June 24, 2025 • 29 mins
What if your best skincare tool isn’t in your bathroom, but in your kitchen?
In this episode, Dr. Matt Zirwas, a board-certified dermatologist and leading researcher, breaks down how diet directly impacts your skin. From the link between acne and foods like skim milk and chocolate to the benefits of the Mediterranean diet, he simplifies what really works.
We also dive into surprising dangers in processed foods, like emulsifiers, and explore affordable, evidence-backed supplements like omega-3s, ceramides, and collagen.
No gimmicks, no perfection required, just smart, science-based tips to help your skin glow from the inside out.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
What do you tell people about diet and acne and
what can make it better or maybeworse?
Speaker 2 (00:05):
Yes, so an acne, interestingly, is one of the
relatively unique ones.
So if you want to make a food,a processed food, that has both
oily stuff as an ingredient andwatery stuff as an ingredient,
you got to put emulsifier inthere.
My bet is that, long-term,we're going to find out that
that stuff bet is that, longterm, we're going to find out
(00:26):
that that stuff increases ourrisk for neurodegenerative
disease.
So the individual hairs likebigger diameter and more
resistant to breakage, and itmakes your fingernails stronger
and more resistant to breakage.
Speaker 3 (00:39):
Welcome to Dermot Trotter.
Don't swear about skincare.
Where host Dr Shannon CotTrotter?
Don't Swear About Skin Care.
Where host Dr Shannon C Trotter, a board-certified
dermatologist, sits down withfellow dermatologists and
skincare experts to separatefact from fiction and simplify
skincare.
Let's get started.
Speaker 1 (00:58):
Welcome back to the Dermot Trotter Don't Swear About
Skin Care podcast.
I've got Dr Zyrus back herewith me here today, who's an
expert in everything skin, soI'm excited to have his thoughts
and comments with us.
But if you know Dr Matt Zyrus,you know he's been an expert in
the eczema field for over 20years.
He's written a textbook, he'spublished over 200 peer review
(01:18):
articles and lecture tothousands of dermatologists and
he's been on our podcast beforeto really reach out to you guys
out in the public and ourpatients.
His passion is reallydistilling topics down, making
them into simple concepts so allof us can understand what we're
even talking about.
So welcome back to the podcast,matt.
Speaker 2 (01:36):
Rude to be here.
Dr Trotter, how are you?
Speaker 1 (01:40):
I am doing fantastic and always better because you're
now here with us.
So you know, I think you know,as we've talked about different
things in dermatology.
You know there's really peoplethat are focusing on diet.
Now everything's about what weeat nowadays, whether we're
trying to lose weight, we'retrying to look good, just feel
better about ourselves, and soyou know, I really want to know
your answer to this question Canwe really eat our ways to
(02:03):
getting better skin?
Do you think we can eat our wayto better skin.
Speaker 2 (02:09):
Yes, with some qualifiers, so I would, if you
include so first.
If we say can we get somediseases doing better, yes, and
if you say, if you include, canwe take some natural supplements
, then definitely yes, it goesbeyond just can we get certain
(02:34):
diseases better to?
Can we get people's skinlooking better?
Yeah, there are a number ofreally cheap supplements that
have really strong data.
The biggest thing I would tellpatients about the supplement
stuff if they're expensive,you're wasting your money
(02:54):
Because the good stuff you canget cheap on Amazon, but the
diet by itself I don't.
Maybe, right, Maybe is the waythat I would put it, Maybe.
Speaker 1 (03:09):
No, I agree with that , because really to get
everything you need, or maybe inthe right quantities, I mean,
who can really design a dietthat's perfect around that and
realistically do it every day?
I mean, sometimes you just wantto go to Taco Bell late at
night, right, and you're notgoing to get those nutrients
that you want.
So that makes sense.
So maybe if we can't eat ourway, maybe we can supplement our
way.
But you know, if you look atsort of different skin
(03:31):
conditions, I think one of theones that gets a lot of
attention and maybe diet playinga role is acne.
So I'd love to hear what do youtell people about diet and acne
and what can make it better ormaybe worse.
Speaker 2 (03:42):
Yes, so, and acne, interestingly, is one of the
relatively unique ones.
So with because acne, weactually do have some very
specific like don't eatchocolate and don't eat skim
milk, right, those are the twothings that have really been
shown in particular.
(04:02):
Now the questions become well,why?
Why chocolate and why skim milk?
And we can also add into acnesort of sugar and so high
glycemic index things, and thebelief here is that anything
that spikes your blood sugarsubsequently spikes your insulin
(04:25):
, and insulin can activatesomething called the
insulin-like growth factorreceptor, which is involved in
acne pathogenesis, and so thismight fall somewhat into the
category of hormonal effects ofacne, the category of, you know,
(04:50):
hormonal effects of acne.
And so that's the very specificthings that I would say about
acne, chocolate and skim milk.
We have very good evidence forboth of those.
But then the second part, and itbecomes a really interesting
thing, because when you say diet, people often want a like eat
more avocados, like, which iscomplete, like any simple
dietary recommendation of eatthis, don't eat that immediately
(05:12):
.
