Welcome to Grounded Wellness. I'm your host Bethany McDaniel,
founder of Primarily Pure, mom of Three, and biohacking
enthusiast. We created this podcast to bring
you practical advice to live a more vibrant and intentional
life rooted in long lasting health.
We record right here on our regenerative farm, grounded with
our feet in the soil, exploring bold truths, overlooked wisdom,
and holistic tools that support true well-being.
These conversations will challenge everything you know
about health and Wellness. Today's guest is someone whose
expertise and perspective is exactly what all of us need to
hear right now, especially as we rethink the way we protect our
skin and honor our connection to the sun.
Dr. Te'o Soleimani is a Stanford trained double board certified
dermatologist and skin cancer surgeon who operates on some of
the most complex and high risk cases of skin cancer.
Known as the anti Dermatologist, Dermatologist, Doctor Te'o
believes in a more simple, ancestral way of caring for the
skin. His philosophy bridges cutting
edge science with an intuitive understanding of how diet, light
and lifestyle impact the skin and overall health.
He's here to literally shed light about why fear around sun
exposure may be misplaced, how chemical sunscreens may be doing
more harm than good, and what true holistic skin health really
looks like. Get ready for a conversation
that might challenge a lot of what you thought you knew about
the skin, sun, and health. Let's dig in, Doctor Te'o.
Thank you so much for being here.
I am so confused right now because you're a dermatologist
and we are outside in the middle of a sunny pasture.
You're not wearing UPF clothing, you're not wearing a hat.
You told me earlier you don't have sunscreen on.
I feel like I'm living in an alternate universe.
What is going on? Well, thank you for having me.
I'm really happy to be here and a lot of what we may talk about
may not be status quo for my specialty.
But I will tell you the evidence based stuff and I will tell you
my opinions because I think there's a lot of misconception
in my field. You're right, I'm not wearing
UPF clothing and I am not wearing sunscreen right now, am
I? In midday, bright sunlight
directly overhead, Not that much, right?
And we bring up a bunch of things.
And what you're touching upon is the sun.
And should we fear it or should we embrace it?
And I think, I think we should do both.
And why I bring that up is, like with everything in life, too
much of a good thing can be a bad thing.
But the sun for the majority of what we use it for and our
well-being both physically and mentally is a good thing.
I think me being a little bit more olive skin and a little bit
more baseline tan, I know my skin's risk, right?
I know how much sun my skin can tolerate before it burns.
So I am fine and comfortable as both a dermatologist and a skin
cancer surgeon to be outside unprotected before I hit that
threshold. So do I think I need UPF
clothing? Maybe.
Do I think I need it right now? No.
Do I think I need sunscreen right now?
No. But I will make that decision
based on my own personal skin health and my own understanding
of its benefits. I love everything you just said
and I just heard a lot of common sense, but that unfortunately
doesn't seem to be the norm in in the field of dermatology.
What do your colleagues say? How do they react when you make
a statement like that, which feels very, like I said, common
sense to I think most people, but would seem to be blasphemous
among the field of dermatology? Well, I'll tell you it's
controversial, but you have to look at evidence and you know,
I, I trained in some really amazing institutions and
evidence based medicine is what I practice in my practice and
what I've been taught to provide patients.
We know from just a skin cancer risk that there is an entire
subset of skin cancers that are not related to the sun.
In fact, our most life threatening skin cancers,
particularly in younger patients, don't have what we
call AUV signature or UV mutation signature.
So this misconception of you have to fear the sign you got to
protect yourself from from birth to adulthood and beyond, I think
is overkill. I think it's been overdone.
Now, why do we do that? Why do we as dermatologists make
a big stink about the sun? Because I can't control your
genetic predisposition. So I can't control what your
family's genetic pool has provided you.
So what I can control is environmental injury or insults
that I can protect against. So my goal as a dermatologist
and both as a skin cancer surgeon is to keep you safe,
keep your skin safe and keep you away from things that can kill
you from a skin cancer standpoint.
But I think the sun provides a lot of benefits that we tend to
ignore. And in fact, in fearing the sun,
it doesn't reduce the likelihood of dying from a certain skin
cancers. So I don't think we should fear
it. I think we should respect it
because, you know, try to sit outside for a week in the sun
and you'll burn, right? And the sunburns, never a good
thing. It's your skin dying from excess
UV exposure. But I think sunlight makes us
feel better. It provides some benefits.
Vitamin D synthesis, it actually modulates our skin's immune
system. We'll go into that in a little
bit, but there's a lot of things the sun provides.
I go out every single day. I get 20 or 30 minutes every
single day, whether it's in the morning or in the afternoon
playing with my kids, and I feel completely fine telling my
patients to do the same. So skin cancer is the number one
cancer in the United States. But here's where it gets
confusing. We've been told for decades to
slather on sunscreen every single day, but the rates of
skin cancer continue to rise. Why is that?
So there's a few important factors.
There's some variables we've got to take into consideration.
So skin cancer is the number one cancer in the world, and in the
United States, one in four Americans will develop it.
Well. Interestingly, the most common
causes of skin cancer Death are not preventable from sun
protection. So Melanoma historically has
been our deadliest form of skin cancer and it's been.
It's the number 2 cause of cancer death in young women ages
like 25 to 35. Those skin cancers tend to arise
from mutations in our skin's genetics that we can't control
for. What is important to know is
that the sun will contribute too much UV exposure will contribute
to certain garden variety skin cancers that may or may not play
a significant role in your longevity in your well-being.
But surely we don't want those and.
What would you consider a garden variety skin cancer?
Yeah. So things like early squamous
cell carcinomas in elderly patients, certain early basal
cell carcinomas. And interestingly enough,
there's been several really big sunscreen studies, a large one
in 1999. We, it was like our gold
standard published in The Lancet that looked at really strict sun
protection with sunscreen versus no sun protection with
sunscreen. And the incidence of basal cell
carcinomas, which is our most common skin cancer didn't
change. And in fact, although there was
a slight decrease in certain squamous cell of the Melanoma,
there was no change in Melanoma specific deaths.
So we've become a sun fear mongering society.
I think it's I think its intentions were originally good
to keep people protected, but we've gone kind of way out the
deep end and I think kind of coming back to normal common
sense is much is a much better idea.
Can you give a breakdown of the different types of skin cancers
and which ones are sun related and which ones are not?
Totally. So there's a lot of forms, but
the three big ones we talked about, which is the predominant
forms in the US and the world are Melanoma.
Most deadly. Exactly.
OR historically has been the most deadly squamous cell
carcinoma and basal cell carcinoma, and these make up
essentially 90% to 99% of our skin cancers.
Melanoma historically was our deadliest form of skin cancer.
A lot has changed in the last five years.
It's no longer a death sentence. You know, famously our former
president Jimmy Carter had it in his brain and now he's been
alive. We've saved him for from dying
from Melanoma for with, with certain medications.
But it's the one we take the most serious because of its
ability to spread throughout the body.
What people don't understand is that the vast majority of life
threatening melanomas, particularly in young patients,
are not sun driven. They occur in areas of sun,
Naive skin backs, abdomen, upper legs, young men and women.
