Unveiling the Brilliant Co-Host: Dr. Vicki Rapaport - Let's Get Acquainted!

Trina Renea  0:07  

Hey everyone, welcome to Facially Conscious. I'm Trina Renea – a Medically Trained Master Esthetician here in Los Angeles, and I'm sitting with my rockstar co-host, Dr. Vicki Rapaport – a Board-Certified Dermatologist with Practices in Beverly Hills and Culver City, Rebecca Gadberry – Our Resident Skincare Scientists and Regulatory and Marketing Expert, and Julie Falls – our Educated Consumer who is here to represent you. We are here to help you navigate the sometimes confusing and competitive world of skincare. Our mission is to provide you with insider knowledge on everything from product ingredients to medical procedures, lasers, fillers, and ever-changing trends. With our expert interviews with chemists, doctors, laser reps and estheticians, you'll be equipped to make informative decisions before investing in potentially expensive treatments. It's the wild-west out there, so let's make it easier for you, one episode at a time. Are you ready to discover the latest and greatest skincare secrets? Tune in and let us be your go to girls for all things facially conscious? Let's dive in.

Rebecca Gadberry  1:26  

Hello, I am Rebecca.

Trina Renea  1:29  

Hi. I'm Trina.

Dr. Vicki Rapaport  1:30  

Good morning. I'm Vicki.

Rebecca Gadberry  1:32  

Dr. V is in the house. Well, we're going to record our, let me see, our tip of the week. And it's my turn, Rebecca. So, I don't know how many of you know, but I have been a Licensed Esthetician since 1977. I was the 13th Licensed Esthetician in the state of California. And one of my tips is an esthetician tip today. So, what I wanted to share with you is, I've been working on some new eye creams and when I give them to people to test, I find out that they don't know how to put on an eye cream. So, here is a really simple way to do it. – You put a little tiny bit on your forefinger, like right here, your middle finger right here. Trina is doing it with me. She knows the way so you don't use your forefinger, you don't use your whole hand and go like that. You use your middle finger. And she just one maybe two tiny, tiny pumps, I like to warm it up a little bit to break the product down a little bit make it go easier into the skin. I'm going to turn this camera on you Trina, because she's doing it with me. And then rather than putting it like just swiping in under your eyes and going out, we pad it with that middle finger because they are your weakest fingers of your hand. And you're going to start from the outside going in because that's the way the muscles go under your skin. They go in if you ever look in the mirror and you squint, you see your skin is pulling together towards your nose, not pulling out. So, we want to go with the direction of the muscle, we tap it on and then we tap it above. Tap it under, tap it above, tap it under, tap it above. No swiping. No going both ways. No, just whatever you're going to do up here. Tap, tap, tap, tap, tap, tap. That's the tip of the day. I hope you use it for the rest of your life. 

Julie Falls  3:43

Hello, everybody. How are you? 

Rebecca Gadberry  3:45  

Hello. Well, I hope you enjoyed the tip of the day.

Dr. Vicki Rapaport  3:49  

I videotaped you in slow-mo with that tip of the day. It’s impressive.

Rebecca Gadberry  3:56  

Oh, shoot, my old TV days are coming out. Play to the camera. And now Dr. Vicki has me as a side view. One of my least favorite views. Everybody has a favorite and least favorite view of your face. 

Dr. Vicki Rapaport  4:12  

Do you know why? Oh my gosh. 

Rebecca Gadberry  4:13  

Why?

Dr. Vicki Rapaport  4:14  

Because we're very asymmetric. And one side of the face is shorter and fatter and the other side of the face is longer.

Trina Renea  4:21  

Oh, this is my good side. So, does that mean it’s shorter and fatter or longer? 

Dr. Vicki Rapaport  4:26  

Usually, we prefer our shorter, fatter side. Because it looks like a baby and looks more youthful. The longer skinnier side is usually older. 

Rebecca Gadberry  4:33  

Look at you. Oh wow. That is really interesting. 

Trina Renea  4:38  

Tip of the day. 

Rebecca Gadberry  4:39  

That isn't even a tip. That's like a trivial question that you can use at a bar. This is an old joke. This is an old joke. My kids and I've been godmother to a lot of kids. I only have one child, my son but I have a lot of kids that I have played a mother image to and I teach them to learn the names of the seven doors. And the reason is because when you go into a bar and you want a free drink, I say you could go into a bar you want a free drink? You bet somebody you can name all the seven dwarfs and people say, I bet you can't, and you know them and you win the drink. 

Julie Falls  5:20  

You teach the children this? 

Rebecca Gadberry  5:23  

I teach my children like teenagers that or on their 21st birthday I may tell them that but I have had reports from several of my little group that it works. 

