl sulfonyl methane. And what that's meant to do, again, is be like a keratin or like a protein building block of like the hair papillar or like the hair shaft. So a lot of them are focusing on that, just adding proteins and keratins so that you can help build the hair shafts. Anything that will reduce inflammation and lower the cortisol levels to help with the stress levels on, you know, the cells and the hair follicles. And then two vitamins, a lot of them have B12, folate, vitamin D, vitamin A, vitamin E, all of those to just kind of get those nutrients in. And like I mentioned, NAD and then the pumpkin seed oil are all to enhance that cellular activity.

SPEAKER_02 14:18

If you were seeing somebody who was about to start a GLP one, we know that we can sometimes see hair loss as a result, kind of a telogenefluvium-like process. We believe some of that might be due to vitamins. You know, you're not eating as much. So you may not be taking in as much. So for somebody who is maybe thinking about starting a GLP one, concerned about undergoing a hair loss process as a result, would you kind of encourage them to start one of these around the same time?

SPEAKER_01 14:47

Absolutely. Yeah.

unknown 14:48

Yeah.

SPEAKER_01 14:49

Yeah. And I do, all my patients are on GLP ones, even if they're not realizing hair loss. Yeah. But we just know that their their food intake is so much more limited because they're just not hungry anymore. Kind of like back in the day when they were doing the gastric bypass surgery. Yeah. You know, a lot of those people had to take crazy high doses of vitamins because they weren't absorbing the majority of it. So for sure, it's definitely a great, great adjunct for patients on GLP ones for sure.

SPEAKER_02 15:16

And then you so nicely displayed the cost. Tell us a little bit more about the cost of the the four that you kind of honed in on. What do we know about that?

SPEAKER_01 15:28

So Neutrophil is still probably the most expensive. And I think they are because they've been around the longest and they have the most studies and the most data to back them. And they have the most products also. They have, you know, probably about 15 different product lines. Um, so they're gonna be the most expensive. They're probably around $90 a month, and they have a subscription that you would um, you know, uh apply to. And then probably next would be Viviscal, probably somewhere around like $80 a month. Um, well Bell's a little less. Um, they're probably around 70. And then the Extressy Gummies are somewhere around 60 and 70 as well. Typically, though, these companies, like your first subscription, they'll give you a discount. So you know they usually have a 10% or 20% off. But I would say from Neutrophil to Viviscal to Wellbell to Extressy in that order.

unknown 16:19

Okay.

SPEAKER_02 16:20

Are there any products outside of those four that you feel are worth special attention, something unique to them that might appeal to some folks out there?

SPEAKER_01 16:30

If anything, the pumpkin seed oil is becoming a little bit bigger now. So things with the pumpkin seed oil extract, you know, if there are any new products that are putting that in.

SPEAKER_02 16:40

And are you have you observed any side effects with your patients who are on these? Yeah. Yeah.

SPEAKER_01 16:45

If any of my patients can't tolerate any of these, it's going to be the neutrophil. And I'm pretty sure it's because of the ashwagandha, because ashwagandha can cause GI upset. So a lot of patients aren't able to take that. Um I'm sure the other ones with ashwagandha too, but it's just neutral, the one that I hear the most about. Um, but any other side effects, not really.

SPEAKER_02 17:04

Do you always tell them to take it with food? It in general with vitamins, I feel like I always tell people to take with food for adequate absorption and stuff.

SPEAKER_01 17:11

Yeah. I mean, a lot of these have like the fat-soluble vitamins in them. So with, you know, vitamin A and D. So yes, they have to be taken with food. And that's another thing we talk about too in our in our hair conversations and our hair conferences. You know, some people will take these supplements and say, like, oh, it's not really working. It has to be taken with food.

SPEAKER_02 17:30

Yeah, yeah, to really reap the benefits. Yeah. I remember one study, it wasn't done with any of these particular things, but they did a study about like multivitamins. And if you take them without food, they basically just like course right through you.

SPEAKER_03 17:43

Like it's like they're untouched by your digestive system. Yeah.

SPEAKER_01 17:46

I had I had one instructor who would say, like, it's just like having expensive urine, you know, you're just letting it out, you know? Peeing that neutrophil out. Right. Right. And you don't want to do that. If you're spending $90 a month, you want to keep it.

SPEAKER_03 18:01

Very true. Very true.

SPEAKER_02 18:04

Now, are you utilizing them monotherapy or in addition to other maybe prescription things that you're that you're doing for your patients?

