Transcript

[Intro…] (0:00)

I am the experiment. You can write your own story. Stop trying and don't give into the fear.

Dr. Jeffrey Lauber (0:37)

Chemistry major, UCLA. Medical school, USC. Residency in dermatology at Tulane in New Orleans.

Justin McMillen (0:43)

So you have to ask yourself, Jeffrey, why did you leave New Orleans since it's such a fun place?

Dr. Jeffrey Lauber (0:52)

And the answer is, New Orleans is ninety-five percent Black people.

Dr. Jeffrey Lauber (0:54)

Black people don't get skin cancers. A big part of what a dermatologist does is treat skin cancers, so I would sit there with nothing to do. God. As I moved here, my sister married one of my fraternity brothers from college, and during the course of my three years in New Orleans, I went to visit her, and she drove me around, and she specifically dropped me off at the beach to take a look.

Dr. Jeffrey Lauber (1:11)

There's a beach here with everybody, no hats, no sunscreen. [...] No t-shirts. This is a good place for you to start your practice. And that was thirty-seven years ago.

Justin McMillen (1:25)

That was good advice. Wow.

Dr. Jeffrey Lauber (1:28)

Yeah. So because I was in New Orleans, I didn't have a lot of experience with melanomas per se, or skin cancers.

Dr. Jeffrey Lauber (1:31)

I spent a month in Sydney, Australia, the melanoma capital of the world, no ozone. There are people that look like you and me, with no ozone, with horrendous melanomas. And it was at that time the surgeon in charge said, "Yankee, what do you notice about our skin cancers?" "Oh my God, these are horrendous." "No, no, no, no, no."

Dr. Jeffrey Lauber (1:51)

"You Yankees have all your skin cancer on your left side. We drive our cars on this other road, so we have all our skin cancer on the right side." After thirty-seven years, when someone calls me on the phone, "Doctor, I'm really worried about a spot," left ear, left cheek, left nose. "How do you know that, even without seeing me?"

Dr. Jeffrey Lauber (2:09)

Well, that's simple, because you don't have an accent from New Zealand, South Africa, or Australia. You sound like me. So it's always the left side.

Justin McMillen (2:15)

So it's the driving? That's why it's on the left side, is that so?

Dr. Jeffrey Lauber (2:20)

Driving. It's the driving. So I talk to patients, talk about sunscreen. Like, are sunscreens a lot of money, a waste?

Dr. Jeffrey Lauber (2:25)

Just roll up the driver's side window, or get it tinted. So I get to do. Okay. During my training, we did a lot of skin cancer surgeries on, you know, what have been like the Cajuns, you know, that kind of people out there. So there's a lot of just skin cancers like that, but not melanomas.

Dr. Jeffrey Lauber (2:43)

And what's the difference? Melanomas will kill you. They're black, they're black spots. Most of the time they look like licorice, on your back, arms, neck, and scalp. So there was very little melanoma we had, because most of the patients were Black. So I had to go to Sydney, Australia, to learn about melanomas. And what's the other kind called? Basal cell or squamous cell.

Dr. Jeffrey Lauber (3:03)

Okay. And, you know, the cancers, they all start out with early lesions, like yours. So basically, if I had to explain it, I would say you had, quote unquote, an abnormal pap smear of your skin. So a woman gets a pap smear and it's abnormal, the doctor isn't telling her you're going to die, but it's not saying put your head in the sand.

Dr. Jeffrey Lauber (3:26)

Just treat it. So with yours, yours was so early, it was amenable to a special cream in a tube, as opposed to me sending you to a surgeon and hacking you up. Okay. And so my training was surgery, but as I get a bit older, you know, a chance to cut is not always a chance to cure. And a very famous dermatologist sat me down in the hospital where I was training.

Dr. Jeffrey Lauber (3:49)

And he said, "Jeffrey, sit down. I don't want to ever hear that you're practicing medicine as if your mortgage depends on it." And his meaning was, don't be greedy. You make a lot of money doing cutting, but that's not the right thing for some people. And I've had, you know, for thirty-seven years, enough patients tell me, "Jeffrey, whatever you're going to do, I do not want to see a surgeon, do what you've got to do."

Dr. Jeffrey Lauber (4:11)

So yours was easy, just put the cream on, and, you know, sometimes do it a second time, it's no big deal. But there's some people that come to me, you know, they wait five, six, seven, eight, nine years, praying it's going to go away. And, you know, they have a huge nodule, it's bleeding. "Well sir, I can't use a cream on this."

Dr. Jeffrey Lauber (4:29)

"You've got to go to a surgeon." And those are probably the pictures I showed you, when they're horrendous, where these people, they wait, and they're... most of the ones you saw, left side, left side, left side, left side, left side, it's classic, because they're white, over thirty, live in Southern California, and they neglected it.

Dr. Jeffrey Lauber (4:45)

So you just got to take care of things early, and they're really simple to take care of, really, yours is as easy as a cream.

Justin McMillen (4:55)

How does, Doctor Lauber, Doctor Jeffrey Lauber, how do you know... let's say someone has a thing on the side of their face, what would be an indication to go see a doctor?

Dr. Jeffrey Lauber (5:03)

Well, I tell somebody, look, if you weren't born with it, and it's bleeding, and it's a scab, and it's been there for more than a month or two, you got to come in. Because a scratch of a dog, scratch of a thorn from a rose, or a scratch of a cat, a shaving injury, you'll heal up in a week. But if it's there for more than a month and a half...

Dr. Jeffrey Lauber (5:19)

...if you're white, over thirty, live in Southern California, it's not going to go away. And the kicker now is I ask a further set of questions: "Do you ever spend time in a tanning booth?" "You'd be surprised, yeah, I'm still in the tanning booth, I've been doing it since I was in high school." "Well, lady, you've got one called Sailor's Lip."

Dr. Jeffrey Lauber (5:39)

"You've got a huge thing on your lip that's not going away." "How many years have you had it?" "Two or three years, I just thought it was from biting my lip." The left side of the lip. Wow. I use the same cream, they're a little bit nastier to treat because it swells easier. It was the same thing, like, you know, I gotta tell them.

Dr. Jeffrey Lauber (5:55)

Denial is not a river in Egypt. It's not going to go away. So I think what people need to understand is if there's blood in your pillow, if there's blood in your towel, if there's blood in your shirt, go see a doctor. Had a case, like, maybe thirty years ago, a guy came through, and, "How'd you find me?"

Dr. Jeffrey Lauber (6:16)

"A dry cleaner." You know, in those days, I'd get patients from the Yellow Pages, other patients, nurses, friends, doctors, insurance companies. "A dry cleaner?" Yeah. The dry cleaner said, "Listen, every shirt has blood in the same spot, on the left shoulder. What are you, nuts? You've got blood in your shirt." We're taking blood off every one of your shirts.

Dr. Jeffrey Lauber (6:37)

Go see a doctor. He had a cancer the size of a half dollar.

Justin McMillen (6:41)

Holy shit.

Dr. Jeffrey Lauber (6:43)

Yeah, yeah. And it was just ignored. Well, I mean, it was a dry cleaner that brought it to his attention, like, "We're taking blood off your shirts, you know? Get a grip." So if you catch it early, use a cream, you're fine.

Dr. Jeffrey Lauber (6:54)

So, anybody listening to this, if you have something on your body, and it's there, if you're white, over thirty, and live in, say, Southern California, and it doesn't go away in a month, mark your calendar. It's not a scratch from a dog, a scratch from a cat, a rosebush, that'll go away in a week or two. If it's there for a month...

Dr. Jeffrey Lauber (7:12)

Get it looked at. Just get it looked at, don't put it off.

Justin McMillen (7:15)

What's the process with the cream that you gave me? What is that?

Dr. Jeffrey Lauber (7:19)

Well, the cream, the cream was invented, like, in 1958, by a doctor, I can't remember his name now, but it's a very interesting story.

Dr. Jeffrey Lauber (7:30)

It was originally used intravenously for people with colon cancer, in the late fifties. Colon cancer, it's a pretty powerful drug. And a medical dermatology resident at the University of Arkansas noticed, he's a dermatology trainee, a young guy, that every patient on the wards that was given this medicine intravenously, their cancers kind of lit up, but they weren't...

Dr. Jeffrey Lauber (7:55)

It was just lit up, like, as a side effect from the intravenous medicine. So he made a point of, like, "why is that going on?" And he had the brilliant idea to take that IV medicine and put it into a cream and use it on skin cancers. He became the chairman of dermatology at that department for forty years.

Dr. Jeffrey Lauber (8:14)

The genius.

Justin McMillen (8:16)

And that's what happens when you do stuff like that.

Dr. Jeffrey Lauber (8:18)

Sure. You know, the medicine's been around that long. Sadly, it's not as popular as other modalities, because the pharmacist makes the money and not the doctor, because the cream is kind of pricey. So when a doctor does freezing, or burning, or cutting, you know, he makes a few bucks.

Dr. Jeffrey Lauber (8:36)

But if he prescribes a cream, matter of fact, I think I gave you the cream, I had it, you know, the pharmacist makes the money, so it's out of favor, because it's not... it's in the patient's best interest, but the doctor doesn't make any money. And remember, I got a lecture from somebody that said, "Jeffrey, put your patients first."

Dr. Jeffrey Lauber (8:53)

"Don't be greedy." Yeah, that's the first thing you do. And so, now, I'm sixty-seven, I've been doing this for almost forty years. If I can get you the cream, I don't want you going into a surgeon's waiting room. So there are patients who say, "Let's try this, I'll do it two or three cycles." If I can't knock it down, you've got to go to a surgeon.

Dr. Jeffrey Lauber (9:11)

And that brings up a point, when you say "knock it down." If you wake up and you've got, like, a big bulging matzo ball or meatball on your face, the cream's not going to work. Sure, you've got to go to a surgeon. But all these things start out as precancerous lesions, and patients just neglect them. You catch them early, you use the cream, you're done.

