Welcome to the huberman Lab podcast where we discuss science and science based tools for everyday life.
I'm Andrew huberman, and I'm a professor of
neurobiology and Ophthalmology at Stanford school of medicine
today. We are discussing skin Health our skin is an incredibly important organ not just for our appearance or because it serves as a barrier to the other organ
systems of the body,
but because it actually reflects the health status of all the other
organs and systems.
In our body including
our brain as well, you'll learn today about the direct and reciprocal relationship between the immune system and our skin and if you think about it, you've seen this relationship in action before when any of us as feeling fatigued or sick the color the tone of our skin tends to be a bit quote-unquote
off at least for us relative to what it normally is conversely when we are feeling particularly. Well rested and vibrant and healthy
our skin reflects that so today. We will discuss the skin.
In Oregon will talk a little bit about the biology of skin. So that everybody is on board the nomenclature of the different cell types in the
skin and how they're affected by various things
and then we will discuss those things such
as sunlight and sun exposure as it relates to skin
cancers will talk about sunscreens. Of course something that I know Garner's a lot of interest these days and even some controversy we will talk about common conditions of skin that concern
people such as acne.
Rosacea psoriasis eczema, and of course we will talk about
About so-called anti-aging treatments for skin. That is the things that can be done to
help reduce the degradation of
the protein components and skin things like collagen things that you can do to improve collagen turnover as well as elastin. These are other proteins within skin that gives skin its
youthful or in some cases where it's
degenerative non youthful appearance things like wrinkles and sagging skin. So we'll talk about all of that will also talk about the
various products that have been
developed in order to treat
wrinkles.
Sagging skin reverse acne Etc
will talk about which ones are safe which ones are not safe. And which ones for which there still is no clear answer. I want to make very clear here at the outset that weíll discuss various skin products during today's episode. I nor the podcast has any Financial relationship to those products. I will provide examples of certain products
and provide a few links in the show notes captions, but I want
to point out that those serve merely as examples that I found during researching this episode which by the way
included speaking to several board-certified dermatologist including a dermatologist expert in oncology cancers of the Skin So by the end of today's episode you will have a much clearer understanding about skin and what it is at the level of biology and function its relationship to other systems in the body, including the immune system and gut microbiome and you will be armed with the knowledge to make the best possible decisions for you in terms of skin health and Skin Care depending on your age your goals and any
current conditions you may have
We Begin I'd like to emphasize that this podcast is
separate from my teaching and research roles at Stanford
it is however part of my desire and effort to bring zero
cost to Consumer information about science and science related tools to the
general public in keeping with that theme I'd like to thank the sponsors of today's
podcast our first sponsor is Juve
Juve makes medical grade red light therapy devices now if there's one thing I've consistently emphasized on this podcast, it's the incredible impact that light can have on our biology now in addition to sunlight red
Light and near-infrared Light have been shown to have positive effects on improving numerous aspects of cellular and organ Health including faster Muscle Recovery improves skin health and wound healing even improvements in acne reducing pain and inflammation improving mitochondrial function and even improving Vision itself. What says Juve lights apart and why they're my preferred red light therapy devices is that they use clinically proven wavelengths meaning it uses specific wavelengths of red light and near-infrared light in combination to trigger the optimal Cellar adaptations.
Use the Juve handheld light both at home. And when I travel it's only about the size of a sandwich. So it's super portable and convenient to use. I also have a Jew whole body panel and I use that about three or four times per week. If you'd like to try Juve you can go to Juve spelled j 0o v v.com huberman Juve is offering an exclusive discount all huberman lab listeners with up to four hundred dollars off select you of products again. That's Jus Jo o VV dot coms huberman to get $400
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Today's episode is also brought To Us by rokka rokka makes eyeglasses and sunglasses that are the absolute highest quality. I've spent a lifetime working on the
LG the visual system and I can tell you that your visual system has to
contend with an enormous number of different challenges in order for you to be able to see clearly from moment to moment. Roka understands all of that and has designed all of their eyeglasses and sunglasses with the biology of the visual system in mind Roka eyeglasses and sunglasses were first designed for use in sport in particular for things like running and cycling and as a consequence Roka frames are extremely lightweight so much so that most of the time you don't even remember that you're wearing them and they're also designed so that they don't slip off
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If you'd like to try Roca, you can go to Roca.com huberman to get 20% off your purchase. Again. That's Roca.com
huberman to get 20% off. Okay. So let's talk about skin health and by extension skin
care. What should we all be doing to take care of this organ that
we call our skin our skin is a very interesting organ as I
Mentioned earlier not just because it protects all the other organs of our body and I should mention it protects them not just by a physical
barrier, but there's also chemical things a chemical composition a skin microbiome to the skin that also provides additional layers of support such
as neutralizing different
bacteria that land on your skin. There's a lot more to skin than you might realize but to start off let's just talk about what skin is at the level of its structure some of the cell types because in understanding that you'll be best equipped to understand some of the recommendations
Jeans for skin health and Skin Care
the skin like many other organs in the body is a layered structure. So the very outer most layer is
called the epidermis. The epidermis has cells
in it below that
there are other cells
that comprise What's called the dermis
where sometimes referred to as the dermal layer and then beneath that you have
subcutaneous fat now, of course in different areas of the body the skin and as a consequence
these different layers of the epidermis and dermis and the
fat layer
below it are of different composition and different thicknesses think for instance about the thickness of the skin on your forearm versus the thickness of the
skin on your belly versus the thickness of your skin on your eyelid. Okay? And as soon as you think about your eyelid you realize
okay this thing that we call skin varies tremendously in thickness, depending on whether or not worth the scalp the eyelid the face the chin, even, you know, neck versus chin body Etc. So what will you think of it as skin while it may have
A designated set of layers
that have particular names can vary tremendously
in terms of its overall thickness and therefore its vulnerability to things like sunlight
which indeed can mutate the cells within the skin caused them to you know, have dysregulation of the expression of DNA and the production of other cells will get into that.
So I just want you to think about skin as having these critical
components of layers epidermis and dermis below it. And by the way within the dermis is where you're going to find
find the blood supply the vessels and capillaries the innervate the skin innovate simply means that Supply or go to the skin you of course have hair follicles and hair growing
out of those follicles in many cases. And then of course you have skin that does not have how the so-called
glabrous skin like on the palms of your hands the bottoms of your feet Etc.
So I don't want to give the impression that skin is the
same everywhere it varies in thickness. It varies in terms of the presence of
hair or lack of hair. It varies according to a
Of different parameters including how much oil is produced in one region or another but if you just know that the skin has an epidermis and outermost layer a dermis or sometimes referred to as the dermal layer which is below it and then it has fat below that and that the vasculature right the vessels and capillaries are at the level of the dermis. They come up through the subcutaneous fat and into
that dermal layer, but they
don't reach into the epidermal layer that
outermost layer and if you understand also that nerve.
Endings, okay, the little
terminals as we call them of neurons nerve cells also go up into that dermal layer. You've got temperature sensors in the skin all of this
becomes very important for our discussions of skin conditions things like rosacea
things like acne which sometimes can be painful or can be exacerbated by things like heat they can be suppressed in some cases or even activated by things like cold. Okay. So if you just understand that the three layers epidermis on the outside dermis below it subcutaneous fat and the skin varies in thickness.
To us and that nerves
that is nerve endings and blood vessels and capillaries are within the dermal layers of the skin. Well, you're going to be very well equipped for the rest of today's discussion. I'll throw in some additional
information about oil production within the hair follicle
and a few other things like extracellular Matrix, which as the name suggests is
extracellular. It's outside where the cells reside but gives it its
composition as either plump and moist appearing on the outside or it can be kind of sagging and wrinkled.
And dry
up hearing all of that relates to the different components of
proteins and other things within those skin layers, but if you understand what I just
told you even at a crude level
if you can just imagine it
just a little bit those three layers
you're going to be very well equipped for the rest of today's discussion. I should also mention that their glands within the skin. This won't be surprising to most of you those glands will produce oil either more or less depending on certain conditions
and there are things that live on the skin on that epidermal layer and within it
We call microbiota. You've no
doubt heard of the gut microbiome, right the existence of trillions of little micro bacteria that live within your gut
that provided they are varied in their composition and of the right sort really support your immune system and other aspects of Health including brain function and health. Well, you
also have a skin microbiome that
is the existence of microbiota on the outside of your skin that serve as a barrier to infections,
but that also provide things that are nourishing to the skin and give it that vibrant look
that most
people want
and by cleansing your skin in
particular ways that is washing it with certain substances and avoiding other substances. You can support as opposed to diminish that skin microbiome. Okay, so to start today's discussion, I want to jump right into the deep end meaning into one of the more controversial issues related to skin health and Skin Care out there right now, which is sun exposure and sunscreen.
Now, it makes sense why this would be
such a heated issue. No pun intended because
most everyone is exposed to the Sun or
Opportunity to be exposed to the Sun to some degree or another every single day. Even on cloudy overcast days. It's
also the case that we've learned a lot in the last 10 years or so about how different
sunscreens and their components may be good for us maybe less good
for us. And today we're going to talk about what is known and what is still unknown. But before we do that, we
need to take a step back and look at the context in which all this controversy is happening
my read of the online
community as a whole as it.
Eights to sunscreen and sun exposure in particular is the following I think most everybody and say everybody but most everybody out
there seems to accept the idea that
excessive sun exposure can
cause certain cancers of the
skin. That's the general belief out there and
there is good reason for that belief because indeed the Sun as full spectrum light includes long wavelengths. It's probably easier to think about those long wavelengths as the Reds and oranges and yellows and so forth that are
present and while there
Always present from sunlight but their most obvious to us when the sun is low in the sky so called Low solar angle sunlight at sunsets and also at Sunrise but of course
as full-spectrum light sunlight also includes UV ultraviolet light
of different types, we'll talk about those types today as well as blue light and green light and in midday sun when the sun is
overhead. We just see the Sun as white light right
because containing all those different wavelengths.
So while this is not a discussion about wavelengths and optics
for sake of today's discussion
just understand that long.
Light tends to be more of the red orange yellow
variety. Okay Loosely speaking and down at the other end of the spectrum the short
wavelength light is more
of the blue and green
and so called ultraviolet light. So it's well accepted light of different wavelengths such as UV Blue Light Green Light all the way out to Red Light even near
infrared light can penetrate into cells it can actually pass through surfaces turns out that long wavelength light can actually go deeper into the
Force of our skin, right it literally can penetrate just by shining a red light on your skin. It can actually penetrate the skin to a deeper layer.
Then can short
wavelength light like UV light
and it's well accepted that UV light when it penetrates mostly that epidermal layer of the skin that outermost layer it can cause changes in the way that DNA functions it can cause mutations such that DNA
which as many of you probably remember from high school biology DNA is transcribed
and into RNA and
RNA is translated into proteins, the proteins of the things that the
cells produce they're actually made up
of proteins.
Well UV light can
disrupt
which DNA are expressed and how they are
expressed in some cases leading to over production of too many cells or
disruptions in the functions of cells, and that's why people link UV light to skin cancer. That's the whole idea there. And that's the whole notion behind using sunscreens and notice I'm saying sunscreen, so ways.
Screen out UV light or maybe all
sunlight in some cases in order to
prevent that penetration of the UV light into
cells which can cause mutations which in some cases can lead to skin cancer. Now, I realize as I'm saying this there's probably a group of you out there saying what's the evidence that sunlight can actually cause skin cancer? Well,
there is clear evidence that sunlight can cause
skin cancers which skin Cancers and how deadly those skin cancers are we'll get to in a few moments that turns out to be a very interesting twist in the whole story.
Yeah,
but I want to highlight the fact that there's very little controversy as to whether or not
UV light can cause mutations in cells, right? But what you should be asking yourself is
well, why would
long wavelength light like red light? Perhaps be good for skin. We'll talk about that later. There are therapies photo therapies that use that exploit red light which can penetrate deep into the skin that actually can enhance the health of skin if done correctly.
Whereas short wavelength light which only
hits that epidermal layer on the outside of the skin may be bad for our skin
and I say maybe
Because it's really a function of dose and timing and
genetic background. Okay, if all this assuming rather complicated, I'm going to make it very simple. And before I do that, I do
want you to ask yourself a question. I want you to ask yourself where you reside on the Continuum
of beliefs about
sunscreen UV
light and skin cancers. So here goes
my read of the landscape
out. There is that there are some people it's a
small minority but there are
some people who feel that sunscreen.
In
any form is bad for them. I think okay son is great for them and sunscreens of any kind
chemical or physical barriers bad for them. Okay, some people believe this I'm
not saying I believe that's in fact, I don't believe that I'm a big believer in sunlight in the power of sunlight for health, but I am not what is
called a sunscreen truther. Okay. I'm not somebody who thinks that sunscreen has no value. In fact quite the opposite under certain conditions and certain sunscreens. When I say that for the record other people out there
believe that certain sunscreens can be valuable.
But only the sunscreens that lack certain chemicals because they are concerned about chemicals in certain sunscreens being so called endocrine disruptors or maybe even
causing cancer on their own. Okay
other people are so afraid of sunlight and believe that it causes so many issues as it relates to skin cancer that they basically
create beekeeper
uniforms for themselves. So that anytime they're out in sunlight. They want to have
sunglasses on they want to have a hat.
I want to cover their neck every part of their body. OK they sit at the opposite extreme of the people who don't believe in using any sun protection whatsoever. And now of course, there's the
backdrop of how much natural melanin production we each make
that is how dark our skin happens to be according to our genetics. And of course, there's the issue of where we live on the planet and how much sun we have available to us in order to potentially expose ourselves to and perhaps also ask
yourself. If you are in what I
believe is the largest category of people out there,
which is the category of people who
Probably don't wear sunscreen everyday. Maybe they put it on occasionally. But only if it's very bright out very hot out because they don't want to get a
so-called Sunburn and I believe most people fit into that General category of a not wanting to be burned be not wanting to age any faster than they would were they to not wear sunscreen, at least that's their belief and see
they've just been told that sunscreens good for them. And they'll reach for whatever sunscreen is on the shelf for that was recommended to
them either by their dermatologist or that they happen to find in the
Embassy or when they're out skiing and they you know, they know it's a bright day. And so they buy some sunscreen and slather it on. So before I go any further just ask yourself those questions. You know, where do you reside? Are you afraid of sunscreen? Do you love sunscreen? Are you in The Beekeeper category? Like you think all son is bad. It's going to give you skin cancer. It's going to age you faster. We get to the agent component a few minutes,
but just ask yourself that question as we wade into the material. I'm about to cover. So what's the story with sun exposure sunburn sunscreen skin cancer and
Aging
I spoke to several different dermatologists about this including one expert in skin cancers specifically and what I was told is the following first of all sun exposure will disrupt the collagen and elastin but mostly the collagen composition of your skin in a way that makes it appear as if you're aging
faster. Okay. So sun exposure. Yes ages the skin now that
does not mean however that you want to avoid all son.