SPEAKER_01 18:14

So it depends on the condition, you know. Um, so for my androgenetic alopecia patients, I always recommend taking a nutraceutical or hair growth, whether they do or not, you know, because they're already probably paying for their monoxidyl and their pharasterid or, you know, all their other things, their shampoos and stuff, but a lot of them will. Um for the Telogen of Lluvium patients or the GLP1 patients, like you mentioned, for sure I have them do it. And then, you know, for like my, you know, my scar, like my alopecia ariatas, you know, a lot of them I will recommend, especially the ones that I have on, you know, some of the Jack inhibitors, just to get anything to give them help because when you have that kind of significant hair loss, you know, you you want all the help you can get. Um, and then for my scarring alopecias, not really, you know, the scarring alopecias, I don't really think there's too much data supporting it.

SPEAKER_02 19:02

Totally, totally. And that's a good point. I think these nutraceuticals are more geared towards patients dealing with androgenetic alopecia, which is kind of a gradual pattern and thinning over time that occurs in both males and females, and then the uh telogenifluvium folks, which as you alluded to, most times will improve and recover on their own, but maybe these things help give them a boost. Definitely thinking about a patient with androgenetic alopecia, if you saw a female come in, maybe 40s, 50s, androgenetic alopecia, said, I want to do everything I can short of like hair transplant, what would be your full court press? I I think in clinic, I would talk about back when I used to see more adults, I'd probably talk about like the nutraceuticals, low dose oral monoxidyl, maybe ketoconazole shampoo, maybe spironolactone since she's a female, maybe phenasteride if like she's past pregnancy considerations. What am I forgetting?

SPEAKER_01 20:03

There is compounded topical minoxidyl, phenasteride, and spironolactone. And even tretinoin is a lot of times compounded in the topical formulations because it enhances absorption. So I always recommend one of the orals, you know, depending on their age, if they're post-menopause, I might do a phenasteride, although I think monoxidal works better, oral monoxidal for sure. Um, if they're not willing to pay for a compounded topical, like I mentioned, I would say topical monoxidal as well. Um, PRP is huge in my practice. I do a ton of PRP for patients. Yeah. And I love it. I think it works amazing. I do it for my Tilgenofluvian patients. I do it for my my male androgenetic alopecia and my female, and even some of my scarring alopecia patients just try and trigger some growth and shut down any of their scarring that they're getting. But for that female patient, um, like we said, the topical compounds, oral monoxidal, maybe a spironolactone, but if they're on the oral monoxidal, I probably won't. PRP for sure. And the way I do PRP is I do three treatments every two months to start, and then I have them come in every six months for like a booster. And I find it to be really, really helpful. And then also we have the uh the low light level uh laser therapies where it's like the hair caps and the brushes, and I do recommend those a lot for patients. They used to be very, very expensive, somewhere between like $3,000 and $4,000. And you know, at that point you're like, just get a hair transplant. Right, right. Yeah. You're already spending all this money. But they've come down in price. There's lots of companies that discount 10% off, 20% off here and there. And they've made them where they're like a cap now as well, where you can just kind of put it on, run around your house for 20 minutes and you know, do pretty well, or the brush as if it's just a certain area. They make like a headband one too, which is pretty cute. Oh, that's cute.

SPEAKER_00 21:53

Yeah, yeah.

SPEAKER_01 21:54

I tell my patients all of these things are are what I recommend, what fits into your day. Daily routine and what fits into your price budget because none of this stuff is covered by insurance, which you know, our other alopecia areata and other stuff typically you can get covered by insurance, but these are are definitely not. And it gets it gets expensive.

SPEAKER_02 22:15

It can very quickly get expensive. I I love that you mentioned PRP. Some of our listeners are medical, some are not. Can you explain what PRP is and what's entailed?

SPEAKER_01 22:27

So PRP is platelet-rich plasma. So this is taking your own blood. You come into my office, I draw your blood. Um, I have a machine or device or centrifuge where I can spin it down and I can extract out your platelets. Um, and then from there, we found that within the platelets or the surrounding molecules around the platelets can release growth factors. And we believe that injecting it into the scalp, into the hair follicles, can trigger growth. It's a bit of a process. It's a little uncomfortable. I'm quick. Most of my colleagues are pretty quick at doing it. When it was started with our orthopedic colleagues, they were doing it for joints, for knees, shoulders, for anyone who, you know, maybe they were had like a meniscus tear in their knee and they weren't doing well with whatever other injections they were doing. Well, they found that platelets can trigger a lot of growth factors. So we stole that.

SPEAKER_02 23:18

Yeah. And so it's an in-office procedure. Draw the blood, spin it down, then inject the platelet-rich plasma into your scalp.

