In this episode:

From the operating room to one of Canada's first RN injectors, and the year it took to convince a surgeon
Why she built nurse training in 1994 when nothing existed, sold it, and started again in 2016
Inside THMA's foundation program: facial anatomy, assessment skills, medical history, skin quality, neuromodulators, fillers and PRP, and the business of practice
Advanced training, and why lip enhancement is taught one-on-one rather than in a group
The adverse events course, and the informed consent conversation most providers avoid having
The biggest obstacle for a newly qualified nurse, and why it isn't clinical skill
Social media and the colleges: what you can post, what you can't, and why self-injecting content is a problem
Why a curriculum that hasn't changed in five years is a red flag

As Tracey Hotta puts it, on informed consent: "If it's documented in the literature and something happens and you haven't told them, you're accountable." And on the Instagram version of the job: "They go, oh my God, there's so much to learn. It's like, yeah, it's medicine. There's a lot to learn."

About the guest: Tracey Hotta, RN, BSN, CPSN-R, CANS, ISPAN-F, is the founder of THMA and a partner of The DermaRoom Collective. She began nursing in 1984 and moved into aesthetics in 1990, becoming one of the first registered nurse injectors in Canada. She is a past president of ISPAN, a founding member of the Canadian Society of Aesthetic Specialty Nurses, and a member of the Registered Nurses' Association's Quarter Century Club. She lectures on facial anatomy across North America.

Most acne education stops at the surface: cleanse harder, exfoliate more, dry it out. Alex Lee thinks that advice is why so many patients never get clear. In the first episode of The Practice Lab, the DermaRoom Collective's clinical trainer walks through the biology underneath acne — the pilosebaceous unit and the four drivers that feed it — and makes the case that barrier repair, not stripping, is what actually breaks the cycle. She also shares a cystic acne case that improved roughly 75% before she performed a single treatment.

In this episode:

The gap between graduating and facing your first real acne patient, and why Alex built a course to close it
The pilosebaceous unit, and the four pillars of acne: follicular hyperkeratinization, excess sebum, Cutibacterium acnes, and inflammation
Why over-cleansing and over-exfoliating make acne worse, and what barrier-first treatment looks like instead
Reading the pattern: cyclical jawline breakouts versus uniform, itchy presentations, and why one patient often has several types at once
A severe cystic acne case: two weeks of stopping everything, then a simple routine, then mapped microneedling
Where Alex stands on microneedling over active acne, including her extraction and antimicrobial protocol
Three things a practitioner can change the day after finishing the course

As Alex puts it: "The key to healthy skin is a healthy microbiome." Or, on why sequence matters more than product choice: "You need to have a healthy foundation in order to use those ingredients and to use them properly."

About the guest: Alex Lee, CBAM, is a medical aesthetician practicing at Beauty Mark Medical Aesthetics in Prince Edward Island, and clinical trainer for The DermaRoom Collective. She is Course Director of Understanding Acne: From Pathophysiology to Practice.