EP 58: Would You Do This? Botox at 25, Accutane for Your Kid, Spending $1,000 on Skincare — Part 1

There is a version of skincare advice that stays comfortably abstract, and then there is this. Dr. Dustin Portela and Austin Lee turn the tables on themselves, answering yes-or-no questions about real decisions they face in the clinic, the treatment room, and their own lives before explaining why. The format cuts through the usual hedging fast. Would they put their own teenager on Accutane? Yes, both of them, without hesitation. Dr. Portela has taken it himself and would take it again. Would they spend $1,000 on a single skincare product or a full routine? No, and Dr. Portela's take on that is blunt: you will get more benefit from spending $1,000 on a laser procedure than from any cream at that price point. Would they get preventative Botox at 25? They both said no, and their reasons are more honest than the clinical ones. Some questions reveal real disagreement. When Dr. Portela asks whether Austin would try a treatment that is not yet FDA-approved if the evidence was compelling, Austin says yes. Dr. Portela says no, and explains why the gray market makes that position nearly impossible to hold in practice: unknown purity, no human data on most peptides, and third-party testing that frequently finds the active ingredient is not even present in the bottle. Other questions open into something more personal. Would they do a procedure on a close friend or family member? Both have, and both still do. Dr. Portela performed a laceration repair on one of his kids and still hears about the occasional scar twitch years later. Austin did a CO2 laser on his wife. The tradeoff, they both agree, is that you become on-call around the clock for people who know exactly where you sleep. The episode closes with a question that is less clinical and more revealing: would they choose dermatology again? The answer from both hosts is yes, though Dr. Portela adds a caveat that has more to do with the state of healthcare than the specialty itself. Part 2 continues the format with more scenarios. Product of the Week DENE Skin Care The same line Dr. Portela and Austin use in-office with their own patients. The Activé Repair Cream and Sheer Shield Sunscreen are available on the DEEN website. Sign up for the email list for current specials and discounts. Follow Us Dr. Portela TikTok Instagram YouTube (Reactions) YouTube (Educational) Pinterest Austin Lee, PA-C Skinfluence Podcast Instagram