Dr. Jeffrey Lauber (9:31)

You're on your way. You're on your way. And I gotta say, the tanning booth, just, anybody listening, before you go into a tanning booth, you gotta be over eighteen to go in there, because you have to get consent from your mother. And there's a big sign that says this will cause skin cancer.

Dr. Jeffrey Lauber (9:47)

Just like, you know, people that smoke cigarettes, it says it causes lung cancer, right, it's like giving you a warning. So if you decide not to heed the warning, the old saying is, "fry now, pay later."

Justin McMillen (9:56)

You've got a problem. Is it from burning that skin cancer's caused, or...

Dr. Jeffrey Lauber (10:00)

No, it's actually just chronic exposure to ultraviolet light.

Dr. Jeffrey Lauber (10:07)

And that's why you have them, in our world, on the left side, because there's more light coming in from the car.

Justin McMillen (10:11)

What about this talk around, I don't know if you've heard this, there's some, you know, bandwagons, we were talking about bandwagons on here in the last episode, people get on these bandwagons.

Dr. Jeffrey Lauber (10:19)

Yeah.

Justin McMillen (10:21)

Bullshit. What... this idea that,

Justin McMillen (10:25)

that there's a correlation between the rise of skin cancer and the use of sunscreen. Have you heard this?

Dr. Jeffrey Lauber (10:34)

Oh, God. You know, I hear stories like sunscreen is dangerous, the chemicals, stuff like that. But, you know, the amount of surface area on the body you're putting it on is so small, it doesn't get absorbed. I don't believe that.

Dr. Jeffrey Lauber (10:43)

Okay, you know, if you have skin that's just like psoriasis skin, that's all opened up, yeah, you're going to have a problem. But I don't think those are a problem, it's such a small surface area. Personally, sunscreens, they're kind of a pain, because they get into your eyes and they burn, you gotta keep reapplying it.

Dr. Jeffrey Lauber (11:02)

It's a marketing deal.

Justin McMillen (11:05)

Yeah.

Dr. Jeffrey Lauber (11:06)

If you go to the beach, wear a hat, wear long sleeves, you'll be fine.

Justin McMillen (11:08)

So what about its value in having a base tan to protect you from the sun?

Dr. Jeffrey Lauber (11:12)

No, not really, because if you're basing it in ultraviolet, it's just not a good idea, it doesn't do anything.

Justin McMillen (11:15)

Yeah, that's... there's a lot of talk around that.

Dr. Jeffrey Lauber (11:18)

The key is to just not burn.

Dr. Jeffrey Lauber (11:22)

Don't burn, burn, burn. Just don't burn. Just don't burn.

Justin McMillen (11:27)

Yeah.

Dr. Jeffrey Lauber (11:29)

Some people think the risk factors are more than two summer jobs outside and more than two hardcore sunburns raising your risk for skin cancer.

Justin McMillen (11:49)

Oh, man, I had one, the worst sunburn you could ever imagine. I went snowboarding when I was fifteen, and my sister, this... I basically put baby oil on my face. Yeah, and I burned myself so bad that in Spanish class, second period, I went like this, and a piece of my nose came off. My eyes were pure red, and I ended up having to go to the hospital, and I had, like, third-degree burns on my forehead, some places, big pieces were coming off, and that was terrible.

Dr. Jeffrey Lauber (12:05)

Yeah, I see people, a little older now, even older than me, that in the old days they would put iodine in baby oil and put it all over their bodies.

Justin McMillen (12:15)

Oh.

Dr. Jeffrey Lauber (12:17)

Because it would, they'd get a deeper tan. And this was probably thirty-seven years ago, when I first started my practice, two sisters from Long Beach, they had skin cancers on the bottom of their feet, because they'd been in Long Beach.

Dr. Jeffrey Lauber (12:28)

This is before, Long Beach was a beautiful place, and then there was an oil spill, and now it's kind of gross. But when they would lay down face down, their feet would be up past their heads. So their feet got all the sun. So they had skin cancer on the bottom of their feet, first time I'd ever seen that.

Justin McMillen (12:45)

That's crazy, laying down.

Dr. Jeffrey Lauber (12:47)

And so they were just tanning their backs, and then they got it on their feet. Now, we should talk about melanomas for a little bit.

Justin McMillen (12:51)

Yeah.

Dr. Jeffrey Lauber (12:53)

You know, melanomas are the ones that kill people.

Justin McMillen (12:55)

And so, I didn't have melanoma?

Dr. Jeffrey Lauber (12:58)

No. God, I don't use cream for melanoma. Okay. And just so you know, when I ask people a history, you know, about their personal history, their family history...

Justin McMillen (13:04)

Well, I think my grandmother, they may have had, might have had melanoma.

Dr. Jeffrey Lauber (13:09)

One way to know: if the scar is huge, was it a melanoma scar? After they take it off you, right, the scar is going to be huge. If it's a very, very small scar, that person did not have a melanoma. There was a doctor at UC Irvine, he was a surgical technologist.

Dr. Jeffrey Lauber (13:25)

Only did cancer surgery, internal, external, you know, deep stuff. He did not work with a scalpel, he worked with a chainsaw. So when you went to him, the scars were huge. That's how you know he had a melanoma. That's how you know, if you have a small scar, it wasn't melanoma. So, I have to ask that.

Dr. Jeffrey Lauber (13:47)

Because if someone comes to me, like, thirty-five, forty years old, and the mother had a melanoma, then I've got to do genetic testing on them, because if they're going to have any kids, the kids are going to get it too. It's like, back to the genes, we're very sophisticated now, we can tell if there's going to be any passed-down autosomal dominant risk.

Dr. Jeffrey Lauber (14:06)

Passed down to the other generation. So when I do have people with melanomas, the first thing I do is send them for genetic testing, to make sure that if they have a special gene, they don't pass it on.

Justin McMillen (14:25)

Is it clear whether melanoma's all genetically driven?

Dr. Jeffrey Lauber (14:29)

Yeah, it's genetically driven.

Dr. Jeffrey Lauber (14:32)

Maybe fifty percent, because people who live in Australia, they have a hole in the ozone, that's not genetic, they're just getting more UV going through. When I try to see whether it's genetically driven or the ozone business, you just... with the melanoma, she had to be really astute, because the melanomas don't start out as huge black lesions.

Dr. Jeffrey Lauber (14:50)

They're mostly black for the most part, and they don't start out as things that are large, they start out small. So I tell a patient, look, if you've got a family member that had it, you should be checked, and then get the genetic testing. A patient, maybe ten, fifteen years ago, came here for something else, and his mother had a melanoma.

Dr. Jeffrey Lauber (15:06)

I said, "You've got to get checked." "I don't have anything now, but your mother didn't get it when she was your age either."

Justin McMillen (15:11)

Sure.

Dr. Jeffrey Lauber (15:13)

Who knows, it saved their life.

Justin McMillen (15:15)

Now, when someone gets checked, let's say they know they're carrying the gene, then what do you advise them to do?

Dr. Jeffrey Lauber (15:20)

Well, I like them to go to a university, because they do what's called mole mapping. They get you in a big machine with all these fancy cameras, and they take pictures, they make a CD-ROM, and they look at that sequentially over the course of a couple of years, to see if there's a change in their moles. Yeah, because the same people, they have thousands of moles, sure, where do you start? You take everything off.

Dr. Jeffrey Lauber (15:39)

So they do mole mapping with hardcore photography on CD-ROMs.

Justin McMillen (15:46)

Is that... are the moles... what is that, where does it start? Is it always...

Dr. Jeffrey Lauber (15:51)

Generally speaking, yes. I don't know of anything about a mole that went awry, like, they had a mole and it changed because ultraviolet light changed it, or the genetics changed it. I'd say it's fifty-fifty, half ultraviolet light and half genetics.

Justin McMillen (16:01)

What the hell is a mole? I mean, explain to me...

Dr. Jeffrey Lauber (16:04)

I mean, obviously not... moles are... but, you know, moles are just, you're not really born with them for the most part. They come up later on, and, you know, sometimes they can be clear, maybe skin colored, they can be a little bit darker.

Dr. Jeffrey Lauber (16:17)

But if they come up and they're black, that's a melanoma. Okay, they're going to be like black, like your t-shirt that's out of...

Justin McMillen (16:27)

Yeah, that's small.

Dr. Jeffrey Lauber (16:29)

And so, a medical student, I'll tell a patient, look, you want to be like Michael Jordan. Well, Michael Jordan knows, you want to bounce a basketball to know it's a basketball.

Justin McMillen (16:35)

Right, right.

Dr. Jeffrey Lauber (16:36)

Get some on your body they weren't born with, and it's black, they should get checked.

Justin McMillen (16:41)

Gotcha. I have a mole.

Dr. Jeffrey Lauber (16:44)

No, you're fine, like that.

Justin McMillen (16:45)

I used to think it was a tick, because I'm from North Dakota.

Dr. Jeffrey Lauber (16:48)

Oh, she would, you would be, I don't know.

Justin McMillen (16:49)

Every year she'd try to pull it off.

Dr. Jeffrey Lauber (16:51)

Yeah, when you would come off, you [Bleep].

Dr. Jeffrey Lauber (16:55)

Sadly, a gynecologist in my building said, "Jeffrey, one of my family friends has a nasty mole on the back of his neck." So he comes in, his wife's in church number one, the wife's in church number two, filling out the paperwork. And I said, "So where's your mole?" So I look at him through a little doctor window in the front office.

Dr. Jeffrey Lauber (17:08)

He turns around, he's got, you know, an eight ball, it's black. Yeah, he's got an eight ball on the back of his neck. And I yanked the clipboard and said, "You can't be my patient." And when I'm about to tell you, it gives me no pleasure, get your affairs in order, this is a melanoma, you're not going to live. And the wife chimes in, "I told him five years ago to get checked."