You should think thisinfluencer is a moron and I
should never listen to anythingthey have to say again.
So what has been shown withdiet is there's one particular
diet right, the, theMediterranean diet, which is
fruits, vegetables, nuts,legumes and fish, and that diet
(05:33):
is good for everything.
So when people are like, oh,whole food or whole 30 or
anti-inflammatory protocol orwhatever.
Fine, I don't care there.
Maybe it helps, maybe itdoesn't, don't know, but I know
the only diet I really haveevidence helps in everything is
the Mediterranean diet.
(05:54):
Because if you follow theMediterranean diet, you're going
to be eating low glycemic indexfoods, right?
So in in ancient Italy andancient Greece, right, they
weren't eating chocolate.
They probably weren't eatingmilk, right?
So if you're following theMediterranean diet, you're like
it's really easy, that's forevery.
(06:14):
Any time any patient ever askedyou anything about diet, the
right answer is Mediterraneandiet.
Now the other part that isinteresting and this is
fascinating to me so gets intothe processed food idea.
And right, because you'rehearing more and more about
(06:35):
processed foods and we'regetting some answers about
processed foods from there'sthis big study in France called
like the Sante NutriNet study orsomething.
It was like millions of peoplethey're following prospectively
and monitoring their diet and sowith processed foods, right,
which you normally hear frompeople is like well, if you
(06:56):
can't tell what it is, then it'sa processed food and the water,
sure, okay.
However, the real interestingthing with me at this point with
food, are there particularingredients and we're finding
out.
Yes, in particular, it'sprobably emulsifiers, and so
emulsifiers allow oil and waterto mix, and so if you want to
(07:20):
make a food, a processed food,that has both oily stuff as an
ingredient and watery stuff asan ingredient, you got to put
emulsifier in there, andemulsifiers seem to maybe break
down our intestinal lining, andso they're finding certain
emulsifiers seem to have aunique correlation with
(07:44):
cardiovascular disease andcancer.
So we've got pretty good,getting pretty good data around
that, so that it's not justbecause, if you say, okay, you
can't tell what it is, well,hell, you can't.
Bread like whole grain, totallynatural bread.
You can't tell what that is.
Or you know a chip made out ofchickpeas, where it's chickpeas
(08:08):
and nothing else, and they makeit into a chip.
You can't tell what that is,does that?
No, that's, it's got nothing inthere.
That's bad for you.
So I now think of emulsifiers asa big issue, and then all of
the stuff that's not listed onthe label, so meaning the
potential for pesticides, andnot just like, oh, you wash your
(08:30):
food and you're fine, like thepesticides that were in it
before it got made into whateverit is the hormones, the
antibiotics, you know, theherbicides, that kind of stuff.
My bet is that long-term we'regoing to find out that that
stuff increases our risks forneurodegenerative disease and
(08:55):
for autoimmune disease.
So I think it's going to beemulsifiers.
Now this is all think, right,not like, but I think there's
enough evidence now to sayemulsifiers likely
cardiovascular disease andcancer, and then antibiotics,
(09:17):
hormones, pesticides, what youwould call contaminants,
autoimmune and neurodegenerative.
Now, I bet there's a lot ofoverlap and everything else, but
if I was motivated enough, 100%, I would be eating a
(09:38):
Mediterranean organic diet.
I think that that is as good asyou can with the data we have.
I think that is, if you didMediterranean organic, I think
that's as good as you couldpossibly do.
Uh, and it's super simple,right?
So it's, it's, I mean, itdoesn't mean it's easy, right,
(10:01):
but it's super simple,Mediterranean organic.
I think that's the best you cando.
And for everything, I don'tcare what you're talking about.
I have this, okay, do that.
I don't want to get this, okay,do that.
Whatever, it is organic,mediterranean diet.
I don't think you can do anybetter than that.
So every otheranti-inflammatory blah, blah,
(10:22):
blah, blah, blah.
Mediterranean organic.
That's it, you're fine.
Why don't you hear that?
Because people can't make moneyoff of saying that.
I can't write a cookbook, Ican't have a gut health podcast
around.
Eat Mediterranean organic.
Okay, bye, everybody.
That's this week's episode.
Next week I'll say that samething.
(10:44):
Like you can't do that, butthat's the truth.
That's what we have, what Iwould call re the the reasonable
evidence for reasonableevidence.
Speaker 1 (10:57):
So you probably scared the hell out of a lot of
people talking about thoseemulsifiers and what can happen.
Now we're going to have anotherconversation on those in more
detail.
But I think that's great, youknow, kind of thinking around
those and the impact it may have, because, who knows?
But the evidence is suggesting,you know, I think there is
concerns about those and therole they play in our processed
foods.
And of course processed foodsare all the good foods, they're
(11:17):
the fun foods that we all enjoyeating.
You know, at times I'm sure weconsumed a lot last night at the
Super Bowl as well.
But if you talk about kind ofthe non-inflammatory diet I
heard you mention that a coupleof times Can you explain a
little bit more?
