New York dermatologist Dr. Marnie Nussbaum likes to tell a story about her last day of medical school:
“They have an awards ceremony, and the final award goes to the highest honors in the class,” she explains. “It was a few hours long, so toward the end, my family and I decided to head out. And that’s when I heard my name. The whole auditorium was like, ‘her?’”
The look on her face when Nussbaum utters that shocked response of her classmates reminds me of Joan Rivers on E!’s® “Fashion Police®,” when she couldn’t get over an outlandish outfit someone wore on the red carpet. Nussbaum continues, relaxing into a smile with an affirmative nod: “I was like, ‘Yep…’”
The board-certified Nussbaum has a million anecdotes like this, and they’re all entertaining. When certain words escape her mouth, the decibel can lower to a growly sotto voce, even though said words are innocuous ones like “cleansing balms” or “residency.” She laces every fact and explanation with insightful intelligence and humor and, even though she balks at the compliment, she doesn’t hold back on the comedy — you get the brains and the wit when you visit her Upper East Side office.
She grew up outside of New York City, and can’t remember not wanting to be a doctor. “I always wanted to help people; I never thought of anything else,” she says, before quickly editing herself. “Well, that’s not true. I also wanted to be a ballerina, and Mom said, ‘Sure! As a hobby!’”
After completing her undergraduate degree from Cornell University, Nussbaum attended Weill Cornell Medical CollegeTM; in Manhattan, where she was perceived as the Elle Woods of her class. “I’d wear Juicy Couture® outfits to lab,” she says, smiling. “Funny how no one wanted to be my lab partner.”
Growing up with severe acne, coupled with losing a grandparent to malignant melanoma, influenced her direction toward dermatology. “I love that you see patients from kids to adults, I love that you address issues as serious as cancer, but you also do beauty [and aesthetics],” she says of the field. “And I’ve always been into beauty. I ate lipsticks many times as a child. There’s a certain Revlon® pink you can’t eat and, well, my mother had to call poison control more than once.”
When she opened her own practice in 2015, word of mouth spread quickly, and she became known as much for her artistic eye as for her discerning one. “I always start with a skin check, then we can [discuss] the injectable wrinkle reducer,” says Nussbaum. “Business before pleasure! No one can remember their last skin check, but they sure can remember the last time they had injectable wrinkle reducer!”
Nussbaum spoke with SpotlyteTM; about her favorite procedures, the two skincare products everyone needs, and why we should never discount our face.
Spotlyte: What procedure do you do most frequently?
Dr. Marnie Nussbaum: Probably injectable wrinkle reducer. [Also] filler. Every doctor has their own [favorites].
[Editor’s note: Injectable wrinkle reducers temporarily smooth the look of moderate to severe wrinkles in certain areas of the face, including the forehead, frown lines, and crow’s feet; they should not be used more frequently than every three months. Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, both injectable wrinkle reducers and injectable fillers have potential risks and side effects. Talk to a licensed provider to see if they’re right for you. And learn more now by chatting with a trained aesthetic specialist.]
Spotlyte: What surprises you most about your patients?
MN: So many patients come in for procedures and have no skincare routine. This is true for patients of all ages. They’ll come in and confidently say, ‘I need injectable wrinkle reducer and filler,’ but when I ask what their skincare routine is, they’ll say soap. Another popular one is St. Ives® Apricot Facial Scrub (still going strong)! So, yeah — we put them on a skincare regimen.
Spotlyte: What are the skincare must-haves we should all be using?
MN: Vitamin C. I don’t care who you are, you [should use] a vitamin C every morning. It’s the best antioxidant out there. It not only [helps] prevent skin cancers because it oxidizes free radicals, but it protects against external pollutants, and it gives you that glow. Also, everyone [could benefit from] a retinoid (unless you’re pregnant or breastfeeding) to turn the skin cells over faster. They also [help] prevent fine lines and wrinkles and, if you’re acne-prone, retinoids [may] help with that, too.
[Editor's note: Retinol shouldn't be used by those who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.]
Spotlyte: Prescription or OTC?
MN: It depends. I have this discussion with patients a lot, and it depends on the sensitivity of their skin, and what they want. There are so many good ones out there now. I love SkinBetter Science® Alpharet® — it combines an alpha hydroxy acid with a retinoid, and it tends to not cause irritation. It’s really about the long-term steadiness.
Those are my two mainstays, but also, everyone, of course, needs a cleanser. Skinceuticals® LHA Cleanser is my gold standard.
Spotlyte: What’s your beauty routine?
MN: Oh, boy, a lot. In the morning, I use Skinceuticals Prevent Phloretin CF® serum. Skinceuticals was developed by [a] chemist, [physician, and professor] at Duke University. Their CE Ferulic® acid, which Phloretin CF serum is based on, took over 30 years of research, and is backed by 6 clinical studies. I don't get paid by them; I just really think it is the best vitamin C serum!
Speaking of the CE Ferulic, I use that, too. It [can be used] for acne-prone skin, and I’ll get acne forever. My mother is turning 70 and she still breaks out. There’s a real lack of anti-aging products for acne-prone skin, so I’m always looking for new ones. But back to my own routine . . .
I’ll use my [Marnie Nussbaum, MDTM;] Glow Pads, which contain alpha hydroxy acid, then a little Cerave® PMTM;, if my skin is feeling dry in the morning. Then, SkinBetter InterFuse® Eye Cream and Neostrata® Triple Firming Neck Cream. I also mist with Emma Hardie® Facial Mist, if I’m extra dry and, finally, Elta MD® UV Clear sunscreen. I also like Laura Mercier® Tinted Moisturizer. It’s only SPF 20, but I love the way it makes my skin look. On my legs, Kiehl’s® Creme de CorpsTM;, and I like the lavender hand cream, too. For fragrance, I love Le Labo® Another 13TM; (in the colder months, Le Labo Santal 33TM;).