In fact, it's the second most common cause of death in young
women. But those melanomas don't have
AUV signature. So we make this big stink about
avoid the sun, avoid the sun. But of our most lethal form of
skin cancer, it makes an insignificant difference.
Now, this doesn't mean go outside and burn all the time,
Doc said. Doctor Teo said go do whatever.
But we have to be pragmatic here, right?
Squamous cell carcinomas are second most common form.
And now, unfortunately, it's become the number one cause of
cancer death, skin cancer death in the US that tends to be a
little bit more linear in terms of chronic excess sun damage.
We see farmers, coal miners, people who live at the beach,
you know, deserts with aged, wrinkly, rough skin.
Over time those developed the what I call garden variety skin
cancers. Interestingly, squamous cells
that go on to to kill patients don't have AUV signature.
The majority of them don't have the UV signature that we see in
sun damaged skin. So it can cause or it's it can
be related to squamous cell cancer, but not the most deadly.
Yeah. And we're just understanding
this interplay between sun, our immune system, the skin cancer
biology. There's a really cool study that
came out several years ago that looked at cosmetic surgery
patients and they took when we did eyelid lifts.
When we do an eyelid lift, we normally discard the extra loose
skin that we take out. Well, we studied the genetics of
those of that skin and we saw the same mutations in the skin
that we see in skin cancers. But those eyelid skins were
normal. They didn't have any cancers.
So we're just now understanding, well, what does this all mean?
What this means is 1. There's a lot, lot more to it
than just you get sun, you're going to get skin cancer, which
is why I don't want people to fear the sun.
What I want them to understand is if you start to burn all the
time and too much of it, well, you're not doing your skin a
favor. The other important thing is to
understand our immune system and how it plays a role in
protecting us. We know that as our immune
system gets weaker, skin cancers increase.
In fact, patients who have autoimmune illnesses, patients
who have are on medications to weaken their immune system and
older patients have the highest risk of skin cancer regardless
of sun exposure. Just because their immune
function isn't where it should. Be the immune systems are the
police of our body. So things grow and our immune
system takes care of it. As that weekends things like
weeds grow that we can't control for and they they become a
problem. And as you're talking about
this, I'm thinking about vitamin D.
The sun is probably the best source of vitamin DI mean people
can supplement as well. But perhaps the best natural
source of vitamin D is from the sun, which plays such a critical
role in immune function, which protects US against skin cancer.
So how does vitamin D factor into the equation?
Totally. And before I touch into that, I
forgot to mention the most common form of skin cancer,
which is basal cell carcinoma. And that one doesn't have the
ability to hurt you in terms of a threat to your life.
It doesn't have the ability to spread inside the body, but it
is functionally or cosmetically destructive.
That is even less understood because in all of our sunscreen
studies, and we touched about this earlier, but patients who
used diligent sunscreen versus those who didn't, there was no
significant difference between the rates of basal cell
carcinoma formation. So we're still scratching our
head saying what the heck is what's the player here?
Yeah. Is it like another ray that
sunscreen doesn't protect? Again, it's it's.
Family history, genetic predisposition, immune
dysfunction, too much UV altogether.
Yeah, if it was truly UV related, that rates of basal
cell in Equatorial countries should be higher than northern
European descent. And we don't see that.
That's where family and genetics play a big role.
So you touched about vitamin D and vitamin D is a really
interesting vitamin, which is a fat soluble vitamin that's been
studied almost at nauseam. Now about its effects on overall
health, certain skin diseases, certain internal diseases, you
know, all sorts of things. And you're right, I agree with
you. Vitamin D, the best source in my
opinion is skin is getting it from the skin synthesized
naturally. But my my medical counterparts
will argue that we've looked at patients in heavy sun exposed
areas, surfers, people in Ecuador, Panama, Hawaii,
Colombia and we found that they are vitamin D deficiency as
well. My argument to that is I don't
think our current testing models represent biologic activity.
I think just because a level is beyond a certain marker doesn't
suggest whether even that that messenger or that chemical is
doing its job or not. It can't be that everybody in
the world is vitamin D deficiency.
That's silly. And I also don't like
supplementation from a vitamin D perspective for several reasons.
I see a lot of vitamin D toxicity.
Patients come in with a lot of problems from toxicity.
Yeah. I thought that was a pretty rare
thing, but. No, because everybody thinks
that they can self medicate and if we're going to treat this as
medicine, it should be treated in a controlled fashion.
I still think getting getting vitamin D from the sun is the
best source. What we do know is that
deficiency in vitamin D over long periods of time have been
shown to be a problem in autoimmune diseases, certain
cancers. In fact, there was a really
interesting study that looked at women in Sweden who avoided the
sun for fear of Melanoma, and they looked at those who avoided
the sun and they had the same rate of cardiovascular mortality
as pack a day smokers. And the thought was that their
immune dysregulation, partly due to low vitamin D, partly due to
sun avoidance and probably other habits that they were doing in
fear of Melanoma, resulted in the same immune dysregulation
that pack a day smokers had. Nobody talks about that study.
And it's it was over 20,000 women in Sweden.
It was a very good study. Really big group.
Now, I'm not saying if you get a bunch of sun you're never going
to have a heart attack, or if you get a bunch of sun, you're
never going to get skin cancer. That's not the purpose of this.
But I think being outside produces some natural synthesis
of vitamin D that we need and a component of Wellness that I
can't measure in a test tube. You feel better outside.
When I was training on the East Coast, I had, you know what,
what they call in medicine a seasonal affective disorder.
I call it just being sad because it was cloudy, you know, And
when the sun would come out, I would feel better and I would
perform better. I was better at my job.
I was happier. And I don't have a test tube
measurement for that, but I know when I felt better I was
healthier. And it it it translates.
Yeah, I don't think science has fully caught up with all of the
healing benefits, for sure, that sunlight and that everything on
the earth has to offer yet. But like you said, it's
something that we can all feel and that we've all experienced
when we're outside, when we get natural sunlight, not too much,
but the right amount, it feels really good.
You can't deny that. I agree.
I remember in like the 90s and early 2000s when I grew up,
there was a lot of talk about how the ozone layer is
diminishing and therefore we all need to be more vigilant about
sunscreen use. How much of that was real and
how much of it was just marketing for us to start using
more sunscreen as a society? So the depletion of the ozone
layer was real for certain, and it did provide the ability of
certain rays of sun, particularly X-rays, gamma rays,
UVAB&C to penetrate. However, common sunscreens only
protect for UVB and UVA. All the other stuff that got
through the holes in the ozone, we're not blocked by the common
sunscreens we use anyway. So if we were to think, you
know, there's a hole in the ozone, which means there's some
mutagenic rays coming through, what are other ways we can take
protection? And I tend to say shade,
shelter, supplement, sunscreen, in that order.
So the ozone's changing now for the better.
People have gotten smarter about the stuff we're doing to the
environment, and we're allowing the Earth to rebuild.
The ozone layer that was depleted is closing.
That still doesn't mean that we shouldn't take some form of
protection. But the sunscreens we put on
barely blocked UVB back in the 90s.
So it didn't even do anything for the stuff that was getting
through to begin with. And how would you say sunscreens
work now to prevent both UVA and UVB adequately?