Dr. Vicki Rapaport  5:37  

Oh my god. That’s like a pool, shark you're like a seven dwarf’ shark. 

Rebecca Gadberry  5:41  

Hey, anything for free, merch,

Dr. Vicki Rapaport  5:44  

Somebody stupid named the seven dwarfs. 

Rebecca Gadberry  5:52  

I know Snappy, Grumpy and Sneezy. 

Dr. Vicki Rapaport  5:57  

Droopy.

Rebecca Gadberry  6:01  

Droopy. Now that also applies to the face, right? So, you look sleepy, you are droopy.

Trina Renea  6:07  

Yeah. So, I wanted to tell the audience that we've been getting some questions about like, people wanting to get to know us better. So, they just want to know a little bit more about our background. So, I thought it'd be fun to do like a little episode on each of us. And we'll just explain who each of us are. So, that's what we're going to do. And we're going to start with Dr. Vicki Rapaport, you get to be the first one.

Rebecca Gadberry  6:37  

She is our Resident Dermatologist. And she is as we have talked about on many other podcast episodes. She is a second-generation dermatologist. Oh, if you could see her. She's blushing right now.

Trina Renea  6:52  

And a superstar.

Rebecca Gadberry  6:54  

She's a super Rockstar in the dermatology area.

Dr. Vicki Rapaport  6:57  

Okay, guys I’m leaving. I'll see you later. This is terrible.

Rebecca Gadberry  7:02  

Okay, she likes to be behind the scenes and helping people with their skin. That's her gig. That's her passion. That's her love. And if you've ever been a patient of hers, you know that but we're going to be putting the spotlight on you. So here we go. Dr. Vicki Rapaport is a Board-Certified Dermatologist, running a successful private practice at what is called Rapaport Dermatology, who her father, Dr. Marvin Rapaport founded decades ago. And they're in Beverly Hills and also in Culver City here in the Los Angeles area. Vicki attended undergrad at UCLA. Yay, UCLA, earning her BA in both pre-med and art history, which I think there's a story there, which I'd love to find out more about when we dig deeper on you. And she then attended Jefferson Medical School, which is now called the Sidney Kimmel Medical School, which is one of the oldest medical schools in America, which is founded in 1824. Do they still have some of the original professors there?

Dr. Vicki Rapaport  8:17  

Well, yeah, on the walls. The aging medicine is really thriving in Jefferson. Yeah, they're still alive. Yeah.

Rebecca Gadberry  8:25  

Now, where's that located? 

Dr. Vicki Rapaport  8:27  

It’s in Philly.

Rebecca Gadberry  8:28  

Oh, that's right. She did her internship for a whole year at Pennsylvania Hospital, which is the oldest lying in hospital and then joined the Jefferson Dermatology and Cutaneous Biology Departments Residency Program, where she was Chief Resident in her senior year. Vicki started a boutique dermatology skincare line which is called SKN Beverly Hills with her dermatologist father while still in medical school, but before dermatology skincare lines existed, so they were one of the very first to realize that good skincare was essential along with the health of the skin. She now owns and creates she now owns creates and brands her own skincare line, Skin Beverly Hills, a percentage of the proceeds from this line proudly supports Camp Discovery, which I'd love to have you tell us more about what that is. This is a – oh no, we talk about it here. This is a remarkable camp for children with severe skin disabilities who cannot attend basic summer camps due to their special dermatology needs, such as severe vitiligo, Epidermolysis Bullosa, that's why you wanted me to read this, Trina, isn’t it? Alopecia universalis and other severely disabling dermatological diseases. She has collaborated with the Skin Cancer Foundation, one of my Favorite educational groups for skin, participating in the free skin cancer screening each year on Melanoma Monday. When is that, by the way? Oh, it was.

Dr. Vicki Rapaport  10:10  

I think it was last Monday. May is Melanoma Awareness Month and I believe the first Monday of May is always the Melanoma Monday. Yeah. 

Rebecca Gadberry  10:21  

So, for those of you who are listening closely, you now know that we go about a month or two out and recording our sessions. Because last Monday is not your last Monday, it’s our last Monday. And that is the first Monday of May is Melanoma Monday, meaning that you need to visit your dermatologist for your derm checks. And it's just a really good way to remember. She provides free skin cancer screenings out of a medically converted camper in the parking lot of the participating pharmacy chain. And in doing so helps to educate on the importance of sun protection and skin exams. And she does this out of the goodness of her heart. And because she really believes in taking care of your skin, especially with skin cancer. She just opened up her boutique satellite practice in the “Newest”, “Hottest”, “Latest” that's all in quotes everybody, neighborhood of Culver City, where she will serve patients from Playa Vista, Silicone Beach, Culver City and the surrounding area. So, welcome Dr. Vicki, you are under the microscope.