Exposure because the same dermatologist said that some sun exposure is
healthy for us. Why because our skin is also an endocrine organ its involved in making various hormones is part of the vitamin D
production pathway, although little bit later. We'll talk about the fact that most people get their Vitamin D from
their diet and in some cases also from supplementation, but it is a good idea to get some sunlight for sake of vitamin D production, but also the production of other hormones like testosterone and estrogen. Okay, so
every single dermatologist that I spoke to
Said that some sun exposure is good for us,
but that too much sun exposure will accelerate the appearance of Aging in our skin. So let's pin that up on the wall as
fact. Okay, this again is not saying you should avoid
Sun completely. It's also not saying you should get
excessive sunlight exposure. It's saying sunlight exposure by virtue of the UV wavelengths ability to cause mutations in the
epidermal layers of the skin
and to impact the collagen composition of the dermal layers below it as well as some of the
other proteins present in the Coretta no sites. Okay, one of the major skin cell
types and other cell types of the skin does lead to the appearance of aged skin, which is one rationale for wearing sunscreen. Now when I say sunscreen everyone including myself thinks about lotions or in some cases sprays, but let's
pay attention to the one fact that I do think
everybody regardless of what category they are in the general population or what background training a dermatologist has
believes which is a physical
barrier a shirt a hat a jacket
a physical barrier can provide in some cases very good protection from the Sun and I don't think there's any controversy whatsoever as to whether or not the composition of the physical
barrier is having negative effects on the skin. Okay, you will find those Niche communities out there that are saying okay certain chemicals present in certain materials that clothing or made with can be problems for the endocrine system, but we're not talking about that here. Okay what I'm
Is that all dermatologist I spoke to and I think most
every rational human being on Earth would say that a physical barrier can help to a great degree in order to protect our
skin from the Sun as it relates to
sunburn but also
acceleration of the appearance of Aging in our skin. Okay, so I don't think there's any dispute about physical barriers for protecting the skin how much you want to protect your skin from the Sun? Well that will depend on what category you decided you were in from the earlier discussion. We'll get back to that.
What else did all the dermatologists and skincare experts that I spoke to also agree upon? Well, they all said that indeed excessive sun exposure can increase the propensity for certain skin cancers. I want to go on record by saying I believe that why well because of this ability of UV light and some other wavelengths of light potentially to cause mutations in skin cells that can lead to certain skin cancers. Okay. I don't think that's a debated topic out there. There might be a few people out there who are going to hang.
Their hat on a study that I'll go into a little bit later, which is that the relationship between sun exposure and all-cause mortality is a tricky one and it's one that will parse. Okay meaning I'll just give it a little, you know, hint into what I'm saying people who avoid the sun entirely don't tend to live as long as people that get some sun exposure but there are a bunch of confounding variables that have to be understood in order to really interpret that statement and the study that will parse a little bit later for now. Let's just accept the reality that the vast vast majority.
Dermatologists out there in skincare experts really understand that sun exposure can accelerate aging of the skin but most will also tell you that
some sun exposure is good for you not just for skin Health, but for overall brain and body Health
now as it relates to skin cancer the
dermatologist oncologist that
I spoke to all right who did his training at Stanford and I'll provide a link in the show
notes captions to his clinic and you can learn
more about some of his work. He's published some really nice papers
said the following
Going and this was surprising to me. He said it turns out
that the skin
cancers that sun exposure
causes while they can be serious and should be taken. Seriously. They should be treated
those generally are not the most deadly of the skin cancers. Now, why
would he say something like that? Okay, he said it because it turns out
that there are lots of different kinds of skin cancer
some of them arise or can arise through sun
exposure others and indeed some of the most
deadly of skin.
Servers are independent of sun exposure. And this is where things can get a little bit tricky. You'll hear out there. Oh, you know Sun can cause skin cancer but not the skin cancers that kill you. I don't think that's really a fair statement. You'll also hear however that all the skin cancers that are out. There are
the consequence of sun exposure and that also is not true and if anything this provides motivation not just on the part of the dermatologist, but it should be motivation from within all of us to
make sure that we understand our background
genetics.
At just how much pigmentation We Carry in our skin by virtue of our genetics,
but we should know
by asking if you're not going to get genetically sequenced which you can do nowadays, of course, but you should
know whether or not your family your genetics tends to carry certain mutations that make you more prone to skin
cancers in general. Not just the type that can be exacerbated by sun exposure.
What I'm basically saying is that if you have particular genetics in your family, even if you avoid all sun exposure,
you know, nobody should do that. Of course you need some
Online I mean like all other or most all other creatures on Earth sunlight is important for us. It's important for setting our circadian rhythms. That's why I'm always telling people to get sunlight in their eyes early in the
day which by the way when the sun is low in the Sky low solar angles sunlight the UV index
tends to be very low. Okay. So you
are at the lowest possible risk of getting burned of getting any kind of mutations to your skin. That doesn't mean you should overdo.
It doesn't mean you should stare at the Sun and damage your eyes. I've talked about this a lot on other podcast how to get mornings.
Unlike exposure properly but when the sun is low in the sky that's generally a safe time to get sun exposure. It's that midday Sun typically between the hours of you know, 11 a.m. Or even 10 AM Depending on time of year and where you're at and
2 or 3 or
4 p.m. That the sun is overhead and that its greatest intensity and where the UV index can be very high. It's very easy to look up the UV index and when the UV index is very high, right. I was
down in Australia earlier this year
and the UV index down. There is so high you can almost feel it you actually
I
can feel you step outside and you immediately feel
like wow. My skin is really being bombarded with the sunlight and I'm somebody who tolerate sunlight pretty well because my dad's fairly, you know, dark pigmentation just Naturally by virtue of being South American. Normally I can tolerate this game pretty well, but you should not rely on just that subjective feel you should look up the UV index and will provide a few Links of good UV index sites that you can look up the UV index and where you might want to be extra cautious about providing a physical barrier or a chemical barrier to protect your skin.
Now a lot of people out there also believe that if you avoid
Sunburn you're avoiding skin
cancer, perhaps you're very pale or it's the early phase of the summer season or you have a susceptibility of sunlight such that you step outside and you get too much sunlight on a given day and you get a sunburn that reflects an immune reaction and inflammatory reaction within the dermal layers of the skin. So that means the vasculature right those vessels and capillaries. They're going to dilate you oftentimes will get infiltration of things like cytokines which are of the immune system you get a an inflammatory response. That's
It's red. That's why it's tender to the touch
the nerve endings. There can be overly activated. So the reason why your skin actually feels warm, right when you touch your sunburn is because in
fact you have an activation of some of the nerve endings at that side as well as the activation of the local immune system properties that give rise to again vessel and capillary
dilation. It's a wound of sorts
induced by excessive sun exposure now
does sunburn cause skin cancer? There's no direct relationship between Sunburn and skin cancer.
Accept the fact that sunburn reflects
excessive sunlight exposure. And yes, as I mentioned before it's conclusive that excessive UV sun exposure to the skin can cause certain mutations in skin cells that give rise to certain skin cancers. Why are we parsing things that this level of detail? Right is this all just semantics? No, it's not just semantics many people
believe that if they didn't get a sunburn they are
not additional risk for inducing skin cancer other issues with skin right? We're not just talking.
About skin
cancer. We're talking about accelerated aging of the
skin according to sun exposure. So let's make this very
simple. You don't need a sunburn for the sun to accelerate the Aging appearance of your skin. You don't need a sunburn to induce the kind of mutation that may again. I want to highlight may give rise to a skin cancer. It's also not the case that if you got a sunburn or even multiple sunburns that you'll necessarily develop skin cancer, although by virtue of the fact that sunburn reflects UV exposure.
Multiple sunburns would reflect
increased UV exposure and therefore increased risk for certain skin cancers. So all this to say
avoid sunburn however, you can and if you're somebody who just loves sunscreen that doesn't want to even hear the
discussion. We're about to have next about which sunscreens are safe. And which ones appear to be
less safe. If you're just one of these people it does not want to put sunscreen on
because you're very concerned about whatever
chemical might be in sunscreen. Well then consider that the physical
barrier
Barrier of an article of clothing or a hat or a bandana of sorts can indeed Shield you from the Sun to some degree often to a great degree. And again, I don't think there's any controversy as to whether or not those are safe as
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One.com hubermann, okay. So before we dive into our discussion about sunscreens in the chemicals in sunscreens,
let's just take a moment and talk about vitamin D vitamin D is important for a great
number of bodily and brain functions as I mentioned earlier. Most
people get their Vitamin D from the foods they eat if you
eat dairy in most countries, the dairy is fortified with vitamin D many people nowadays supplement with vitamin D anywhere from 1,000 I use to
5,000 IU's there folks.
There who perhaps even take 10,000 IU's seems a bit high for most people but it's going to depend on how much sun exposure you get the pigmentation of your skin,
but there are a number of people especially in countries where they don't get a lot of sun exposure in
particular times of year and maybe they're not eating enough
Dairy fortified with vitamin D who would benefit from vitamin D supplementation and many people find they feel
better when they supplement with vitamin D.
But I encourage you that if you're going to supplement with vitamin D to probably start at the lower end.
And of supplementation like 1000 to 3000 I you maybe 5000 IU best would be to measure
your vitamin D levels many people are surprised to find that even if they
live in a part of the world where they get a
fair amount of sun exposure and they eat some Dairy that's fortified with vitamin D
that for whatever reason their vitamin D levels are still too
low and benefit from supplementation with vitamin D. The dermatologist that I spoke to told me that yes, even if
you wear sunscreen or a physical barrier, okay. This is interesting even if you wear sunscreen
Or a physical barrier when you get outside into the
sun.
It can still have a
positive effect on your vitamin D levels. This was surprising to me. But then of course, it makes sense
sunlight is full spectrum
light. It's not just UV and short wavelength light the
ability for longer wavelength light to penetrate the skin is clear and those longer wavelengths can also impart a positive influence on the vitamin D pathway. Okay. So if you're concerned about wearing sunscreen because
you're worried that it's going to impair your vitamin D
synthesis or metabolism in any way.
Probably no reason to be concerned. Now if you're somebody who is in The Beekeeper category who's completely avoiding sun exposure for whatever reason.
Well, then you probably want to get your vitamin D levels checked and you may want to rely
on supplementation or something of that sort
at the same time because of
variation in genetic background. There
will even be some of you out there who are super anti sunscreen who are peeling your shirts off all the time. We're getting lots of sun exposure whom a surprisingly have vitamin D levels that are
Hello that's rare. Okay for all the obvious reasons, but it could still be the case and indeed some of the dermatologist that I
spoke to said. They occasionally have a patient like that vitamin D as you may recall is involved in a bunch of different things it acts as a hormone. It's evolved in
calcium absorption. It's involved in some of the other hormone Pathways and I should mention that there's a study I'll link to this in the show no captions that shows that some amount of sunlight exposure to the skin. This is an
Israeli study where they had people, you know,
get several tens of minutes of sunlight.
Exposure in the afternoon
during particular times of year. They didn't have them going naked outside. Okay. This was sort of like context and culturally appropriate skin exposure to the upper body into the legs could induce increases in hormones such as testosterone and estrogen
which were correlated with it wasn't causal but it was correlated
with improvements in mood while being
libido Etc. Well some of that probably relates to
testosterone and estrogen synthesis directly again the skin as
Endocrine organ
guy there are certain elements within the Kratt no side skin cells that can literally communicate with some of the
organs of the body that produce testosterone and
estrogen even some of the glands pituitary Etc. This is through a number of different stations. It's not necessarily direct
but also through the sun's ability to impact the vitamin D
pathway that then impinges on those testosterone estrogen and things like luteinizing hormone Pathways. We don't have time to go into all this now. I covered this in an episode about testosterone and estrogen
you have hormones such as luteinizing hormone, which then stimulate the gonads the test used to the ovaries to make testosterone and or estrogen the skin is a not so
obvious player in this whole thing
where by external environmental stimuli such as the availability of sunlight which in most places in the world varies across the year
can stimulate more or less vitamin D production luteinizing hormone
production that can impinge on testosterone and estrogen production
these pathways.
One of the reasons why when we get the right amount of sunlight not too
little not too much. We feel better. We feel better because certain hormones are being produced at certain levels when we're getting that sun exposure and when we don't get that sun exposure, we have lower levels of those hormones. This is well established and the study that I'll link to in the show notes captions, which I've covered in previous episodes is but one example of that phenomenon, okay, let's talk about sunscreens. Now. The reason I change my tone of voice with this is that if you look on the internet you will see
She claims that I don't use or believe in sunscreen. That is just false. I've worn sunscreen my entire life. I don't necessarily wear everyday. I don't tend to burn easily. Okay, I have some natural level of pigmentation in my skin based on my genetics as I mentioned earlier, but as we talked about earlier just avoiding sunburn is not going to protect me or anyone else again certain sun induced mutations in skin cells and the Aging effects that son can have so I
do believe in certain
Sunscreens meaning I will put sunscreen on on certain days on certain parts of my body. However, I do believe now having spoken to multiple dermatologists and looked into the literature very deeply that there are certain chemicals in certain sunscreens that are of concern. I don't mean that if you put these on once or even twice that you are going to suffer negative consequences,
I mean, they are of concern meaning we should pay attention to them and when
In the
option, we should opt for the healthier choices. And in fact, there are known healthier choices
to make all of this very clear. I'm going to tell you what is very clear to the
Dermatology community at this point in time. Okay in June of 2024. Here's what we know.
There are two major types of sunscreens out there.
