there are some fabulous and mega popular dermatologists online and if I were into views I'd be interviewing one of them right now but I am interested in who the sinist are who toil away in Labs figuring out what really works and is safe among the treatments that companies try to sell us and dermatologists recommend for that we go inside a lab at Harvard to meet anamanda NOA her papers are widely admired but she's never had time for social media so you said something that really caught my attention which is that skin creams 99% of them
work on hydrating the cells to cause the cells to expand but they don't actually have a long-term effect on the skin or how does that work when you get to your favorite skin cartin your favorite skin cream what is very exciting for you usually is that within the first week of use you see a change and that's what we like that's what most of the consumers actually want but let me explain to you what that really means probably 99% even if not all of um skin cream provide hydration that's actually good hydration is good because
as we age we start to lose moisture for our skin but what does hydration of the skin means in terms of appearance when you look at the mirror imagine a cell which is starting to to shrink a little bit because he's losing moisture all of a sudden you provide moisture boom it expands and why expands it levels your skin and also it covers things it covers spots it covers delated blood vessel spread and it's really just a cover it doesn't affect actual skin health and that's what our goal should be I see so as soon
as you stop using it you look bad again so you go to C going by in the tube of itct skincare products are it must be an enormous Market let's start with sunscreens they're fairly complicated too right I mean there's mineral sunscreens so when I was growing up I was a caddy at a country club as a kid I always had a burn scabby nose and then I skied and had a burn and scabby nose and eventually somebody convinced me to put on zinc oxide so I went around with a white nose all the time
and that prevented me from getting a red scabby nose and now there's mineral sunscreens but they're not they don't visibly reduce light but the minerals somehow block the UV that is correct currently the sunscreens we have the broad spectrum sunp they block both types of UV light UVA and UVB and that's important and they work fairly well but our relationship with sunscreen is funny one every one of us knows that they should put sunscreen those who do it many will do it and forget about it doesn't work that way it's unfortunately we hav found the
sunscreen in a PE which you take once a week and it works you have to be diligent and put it every hour every hour even every hour every hour I know that the ru is every two hours but part of the sunline part of the spectrum of the sunline is so dangerous UV UV light correct we should be overprotecting ourself here I am an advocate for over protection complete advocate for over protection also because staying in the sun is addictive it's been shown scientifically by excellent scientific group here on this floor similar to Opps sunline
is addictive so that's how sunbathing becomes your drug of choice yes you go to the beach and you lie on the beach and and the UV lights the artificial UV lights the tanning salons the same addictive they are the same do they give you the same UV exposure as the beach does or is it higher it depends but in put a lot of Protections in but what kind of protections they change a spectrum which UV you're exposed to that there are no Burns however it's very simple if you 10 your DNA is damaged it's as
simple as that there is no tanning without damage of the DNA cancerous damage of the DNA when you get a tan it's an injury response to DNA damage a lot of people think of skin injury solely as it relates to Sunburn and that is what they're hoping to get away from with the tan but they're replacing one form of skin injury with another the tanning bed just gives you really really high deadly doses of UVA Ray which lead to premature aging suppress the immune system and skin cancer in fact it is estimated that indoor tanning
is responsible for around 419,000 skin cancers a year so have all kinds of Dermatology problems I've had six skin cancer operations I have skin graft on the side of my nose there so I have to see the dermatologist all the time every six months I have I have Fair freckled skin I have a reddish mustache I have blue eyes I've lived my life in the sun doing Iron Man competitions where the sunscreen sweats off and you're you swim it off or whatever and I get burned so not only do I talk to dermatologist but I
watch them on YouTube and they get millions of views and I always wonder if they really know what they're talking about how much this information is there out there when you're watching the internet and listening to dermatologists do you ever cringe do you ever watch them do you know how well educated they are we have to give credit to the dermatologist because the Dermatology office is the place diagnosing and curing the most cancers in the world so there is no other place which discovers and cures more cancer than the dermatologist and you're saying that because
skin cancer is so prevalent compared to other cancers and because it's visible because when you go to the dermatologist they can see it that's huge they don't get much credit for that that also needs to be S because they're not oncologist they don't really cure the deadly metastatic cancer but they prevent it from becoming qu I see and that's important that's why skin checks are important uh annual skin checks and and that's why visiting the Dermatology is important at the same time what we have to remember is that the actual discoveries which are changing skin
