As one of the most recognized voices in aesthetic dermatology, Dr. Michael Gold continues to shape the global conversation around beauty and innovation.
In this episode of The Dr. Randi Show, Dr. Randi Boyette. Randi Boyette sits down with Dr. Michael Gold —founder of Gold Skin Care Center and a recognized leader in dermatologic research and innovation—to explore how decades of experience, clinical research, and patient care come together to define the future of aesthetic medicine.
They discuss:
• The evolution of lasers and energy-based technologies
• How regenerative aesthetics is influencing the future of treatment innovation
• The science behind natural-looking, long-term results
• Why clinical research continues to drive better patient outcomes
From his leadership in research to his role as a global educator and dermatologist, Dr. Gold offers an inside look at what it takes to guide an industry forward—and why experience, evidence, and innovation remain at the heart of modern aesthetics.
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Episode FAQ
What are the most important trends shaping lasers, cosmetic dermatology, and aesthetic patient care today?
On The Dr. Randi Show, Dr. Michael Gold, a Nashville cosmetic dermatologist who founded his own laser and research center, shared how 36 years in practice have shaped his approach. He said simple is better, and that he now starts every consultation by asking patients what bothers them rather than telling them what they need, combining treatments he knows work and saying no to requests like excessive lip filler. He described botulinum toxin, biostimulatory fillers, and rapidly improving IPL and laser devices as key areas to watch, urged caution with unproven regenerative treatments like exosomes, and called teaching physicians around the world a growing part of his role. This reflects Dr. Gold’s personal and professional experience and is not medical advice.
What is the SCALE aesthetics conference in Nashville, and what makes it different?
On The Dr. Randi Show, Dr. Michael Gold described SCALE, the Nashville aesthetics and medical dermatology meeting he co-founded and runs with oculoplastic surgeon Dr. Brian Biesman. He said the meeting began with about 20 attendees and has grown to roughly 1,500 to 1,600 attendees and around 150 vendors, with a goal of featuring the physicians who publish and lead the research while keeping them accessible to attendees. He highlighted its anatomy course, ultrasound teaching, and live laser and injectable demonstrations, along with an effort to bring rising young physicians onto the podium. More information is available at scalemusiccity.com. This reflects Dr. Gold’s perspective as a co-founder of the meeting.
What is new in botulinum toxin, including liquid and short acting toxins?
On The Dr. Randi Show, Dr. Michael Gold said botulinum toxin remains central to aesthetic medicine and pointed to newer toxins as the pulse of what is coming. He described the arrival of the first liquid toxin in the United States, which he said is already available in at least 17 countries and which his center helped study in US clinical trials, noting that it can be drawn straight from the vial without mixing and is described as gluten free and vegan. He also said a very short acting toxin, one he described as working within about 12 hours and lasting three to four weeks, is expected in the next few years and could appeal to patients who are nervous about trying toxin. This reflects Dr. Gold’s clinical and research experience and is not medical advice.
Are dermal fillers being overused, and what are biostimulatory fillers?
On The Dr. Randi Show, Dr. Michael Gold said fillers are safe and effective when used in the right amounts, but that some injectors are using too much, which in his view can lead to lumps, bumps, and in some cases granulomas down the line. He reminded listeners that even moldable fillers still occupy space, and that understanding facial anatomy is essential. He was enthusiastic about biostimulatory fillers, explaining that researchers are now studying gene expression beneath the skin to understand how these products stimulate collagen and possibly fat tissue, and said he expects exciting new data in this area. This reflects Dr. Gold’s clinical experience and is not medical advice.
What is new in IPL and laser skin resurfacing technology?
On The Dr. Randi Show, Dr. Michael Gold, who began working with intense pulsed light (IPL) about 30 years ago, said IPL devices are now safer, more user friendly, and more effective than ever, though they still require knowing the technology. He described AI assisted IPL that moves smoothly over curved surfaces, and a new 755 nanometer cutoff filter being promoted for photo rejuvenation in one or two treatments. For resurfacing, he pointed to a new three in one laser platform and a new cold fiber laser that he said his patients love. Among his favorites he named the Lumenis Stellar M22, the Sciton BBL HEROic, and the Acclaro UltraClear, and he mentioned that the Sofwave ultrasound device and the Aerolase Neo run all day in his practice. This reflects Dr. Gold’s clinical experience and is not medical advice.