Something such a controversial topic and I recommend it for my
patients. I think common sense things are
if you have a reason to shield yourself from too much UV
exposure and I don't like to like to use the term sun.
I don't even think it's sun. It should be against
specifically UV, right? I like the old school zinc and
titanium based sunscreens. The stuff in the 1980s and 1990s
that you saw the lifeguard with the white nose at the beach or
at the pool. Those are time tested.
They're the broadest spectrum. They cover UVA and UVB very
adequately, and they're safe. For all intents and purposes.
What's happened in the last 20-30 years is the Cosmos utical
industry has found that the old sunscreens had a chalkier feel,
so people wouldn't be able to put it on under their makeup
very comfortably without residue, greediness of their
skin or this kind of pasty feeling that they didn't like.
So out came the chemical sunscreens as a need or desire
to have something that felt more elegant on their skin, in which
you can cover with makeup. The problem is that the chemical
sunscreens in reality have a whole slew of questionable
concerns. And I'm in the camp that there
are some problems, some significant problems with the
chemical sunscreens available in the US.
Let's talk about that. What are some of the biggest
issues with chemical sunscreens? So one thing people don't know
or understand is actually how chemical sunscreens work.
So chemical sunscreens work by absorbing UV light.
Undergoing A mutation or a change, a chemical reaction in
your skin and releasing that chemical reaction energy as
heat. So they're actively undergoing a
chemical reaction on your skin. The problem with that is these
are chemicals we are putting on our skin that were made or
synthesized in a lab. And we didn't know at the time
when these products were being developed in the late 90s and
2000s what their breakdown products meant.
We just knew that the active ingredient would absorb UVA and
B, undergo a shift, release that energy as heat.
But the degradation product we found are actually carcinogens
in a lot of the chemical sunscreens.
There's some notorious ones that have been banned in Europe and
Australia because of how carcinogenic their metabolites
are. We still have them in the US,
which is a big problem. And then the other thing that we
didn't know, or maybe we didn't know and we didn't talk about
it, I'm not sure, is that a lot of these chemical sunscreens are
organic phenol derivatives. So they're molecules that mimic
the structure and shape of our natural hormone chemical
messaging signals in our body. So one problem with sunscreens
is we tell patients, or at least collectively as dermatologists,
we tell patients, put the stuff on your skin from six months old
to 80 years old. We're talking decades of
application. Any common sense you would
think, wait a second. I'm putting something on every
single day of every single week of every single month of every
single year, compounded over years.
Is this stuff getting in my system?
Am I absorbing this? Am I inhaling this?
Like, what does this mean? And only now are we finding out
after 20 or 30 years of data. Like, wait a second, this can
interfere interfere with natural hormone messaging signals.
They mimic the same molecules in our body, or at least some of
them do, and they're not as inert as we think.
Actually, a big study that came out in Jam a couple years ago
showed that one application of a chemical sunscreen on our skin
was detected in a blood test at nearly 200 to 500 levels above
what we considered safe and normal.
So only now are we figuring out, wait a second, the stuff we said
in the 90s and 2000s that's great and became widely flooded
on the market is probably not as safe and harmless as we thought.
Yeah. And if you think about, I mean,
that's just one application. If you think about every
application over the course of one day in the sun and then a
week in the sun, a lifetime, I mean.
Our babies, our kids, elderly patients, patients with, you
know, different types of skin that, you know, maybe they have
more sensitive absorb. You know, kids have a skin type
that's behaves more like mucous membranes, especially when
they're young, especially before a year or six months.
They absorb everything. You know, we're telling people
to put this stuff on every single day.
And you know, that brings up a really important fact that
people often overlook. The American Academy of
Dermatology and the American Academy of Pediatrics recommends
against using chemical sunscreens for for infants 6
months and younger. Why?
Because we know that stuff is absorbed.
We know those chemicals may not be safe, and it's been like that
for years, but nobody talks about it.
So you assume if we knew something was wrong or if we
knew something was questionable, why are we telling everybody
else to put it on? But not for babies.
Right, right, right. Man, there's so much to unpack
here. So, so these chemicals, a lot of
them are endocrine disruptors. They are actually causing a
chemical reaction to happen on our skin which has carcinogenic
or cancer causing byproducts. So is it safe to say that the
products that we've been told to use to protect ourselves from
skin cancer may actually be contributing to skin cancer?
Maybe, maybe, I don't know if they're directly contributing to
skin cancer, but they may be contributing to other other
cancers, lymphomas, leukemia, certain other issues that we're
noticing. In fact, one of the most
commonly available chemical sunscreens, octachrylene,
undergoes a chemical reaction in our skin.
And the breakdown product is a product called benzophenone,
well known carcinogen, like very well documented in the
literature. But for some reason we still
have it in the United States. Now, am I saying avoid all
sunscreens at all costs? No, of course not.
You know, people burn, they get blistering sunburns.
We know the consequences of that.
But if you were to ask me, there's a there's a group of
sunscreens that doesn't really have any data suggesting it's
harmful besides the fact that it goes on your skin kind of
chalky. And then there's a group of
chemicals that have a bunch of publications, whether it's in
lab studies, animal studies, or in humans that have questionable
properties. Which one would you pick?
Yeah, it's a common sense thing. Pick the safer 1.
Right, which is the physical? Which is the physical zinc and
mineral? Yeah, exactly.
Zinc, titanium. In my practice, I don't
recommend chemical sunscreens. That's my personal preference
and opinion. If I'm going to have somebody
apply sunscreen, it's because I, as a physician, want to protect
their skin. I treat it as a medicine.
I don't treat it as makeup. I treat it as medicine.
Which it technically. Is it?
Is the FDA regulates it as a drug?
It is. It's an FDA defines sunscreen as
an over the counter drug, same as Tylenol, same as Advil.
So if I'm going to treat it as such, I and maybe my patients
don't think the same, but I don't really care if it's
chalky, if it's doing its job and it's safe.
I've done my job. Now, in my opinion, there are
even better ways to protect your skin than sunscreen.
I probably put that as third or fourth best.
I like shade and shelter. I like clothing.
You know, there are, and those have never been question to
cause any sort of chemical reaction on your skin unless
you're like, I don't know, jumping in on that full of
benzene with your clothes on. But those are, you know, you'll,
you will never burn in shade. It's literally impossible.
You can sit at the beach for 30 days in a row under shade and
you'll do fine. Try sitting at the beach for 30
days with sunscreen on. You will burn.
So that's that's like my common sense approach to sun
protection. I agree, I think about it in the
same way. It's like finding shade, I think
is the best, the best thing to do if you had a long day in the
sun and like you're, you can feel it, you know, you can feel
when it's been when it's a little too much and then finding
shade or like wearing a hat, wearing clothing.
What about what's the deal with UPF clothing?
Is does that really protect you? Because I have never burned
under any clothing, garment, UPF or not.
Very good question. So part marketing, part
marketing, part not. The defining features of what
makes clothing a certain UPF number is the weave of the
fabric and the material of the textile.
So some materials are more reflective of light sources,
some materials are less reflective.
So all clothing has some component of UV protection.
