Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Vampire Facials

Episode Date: April 30, 2024

You may have seen some celebrities or influencers on social media getting something called a Vampire Facial. It's exactly what it sounds like: blood spread on the face like a cream mask. But why would... anyone do this unless it's supposed to do something for the skin? Dr. Sydnee and Justin draw out where this trend came from and its questionable benefits.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

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Starting point is 00:00:00 Sawbones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. Alright, this one is about some books. One, two, one, two, three, four.
Starting point is 00:00:26 One, two, three, four. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert.
Starting point is 00:00:34 We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert.
Starting point is 00:00:42 We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. We came across a farm in the middle of the desert. Hello, everybody, and welcome to Sawbones, a marital tour of misguided medicine. I'm your co-host, Justin McElroy. And I'm Sydney McElroy. And what a joy it is to be back here with you, Sydney. I was out of town for a little bit in Chicago, but we're making up now for lost time by recording an episode that I have very little context on,
Starting point is 00:01:25 but I'm extremely excited by the title. Well, my dear friend Amanda sent me the article that inspired this topic. Thank you, Amanda. Yes, because it made news. It was a newsworthy medical item. Newsworthy medical debacle. And it was one of those things that I was vaguely aware
Starting point is 00:01:45 this existed and then because it's made news, I thought, you know, I cannot, I have no idea why we do this. I must look into why this thing is happening. So you may have also seen an article, oh, a lot of- Are you using the Royal You or the Justin You? All of you, the Royal You. You may have seen a variety of news sources reporting on the consequences
Starting point is 00:02:08 of some unregulated vampire facials. That were occurring. Vampire facials, now these are not, and I can't really stress this enough, facials for vampires, right? No, I mean, I don't think there are any specific disqualifiers if you're a vampire. So you could, but one hopes that you don't need it, right?
Starting point is 00:02:35 Well, yeah, because then you're eternally youthful. If you need a facial as a vampire, I'm sorry, I've been sold a false bill of goods on the whole thing, the whole organization. I think these, I remember hearing about these a couple years ago I feel like because one of the Kardashians did one and took a picture and it and I mean This is why things like this get a lot of attention a vampire facial We're gonna get into exactly what it is
Starting point is 00:02:59 But in in the midst of the procedure if you were to take a picture of your face Your it looks like it's covered in blood. So it's very visually disturbing, evocative, whatever word you prefer. It is vibrant, and to imagine it, it's probably not as bad as I'm imagining it is, because I have quite the theatricality in mind. You can Google pictures.
Starting point is 00:03:24 A lot of candles when I'm picturing this, I should warn you. There are a lot of celebrities and influencers and the like who have had this done and post pictures of themselves with it, so you can find these images widely available. I would just tell you, it is blood. So I know not everyone wants to see blood. It doesn't seem like you should need a trigger warning for that because it seems implied, but let's be 100% clear.
Starting point is 00:03:45 Some people don't want to look at blood in which case I wouldn't look at those pictures, but if it doesn't bother you There you go. Okay, so there was a there have been a lot of news reports because it has been Revealed I mean this didn't just happen this happened over the course of like the the investigation of this went from like 2018 to 2023. So this is something that has been a story in development. But three people contracted HIV. What, really? During a quote unquote vampire facial. Oh my gosh.
Starting point is 00:04:18 Now before you freak out. Too late. I think it is really important to note that it was at an unlicensed spa in New Mexico where the person who was running that facility would be charged with practicing medicine without a license. Okay. So this was not. It's good.