Well, really three we talked about physical barrier before no one argues about a physical barrier. No one's worried about the chemical composition of physical barriers. Okay, when we talk
about sunscreen solos
Ins creams sprays Etc. There are two major types. The first are organic types, which is essentially
chemical sunscreens. Okay. So when you hear organic sunscreens, that means chemical type sunscreens
and then there are inorganic types, which are sometimes referred to as
mineral-based sunscreens.
Here's what most everybody seems to accept that mineral-based sunscreens meaning sunscreens that tend to include
either zinc oxide or titanium.
Any mm dioxide or both in some cases
are generally
thought to be safe up to
concentrations of
25% 25% is a pretty high concentration. You can
find some screens out there that have 25% zinc oxide or 25% titanium dioxide. They're rare to
find however more
often you'll find sunscreens that
have fifteen percent ten percent 18 percent zinc oxide sometimes alone or in combination with Ty
Any mm
dioxide you'll find some pure titanium dioxide sunscreens out there. All those
are bit more rare right little bit harder to find
here's the story zinc oxide and titanium
dioxide reflect back UV
light the short wavelengths of light that would otherwise potentially cause
mutations in your skin cells at the level of the epidermis. Okay in the outermost layers of skin remember short wavelength light doesn't pass very deeply into the skin
sunscreens containing zinc oxide and or titanium dioxide.
I'd wear engineered for that specific purpose to
reflect back UV light. This is very
different than organic or chemical sunscreens, which contain certain
compounds these Go by different names oxybenzone Avo. Been Zone. There are a
bunch of these different chemicals that are
contained in so called organic or chemical sunscreens
those chemicals in general don't serve to reflect back UV light but rather absorb UV light. Okay, so when they're applied to the skin they're designed to absorb the UV light so that the UV light can
Negatively impact the skin those chemical again chemical AKA
organic components with inorganic sunscreens again, sometimes called chemical sunscreens are designed to absorb UV light mineral based sunscreen. So called inorganic sunscreens containing things like
zinc oxide or titanium. Dioxide are designed to reflect back UV like why am I telling you this? Well, I'm telling you
this because it's generally believed that the zinc oxide and titanium dioxide containing
sunscreens are safe up to concentration.
Of 25 percent whereas there
is some again some concern about the chemicals within chemical AKA organic sunscreens as potential endocrine disruptors.
So disrupting things like
testosterone synthesis, estrogen synthesis and other
hormones, it's not all just about testosterone and estrogen folks other hormone Pathways that many people
including some governing bodies and agencies that assess the
safety of different cosmetic and sunscreen products are concerned
about
Now how concerned they are depends on where you are in the world. Okay, so when Europe they have different
stringencies for what is considered safe versus unsafe or just of concern as opposed to in the US.
Here's what every
dermatologist in the u.s. Because those are the ones I spoke
to told me which is that it is advised that on children younger than six months of age. You do not use chemical based sunscreens. Why well
young skin even the skin on the
Sternal part of the
body in children, six months or younger acts more like mucosal skin in that it can very easily absorb things transdermally through the skin.
However, even as we age into puberty our young adult years and even into our elderly years
there is still a capacity for things to pass transdermally through the skin, although because of some of the additional barriers formed
within the dermal and epidermal layers of the skin things like extra cellular matrix the changes in collagen etcetera,
there is less.
Tenancy for compounds to pass transdermally through the skin now
that just simply highlights the
fact that if you are a very young person or if you're applying sunscreen to a very young person maybe six months or younger
but also
perhaps older depending on how careful you want to be to avoid these chemical based sunscreens.
There is very little if any evidence that the mineral-based sunscreens are of concern for transdermal passage into the skin at concentrations of
25% or less meaning son.
Screens containing zinc oxide and titanium dioxide are probably safe or at least have been deemed safe enough that they are freely available on the
market and we are told that they are safe for people of all ages.
So if you are somebody who is concerned about the chemicals in
sunscreen, most every dermatologist or chemists who works on sunscreens will tell you well mineral-based inorganic sunscreens are going to be your safer option if you're concerned,
but get this the chemical base
sunscreens while
some
Chemicals in them indeed can be quite scary when you read the literature you look
at some of these things like oxybenzone able been Zone and some
similar chemicals. Even at low concentrations have been shown to be endocrine disruptors
people talk about how the fact when they apply these sunscreens. They can taste them in their mouth. There's a lot of fear around these and some of that fear is substantiated
when one goes and
looks at the studies that have been done on these chemical based sunscreens.
You may find it interesting to note that the way these studies were done
often involves.
is having people apply a ton of these chemical based sunscreens, like
two full bottles of these sunscreens over the course of a very short period of
time and then have their blood drawn and then
it's revealed that some of these chemical
components are within the blood
so a big issue that's not often discussed because it's very difficult to control
for in a natural setting but is straightforward to control for in a laboratory setting is how
much sunscreen one is applying and how often and across how many years of time
So there's no real prescriptive that can tell you. Hey, if you put chemical sunscreens on
once that's problematic,
although certainly pay attention to that
six months in younger. What is essentially a rule that I mentioned earlier and do not put chemical based on screens on really young kids. You might want to avoid them entirely depending on how stringent you are about this stuff.
But when it comes to chemical based sunscreens personally, I avoid them but then it becomes a question of if you could only use a
chemical based sunscreen you simply look at the label some of these have
By the way, zinc oxide titanium oxide and chemical based components. Okay. Keep that in mind.
Some are purely mineral-based. Some are purely chemical based. But if you look at a sunscreen label, you know get with this is the only thing available on this very hot day with a very high UV index and otherwise, I'm going to get a
burn. Well, if you're really concerned then I would resort to a physical barrier if you are less concern and you could perhaps tell yourself. Okay, you get to put it on that day, but you might not want to
use it every day and you might want to use a small
volume of it, right or maybe just on parts of
Face or your ears your neck that are particularly sensitive to Sun. Okay. These are the things that need to be taken into consideration. But when we
step back from all of this all of the literature including by the way some of the literature that assess and I'll put a link to this review a review on the potential neurotoxicity of titanium dioxide nanoparticles. I'll get into this in a moment. It has been explored whether or not titanium. Dioxide is more risky than zinc oxide talk about that in a moment. But when you step back from all of this, here's what you get physical.
Er, no one argues About That No One Believes that
clothing is dangerous per se when it comes to avoiding excessive sun exposure again, excessive relates to your skin tone your background genetics your activities and where you are in the world and what time of year? Okay, very specific to your needs
very few folks are concerned about mineral-based inorganic sunscreen. So if you want to use sunscreen as many people do and you want to make sure that it's not an endocrine disruptor and it's not a neurotoxin or something else that's been raised for
some of these chemical based sunscreens.
Then find a sunscreen that has 25% less zinc
oxide and or titanium dioxide.
If you were a bit more concerned about say titanium dioxide and some of the suggestive evidence only suggestive evidence that maybe titanium. Dioxide is
more risky than zinc oxide, especially when it's in its Nano
form the very small form that may indeed. Allow it for
more easy Passage through the layers of the skin that transdermal
passage. Well, then find a sunscreen that is purely zinc oxide sunscreen.
And again, they always have other things in them. But what I mean is the only active ingredient in a zinc oxide only containing sunscreen is
zinc oxide and then they're a bunch of other things that allow it to be a
lotion for instance again up to 25 percent concentration. Why would somebody not want to use zinc
oxide containing sunscreen up to 25% and opt for anything else you might ask right if that's considered safe. The reason is the
consistency of the zinc oxide is it's pretty sticky and thick and it's kind of
pasty right back in the 80s and 90s.
Of you may recall that zinc oxide sunscreens that would actually, you know color than those white so you can really see it was really prominent on the face. They tried to turn that into a fashion statement didn't go over so well over time
but in any case the addition of titanium dioxide to those think
oxide containing sunscreens allow it to be a bit
silkier so that it would spread on more evenly and then you may say well why even put chemicals in
sunscreen at all, if there's risk the reason why chemical-based organic sunscreens even exist is that they
can come up
with compositions of those sunscreens that are very silky than that could spread on clear
over makeup and things of that sort, but there are these concerns about some of those chemical components as
endocrine disruptors and potentially as mutagens that could cause other issues or any number of different things, you know, you can
find all sorts of concerns out there on the internet. Most of those concerns are not substantiated but these chemicals can be
problematic at high concentrations and that takes us back to the
point made earlier, which
is the in the studies of those chemicals and the reasons in
Is it being banned in certain countries and other countries carrying warning recommendations the amount of those chemical based
on screens that were applied was exceedingly high. So if you're wearing sunscreen very often you're wearing
a lot of it
probably best if you're towards a mineral based sunscreen, if you are concerned at all about the chemicals and chemical based on
screen where a mineral based
sunscreen and or use physical barrier
and if you're somebody who just doesn't believe that sunscreens are safe whatsoever. Well, you know
As far as I know it's a free world. You don't have to wear sunscreen, but then I would say you need to be
very aware of the fact that son can induce the appearance of accelerated aging in the skin, right? That's an actual process that takes place is really no debating that frankly and
sun exposure can potentially accelerate or even give
rise to certain skin Cancers and nobody wants that
okay before we move on to a discussion about what can be done to increase the
youthfulness of our skin or the appearance of youthfulness in our skin needs.
Have a bit more discussion about skin cancers notice. I said skin cancers plural because there are many different forms of skin cancer some of them relate to sun exposure as we discussed earlier others do not and in fact some of the more deadly skin cancers are independent of sun exposure. They can relate to genetics and two other factors. So the most straightforward story about all of this is that approximately 80 to 90% of melanomas which are skin Cancers and they are very serious skin cancers that can.
Can indeed be very deadly arise in what's called de novo. Skin de novo skin is non moleskin now does that mean that you should not pay attention to the shape and any changes in your moles? No, you absolutely should but for people who have naturally darker pigmentation everywhere or who have very few moles, then you aren't going to be able to use the monitoring of your moles as the only read out of
potential development of skin cancer
and frankly. Everybody should be thinking about these more serious skin cancers.
Dependent of moles or changes in moles here are a couple things that everyone should pay attention to if you have a pimple like lesion or you have any kind of spot on your skin that seems like it's an acne that's lasted more than a month or you have an area that seeping something that might look like plasma or pause or blood and it persists over a long period of time like a month or more absolutely get that
checked out by a dermatologist.
Okay, don't wait.
Me longer than a month get it checked out in addition. It's highly recommended that you go in and you get your moles checked by a dermatologist and frankly that you get
all of your skin checked by a dermatologist at least
once per year. This is going to
really protect you
against both the Sun and do skin Cancers and other forms of skin cancer the most common form of
sun exposure induced cancers are
basal cell carcinomas and indeed those are less deadly than many of the melanomas, but they still can be exceedingly problematic and they can be deadly.
It's very important to get these checked out. Now there are websites and I'll provide a link to one of them in the show no captions for which you can look at a bunch of different examples of different moles and how they change over time. And if you happen to have a
mole that resembles the appearance of any of the moles in
that image gallery, then you would be wise to go to a dermatologist right
away because it could be again could be
cancer of some sort, but you
do not want to let these things linger for too
long at the same time many people get concerned about 1 mole that didn't have an irregular border and then suddenly has an irregular border.
There are a lot of different features you'll learn from the website or if you talk to your dermatologist that relate to whether or not something is predicting skin cancer or has become skin cancer. It's not just a regular border. It's changes in size certainly changes in pigmentation vascularization bleeding any kind of seeping. There are a lot of different things there. So don't be alarmed at first appearance of one of these things, but do take it seriously and keep in mind that there are things that your dermatologist can do to help prevent certain skin cancer. So for instance, there's a growing Trend now among
Just to suggest laser resurfacing of skin that is a laser used to essentially disrupt that epidermal outermost layer turn it over so that it
regenerates because it can indeed
regenerate to create new cells there. Keep in mind that UV light and other factors in the environment can cause mutations within that skin layer.
Sometimes they're caused by genetic factors, but often environmental
factors, like sun and chemicals and other things and by encouraging turnover of that skin layer through laser resurfacing which by the way they also
So increase the sort of youthfulness appearance of your skin.
So many people are motivated to do it for
that reason can dramatically reduce the incidence of certain kinds of skin cancer. In fact the dermatologist. I spoke to who's an expert in Durham Oncology. Okay cancers of the skin said that laser resurfacing can cause a 30% reduction in
skin cancers because of this ability to rejuvenate the epidermal layer
and that's especially true for areas of the body like the face ears neck tops of the hands, etc. For which the
Often induces the most damage because those are the most exposed parts of the body on a regular
basis. And by the way, this whole thing about skin cancer is not a trivial a small number. It's a big number in the us alone there up to 4 million cases per year of what's called squamous cell carcinoma one of these forms of skin cancer. So getting checked out by a highly qualified dermatologist on a yearly basis maybe even more if you're really concerned about this because you have a lot of familial genetically inherited skin cancers things of that sort is really
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now with respect to everything we talked about about sun exposure sunscreen and skin cancer. I'd be remiss if I didn't discuss a study that's often
used kind of as a wedge or a weapon
in the online debates about
sun exposure skin cancer and mortality and the title of this study is
quote avoidance of sun exposure as a risk factor. That's right sun exposure as a risk factor for
major causes of death
a competing risk analysis of the melanoma in southern Sweden cohort.
So the basic design of this study was to evaluate people's self-reported amount of sun
exposure across many years
and then to correlate that with all-cause mortality and then to relate it to different causes of disease in particular cardiovascular death compare this to Smoker's keep in mind that some of the people who were reporting their sun exposure were smokers some weren't and the conclusion of this study that Drew a lot of attention and continues to draw
Of attention is the following quote here. I quote from the abstract non-smokers who avoided sun
exposure had a life expectancy similar to smokers in the highest sun
exposure group coming to repeat that
non-smokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun
exposure group.
So what many people take this to conclude is that avoiding sun exposure is as dangerous as
smoking, okay?
Okay,
that's not the conclusion that I'd like you to take away because what this study basically shows is and here I continue quote
compared to the highest sun exposure group
life expectancy of
avoiders of sun exposure was
reduced by 0.6 22.1 years.
So you'll wait a second
can this really be true that
people that are avoiding sun exposure
have a lower life expectancy than people who get sun exposure and indeed in this particular study.