You're right. I've never burned with, even AT
shirt on, whereas my arms that were exposed have gotten
sunburns before, or at least I've gotten a tan now.
Everybody's what I call minimal erythema dose or sun sensitivity
or UV sensitivity is different. Some patients are very sensitive
to UV. They may have skin conditions
that make them very sensitive to UV.
Think of things like lupus or melasma, or you know, what we
call spring eruption or polymorphic light eruption.
Some people have a history of a lot of skin cancers that are sun
related, so they may need a little bit higher protection
than say, you or I. But part of the UPF popularity
is marketing, because all clothing will have some
component of sun protection. Some of it is true.
When you go up into the 50s range, really it's a much
tighter weave of product and it's a textile that tends to be
a lot more reflective than natural cotton.
OK, interesting. Yeah.
What about spray sunscreen? What is your take on spray
sunscreen? That stuff.
Me too. Take that stuff. 2 reasons.
Every time I've had a sunburn as a kid, it's been with spray
sunscreens. Every time I've had an uneven,
you know, tan or uneven burn, it's from spray sunscreens.
And now we're finding out that the majority of the propellants
that get the sunscreen product out or some sort of benzene
derivative. So you're spraying this all over
your body, you're inhaling it every time you apply this.
And we know obviously anything in the benzene family tends to
be a carcinogen. We tend not to recommend this.
If we're going to treat sunscreen as a medicine, then we
should make sure most of it, if not all of it, is safe.
Now people will come back and say, well, the amount of benzene
is not a lot and the amount, but we're treating this to diagnose,
treat or prevent something, right?
People make the argument while you're getting more inhalational
benzene when you go pump gas. Possibly, though I don't agree
all the time, but assuming that's.
Especially with children. 100% they're not trying.
To avoid it, yeah. Oh, they're not like holding
their breath while their mom is 100% covering them in this cloud
of benzene. Every day, yes, every day.
And you're spraying it on areas where like if I'm at the like,
let's say that argument's true, right?
I'm not at the gas station sniffing the the nozzle that I
put in my gas tank, right? But we're spraying this on their
face, shoulders back. So that's number one.
Smell that stuff from like 20 yards away 100% It is so
offensive. It is like my #1 pet peeve 100%
at the pool when all of I know right away I'm like OK, who's
who's spraying the sun? The.
Salizes and goes far, Yeah. So that's number one.
The propellant, that's a huge problem #2 most of them are
chemical sunscreens. Most of them are chemical
sunscreens with a bad degradation product #3 the
application, the amount you need to apply to get the actual SPF
number on. There is a shot glass worth.
That's like the simple description.
Nobody's ever spraying a shot glass worth of product on their
body. They're maybe getting like a
whiff of it, which is why they, you know, most patients burn
with spray sunscreens. It's just it's become this
marketing thing because it's easy to use and you can grab it
and go and think you get some protection.
Do you remember back when we were growing up?
Because we're the same age, we figured this out before we
started recording. A lot older.
No, you don't. We're like, we're like within a
month of each other. Unbelievable, unbelievable.
But OK. When we were growing up, do you
remember seeing those commercials for like the the
purple tinted sunscreens? Yes.
And you would like go to the beach and see like purple and
blue kids running around. And I think they did this so
that parents would know like when the sunscreen has worn off.
But now there's so much awareness about synthetic dyes
and the negative effects of those. 100%.
So I'm like, this is so crazy that this was a thing and that
everyone just went with it and didn't question it.
And it just goes to show that not everything that is sold to
us is actually safe to use. What million percent?
The intentions were good. They wanted their the intention
was to make some sort of identifiable product where you
can say, OK, my kids covered or not, and if it's wearing off,
they need to reapply. The problem is the stuff we used
to do that was worse than the product or concept itself.
You touch upon a really important thing, the original
FDA manuscript. So the FDA control sunscreens
the way they control medicines. We talked about that.
It's an over the counter regulated drug.
So the original manuscript came out in 1999 that defined the
most commonly used acceptable chemicals to be used and defined
as sunblock or sunscreen in the US And the terminology changed a
little bit, but back then it used to be called sunblock.
And in order for you to be determined to sunblock, you had
to protect the skin against so much redness or burn.
The FDA hadn't updated their manuscript until two years ago
where they made a statement. They haven't even updated it
yet, but they made a an update letter or an update statement
looking and re examining after 20 or 30 years worth of data
whether those original chemicals were safe.
And 19 of those most readily used stuff that was originally
deemed grace, generally recognized as safe and effective
are no longer deemed GRACE. So the stuff that we were
readily accepting, you're on vacation, you pick it up from
the convenience store in the hotel lobby or wherever or your
your local pharmacy. The stuff that was widely
accepted is now saying, the FDA itself is saying, I'm not sure
this is just as safe as we thought it was.
Let's look into it. In fact, they pulled a few
things off the shelf, a few older chemical sunscreens
because they provide no benefit and they had some consequence in
the studies looking at interference with health.
But it's always, especially in the US, it's always 2 steps
forward and then a half a step sideways or back, you know?
It's like 10 years after something has been used by
millions of people, everyone, they then realize that it isn't
safe. And so they they've come out
with this statement and they've pulled a few of these chemicals,
but many of them are still being used.
Yeah. Because there's.
So lobbying in the United States is really, really, really strong
and unfortunately everything is still a business.
So the big players that benefit widely from keeping certain
things on market have a have deep pockets.
So you can convince governing bodies to do or not do certain
things based on whose financial interest it is, right.
So a lot of these things that are a problem everywhere else in
the world, which have been pulled from many other
countries, are still widely available here.
And in fact, there are certain chemical sunscreens available in
places like Canada and Europe that are much safer, that don't
have the degradation products. But we still can't get them in
the USI still I've heard about. These these like new UVUV.
They're filters, Yeah, I still I'm skeptical.
I like the old mineral, mind it from the.
Earth. Pride and true because it's
like. Blocker, might we possibly find
out about those? I agree, yeah.
Whereas physical blockers essentially function like
clothing where they sit on the surface of the skin and they
shield from UV. So if you're going to pick
something, pick the old time tested, you know mine from the
Earth ingredients. I'm glad you mentioned that.
I feel like we have very similar approaches to sun exposure, like
finding shade is important after being in the sun for a long
time. Like you said, you will never
burn in the shade, wearing protective clothing, wearing
hats. But then for the times that I
may be like in the water or just in the sun for extended periods
of times, I will opt for a physical barrier sunscreen.
Non nano zinc and we actually are launching one soon, a
sunscreen of our own. Amazing.
Congratulations. Thank you.
Thank you for something that's been in the works for so long.
Amazing. Because like we talked about,
it's considered a drug by the FDA.
So the processes for testing and whatnot totally take forever.
But yeah, you wanna take a look? That's awesome, love the
packaging. Thanks.
Let's see. So right off the bat, it has a
really high zinc concentration, which I like because oftentimes
we don't get enough sunscreen product on our skin or active
ingredient on our skin. So the lower concentrations of
minerals tend to not be as protective as the label
suggests. I love the inactives.
There's very few of them. All of these my kids can
pronounce. I'm just going to feel this.
Yeah, it has a bit of a white cast, but not quite as bad as a
lot of other zinc based sunscreens.
