In Conversation With: Dr Marisa Garshick, Board Certified Dermatologist at MDCS

Did you always want to be a dermatologist?

Yes, believe it or not, as early as 12 years old, I told my parents I wanted to be a dermatologist. Even at a young age when I visited my own dermatologist, I appreciated the way as a dermatologist, you could treat individuals as more than just a skin condition and really understand how skin conditions can impact people’s quality of life. 

As I pursued my medical training, I always kept an open mind as I knew there were many different specialties, but what continued to draw me towards dermatology is the way it’s a blend of many other specialties while having its own unique features as well as the ability to truly improve a patient’s quality of life by improving their skin. One of my first experiences as a medical student that showed this was with a teenager who had been suffering from acne that impacted his self-esteem, and after a few months of treatment, he walked into the office smiling, confident, and feeling grateful. 

It offers a mix of medical conditions, skin cancer detection and treatment, surgical procedures, and cosmetics and allows you to see patients of all ages from babies to the elderly. I love that I often have multiple generations of a family as my patients, including grandchildren, parents, and grandparents. Another reason I was drawn to dermatology is the detective work involved as often the skin offers a clue to what may be happening internally as well as the ability to identify a problem and diagnose it often by just looking at the skin. It is a very visual field and I love being able to see exactly what the patient sees and be able to work together to improve the condition. Importantly, there is a wide range of conditions in dermatology, some of which can be improved with a quick fix of either being zapped or removed which can be very satisfying, while other conditions can take time to see changes that may come with challenges but is often very rewarding. I am thrilled with my decision to become a dermatologist as I genuinely enjoy going to work each day and am so grateful for my patients who have trusted me with their skin. Beyond that, I enjoy getting to know my patient’s beyond just their skin condition.  

What did you study at College in order to become a dermatologist?

I was a pre-med but specifically majored in Neuroscience and Behavioral Biology. Your major in college is a great time to focus on something that interests you while still getting the requirements needed for your medical school application. I had many colleagues and friends throughout my training who majored in anything from economics to art history. There is no specific major needed in college to become a dermatologist, so just study what interests you.

For those looking for a dermatologist to see, why is it so important that whoever they go to be board certified?

Dermatologists go through many years of training which includes at least 4 years of medical school, 1 year of internship, and 3 years of dermatology residency, with many dermatologists also taking time to pursue additional fellowships. It is important to see a board-certified dermatologist to ensure you are seeing someone who has had the proper training in what you are looking to treat.

What is the most common skin concern you come across?

It is difficult to choose just one, as on a given day I see patients with so many different skin conditions, including acne, eczema, psoriasis, skin cancer checks, sun spots, rosacea, and more.

That said, acne and the various skin changes that go along with it such as discoloration and scarring are definitely a very common skin concern and affect people of all ages and both men and women. What is particularly interesting about acne is that it can present in different ways in different patients, suggesting different contributing factors and even the same person who experienced breakouts one way may find they subsequently develop a different type of breakout. People are often also concerned about the residual scarring even once the breakouts subside for which we have various treatments and lasers to help with.

What is the one thing you wish people understood more about skin?

Take care of your skin, early! I always recommend thinking about your skin regimen and skincare routine before you “need” to. What that means, is many people wait until they start seeing fine lines to begin a skincare routine. This can be as simple as starting with sunscreen and moisturizer, as we know the importance of sun protection and hydration on the skin.

What does your own skincare routine look like?

I generally take a ‘less is more’ approach to my skincare routine. Part of this is because it allows me to be consistent and stick with it. In the morning, I typically start the day with a gentle cleanser such as Cetaphil, Cerave, or Neutrogena Ultra Gentle Cleanser and then follow that with an antioxidant, such as Skinceuticals CE Ferulic or Revision C+ Correcting Complex and then a moisturizer with sunscreen. Depending on how dry my skin is and what time of year, I will either use a moisturizer combined with SPF, such as La Roche Posay UV Double Repair or Elta MD UV daily or a plain moisturizer followed by a sunscreen. In the evening, I will do a gentle cleanser and sometimes also incorporate micellar water, depending on how much makeup I am wearing. 

Then the key next step (if not pregnant or breastfeeding) is retinol or retinoid and this I will often rotate between a prescription-strength retinoid such as tretinoin or altreno and over-the-counter or professional-grade retinol, such as SkinBetter Science AlphaRet. 

Although a retinoid can be used nightly, I always say it is important to get a sense of your skin, and if it is feeling dry, you can consider skipping a day. If pregnant, a nice alternative for breakouts and helping to even out skin tone is azelaic acid, so that is my go-t0 while pregnant or breastfeeding.  After my retinoid, I’ll use a moisturizer and my general go-to’s are Cerave PM or La Roche Posay Double Repair moisturizer and if I am particularly dry, Skinceuticals Triple Lipid Restore. For eye creams, I generally rotate between the First Aid Beauty Triple Eye Remedy, Neutrogena Hydroboost gel eye cream, and Neocutis Lumiere Eye Cream. About 2-3 times per week, I’ll use a gentle exfoliant such as First Aid Beauty Facial Radiance Pads. Before bed, I always apply Aquaphor or Vaseline to my lips and hands.

I am a big believer in knowing where to save and where to splurge when it comes to skincare as not all skincare needs to be expensive to be effective. For many products, it is a matter of finding the product that works best for your skin type but especially when it comes to cleansers and moisturizers, the over-the-counter, drug store options are a great option. When it comes to vitamin C and antioxidants, it is important that the product remains stable to be effective and so It is important to find a product that has science to support it.

What’s a product you couldn’t live without?

Sunscreen. Sunscreen is an essential part of any skincare routine both to help prevent skin cancer as well as sun damage. Even on days that I know I will be inside or that it is cloudy or rainy, I always commit to wearing my sunscreen.  It is one of the best things you can do early on to help your skin. As they say, an ounce of prevention is worth a pound of cure!

If you could recommend one skincare treatment that everyone should have, what would it be?

Laser resurfacing. Although it may come with some downtime, I think laser resurfacing is a great option for people who are looking to slow down the antiaging process and for those who are trying to correct fine lines, wrinkles, or sagging of the skin. By creating controlled injury to the skin, it helps to stimulate collagen production which is important for tightening as well as improving the appearance of fine lines and wrinkles. Additionally, the laser helps to improve skin tone and texture, leaving the skin glowing. The best part is because collagen takes time to develop, the results continue to improve over the course of 6 months. If you prefer to avoid laser treatments, in-office microneedling is another great option to help stimulate new collagen and improve the overall appearance of the skin.

Are there any skincare habits you’ve seen, that you think we’d be better off the steering clear of?

Don’t pick at your skin. It can be tempting to pop a pimple on your own, but the less injury you cause to your skin, the better as the less scarring that will occur. This also is relevant for exfoliation. Some exfoliation is important to eliminate dead skin cells, but I always caution people against over-exfoliating as the skin can become easily red, irritated, and sensitive due to potentially stripping the skin of its natural moisture as well as creating micro-injuries to the skin.

Finally, what advice do you have for anyone reading this who also wants to become a dermatologist?

Just do it! Don’t give up on your dreams or interest. While the path can be long, it is worth it in the end if you are doing what you love. 

One thought

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.