Dr. Jeffrey Lauber (17:26)

I said, "Sir, there's two reasons why you're going to die. A, you're a moron. And B, the barber who shaved around an eight ball on the back of your neck for five years should have said, go see a doctor."

Justin McMillen (17:35)

Wow, it was huge, like an eight ball on the back of his neck, that's crazy.

Dr. Jeffrey Lauber (17:40)

Yeah, yeah, those are... that's denial.

Dr. Jeffrey Lauber (17:46)

Complete denial. So the headline of this conversation is just pay fucking attention.

Justin McMillen (17:49)

Yeah.

Dr. Jeffrey Lauber (17:51)

I mean, just look in the mirror, and, you know, interestingly, the melanomas occur on what's called balance: back, arms, neck, and scalp. So a lot of times you can't see your back. So the picture I may have shown you, other people, you take a small hand mirror to the mirror in your bathroom and go like this, to see if there's any on your back, because they occur on the back, arms, neck, and scalp, which you can't see.

Dr. Jeffrey Lauber (18:14)

You come into my practice and you have athlete's foot, or you've got something on your finger, take your shirt off. I'm not letting anybody leave my office with a melanoma on their back. Somebody comes in with their husband or wife, I say, "Sir, would you mind if I just take a look here?" Because I don't want you dropping dead.

Dr. Jeffrey Lauber (18:32)

And I've had other instances where I had some brochures, which I stopped doing, I'd send a patient home with a brochure, "What You Need to Know About Melanoma," from the National Cancer Institute, a free brochure. I stopped sending them home with patients, I got a call from, like, the spouses, and this happened multiple times: "Doctor Lauber, you sent a brochure home about melanoma?"

Dr. Jeffrey Lauber (18:51)

"About my husband, or my wife, do I need to change the beneficiary?" Well, yeah. Wow. I said, not just for information purposes, like that. So what I do in my office has ramifications outside. "Do I need to change my beneficiary? I never thought about that."

Justin McMillen (19:01)

Right.

Dr. Jeffrey Lauber (19:03)

So I don't give them a brochure now, because, you know. So what's the death rate of melanoma?

Justin McMillen (19:13)

Well, how many people, what percentage of people die from melanoma?

Dr. Jeffrey Lauber (19:17)

If you get it early, you live. Okay, like John McCain, I don't know if you... he was a senator, you know, highly decorated war veteran, POW, senator, ran for president, blah blah blah. You never really saw any of the campaign images with less of his face.

Dr. Jeffrey Lauber (19:34)

He had a huge surgical patch, or a graft, put on his face. So this guy had a melanoma. Well, you know, if you're a POW, a senator, and ran for president, you have access to good medical care. Somebody in his world missed a melanoma.

Justin McMillen (19:41)

Wow.

Dr. Jeffrey Lauber (19:43)

Yeah, somebody missed it. So in my world, we call that malpractice.

Dr. Jeffrey Lauber (19:55)

And in his world it would be court martial. You don't miss a melanoma on a political guy out there. Yeah, that was around maybe two thousand, two thousand two-ish. The New York Times had some articles about his melanoma. So if you catch it early enough, it's fixable.

Justin McMillen (20:04)

But always surgery, can't you...

Dr. Jeffrey Lauber (20:07)

Yeah, melanoma, there's no cream for that. And if you don't catch it early enough, survival...

Dr. Jeffrey Lauber (20:19)

It's better now, there's medicines now which are very sophisticated, they're immune medicines, you can extend their life maybe five, six, seven months more. But, you know, when I was in Australia doing melanoma research a long time ago, some people had such bad melanomas that when they would urinate, it was brown, there was that much melanin.

Justin McMillen (20:42)

Wow.

Dr. Jeffrey Lauber (20:44)

Yeah, their body was, they had melanoma-ptosis, their body was riddled with pigmented lesions, and they'd pee and it was brown.

Justin McMillen (20:51)

Oh.

Dr. Jeffrey Lauber (20:54)

Yeah, yeah, it's a bad one, it's a bad actor. There was a Seinfeld episode a long time ago, not a Seinfeld fan myself, but my patients are, did you see that?

Justin McMillen (21:01)

No.

Dr. Jeffrey Lauber (21:03)

So, somebody, they were at their little restaurant, they hang out having coffee, and somebody was making fun of a dermatologist, like, not being a real doctor. And a person came in and talked to the guy sitting with them: "Thank you for saving my life, he's a dermatologist, I had a melanoma."

Dr. Jeffrey Lauber (21:18)

Got it. So that's great.

Justin McMillen (21:20)

That's... oh man.

Dr. Jeffrey Lauber (21:23)

I didn't... I've been in my practice for thirty-seven years, and now I treat a younger population, so in my world, a melanoma risk factor would be like twenty-eight people out of about thirty-four thousand. So it's not, that's my practice, of younger people, I treat a lot of acne too.

Dr. Jeffrey Lauber (21:39)

So the risk of melanoma until, say, age twenty-eight is about twenty-eight divided by thirty-four thousand. But in a practice where they're all older people, it would be about ten times that.

Justin McMillen (21:46)

Okay, so I want to make sure I understand, so you said melanoma is not primarily driven by sun exposure?

Dr. Jeffrey Lauber (21:51)

No, it's fifty-fifty.

Dr. Jeffrey Lauber (21:56)

Half genetics and half sun exposure. Genetics loads the gun, and then sun, where there's no ozone, like there's no ozone in Australia, that means more UV light gets through.

Justin McMillen (22:06)

Okay, I lived over there for a little while. They had a campaign called Slip Slop Slap, oh yeah, you know about this? They would give you sunscreen at the beach, on the machines.

Justin McMillen (22:16)

Little kiosks.

Dr. Jeffrey Lauber (22:19)

Yeah, yeah, I was really impressed by their approach to medicine, because it's a small enough population to write in and tackle things. Like in school, you know, I spent, I spent a month there. So their deal is, you train until there's an opening for you in the community. So you could theoretically be training until you're thirty-five, forty years old.

Dr. Jeffrey Lauber (22:35)

So there's an opening for you.

Justin McMillen (22:39)

Wow.

Dr. Jeffrey Lauber (22:41)

Yeah. And interestingly, they have so many melanomas, but it's public health.

Justin McMillen (22:44)

Yeah, yeah.

Dr. Jeffrey Lauber (22:46)

And public health is free. But when they started instituting, like, a dollar-a-day admission, you had to pay a dollar, people wanted to leave the hospital. "No, I don't want to stay." But it was free.

Dr. Jeffrey Lauber (22:54)

They'd let me stay forever, but it was a dollar a day. "No, I want to go home now."

Justin McMillen (23:00)

Yeah, yeah, that's funny.

Dr. Jeffrey Lauber (23:03)

It's a cool place, I really love Australian people, I love that country.

Justin McMillen (23:05)

I ended up getting burned there quite a bit too.

Dr. Jeffrey Lauber (23:08)

Oh, sure, I had to keep an eye on things.

Justin McMillen (23:10)

My host family, they were like, "You've gotta stop," they were all white, and I was like, loving it. I was in Melbourne.

Dr. Jeffrey Lauber (23:17)

And you know the city from... Sydney? Brisbane?

Justin McMillen (23:20)

Yeah, it's such a cool area.

Dr. Jeffrey Lauber (23:22)

So, okay, so for people who are listening to this, you should be looking at your skin, and if you see something, and it wasn't a scratch, but it just, something appears like a stigmata, just comes out of nowhere, and it bleeds and it doesn't heal.

Dr. Jeffrey Lauber (23:39)

You need to go see a guy like you.

Justin McMillen (23:40)

Yeah, give it a month.

Dr. Jeffrey Lauber (23:43)

I'm not, I'm not an alarmist doctor, but you mark your calendar, if it's still there in a month, take a look at it, because it's not going to go away.

Justin McMillen (23:49)

Yeah, well, I think it's, I mean, I think it's great, because had I not run into you, this could have gone on for a super long time.

Justin McMillen (23:56)

But there's no pain involved.

Dr. Jeffrey Lauber (23:57)

No. You know, a big driver to go to a doctor is that it hurts, but skin cancer doesn't hurt.

Justin McMillen (24:00)

Yeah, so there's no pain, I think it's okay.

Dr. Jeffrey Lauber (24:03)

But I tell a patient, the pain is when the pallbearers put you in the ground at your funeral. Or the cutting, the hacking, like the pictures I showed you.

Dr. Jeffrey Lauber (24:11)

Hacking huge sections of your face off.

Justin McMillen (24:13)

So, also for the audience, what he did is he gave me this cream, and I was freaked out by it, because you're rubbing it on your own face.

Dr. Jeffrey Lauber (24:17)

Yeah, yeah.

Justin McMillen (24:19)

I was like, is this, like, super toxic or whatever?

Dr. Jeffrey Lauber (24:21)

I said, no, it only responds to the cells that are bad.

Dr. Jeffrey Lauber (24:27)

Well, the medicine is very specific, it's only absorbed by those cells that are abnormal, because they're dying rapidly. So for some patients that don't want a biopsy, I say, "Here's a cream, if nothing happens in a week or two, don't worry, you're fine." So it's a way of doing a biopsy without doing surgery.

Dr. Jeffrey Lauber (24:45)

And if somebody's got it, it's almost like a way to identify it.

Justin McMillen (24:48)

So when I put that on, and I started to get all the, you know...

Dr. Jeffrey Lauber (24:51)

Yeah.

Justin McMillen (24:53)

It became obvious, because it went, like, really dry.

Dr. Jeffrey Lauber (24:54)

Yeah, that was an issue.

Justin McMillen (24:56)

And then it just basically ate it all. What does it do, is it just killing...

Dr. Jeffrey Lauber (25:00)

I've had one or two cycles, remember, one cycle, you may need to do another one.

Justin McMillen (25:03)

Yeah, because I just got back from... I always tell patients that.