health and are finding a ways to diagnose and cure cancer are done on on the bench by skin scientist like yourself scientist so you know how the sausage is made right when I get really on the vir of intervening with my strong opinion is when I hear someone say oh I I saw on the internet this works great for skin or oh I heard in this and this forum a dermatologist said that you should use this or this we live in a world where evidence matter that means that we go into deep into science we
learn what skin scientists do because they look at this themselves they know how they function and then we go to the next level where we have this large trials this is evidence-based Dermatology not a single person did that or works or not a single dermatologist said well I have a patient who used this and this and never got cancer this is not what we should be doing no anecdotes yes anecdotes are everywhere on the internet consumers seem to love them so what do you say to people who say yeah but applying sunscreen every day these
dermatologists who make apply sunscreen every day they end up harming your health because the sun has other beneficial effects like everything is you have to put it on the scale it's it's a simple risk benefit analysis I see let's talk about the benefits of the the sun this is why sunlight is addictive evolutionary we had to look for the sun to make vitamin D because without vitamin D we wouldn't survive so we were programmed to look for the Sun and that's why we feel good when we are under the sun my dermatologist says for someone
like me I have to put sunscreen on first thing in the morning because in the house I sit by a window and things like that and UV comes streaming in the window I notice my photos on the wall are all faded when they're close to the window from UV light um and those are supposed to be UV protected photos just like I'm supposed to be UV protected with sunre so car windows do you put the UV protection shields on your car windows what we have to take into consideration is what type of skin do you
have my is not that sensitive so I don't I'm not that careful but people with really fair skin like yourself I would be because because again over protection is here Justified your window glass can filter out UVB but not so much UVA and that's why I made a tick talk the other day that you should wear sunscreen in the car cuz a lot of my American patients have more photoaging skin cancer on the left side of their face whereas my UK or Australian patients might have more sun damage on the right side of their face
and I see that in clinic very much so um and also left arm right arm so for example there's a famous photo of a truck driver he drove a truck with the windows closed for about 28 years the left side of his face received direct sun the right side received indirect sun and you can see the massive difference in wrinkles so diet carotenoids that you get from carrots and things like that they make your skin a little bit orange I understand you can get up to a fair P fair skinned person like me if you
eat a lot of fruits and vegetables and things you can get an SPF factor maybe of two or something like that is that about right something like that yeah but I'm someone who tell you that you're still a big risk with two so if you can imagine an SPF of two it sort of means that it will take twice as long to burn and four is four times as long to burn SPF in the United States is only calculated based on how much UVB gets blocked since we really only knew about UVB risks when making
the standards so if you wear SPF 30 the general idea is that your skin absorbs about 30 times less UVB than it would without sunscreen what this means is that in general a high SPF is going to give you better UVA protection Australian and EU sunscreens also give you better guaranteed protection than a US sunscreen one recent study did find that us sunscreens give less protection out of the 20 sunscreens tested in this study 19 of them passed the US test but only 11 of them passed the EU regulations but in general products that are
formulated outside of the United States are going to be using these newer filters but people are I think concerned because they're like oh this doesn't have FDA approval so is it safe but it couldn't be further from the truth these newer actives actually have been tested at much higher standards I use pretty much exclusively for my daily sunscreen Korean sunscreens because the United States has really backwards sunscreen laws we have come so much further in the development of new sunscreen actives the newer actives that we don't have in the United States but are popular in
Europe and Asia they are photostable they're non- greasy they're non-irritating they don't get absorbed by your skin they don't get into your bloodstream I think SPF doesn't matter as much as coverage and durability there isn't as good of a rating system for how long sunscreen stays on your skin and that's sort of problem so sunscreens that some sunscreens wipe off very easily and this is a problem that I had with some of the Japanese sunscreens that I were using is that they just weren't durable they wiped off super easily so even though they were high
SPF they would come off almost immediately so what do you say to people who say skin creams cause cancer they're toxic you know and you should be afraid of them I would say that I've studied for 20 years now epidermal biology which is where you get cancer I have seen with my eyes how sunlight damages the DNA I haven't seen on my watch durable reproducible and that's important that's my one of my favorite words reproducible damage from sunscreen or skin creams I'm not saying I'm a scientist I would never say it doesn't exist but the