Dr. Vicki Rapaport  11:28  

I cannot wait for the questions to pour in.

Rebecca Gadberry  11:32  

There were two questions that I had. What two questions Did I have? You

Trina Renea  11:39  

Said you want to know more? 

Rebecca Gadberry  11:41  

Oh, after we get to know Vicki a little bit more.

Dr. Vicki Rapaport  11:44  

You want to know about art history? 

Rebecca Gadberry  11:46  

Well, yes. Oh, art history, I want to know. Okay, so what's the deal between pre-med and art history? Normally those don't go together is just saying a lot about who you are. I want to know if it's a dissatisfaction with life, or if it's a curiosity that just can't be quenched. Or what it is?

Dr. Vicki Rapaport  12:06  

You know, I guess it would be the Right Brain - Left Brain Balance that I have. So, when I first entered UCLA, I was pre-med, but I knew that I didn't want to be so solely scientific. And I took a couple of our history classes and just loved them, so I knew it then I could double major and North Campus was sort of the artsy-fartsy part of UCLA and South Campus is the medicine you know, the biochemistry and physics section of campus and it's actually pretty big campus. So going from class to class, it was really, really, really challenging timewise because you have 10 minutes and it's very, very difficult to walk north-south campus in 10 minutes, so I actually…

Rebecca Gadberry  12:47  

You don't have the scooters yet. 

Dr. Vicki Rapaport  12:49  

No, this was long time ago, this was 20 years ago, I had a bike that I just would bike. I’d jump on my bike and get into class and then lock it up. And I was always late for every single class but I really did like the balance of like, I'm not an artist. I personally can't draw but I appreciate artists and I love art and it's very calming and beautiful. And you know, I don't love all art. There's some art I just walk right by I'm like, ooh, that is not my style. And then there's other art that I'm like wow, I don't even know why that speaks to me but it does, it just calms me and I have always really appreciate, I wanted it to be a part of my life. But then of course medicine took over and so I'm not really an art history expert anymore. Although I appreciate going to museums.

Rebecca Gadberry  13:30  

So, you still go to museums? 

Dr. Vicki Rapaport  13:34  

I love them. I'm going to go see Basquiat with my good friend in like a couple weeks.

Rebecca Gadberry  13:37  

I heard that was a good. Yeah, so you like Basquiat?

Dr. Vicki Rapaport  13:40  

I don't know yet. I'm going to go check him out. I know enough about him to say that. I want to see it.

Rebecca Gadberry  13:44  

Yeah, I love his history. His biography. His work doesn't speak to me. But I love who he was and what he represents. 

Dr. Vicki Rapaport  13:54  

I also just like museums, the walls are huge and the ceilings are high and I don't know I always just like I feel very safe and sort of have a feel like I'm living a charmed life when I'm looking at art. It feels very fancy.

Rebecca Gadberry  14:09  

What's your favorite Museum in Los Angeles area? 

Dr. Vicki Rapaport  14:13  

I actually do like the Broad because I like modern art. I like the LACMA it's beautiful. I think between those two I'd probably have to say I'd jump around those and I'd be satisfied. 

Rebecca Gadberry  14:24  

Awesome. Okay, so we have now got that one question that everybody wants to answer. 

Dr. Vicki Rapaport  14:31  

Well, I mean, and also there were really dark classes. So sometimes you can take naps like in the art history classes because the lights go dim and back then they had slot it was slide projectors. There were no computers, so it was like the sound of the slide projector was really calming. It was like that white noise and so I definitely took some naps in the dark.

Rebecca Gadberry  14:48  

That flicking regularly. Yeah, the drone of the professor's voice.  

Trina Renea  14:54  

So, did you like medicine? Did you want to be a dermatologist or did your dad say this is what you're doing?

Dr. Vicki Rapaport  15:02  

Oh, I was a biology-obsessed high school student. Loved bio, I couldn't just get enough bio. So, I knew that I was bent that way. And it just came very easy to me as well. And I remember teaching my friends bio, you know, and when you're in high school, you're on your own in a sense, like, there isn't like a lot of collaboration back then. Remember, this was like in the 80s. I graduated high school in 87. So, it was just different back then it was, but I taught my friends biology, because I guess it came very natural to me, it was very easy. And I remember this one friend always said, I would never have passed if it wasn't for you. And that really spoke to me. Oh, well, that means something. Maybe I'm good at this. And maybe I do, there's more to it than just loving biology. And then I realized, okay, maybe I love it. Because my dad is a doctor, maybe there's something genetic. And then I did work for him when I was 16. I just filed charts because back then there were actually charts. 