Dr. Jeffrey Lauber (25:06)

Yeah, and if, like, "Doctor Lauber, the second cycle, nothing really happened," that's good news, because it got the bad cells the first time.

Justin McMillen (25:11)

Yeah.

Dr. Jeffrey Lauber (25:13)

No, you'd need to do it again if it popped up.

Dr. Jeffrey Lauber (25:16)

Just a little tiny hitch again, so you'd need to do it again.

Justin McMillen (25:19)

You survived, see what I did, no scar.

Dr. Jeffrey Lauber (25:22)

I did, I showed you in the pamphlet, it says these will make your skin feel really red and irritated, but generally leave no scar.

Justin McMillen (25:27)

That's the part that people want.

Dr. Jeffrey Lauber (25:30)

Yeah, in fact there is, like, a little bit of redness.

Justin McMillen (25:35)

It's not red, it's just, it's almost like the skin, the texture, it's like nicer right there, like brand new, shiny pink skin, where it's been damaged.

Dr. Jeffrey Lauber (25:41)

Yeah, it's like it got rid of the bad skin.

Justin McMillen (25:44)

And so I was going to get a whole bunch and put it everywhere.

Dr. Jeffrey Lauber (25:47)

Yeah.

Dr. Jeffrey Lauber (25:50)

Don't do that.

Justin McMillen (25:51)

No?

Dr. Jeffrey Lauber (25:53)

Because notice I gave you just a very small amount, because I've had people who kind of abuse it, they think, "Oh, if it worked like this, let me just put it all over." But this is not just a moisturizer, this is nasty stuff.

Justin McMillen (26:01)

Yeah, you gotta be monitored by a doctor.

Dr. Jeffrey Lauber (26:04)

No, we're not giving medical advice in any way, shape, or form.

Dr. Jeffrey Lauber (26:06)

Just sharing the experience.

Justin McMillen (26:07)

Yeah, it was, it was good. I'm incredibly grateful to you. And then, through that, you also mentioned, "You know what else I do?" which I thought was interesting. And I was like, should I, I haven't talked about this. And I want to make it clear, everyone knows why I went to you, it was for this.

Justin McMillen (26:23)

But you shared what you do that no one talks about, right? Can you talk about that? Because maybe this'll be the first podcast where somebody's got that going on.

Dr. Jeffrey Lauber (26:29)

We'll find out, help them out. You know, another major part of what I do for a living is skin disease related to HPV infection.

Dr. Jeffrey Lauber (26:40)

And, you know, HPV, you have it on your hand, a wart, your arm, whatever, those are HPV. But HPV on their private parts is called genital warts. Still HPV, human papillomavirus. It's a big part of what I do for a living. It's not talked about, because it's covered by your underwear and nobody sees it. And there are some people who hide in shame and embarrassment for years and years and years, because they don't know where to go.

Dr. Jeffrey Lauber (27:05)

They're afraid to go to a doctor's office and have the front office ask, in front of the whole waiting room, "Why are you here, to see the doctor?" So there's a lot of shame and a lot of inhibition to go see a doctor, because they're afraid of who's going to be in the waiting room. And I get phone calls from people, you know, "Doctor Lauber, I went to an office..."

Dr. Jeffrey Lauber (27:22)

"...there were a lot of pretty girls working up front, girls in the back, who's going to be there?" Just me, that's what I do for a living. So, a couple things about genital warts: if you have a bump, and you're not a virgin, and it's down on your private parts, get it looked at, get it looked at.

Dr. Jeffrey Lauber (27:44)

Yeah, and after doing this for so long, when someone comes in, I can kind of tell just from what they have, where their partner had it. Can we discuss this? Is it okay to discuss this?

Justin McMillen (27:51)

Yeah.

Dr. Jeffrey Lauber (27:53)

So, if a man presents with warts just on the left side of his private parts, his partner gave it to him.

Dr. Jeffrey Lauber (28:04)

She had him on her right side. So I tell the guys, if you know where your partner is, and a lot of times they don't, get a magnifying glass and a flashlight, you'll find them. And I have to have the partner discussion, because, you know, I'm going to be taking care of these guys and getting paid.

Dr. Jeffrey Lauber (28:25)

I don't want them coming back to me in a month thinking, "Hey, Doctor Lauber didn't do a good job here," when the reality is they got reinfected because they didn't tell their partner.

Justin McMillen (28:39)

Can you get rid of them? Like, if somebody has them, do you have them forever?

Dr. Jeffrey Lauber (28:43)

Yeah, that's a good question. I get a lot of questions, like, "Doctor Lauber, I went to the free clinic, had a million blood tests, all negative."

Dr. Jeffrey Lauber (28:45)

"Why do I have these?" Because blood tests are for internal things, antibodies, internal infections like syphilis or hepatitis. Genital warts are external. So if you think about it, I'm a dermatologist, but more specifically, I'm an external medicine doctor, I treat the outside of the body. So we're the best guys to treat this, because we don't do the inside.

Justin McMillen (29:09)

I was going to say, also genital warts, this is an important concept...

Dr. Jeffrey Lauber (29:13)

Rarely, rarely, rarely, they can also be cancerous warts. And that's why, if a woman has a partner with a cancerous strain, he'll transfer that to her, and she'll get cervical cancer. On a man, they're pretty visible. On a woman, they're occult, in my practice they're occult, or latent, or just invisible.

Dr. Jeffrey Lauber (29:35)

You can't see it from the outside. So in my practice, I need to make sure I have a discussion about the partner issue, because, sir, I'm going to treat you, and if you don't discuss it with your partner, you're going to come back to me thinking I'm not a good doctor, but also, there's a risk of her having cervical cancer.

Dr. Jeffrey Lauber (29:53)

So every man I treat spares one, or more than one, woman from cervical cancer. And that can kill you. No one's going to die from genital warts as a man, but a woman, if they wait long enough, they can die.

Justin McMillen (30:01)

And this is super common, right?

Dr. Jeffrey Lauber (30:04)

Oh, yeah, very. I mean, some people say one out of three patients, but that's not really true.

Dr. Jeffrey Lauber (30:14)

It's common enough to warrant having a practice that deals with this specifically. It's out there enough that people have it and don't know they have it.

Justin McMillen (30:22)

Correct.

Dr. Jeffrey Lauber (30:24)

And one of the reasons is, men don't routinely shave their pubic hair, and it's hidden down there. If a man wears a condom, the warts won't occur on the shaft, but the condom doesn't cover the base of the penis.

Dr. Jeffrey Lauber (30:36)

And I'd say ninety-five percent of the work I do is warts at the base.

Justin McMillen (30:40)

Wow.

Dr. Jeffrey Lauber (30:42)

Yeah, I know, and they don't know. When I'm on the phone, I ask them questions about their medical history, and also, when was the last time you shaved your pubic hair? I say, you're going to shave it, or you can't come in, because I can't miss anything.

Dr. Jeffrey Lauber (30:54)

And invariably I get, "Wow, I thought I only had two or three," and I see twenty now.

Justin McMillen (30:58)

That's crazy.

Dr. Jeffrey Lauber (31:00)

Yeah, oh yeah.

Justin McMillen (31:01)

So let's stratify this between men and women.

Dr. Jeffrey Lauber (31:04)

So, I'm not a gynecologist, so I can't speak to... I'm a male, outside the body. So the reason I don't treat gay men for warts, and I don't treat women for warts, is I'm an external medicine doctor.

Dr. Jeffrey Lauber (31:18)

External. So if I treat a woman's outside and miss one on the inside, she'll have a problem. Same with a gay man, I could treat the outside ones, but if there's something inside and I miss it, that's on me. So if a man, if he's a gay man, has warts around his anus, I have to send him to a colorectal surgeon.

Justin McMillen (31:36)

Wow.

Dr. Jeffrey Lauber (31:38)

Yeah, it's serious stuff, it's risky.

Justin McMillen (31:41)

And is it something that lives in your body?

Dr. Jeffrey Lauber (31:43)

So, like, if you burn them off, it's not in you, it's on you. That's why there's no blood test for it. So the big misnomer is, "Jeffrey, why don't I go to the free clinic and get all these tests?"

Dr. Jeffrey Lauber (31:51)

"They're negative, why do I have these?" Yeah, they're on you, not in you, there's no blood test for this. So if a guy has genital warts and he gets them removed, he's good to go.

Justin McMillen (32:08)

He's good to go.

Dr. Jeffrey Lauber (32:10)

He's good to go. And I tell a patient, only God cures, us doctors just send the bill.

Dr. Jeffrey Lauber (32:25)

So, God cures. But I tell a patient, if you take a magnifying glass, and you shave your pubic hair, and you don't see anything, you're not going to pass anything. But somebody comes in, I've seen them where they look like broccoli and cauliflower, big ones, you're going to pass them to somebody else. Those are tough cases.

Justin McMillen (32:36)

So, you'd know about herpes too, obviously.

Dr. Jeffrey Lauber (32:39)

Yeah, yeah, this is a virus, but it's not the herpes virus, very different.

Justin McMillen (32:42)

Okay, but the virus lives in the body, so it could come back, like herpes?

Dr. Jeffrey Lauber (32:45)

No. HPV's also a virus, but it doesn't do the same thing. What happens with herpes is, herpes sits in the dorsal root ganglia, and it comes back because it's inside you.

Dr. Jeffrey Lauber (32:49)

It manifests as blisters, but the herpes virus sits in the nerve roots and comes back when you're under stress, like shingles. But HPV has no internal manifestations at all. For female patients it can be on the surface or inside, and for gay men it can be on the inside, but in my male patient population, it's on the outside only.

Dr. Jeffrey Lauber (33:11)

So for women, it can be on the inside or the outside.

Justin McMillen (33:15)

Can women get blood tests for HPV, right?

Dr. Jeffrey Lauber (33:18)

Well, a pap smear is a better test. There's really no good blood test for it.