Starting point is 00:04:39 You know what? I think that's a valuable bit of context for you to share, Sydney. That's very noble of you. It doesn't, I am not saying right now whether or not there's any validity to this procedure. You're withholding that. But the fact that there are always going to be some people who will try to do this stuff sort of off the grid. Yeah, there's a gray area that they're kind of
Starting point is 00:05:04 hanging out in a little bit. That doesn't, I don't think that alone would negate a procedure, right? Like just because there are people who would do it wrong doesn't mean the procedure itself is a problem. But it does call into question, should we be offering widely something that could carry this risk? In this particular incident, they found that at this spa,
Starting point is 00:05:26 they were not using appropriate sterile procedure. So this would be similar to like, I mean, you don't hear about this as much in medical offices, but like you think about something that is widely available that you don't have to have a prescription for, like a tattoo, you expect that at a tattoo parlor, they're going to use appropriate sterile technique
Starting point is 00:05:45 and they don't reuse, you know, there are certain items that are single use, right? You use them on one person and then you dispose of them and you don't use them on multiple people. And basically this spa was not using appropriate techniques, reused items on multiple patients. Oh man, I know. This is why there was cross contamination
Starting point is 00:06:04 and infections resulted. So that is not part and parcel of the vampire facial. Because you're really just supposed to be exposed to your own blood. So do you have any idea how this works? Okay. I mean, the simplest, like, have you looked at pictures now? I see you over there Googling. You didn't look at any pictures? No, no, I'm just, specifically not.
Starting point is 00:06:26 Cause it just looks like somebody's put their own blood all over their face. Like that's what you would initially think. Like, okay, what now? So you just, you've got to bleed and then put blood on your face. It's a little more complicated than that, okay? Yeah, oh wow, yeah, bad.
Starting point is 00:06:43 Here's what happens. It looks bad. It looks like a little bit kind of Silent Hill energy that I'm not wild about, don't love it. If you go in for a vampire facial or platelet-rich plasma facial is what PRP, you'll see that abbreviation used a lot, a PRP facial. Here's what's gonna happen.
Starting point is 00:07:03 First, they're gonna draw some blood from you. Okay. So, just the same as you would have blood drawn in any medical facility. It really is just like 10 to 15 milliliters that they need. Like a tablespoon of blood. Not so much blood. So, it's not a ton.
Starting point is 00:07:19 Not a ton of blood. What are you doing with all of it? You shouldn't need that much. And then they take your blood. they put it in a centrifuge. Do you understand basically what a centrifuge is doing? Yeah, you put a liquid in it, and then you spin it so fast that it separates a liquid into its component parts.
Starting point is 00:07:39 Based on its density, yep. So you can isolate parts of it based on their density. Exactly, exactly. So now you can select for a specific part of the blood that is supposed to be the most effective in achieving what I'll go over, what our goals are here. So you spin it out and you get a layer of the plasma on top. You've got blood cells and platelets and stuff in the middle and then you've got the red blood cells.
Starting point is 00:08:02 You don't need those. What you need is the stuff with the platelets. The platelets are what's supposed to, that's like the magic, the special sauce, if you will. The special blood sauce. So then you just take that part. So now we've just got this one platelet-rich portion of your blood that has been isolated,
Starting point is 00:08:23 and we're gonna put it back in your face. Now the way we do that, there are a couple different options. There are people who have for a while just been injecting that into different places in the face. Places where you might have fine lines or wrinkles or aging spots, anything. So you could do that.
Starting point is 00:08:44 What these facials, the reason I think they have gotten so much attention is that what they do is first they numb up your face, they're gonna numb it with a topical numbing agent. Just rub something on there that will make it numb. And then they use a micro-needling device, which I saw one dermatologist describe it as like a lint roller covered in needles.
Starting point is 00:09:06 Oh my God. I know, this sounds brutal. I have never used one and this came from a dermatologist. But still. So, and teeny needles, they're micro needles. It's called micro needling because they're teeny, teeny needles. And you're gonna make tiny holes all over the skin surface,
Starting point is 00:09:24 which basically what you're trying to do is very, very minorly damage the surface of your skin. Okay. So can I tell you what you are talking about? You're talking about scuffing. That is a technique that we use in woodworking. Basically you're sanding off some of the rough edges and you're scuffing it so the stain can get in and apply. So you're basically scuffing the surface.
Starting point is 00:09:49 We would use sandpaper for that, but you're basically, this metal lint roller's basically the same thing. You're sanding down so that it can better soak in. And this on its own, by the way- It'd be smoother, I guess you do get a little bit of, I don't think you're smooth by this, but that's part of the reason it would.