Trina Renea  16:01  

So, you sat in the back office and filed charts? 

Dr. Vicki Rapaport  16:03  

Yes, sat in the back office, filed charts, I just got comfortable with the medical scenario, and settings. And I don't know just sort of decided as I had to claim my main my true-true or true major, one that I remember I had to decide what I was going to do. And when I realized that I didn't want to be a docent at a museum, I didn't really want to just do art. The night I decided to be a doctor. It just clicked. I said, okay, this is what I'm doing. I've always probably known it, I never had to verbalize it never had to actually, you know, put it on paper. And then that was the night I decided to be a doctor when I had to say that I was truly pre-med and pre-art history.

Trina Renea  16:42  

So, when you said I'm going to be a doctor, were you like a dermatologist or some kind of doctor, like you didn't know?

Dr. Vicki Rapaport  16:48  

Some kind of doctor. I didn't know which one. I didn't know skin at all, really, I just knew like that my dad's walked into the room and came out about 15 minutes later. I didn't know what he was doing in there.

Rebecca Gadberry  16:59  

Not a lot of involvement.

Dr. Vicki Rapaport  17:03  

I did see a couple surgeries eventually as I was in that office longer, but yeah. And then I didn't know what kind of doctor. I hadn't necessarily been to doctors, you know, good the pediatrician once a year. And maybe, you know, the gynecologist starting at 18. And I thought, oh, maybe gynecologist is kind of cool. I never really thought about which kind of doctor I wanted to be. I just knew that I wanted to go check it out and have my mind blown. And then when I did start medical school, I remember when we got to the dermatology section of histology, which is when you look at slides, it was just one week, you know, you do liver and you do kidney and you do heart. And then the derm section. I'm telling you, it was again, like the bio experience in high school like it just came so easily. Which is weird, because again, I wasn't in the room with my dad. I didn’t know what he was doing in there, but I just really enjoyed it. 

Rebecca Gadberry  17:51  

Yeah, and it's, you know, the skin biology is I got freaked out on that too. I was actually pre-med for about a year. And what I was attracted to was the skin also because there's three different tissues at least that you're dealing with. There are so many different cells that you're dealing with so many different diseases, so many different conditions. It's a challenge. And it affects people's mental state, it affects the way they think about themselves, the way that they communicate and are related to and relate in the world. It's such a huge difference.

Dr. Vicki Rapaport  18:29  

I was in an Uber last night and he asked me what I did. And I told him I was a doctor and he said – ‘Well, what kind of doctor?’ And I was like, God this is too much. Yeah, he was always a chatty guy. And I said, I'm a dermatologist and he's like – ‘Oh, what do you like about dermatology?’ I swear to God, this just happened last night. And I said, you know, I love rashes. He laughed. I laughed. I know that sounds so weird. And I thought about it further. I said, I don’t love rashes, like on people and I feel bad for them. But I love rash because I can get the better that I think that was a sort of a nice sort of reality that I'm like, I'm a freak. Why do I love rashes? No, no, I just know that I can tell you what the name is, and I know how to make it better. And if the patient is listening and wants to get better fast, then they'll you know, do as we recommend, sometimes, you know, they have their own ideas. And that gets a little bit challenging again in the art of medicine, but I think I really enjoy the diagnosis is easy in a sense, sometimes you have to do biopsies, but it's rare that you really are like, I don't know what that is like, usually you just know what it is 95% of the time. You don't necessarily have to do biopsies, the 5% of the time you do have to do biopsies then the biopsy helps you and you can still get them better, which is so satisfying.

Trina Renea  19:46  

Yeah. So, what would you say like are the couple of the most challenging things that you've had to deal with in dermatology?

Dr. Vicki Rapaport  19:57  

I would say just the learning process. I suppose because the book is thick and there are so many diseases and you really do have to when I say memorize you eventually you memorize it all but it's overwhelming at the beginning but every year of residency you build on what you know. So, we would meet every day at lunch we would meet and we would have either a case or somebody will come and speak and they will always let the first year derm residents describe the lesion so they just want you to master describing the lesion. The second-year residents would have to give the differential and say like, okay, based on that first year as description, this looks like either psoriasis or lupus or whatever. And they would have to build on the education, they learned the first year and the third-year residents would have to describe what they would see under the microscope. And so, that's why I also like science is because it's so organized. And it's sort of like a pattern, how you learn is a pattern and sometimes you know, diseases come in patterns but I liked how you build on it but the biggest challenge was at the beginning was overwhelming. But then as a third year like wow, those first years all they have to do is describe it. That is easy. Whereas as a fresher, I sweat, sweat tried to describe it, which is so silly. And then oh my god sweat when you're like oh my god, that differential have to come up these days? Oh, how do I look stupid in front of my car, you know, just there's a lot of anxiety that goes along with it. But you build on the knowledge and that is brilliant. And then practicing medicine for me was easy. I you know, I'm social enough. I feel like I can read people I feel like I can get along with most people. I didn't really feel challenged in terms of actually the work of itself. The work is the reward it was the learning how to be good at the work was the biggest challenge.