SPEAKER_01 23:27

Yep.

SPEAKER_02 23:28

And so there's a little bit of pain, as you mentioned, but you go to somebody experience it doing it and it's pretty quick, and then you're you're in and out and on with it. And I think the one thing that I have gleamed is that there is no solid regimen for PRP. It seems like everybody does it a little bit differently. And your protocol, you do it every two months for the first three treatments, and then every six months thereafter.

unknown 23:53

Yeah.

SPEAKER_02 23:54

Okay. Okay. Yeah. Okay. Um, but there doesn't seem to be any consensus. So if a listener goes to see a specialist and they recommend a different uh schedule, that's okay.

SPEAKER_01 24:04

Agree, agree. And we don't even really have a good sense of the outcome. I always tell my patients 50% of patients will get up to 50% of their hair growth back. So it's kind of a weird number to explain.

SPEAKER_02 24:18

And uh costs will probably vary based on community where you're at and and all of that kind of stuff. Do you mind sharing just a rough cost estimate for some listener that's thinking about it?

SPEAKER_01 24:29

Yeah, and it also depends on how many areas, but I do two areas. I just do the top, like the crown, and around here, or else I do full head. So I had two prices. But some people will do maybe just here and have a price, maybe just here. So it depends, but anywhere between like a 500 to probably up to 2,000. And I say that that higher end because some people are also adding exosomes. Right. Factors. So when you add that, it ups the price because they're pretty expensive too for us to purchase and include in the PRP.

SPEAKER_02 25:04

I hear people at conferences talking about exosomes, and I feel in the moment like I'm faking it till I make it. I'm like nodding, like, oh yeah, exosomes. In Peds germ, this is not something that we're utilizing. Tell me and our listeners a little bit about exosomes.

SPEAKER_01 25:21

So they're meant to be growth factors. They're just an additive that people are using. And it did start with with scalp, and they're adding it into PRP and any area that you're trying to grow. Um, as well as when PRP started too, we had that vampire facial. You remember that was pretty famous?

SPEAKER_02 25:37

Yes, I think the Kardashians did that and they were they got famous for that too.

SPEAKER_01 25:41

Yeah, yep. In addition to all the other things, right? There's a lot. Yeah, so what I I do it too, I would inject PRP into the face, and then I would also use it as a glide and do microneedling or some kind of laser procedure over to kind of get it to absorb in. And it works nice again for anti-aging and rejuvenation. So the exosomes is the same idea, and they, you know, were adding them into formulations for PRP for hair growth. And then now they're also making them in topicals for again anti-aging. So there are companies out there that are including exosomes in their skincare lines and there's anti-aging products. I was just gonna say again, like these nutraceuticals, trichoseudals are not FDA regulated or FDA approved. They're more kind of considered a dietary supplement. The exosomes, again, they don't have a regulation either. So my point in saying that is we don't really, really know all the data and all the clinical studies. There's companies doing them, but they're still still kind of fresh, kind of like the GLP ones are still kind of like fresh in our practice as well.

SPEAKER_02 26:43

And in your experience, if you did PRP, just PRP, PRP plus exosomes, do you feel like you see a difference in efficacy just as an opinion?

SPEAKER_01 26:56

Not a significant difference in my in my practice.

SPEAKER_02 26:59

So maybe not worth additional cost. Yeah, I feel like every time I hear about exosomes, I'm reminded of there was this episode of Center Live where Elon Musk was the host, and during the weekend update segment, they asked Elon to talk about what is cryptocurrency? What is Bitcoin? What is cryptocurrency? And Elon would go into a spiel about it, and then Colin Jose would be like, okay, okay. So what is it?

SPEAKER_03 27:27

Elon Musk might describe it. I feel like that's me. Every time I hear anybody talk about exosomes, I like hear it, but I'm like, but still, what are they?

SPEAKER_01 27:35

I just exactly. Exactly. I agree. I agree. That's funny. I wish I saw that skit.

SPEAKER_03 27:41

It's really good. I'm certain it's on the internet.

SPEAKER_02 27:43

It's it was a really funny one. It was really good. Well, that that was awesome, Amy. Thank you so much for taking us through all of that. I wanted to finish our podcast session with a rapid fire speed round designed to have some fun and let the audience get to know a little bit more about you. Sounds good. Do you feel ready?

SPEAKER_01 28:04

I'm ready.

SPEAKER_02 28:05

Okay. Number one. As a New York City dermatologist, were you at the next victory parade?

SPEAKER_01 28:12

I was not. I was actually uh working.

unknown 28:15

Okay.

SPEAKER_02 28:16

Yeah, yeah. Was your clinic like quiet because everybody was there?