This is awesome. Particle size is really uniform,
the zinc particle size. So it's still non nano, it'll
still sit on the surface of the skin, but the white cast is I.
Love the feel, love the smell. I would put this on my kids.
Yay for sure. Great product.
Yeah, yeah, totally awesome. Congratulations.
Thank you. Thanks so much.
I think it's nice to go back to fundamentals.
I love the that's probably the highest concentration of zinc
I've seen in a very long time. It's great.
The inactives are very straightforward.
They're biologic, they're organic.
I would I would put this on my family for sure.
Amazing. Yeah, let's transition to
internal sun protection. Sure.
Are there certain nutrients or foods that people should be
aware of in terms of giving your body the best defense possible
from an internal perspective? Yeah, I love that.
So something that's not commonly known about is things that you
can consume that will protect your skin from the inside out.
Whereas in many other countries, particularly in South America,
this is a well known phenomenon. There's several ingredients.
There's actually a plant that I love and recommend for all my
patients called polypodium, and it's from a Fern in the Amazon
rainforest. And this Fern was found when we
studied a group of indigenous people in the Amazon that would
consume this Fern before they went out on fishing expeditions
on the Amazon. And if they knew they were going
to be out for, you know, several days, they would take this Fern
and they would eat it, and it would protect them from burning.
So it's essentially like an internal sunscreen or an
internal sunshield. So that was identified to be
polypodium. And I recommend that literally
for everyone, for anybody who wants another form of sun
protection, if you're going to be outside, if you have sun
sensitive skin conditions. I know I see a lot of young
women with melasma. We used to call that the mask of
pregnancy. And it's this discoloration
that's so sensitive to sunlight. It's extremely sensitive to not
only UV, but also visible light. And sunscreens don't do a great
job shielding the visible component of light, whereas
polypodium does. So there's a lot of things that
we can consume or take orally that will actually improve the
Wellness and and vitality of our skin.
And there's a lot of science behind this.
It's not just assumption or opinion.
There's a lot of published data behind all of these ingredients.
I help formulate a product called Sunpowder, which is what
I recommend for my patients. It's it's a daily drinkable skin
supplement. It's the first of its kind in
the market that has all of these ingredients at the clinical dose
needed where you just mix into water and drink once a day.
And the premise behind this is if we're doing stuff to our skin
from the outside, if we're protecting it for shielding it
and sheltering it, at least let's give it a fighting chance
from the inside with evidence based ingredients to help reduce
sun damage, sunburn risk, skin cancer risk and premature aging.
Yeah, absolutely. It's creating resiliency from
the inside out. Yeah, we actually have a
clinical trial that I am conducting now at our practice
that looks at patients who consume this before and after UV
exposure. So it's not just, you know,
there's good evidence and science behind it.
It's not like a marketing gimmick or ploy, but there's
many things that we can learn from other realms, the Wellness
realm, you know, nutrition, other societies.
We found polypodium in the Amazon.
You know that's. Fascinating.
How close to the sun exposure did they consume this to get the
protection? So if you know you're going to
be out for a long period of time or like let's say you're going
on vacation for a week, we found that it builds up tolerance when
take it a week before. But say you don't know and
you're going to be out hiking 2 hours before you can consume
this, and I'll give you some sun protection.
It double S the time that you can spend outside before your
skin burns. Wow.
It's not. You've tested this.
Oh, yeah. There's a lot of data.
There's ten years worth of data behind.
Yeah, it's it's awesome. And it's not a replacement for
sunscreen. Sunscreen has its role in
protecting your skin from the outside in.
Shade and shelter protect your skin from the outside in.
But this is a way to increase your skin's resilience to UV
exposure. I remember seeing something like
that on the website. There was some bold claim.
I think that was it. Yeah, it increased double S the
amount of time. Yeah, double s the amount of
time, yeah, that's why. And especially if you, if you
know you're going to have like a event coming up or a trip or a
hiking, you know, or a fishing trip or what have you.
Yeah. Can starting in a week before
increases your skin's UV tolerance even more.
Wow. Yeah, it's.
I love that it has astaxanthin. Yeah, that's an ingredient we
use in a lot of our topical skin care products and our plumping
serum, our Antioxidant bomb. It's just an amazing antioxidant
for the skin. And it's not well known in the
skin care space. So for some reason it's it's
like overlooked but well known more in the Wellness, health,
nutrition category. There's several really good
studies that looked at actual objective changes in skin health
and appearance with astaxanthin dosing anywhere from 2 to 12
milligrams and you saw improvement in tone, texture,
elasticity, firmness and collagen production.
By taking it internally. By taking it internally.
So we added a full clinical dose of that.
Amazing. It's it's an amazing
antioxidant. Nobody talks.
About right, right. And we have it here, actually,
yeah. Let me try it.
Cheers. Cheers.
Sorry I didn't make a liver smoothie for you next time.
Next time. This is Yeah, this is our first
year of flavor. Yeah.
I figured if my kids will like it and anybody can like it.
Yeah. Thanks.
So. If someone's taking taking like
a multivitamin will anything, well, is it OK to take this at
the same time? So everything is water soluble.
Everything is at the right clinical dose but doesn't
interact with any medications that we know of.
There's also bio active collagen in there, there's hyaluronic
acid in there, vitamin C, glutathione, a few other
goodies, but doesn't interact with anything you take.
What about foods to avoid? Is there anything that you would
recommend people not consume if they want to increase their
resilience to the sun on an internal level?
So that's, that's a tough question because we haven't
identified foods yet that will necessarily increase your
susceptibility to sunburns or sun damage.
But we do know foods that will weaken your skin's immune system
and make your skin health worse. And what do I mean by this?
So we've known for many, many years, and I practice this in my
practice, that certain diets, certain foods will improve skin
disease. We can improve eczema, we can
improve psoriasis, we can improve acne.
These are quintessential skin problems with diet.
Will they cure them? Not necessarily per SE, but will
they improve them? By far.
I've never heard a dermatologist say that.
Oh, it's really. And I struggled with acne in
junior high high school. I remember point blank asking my
dermatologist, is there anything I can change about my diet or
lifestyle that will help this? And she said no, it is purely
genetic. There's nothing you can do.
Just keep taking these antibiotics on and off.
No, no. For years and years and years
and putting these creams on your face.
No, SO I'm sorry about that because we we do know and that
evidence has gotten better and better over the last several
years. And fortunately I trained up at
Stanford, they were very forward thinking and not just medicine,
but also identifying other causes that can improve skin
health. That's not just give a drug.
So we learned this during training and there was great
evidence behind it as we as we got better in understanding skin
disease. But we know for certain high
glycemic index foods, high inflammatory foods and non fat
or skim dairy products will worsen skin disease.
Now everybody's scratching their head.
They've heard dairy or the controversy behind dairy.
But a really nice study came out of a very good university in in
Pittsburgh that showed that actually it's not dairy itself,
but it's the emulsifiers that we put in non fat or skim dairy
products to give it the mouth feel of full fat that triggers
the worsening of acne. Whole fat, whole whole milk
dairy products didn't. Non fat and skim dairy products
did. And you can replicate this in
clinic. You can tell patients I wouldn't
recommend to do this but you can tell patients if you go on a non
fat dairy product watch your skin will get worse and they do.