Trina Renea  21:47  

Is there a challenge in like a very difficult skin situation that has ever like really kept you up at night?

Dr. Vicki Rapaport  21:59  

I would say yeah, the kids who have severe disease and the parents who are not on board with the appropriate treatment plans, because they have their own ideas. That's the most frustrating when you know you can get them better. And yes, there are potential side effects to the medications and then the parent doesn't really see the benefits. All they see is are the side effects and the danger. And then these kids suffer. And that’s sad like severe eczema, even severe acne, as we talked about, you know, when somebody might be appropriate, Accutane might be appropriate for them and the parents like absolutely not. And you and I are like, please just try this magical miracle of a medication, but a lot of eczema. There's a lot of parents who are like in psoriasis but we have so many new incredible medications with psoriasis that are so safe, that psoriasis really isn't so much of a social challenge anymore to try and get them to come around to the medications. I mean, once in a while you have a patient, I just had a patient this week 95% body surface area of psoriasis and haven't seen him for five years. So, I thought okay, he's ready now, he's ready for the biologics, and he sounded like he was ready in the room. It really was cool. I was like, okay, this is great. I talked to him all the safety profile and this and that, and how, yes, it's an injectable, but it's so safe, I barely need to see you. But once a year, we don't really need to even check blood work. We'll do it because we do it but and he's okay, we filled out, you know, filling out okay, I'll be back we'll fill out the paperwork, because that's what you have to do to get it approved to the insurance because they're very expensive medications. And the nurse came to me at the end of the day, and she's like, I just want you to know that, you know, I was in the room, I needed his signature. And he's like, yeah, don't bother filling that out. And so, he decided like that. So what were the disconnect was I have no idea because it wasn't even like he was hesitant at all towards the end. He's like, okay, let's do this. And then he ended up not doing it again. That's okay. It's just psoriasis. He doesn't have psoriatic arthritis, which can be a debilitating part of it. But you know, there's sometimes there's disconnect when you just think you've connected with the patient and they end up not taking your recommendations. 

Trina Renea  24:02  

Yeah. I remember there was in your office when I worked there many years ago. Your dad worked with a lot of the red patients and he would have to take them off of steroids. And people come from all over the world to come and see him and getting off the steroids was so hard and it was very mental. And that I felt like was super challenging. I mean, I remember I saw one patient that was also a patient of mine in the office, and I saw her out on the street. She saw me in a coffee shop and she like came up to me and she said – Look at my face. Look at this. He won't let me take the medicine, but I need something like can you help me? And I'm like, I'm not the doctor. I don't know. I've just worked there does your facialist, like I'm sorry. Like it's so sad.

Dr. Vicki Rapaport  24:56  

I'm glad that you brought that up because part of the reason why I didn't think that that was a challenge because honestly, now we have medications for those patients. In just 10-15 years ago, if we did realize that it was a steroid over use, and they were getting like rebound eczema, and we really did want to cold Turkey to steroid, there really wasn't that much we could give them. I mean, there were things, we didn't just let them suffer, there were a lot of things you can give them cyclosporine, they can do light therapy. But now we have true medications that will help severe eczema, whether it's rebound from steroids, or whether they really just have steroid up severe case of it, we can give them dupixent, we can give them orals. Well, they have side effects, but different than steroids.

Rebecca Gadberry  25:39  

And they're not as bad.

Dr. Vicki Rapaport  25:43  

They can be there, some of these medications are different. Yeah, different bad.

Rebecca Gadberry  25:48  

You're trading bad for another bad. 

Dr. Vicki Rapaport  25:51  

Not necessarily, they're very safe. But on paper, the side effects can seem very scary when you made the list of side effects. Again, that's where the dermatologist can help you to sort of console you if you're really panicking about these potential side effects, but that we still think the medications appropriate for you. But you're worrying about them. We can explain the reasons why the list of side effects are there. And oftentimes, it's because these patients had different diseases that they weren't on the medications for. And those medications were FDA approved for rheumatoid arthritis. Those patients have different risk factors than a purely examined as patient.