Starting point is 00:10:08 No, you wouldn't be smooth by this part, but the idea, because microneedling alone, like that's a procedure you can get done all on its own. You don't have to do this next part, but like microneedling. And that's what they say to you in the exam room, like you don't have to do this next part. But you can.
Starting point is 00:10:25 You can, it seems kind of gross, I know. The idea is that if we're irritating, we're basically getting your skin to activate its own sort of healing, rejuvenating factors. Like all that tiny little bits of damage that the micro-needling creates activates healing properties in your skin. And then specifically for this type of facial,
Starting point is 00:10:49 after you've done the microneedling, you're going to apply the blood product, the PRP, the platelet-rich plasma, that you have centrifuged down. You're gonna rub that all over. So then it can get in there. Get in there. So the whole thing takes about an hour and a half.
Starting point is 00:11:08 Time well spent. You, after you're first done for like the first 12 to 18 hours or so-ish, you're gonna look kinda irritated. And that's true for a lot of these like facial cosmetic treatments, not all of them, but there are quite a few that are somewhat abrasive and you're gonna have a time period where your skin is kind of red and puffy
Starting point is 00:11:27 and swollen and irritated and whatever. But then it does settle, it'll settle down and supposedly you get all the benefits after that time period where everything's kind of irritated and puffy. Each session can run you, I mean, this depends on where you are in the country and who is doing it and how credentialed they are.
Starting point is 00:11:46 And I mean, if you got Dr. Nick from the Simpsons, you know, I don't know 10 bucks, but no, I have seen people who are like you could find it for as little as 250 and other people were like, no, no, no, 500 is as cheap as it gets. There are definitely people out there charging in the thousands for these each individual treatments one 1500, 2000 bucks a treatment. And what they tell you is that... I mean, I will say this though, it's not gonna get it done, but if I were, not sure I'd be cost cutting with this exact procedure,
Starting point is 00:12:15 I think I'd probably try to shave down my spending somewhere else. And there are people who decide to get it done in conjunction with other treatments, which would of course increase the overall cost because like some dermatologists will recommend, why don't I inject some filler in there while I'm doing stuff to your face?
Starting point is 00:12:32 Yeah, let me put some filler because the filler will give you immediate results while you're waiting for the longer term effects of, because this is not immediate. Like we have torn the skin down, so to speak. I mean, not really, but you know what I mean. Like, we've created all this damage and irritation with the thought that it's going to stimulate cells
Starting point is 00:12:53 to heal and improve your look long-term. So you're not gonna see the improvements in a day or a week. I mean, it's gonna be over the course of... So they're making it clear that this is not a topical thing. This is like a, this would be akin it's gonna be over the course of... They're making it clear that this is not a topical thing. This is like a, this would be akin to like putting fertilizer into the bed. There you go.
Starting point is 00:13:10 So it's gonna be a better growing environment. You're gonna see longer term results. So then the idea is like, I'll pair it with something immediate like some filler so that then you can see results immediately. And then in six weeks, it's still gonna, it's gonna look even more incredible than you can ever imagine.
Starting point is 00:13:23 And they recommend that you get like six treatments of this over the course of a month or so. So it is not something that you, you're not one and done. I mean, you could, but that's not the thought process. Yeah. What is it supposed to do for you? Why would you get this done?
Starting point is 00:13:37 So these are aimed at people who, I mean, it can be for anything. It can be for like specific fine lines, wrinkles, acne scars, dark circles. But then you'll also sort of see that kind of nebulous, like if you want... Glow, healthy glow. Yes, a healthy glow. Yeah, yeah, yeah. Younger, better looking skin.