Dr. Jeffrey Lauber (33:30)

So when a woman has her pap smear, there's a couple of newer tests, a little more sophisticated, with a bit better predictive value. But a woman should not miss her pap smears. I had a few cases where a woman comes to me with what looks like a skin tag, but it ends up being a genital wart that's cancerous, and it's in a spot I hadn't caught right away.

Dr. Jeffrey Lauber (33:50)

I don't treat the labia, but I biopsied it. She'd had a pap smear, "I don't get it." I said, well, this originated from a genital wart, and it's cancerous, you've got to get pap smears regularly.

Justin McMillen (33:59)

Does a pap smear just test for that?

Dr. Jeffrey Lauber (34:07)

No, it tests for everything. The cytology just looks at the cells.

Justin McMillen (34:13)

You're going to think I'm ridiculous for asking.

Dr. Jeffrey Lauber (34:16)

No, no, no, no. It uses a pathologist, cytology, looks at the cells, sees if they're HPV related, is it cancer. But you've got to get it done.

Dr. Jeffrey Lauber (34:24)

And I've got to tell a patient, look, if you have a partner with warts, you can't miss a pap smear.

Justin McMillen (34:28)

If a female has HPV, can it be treated and go away the same way?

Dr. Jeffrey Lauber (34:32)

The gynecologist has plenty of tools to take care of it, okay, and they have to be...

Dr. Jeffrey Lauber (34:42)

...monitored, you know, because, God cures, they can pretty much get rid of it, but not a hundred percent, you've just got to make sure you follow up.

Justin McMillen (34:51)

Gotcha.

Dr. Jeffrey Lauber (34:53)

Nothing's absolute in medicine, it's just not like that. So if you have an abnormal pap smear and the doctor says, "We'll just follow it..."

Dr. Jeffrey Lauber (35:02)

I think it should be treated, I tell patients, get another opinion, I don't like that. Because if you wait too long, it'll be too late. And for women it's more dangerous, because it can become cancerous. And then there's also vaccines for it, right?

Justin McMillen (35:09)

Right, Gardasil.

Dr. Jeffrey Lauber (35:11)

Okay.

Justin McMillen (35:12)

Worth it?

Dr. Jeffrey Lauber (35:14)

Totally worth it, three shots.

Dr. Jeffrey Lauber (35:20)

You're supposed to get it when you're a younger girl. For men, I'm not really a big fan of it, because the risk of a man having an HPV-related skin cancer is very, very low, but it's much different for women.

Dr. Jeffrey Lauber (35:32)

In my practice, I think I've had thirteen men out of about thirty-four thousand whose warts were cancerous.

Dr. Jeffrey Lauber (35:42)

If I had a gynecology practice, it would be a hundred times that.

Justin McMillen (35:44)

Okay, so is there an epidemiological reason for the vaccine? The idea is, if everyone got it, you could wipe it out, correct?

Dr. Jeffrey Lauber (35:49)

Correct. If you get it early enough, you can wipe it out. That's why they recommend it in the vaccine schedule for kids now.

Dr. Jeffrey Lauber (36:04)

But they also say, if you're an adult who's already had sexual exposure, it's too late for that reason. But there's another reason to get it: Michael Douglas had throat cancer, and it originated from HPV. So they're using this same vaccine, Gardasil, to prevent throat cancer too.

Justin McMillen (36:13)

Wow.

Dr. Jeffrey Lauber (36:15)

Yeah.

Dr. Jeffrey Lauber (36:22)

So, how do you get it in your throat? I'll give you three guesses, and the first two don't count.

Justin McMillen (36:26)

You're a woman, and your husband has warts on his penis?

Dr. Jeffrey Lauber (36:31)

There you go, okay, I've had patients like that. I've had one couple in particular...

Dr. Jeffrey Lauber (36:43)

...a husband and wife team comes in, and I have to ask them some very serious questions about the intimate details of their sex life. I guess I can talk about this?

Justin McMillen (36:49)

Yeah.

Dr. Jeffrey Lauber (36:51)

You know, do you guys engage in oral sex? They did. So I sent his wife to an ENT doctor, so she'd have to see a gynecologist too, to make sure it was fine.

Dr. Jeffrey Lauber (37:04)

And I sent her to an ENT doctor, to make sure there was nothing in her throat. And he chimed in, "You'd better send her to a colorectal doctor too, because you have anal sex." So they got the Doctor Lauber trifecta: gynecologist, ENT, and colorectal doctor. Thank God she was negative, but that's a big deal. So that's how women get it. So if a man has HPV in his throat, that means he was probably exposed some other way.

Justin McMillen (37:32)

Okay, wow.

Dr. Jeffrey Lauber (37:33)

Yeah, I've treated a couple of guys with warts on their tongues.

Justin McMillen (37:37)

No fun.

Dr. Jeffrey Lauber (37:38)

And you know how you treat it? You've gotta pull their tongue out and burn it off, in general, and that's how you do it. You can't use, like, the chemicals that are used on you.

Dr. Jeffrey Lauber (37:49)

You can't put that in somebody's mouth. So I have to do physical modalities, pull the tongue out, and burn it off. For thirty-seven years I've been asked, "Jeffrey, how did you learn how to do this?" And the answer was, during my medical training in New Orleans, we also had to take care of the city prisoners, with shackles on their hands and shackles on their feet.

Dr. Jeffrey Lauber (38:07)

So for three years, you're taking care of men, one guy comes in with warts on his penis, two days later a man comes in, shackled hands and feet, with warts on his rear. It's kind of a pattern, and it's, you know, kind of what they're doing in prison, right?

Justin McMillen (38:17)

Right.

Dr. Jeffrey Lauber (38:19)

No sugarcoating it.

Dr. Jeffrey Lauber (38:23)

That's the reality of the situation. And another thing, I've been doing this so long that I can tell when a man's had more than one partner, because you look with a magnifying glass at the warts, some are lighter, some are darker, some are flat, some are raised, because there are different strains of warts from different partners.

Justin McMillen (38:51)

Are they the same kind of warts someone would get on their hands?

Dr. Jeffrey Lauber (38:55)

Yeah, but the ones on the penis are called condyloma acuminata, that's the Latin name, it's still HPV, but they're a little bit different under the microscope, a different strain. And the pathologist sees a different look to them than the ones on your fingers.

Dr. Jeffrey Lauber (39:13)

I had one guy in thirty-five years where the pathologist said, "genital location, but not genital in origin." Genital location, but not genital in origin, we had to talk.

Dr. Jeffrey Lauber (39:23)

He called himself a chronic masturbator, so he transferred the wart from his hand to his private parts.

Justin McMillen (39:29)

Wow.

Dr. Jeffrey Lauber (39:31)

Yeah, a little aggressive.

Justin McMillen (39:33)

Yeah, a little aggressive.

Dr. Jeffrey Lauber (39:39)

Can't mention his name, but a little aggressive. Yeah, don't, don't do that.

Dr. Jeffrey Lauber (39:44)

I've had certain cases where a man pulls his pants down, "Sir, your girlfriend's Black." "How do you know?" "You're white, and your warts are black."

Dr. Jeffrey Lauber (39:54)

You can tell. Yeah, the donor strain is from a Black person, and they're black warts. "He's a liar."

Dr. Jeffrey Lauber (39:59)

So if somebody's partner has genital warts, they need to get checked and treated: evaluate, manage, diagnose, treat, get it done.

Justin McMillen (40:06)

Treated, why treated, if they don't have him... oh, you're saying, if the partner has them.

Dr. Jeffrey Lauber (40:14)

Yeah, like, if Joe finds out his partner Sally has warts, they both need to go get treated at the same time, otherwise it'll ping-pong back and forth.

Dr. Jeffrey Lauber (40:26)

I've had cases where the man's got a hundred warts, and I have to send his wife to the gynecologist, and they don't find anything. That's happened many times, but I say, look, you've got a pretty extensive case...

Dr. Jeffrey Lauber (40:38)

...I've got to make sure she doesn't have anything. So the partner should get checked too, because if I don't get everybody evaluated, managed, and diagnosed at the same time, it's going to ping-pong back and forth.

Justin McMillen (40:47)

What about, in the age of Tinder hookup culture, what should people who are going out having casual sex, how should they think about this, and should they have conversations about it?

Dr. Jeffrey Lauber (41:03)

They should at least bring a flashlight to the bedroom the first time around, take a peek.

Justin McMillen (41:07)

I don't think anyone wants to do that.

Dr. Jeffrey Lauber (41:10)

Yeah, you'd need a slick way to teach people how to do that.

Justin McMillen (41:12)

Kind of a buzzkill.

Dr. Jeffrey Lauber (41:15)

Yeah, it is kind of a buzzkill.

Justin McMillen (41:19)

But, you know, if somebody told me they had HPV, I don't think, I would wear a condom for sure, but I'd be a little hesitant, like, you know, I'm out of here.

Dr. Jeffrey Lauber (41:27)

So if somebody tells you they tested positive for HPV, like, say it was four years ago...

Justin McMillen (41:37)

Does that mean that...

Dr. Jeffrey Lauber (41:39)

Was it a retest? If they tested positive four years ago, did they have any therapy done, and did the repeat test come back negative? If not, you'd better wear a condom, but, you know, the condom only covers the shaft, and I said most of the work I do is at the base.

Dr. Jeffrey Lauber (41:53)

So if a woman tells you she tested positive, did she ever test negative after? Because if she's treated properly, the follow-up test should be negative, and she's good to go.

Justin McMillen (41:59)

Okay, right. "I tested positive once, it was a retest."

Dr. Jeffrey Lauber (42:02)

Did you get everything done? If you didn't do anything, you're going to test positive. If you got it treated and evaluated...

Justin McMillen (42:09)

Man, what if a guy or girl doesn't want to have that conversation, but wants to be sure? So condoms aren't going to fully protect them, so it's basically inspection, on a man?

Dr. Jeffrey Lauber (42:17)

Yeah, I mean, yeah, that's basically it, a flashlight.