That does seem to be the case, but the interpretation of this is not completely straightforward. Here's what we know getting some degree of sun exposure appears to be good for life expectancy. That is true. But is it directly related to sun exposure? That's a critical question and is the increased sun exposure that one gets if you do get sun exposure linked to other issues in particular the development of melanoma as
you recall melanoma was even in the title.
Of the study.
So here's how I think we should think about this study. It does appear that getting sun exposure is correlated with longer life expectancy, but there could be any number of different reasons for that. For instance people that are getting regular sun exposure presumably are also enhancing activation of the vitamin D
Pathways, which is related to any number of different things. They no
doubt are experiencing increased feelings of well-being. I talked about papers that have substantiated that earlier and frankly we didn't even need us.
Tuvok study to substantiate that although it's always great to have it. We know that being out in sunshine for some period of time each day. As long as we don't get burned in the sun feels good. Why is it feel good, it leads to the production of testosterone estrogen some of the endorphins that generally make us feel good. It is directly related to the pathways associated with dopamine release. There's a whole story there about seasonality both in humans and other animals about dopamine synthesis when we get sunlight, there's elevated dopamine and serotonin and
stas drone and estrogen and feelings of well-being and libido is all well substantiated in animal models and humans. So getting sun exposure makes people feel good when people feel good they tend to be lower stress when people are feeling good and they have energy because there indeed is a direct relationship between sun exposure especially to the eyes early in the day and our feelings of
elevated mood and
alertness and energy. They tend to exercise more walk more and of course if you're outside exercising more walking more
Swimming you're also going to get more sun exposure and we know that exercise is strongly related to improved or
extended life expectancy.
Okay, so the study basically says getting sunlight as opposed to very little sunlight is good for life expectancy, but it doesn't say get too much sunlight right? Because and this is interesting. It is very clear that the people who lived longer because they were getting more sunlight also tended to have more
Cancers including melanoma, but this is a very important point. It's also the case that the longer one lives the more likely you are to develop a cancer. Okay. So as you can see these studies that many people just draw one straightforward conclusion from such as people get less sun exposure don't live as long as people to get more sun exposure. Well, that's true. But when you get more sun exposure very likely you're doing other things like exercise and feeling better that relate to living longer. So it's very difficult if not impossible to isolate one.
Variable in this case sun exposure as the key variable. However, I'm happy to go on record saying that we know from so many studies of animal models in humans that sun exposure especially early day sun exposure when the sun is low in the
sky to set your circadian rhythm and late day sun exposure. Okay, I'm not
talking about middle of the day getting baked in the Sun and you know sunburned or things of that sort, but around the time of sunset, especially sun exposure to the eyes is powerfully modulating your
circadian rhythm to elevate daytime mood focus and alertness and improves sleep both of which are strongly correlated with improvements in mental health immune system function feelings of well-being enhanced cognition. I mean, there's this whole story about people with Alzheimer's and disruptions in circadian rhythms and sleep. So sun exposure to the eyes in terms of setting circadian rhythm powerful powerful Improvement of life expectancy and immediate health sun exposure to the skin. No,
Out very powerful positive modulators of certain hormone and neuromodulator Pathways such as
dopamine testosterone
estrogen and so forth that make people feel good and do things generally that are good for
them. Okay, generally not all the things people do with elevated dopamine testosterone and estrogen are good for them. We know that for sure
but getting some sunlight that is some appropriate dosage of sunlight, especially to the eyes early in the day don't stare at the sun don't damage your eyes, but getting some of that sun exposure to your eyes early in the day.
And some to the skin especially in the early and later part of the day clearly is positively correlated with various Health metrics in terms of mental health and
physical health and not surprisingly with lifespan.
So I mention this study because I do think it's very interesting right? I think it's really interesting that people who completely avoid sunlight are not living as long as people who get some sun exposure and some of this actually is on par with what's experience with cigarette
smoking. I think something that everyone agrees is negative in terms of life expectancy.
See and certainly is not
good for a great number of different systems within the brain and
body, but I think the study sometimes is used to highlight the wrong conclusion, which is that sunlight itself is extending lifespan. I think that that very simple conclusion can be taken too far and can start to negate some of the equally important messages about excessive sunlight
exposure causing certain problems as it relates to skin cancers, which we talked about.
Earlier as it relates to things that you can do in order to offset some of that risk with if I were to suggest a physical barrier if you need it a
chemical based sunscreen, if you choose to use sunscreen,
and of course, that's an independent choice that each of us have to make for ourselves. Okay, let's talk about youthfulness of
skin or the appearance of youthfulness and skin
before I did this episode. I put the call out on social media for
questions about
skin and skin health and I must say that
the vast majority
Of questions related to this
topic and it's a very interesting one because it relates to a lot of
decisions that people are making about what to do what to buy or not
buy as the case may be and it is an enormous
probably hundreds of billions of dollars industry. If not trillion dollar industry over time
this business of devices products and
procedures to try and reverse aging or the appearance of aging and skin or even
create
de novo new synthesis of collagen
and skin and other things to make skin look more youthful. Okay. So if we
step back from this whole area we have to ask ourselves. What do we know for
sure about what makes skin look youthful and what can be done to make skin look more youthful and to understand the answers to those questions. We simply have to go back to the beginning of today's discussion for just a moment. Remember that we have the
epidermal layer of skin. We have the dermal layer of skin
where you have the vasculature of the blood vessels and capillaries. You have the nerve
What's there and you have a bunch of different cell
types in there? The kurata know sites you have
different proteins within those
cells like collagen elastin that over time can yes be mutated by things like UV rays from the Sun but that over
time 10 to lose their elasticity which leads to
wrinkles and sagging skin. You also have
this issue of hydration of the skin right skin is a lot of watery components within it actual water within it and those watery components are what
Give it its kind of plump moist look smooth.
Look as opposed to desiccated, you know sagging wrinkled look to speak in
extremes and there are hundreds if not thousands of different
chemicals out there that
dermatologist as well as cosmetic surgeons as well as
just, you know, frankly manufacturers of products assert are going to be good for skin.
So let's talk about where there is a lot of evidence for certain things that you can do if your goal is
to increase the youthfulness or the appearance of youthfulness in your skin and
Of the main ones is collagen itself. And now I have to admit I was very surprised when I looked at this literature, but I was positively surprised here's why as you know, there are various macro nutrients present in foods, you can have
proteins fats and
carbohydrates when we ingest
proteins such as beef chicken fish eggs as well as some vegan sources of proteins like beans or lentils or tofu and things of that sort.
They contain different amounts of different essential amino.
AIDS and those essential amino acids and other amino acids are used as the building blocks for proteins in our muscles in our tendons in essentially all the organ
systems of our body. The
lipids are also used for cell membranes Etc. Okay. This has been
discussed various times on this podcast before people like dr. Lane Norton. Dr.
Gabriel lion and others. It's well established that when these proteins are broken down in the gut some of those amino acids go and serve for the purpose of tissue repair.
Others are for the purpose of
other things what most people
in the field of nutrition agree upon and what certainly I believe is
that if you were to say eat a little bit of liver,
right? You might have a little bit of cooked liver
or a little bit of skeletal muscle in the form of like a steak that there's no selective
trafficking of the amino acids that are broken down from the liver that you eat to
your liver. Right? So when you hear that eating liver supports your liver, it may do that by the broad process of
certain amino acids and vitamins and lipids Etc serving your liver and other organ
and tissue systems of the body, but not selectively your liver.
However, when we talk about collagen this protein that forms one of the most essential aspects of what makes our
skin what it is which is elastic and you know, and to have some tensile strength we can push on it returns to its original position, especially if it's well hydrated and makes our skin very youthful and appearance when we're young and then as it degrades when we
Old makes it look less
youthful wrinkles and sagging and so forth. Well, then why would eating collagen protein which can
come from any number of different sources? It can come from fish sources. It can come from Believe It or Not animal. Both sources
can come from any number of different sources tendon, etcetera. Why would ingesting collagen be selectively trafficked to the collagen in our skin right that doesn't square with everything we know and yet when you look at studies including a meta-analysis of studies where people supplement
with collagen powders and these powders typically come from fish or 10 in any number of different
sources
when people do this
and then measures are taken as to skin appearance skin elasticity there bunch of measures that could be done in humans in the laboratory to do this.
Do you often will find studies that show statistically significant improvements
in college and composition and skin
appearance and even the appearance of reduction in wrinkles and so forth. So this is an interesting exception where the ingestion of a particular protein that naturally
In abundance in certain tissues such as Skin but also other tissues like tendons ligaments etcetera
seems to be assisting in either the repair and Rejuvenation of collagen or perhaps some other aspect of collagen synthesis that leads to
improvements in collagen composition and the appearance of skin in humans.
That's very interesting and the study that I find particularly interesting is when they'll link to in the show no captions. It's entitled quote exploring the
Act of hydrolyzed
collagen oral supplementation on skin Rejuvenation a systematic review and meta-analysis
and the basic takeaway of this and other meta-analyses and
the studies with in this meta analyses is
that when people supplement with anywhere from five to 15
grams? Okay grams of
hydrolyzed collagen per day in particular in combination with vitamin C. It doesn't have to be a lot of vitamin C that one can observe. Okay, not always but can observe some visible.
Improvements in skin composition meaning less wrinkles even some reversal of wrinkles less skin sagging more youthful
appearance more kind of let's just call it
rebound elasticity of the skin. I realize that's not the appropriate technical term, but the ability of a skin to bounce back from an indentation when you push down on it as opposed to sing down or sagging so some pretty impressive results when one considers that what people are basically doing here is just mixing up
some hydrolyzed collagen protein.
And then drinking that down once per day or so
now that is not to say that you have to supplement with hydrolyzed collagen. Why well collagen is also present in various Foods. So for instance drinking bone broth beef bone broth chicken bone broth is a rich source of collagen, you can go online and simply look
up just by web search. You can just say, you know, what
foods contain high levels of collagen
and you'll get a list of things back there. Hopefully a few of those are not
just palatable to you, but you
actually like and you can start to include those in your daily
diet or
Could supplement with hydrolyzed collagen
protein there any number of different sources for these it's interesting that while indeed I don't believe and there is frankly zero evidence for Selective trafficking of amino acids arising from a particular organ source to that particular organ when you
ingest it. It is interesting that
consuming hydrolyzed collagen in the form of a supplement or deriving it from foods like bone
broth Etc does seem to be able to improve
collagen synthesis or the appearance of skin?
In making it more
youthful for those of you that are interested in ingesting collagen peptides as a
way to improve the usefulness of your
skin should mention that the dosage is there come in a Range depending on the studies that you've
looked at in the dermatologist that I spoke to said if one decides to go down this route of
supplementing or getting College in from food sources, you want to aim for anywhere from 15 grams to 30
grams of collagen peptides per day. Okay, that's a bit higher than what was used in a number of
studies, but you'll find studies that
Is 30 grams
and that that whole process
can be augmented can be improved through ingestion of 500 to 1000 mg of vitamin C as well, but check the label on those collagen peptides that you might be supplementing with because oftentimes they already include that 500 to 1000 mg of vitamin C. I should also mention that the dermatologist I
spoke to said that they like collagen protein supplementation. Not
just for the reasons discussed up until now but that they like
them for a number of other reasons such as the
Anti-inflammatory effects of collagen proteins to be honest, I don't know what the exact mechanism of that is. Maybe if you get a certain protein threshold and inflammation is down. But anyway, that's still cryptic to me. But
in any case they did describe some of the potential mechanisms by which
collagen ingestion can do its thing in terms of improving youthfulness. It's
broken down in the blood into dipeptides and tripeptides
which then are
used within the college in itself or the skin. This is the hypothesis and that it can
increase
Chemotaxis the mobility of fibroblasts which make up some of the skin tissue and give rise to the appearance of more youthful skin. There's also evidence that ingestion of hydrolyzed collagen peptides
can improve the elasticity of the Skin Barrier on the outside
right? Make it look nice and taut. If I guess we say nice were surpassing subjective readout on this make it appear taught through the
increase of certain proteins unrelated to college in such as Phil agron's elastins
Etc. What about
Other peptides. Okay. So this is a big topic nowadays, especially in the online communities. I did an entire episode of this podcast about peptides. Keep in mind. That
insulin is a peptide hose em pick
what is essentially an Agonist for glucagon-like peptide one. This is a very popular prescription drug now for the treatment of obesity and for the treatment of diabetes,
there are lots of things
that qualify as peptides a peptide is simply a small chain of amino acids the polypeptide.
A bit longer chain of amino acids and then proteins are made up of amino acids. Okay. So when we say
peptides that means many many things but these days when you hear about
quote-unquote peptides, especially in online communities
generally people are referring to
exogenously given, okay,
so pills ointments or more
typically injections of peptides that are designed to achieve some specific biological or physiological outcome. And one of the more common of these peptides being used nowadays is one of the talk.
About before called bpc 157 body protection compound
157 which is essentially a
synthetic version of something found in gastric juice in all of us. It's known that certain peptides within the gut that bpc 157 is known to mimic or it actually is a synthetic version of that exact sequence or a portion of that
sequence can assist in tissue and wound repair of different kinds tendon anything involving fibroblast. All of that has been well
demonstrated in vitro in a dish.
Okay, so not in Vivo as well as in Vivo in certain cases, but only in animal
models to my knowledge. There's only one study and frankly. It's not a very good study at all
on BBC One 57 in humans and yet a
lot of people are taking bpc 157 either
orally and the form of a capsule or pill or
more typically injecting it. What does it do or what is it likely do in humans? We know from animal
models that PPC 157 increases angiogenesis the growth of
capillaries and blood vessels. We know this.
Can
accelerate wound healing by virtue of increasing
fibroblasts motility for this reason? It's
used post-injury in sports.
It's used by people who want to build more muscle. It's used by endurance athletes. It's used
for cosmetic purposes. Any time people are using bpc 1574 any of those purposes. It's likely that they're using
it in part to increase the blood flow that's available to a given tissue and the repair of that tissue now, I again I do want to
Russian people that there is very little basically no evidence in humans besides the anecdotal evidence that people say they healed faster.