sun light damage is so prevalent it's so massive undisputable and we map now every single step of cancer development in in the skin that it's such a convincing story that it really forces us to preach protection so diet matters of course outs say matters more for General Skin Health than for skin for some protection what do you mean by that so prevent wrinkles and things texture texture of the skin my laboratory story that's and I think what you see here is probably part of that project even so we study what type of nutrients are more
beneficial for the skin what what type of nutrients actually promote the ability of the skin of the epidermis the top layer to renew every four weeks and then build the full blown multiple layer structure because what happens when you age a whole Mark of age skin is thinning of the epidermis so the epidermis has you know six seven layers of cells top of those layers are dead cells and this is our barrier and as we age the epidermis tends to thin so less and less layers we ask the question why and we believe based on
what we've studied is that these stem cells which are at the bottom are starting to get tired so they don't have the proper nutrients and elements around to really be able to now produce the six seven layers they're doing they're still doing well but they're going for four or five layers and that's enough for your skin to start look thin now your burial function is disrupted so toxins and and other elements start to get in chronic inflammation starts to be prevalent so we strongly believe here in my lab and I think um many of our
colleagues that your diet is actually able to booster the ability of a tiring tired skin stem cell to get more energy and produce the necessary layers with carotenoids they're the pigments that make a lot of fruits and vegetables the color that they are so beta carotene makes carrots orange and lopine makes tomatoes red and there is a whole spectrum of carotenoids and the cool thing about carotenoids is that when you consume them we accumulate them in the fat underneath our skin and it can change the color of our skin and it's subtle but that subtle
change in color makes a huge difference in terms of how healthy you appear to other people and there's a lot of literature on this where they apply these transformations to look at more or less carotenoid colored images and people find carotenoid colored images of people regardless of the race of the person in the picture or the person perceiving the images they find ID color to be more attractive and this is really fascinating because it's almost as if we're displaying the richness of our diet on our skin that actually goes back to our initial conversation about
moisturizers what a skincare product should actually do is exactly that it should provide more nutrients and more energy to the Bas layer baso layer of the epidermis how how does it get down that low I'll get to that so that it now produce old the layers your skin starts to look younger because the texture changes so when I send that when you look at the mirror within the first week of skin care use and you say wow that work that's not what you should be concerned you should look at your skin 6 to 8 weeks
after you started product and you should say wow now after six weeks I see additional change I see not only this more izing effect but I see a durable change that's the goal that's good skin care product I see back to your question how does it get there that's the problem and that's what we've been struggling with for decades because the skin is designed not to let it get through it so two questions in skincare compounds which really boost the energy of the stem cells and number two how do they get there then a lot
of new technology Oles on formulation of skincare products and and actually skincare companies are doing a lot on that are they successful I would say we are on the right track but long way to go this is why more invasive more drastic measures usually work better such as micro needling device assisted skincare like lasers micro needling is where you poke thousands of little holes in someone's skin it sounds great doesn't it but it actually has some really unique benefits the different devices that we have options out there we can control the depth you can go
to like5 mm which is going to basically just break the epidermis layer of the skin to all the way down to like 8 mm I think like the Morpheus 8 gets all the way down to like 8 millim on some of the hand pieces which is outrageously high but most of the time we're dealing between .5 mm in depth and 2 mm in depth depending on what you're trying to Target But ultimately by poking holes in the skin it creates a controll damage and by doing that it activates those wound healing factors in your skin
and does what we call collagen induction we know that the skin is first and foremost like Dr Shaw said a barrier and half the battle of using active ingredients is actually getting them into and through the skin to be effective so the number one thing that actually stops your skinc care products from reaching into the dermis or in the lower layers of the epidermis that you actually want to see the benefits of them is that stratum corneum layer of the skin and so by puncturing it you can introduce new ingredients into the skin as long
as you're being careful Micron needing is actually something where there has been tons of research on it so there's like hundreds of papers on the benefits of Micron needling so you can pretty much count on it being an effective thing for your skin a laser is technically a single wavelength of light that targets an end point and usually the Endo is one of three things red blood cells for redness pigmentation for brown spots and water for collagen production I've always said that the the complement of the two is the perfect marriage because what you can't