Dr. Jeffrey Lauber (42:26)

It's kind of interesting, there used to be a ninety-nine-cent store, I'd buy the dollar magnifying glasses, a hundred at a time. The cashier says, "What are you doing with these?"

Dr. Jeffrey Lauber (42:35)

I said, "Lady, if I told you, I'd have to..."

Dr. Jeffrey Lauber (42:44)

"You wouldn't believe me." But I give patients a magnifying glass, and I say, take a look at yourself and take a look at your partner. If you see nothing, you're fine, but if you see something, get it taken care of.

Dr. Jeffrey Lauber (42:53)

So I give patients what we call my GSEK, my genital self-exam kit.

Dr. Jeffrey Lauber (43:01)

Just a magnifying glass, that's it, it's a dollar. In my world, I don't need sophisticated tools like X-rays, CT scans, MRIs, just a light bulb and a magnifying glass, that's all you gotta do and you're good to go.

Justin McMillen (43:07)

Doctor Lauber, why do you do this? It's a strange thing to focus on, why do you do it?

Dr. Jeffrey Lauber (43:20)

No one else does. And, just so you know, I've been here in Newport Beach for thirty-seven years. When I first came to Newport Beach, there were only two of us dermatologists, myself and one other doctor.

Dr. Jeffrey Lauber (43:34)

Now there's thirty-two, and a lot of them are very attractive women with nice hair, nice nails, nice clothing, nice jewelry, nice shoes. I can't compete with a beautiful, model-quality-looking dermatologist and have a patient say, "Doc, I want to look like you."

Dr. Jeffrey Lauber (43:49)

So I get to do what those dermatologists don't want to do, because a really attractive female dermatologist doesn't want to touch a man's warts. That's not what they want to do, they want to do Botox and fillers.

Justin McMillen (43:56)

And also, a man doesn't want to go to an attractive female dermatologist for that.

Dr. Jeffrey Lauber (44:00)

Correct.

Justin McMillen (44:01)

That checks out.

Dr. Jeffrey Lauber (44:04)

I try to teach them that, you know, you've got a male problem, go to a male doctor. So it turned out to be a very good business decision too, because I don't do Botox and fillers, I went to medical school, not beauty school. So I had to do something that no one else wanted to do, and that's pretty much it.

Justin McMillen (44:22)

It's not a glorious job or glamorous, but there's a need, and you're ending some pretty serious, unnecessary suffering.

Dr. Jeffrey Lauber (44:29)

Well, you know, I gotta say, I have ruined a lot of relationships.

Justin McMillen (44:32)

Yeah?

Dr. Jeffrey Lauber (44:34)

Sadly, I have ruined a lot of relationships. But there's been some, I've had cases where a patient goes to several dermatologists, and they're frozen, frozen, frozen, frozen, frozen, spent thousands of dollars, and they never solved the problem.

Dr. Jeffrey Lauber (44:51)

And the doctor didn't do the easiest thing in the world, just do a biopsy, see what it is. It comes back, it's not warts. I've got to sit them down and tell them, I'm sorry that you were misdiagnosed and mistreated and spent thousands of dollars with the other doctors, but you have a dermatologic oddity that just has a very long Latin name.

Dr. Jeffrey Lauber (45:10)

It's not contagious, it's not infectious, it's just an odd dermatology issue. And one family said, "Doctor Lauber, we've been putting off having a family for over five years because I thought my husband's warts... how could I ever thank you?" I said, "Oh, that's easy, have a kid, name him Jeffrey."

Justin McMillen (45:21)

Has anyone ever done that?

Dr. Jeffrey Lauber (45:24)

Well, I had an Asian family, and I said, you know, if you have a kid, name him Jeffrey. And the husband said, "We already have a Jeffrey, we've got a problem."

Dr. Jeffrey Lauber (45:36)

I had red hair as a kid, in first grade. "If you have a redheaded kid, we've got a problem here."

Justin McMillen (45:43)

Okay, yeah, that's not going to happen like that. Funny man.

Dr. Jeffrey Lauber (45:48)

So, you know, it was a business decision. I learned it during my training, and I realized there's a big need for it.

Dr. Jeffrey Lauber (45:54)

And I had some advertisements in the OC Weekly, which became a casualty of Covid, they were print ads. The very first day, the phone rang off the hook. I looked at the girls in the office and said, "This is going to be very interesting." I did it for eight years, print ads, and then it went to digital ads for eight years.

Dr. Jeffrey Lauber (46:15)

It was unbelievable.

Justin McMillen (46:17)

How do you make people feel comfortable when they come in?

Dr. Jeffrey Lauber (46:21)

Well, I'm the doctor, and nobody's going to ask them why they're here. The answer is, I have a complete screening questionnaire on the phone before they come in. So I make sure they're connected with me on the phone first, so I can tell if they're not going to like me.

Dr. Jeffrey Lauber (46:39)

Because not all doctor-patient relationships are a good fit, and some patients I can tell aren't going to get along with me, I need to refer them out. But by the time they get to my office, in the waiting room, we've already talked for about half an hour.

Justin McMillen (46:49)

Okay, yeah.

Dr. Jeffrey Lauber (46:52)

So I screen them all pretty well, because I don't want them coming in if I can't help them, or they need another doctor, they need to go to a gynecologist.

Dr. Jeffrey Lauber (46:57)

Or a colorectal surgeon. So the front desk knows, please don't tell me your life story, that's for the doctor to hear, but he'll talk to you.

Justin McMillen (47:05)

I get to speak to the doctor?

Dr. Jeffrey Lauber (47:08)

Yes. And most people are very glad they get to speak to me first. I tell them, look, the girls up front are really cute, but I went to medical school.

Dr. Jeffrey Lauber (47:18)

Talk to me. So, to make it feel comfortable, I think the comfort comes from the fact that people can look me up online and see people have nice things to say about me in the reviews. So that's one thing that takes some of the fear factor away. But look, they're still, they're still very nervous.

Dr. Jeffrey Lauber (47:34)

They're sitting in the waiting room, and I tell them, look, your anxiety is probably at a ten right now, it has to come down to at least a five, you have to meet me halfway. If your anxiety doesn't get down to a five by the time you leave, you're not leaving until it does.

Justin McMillen (47:50)

I've never had a doctor say that before.

Dr. Jeffrey Lauber (47:52)

That's the difference between a good doctor and a great doctor. You just ask, what are you nervous about, and how can we ease your fears. And when I take a look at them, I work on it.

Justin McMillen (48:01)

You know, Doctor Lauber, I was nervous for like a week.

Justin McMillen (48:06)

You took care of me in like three seconds.

Dr. Jeffrey Lauber (48:09)

I know, I know, but you were nervous. Next time you come in, you won't be nervous.

Justin McMillen (48:13)

Hopefully there won't be a next time.

Dr. Jeffrey Lauber (48:16)

The best way to answer that is to allay their fears, I talk to them first on the phone, and then when they come in, it's just...

Dr. Jeffrey Lauber (48:21)

"Let's get it done," and then they move on.

Justin McMillen (48:23)

You're doing really good work, you know, God's work, trying every day.

Dr. Jeffrey Lauber (48:27)

I appreciate that.

Justin McMillen (48:30)

It makes sense, you have a really great bedside manner. That's part of why I chose you.

Dr. Jeffrey Lauber (48:34)

I didn't learn that in medical school, medical school doesn't teach people skills.

Dr. Jeffrey Lauber (48:41)

And I have prostate cancer myself now, I'm being treated up in Los Angeles, and my doctor was very interesting, giving me a lot of statistics, going on about his schooling, "Doctor such-and-such," and I just wanted to say, I've been a doctor longer than you, and where we're standing right now, when I was in medical school at USC, this is where the gangs used to bury the dead bodies.

Dr. Jeffrey Lauber (49:01)

So I learned a long time ago, you're a smart guy, I know you're smart, I can tell because I'm from here too, but I don't care how much you know, until I know how much you care. And that's all patients want to know: just care about me. Just make a phone call. I've had patients for thirty-seven years who just want that phone call.

Dr. Jeffrey Lauber (49:15)

Because they trust you, trust is a big thing. And I don't think you can build trust in a doctor-patient relationship when you've got your hand on the doorknob, or you're typing on the computer, instead of finding out about their life. That's all they want, patients just want to be listened to, and just want to know that you care.

Justin McMillen (49:35)

Why don't more doctors do that?

Dr. Jeffrey Lauber (49:38)

Well, a lot of it is, if you ever see a doctor's website, and there's one doctor with thirteen girls behind him, all in matching scrubs, think about that. A doctor's practice, how many extra patients does he need to see just to pay all those salaries?

Dr. Jeffrey Lauber (50:00)

So he's got to produce, he's got to make a lot, he's got to make enough money to pay all those salaries. That's not the way I practice, I'm not a mill, or a quantity doctor, I'm a quality doctor, and I like to give the patient the same care that I'd want to receive.

Dr. Jeffrey Lauber (50:19)

But other doctors, they've got alimony, child support, tuition, and they never got that lecture: don't practice medicine as if your mortgage depends on it, patients come first. If you do that, you'll never have a problem, you'll be a good doctor. Just, patients come first.

Justin McMillen (50:34)

I love that. Yeah, the doctor I met with, actually recorded yesterday...

Justin McMillen (50:39)

...has a similar thing, he's a psychiatrist, but he does one-on-one therapy, which is unheard of, it's usually just med management, he actually meets with people to do psychotherapy.

Dr. Jeffrey Lauber (50:47)

Well, you know, I don't do psychotherapy, but I'll tell you, I do this much dermatology, and this much psychiatry, because in my world, people can see the rashes.

Dr. Jeffrey Lauber (50:57)

It's not like a CT scan, an MRI, or a chest x-ray, they can actually see it. So the husband and wife, or boyfriend and girlfriend, they're worried about whether they're going to get it from their partner, it's a visual thing, so I have to allay their fears. And I treat little girls with acne too, and they don't want to go to school.