Starting point is 00:14:04 Vibrant. Vibrant, exactly. I mean, you see that kind of, those kinds of claims too. And that's really common for these kinds of procedures where there are some, maybe some evidence-based things that they can actually claim it will do this. But then there's a lot of other stuff that won't get you in trouble if you say,
Starting point is 00:14:25 you will look better after you have this done. And I mean, basically, I think that if somebody was, especially stood to make money off of these procedures, they would be in a position where anybody, especially once they start getting older. Oh, well, won't they? Yeah, well, what wouldn't it be good for? And we know that that, in terms of like, once we, whatever that means, quote, start to get older,
Starting point is 00:14:51 what age that is has changed over time. We know there are younger and younger people seeking cosmetic procedures, whereas I think the idea was that these used to be things you did, you know, middle age and later, now we're seeing people in their 20s and 30s seeking a lot of these procedures. It's a really troubling idea, I think,
Starting point is 00:15:09 that, and obviously I have privileges as a man in this environment, because I feel like men are under such less pressure on this front in terms of aging, mainly because we've used the media to idealize our aging process, rather than demonize it for women. But I think it's so unfortunate that that has become more,
Starting point is 00:15:32 it seems to be more of a maintenance thing, like a regular upkeep. Like it's something before, you like do it before, get out ahead of it. You know what I mean? And I think that it is so unfortunate, I think. I think that it's a really, really unfortunate thing. Well, I mean, I think that the idea is
Starting point is 00:15:51 it should be something like anything cosmetic. I mean, it's the same, and when I say anything cosmetic, I don't just mean procedures. I mean, like what you choose to wear and if you make up or hair or- Your aesthetic, yeah, your whole visual thing. All that stuff. I mean, it really should be what you prefer
Starting point is 00:16:07 and not an expectation, you know, that now you've reached the age where we expect that you have these things done. No, you just do it if you want and don't if you don't. And, but that, I mean, There's no judgment, by the way. I should make that clear. Like it is a, obviously it's a personal thing.
Starting point is 00:16:23 I just think it's sad that there's this seeming like societal pressure and media pressure to, yeah, to normalize that. It's the same damaging expectations that have created so many body image issues for so long. It's the same idea that there is one perfect way that you should be trying to look at all times. And if you're not making every effort to look that way,
Starting point is 00:16:47 then you're failing in some way. And obviously we know how damaging those ideas are. So that's what a vampire facial is. And they're offered all over the country and all over the world, not just country, everywhere, by various spas and clinics and dermatologist office certainly are offering these too, usually like part of a wide array of cosmetic services that are being offered.
Starting point is 00:17:13 Who came up with this? Who came up with it? Yes, that's what I was going to say. That's so far from my question of can I get one with a beard? Because I'm trying to imagine it and I don't think it would pan out. You know, I didn't specifically look that up, but it's hard for me to see how this would work with facial hair.
Starting point is 00:17:29 All right, well, who came up with it? Well, and I see a lot of people, and I wonder if you would be recommended, I don't know, this is just me theorizing. I see a lot of influencers talking about the importance of shaving all of the fine hairs off your face. Have you seen people do that? Like every little, like it's not just shaving like you're thinking of.
Starting point is 00:17:50 It's like these tiny little tools that remove all the fine fuzz. Why? Why? I... Because a 4K camera is why. Well... Survey's on the dang TikTok. And it's supposed to...
Starting point is 00:18:01 Everybody's gotta look camera ready. To be fair, it's also supposed to like smooth makeup application So, okay. I'm just saying I wonder if I wonder if you came in like me. I'm kind of I'm kind of fuzzy I wonder if they would say like we're gonna have to do this first. I love your fuzz. I wouldn't let you well I'm just I wouldn't let him I'd stop them That's right. Well, I'm not in a hurry to have this done. I don't like the lint roller covered with micro needles was a lot for me to consider. Okay.
Starting point is 00:18:32 I'm going to tell you who came up with this. Why are we doing this? Why are we putting blood on our faces? I'll tell you after we go to the billing department. Oh, okay. Well, let's go. The medicines that I found your podcast. I just cannot thank you enough for just being the voice of reason
Starting point is 00:19:12 as I'm trying to figure all of this out. Thank you and cheers to your incredible show and the vision you have to provide this space for all of us. This is still a show about life after giving life. And yes, there will be swears. You can find us on maximumfun.org. And as always, you are doing a great job.