Rebecca Gadberry  26:30  

And that's one reason why you need to go to a doctor and not just look up on their website of the drug, you know, oh, these are all the scary things that can happen. We'll have the doctor explain it to you. So, I was going to ask you, you've been in this business for 20 years now. 

Dr. Vicki Rapaport  26:45  

Exactly 20 years.

Rebecca Gadberry  26:47  

Wow. So, what changes have you seen?

Dr. Vicki Rapaport  26:50  

Oh, my goodness, yeah, let's talk about that. The biggest change is how cosmetic dermatology has actually become. And also, as I was sort of, barely touching on the biologics, so the big arm of change would be cosmetics. We didn't really learn cosmetics at all. Botox came out when I was a resident. Botox came out in 2002. So, we barely learned it in in residency. Now the residency programs teach filler and Botox and all that stuff. And so, there's a huge you know, desire for cosmetic treatments from the public. So, we need to learn that stuff on our own. I mean, I've learned it over the years, but that is something that's new and then the biologics a whole new like World of magic options for patients with severe skin disease.

Rebecca Gadberry  27:38  

Now, could you tell the audience what the differences between biologics and cosmetics, how were those defined? 

Dr. Vicki Rapaport  27:46  

Yes, and they're very different because though the cosmetic world is the injectables the lasers, I don't do surgery, but some dermatologic surgeons do certain surgeries like blepharoplasty and eyelids, so anything that has to do with the elective choice to do a procedure, Botox, Restylane, Juvederm, IPL, CO2 lasers, BBLs those are all elective because usually they're curing wrinkles or brown spots, not a disease, right? And then the biologics are the biological medications that work on things such as eczema, psoriasis, vitiligo, alopecia, true medical diseases that are considered to be non-elective, the medication, possibilities for those, those diseases are endless at this point now compared to even just 20 years ago.

Rebecca Gadberry  28:41  

Wow. 

Trina Renea  28:43  

Well, and really good change options.

Rebecca Gadberry  28:47  

And we see much more effectiveness and results, I think.

Dr. Vicki Rapaport  28:51  

And much more pinpoint. So, some of the, the biologics are it's not synonymous with an injectable medication. Some biologics are actually oral medications, but in general, the biologics started out all being like the shots that we used to get we gave for not vaccine shots, but shots of medication, just a different delivery system to you know, deliver medication. They're much more pinpoint. So, think of psoriasis as like a multi stepped way to make a psoriasis plaque. It picks out one of the immunomodulators that basically causes a psoriasis plaque versus a steroid, which will annihilate the whole cascade of events that causes a psoriasis plaque. 

Trina Renea  29:33  

Fascinating. Yeah, you guys had to learn a lot of medications and different types of these things like how do you learn them? Do reps come in and teach? 

Dr. Vicki Rapaport  29:43  

I mean, we learned the process in residency and that's part of the reason why it's it builds how you learn the biochemistry of how psoriasis occurs. And 2020 years ago in residency, we thought there was going to be like a sort of a genetic cure. Just find the gene, fix the gene and you'll be fine. Now, it's not a genetic cure. It's actually they pick out an interleukin. So, interleukin 17, interleukin 23, just to sound scientific, or to have the interleukins that are a little higher and a psoriasis patient. So, it's these anti-interleukin medications that will sort of sap up or sponge up the extra interleukins that causes psoriasis plaque, and by pinpointing just those few interleukins it's safer than a steroid, an oral steroid, which is like a nuclear blast.

Rebecca Gadberry  30:36  

Which shoots everybody down, and now you're using just a little dart something with a lot of power behind it. 

Trina Renea  30:42  

Okay. But so, if somebody has like, let's say, really severe eczema, or psoriasis, and over the course of their life, and so you introduce a steroid. Could you take them off that steroid after a few months, so they don't have a rebound or whatever and then put them on one of these other things that you're talking about, these bile and then take them off of that and put them on a different ones. And then bro, put them back on steroids and then like do it course of these so that it's constantly being treated without having something happen where you have the addiction or whatever it is,

Dr. Vicki Rapaport  31:18  

Yeah, absolutely. rotating around medications is done all the time. And whether it's because the patient sort of became immune to that therapy, because that can happen. You know, some of the old either biologics or some of the old orals for psoriasis, say, stops working for that patient, you can switch to the different class of medications, different set of side effects, different set of instructions, but yes, you can rotate. And of course, steroids are absolutely a mainstay. I love steroids, and I don't do injectable steroids much. Maybe I've done 10 In my career. So shot a steroid every two years. Sometimes we'll do oral prednisone, but it's very, very rare again, because it’s just a band-aid, they're going to rebound. So, these other medications are more long-term solutions for these people with severe disease. But I do say that there are a lot of dermatologists still do way too much steroids. I think there are less and less of those-dermatologist around because the biologics are everywhere. And we learn even though I didn't learn the biologics in residency, yes, we have fall clinical, which is the big meeting, we have the AD, the biggest meeting and we learn about the studies, we read the studies in all our journals. I mean, you're bombarded by the information all day long every day. 