What I do know is that anytime you get vascularization of tissue you're going to get improved blood flow. So it all makes sense mechanistically. I also know that vascularization due to be PC 157, even if it's injected locally into a given tissue is likely to occur globally throughout the body. This is why some people taking Oral B, PC 157 or injecting it just subcutaneously at the level of
Of you know their stomach a little bit, you know Under the Skin at the level their stomach report faster wound healing even in a distal limb or like a hand or a nerve injury in their foot or something like that that also tells us that there's going to be increased vascular ization of other tissues such as Skin such as tumors if tumors exist, so you need to be very careful. I need to say that upfront as a cautionary note because it is very clear that many people are starting to either inject PPC 157 or apply in the form of a topical cream in efforts.
At more vascularization of
skin in order to make that skin appear more youthful and more and more products are out there that contain PPC 157. I can't in good conscience
recommend those products. I can only offer to you the likely mechanism by which they work if they work and also offer you the caveat that it is unclear that bpc 157 can go transdermally
if it's applied topically so if you put it on a say wrinkly portion of your face, like I've got crows feet crow's feet come from either Beijing smiling or both
You know, the crow's feet are the column wrinkles that extend out the corners of your eyes when you smile or for me because I'm you know, 48, you know probably do that. Even when I don't
smile the the logic would be that if you take a cream containing bpc 157 and you put it on there that you'll get increased vascular ization of that area delivery of more growth factors and nutrients and those wrinkles will either be halted in their aging progression or that they will
reverse that's the logic to my knowledge. There are no clinical studies and I'd love to know from you if you've tried these products.
Please put your experience of
those in the comments on YouTube so we can get a sense of whether or not people are having good results with this out. Of course is not a controlled study, but I'm very curious as to know many of the products that contain bpc
157 by the way also contain
copper copper is a trace mineral. It's found in your
diet. There is some evidence that copper is important for some of the collagen and other elements of skin synthesis
Pathways. And so the mechanistic logic and the biochemical logic is there on paper
/
however, it's also clear
that ingesting too much copper can induce an inflammatory response and would lead to the exact opposite desired effect that people who are using copper and usually copper PPC containing products are taking them for which is to Halt or reverse the appearance of Aging in their skin. Why am I going through this whole gymnastics of you know, BBC 157 and copper well because nowadays many many products are starting to include code.
But peptides for skin Rejuvenation and most often those peptides are of the copper variety of the bpc 157 variety
and oftentimes also
with things related to collagen synthesis sometimes collagen directly. So you'll
find oral products that one takes by pill form that
are bpc 157
copper and collagen or things that
promote synthesis of collagen, you'll find ointments that are pure bpc 157 still unclear if those goat
Transdermal? Okay. So
this is still a very very young
science and
most of this is not being explored
in randomized control trials.
However, I know some of you out there are pretty
experimental you like
experimenting with this kind of
stuff you like hearing what's working for other people. Here's what I suggest
if a sunscreen or a lotion or pill or an injection is asserted to contain peptides to
help with skin Rejuvenation. Make sure you look and see which specific peptides are included.
I know the risks associated with BBC 157. It's uncertain risk about acceleration of tumor growth. But the mechanistic logic is just too strong for that with PPC 157 as it is for bpc 157, encouraging vascularization of any other tissue muscle tendon ligament or skin for that matter.
So I'm not telling you what to do. Just know what you're doing and
understand the likely mechanisms behind it in the absence of any of these randomized control
trials. I will say in service to making sure that your diet and or supplementation includes enough Trace mineral.
Copper copper has been shown to play a key role in DNA repair, which is a critical component
of the turnover of collagen and other proteins in skin. It has been shown to reduce so-called reactive oxygen species. So it serves as a so-called
antioxidant and
and this relates to what I just said reduced inflammation, but too much
copper is a problem. So I wouldn't run out and start
supplementing with excessive amounts of copper. Please don't do that. But you want to make sure that you're getting sufficient amounts of copper from your diet and you can simply look up online what sufficient amounts
Copper are given it's a trace mineral and
it's very likely that if you ingest any kind of supplement
that is a multi vitamin mineral supplement into our foundational nutrition
supplement that includes at least some
copper. So it's likely that you're sort of quote unquote topped off in terms of the amount of copper that you need
but very unlikely to be
excessive amounts of copper. But if you start supplementing with copper beyond that again, you can induce an inflammatory response. So it's a dosage kind of Middle Ground issue there. You don't want your copper to know you don't want
Your copper too high. You want it right there in the
middle? Okay, as I mentioned before we will talk about other components of food that are great for skin health and we will also talk about components of certain
foods, like Advanced glycation end products don't know if you've heard of those before but very interesting not good stuff that you want to avoid if you can especially if your concern is youthful looking skin and healthy skin and frankly Health
overall, but before we do that, it's worth paying attention to a few things that you can potentially take that can really improve the usefulness of your skin for
There is excellent science to support it. Okay. So when I spoke to board certified dermatologists
who trained it, excellent institutions what people can do to improve the youthfulness or the appearance of youthfulness and their skin and that they're specifically be peer-reviewed studies to support their statements. They mentioned hydrolyzed collagen protein in combination with vitamin C. We talked about that earlier. They mentioned a bunch of do's and don'ts as it relates to sun exposure and nutrition Etc. Some of which we've covered.
Heard some of which we are yet to cover but will soon and they mentioned supplementing with niacinamide niacinamide is a form of vitamin B3. It is also sometimes referred to as nicotinamide and I was told that when taken at twice per day at a dosage of 500 mg per dose for a total of 1 gram or 1,000 milligrams per day that niacinamide supplementation can increase the production of ceramides which relate to the lipids in.
In that
improve the moisture and skin and by the way moisture and skin is a key component of the youthfulness or plump appearance of that skin when I say plump, I don't necessarily mean
outwardly rounded plump mean the fact that the skin looks like the
outermost layer of the skin
which you now know is the epidermis is kind of taught in the skin looks hydrated and
smooth at the level of its outer appearance. All of that
is improved by niacinamide supplementation, but that the supplementation has
to be carried out for three to six
months or more before
that effect is noticed.
Now the origin of the niacinamide effect on the youthfulness of skin could also be related to the fact that there's evidence that niacinamide
supplementation can reduce
inflammation of skin overall. We haven't talked so much about the immune skin relationship. Although is that alluded to at the beginning of the episode? This is a key relationship, but for those of you suffering from
rosacea from acne,
so rosacea being a reddening of the skin,
we're going to talk more about it later and specific things that can be done
for it acne.
Always involve some reddening often painful reddening of
specific pox on the skin sometimes even the appearance of
pus-filled bumps the sort of thing that niacinamide supplementation may also assist there because of the reduction in inflammation
and we'll talk all about the relationship between inflammation and acne
regardless of whether or not you suffer from rosacea
acne or not at all that niacinamide supplementation May benefit you
also because niacinamide supplementation appears to balance the level of oil production.
In the skin you need oil in the skin you need oil down in those pores, but not too much and that it can definitely help reduce the appearance of clogged pores. And if you're concerned
about pores that appear too large this typically happens in the face around the
nose on the upper cheeks, although other regions of the body as well
niacinamide supplementation May assist with that as well.
There's also a number of people out there that are concerned with specific spots that they see as hyper pigmented
spots. So regardless of whether or not overall your skin is very light or very heavily.
Ted supplementation with niacinamide can reduce the appearance of accumulation and maybe even the actual accumulation of melanin a
particular spot so-called dark pigmented spots that some people decide that they don't want for whatever reason usually just cosmetic reasons. Although there may be reasons why hyperpigmentation in a given area could relate to skin cancers. We talked about that earlier another reason to go get not just your moles, but all of your skin checked at least once per year
now if you decide to supplement with niacinamide, you have the option of either taking that thousand.
Mg into
500 milligram dosage is per
day. You also have the option of using any number of different topical niacinamide ointments or serums that
exists out there. Keep in mind that many skincare products already contain niacinamide. So
check the label and their the dermatologist tell me that to be effective. The niacinamide needs to be present at at
least a two and as high as 10% concentration within those appointments or serums
keep in mind that many serums and ointments also contain what's called hyaluronic
Hyaluronic acid is a natural component of the skin that provides a physical substrate for holding in water. So moisture within the skin.
It does a bunch of other important things to within the extracellular Matrix and elsewhere. The Region's
between the cells that is and supplementation
with hyaluronic acid or ointments or serums that contain hyaluronic acid niacin amide are pretty common out there because of the already stated effects of niacinamide
and the fact that hyaluronic acid can
serve as what's called a humectant something that serves to barrier in moisture.
ER at the level of the skin. Okay, so it gives that kind of Plumping moist look of skin. That's characteristic of youthful skin as opposed to age skin
the dermatologist and the cosmetic surgeons that work on
faces that I spoke to I told you I consulted with a fairly large and Diversified Group of folks in preparation for
this episode all agreed that supplementation with collagen vitamin C niacinamide and hyaluronic acid was
something that they suggest to their patients.
The other supplement will actually it's a prescription treatment most often that dermatologists recommend. If the goal is youthful appearing skin are things within the so-called retinoid
pathway such as retinol. Okay, many of you have perhaps heard of this
and it's a whole story related to the relationship between vitamin A and skin. Okay. So
Trenton Owen is the common name for it. Although some of you may know it as Retin-A and
prescription drugs that are similar to that.
That are basically derivatives of vitamin A. Why why are these used for skin care? Why are they used to increase the usefulness of skin? Well vitamin A gets into skin
cells and is converted into something called retinaldehyde then into something called retinoic acid. Now,
very important to know that retinoic acid is involved in a lot of different cellular processes, especially during neural
development. This is why please pay careful attention to this. This is why
women who are pregnant or breastfeeding should avoid
He'd taking these products because it can seriously disrupt the
development of the fetus.
Okay, and keep in mind that many times people don't realize
they're pregnant for some period of time. So this is of Paramount concern.
Okay, we could have a whole discussion as to the role of retinoic acid and Fetal development, but you don't want to tamper
with that pathway. Okay, very serious consequences can occur.
Okay. So when retinoic acid gets into cells that can activate what's called transcription factors transcription factors bind to
DNA.
Okay, your genetic code
and can induce the transcription and translation of DNA into RNA and RNA into proteins a particular type. So think of transcription factors that sort of setting a menu of different proteins that ultimately will be formed okay by binding to DNA and then you get DNA to RNA RNA to protein and you're getting a set of proteins related to a
particular process. That's generally how transcription factors
work and Retin-A Trend knowin and things similar to that are going to induce the formation of collagen protein Within.
Skin as well as other proteins that
relate to the formation of de novo skin new skin and can replace old degenerated skin.
So the dermatologist that I spoke to
were really bullish about the fact that believe it or
not. They felt that people starting in their 20s could very well as long as they're not pregnant or
lactating or planning to get pregnant could take Retin-A or things similar to it in order to stimulate.
The production of more skin and look more youthful now for people already in their 20s by my radar already youthful but that they could initiate the use of these compounds at least in ones 20s and continuing on really as long as they wanted through life
and they told me about quote remarkable results. So I said well, why isn't everyone aware of this?
Why isn't everyone taking them? Well, it turns out that these different compounds can
also
increase sensitivity to light make you more prone to
sunburn to some of the other effects of light.
Tan skin even
from screens or from artificial light. So one has to be careful about inducing too much skin sensitivity to light of all kinds not just sunlight that they can also induce some redness or dryness or one has to get the
dosage right the frequency of use right? They can be a little bit tricky to work with but that if one can home in on the right dosage has the right frequency Etc the dermatologist felt like this was one of the best things that one could do to improve the youthfulness
or the appearance of youthfulness in one skin.
Now, I find this interesting for a number of reasons. First of all, I've heard of
Nay right I've heard of these compounds before but I hadn't heard about all these, you know, reportedly spectacular things like improved angiogenesis vascularization of the skin. This is why people are taking the rather experimental untested PPC 157 that I talked about before the improved
elasticity of skin, which somehow seems related to the ability of these compounds to remove
degenerated elastin within the skin to clear that out as well as to induce de novo synthesis.
And even the number of different fibroblasts that are present in skin. So more new skin
clearing away of
old skin improve vascular ization. And while all of this sounds a little
bit too good to be true the mechanisms by which its asserted to work all hold up. So that's always reassuring right mechanism isn't everything but it's really nice to see there for instance. These compounds are known to get into the nucleus of
cells right to impact gene expression. We talked about that before you have receptors on
the surface of cells. Okay, so cell
Receptors you
also have nuclear receptors and the ability of certain things. We call them Liggins.
But these are chemicals right in this case, you know in the vitamin A pathway to get
into the nucleus of cells and
impact gene expression. This is actually how hormones like testosterone and estrogen
change the way that people look so
dramatically during puberty. They actually, you know, they operate by binding to cell surface receptors. They also get into the
nuclear compartment the cell they bind a nuclear receptors and they turn on entire genetic programs that cause
for instance deepening of The Voice or the growth of hair or breast tissue etcetera.
Huh? So these are powerful
compounds. Now. I talked to a cosmetic surgeon
expert in face specifically remember cosmetic surgery is done for a number of different areas of the body,
but for face specifically who also
specializes in these sorts of treatments for
skin and they've started using and are frankly quite confident in the use of retinoid Esters that can be applied to the surface of the Skins. These
things are available not by prescription. There's
far less research on these sorts of compounds.
But these compounds get enough positive support from the people that have tried
them reporting improve youthfulness of skin Etc that some of them are becoming quite sought after and people let's just say are very enthusiastic about
them and I will say that in discussing the various mechanisms of this with these cosmetic surgeons and some dermatologists the logic holds up. So you're starting to see more and more of these now as I mentioned the beginning of today's episode there is zero business relationship between me the podcast or
any of these
these people that have
marketed serums or creams or prescription drugs for that matter
related to skin health and Skin Care. However, I have
provided a couple links in the show notes captions of some of the different sources of
these obviously if you need a prescription for something like Trent no one or something similar because you're interested in this whole retinal Retin-A
vitamin A pathway story.
You need to talk to a board certified dermatologist who could potentially prescribe that for you if they decide it's right for you,
but in terms of these topical ointments,
Serums and creams and things like that. I do provide a link to at least one
source of those that uses the retinoid Esther
just keep in mind that these various ointments and serums do not yet have the randomized control trials to support
them that some of the other compounds that we were discussing do have
now. I'd like to talk about things that one can do to improve the health and appearance of one skin that don't involve taking anything or putting on any kind of ointment or serum or anything like that and what I'm referring to is phototherapy now.