Starting point is 00:19:36 Alright class, tomorrow's exam will cover the science of cosmic rays, the morals of art forgery, and whether or not fish can drown. Any questions? Yes, you in the back. Oh, what is this? It's the podcast Let's Learn Everything. Where we learn about science and a bit of everything else. My name's Tom, I study cognitive and computer science, but I'll also be your teacher for intermediate emojis.
Starting point is 00:19:58 My name's Caroline and I did my masters in biodiversity conservation and I'll be teaching you intro to things the British Museum stole. My name's Ella, I did a PhD in stem cell biology, so obviously I'll be teaching you the history of fan fiction. Class meets every other Thursday on Maximum Fun. So do I still get credit for this? No. Obviously not. No.
Starting point is 00:20:19 It's a podcast. All right, Cyd, you're finally, you're gonna give me a little bit of history here, contextualize this process. It's interesting because this really started out in orthopedics, in joint care. Okay. So they don't normally get so silly, I feel like. They're usually a little more buttoned down, maybe? I don't know. No, they have some fun over there.
Starting point is 00:20:41 They have some fun over there too. So in orthopedics, and this has been like an ongoing thing, we still don't have a great way if a joint, a knee or a hip or whatever, has undergone a lot of damage, whether that be from some sort of injury or the wear and tear of just life, or the specific intense wear and tear of like a high performance athlete or something, right?
Starting point is 00:21:04 We don't have a perfect way to fix that joint. We can replace it, but that comes with a lot of limitations as to what you can do with that joint afterwards, right? So there have been investigations and research into that area. How can we regrow, so to speak, the cartilage and the, you know, the tissues that exist within a joint that make it do its thing, how can we replenish and regrow and rejuvenate those tissues to give people longer sports careers or better performance or just generally keep people
Starting point is 00:21:39 active longer? It doesn't have to be an athlete. But I think that's why there's so much interest in it is because you have very high profile, high paid clients whose whole job, livelihood, everything, career, depends on advances in this area. 100%. So what we saw back in the early 2000s
Starting point is 00:22:02 is a number of athletes who were going to specifically to Germany, but other parts of the world to get injections into their joints of platelet rich plasma. This idea, because we know that you think of platelets as something that just clots your blood, right? Like that's what we're taught. Yeah, that's what I think of. The right thing that they do, yeah. But a lot of people don't have my deep understanding
Starting point is 00:22:30 of platelets, so of course the, you know, everyday Johnnies are like, yeah, it just clots blood, but us true fans, what do you think? And I'll like nod. And you'll just nod along, right? No, they do clot, I mean, I'm not saying they don't do that. They do that. We all agree. Yeah, they do that. But they also'm not saying they don't do that. They do that. We all agree. We love that. Yeah, they do that.
Starting point is 00:22:45 But they also release a number of signals. Signals. And cofactors. Cofactors, yeah, cofactors. That's how I normally describe it, yes. That can help things heal. Things heal, yeah. Right.
Starting point is 00:22:56 To rebuild, regrow tissue. Are they anything like stem cells? No, I mean, they're not. Platelets and stem cells are very different, but I think we're talking about the same idea. Is there something we can inject into a joint that will make it start growing cartilage again? Supercells, we take the cells from their normal job
Starting point is 00:23:16 of healing or doing a good thing that they do, and we say, hey, what if we got all these in this one joint? What if we, a high density of platelets all in there together, yes. And so, and then there were other, there's a ton of investigations in this one joint. What if we, a high density of platelets all in there together, yes. And so, and then there were other, there's a ton of investigations in this area, not just with platelet rich stuff,
Starting point is 00:23:31 but with heated plasma, with a lot of these inflammatory factors in it, or with stem cells, like you said, and all of these areas are highly investigational. Even today. Meaning? We still don't know for sure if they work or how well, or what all the risks are. I mean, these are all still evolving areas of research.