But when they go on a full fat, or what you know my parents call
is natural or normal, they go on a full fat dairy diet, their
skin disease improves. Interesting.
Yeah. Do you do you think there's a
difference even in the category of whole fat between raw versus
pasteurized? Good question.
I don't know if there's evidence to it yet.
I think I would presume the live version would tend to be more
beneficial and we're that's touching upon a very interesting
topic and that's the gut microbiome, the skin microbiome,
the immune homeostasis between them.
But I would presume that the raw version would be a little bit
better. Now, there's an asterisk to that
because pasteurization has been a problem, but it's also been a
benefit in, in many settings across the world, the quality of
food and food services is not uniform.
So for for me to say, you know, raw is great, maybe great in
places where we have good, you know, farming quality, good
animal hygiene, you know, good techniques to get raw dairy
products. Perhaps in other parts of the
country or other parts of the world, the quality is not the
same. That's where some illnesses come
into play. But I don't know yet.
I think give it 10 years. And if somebody studies that, I
would bet that the raw version would be better than the
pasteurized version. But for sure we know high
glycemic index. What does that mean?
Sugary foods? You know, my mom always told me
don't eat that candy. And I was like, as a kid, I'm
like, mom, what are you talking about?
And I'm like, don't eat that candy to my very own kid because
we know not only does it it's not good for you, but you
actually see skin disease get worse.
And the other thing is we talked about inflammatory foods.
So what are inflammatory foods like what this definition of
anti-inflammatory versus inflammatory?
Inflammatory foods tend to be ultra processed, tend to be
heavy processed grain based diets and they tend to be full
of oils or fats that were that are not what I call biologic,
meaning seed oil, heavy preservative heavy foods.
These tend to be more inflammatory.
What and why inflammatory foods are a problem is, and we have to
understand our gut is a whole other ecosystem that we're just
starting to understand. You know, and there's amazing
labs that are just looking at what the gut does.
And the gut itself plays an incredible role in our skin
health. And that's because the
microorganisms that we have in our gut metabolize our food.
We consume our food and the nutrients are pulled by the
microorganisms that reside naturally in our gut.
Those microorganisms have preferences as what they can
metabolize and what they cannot metabolize.
So when you feed your body things that aren't meant to be
digested regularly or that our ancestral bacteria can't digest
naturally, the metabolic waste products that they produce tend
to be inflammatory. They trigger an immune response
that wouldn't be triggered. So we see that the first place
we see that is in our skin. Psoriasis gets worse, eczema
gets worse, your acne gets worse.
And then you see it in other things too.
You know, patients who have joint disease are arthritis, you
know, osteoarthritis, rheumatoid arthritis.
They'll say their joints hurt more when they have a pizza,
beer and you know, donut diet as opposed to animal proteins,
fruits and vegetables. You know, farm to table style.
Yeah, I love that. I mean, you just touched on so
many important things like the skin, it's a part of our body.
And it just makes sense that when these things show up, we
should view them as warning signs 100% and opportunities to
tune in and think, OK, what what needs to be corrected here
versus the more traditional Western model of just masking
everything. And it's really refreshing to
hear you say to say that as a dermatologist and to hear that
hopefully things are maybe starting to shift within the
field of dermatology for sure into looking at things more on
an internal level versus just covering up symptoms with like
steroid creams and antibiotics and all those.
For sure there's a time and place for everything.
I think with severe disease of any kind, you can't replace
certain medicines with lifestyle changes.
But to ignore lifestyle changes and negate them and not playing
a role in our health is craziness.
One of the things that drove me into dermatology and one of the
things I love about our skin is you can see right away the
status of your health. Very rarely.
How often has somebody come up to you and say, how's your liver
doing, you know, or how is your heart health?
We, we don't really see that day-to-day, but I can see just
looking at your skin, how you're doing.
I can see whether you're I'll, I can see whether you're, you're
glowing, you're healthy and vibrant.
I can see if your hair and nails are growing, you're probably
doing well internally. If you're sick, there's changes.
I can see if you're in, if you have immune dysregulation, I can
see it in your skin. If you're inflamed, I can see it
in your skin. So listening to our like
biosensor, which is our skin, is an easy way to say, hey, let me
tweak this. Or maybe maybe I need to go
outside, or maybe I need to change my diet a little bit.
Maybe having doughnuts for breakfast.
Probably not the smartest idea though.
I'd love me a doughnut. I try to minimize it, you know.
Going back to sunlight, our philosophy is that there are so
many benefits of getting adequate natural sunlight.
What are some of those benefits that the Sun provides for us?
So completely agree. Light in particular is medicine
and we we use light every single day in dermatology.
Sunlight itself is like the most original ancestral form of light
that we have. There's a component of physical
Wellness that we get and a component of Wellness and mental
health that we get that may be less measurable.
But right off the bat, the discussion about vitamin D is
really important. We get vitamin D from sun
exposure or supplements. I tend to find sun exposure to
be more natural form and I tend to recommend it for everybody.
That being said, I would, you know, listen to whatever your
doctor suggests in terms of what you need medically.
But I love being outside 20-30 minutes a day, morning or
afternoon, just enough to stimulate my skin's ability to
produce some vitamin D. That's right off the bat.
We know that sunlight, particularly certain wavelengths
of sunlight, can modulate our skin's immune system, and we've
harnessed that to actually treat skin disease.
So when patients come into my office and many other practices
and they have psoriasis or they have eczema that isn't
controlled, or they want a natural source, I actually use
phototherapy. And phototherapy is a very
precise wavelength of light that we learned from many, many,
many, many years ago where patients would sit and bathe in
mud and get sunlight to treat their skin disease.
And we would see this, you know, in the Middle East very
frequently. We would see this in other
countries where patients were instructed to go lay in the Dead
Sea mud, rub it all over their skin and lay outside in the sun
to improve skin disease. When we studied that we we found
that actually light will modulate our skin's immune
system. It will actually calm it down.
So I have many patients who, you know, self medicate by going
outside and getting some sun and their skin disease gets better.
So even in the office, we utilize light to treat a variety
of conditions, you know, even things like vitiligo where
patients lose skin color because of an autoimmune condition.
We utilize UV light, very specific wavelengths of UV light
to treat their skin without the need for medicine or pills or
certain drugs. So light itself is totally
medicine. I myself have psoriasis and
during the summer, my psoriasis gets better.
I'm outside longer, I'm getting more UV on my skin.
Now I'm not burning. So I know my skin's tolerance
and how much I can get. And everybody should know that,
for example, I can be outside for an hour before my skin turns
red or burns. So I'll be outside just before
that. If you, you know, you tell me I
can go outside for 20 minutes and then my skin turns red.
I would say go out and for 15 minutes and you'll be fine.
So I love, I love, love, love sunlight.
I love light. We utilize light for many
different things. And in fact, being in Los
Angeles, being in the 21st century, cosmetics is very big.
And we utilize light sources for cosmetic treatments as well.