Now at the earlier part of the episode, I talked about how different wavelengths of light like UV light and long wavelength light can penetrate skin two different depths and some of the negative but also positive things that that can do. So for instance, we talked about UV light mutating DNA and cells and potentially causing cancers accelerating the aging process and so forth. But as you also recall long wavelength light so-called red light and near-infrared Light, which is even longer wavelengths of light can penetrate deep into the skin tissue.
Past that outer epidermal layer
into the dermal layers of the
skin and
can access the
vasculature the neurons some of
the glands located deeper in the skin. And of course the cells they're like cells in the
epidermis. I should point out
contain things like mitochondria for which red light has been shown to be beneficial why red light and near-infrared light photo therapy has been shown to reduce reactive
oxygen species and thereby to improve mitochondrial
function in cells and that
an intern has been shown to be beneficial for all the different processes within cells that involve mitochondria, which of course include energy production but a bunch of other things too. So when I say that photo therapy has been shown to be beneficial for cells of the body. It's not just cells of the skin. In fact a Nobel Prize
was granted in the early 1900's
for the use of photo therapy for the treatment of Lupus. So this is not a new technology at the same time while there are many studies exploring the use of photo therapy for
And of
skin health and appearance, most of
those Studies have fairly low sample sizes, but there are a lot of those studies and fortunately by now. There are a few meta-analyses and reviews that take into account lots of different studies using slightly different wavelengths of light
apply to different portions of the face for different purposes treatment of acne, maybe even
putting red light near infrared light on one
half of the face to have a so-called within person control to compare, you know, the changes in skin or lack of changes in skin as the case may be
Between one side of the face and the other
I'll put links to some of these studies and some of the
meta-analyses and reviews of these studies
one that I like in particular was published in 2018 and titled light-emitting
diodes and dermatology a systematic review of randomized controlled Trials, of course randomized control trials being one very powerful way to analyze the utility of a practice or a compound not the only way to assess the utility of something. I know some people argue that they are very useful
but keep in mind in the field of medicine we often
Entire fields or even entire
chapters of medical books that are based on case studies. For
instance. We implicate the so-called hippocampus of the brain for its function in human
memory, which it absolutely has and
that fact largely Grew From one major case study that then exploded into a number of different animal model and then
human studies later on. So we
all love randomized control trials reviews of randomized control trials in the uses of their photo therapy for treatment of skin conditions and
Improving the quality of skin are wonderful and point to the fact that phototherapy can indeed improve the appearance of skin in
conditions like acne can accelerate wound healing can improve the youthfulness
appearance of skin but these effects tend to be somewhat mild to moderate when they occur and certainly there are many studies that show no significant effect. No statistically
significant effect
that said I'm of the belief based on my reading of the literature and this is a
Spend a lot of time with frankly
because I did an episode all about light and health. I've also been very interested in the use of photo therapy for the treatment of eye diseases and offsetting age-related decline in visual function. There's some interesting evidence there again mild to moderate effects, but that can be
meaningful in the real world. And when I step back from all of the literature, here's what I see and this is what I ran by a dermatologist to make sure that they thought that this protocol would
be useful or not useful, right?
I asked them I didn't tell them do you think this will be useful tell me? Yes, I
asked them and what we basically converged on was that if somebody decides
to do phototherapy the
use of phototherapy that involves long wavelengths of light so red light plus
near-infrared light typically
at a distance of about a foot to two feet from the light source, depending on the intensity of the light source, although that doesn't seem to be so critical but one can't be across the room from the red light source nor should one get right up next.
The red light source so that there's a lot of heat generated from the red light source that one can feel but at a distance of about a foot to two feet away at fairly High intensities done for anywhere from 10 to 15 minutes five to seven days per week on a consistent basis does seem on average to lead to improvements in the youthfulness appearance of skin why this would be the case isn't exactly clear but there are a
number of different logical interpretation such as reduced inflammation improve mitochondrial
function.
All Downstream of reduced reactive oxygen species improved blood flow to that particular area because of the effect that long
wavelength light can have on vasodilation serve expansion as opposed to contraction of blood vessels and capillaries.
All of this makes mechanistic logical sense and the effects that one sees in
these various peer-reviewed papers randomized control trials
seem pretty good. Meaning they
are mild to moderate. None of them are sort of jaw-dropping like wow
complete reversal of severe acting.
You know massively accelerated wound healing and
we also of course have to take into account that many
people who are doing phototherapy often are combining it with other things sometimes in today's era like injections of PPC 157 or the use of hyaluronic acid
or niacinamide Etc. So these things aren't always being examined in isolation. But when we look at this literature, I think it's fair to say that there is now a substantial evidence for the use of photo therapy for
improving the quality of skin and in some cases
For reducing the symptoms of acne reducing the symptoms of
psoriasis basically any condition where improved blood flow lowered inflammation fewer or reduced oxygen species
improved mitochondrial function delivery of nutrients.
Anytime. Some are all of those things are going to be involved phototherapy makes logical sense. And so it's no
surprise that we're seeing increased evidence for phototherapy in these conditions. Now, I've provided a link to the review of the randomized control trials that I mentioned to bit ago. I also provided few links to
Specific studies that show pictures of before and after some cases on two sides of the very same face.
I did an entire episode about light and health. I'll also provide a link to that episode and if you don't
want to listen to or watch that entire episode, you can go to specific time stamps in that episode to learn about the use of photo therapy for the treatment of skin. I and other conditions related to mental health and physical health.
Now keep in mind that when people hear phototherapy, they almost immediately think about a device
And that makes
sense right red light near infrared light. However, if you recall there's this thing called the Sun that emits full-spectrum light which of course
includes red light and longer wavelengths
of light. Okay, so just because you can't see those longer wavelengths of light. That doesn't mean they're not there just like UV light you can't sense UV light with your eyes by the way ground squirrels and some other animals can it's thought to be the case that they have photoreceptors to detect UV because they actually this is sort of strange but interesting you'll never forget this that they'll take
Urine and they'll spread it on their stomach with their little paws and they'll stand up in there like signal flash one another from across the Prairie or whatever. It is for across the lawn to Signal the one another so they're sending uvp signals across the lawn. I'm not making this up. I actually studied a little bit of this when I was an undergraduate but not at the level of the urine and the signaling at the level of the
retina any discussion about skin has to include a discussion
about nutrition why or
remember the fact that I mentioned at the beginning of today's episode that your skin and your immune system
Have a
very intimate relationship. It's bi-directional your skin reflects the status of your immune system in many ways. And this is why many people with
autoimmune conditions things like lichen planus. You can look it up or if you you know mind particularly striking photographs. Please don't look it up but people that have autoimmune conditions that often manifests in skin conditions will talk more about this in the context of psoriasis and a little bit but any time we're talking about the immune system or
Skin, we need to take into account the gut microbiome and nutrition so many people asked what are the things that they should eat to have healthy appearing youthful skin. They also asked what are the things that one eats that could exacerbate things like acne and what can one eat in order to reduce their acne. So let's just start off with the basics and here I'm going to be fairly brief because I think we all know the big take home message about nutrition nowadays.
We hear over and over again and we should pay attention to the fact that the
vast majority of our
food. Well, I should say if one desires to be healthy mentally healthy physically healthy and a
high-performing individual in any number of different things cognitive physical or otherwise, we want to consume the vast majority of our foods
from non-processed or minimally processed sources so-called Whole Foods of fruits vegetables, if that's within your diet, some people include grains, some people don't I'm not here to discuss that meat eggs fish.
Fish
chicken and so forth if that's within
your diet plan or your nutrition or if you're a vegetarian or vegan you
make the associated adjustment
so that you can make sure you're getting enough protein and amino acids, but it's in keeping with your ethical and maybe your health goals. Okay, so we're not here to discuss vegan vegetarian omnivore of which I am or carnivore. Okay, that's not the discussion. I think
all of those groups agree that getting the majority of your
nutrition from non processor minimally processed foods is going to be
Best and that of course if you're human sometimes you'll ingest processed foods, but really
trying to avoid highly
processed foods is critical now
with respect to the specific foods
that can improve skin appearance and skin Health.
It's very clear that diets that are of the so-called low
inflammatory type that don't spark inflammation. So these would be things that sometimes are referred to as the
Mediterranean diet or a Paleo
like Diet you hear these terms
but what are we really talking about? Mostly Whole Foods
minimally processed?
Foods okay, and then there's variation depending on whether or not you emphasize or de-emphasize meat and fish or emphasize or de-emphasize vegetables this kind of thing again, I'm an omnivore. I love fruit. I love vegetables. I do like rice oatmeal and some pastas. I like a great sourdough bread. I like butter. I like olive oil
like me. I like fish. I think I am representative of most
people out there because I
eat most all those things but I also
eat the occasional croissant. I also the occasional slice of pizza. I don't need a lot of stuff but I eat it now and again and then of course
Of people that are super strict. What do we know about the relationship between specific foods and skin health and skin appearance? Well anti-inflammatory diet, we've more or less spelled out what that represents without getting into too many specifics
and then there are the specific components within food. So
vitamins minerals and micronutrients as well as things like collagen present in bone
broth that can be really useful to include. So one of the
I think best accounts on dermatologic health and skin
in health and appearance on the
Internet is dr. Andrea
Suarez. She's a medical doctor board-certified
dermatologist and she has a wonderful
video that describes the various foods that one can eat to promote skin health and skin appearance and
rather than repeat that entire
video because a that wouldn't be right and be it already exists out there in excellent form. I'll just give a
brief synopsis of some of the things that she suggests because I entirely agree and again, there's no need to be
repetitive and she does an excellent job
so she certainly
Mentions collagen and bone broth. She also mentions various sources of omega fatty acids that are often lacking in people's diets that
they should pay extra careful attention to get so things like
walnuts flax fatty fish. I personally am a big believer in supplementing with liquid form fish oil. That's what I do. Why am I a big believer in that? Well, I don't tend to cook much fatty fish. I love the taste of it if it's prepared,
right but I don't tend to do that very often. So I
use a liquid form fish oil or capsules, but the
liquid form is generally more affordable. This was
discussed in episode that I did with dr. Rhonda Patrick so we can put a link to that particular segment in the show. No captions. It's also suggested that we eat a lot of leafy greens. So dark leafy greens.
You're probably noticing a lot of these recommendations are kind of typical for what people describe any time. They're talking about nutrition for
health highly recommends people get enough folic acid for the role that folic acid plays in DNA synthesis and
repair of skin cells as among other cells and
Cell proliferation and of course we should
get our colored fruits and veggies. So our oranges are strawberries at the Reds and oranges are critical out there
and she also highlight something very important that I want to reiterate which is that we have a critical need for Vitamin A for our skin health and this was covered albeit through the lens of
exploring the
pharmacology of Trenton Owen and those Retin-A compounds but vitamin A is crucial for a number of different
processes within the cell types that make up skin.
She appropriately cautions.
Against supplementing with vitamin A because as a fat-soluble vitamin, it's very easy to overdose vitamin
A if one is supplementing with too much of it. She recommends rather getting enough vitamin A from things like oranges carrots sweet potatoes recommends As
Much Barry intake as is appropriate for someone in one
can afford the berries are so delicious, but they tend to be expensive Depending on time of year ingesting things like
garlic because garlic has sulfur
which is key for
collagen synthesis and repair
She talks about the critical role of taurine. Anyway, she does such a terrific job of describing the nutrition for skin health and skin appearance.
Those are just a few of the highlights. I do encourage you to check out that video and her other content is spectacular as well again, she's an Instagram account YouTube channel that are really wonderful.
So again without doing a deep dive into nutrition decide whether or not you're going to be vegan vegetarian omnivore or carnivore and then make sure that you're getting enough of the vitamins and minerals and micro nutrients from your Foods or supplement if necessary.
Three
but note that caution about vitamin A supplementation in excess and also make sure you're avoiding
excessive amounts of Highly processed foods, you
know, I mentioned earlier these Advanced glycation end products. These are
things that are present in a lot of processed
foods, like crackers and chips and things like that that make those Foods
inflammatory. So you're getting the theme now inflammation is bad not just for the skin, but for all organ systems
of the body, it's not just
about the high density of
calories and the high density of taste present in highly processed foods,
though.
Are problematic but a lot of the issue with these highly processed foods is
the high heat conditions used to
make those Foods stable on shelves or stable and packaging over time because
there's a whole discussion to be had here that frankly I don't think he had enough
but that is outside the scope
of today's episode.
The point is that when these highly processed
foods are basically made right there constructed they involve the interactions between sugars and
proteins and fats at high heat that make them stable on the
A shelf or in packaging and those can
be very inflammatory and that can
show up in the form of reactive skin. It can make your psoriasis worse. Yes. It can make your acne worse. It can make your skin more tender and painful it can make your skin basically more reactive to some of the underlying predispositions you
might have either because of genetics or other things you're doing or not doing maybe you're going through a particularly stressful time. Maybe you're getting a little bit of
extra sun and you're eating more
highly processed foods, and those things are combining and making your
Skin break out or
flush more than it would ordinarily again. There's so many reasons to eat most of your foods
from non process or minimally processed
sources, and of course and now I sound like a broken record because you can hear this all over the Internet adjusting foods that are excessively high in sugar
excessively high in sugars combined with fat
just not good to do pro-inflammatory.
It's going to cause all sorts of issues and we're going to get into this more as it relates to acne in particular because
as you probably know when
You ingest foods that are high in sugars or even just carbohydrates. Generally that also contain a lot of
fats and in particular when those foods are highly
processed. Well, then you initiate an inflammatory response and you often can initiate additional things happening in the pores of cells that can start to really aggravate
acne and cause more acne. This has to do with the
whole insulin pathway. So when we talk about acne, I'll talk
about diets that create a high
glycemic load. We're not necessarily talking about the glycemic index of food.
You may know that
People measure the glycemic index of food. They're looking at the blood sugar response after eating that food typically in isolation and not in combination with other Foods when I'm talking about is eating
combinations of foods that induce high levels of insulin high levels of blood glucose that then leads all sorts of things in the hormone Pathways in cell growth
Pathways that exacerbate acne. So we'll get there in a moment.