get from skincare you get from a boost from in office laser treatments but laser treatments alone are never going to give you long-term results if you're not doing your part at homeless skincare how come Oprah looks so beautiful at 70 she looks like she's 30 it's not just her there are many individuals like that it's great you look like a teenager well I'm not a teenager at all but I will have to say and I get this question very often and my answer is they are procedures which are very successful laser treatments make up a
large part of my cosmetic practice when you do these pre-juvenile Botox injections with a series of preju venation lasers can do wonders for the skin that's really popular in my office I treat a lot of younger patients who are really invested in optimizing their skin and that combo is such a win redness treatment is something that is very near and dear to my heart as someone who has rosacea and who has personally undergone numerous laser treatments to improve it I do clear and Brilliant on myself quarterly when I do my Botox I also do my
clear and Brilliant micro coring is otherwise known as micro exisal skin removal it involves making tiny little punches in the skin using an energy-free needling device it's removing up to 8% of the skin and what that does is it has a tightening effect but it also stimulates collagen production and elastin production so the end result is skin tightening and subtle soft Improvement in fine lines and wrinkles through induction of collagen synthesis so I did an interview with the surgeon Who removed my various lesions and he said you know I go out unprotected in the mornings
and the evenings I'm a surfer in San Diego and I feel like the spectrum of light at that time of day is actually probably a little bit healthy I just don't go out when the UV index is over one or two something like that I just checked that any feelings about that I've heard somebody say that UVA is still pretty high in the evening in the morning but it's UVB that goes away in the early morning I would say that definitely is less dangerous to the point that when we do our risk benefit analysis it's
starting to get on the verge of maybe even but a huge Factor would be type of skin so not me not you probably me he's Filipino and so I guess they're half Hispanic half asian yes so he has dark skin yes there is no one siiz fit it it has to be a very conscious choice voice of the individual I think we can make those so I've been bothered about how much we're learning about how significant UVA is in both skin aging and in skin cancers and yet how focused we still are on UVB the
SPF factor is exclusively focused on UVB and the UV index which you see on your weather app is dominated by UVB and we're finding out that American sunscreens are not as effective at blocking UVA here's a graph of of the amount of UVA in the atmosphere versus UVB from a scientific paper I'll clean it up for you it's at the latitude of Dublin Ireland on the longest day of summer when the sun comes up at 5:00 a.m. the horizontal scale is time of day the left vertical scale is the relative amount of radiation they assigned
a one for Peak radiation at noon and zero for no radiation at midnight the red line is UVA note that by 6 am. it has already reached 30% of its Max for the day compared to UVB the blue line which is at less than 10% of its Max for the day at that time so the actual amount of UV landing on us is maybe three times what our weather apps are telling us not only that but look at the scale on the right what it's telling us is the ratio of UVB to UVA is small
meaning 95% of the UV radiation we get is UVA and I'm seeing disturbing recent papers claiming that human squamous cell tumors contain more fingerprint mutations from UVA than UVB we know tanning beds filter out UVB and yet the number of young adults whose deaths are attributed to tanning beds is tragic I know we just published an episode about the health benefits of infrared light and that a good time to get it is before the UV index gets too high but infrared penetrates clo and sunscreen so you can wear a hat and sunscreen in the morning
and still get in for red I don't promote any products on my channel and I don't even accept freebies or donations but I have to say even I am using Korean sunscreens too and I love them the fact that so many people get SOS cell carcinoma makes the actual number of people who die on sell carcinoma huge and we believe that in the next 10 years the number of patients which are dying on metastatic s cell carcinoma of the skin it's going to reach the number of patient which are dying melanoma wow that's crazy it
has been shown that the renewal of your epidermis of the top layer of the skin happens during the night and it's part of our tadian rhythms and that makes sense because this is when you're not being damaged by the SK sun right you give time your skin to repair and then it starts to proliferate otherwise cancerous cells will multiply how long does it take at night do we know it depends it's usually takes the whole night but now when you change um time zones all of a sudden it takes time for you to change your
circadian rhythms and all of a sudden in the first couple of days your cells are multiplying while you might be on in the Sun so that's dangerous so so I stayed up till 1: in the morning reading your papers last night so you're saying I won't look as good on the camera today because I didn't give it enough time to replenish no what I'm saying is that maybe four weeks from now you're going to because it takes that oh I see for the appearance I see oh fascinating