All of the lasers that we use in skin come from understanding how
light modulates our skin. We call it photobiomodulation so
we can harness specific wavelengths of light to treat
certain parts of the skin. Now I brought this up being on a
farm, you know, too much of a good thing can be a bad thing.
You know, leave some animal hide outside in the sun for 30 days
and it starts to turn into leather.
So I'm not saying go outside indefinitely and don't do the
stuff that's trending now on social media, like the peroneal
tanning and the people laying outside with, you know, the legs
up in the air. I don't think that's the
smartest idea, but I think getting sun is great.
Yeah, I do think it's important to have a healthy respect for
the sun and recognize that it can cause damage in excess.
Yeah. And that's why recently I had a
screening, a full body screening for moles.
Like I, I'm a Molly person. I have a lot of moles and I
hadn't had one in a really long time.
We're launching an SPFI was like, I feel like I should just
do this for sure. And it was.
I was actually really surprised. It was really quick and easy and
everything came back good. Excellent.
But what are your thoughts on the importance of like regular
screening? Love it, love it.
I'm biased. I am a dermatologist and a skin
cancer surgeon. So for me, catching things
earlier, and this is, this is true across all of medicine, but
catching things earlier results in better outcomes.
Skin screenings are so easy to do.
You mentioned it. It's not invasive like getting a
colonoscopy or ACT scan of your lungs or something.
It's quick, it's painless. There's no added medicine that
you need. There's no added procedure.
You don't need to go to the hospital for this.
You don't need any anesthesia for this.
And any good dermatologist should be looking at your skin
from the top of your scalp to the bottom of your torus and
every square inch because in essence, you can develop
something anywhere. You know, I talk about this all
the time, but Bob Marley died of a Melanoma on his toenail, and
he would have never thought that he was susceptible to that.
Actually, he thought it was a soccer injury and a bruise.
So any, every square inch should be examined.
But it's so easy to do, and I would recommend it because best
case scenario, nothing shows up. Worst case scenario, you find
something and you find it early and you can treat it.
Yeah, she had like a little a little thing.
Yes, dermatoscope. I love that thing.
What does it do? It helps us identify features
under the microscope that will tell us, OK, is this harmless or
is this something that needs to come off?
So it's just a little magnifier. Yeah, yeah, it's, it's pattern
recognition. You learned this in training.
And it was like coming up with like a yes or no.
Oh no, we're. Almost there.
We're not there yet, but yeah, we're almost there.
There's like that. And that's the realm of AI in
medicine and, and the interface between computers and humans.
But what we've learned in training is pattern recognition.
So we look at look at this under a lighted microscope.
We call it epiluminescence transmicroscopy, a fancy name
for a shiny microscope on your skin, and we can see certain
patterns or features that tell us with good confidence this
needs to come off or this is a harmless mole, or a pimple or a
growth. OK.
And if people wanted to do any sort of like self checking, are
there certain signs that people can look out for in their own
moles if they're just looking at themselves?
Totally. So we talked about skin cancer
is the most common cancer in the world and one in four Americans
will develop this at some point in their life.
So it is something to, you know, pay attention to the the
earliest and most common sign is a pimple or a bump that won't go
away in a month. So if you think you have a
pimple or a bug bite, mosquito bite, ingrown hair, what have
you, they usually resolve within a month.
If they're there longer than that, see your dermatologist.
If you're washing your face or rubbing your skin and you notice
something bleed easily. That's the most common sign of a
basal cell carcinoma and that is something that can be easily
treated when caught early. See your dermatologist.
In terms of moles, we look for the ugly duckling or something
that is new or changing. So if you have a lot of moles,
you've gotten a sense of your skin just every single day
showering and changing what your normal pattern looks like.
And I don't expect anybody to to make a diagnosis.
I don't expect anybody to tell me this is harmless, this is
malignant, etcetera. But you know, an ugly duckling,
when you see it, you're like, hey, this mole looks different.
This is catching my eye. You should see your
dermatologist. And something that's easy to do,
and I recommend this for anybody who has a lot of moles is mole
selfies. It's like literally what it
sounds like is have somebody or you can do it yourself.
Take a good resolution photograph either on a
smartphone or a tablet of areas that have a lot of moles.
And once a month or even once every other month, just match
them after the shower and you can say, hey, that mole's there,
that mole's there. This is new.
This isn't in the photo. See your dermatologist.
I've heard you talk about how moles can shift and change with
hormone fluctuations, and I've noticed that pregnancy I've seen
that. Is that something?
Is that like a red flag or is that just normal?
That's so. That's totally normal.
So moles are under progesterone response.
So you can see this in women who are on birth control and women
who are pregnant in moles will get darker.
They can develop what's called the linea negra or dark streak
on their abdomen. And that's also the same reason
why melasma shows up against darker during pregnancy or when
you're on birth control. So our pigmented friends or our
freckles or moles can get darker with pregnancy.
Now, that doesn't mean you get a carte blanche to say, hey,
anything goes. Anything dark during pregnancy
is normal. If you notice a mole that's
changing faster. If you notice a new mole that
wasn't there, still see your dermatologist.
But definitely things can change during pregnancy and they
regress after delivery or if you stop birth control.
Anything that stops the progesterone response, the color
will lighten over the coming months.
I love that you call yourself the anti dermatologist.
Dermatologist. I mean, I agree with that.
And I mentioned earlier a little bit about my experience and
going to a dermatologist for my acne in junior high high school
and was pretty much prescribed every Band-Aid under the planet,
some of which helped for a little while, some of which I
think caused more damage than if I had just done nothing to begin
with. And I'm curious as a
dermatologist. What would you say most
dermatologists are getting wrong, whether it's a mindset or
a practice? What's like the biggest thing
that you think dermatologists are thinking about in the wrong
way? I think this will apply to all
doctors is not listening to their patient because we're
trained to think that we know better and we may know disease
better. We may know maybe
pathophysiology better of how disease develops.
But you know your body way better than I will ever know it.
So if you come in and tell me, hey, like my acne is flaring and
I don't sit down and say, hey, like, what's your life like?
Oh, well, I started a new job or I, I'm in finals week or you
know, I got into I, I was divorced or what have you and I
don't take into consideration, Oh, my diet is terrible.
I started a new medication. I don't listen to you and find
out what's going on in your life besides saying acne is caused by
this, therefore treated with this.
I've done you no service. So the the far and beyond the
simplest thing that we can fix is listen to the patient.
In addition to that, I think it's keeping an open mind to
alternatives that may have not been taught in strictly in
medical school that have been tried and true in other
societies, other cultures, and maybe even in our own population
that isn't in medical textbooks, but works right.
My, it's funny, the older I get, the more I realized my
grandparents and parents were right about a lot of things that
I like waved off during my training.
You know, you go through college and you go through medical
school, very science oriented, very, not to say westernized,
but westernized. And then you come out, you
practice a little bit, you see some bad things, you see some
good things and you're like, wait, fucking they were right
about this. I can't go out in the sun.
It'll make me feel a little better.
I shouldn't eat that. They're right.
This is bad for my skin, bad for my health.
But because it wasn't in my textbook, I didn't know about
her or think it was true. So keeping an open approach or
an open eye, like I talk about the sun all the time, all the
time. I'm outside all the time.
I got 3 kids, I'm running around outside all the time.