Trina Renea  32:33  

You guys have to take classes every year in points that go towards your CMEs.

Dr. Vicki Rapaport  32:37  

Yeah, continuing medical education. Yeah.

Trina Renea  32:41  

Constantly. All doctors.

Rebecca Gadberry  32:42  

And ADD is the American Academy of Dermatology.

Dr. Vicki Rapaport  32:46  

It's like our governing body that board cert… well, actually, the ABD is the board certification but AD is like our… Yeah, like the I'm a member of the AD means I'm in good standing. I haven't, you know, done anything really bad. They still like me, they want me around.

Trina Renea  33:06  

So, you've had in one office in Beverly Hills for a long time, and you start your skin care line 20 years ago. And now you have a new office, which I can't imagine that gives you any more time to yourself. What prompted you to open a second clinic?

Dr. Vicki Rapaport  33:27  

Great question. Okay, I live about two blocks away. And this was available. And I thought – You know what, we're busy enough. We were like bursting at the seams in Beverly Hills. So, you know, when you feel like you can satisfy, you know, the schedule in one place that you just kind of can tell that you could open up a second place and that you also have time, obviously, I cannot be in two places at once. But I had time, I worked Fridays and Saturdays in Culver City. Now I don't really do that, obviously, because I can't work six days a week. But it's a small enough space that even if I just go a couple times a week, it's okay, I can support it. But it was close by in the space was available. And I thought as I get older, you know, maybe I would just want to work closer to home. And then if I want to go see a patient on the weekends, or somebody has an emergency, if they want to meet me somewhere for me, it takes me three seconds to get there. I'm happy to do that.

Trina Renea  34:19  

And you also took on a partnership with a giant product company SkinCeuticals, which is another big thing that you've introduced into your life.

Dr. Vicki Rapaport  34:32  

We used to carry SkinCeuticals sunscreens a long time ago and then we just sort of stopped because there were so many other products, sunscreens that actually liked a little bit better. But SkinCeuticals has really exploded in their product offerings. And they offer this flagship program for offices that they see would be a good partner for them or a good fit. And what really that entails is just you know, we get lots of attention from SkinCeuticals we can now sell SkinCeuticals online, they make this beautiful display in the office, it's a nice partnership and helps us, you know, educate the staff on the product line and market the product line. And I decided to do it because my esthetician was getting such great results with her SkinCeuticals. She has always used SkinCeuticals. And she knows how to get good results with those products. So, you know, I started using them myself, and I do like them. And I feel like they're very universally loved products. But there are a lot of products and I can't have all of them. And I'm learning that I can't have all of them. I don't want all of them. But the ones I really do love, they work well for me and my patients.

Trina Renea  35:38  

And so, what do you feel like some in your whole career? Like, what are some accomplishments that you're proud of?

Dr. Vicki Rapaport  35:49  

I just love to be able to make my own schedule. Seriously, that's the most beautiful, independent feeling is that I'm not beholden to like somebody's schedule and somebody's demands. So having my own practice, not working for Kaiser or UCLA or at Cedars or have my practice be bought by a big, you know, private equity group, I think I'm most proud that I can still stay standing in this atmosphere where a lot of practices are selling their practices to these big conglomerates, you know, I like being in charge. 

Trina Renea  36:20  

That's interesting you say that, because I've recently been thinking like, you know, I've only ever worked for myself. And so, I'm like, what would it be like to work in a corporate world, you get all your benefits paid for you, you go home, you don't think about it. And like you could get a huge paycheck, and then just go home at the end of the day. And it'd be done. And you know, it always sounds like the grass is greener on the other side. But then I've spoke to a few doctors that are paid clients of mine. And they're like, why would you ever do that? You have freedom, like you have they work in hospitals, you know, and they're like, you wouldn't be able to have your own schedule, and you'd have a boss that told you what to do. And I was like, oh my god, I never thought about that. I'm like, wait, I can't make my own schedule. Because that is like you just said, such a freedom in life just to be able to have that is better than anything.

Dr. Vicki Rapaport  37:20  

I think so. And for other people, it's not right for them. But I think that what you said at the beginning is not necessarily true, you're like, take that big paycheck and just go home. And I don't think it's such a you know, if you work for somebody, it might not be such a big paycheck, because you might want to have certain hours and you're like; well, if you want to work those certain hours, this is what you're going to make like it is not going to be everything. If somebody owns you, you're not going to get all the benefits that you that you can give to yourself. Because by the way, you can just work harder and see more patients or you can send your client and get that big paycheck, you can decide what works for you.