But I think the take-home message around nutrition is pretty clear so much so that I don't want to spend any more time on it. We all know what the best
nutrition
it really is for us regardless of whether or not you're vegan vegetarian omnivore
carnivore. It's
non-processed or minimally processed foods representing probably anywhere from let's say 75 to 100 percent of your food intake depending on how strict you want to
be and then sure make some room if you want for some
processed foods, but just know that those Advanced glycation end products
and the high glycemic load that
comes from those processed foods can really exacerbate inflammatory responses and skin and set
A whole domino
set of issues related to hormone Pathways and cell growth Pathways that make everything acne psoriasis and overall appearance worse. Yes, your skin will appear to age faster and on the positive side most of the foods that we think of as healthy and an anti-inflammatory are actually quite delicious. So enjoy ah, and I forgot to say what's absolutely clear. You know, that
myth that they told us when we were teenagers they eating a lot of
fried food would make you break out would make your skin worse. Guess what? It's true.
At high
heat preparation required for
creating things as delicious as the donut or french fries, right? There's a reason people love these Foods. They're so delicious. They do cause problems there are pro-inflammatory. Does that mean you can never have a french fry?
No you decide what's best for
you. But know what you're doing
as a segue to talking about acne. We need to talk
about the gut microbiome
and this is a direct outgrowth of our discussion about nutrition. Here's the simple takeaway that
I believe everyone should follow not just for sake of healthy.
Hearing skin but also for sake of
every organ and tissue system in your body,
which is the data clearly showed that ingestion of sufficient amounts of fiber. So Prebiotic and probiotic fiber so fruits vegetables, sometimes this can also come from grains. Some people will supplement with additional fiber if they feel they need it as well as ingestion of low-sugar fermented foods. I've talked about this before so regular listeners of this podcast may have heard this things like
Kimchi, sauerkraut the sort of sauerkraut that has to stay in the fridge. So not the stuff that's stable on the Shelf at room temperature anything containing a brine that salty brine so pickles but not the pickles that are stable at room temperature. The ones that have to be kept in the refrigerated section of the grocery store. These low sugar fermented foods are powerful enhancers of the gut microbiome. And when the gut microbiome is healthy, you have reduced overall inflammation in the body. This is often reflected at the level of the skin.
And
basically skin health and the youthfulness appearance of skin is enhanced. Okay. This can also help with
conditions like acne or
psoriasis, especially in conditions where there's a direct immune
system skin relationship that will talk about more in a little bit. Okay, so I highly recommend people have
anywhere from one to four servings of
low-sugar fermented foods per day or
try and enhance the health of the gut microbiome. Generally. Maybe you take a pill probiotic all those can be very expensive.
There's a little bit of
data suggesting that if you chronically take pill
probiotics that yield very high levels of
bacteria. Well, then maybe there's some Associated brain
fog that's a little unclear pun intended. But you know, they are very expensive. They have to be kept refrigerated and let's face it low sugar
fermented foods. If you find the ones that you like a really great to ingest because they're tasty and they're good for you. Now, why am I talking about
this in part because
we keep coming back to inflammation as a general issue for skin health and that
us also towards some specific do's and don'ts as it relates to Lifestyle.
Let's face it pun intended if you sleep well, so maybe you need six hours. Maybe you need seven. Maybe you need eight. Maybe you need nine. But if you sleep while on a consistent basis your skin is going to look
so much better so much healthier more vibrant
then if you are not getting enough sleep if you drink alcohol and you wake up the next morning.
You know your skin is going to look puffy. It's not
going to look good. But many of you can ingest alcohol without issues. I've been entire episode about alcohol. Yes. It's a poison up to two drinks per week for adults who are non-alcoholics. It's probably
safe 0 is better than any but let's face it alcohol is
going to exacerbate most skin issues. This is just clear from the literature
doesn't mean you never have a glass of wine doesn't mean you never have a beer or
cocktail if that's your thing, but alcohol consumed in excess and it doesn't take much.
To get there is going to cause sleep issues microbiome issues
so indirectly and negatively impact the skin appearance and health and
indirectly and negatively impact the health of other tissues in your body,
but it's clear some of that is reduced to increase inflammation. Some is related to decreased Sleep Quality or duration. So get great sleep.i avoid
alcohol and excess may be avoided altogether
drink plenty of water. That sounds like such basic advice
but proper hydration is key.
Enough water and electrolytes. It absolutely will impact your inflammation Levels by reducing them and absolutely will impact your skin health and appearance in a positive way. So these are just basic things that I'd be remiss if I didn't mention
the other one is smoking and nicotine
from non smoke sources.
So it's very clear that smoking vaping dipping or snuffing is bad
for skin appearance and health bad bad bad. Every dermatologist said this why well with smoking you can imagine why okay a lot of carcinogens
Ian's and toxic and products generated from smoking even from vaping. Yes, even from vaping it will make your skin age faster that's clear
but it's also the substance itself why all of
those things in addition to increasing inflammation nicotine itself is a vasoconstrictor. So you're doing the exact opposite of what you want when it comes to skin health and appearance and that's why people take things like BBC 157. That's why people take nicotinamide. That's why people are trying to improve the hydration
status of their skin. So if you're somebody
That's vaping nicotine or even taking nicotine in some other form pouch
or smoking nicotine and you're interested in having youthful appearing
skin. You are really shooting yourself in
the face.
And as we all know our emotions impact the appearance of our skin and yes,
it can exacerbate so-called breakouts and we'll get to that in a moment as to what the exact pathway is. But
I've done entire episodes about
controlling your stress. We have a master stress episode that talks about real-time tools that you can use like the physiological PSI.
Provide a link to a clip about the physiological side. It's the fastest way that I'm aware of to reduce ones levels of stress. This is something my laboratory is studied in detail at Stanford. There are also things you can do and we're all aware of what they are proper sleep meditation non sleep deep breaths will provide a link for that all
things that we can do that are zero
cost very minimal time investment physiological side takes about 10 to 15 seconds non sleep deep breast AKA Yoga Nidra, sometimes called takes anywhere from
And to 20 minutes per day and
that reduce stress can dramatically
improve not just the health but the appearance of your skin and it makes perfect sense as to why that is the stress hormones
such as cortisol, but other hormones to such as adrenaline when they are chronically elevated because of the fact that adrenaline impacts vasoconstriction in the skin. It's going to reduce
blood flow to the periphery to the skin it can
cause all sorts of issues at the level of nerve endings that can lead to believe or not enhanced flushing when
we're under stress. This is why we measure
the galvanic skin response
or not. Just sweating but also blood flow
and other things to the skin when we are studying stress. Okay, so direct relationship between stress and skin appearance learn to control your stress stress as part of life, but learn to control your stress in real time and through tools like non sleep deep rest that are zero costs that can help you reduce your overall levels of stress get great sleep.i. Don't use nicotine. If you do use nicotine know what you're doing, maybe use it sparingly and please don't smoke or vape it dip it or snuff it there are other forms.
Don't recommend those forms because they're really very addictive and keep in mind that things that improve blood flow reduce inflammation. Give you lower stress better sleep. All of that is going to make you look more youthful. It's not an imagined effect. It is real. Let's talk about acne acne is very common. It impacts anywhere from 80 to 90 percent of young people at some point. Some
people get very
bad cystic acne deep acne in the cheeks on the back of the neck the back. It can be very uncomfortable. Very painful. Some people only get the occasional
Anal pimple but they get them very deeply they're very
painful and look nobody
likes acne. Nobody likes the appearance of acne on themselves. It can be very distressing for people can cause additional stress that then feeds back in terms of inflammation. And you know, I guess my first, you know request I suppose I can't tell people what to do and never do but you know for people that have acne, you know be compassionate. Okay young people be compassion. I remember when I was younger some of the kids with bad acting got teased and it really upset me as a
Really frustrating especially when going through puberty
because there's this hormonal component to acne now
fortunately, there are things that we can do for acne. I'll provide a link to one of the major sources I
used for researching this episode. I also of course spoke to dermatologist one of whom really knows an exceptional amount about acne and its relationship to the immune system.
The paper that I'm referring to now is a systematic review and network meta-analysis of topical pharmacological oral
pharmacological physical and combined treatments for acne vulgaris.
Has which is the technical name for acne. There are a lot of things that impact acne. Let's just briefly talk about what acne is anytime you talk about acne. You're usually thinking about pus or oil that's called sebum the sebum accumulates in essentially the follicle around the hair this also occurs on non-hairy skin or where they're just tiny little hairs that often
aren't visible.
That's why it's very unusual to get acting on say the glabrous skin of the Palms. I suppose it could happen, but it's very rare
at any given moment.
Went ten percent of people worldwide
will have acne as I mentioned up to 90 percent of young people have acne. So very common very distressing the accumulation of that
sebum in the follicle can be due to a number of different things. Some of it can be related
to androgens things like testosterone increasing the amount of sebum. That's produced. Okay. This is why you often see acne during puberty in addition the anabolic the pro-growth effects of androgens such as testosterone and by the way these occur
in both males and females because both males and females have testosterone and estrogen
the androgenic effects of testosterone can also cause hypertrophy growth of the hair follicle. Right? So an increase in the number of keratinocytes the cells in and around the follicle
which can compress that in hold some of that additional sebum beneath the surface and that's why you're getting a swelling of what looks like a pimple or a
cyst. So there's the potential for a hormonal
influence on increasing acne.
Now someone's going through
You Bertie just have to deal with that
increase if there's a
sudden increase in acne when one is post puberty, you
may want to look at levels of androgens that are being produced and
nowadays with increasing numbers apparently of
things like polycystic ovarian syndrome, which in part relates to increases in androgens. This is becoming an additional concern. So getting a quality blood tests looking Androgen levels over time can be very beneficial for both males and females
now in addition insulin.
That is related to our diet. So insulin and glucose
generally go up together or down together depending on whether or not we're ingesting Foods or amounts of foods that greatly increase our insulin and blood glucose.
So insulin is part of an anabolic pathway as well as cell growth pathway program with pathway. We should call it that involves mtor. Mammalian Target of rapamycin that is a general growth signal for cells.
So this occurs in the I this
occurs in the liver, you know mtor is involved in
Both of cells of all kinds including cells within the skin when our diet increases the amount of insulin and glucose to a degree that is in excess of some threshold that's going to be different for
everybody depending on your activity levels your metabolism the way you manage insulin and that happens
you get increases in mtor that then can feedback on those Androgen receptors increase the levels of things like testosterone further that then feedback on the production of increased sebum.
Okay, that oily stuff increased correctness a'ight proliferation
and you get more acne. In
other words having a diet that has a high glycemic load or evokes a large insulin
response can be problematic.
So what to do when we talked about it
before you want to eat mostly non-processed minimally processed foods, you
definitely want to exert portion control, right? You don't want to eat much sugar or sugar in
excess. You don't want big spikes in insulin and blood glucose.
You want to avoid an inflammatory.
A
diet. So again fewer if any highly processed foods because of those glycation end products that we talked about before and on the positive side, if one exercise is something like say intermittent fasting and here I don't necessarily think young people especially people going through puberty should do this because they're growing they need nutrients. So you have to strike that balance between getting enough nutrients and not overloading the system with insulin glucose and calories, but things like intermittent fasting could be useful or making sure that if you ingest complex carbohydrates as I
And I do okay. I'm an omnivore that you don't do it in excess to the point where you're getting big spikes and insulin and blood glucose all of this the dermatologist tell me can help serve to reduce acne and while it might seem indirect, you know, this relationship between testosterone and sebum accumulation the relationship between insulin and mtor and increased testosterone and sebum accumulation and growth of the Koran decides. These are real Pathways that have been established and some of those are discussed in detail in the review.
So much so that their spin the exploration
of specific Foods in particular Dairy and way, you know, we hear a lot about ingestion of whey protein it's a very
high quality protein High bioavailability high in the amino acid leucine, which for those of you that are interested in
muscle building and repair. There's a lot of discussion about leucine being a critical component there you want
loosing but it does appear that people that over-consume way people that over consume Dairy can run into issues now does that mean you should
Consume whey protein.
No I take whoa! Whey protein do I
suffer from acne know if I did would I reduce my way protein intake? Well, I might decide to run a bit of an experiment
where I reduce the amount of whey protein that I eat for a little bit and see how that goes.
Should I reduce the amount of dairy? I ingest. Well, here's where things get interesting. So in discussing
this with a dermatologist who also happens to know a lot about nutrition. They told me something very interesting
a lot of people think that high fat Dairy will exacerbate their acne.
But here's the
situation nonfat and low-fat Dairy
has emulsifiers is
actually based on work. I believe some of which was done at Stanford
that can Spike insulin more than full fat Dairy. So some people in an attempt to reduce the
amount of acne. They're getting
will move from high fat dairy or full fat. I should say
to nonfat milk or nonfat dairy or low-fat Dairy and their acne will actually get worse and that
could be because of the insulin Spike associate with some of the
emulsifiers in
That nonfat and low-fat Dairy.
So what this means is that you don't have to avoid Dairy all together, but you might be better off ingesting full-fat Dairy. You might
be best off not ingesting any dairy at all. Maybe you want to run that experiment on yourself and just see what works and what doesn't work or if there's no change at
all in addition. If you're consuming a lot of fried food. So those french fries you're just in cheeseburgers and things of that sort. It may not be so much the fat content of those meals, but rather the big insulin response that occurs when we ingest high fat meals in combination with things
Sugary milk shakes or fried foods
like french fries and things of that sort that's leading to the acne by way
of increased inflammation. So there are
a lot of different Pathways inflammation androgens, like testosterone insulin leading to increases in testosterone and inflammation a lot of Pathways converge to exacerbate acne and oftentimes, it's just the removal or even just the reduction
of some of this food intake or types of food
intake that can really lead to Big improvements in ones.
Acne. So all of these things combined to support lower inflammation appropriate amounts of
sebum production because you do need sebum production. You do need correctness sites in and around the hair
follicle, but you don't want too many of them and so on but what can be done to directly address acne. Well, there are a number of different prescription
treatments that your dermatologist can suggest but one thing
that all the dermatologists agree upon is first of all getting adequate sleep reducing stress taking care of your gut microbiome the nutrition recommendations that we've been talking about up.
I'll now but also get this this is interesting not over cleansing. A lot of people with acne
will start to wash their face constantly,
when will often use harsh cleansers that can exacerbate that acne either by virtue of
removing some important skin microbiome components that then lead to even other infections like fungal infections
were additional inflammation because you're removing that microbiome
barrier, but they all recommend regular cleansing of the skin usually two or three times.