SPEAKER_01 28:21

It was a zoo in New York City. Some people still work for work from home, but still a big financial capital of the world. So a lot of people do this hybrid thing. So some people that came into the city were like, what did I do to myself? What did I do? Yeah, it was it was crazy, definitely. But the winning game where you know, Knicks in five, yeah. I was actually on vacation in Mallorca. So I woke up the next morning, checked my social media, and saw that the Knicks won.

SPEAKER_02 28:45

Wow. Yeah. And did you go to any of the games? I did not. No, no, yeah. It's a zoo. It's a zoo. But the one coverage that I did love, I loved Taylor Swift and her Haim, the Haim girls in their specially made t-shirts. Did you see those?

SPEAKER_01 29:01

I didn't see it, no.

SPEAKER_02 29:02

Oh my gosh. It was so cute. They made they made t-shirts, and like Taylor said Stevie Nicks, but spelled like the Knicks.

SPEAKER_01 29:10

Cute.

SPEAKER_02 29:11

And then one of the Haim girls wore one that said nickelback, but spelled like yeah. It was that was really cute. Number two, coffee or tea?

SPEAKER_01 29:20

Coffee.

SPEAKER_02 29:21

Coffee. Yeah. Do you just like it black? Do you add cream, sugar? Oh, yeah, there you go.

SPEAKER_01 29:27

Black coffee. Black coffee all day. Yeah.

SPEAKER_02 29:30

Will you will you drink any kind of coffee or are you like particular about your beans?

SPEAKER_01 29:37

Don't care. Any kind of coffee. Any kind of coffee hotel coffee. Yeah. Hotel room coffee, fine. But I do drink tea. Like in the afternoon, I'll have like a green tea with honey. Sure. Sure.

SPEAKER_02 29:47

Yeah. Yeah. Number three, hike in the mountains or walk on the beach.

SPEAKER_01 29:52

Ooh, that is tough. That is tough. Probably walk on the beach because I do like the way the sand feels on my toes. I know, right? And as a dermatologist, I stay covered, I promise. Right?

SPEAKER_02 30:04

Yes, yes. I saw a recent Instagram thing. My boyfriend Larry curates Instagram for me and finds things that I like. And it featured a dermatologist who has social media. She, I think she's called like Mole Patrol MD. She does some cute stuff. Um, but she said she pictured herself in all of her sun protective garb and said, if people are making fun of your sun protection choices, you're doing it right.

SPEAKER_01 30:28

Perfect. Perfect. Exactly.

SPEAKER_02 30:32

Number four, on an airplane, window shades open or closed.

SPEAKER_01 30:36

Open.

SPEAKER_02 30:37

Yeah.

SPEAKER_01 30:38

I like to stare out and see the clouds, everything. Yeah, I love it.

SPEAKER_03 30:42

You do. You don't get scared.

SPEAKER_01 30:44

No, I love flying. I always take the window seat. I love the window seat, and I love to just stare out. Yeah. I love flying. I love heights. I love flying. I don't underground. I freak out. Like in New York City, if I'm going in or leaving, if there's a choice tunnel or a bridge, I'll always take the bridge. Really? Yeah.

SPEAKER_02 31:04

I I get that. Tunnels can be kind of claustrophobic, and you're like, what if this just like caved in on top of me?

SPEAKER_01 31:10

I think it's fear.

SPEAKER_02 31:11

But it's like Viking is a nightmare. The bridges, when I was in New York for your wonderful conference, the driver took us over one of the bridges. I don't, I don't know their names, but one of the bridges. And there are so many cars, and it it did get a little bit scary for me.

SPEAKER_01 31:27

Yeah. You know not heights.

SPEAKER_02 31:29

Yeah, but I think I think my fear of heights started as an adult. I don't recall being that way when I was little, but as I've gotten older, I don't like it. I am airs. I'm a window shades closed off course on the airplane for two reasons. Number one, I don't want to look outside. I don't want to, don't want anything to do with it. Terrifies me. I like to pretend like I'm not 30,000 feet in the air. And so looking out the window just reminds me. And then also the sun. Sometimes the sun coming through those windows. I don't like it.

SPEAKER_01 31:58

So I'm always cold on planes. So I need that heat because I'm always like shivering with like three blankets. Like I look like I'm an Eskimo. It's crazy. It's crazy. You just reminded me of uh bridesmaids. Yes. Did you see that movie where they're on the plane and then the one's like, there's someone on the window, she's churning butter.

SPEAKER_03 32:18

Colonial woman on there on the wing of the plane. Yeah.

unknown 32:21

Exactly.