Starting point is 00:23:54 And I think that's important to know. None of this is like settled scientific law. We are still trying to figure out if this stuff works. So specifically, this platelet rich procedure started to become known as the COBE procedure because very famously. Oh, COBE got it done. COBE, Bryant went to Dusseldorf, Germany
Starting point is 00:24:17 and had this procedure done. By the way, this isn't like against any sports regs or rules, at least it wasn't at the time. I don't know moving forward if someday that'll change, but like, nobody's like breaking any laws by doing this stuff. It's not FDA regulated, so it's not FDA approved. So you're going and getting something done that the FDA is like, I don't know.
Starting point is 00:24:41 Can I say, Sid? But it's not like, I mean, it's not the same as like trying to get steroids or performance enhancing drugs that are illegal. You know, I'm not, because a lot of Olympians went and sought out this doctor who was doing this procedure first in Dusseldorf and then all over the place. Dr. Whaling was the first one to do this. And by the way, this German doctor who was doing these procedures,
Starting point is 00:25:06 I mean, he treated Pope John Paul II. He treated high performance athletes, all kinds of famous celebrities, and like I said, the Pope. It wasn't a guy in a back alley with a weird, you know, syringe full of stuff and you don't know what it is. Like these are, this is a high profile.
Starting point is 00:25:31 I mean, he is doing these things in an open, transparent way saying, here's exactly what I'm doing. And so like, again, none of this is based on some of the kind of wellness weirdness that we pop up with occasionally. There's a foundation. There's a foundation. There's a foundation of science here. Now again, this is-
Starting point is 00:25:48 Is it more of a foundation of science or a foundation of credibility? Of credibility because I mean it is, I think the problem is that when you have areas of medicine where people really stand to benefit financially, and I mean I think with the clientele here, you see the importance of this. If you are an NBA star,
Starting point is 00:26:10 it is really important to you that your joints work. And if they're not, you will pay top dollar for something that will give you more longevity. It's your whole career. And so I think the problem is that those areas of science, maybe we have people who are jumping ahead without all of the data to say like 100% this works. Because like I said, these injections used for orthopedic procedures were not FDA approved and remain so to this day.
Starting point is 00:26:40 And while there was a lot of research done to show that this might be something very beneficial, and there's certainly a ton of anecdotal and testimonial reports, we don't know definitively. I mean, we are not at a point right now where absolutely this is the way we treat arthritis or joint inflammation or joint disease or anything. Now, it seems though, contrary to a lot of these types of things that we talk about, there is a large amount of money on the table that would validate the expense of research and testing, right? That's, I mean, that's the thing.
Starting point is 00:27:16 So there's a huge amount of money on the table when it comes to the orthopedic piece of this. And then I think when you open it up into the cosmetic world, I mean it's essentially endless, right? The amount of money you can make if you can take this technology that supposedly could heal your joints and give you eternal youth on your face. Which is what Dr. Barbara Sturm who is an orthopedic doctor began to see these treatments that they were doing in Germany as perhaps something that we could apply to cosmetic medicine,
Starting point is 00:27:54 even though dermatology was not necessarily her area of expertise. And so she thought if we can do that in a joint, why not the skin? And the original product that Dr. Sturm sort of introduced was a facial cream that was like a bespoke cream. So you would have your blood drawn, spun down, get the platelet rich plasma.
Starting point is 00:28:18 It's like Build-A-Bear, they give you a little Sharpie and you write like, Angelica's facial cream, rich with my own blood. It is your personal cream. Yes, it is literally mixed with your own blood and then apply that. And so that is where you start to see like, from these orthopedic beginnings
Starting point is 00:28:36 and then you have an orthopedist who crosses over into the dermatologic world, introduces this and then the idea of like, well, hey, why put it in a cream? Let's just squirt it in the face. Squirt it right in the face, guys. Because there's, and I think that there's such a like comfort level with, you know, in medicine-
Starting point is 00:28:53 Squirting your own blood in your face? Well, it's your own blood. Yeah. I mean, I think that's part of it, right? Yeah. Like there are times in medicine where we do transfuse someone with someone else's blood and we accept that there are risks to that.