They play a lot of sports. We're outdoors.
I know the sun is safe within a reasonable amount.
I, I respect it, I love it. I don't abuse my sun exposure,
but it's almost blasphemy for me to advocate sun exposure as a
dermatologist. But I don't think there's
anything wrong with it. So keeping an open, an open
perspective and an open viewpoint will change medicine
for the better. Before we wrap up, I have to ask
you about spray tans. Yeah, because I recently, So I,
the last time I got a spray tan was maybe thing for my
Bachelorette party, so a long time ago.
And I recently went on a trip with a good friend.
She had just gotten a spray tan. It looked so good.
So I had my assistant do some research in looking into what's
actually in a spray tan. And a lot of these places they
advertised to be organic spray tans.
I was like, what is that? What's what's in what are the
ingredients in these things? And she she came back to me with
several ingredient list and it was like full of petrochemical
red 40 yellow 5, like all the dyes.
I'm like, how are these things like quote organic?
It's crazy. Is there such a thing as a
non-toxic or what you would consider to maybe be like less
toxic or safe spray tan? I if we're going to pick
tanning, OK, And I don't think tans are a, are a bad thing per
SE. I think the problem is the
pursuit of a tan. I think I tan very easily.
That's what my skin's natural biology does.
In somebody who has blonde hair and blue eyed, their skin will
not naturally tan. So their pursuit of a tan
creates a problem. If you're going to pick between
tanning, I think spray tans are safer than trying to get a tan
in a tanning bed. By far.
I don't think anybody should tan in a tanning bed.
There's nothing beneficial that you'll get from concentrated UV
exposure. If you get a tan inadvertently
because you're outside in the sun, you're on vacation, you're
hiking, you're playing with your kids, I think biologically that
tends to be better than chemical spray tans or artificial tans.
But for the most part, the way spray tans work is it's a
chemical that goes on your skin that undergoes an oxidative
process, and in that oxidation, it changes the color.
It's essentially paint. You are for sure.
Do I?
Do I like it? No.
Do I, if I had to pick the lesser of the two evils because
I know, for example, I can't convince a group of women who
are about to have a great event or a wedding or a Bachelorette
party that they're going to do it anyway?
Pick the spray tan, not the tanning bed.
I think we talked about this concept of organic and natural,
right? And I bring this, I bring 2
important things up. Oil from the ground is natural.
We wouldn't drink it, right? But it's natural.
Poison oak is organic and all natural.
I wouldn't rub it on my skin, right.
So we've, we've learned to market certain terms to the
consumer to make them think it's safe or completely harmless.
And it's not, you know. Yeah, not everything that grows
from the earth is safe. Yeah, run into a, you know, run
into some poison oak, you'll be scratching for dates.
Well, you know, if you avoid it, is it any problem?
No, of course not. You know, but you have to be
very cognizant as to what you're doing.
Spray tan is not a natural thing.
You cannot farm this. You cannot grow this.
So, you know, it's some chemical derivative.
But I also tend to be pragmatic. You know, people are going to do
things and if I can at least guide them in the direction of
the least damage. If it's every once in a while,
it's OK. If it's a daily or monthly
thing, now we're talking about inhalational hazards.
We're talking about certain chemicals that will be on your
skin and may be absorbed over time.
A lot of stuff that's just in the Gray area where FDA doesn't
really regulate. We don't know what we're doing,
so figuring out how often you're doing it once in a while may be
OK. If it's becoming a routine
thing, don't do it. Gel manicures are also getting a
lot of heat and questions right now.
Are these contributing to skin cancer?
Great question. A lot of controversy, a lot of
virality and videos on social media and and even advisory
statements from dermatologists about gel manicures and why
that's a big deal is that often times gels have to be cured with
AUV lamp where you stick your hands and get UV exposure to
cure the gel onto the nail. We theorize or at least discuss
that probably getting UV on your fingernails is not the greatest
idea. And we've thought, at least
dermatologists collectively have thought that this increases the
susceptibility for certain skin cancers under the nail.
Now my practice and myself, we've developed a reputation for
doing the most nail surgeries and most of and probably all of
Los Angeles. So I see a lot of Melanoma and
squamous cell carcinoma of the fingernail.
What I do know and what the evidence suggests is it's not
exactly straightforward. The majority of squamous cells
on the fingernails actually arise from HPV, not gel
manicures. And melanomas that occur on the
nail or underneath the nail tend to have a mutation profile that
is not directly UV exposure related.
So it may not increase your risk directly, but what we do know is
that it ages your hand prematurely when you're sticking
it under that UV box. We know for certain that UV
exposure will wrinkle and pigment your skin faster than if
you didn't. And one of the quickest places
people see age is their hands. So if you're what a lot of my
Durham colleagues do and what I recommend for, you know, friends
and family if they like getting gel gel gel manicures done, is
wear a glove protective glove. Usually the gel itself is
protected from UV penetrating to the nail bed.
I'm not worried about that. And if you're worried about
aging or wrinkling, wear AUV Protective Glove.
I've never heard that HPV can cause cancer under the nail.
Where else can HPV cause? Cancer.
Great question. It's the number one cause of
throat, head and neck throat cancer in the United States.
It's the number one cause of squamous cell carcinoma of the
general region in both men and women.
Historically, it was the number one cause of cancer deaths in
young women ages 25 to 45 is cervical cancer.
That's changed a lot over the last 10 years, partly due to
Gardasil, partly due to awareness, partly due to early
detection. But HPV is a nasty little virus.
It most commonly shows up as warts, warts and kids hands,
feet, you know, and those are benign, but they come with an
invisible sibling, which is the high risk strains, which can
cause a lot of cancer. I do a lot of posting about this
and bring awareness because people don't recognize that this
is a source of skin cancer and they always blame the sun.
And I, you know, I probably operate on half a dozen skin
cancers in the general area and, and on the hands and feet a
month. And none of these are sun
related. So you don't blame the sun?
By looking at the cancer, whether or not it's sun related.
Yeah. And you can, if you even wanted
to, you can go further and test the the tissue for for certain
features that suggest whether this is from the sun, HPV,
etcetera, etcetera. Doctor Te'o, thank you so much
for being here. The world needs more
dermatologists like you and I think people are going to get.
A lot out of this. Conversation.
It was so enlightening. I had a blast.
Thank you for having me as we talked about a lot of fun things
and if I can be of any help to anybody, please don't hesitate
to reach out. We have a small social media
presence. You can message me, you can text
me, you can e-mail me. Any which way I can help anybody
listening to this, happy to help.
That's so generous. And where can people find your
sunpowder? Oh, appreciate that.
So it's on our web sitesunpowder.co.
All the science is there. All of our clinical trials are
there. The data is there.
There is a small Instagram handle called Drink Sunpowder.
You can find out more information.
I have a small social media handle.
It's just my name, last name, MD.
If you want to see what we do, what we, what we provide in our
practice, and honestly just skin health information, I'm happy to
help. Well, we'll have to have you
back sometime because there's so much we didn't cover today.
We covered the sun, but there's so much more that I could.
Yeah, I can talk for hours. Yeah, we'll have to have you
back. Thank.
You thank you, of course.