SPEAKER_03 32:22

I think about that sometimes when I'm flying. Can you sleep on an airplane?

SPEAKER_01 32:26

I can. I can. Not for long periods, but I can take a little nap.

SPEAKER_02 32:29

Okay.

SPEAKER_01 32:29

Yeah.

SPEAKER_02 32:30

And that probably might have something to do with the window seat. Yeah. Yeah. I think being able to sleep on an airplane is a superpower that I am not capable of. Yeah. I would be more well-rested if I could sleep on an airplane, but I can't. I know. Two more. As a child, what did you want to be when you grew up?

SPEAKER_01 32:51

What did I want to be? I think I wanted to be an astronaut. You know what? You know, I'm a twin. So I wanted to be like the first twins in space. Like that, like anybody cares, but in my in mind when I was a kid, I thought that was like the coolest thought. Yeah.

SPEAKER_02 33:06

So your sister that's a dentist, that's your twin?

SPEAKER_01 33:08

Yeah.

SPEAKER_02 33:09

Oh my gosh, I knew your sister. I didn't know you were twins.

SPEAKER_01 33:12

Because I never say that. I always say my sister. I barely say my twin. So yeah, it gets lost in the way I describe it. Yeah, but she's my identical twin.

SPEAKER_02 33:20

Oh my gosh. Oh my gosh. Was she into space at all, too? She didn't care. No. No.

SPEAKER_01 33:24

Yeah. She would have come along for the ride, but it wasn't her thing. Yeah, exactly.

SPEAKER_02 33:29

I am fascinated by space. Even though I don't like heights, I am fascinated by space. I love watching all things space. So I'm I'm with you on that. Last one. Is living in New York City as glamorous as it appears on Sex in the City?

SPEAKER_01 33:44

Not in my life. I'm not a Carrie Bradshaw or a Kim Kutra or whatever, but um, it can be glamorous. There are a lot of fun, glamorous events that that are there, but it's also it's a grind. You know, it's we're it's it's like any hometown where you live. Um there's there's definitely a magic, and I gotta say, living there for as long as I have, and every time that I land at the airport and then take that, you know, road in through the midtown tunnel or in just in towards the city, like the skyline, there's just an energy and there's a magic. Yeah, there really is. Yeah, there's no place like it.

SPEAKER_02 34:18

I love it. I love it. And speaking of magic, this episode was magic, Amy.

SPEAKER_00 34:23

Thank you so much.

SPEAKER_01 34:25

I have one request for you though, Lisa.

SPEAKER_00 34:27

Yes, okay.

SPEAKER_01 34:28

Okay. Will you speak at Durham VIP Summit? And Peter and I would love to have you back.

SPEAKER_03 34:34

Yes, sign me up, count me in. Yes.

SPEAKER_01 34:37

Another I know if you hear schedule conflicts, I get it, but I just wanted to personally invite you. Thank you.

SPEAKER_03 34:43

Thank you so much, Amy. I'm so excited that you want that you want me back. That's great.

SPEAKER_01 34:48

Always. Always.

SPEAKER_03 34:50

I can go back to Central Park for for a few hours.

SPEAKER_01 34:53

Yes, you can go as long as you want. Maybe we'll do your lecture in Central Park.

SPEAKER_03 34:59

That would be cool. Weather permitting, weather permitting.

SPEAKER_01 35:01

Well, thank you. We'd loved having you, and we'd love to have you back.

SPEAKER_03 35:04

Thanks, Amy. That's so nice.

SPEAKER_01 35:06

And you, you know, you had your conference in Scottsdale too, remember? And you you speaking of Scottsdale again, where we trained together.

SPEAKER_02 35:13

Yeah.

SPEAKER_01 35:14

We were going there for a conference. So I grabbed you for one day, and then you, I mean, you were so sweet to really move your schedule around for us.

SPEAKER_02 35:20

Yes, yes. That was that was the same weekend as Swannabe weekend. I flew from your conference to the conference in Arizona and was surprised by the Swannabes. It was a magical weekend. It couldn't have been any better.

SPEAKER_01 35:32

Oh, I'm so glad. I'm so glad. We were so happy to have you. Everyone loves your lectures. So it was so great to have you there. Thanks so much, Amy.

SPEAKER_02 35:39

Um well, thank you, listeners, viewers. Please keep tuning in. I hope that you enjoyed this episode. Tell your friends, tell your family, tell everybody to listen to Skin Credible. Please like and subscribe and keep tuning in. Thanks, everybody. Yes.

SPEAKER_01 35:57

Thank you, everyone.