Trina Renea  37:56  

Right. And I have a friend, she got a new job, doubled her in pay. And she still took home almost the same amount. Because when you get the higher paycheck, you have to pay more taxes, and she was like, oh my god, I'm taking home like $3,000 more a month with a double paycheck.

Dr. Vicki Rapaport  38:17  

She just has to, and then without the deductibles, without having your you don't, you can't deduct the way you. So, there's a lot to think about. You have to have mentors to help you really think all that stuff through. So, I'm happy to be your mentor Trina, don't sell out. Don't sell out. It's not worth it, I don't think.

Rebecca Gadberry  38:35  

And what's to say you're not going to have work to take home when you work for somebody else.  if you have a responsible position.

Trina Renea  38:41  

15 hours a day. 

Rebecca Gadberry  38:45  

So, you're doing it for somebody else. So, like you said, grass is always greener when you're on the other side of that fence. 

Trina Renea  38:56  

So, your accomplishment is your you feel that you're most proud of is that you have stuck with you're not giving in to the higher ups that are trying to buy you out.

Dr. Vicki Rapaport  39:08  

Yes. And I think that, you know, I've mentored a lot of PAs and, and pre-med students, you know, people shadow me and esthetician. In fact, we're getting an esthetician on the next episode who shadowed me and I feel like you know I like to show people you know what the world is all about. I'm happy to open up my doors to people who want to see what it's like I like being the mentor.

Trina Renea  39:34  

Yes, I love that you mentor estheticians, I think that's amazing and beautiful. And I love that, as an esthetician I can call up a doctor's office and a lot of them will let me come in and follow them around for a day or two. And that's you just have to be brave and ask. You know, but… Okay, is there any advice that you would give to any aspiring dermatologists out there who are just starting in their career journey?

Rebecca Gadberry  40:02  

Or who haven't even chosen dermatology yet, but they want a career?

Dr. Vicki Rapaport  40:09  

Oh, my advice would be, you just work really hard and stay honest. I think that you'll benefit from that. I feel like when I say stay honest, I mean, I feel like people in general and doctors are not immune, they kind of sometimes start to do some shady things don't ever, ever, ever do that. Just be really honest with patients, you know, if you screw up, be honest with the screw up. And I can't even really give a specific, I just think it's more like life advice, like, just always tell the truth. Always be straightforward. Communicate with your co-workers, communicate if you have a boss or communicate with your patients like, and also the hard work will pay off. It really will. And I feel like this new generation is really like hard work averse, like they want, want, want, want. And they whine, whine, whine, whine, whine when they don't get what they want. And I just think that that's not the way to be in life ever. Who's going to give you anything? You got to get it yourself. So, I know that sounds a little negative. But I feel like the hard work really does pay off. And the other the last little tiny, tiny tidbit about dermatology would be I think that you choose your specialty based on whatever that reason is. And for me, it was like a flow. I think we talked about, it's important for your challenges and your skills to equal so you want to be challenged enough that it's not too easy. But you also want to have enough skills to be able to meet those challenges. And for me, that was dermatology, because we can do some surgery, but I don't want to do big surgeries like I'm not into like huge surgeons, but I love the challenge of like really, really small surgeries and beautiful cosmetic outcomes. And I love the challenge of a difficult personality. Honestly, I think that sometimes when you win a patient over oh my god, it's like the best feeling of the day. And I like that balance of having the flow and whether the flow means you're going to be urologist and work on those types of problems or a gynecologist and deliver babies. Oh my God, those are scary challenges. But I think finding that flow for whatever that specialty is for you. You're going to know when you find it. 

Trina Renea  42:23  

Yeah. Listen to your gut. Well, thanks for sharing with us everything about you. 

Rebecca Gadberry  42:32  

… says Dr. Vicki Rapoport, you are known. You have been known.

Dr. Vicki Rapaport  42:39  

I’m going to know you next time, Rebecca and I'm going to know you, Trina.

Trina Renea  42:45  

Stay tuned for all of that, we have another guest coming on here and so we're going to say our goodbyes. Tune into our next episode. Thanks for joining. Thank you, Dr. Vicki for sharing all your inner secrets with us. 

Dr. Vicki Rapaport  43:02  

You're welcome and I'm going to tell you my tagline right now is XO and SPF Goodbye. 

Trina Renea  43:14  

What’s XO?

Dr. Vicki Rapaport  43:16  

Love and kisses.

Trina Renea  43:26  

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