Dr. Jeffrey Lauber (51:13)

They hate their face, they don't want to go outside. So there's a lot of that, a lot of psychiatry, I wouldn't say hand-holding, but giving people back the confidence they already had, just bringing it out for them.

Justin McMillen (51:22)

Yeah, that makes sense, because the domains are like your sexual life.

Justin McMillen (51:30)

Right, relationships. And then there's also everything on the outside, like, oh, she's a fifteen-year-old girl, she's a cheerleader, she has pimples, and no one can make her better.

Dr. Jeffrey Lauber (51:36)

And I have to sit and hold their hand and tell them, you're going to be fine, just give me some time, you'll be fine.

Justin McMillen (51:41)

How do you do that?

Dr. Jeffrey Lauber (51:46)

I show them thousands and thousands of before-and-after pictures of what I've been doing for thirty-seven years. And I give them my cell phone number, tell them I'm here on Sunday mornings too, come in whenever you need to, I'm here all the time.

Justin McMillen (51:56)

What's the treatment protocol?

Dr. Jeffrey Lauber (51:59)

Accutane, ultimately, that's what I use.

Dr. Jeffrey Lauber (52:01)

I don't use creams or lotions, they don't work, I take the cases that are pretty tough. Anybody can prescribe creams or lotions, but I want the ones where the creams and lotions haven't worked, and the doctor's afraid to give Accutane. That's where I come in.

Justin McMillen (52:11)

Why would doctors be afraid of giving it?

Dr. Jeffrey Lauber (52:19)

This is going to sound kind of bad, but when a doctor trains in residency, we train on poor people, because the president of General Motors isn't going to let a medical student work on him.

Justin McMillen (52:29)

Wow.

Dr. Jeffrey Lauber (52:31)

Right. So you're working with indigent people, people that live under the freeways, you treat poor people.

Dr. Jeffrey Lauber (52:39)

That's what you're a student for, you treat the people who don't have any money, that's how you learn. And it turns out Accutane isn't a poor person's drug, it's expensive, and there's a lot of compliance issues with blood work, so a poor person can't afford that. So some doctors take their "poor person" protocols and use them on people who are rich, and they don't work.

Justin McMillen (53:02)

Like what?

Dr. Jeffrey Lauber (53:07)

Well, they're using the cheap stuff, antibiotics and creams, and their mentality hasn't changed from their residency program where they were treating poor people. Now you're in Newport Beach, you have to use different treatments, because these people aren't poor.

Justin McMillen (53:19)

I see.

Justin McMillen (53:27)

For people who, I'm curious, what is acne, actually, what's going on?

Dr. Jeffrey Lauber (53:31)

Back to you, acne is just the sebaceous glands. Like a cardiologist works on the heart, a diabetes doctor works on the pancreas, well, for dermatologists, most of the work is acne, that's most of the problems that come through.

Dr. Jeffrey Lauber (53:49)

And the gland we work on is the sebaceous gland. So an acne patient has an oily face, excess oil, and bumps. In my world, I don't think you can put anything on top of the skin that gets down far enough to make the glands smaller, and Accutane is the only one that consistently works.

Justin McMillen (54:01)

Is it a perfect drug?

Dr. Jeffrey Lauber (54:07)

No, but if you give it to a thousand patients, nine hundred and ninety-nine get better.

Justin McMillen (54:11)

Okay, yeah, it's a great drug. So what's the mechanism, what does it do?

Dr. Jeffrey Lauber (54:15)

All it does is shrink the sebaceous glands, so I tell the patients, if the oil glands are smaller, your side effect is dry skin.

Dr. Jeffrey Lauber (54:26)

That's it.

Justin McMillen (54:28)

And, Doctor Lauber, how do I know when I'm done?

Dr. Jeffrey Lauber (54:30)

You shut the lights off in the room and put your hands on your face, if your face is smooth, you don't need me anymore. Which brings up a good point, I've given it to over seven thousand patients in like thirty-seven years, and I tell them, the sad part of what I do for a living is at some point, your skin's going to be movie-star-perfect skin.

Dr. Jeffrey Lauber (54:47)

And the worst part of my job is, you're not going to need me anymore, and you move on. But for seven months, I'm the most important person in your life. When you're done, you don't need me anymore, that's the sad part.

Justin McMillen (54:56)

Are there downsides to Accutane?

Dr. Jeffrey Lauber (54:59)

Can't get pregnant while you're on it.

Dr. Jeffrey Lauber (55:03)

There are teratogenic side effects, meaning it can cause severe birth defects. So I don't have that issue with male patients, but a sixteen-, seventeen-year-old girl, there's a lot of protocol and compliance issues around pregnancy while you're on it.

Justin McMillen (55:11)

What are the other...?

Dr. Jeffrey Lauber (55:22)

Well, sadly, there's so many kids on Adderall.

Justin McMillen (55:25)

Oh my God.

Dr. Jeffrey Lauber (55:27)

Well, Adderall is amphetamine, so I've got to tell the mom, look, if your kid's on Adderall, I can't give your kid Accutane, because every time he takes Adderall, I have to raise the dose of Accutane.

Justin McMillen (55:35)

Why is that?

Dr. Jeffrey Lauber (55:38)

Because Adderall is speed, and speed causes speed bumps on the face.

Dr. Jeffrey Lauber (55:44)

Adderall, speed, that's why these kids do better in school, "I'm so much more productive, I do more homework on Adderall."

Justin McMillen (55:49)

Yeah, because you're taking speed.

Dr. Jeffrey Lauber (55:52)

Yeah, I know that, trust me, speed. So we treat people who abuse Adderall too.

Justin McMillen (55:56)

Oh yeah, oh yeah, I had a lot of Ritalin growing up.

Dr. Jeffrey Lauber (55:59)

Yeah, so, like, I'm not going to give you Accutane.

Dr. Jeffrey Lauber (56:02)

You have to get off the speed, because I'll be raising the dose of Accutane to counteract what you're doing, and I don't want to do that.

Dr. Jeffrey Lauber (56:09)

I've had people call me who are, like, Olympic-level weightlifters...

Dr. Jeffrey Lauber (56:22)

...they're using steroids, and I say, I can't help you, because you're not going to stop the steroids, and I'd be giving you higher and higher doses of something dangerous, you can't be my patient.

Justin McMillen (56:29)

Is Accutane something you put on top of your skin?

Dr. Jeffrey Lauber (56:33)

No, it's a pill, it's an oral pill, it's a systemic therapy.

Dr. Jeffrey Lauber (56:39)

It's been around since 1984, it's got over forty years of history. There's nothing else that gives somebody that level of improvement. Other than treating genital warts, where I give people back their sex lives, with Accutane, I've changed kids' lives, seven thousand kids.

Justin McMillen (56:54)

Seven thousand kids. Is there any other...?

Dr. Jeffrey Lauber (57:02)

It doesn't cause cancer. As a matter of fact, some people are using it for, quote unquote, chemoprevention, using Accutane to prevent skin cancers.

Justin McMillen (57:09)

Wow.

Dr. Jeffrey Lauber (57:11)

Yeah, yeah, there's cheaper stuff to do now, but back in the day, for people riddled with skin cancers, they'd ask, what can we take by mouth to prevent them?

Dr. Jeffrey Lauber (57:21)

They'd use Accutane, or some of its derivatives. And the standard protocol is about six months.

Justin McMillen (57:30)

Maybe a little more?

Dr. Jeffrey Lauber (57:33)

Because I like to dose a little lower at first, just to make sure there aren't any problems with the medication.

Justin McMillen (57:37)

What sort of problems could you see if it's overdosed?

Dr. Jeffrey Lauber (57:41)

Well, you'll get dry lips, some people get nosebleeds.

Dr. Jeffrey Lauber (57:46)

Some people have diarrhea, some people have problems with their fingernails, but if you keep the dose low, you don't get those problems. But the issue is, sometimes people are prescribing it who aren't really fully comfortable with the drug, like physicians' assistants and nurse practitioners who just read the book, and you have to watch the patient, not just what the book says.

Dr. Jeffrey Lauber (58:04)

God, the patient will tell you. So during those six months, you're permanently shrinking the glands, for the most part.

Justin McMillen (58:11)

For men?

Dr. Jeffrey Lauber (58:13)

Yeah, for men. Women are a little different, because they have progesterone surges mid-cycle, so we give them maintenance therapy. For the most part, it's a permanent fix. Sometimes they come in so bad that I have to do acne surgery to drain lesions, because I see some people that look like someone stepped on their face with a golf shoe.

Dr. Jeffrey Lauber (58:31)

Yeah, yeah. So I've got to give them antibiotics for a bit to tone things down, and it takes six months to shrink the glands enough so their skin gets smooth.

Justin McMillen (58:39)

Wow, six months.

Dr. Jeffrey Lauber (58:42)

Six months. And then they're on a maintenance dose and they're fine. And I spoil them, they come in afterward with, like, half a pimple, and they think they need an ambulance.

Justin McMillen (58:54)

Can you? Like, if someone has a pimple and has a big thing going on the next day...

Dr. Jeffrey Lauber (58:59)

People call me all the time, "Can you make that go away, I have a big social function tomorrow," and I say, I'm not God, why don't you come in three or four days before, for God's sakes.

Justin McMillen (59:09)

That's crazy.

Dr. Jeffrey Lauber (59:12)

I can't help you.

Justin McMillen (59:15)

What about root cause, is there a way to avoid getting acne at all? If you're a little kid going through puberty, that's kind of standard.

Dr. Jeffrey Lauber (59:21)

But the people I see... one fella came through, he was putting down cans of Monster energy drink, and he'd get better in twenty-one days...