Starting point is 00:29:04 I mean, when I say risks, I don't mean to make anyone afraid of blood transfusions. We have done everything absolutely possible to mitigate those risks, and the vast majority of the time, they go just fine, and thank goodness we gave someone the blood product. However, there is some risk to it. And the thought is, if you're just injecting somebody
Starting point is 00:29:23 with their own blood, doesn't that seem pretty harmless? Well, what we know, and what the whole impetus for this episode is that, no, it's not always harmless. Because you still have to understand why you're doing it, what you're doing, explain the risks and benefits. I mean, it's more complex than just, what's your own blood, who cares, scored it wherever. So Dr. Sturm developed an entire line of skincare products, which you can find if you so desire. I imagine they're very like premium skincare products. Oh yeah, yeah, yeah, yeah.
Starting point is 00:29:56 You're not finding these in the bargain bin? No. Mainly because it's got my blood in it. So if you see them, please just get them back to me. And this really- You wouldn't want them. Well, and this really popularized this idea of like, why don't we start injecting this platelet rich plasma back into people's faces where we're concerned.
Starting point is 00:30:12 And so it starts again, it's kind of started with these like targeted injections. I have a lot of the kind of nasolabial folds, the wrinkles around the sides I'm motioning, so you can't see me, extending down from your nose along each side of your mouth. That's a common area that people would start having addressed.
Starting point is 00:30:33 You'd get fine lines and wrinkles around your eyes, dark circles under the eyes were a target for these treatments. So all of that started and then eventually that evolved into, you know, if we just abraded all the skin at the same time and then rubbed the blood all over the face, then you don't have to pick and choose where you're getting these injections. Yeah, then you just go for it.
Starting point is 00:30:57 It also makes the most of, you can draw the smallest amount of blood possible if you're going to spread it topically all over the face that way, as opposed to having to inject it into different little pieces of the face. Okay. So that is where we get these treatments. And I think that probably they would not have been as wildly popular had we not had influencers. I mean, similar to the orthopedic world, right?
Starting point is 00:31:21 I'm certain that when people found out Kobe Bryant had these injections done, they also wanted to get them done. It's also in an attention economy, something that is very eye-catching, like, I mean, you can imagine that YouTube video headline, it writes itself, right? I got the vampire facial that's been burning up TikTok,
Starting point is 00:31:39 whatever, you know what I mean? Like, it's a dramatic thing, so it's easy to generate content from. And there are tons of those articles, by the way. So many people who saw the celebrities and influencers who had it done and immediately ran and had it done too and wrote an article about it. Does it work?
Starting point is 00:31:57 Thank you. Does it work? So first of all, as I said, this is not FDA approved. Now, it's tricky. This is considered, this is regulated differently than a drug. The FDA does not consider the platelet-rich plasma. Your own blood is a drug? Yes, your own blood is not a drug. So it's regulated differently and also like, it's more regulated like medical devices almost. Human products and then devices and all the regulation around that is different
Starting point is 00:32:27 and with devices not quite as restrictive. Right, if you think about what's actually happening, making a law against it would be weird. Right. Like if you think about like, what are you banning? Exactly. And so because of that, there isn't the same pathway to like, like we would expect from a medication where we do studies in, you know, in a lab and then in animals and then in humans
Starting point is 00:32:51 and then we look for all the, I mean, like none of that has been done. And so right now these aren't FDA approved stuff. The technology that we use to like extract the platelet rich plasma, I mean, like a centrifuge, all of that is approved, right? Like we know that what we say we're doing, we're taking your blood out, we're putting it in this machine and we're getting this platelet-rich thing,
Starting point is 00:33:12 that technology has all been approved, that's old. So that part is approved. And there's some specific applications where they've tried this kind of thing in like bone grafting situations. So because of that sort of body of evidence, you will see some like kind of misleading language around it. Like it's not FDA approved,
Starting point is 00:33:32 but it is using technologies that have FDA approval. Okay. Do you know what I mean? Yeah, like, yeah, yeah, yeah. It's a little murky. It is considered FDA cleared. It's like an off-label use. They're not actively trying to ban it.