As per day but not in excess of that using a gentle unscented on fragranced cleanser. Okay. So there are a number of different types of these. I personally my
basically my entire life that I least as far as I can remember, I've always used unscented done fragrance Dove soap have no relationship to Dove soap. I'm sure
people out there again say, oh my goodness, you know, it contains a bunch of things that are bad for you, but
that's what's worked for me and not the liquid form just bar soap and there are things like Cetaphil. These are some brand names and there are a bunch of other more sophisticated.
The cated gentle cleansers that one could use there are also a lot of products out there that contain what's called salicylic acid. Okay. This is often
as you know, clear fluid that you put onto a cotton ball or a tissue and then you spread on on the face.
It's very important very very important that if you're going to use these
products that you do it on clean skin that is skin that's been cleaned
with a combination of mild zero fragrance soap and lukewarm water. Okay.
Because of the relationship between inflammation and acne. That's what gives it it's red appearance. You don't want to use extreme temperatures of especially
hot water when washing your skin.
So luke warm water and Mild
soap and then and only if it's been recommended by your dermatologist this salicylic
acid salicylic acid comes from the same class of drugs as aspirin, so it tends to reduce correctness a'ight stickiness
right the extent to which those cells stick together. Why do I mention aspirin?
Well, you may have heard that some people take a
Run to reduce the stickiness between their platelets and attempt to improve heart health will
cover that on a another episode at some point but salicylic acid reduces the stickiness of the curtain aside, so it can lead to less clogging of the pores
by accumulation of correctness eyes, or I should say by less accumulation of the Kratt in the
sights and it can reduce swelling in and around the area related to the acne. Sometimes if people get an acne pimple, especially if they have an event or they don't want to be seen with that pimple the use of a little bit of corticosteroid.
And cream put
on there can reduce the redness or swelling the
dermatologist. Tell
me you should absolutely not pop your pimples
part of the problem. When you pop a pimple.
I know their entire videos about this online. I know please don't go look at them these the whole communities around this is super gross,
but I know people find it very satisfying in some cases to
pop these peoples get the infection out while there are certain use cases for that where someone has an infection. It just absolutely needs to get out then be cleaned then covered with a bandage and
You some topical antibiotic that would be a use case for that. The dermatologist
practically begged me to tell you don't pop your pimples because a they will go away in not too much time. If you leave them alone and be you can always put a little bit of corticosteroid cream on top of them to reduce the redness or swelling but most importantly they tell me that when you pop those pimples what ends up happening is you get a mechanical a physical disruption of that area, which you might just seem like okay, whatever it turns a little bit red and that's
transient but you get the influx of what are called Matrix metalloproteinase has these are enzymes and remember anytime you hear an ace. It's usually an enzyme Matrix metalloproteinases that then and go eat at The extracellular Matrix and then you can get an indentation scar. That is permanent. Okay. So if you're concerned about the appearance of your skin avoid popping those pimples, I know it can be hard to do but really try and avoid popping pimples. It can lead to scarring because of the Matrix metalloproteinase is in the eating away of The extracellular Matrix.
Keep the area clean cover it up. If you need to get some
cortical steroid cream on there. If you want to reduce the redness if it's
really bad and you have some big important event like you're getting married tomorrow, and it's right on the tip of your nose or something like that. Then you can potentially go to the dermatologist and getting injected with a corticosteroid to reduce the redness in a more potent way, but they did ask that I ask you to please not pop your pimples. And if you're somebody that suffers from acne, I'd like you to know I provide a link to a
In the show notes captions and titled acne and diet a review of pathogenic mechanisms. And I also provide a link to the review. I mentioned before that covers all of the other aspects of treating acne topical pharmacological oral pharmacological physical and combined treatments for acne vulgaris because again, I do sympathize with the fact that acne can be very distressing very painful fortunately. There are a number of different avenues that you without a dermatologist, but ideally you and a dermatologist can use to
back acne at the level of inflammation through diet through lifestyle if needed prescription medications and again gentle cleansing and
thinking about the various things that
indirectly will impact that acne so
much so that a few of the
derms told me that they have
patience young and old
who will be suffering from really bad
acne that will sometimes just make a few adjustments to their diet the exclusion of
certain things mainly highly processed foods may be reducing
Dairy a little bit or way a little bit or completely
Lee and increasing the amount of things that reduce inflammation some more fruits and vegetables and
meat fish eggs from healthy sources and seeing dramatic improvements in acne. So that's
always reassuring to hear doesn't
always require prescription medication, but if you need it, you should take
it. Okay, let's talk about rosacea rosacea is reddening of the
skin and some people
suffer from this pretty severely other people mildly some people transiently, but it tends
to be kind of distressing for people
and the reason it's distressing is that
It can look like blushing or
flushing of the
face when in fact one isn't
emotionally embarrassed. However, being embarrassed or having any flushing of the skin can exacerbate existing rosacea. So it's thought to be caused by a combination of genetics there can perhaps be some again over
inflammation of the skin
which probably reflects inflammation more globally at the level of the gut and body Etc. We've been talking a lot about that today and there
are things that can exacerbate rosacea.
Such
as alcohol intake or anything that acts as a vasodilator that dilates the vasculature innervating the skin.
So the approach to treating rosacea is pretty much similar to the other things that we've talked about
consuming a low inflammation low glycemic load diet trying to get enough sleep keeping alcohol intake in particular to a minimum or cutting out alcohol completely.
The reason I say in particular is that a lot of people that suffer from rosacea who cut out alcohol completely essentially eliminate the rosacea or
A tickly reduce it so oftentimes it's alcohol. That's the culprit either directly or indirectly. We don't know again
alcohol is a poison but could be the indirect manner in
which alcohol impact sleep in the gut microbiome negatively that's causing the rosacea
without knowing the direct or indirect mechanism reduce or even eliminate your alcohol
for a bit and see if your rosacea improves that
will give you a strong
indication of what might be going on and even better. It could give you a potential solution to the problem now for those that don't
Experience a reduction or elimination of rosacea If you eliminate alcohol get your sleep right get your diet, right? There are some additional things you can do.
First of all, you want to follow the same recommendation we talked about for acne, which is also the general recommendation for skincare use
lukewarm water not excessively hot or
cold water a gentle on fragrance cleanser. You want to use sunscreen regularly remember sun damage to the skin is also
inflammation. So that's going to exacerbate
rosacea and of course sunlight because of the release of
Oxide is also going to act as a vasodilator. Does that mean you have to go full beekeeper
mode? No it doesn't you can if
you want to I suppose but use a quality mineral-based
sunscreen, which we talked about earlier in the episode and you should
use some sort of moisturizer to help lock in the moisture within your skin. You could use things like hyaluronic acid or use any kind of gentle moisturizing cream. That's not going to cause inflammation or irritate the skin in any way
and can keep the moisture within the skin.
There are a lot of different versions of these available out there and frankly a lot of them are not terribly expensive. You can find
super expensive varieties of any and all these
things but many of the things that meet the criteria of gentle and fragrance cleanser spf30 mineral only sunscreen as well as a quality moisturizer are not necessarily the most expensive available and you know, what justifies the higher expense in some cases could
be I don't know the silkiness or the
packaging. It could be any number of different things. I'm not going to say that
The cheapest varieties are
necessarily as good as the most
expensive varieties, but I do think
and dermatologist that I spoke to definitely
confirmed that there's a lot of
price inflation out there related to kind of the overall milieu of packaging and x and
purported exclusivity of certain skin care products. Look for the things that meet the criteria you are trying to establish for your skincare, but just like with acne just like with General skin care if you have rosacea
you want to think about mild treatments for the skin at the
the level of cleaning at the level of sun protection at the level of locking in moisture and then there's some additional things that if you can
spare the expense could also be beneficial like
nicotinamide niacinamide as it's also called
or there's also been some evidence that things like licorice root can be a
benefit. Okay, these things are typically found as a
topical ointment or in a topical ointment, but in the case of niacinamide
nicotinamide talked about how this can be available in an
ointment form a topical form or
To be taken as 2 500 milligram dosage as per day give you the long list of the various mechanisms by which it can improve skin Health reduced inflammation production of collagen etcetera all of that still holds for the potential treatment of rosacea. Be sure
to avoid any kind of things that are acting as strong astringents or that increase heat. So people who have rosacea will often try to avoid hot
peppers. So spicy foods of any kind. I know that stuff. I'm somebody who really enjoys spicy food. So
You have to avoid spicy foods. I sympathize with you. That's rough anything that
acts as an astringent or can you know really irritate the skin from the inside or from the outside? So think not
excessively hot foods at as it relates to spicy or temperature things of that sort. Now, I should point out there are different types of rosacea. The
dermatologist I spoke to who is expert in rosacea told me there are four major types of rosacea many of them respond to the sorts of guy.
Is that we've been talking about up until now some of them that also include acne need some additional treatment talk about acne treatments that can be easily folded into the treatment for
rosacea. There are people who have very stubborn rosacea. As this may be due to excessive use of cleansers. And again, we're talking about how over
cleansing can really be a problem. So we're not
saying don't wash your face. We're not saying don't take a shower. Please do in fact and I
should have said this earlier by the way for a lot of reasons related to your
comfort and appearance and other people's Comfort
after you work out at a gym regardless of whether or not you're rolling around on the floor with a foam roller or you're rolling Jiu-Jitsu or you're lifting weights you're doing cardio. It is a good idea to take a
shower and cleanse with a gentle cleanser as soon as possible. I know this sounds like just basic advice but a lot of people just throw on a clean shirt or they don't rinse off or they don't wash their face and they're wondering why they're getting all sorts of skin issues. Well,
there's a lot of bacteria and Jim's a lot of sweating.
There are a lot of
bacteria on you a lot of bacteria on the equipment. And yeah, you can spray down the equipment to do these various things, but it's a good idea to
shower as soon as possible where to bathe rather as soon as possible wash your face after going to a gym for your sake and for the sake of others
now some rosacea is very stubborn meaning it does not go away. Even if somebody makes all the appropriate
lifestyle adjustments tries any number of different Medical
Treatments. And by the way rosacea is a medical condition and in some cases people will get
Angiomas,
you know the accumulation of blood vessels near the surface
of the skin that can be you know for them something they don't want so we could say unsightly but they just don't want it or in some cases. They'll treat their rosacea and then they'll get an accumulation of Broken Vessels near the surface of the skin. This is pretty common for people that experience rosacea and treat rosacea for these people. There is a treatment has to be done in a dermatologist office called pulsed Dye Laser where they use a laser of a particular
wavelength that can penetrate.
Excuse me, The Superficial layers of the skin and now you know how different wavelengths of light can
penetrate to different depths within skin and destroy the blood vessels or the broken blood vessels that then call in immune system cells to clear out
the destroyed and ethelia cells and other stuff around it and take it away get rid of those blood vessels that sit beneath the surface. Let's talk about
psoriasis. So when I was researching this episode I asked the dermatologist is psoriasis
related to yeast or overproduction of
skin cells.
And what they told me was really interesting. They said for more than 80 years within the Dermatological immunity. It was thought that psoriasis was just an overproduction of skin cells but it wasn't really known what the source was and it turns out that now almost all the terms at least the ones I spoke to said that it has something to do either directly or at least powerfully and indirectly
with the immune system.
So what can be done to treat psoriasis can probably guess things that reduce
the overall level of activation in
Immune system not so much
that you become susceptible to infections because that's not good. But you treat this like any other autoimmune condition. There are now drugs. These are prescription drugs that directly Target the interleukins the components of the immune system that are
directly involved in
psoriasis such as interleukin 17 and interleukin
23, and I'm told that these drugs are very effective in the treatment of psoriasis. So that's very reassuring, you know, I know especially in communities online.
That are focused more on behavioral tools and nutrition based tools or supplementation based tools of which I am right we focus on those but as you probably notice in this and other episodes of the human
Lab podcast, we also talked about
prescription drugs that have proven to be very effective in certain conditions. So it's very reassuring to hear that. There are excellent prescription drugs that can Target the specific interleukins
that are over
activated in
psoriasis because psoriasis is now known as an over activation of the immune system, and I kind of
turning of
Body on itself. If you will
to create this kitschy scaly uncomfortable and in some cases, unsightly overproduction of skin cells at the scalp and elsewhere
Okay, so we've covered a lot of topics
thus far we've talked about skin biology. We talked about various skin conditions that are very common such as acne
psoriasis and so forth. We talked about ways to increase the usefulness or the appearance of youthfulness and
skin that are based on data some that are a bit more
experimental and we talked about even some
Laser procedures and phototherapy things of that
sort and at the same time I acknowledge that there are many topics and conditions related to skin health and skin care that we
did not talk about we didn't talk about Eczema. We didn't talk about Botox.
We didn't talk about an enormous number of topics that I know are of interest in relevant to many
of you. So as a
consequence the plan is to host various expert guests both dermatologist expert in particular areas as well as yes a cosmetic
surgeon who believe or not does not
To cut but rather likes to use fairly non-invasive procedures that touch on some of these very same mechanisms. Yes injections of certain things things that operate at the surface level of the skin and sometimes
surgical procedures
that you know, I know when people hear cosmetic surgery, they think oh people just trying to improve the youthfulness of their look or something of that sort. But you know that also relates a certain serious skin conditions for which surgery and non surgical approaches can assist in so the point is that any discussion about skin health and Skin Care
is going to be an
ongoing discussion one that I do plan to continue on this podcast in the form of
expert guests episodes, maybe even another solo
episode. We've occasionally done so called toolkit
episodes where we summarize some of the main points of previous solo episodes and that arrived with guests episodes and that reflect the latest knowledge that gets published in between episodes. I do plan to
cover this topic in more detail going forward. Meanwhile,
I like to think that what I've covered today provides at least an introduction to the biology.
skin and an understanding about the various things that we all can and should do for our skin health and appearance as well as ways to attack certain pain points related to certain skin conditions that come from expert sources
from excellent literature that has been established over many many decades and I personally find this organ that we call skin to be infinitely fascinating
not just by virtue of what it does but by virtue of all the different organ and tissue systems that it
interacts within our body
and by virtue of the fact that
that our skin is this incredible living organ on the outside of our body that tells us oh so very much about how we and others are doing in terms of our immediate and
potentially our long-term Health
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