Dr. Jeffrey Lauber (59:31)

He had zits from his neck to his rear. So he came back at twenty-one days and thought I was a genius. I said, young man, I'm not that good of a doctor, and Accutane isn't that great of a drug, although it is, but you quit drinking the Monster, which has a ridiculous amount of caffeine, that's what got it.

Dr. Jeffrey Lauber (59:43)

So it can be diet related.

Dr. Jeffrey Lauber (59:49)

And sometimes I see people on the wrong birth control. People should hear me out on this: if you're listening to this, and you're on the Mirena IUD, and you have acne, get the IUD out now. I can't tell you how many people come through on that.

Dr. Jeffrey Lauber (1:00:01)

No.

Dr. Jeffrey Lauber (1:00:09)

And you scratch your head, why do they just have acne, and you dig a little deeper into their history, "Well, a couple years ago I got an IUD." "Did the doctor tell you it might cause acne?" "No, he just said I wouldn't have periods." Well, go Google it, that IUD can cause acne.

Justin McMillen (1:00:21)

Wow.

Dr. Jeffrey Lauber (1:00:23)

Yeah, and they don't, they don't, they don't tell you that.

Dr. Jeffrey Lauber (1:00:30)

The gynecologist doesn't look at people's skin, they look at their private parts, down below. So there are hormonal factors that play a big role.

Dr. Jeffrey Lauber (1:00:40)

That's why, with the weightlifters on steroids, I'll get a few people, maybe forty-nine, fifty years old, with acne, and I say, lady, you're not going through puberty, you're going through menopause, this is probably endocrinology, not dermatology.

Dr. Jeffrey Lauber (1:00:52)

Go to an endocrinologist or gynecologist and get your hormones fixed, because you don't need me, you need your hormones fixed first.

Justin McMillen (1:01:02)

How do they go about getting their hormones fixed?

Dr. Jeffrey Lauber (1:01:06)

Well, they have to get a lot of blood work done, a complete female hormone panel, and the doctor looks and says, "Here's your abnormality."

Dr. Jeffrey Lauber (1:01:10)

It's simple, and that'll get them better, as opposed to me giving them Accutane when they don't really need it. They need to take care of the underlying endocrine problem.

Justin McMillen (1:01:19)

Go to the root cause.

Dr. Jeffrey Lauber (1:01:23)

Yeah, root cause analysis. Let me give you an interesting, high-tech case...

Dr. Jeffrey Lauber (1:01:31)

Nice family, the little girl was in high school, and they found me because someone did a high school physical, and they said, "We want a good dermatologist." They'd already been to one guy and spent fifteen thousand dollars. So they came to me, and I looked at the daughter, she was sixteen, she had acne, she had facial hair.

Dr. Jeffrey Lauber (1:01:52)

Never had a period, and she looked like a boy. Sixteen, acne, facial hair, never had a period, looked like a boy. I said to the mother, your daughter has PCOS, polycystic ovarian syndrome.

Dr. Jeffrey Lauber (1:02:01)

And after I got the kid plugged into the right doctor...

Dr. Jeffrey Lauber (1:02:13)

"Jeffrey, how the hell did you know that?" You spent fifteen thousand dollars on creams and lotions that didn't even make a dent. Your daughter had facial hair, your daughter had acne, your daughter never had a period, and she looked like a boy.

Dr. Jeffrey Lauber (1:02:23)

It was a slam dunk. And, by the way, I took notes in medical school, shame on those other doctors.

Dr. Jeffrey Lauber (1:02:34)

I can't even tell you, I mean, I try to keep my mouth shut.

Justin McMillen (1:02:39)

How do you not say anything? Have you in the past?

Dr. Jeffrey Lauber (1:02:43)

I don't have a filter.

Justin McMillen (1:02:44)

Yeah, yeah, you don't have a filter, like, what are you thinking?

Dr. Jeffrey Lauber (1:02:48)

Yeah, it's a tough thing, because a lot of times these days, people are seeing a nurse practitioner, or physician's assistant, and these people wear a white coat.

Dr. Jeffrey Lauber (1:02:58)

"Did you see the doctor?" "I don't know."

Dr. Jeffrey Lauber (1:03:01)

Well, they're supposed to have a name badge, so you can see, MD or whatever. So, if you're listening to me now, check on whoever's going to take care of you, check their background, just check. And I tell patients, look, you're going to a doctor's appointment...

Dr. Jeffrey Lauber (1:03:16)

See the doctor, don't see the nurse, don't see the PA. You're going to spend money, see the doctor. If the doctor says no, then make an appointment somewhere else, see the doctor, someone who went to medical school. There are doctors out there.

Justin McMillen (1:03:29)

Yeah, well, we're coming up on the hour, and, all things skin.

Justin McMillen (1:03:36)

This is really cool, I'll be back, you're getting me inspired, I think.

Dr. Jeffrey Lauber (1:03:40)

Yeah, you want to go to medical school now?

Justin McMillen (1:03:43)

No, no, I mean, in another life, I would love to be a surgeon or something.

Dr. Jeffrey Lauber (1:03:47)

Really?

Justin McMillen (1:03:49)

Yeah, there's so many fascinating things, I'm obsessed with human health, but more the mental health stuff.

Justin McMillen (1:03:55)

But you're inspiring me, I think it'd be cool to have different doctors on here who practice different things, to have them teach.

Dr. Jeffrey Lauber (1:04:01)

Body, mind, internal medicine, the one who diagnosed my prostate cancer, he does hormone replacement too, he'd love to do this, he's a great guy, right down the hall from me, Doctor Kavarian.

Dr. Jeffrey Lauber (1:04:15)

Because that's a big thing now, people are into peptides and all that stuff, that's a big thing, he's the man.

Justin McMillen (1:04:21)

Spot on, I could definitely see having him on, and I'm actually interviewing a guy who started the largest peptide company in the US right now, with Doctor Kavarian, he administers those.

Dr. Jeffrey Lauber (1:04:32)

Okay, and speaking of peptides, one of them, NAD, which is a vitamin B3 derivative, they're thinking about using that to prevent skin cancers.

Justin McMillen (1:04:40)

Really?

Dr. Jeffrey Lauber (1:04:42)

Yeah.

Justin McMillen (1:04:43)

Do you know anything about [...] tanning peptides? Are those dangerous?

Dr. Jeffrey Lauber (1:04:47)

Yes, they were, a long time ago, they had liver issues.

Justin McMillen (1:04:53)

Okay, but can they cause skin cancer?

Dr. Jeffrey Lauber (1:04:56)

No, but that came up like thirty-five, forty years ago, during my training, and they took them off the market, they all caused liver problems.

Justin McMillen (1:05:01)

Okay, but they were taking them orally?

Dr. Jeffrey Lauber (1:05:04)

Yeah, oh yeah.

Justin McMillen (1:05:05)

These are injectable, a little different, might be more sophisticated, but, you know, all these things aren't FDA approved yet.

Dr. Jeffrey Lauber (1:05:09)

Be careful, until the FDA stamps it, it's off limits.

Justin McMillen (1:05:12)

It's a whole big subject. Do you know about another big subject right now? So, all politics aside, our current HHS secretary, Kennedy, there's a division under HHS called ARPA-H, which is Advanced Research Projects Agency for Health, right? They do huge things, kind of like DARPA for defense, ARPA-H for health care.

Justin McMillen (1:05:36)

And the head of ARPA-H right now is a woman named Alicia Jackson, and her big platform is female hormone replacement therapy, and now they're kind of overturning the old data, because they discovered the old research was flawed, the stuff saying women shouldn't do it. Do you know any doctors who do the female side of hormone replacement therapy?

Dr. Jeffrey Lauber (1:05:59)

Yeah, Felice Gersh, she's also a PCOS holistic specialist, she wrote a book on that, but she does a lot of hormone work too.

Justin McMillen (1:06:06)

Felice Gersh, is she local?

Dr. Jeffrey Lauber (1:06:09)

Yeah, yeah, Irvine.

Justin McMillen (1:06:10)

Okay.

Dr. Jeffrey Lauber (1:06:12)

Felice, she went to medical school, I think maybe eight or nine years ahead of me, I've met her a couple times.

Justin McMillen (1:06:16)

Is her specialty hormone replacement therapy?

Dr. Jeffrey Lauber (1:06:19)

Gynecology, but she does, she's quote-unquote integrative medicine.

Justin McMillen (1:06:23)

Okay, yeah, alright, I have to get her number, I'd love to talk to her, Felice Gersh, that's becoming really popular.

Dr. Jeffrey Lauber (1:06:29)

Just because it's new doesn't mean it's safe.

Justin McMillen (1:06:31)

That's true.

Dr. Jeffrey Lauber (1:06:33)

Yeah, and I'm not giving medical advice, but I've got gray hairs, I've seen the same thing for a long time, but...

Justin McMillen (1:06:39)

Well, if you have new ideas or interesting stuff to talk about, invite me back.

Dr. Jeffrey Lauber (1:06:43)

Yeah, next time...

Justin McMillen (1:06:45)

Next time. And I need to come see you.

Dr. Jeffrey Lauber (1:06:51)

Okay, sounds good, get in there again to make sure I'm good.

Justin McMillen (1:06:53)

Question, where do people find you if they need you?

Dr. Jeffrey Lauber (1:06:57)

Yeah, well, it turns out you can go to Grok, ChatGPT, Gemini, and type in "best dermatologist Newport Beach," I come up.

Dr. Jeffrey Lauber (1:07:06)

I'm an old guy, but ChatGPT, Claude, Grok, I know, you know.

Dr. Jeffrey Lauber (1:07:14)

Gemini, just, "best dermatologist Newport Beach."

Justin McMillen (1:07:16)

You heard it here.

Dr. Jeffrey Lauber (1:07:18)

That's true. Best... colleagues in Newport Beach for skin cancer, acne, genital warts, genital warts.

Justin McMillen (1:07:23)

There you go, Doctor Lauber, thank you.

Dr. Jeffrey Lauber (1:07:25)

My pleasure, my pleasure.