What treatments help with scars and keloids, including lasers and silicone?
On The Dr. Randi Show, Dr. Michael Gold, who does extensive scar work, said that for hypertrophic scars and keloids he uses the UltraPulse Alpha, which he described as the deepest penetrating fractional CO2 laser on the market, along with the AdvaTx, a 589 nanometer laser that he said does not require replacing dye kits. He noted that scar improvement often happens over time rather than all at once. He also shared that he was the first to bring silicone gel and silicone gel sheets to dermatology many years ago, and that he now uses Stratpharma silicone products that he said can be applied right after laser treatments or suturing to help wounds heal faster and help prevent scarring. This reflects Dr. Gold’s clinical experience and is not medical advice.
Are exosomes proven for skin, and can exosomes be injected?
On The Dr. Randi Show, Dr. Michael Gold called regenerative aesthetics the wild, wild west and said exosomes still need much more research. His advice was to ask any company for published data, noting that very few exosome companies have clinical data to share. He stressed that in the United States exosomes are not an approved drug and should not be injected, explaining that they are topical cosmetics that can be applied to the skin, including with microneedling or devices that help drive them in. He also discussed plant derived versus human derived exosomes, saying more study is needed to show whether plant based versions influence the same growth factors and wound healing pathways. This reflects Dr. Gold’s clinical and research perspective and is not medical advice.
Which skincare ingredients have real science behind them, and which are mostly marketing?
On The Dr. Randi Show, Dr. Michael Gold said much of skincare is marketing, and that he looks for companies with well designed, published clinical data. He named retinoids as an ingredient category that will be around forever, including prescription retinoids, retinaldehyde, and retinol, and pointed to SkinBetter Science AlphaRet as well as a newer formula that uses a synthetic exosome to deliver a retinoid alongside hyaluronic acid, which he said helps reduce irritation. He credited Alastin for its peptide research and Neocutis and SkinMedica for years of clinical work, and called hypochlorous acid a hero product that he uses to keep the treatment area clean during procedures and considers a great take home product for calming inflammation. This reflects Dr. Gold’s clinical experience and is not medical advice.
How do GLP-1 weight loss medications affect the face, and should facial volume loss always be filled?
On The Dr. Randi Show, Dr. Michael Gold shared his own experience losing about 60 pounds and later using a GLP-1 medication, and said he actually likes the hollower cheeks he now sees in the mirror. His advice to providers was not to assume every GLP-1 patient wants their face filled, but to ask whether the change truly bothers them, noting that in his experience most men he talks with do not want facial treatment. When treatment is wanted, he favored a gentle approach with minimal filler, such as Radiesse or Restylane Lyft, and ultrasound skin tightening for areas like the neck, cautioning that overfilling a thin face can look unnatural. He added that loose skin on the body may call for skin tightening devices or plastic surgery, and that he has seen conditions such as psoriasis and hidradenitis improve in some patients on GLP-1s. This reflects Dr. Gold’s personal and clinical experience and is not medical advice.
What international aesthetics trends are influencing treatments in the United States?
On The Dr. Randi Show, Dr. Michael Gold said the US has underestimated how much it can learn from physicians in the Asia Pacific region, whom he described as far advanced in devices and, in Korea, in skincare. He shared that he now features slides from Asian colleagues in his own lectures to credit their work, and noted that laser technology is developed around the world, including in Israel, Boston, California, Brazil, Korea, and China. At the same time, he emphasized that any treatment brought from abroad must be proven to work safely in the US, pointing to past cases where injected cocktails brought from overseas caused necrosis. This reflects Dr. Gold’s professional perspective and is not medical advice.