I change my routine up a lot too, trying new products every day. I always tell my patients, “Don’t do what I do! I’m testing these products so you don’t have to try them all!”
Spotlyte: And what about your night regimen?
MN: At night, either Skinceuticals LHA Cleanser, La Roche-Posay® Gentle Face Wash, or La Prairie® Gentle Cleanser. Then SkinBetter Interfuse Eye Cream or La Prairie’s or SkinMedica® TNS Eye Repair. Then La Prairie or SkinMedica TNS Serum and, usually, Alpharet, which I alternate with tretinoin. MetacellTM; or Cerave PM, but I also love Drunk Elephant® B-Hydra® Intensive Hydration Gel.
Spotlyte: What are your thoughts on “clean” skincare?
MN: I am trying to start steering my routine toward the non-toxic. Not organic, necessarily, but clean. Swapping out the parabens, phthalates, and looking more into lines like Tata HarperTM;, Drunk Elephant, Juice Beauty®, [and] RMS®. If you have a choice, why not?
The problem is that a lot of people, especially my acne patients, only want to use essential oils, and I’m like, “No. Let’s not do that.” Or, they beg me to help them get rid of their cystic acne, but say, “I’m not going to take any medications and only use natural ingredients.” Then they’ll come back to me complaining that nothing worked. They just pick things up that are natural and use them when they’re not necessarily the best antidotes for cystic acne.
Spotlyte: What are your thoughts on all these retinol oils coming out?
MN: The oil probably helps the retinol penetrate, but it’s not for acne. They’re probably great for older patients with fine lines and wrinkles.
Spotlyte: What about cleansing balms?
MN: Cleansing balms are great for dry skin or irritated skin as they gently remove makeup and toxins, however I usually steer clear for acne-prone skin as they may be too emollient and comedogenic. I [personally] can’t do a cleansing balm.
Spotlyte: What procedures do you like to perform in your practice?
MN: Seventy percent of what I do is [aesthetic], and a lot of that includes injectables, like wrinkle reducer and fillers. I love Ulthera® for tightening, and Fraxel® is great for improving skin tone and texture, but Clear & Brilliant® is also great if you don’t want [a lot of] downtime. I combine a lot of treatments: Clear & Brilliant with PRP or a growth factor. We also mix PRP with a proprietary collagen stimulating solution, which we call the RedensifyTM; procedure. It also includes radiofrequency microneedling on the face.
For lasers, I love the V-Beam®, YAG, and IPL. We also have the Vivace laser for the face, which I think is a genius machine. It uses gold-plated needles, which emit radiofrequency when they “stamp” into skin, so you can dial it up, dial it down. You’re tightening while you’re creating the micro-injury to build collagen, and in those channels, we put our Redensify mixture in, followed by a mask.
We also do a lot of hair growth — PRP with my own [formulation].
I approach each patient with the idea of creating an aesthetic journey, versus a one-time treatment — one which is complemented with a personalized topical skin regimen.
[Editor’s note: The above are proprietary Marnie Nussbaum, MD, treatments, and have not been clinically studied together.]
Spotlyte: Do you do any of these procedures?
MN: Everything! None of this is natural. I get injectable wrinkle reducer religiously every three months on the glabella lines between my eyebrows, my forehead, [and] crow’s feet. I also do Clear & Brilliant once a month on my face, on the highest setting. Go big or go home! Everyone thinks my lips are filled, but they’re mine. They’re my mom’s lips.
[Editor’s note: Injectable wrinkle reducers should not be used more frequently than every three months.]
What do you say to patients who try to scrimp by finding cheaper places for procedures?
MN: We don’t discount our face. We discount our shoes, our bags. Not our face. A lot goes into injectable wrinkle reducer and filler placement, and [the provider] who performs the procedure needs to know a lot about the anatomy.
Spotlyte: Who cuts and colors your hair?
Spotlyte: How do you handle the work/life balance?
MN: Every day is a work in progress. Mom does everything. I live seven blocks from the office. I’m like Rosie, the robot maid from The Jetsons®. I drag my 6-year-old son out of bed, take off his pajamas, put clothes on him, and shove a toothbrush in his mouth. Then I deal with my daughter, who’s a redhead and acts like one. She plays with everything in my drawer, and ever since that childhood Revlon scare, I’m scarred for life. So, we are constantly taking everything out of her mouth while I’m getting dressed.
My day off is Monday, when I’m running around doing errands, and pretend to be Mom, going to one or two kid-related events a week. I juggle ten balls at a time, so some of them are always going to drop.
Spotlyte: Which balls will you never let drop?
MN: The most important thing for me is to see my kids when they wake up in the morning and when they go to bed. Not a day goes by when I don’t do that. My husband changed careers two years ago, so he might be 40, but he works like he’s 30.
Spotlyte: Do you cook?
MN: I don’t; I’ve tried, but it’s a waste of everyone’s time. No one likes it. I make challah once a week, I make vegetables, but I can’t do protein — it doesn’t work. I either overcook it or undercook it. We have a wonderful nanny who will pick up something for dinner that I reheat.
Spotlyte: Are you a mindful eater?
MN: My belief is everything in moderation. I eat carbs all day long because I want fat, I crave fat. I know it’s not really a health and wellness kind of answer! Dinner is usually proteins with vegetables, but I really would be happy [having] pizza and pasta and wine every night.
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