Starting point is 00:33:49 They're not trying to stop you. They're saying, we don't approve of this, but we also are not saying no. So it's up to you and your doctor to discuss it. And you need to discuss what is, this is an off-label use. And the idea of using something off-label is, again, that's not wild. like we do that in medicine.
Starting point is 00:34:06 There are, I have in my career many times discussed the risks and benefits with a patient of an off-label usage of a treatment. But what's key there is you need someone with appropriate expertise to be able to have that conversation, and then you need to ensure that the patient has informed consent, meaning they understand exactly why it's off-label, what could go wrong,
Starting point is 00:34:30 what are the benefits, so then they can make an informed decision. And I think what's tricky about that is if you have this area of, I hate to even say medicine, where we don't have, one, we don't only have board-certified dermatologists doing this. That's great if you do. If you have a board-certified dermatologist, they can talk you through all this
Starting point is 00:34:52 because they have the knowledge and training. But if you have, like in the original article, if you've got an unlicensed spa with people who don't have that sort of knowledge and understanding doing these procedures, then informed consent becomes impossible because you cannot be informed. And then the other part of it is what are they telling people it's gonna do for them? Because when I discuss risks and benefits,
Starting point is 00:35:16 I'm very clear on here's what I know this would do for you and here's what I can't claim. Reviews from as recently as 2021 are still not showing clear evidence of improvement from these procedures. And when I say improvement, I mean they're looking at very, like very specific metrics. Are wrinkles less noticeable? Are fine lines less noticeable? Are dark circles less noticeable? Like they are looking for very specific things, acne scarring, that's always an area they're looking at.
Starting point is 00:35:47 Are these things less noticeable? And they do not consistently show a benefit. Part of this is because it's very subjective. But then part of it is that they just aren't showing that yet. The results are not statistically significant. And I will say, I looked at a number of before and after photos. I felt like I was, I don't know, like there was something wrong with my perception. Because I was looking at before and after photos that to me did not look that different.
Starting point is 00:36:17 And so then I'm thinking like, it's something wrong with, like, why am I not seeing the difference? But then that's subjective. I'm looking at them, I don't see the difference, who cares? That's an anecdote, that doesn't mean anything. But right now the data is saying, yeah, we're not sure. These vampire facials may not actually do anything. And certainly we know that like,
Starting point is 00:36:40 whether or not platelet-rich plasma may do something in joint injections may be beneficial to help stimulate the growth and healing of tissues, which it might well be. There's research that indicates it may well be. Right now, I don't have a study to tell you that paying $2,000 to have your own blood smeared on your face is gonna do anything for you. And I mean, and even the, you know, when you ask like the dermatologist with the American Academy of Dermatology,
Starting point is 00:37:12 like when they issue statements on what they think of this, basically what they say is, we're not sure. There's a lot of research that needs to be done and it should only be done by board certified dermatologists who can have the kind of risk benefit conversation that an off label treatment like this, you know, can do. And it's only safe if you have all of the proper technique, sterilization of equipment, informed consent,
Starting point is 00:37:38 someone, you know, an operator who knows what they're doing. Right, right. And then of course, if you do have any sort of bleeding disorders, this is not something, I mean they are drawing your blood. So if clotting and bleeding, if these are issues you already have, I would definitely talk to your medical professional, your own provider about it before seeking these out because obviously they're taking your blood in the procedure. For sure, 100%.
Starting point is 00:38:04 Can't deny it. Yeah. Thank you, Sydney. I'm disappointed that I won't be getting this procedure anytime soon, but maybe for the clicks, maybe we'll do it for the clicks, or for Vine, if they bring Vine back, I might try it. Thank you so much for listening to our podcast. I hope you've enjoyed yourself.
Starting point is 00:38:19 Thanks to the taxpayers for their song, Medicines is the intro and outro of our program and thanks to you for listening. We really do appreciate it. That's gonna do it for us until next time. My name is Justin McElroy. I'm Sydney McElroy. And as always, don't drill a hole in your head. All right!
Starting point is 00:38:52 Maximum Fun, a workaround network of artist-owned shows, supported directly by you.

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