When people are like, well,what the heck is that?
I've kind of heard of it, butwhat does it really mean?
Like what things can I eat?
And how has it been implicated?
Because I know for psoriasis alot of patients come in like I
(11:37):
read this diet, like this iswhat I'm supposed to call
non-inflammatory diet.
How do you respond to that?
Speaker 2 (11:43):
So, in general, when people are talking about a
non-inflammatory diet or ananti-inflammatory diet, they're
talking about kind of avoidingseed oils, avoiding high
glycemic index and processedfoods and processed foods and
then eating things that are richin antioxidants and prebiotics.
(12:05):
Now, there's a lot of uniqueand specific anti-inflammatory
diets people can use that don'treally have any evidence showing
that they do anything but adiet that is high in a variety
(12:27):
of fruits, vegetables, nuts,legumes and fish, and probably
whole grains as well, but wholegrains are probably the least
important part of it.
But you need somewhere to getcalories, because it's hard to
get enough calories eatingnothing but fruits, vegetables,
(12:48):
nuts, seeds and legumes.
So then your calories.
The rest of the calories youneed should be coming from whole
grains and fish, again,anything beyond that.
So whenever you hearanti-inflammatory diet, if
you're doing what I just said,right, mediterranean diet,
fruits, vegetables does it like,oh nightshades, should I avoid
(13:11):
that?
No, it's a fruit or a vegetable.
You can eat it, right, it itreally.
You know the, the concept, saythe paleo diet.
The concept of it makes a lotof sense to me because, right,
we evolved to eat certain stuffand so it makes sense to me that
(13:32):
, like.
You eat the stuff you evolvedto eat.
That's going to be good for you.
But again, mediterranean dietis what we like.
If you're followingMediterranean organic, you're
getting all the benefit of apaleo diet and you're getting
all the benefit of theanti-inflammatory diet and
you're getting and so thosefoods rich in antioxidants, uh,
(13:54):
and low in what what it'seasiest to describe as stuff
that nobody was eating 20,000years ago, like, probably you
could say stuff that nobody waseating a hundred years ago would
be fine.
But it's even easier to saystuff nobody was eating 20,000
years ago.
But that's when, when we sayanti-inflammatory, those are the
big things that people think ofas potentially driving
(14:17):
inflammation.
I'd say the ingredient, theparticular, like substances that
I think really matter.
Number one I do thinkantioxidants matter.
Now, what antioxidants are inyour body?
All of our cells have lots ofoxygen in them.
Your cells need oxygen tosurvive and create energy, but
(14:41):
that oxygen can oxidize and soattach to a molecule, a protein
or a lipid in your cell membraneand cause cellular damage, and
that's oxidation.
Antioxidants sort of soak upthat extra oxygen before it can
(15:01):
damage your cells.
Now, the problem withantioxidants is that, to my
knowledge, there are no goodstudies that taking an
antioxidant supplement actuallydoes anything.
So eating a diet high inantioxidants absolutely does.
But, for example, oxidation ishow your body fights cancer
(15:26):
Oxidation right.
So literally you can think ofit as your body's immune system
oxidizes the cancer cells, oryour body's immune system that's
how it fights infections byoxidizing and damaging the thing
that's infecting you.
And so part of it is just thatif you take too much antioxidant
, it might actually stimulatethe development of cancer or
infections.
(15:46):
But it's also probably thatit's too simplistic to just
think I can take a resveratrolpill or I can take a blueberry
extract or whatever.
It's only been shown, to myknowledge, that antioxidants are
helpful when they are obtainedthrough eating the right dietary
(16:09):
foods.
So I never recommend anantioxidant supplement.
I don't tell people not to takethem because I haven't really
seen evidence that says they'rebad for you.
But if people say, should Itake one, I'm like I don't know,
don't know, maybe they're,maybe they're good, maybe
they're bad.
I wouldn't waste my money on itunless I knew it was good.
(16:29):
So I don't tell people to takeantioxidant supplements, but I
do have.
We have good evidence thatomega-3 helps with acne.
We have good evidence thatomega-3 helps with the side
(16:52):
effects from Accutane.
We have good evidence thatomega-3 helps with atopic
dermatitis, and omega-3 islinked to a whole bunch of
health benefits, right,cardiovascular in particular,
and so it's the only supplementthat I personally take is high
omega-3.
(17:12):
I have no link with the company, but in particular I take one
from a company called LifeExtension.
It's like their super omega-3,whatever, and I use theirs in
particular because there's anorganization called
consumerlabcom that doesindependent testing and pricing
(17:35):
of supplements to make sure theyhave what they say they have,
and then they figure out okay,here's the cost per unit, and so
they tell you what has theright stuff and what is the
cheapest way to get it.
So that's why I take the LifeExtension Omega-3.
It's got the good stuff in itand it's reasonably cheap.
(17:55):
So that's the only one I takemyself.
A couple of other supplements,though, that I think are really
that I recommend regularly fordermatology patients.
So number one, an oral ceramide.
And so ceramides, right, arekind of used in a lot of topical
products because they're thesecret ingredient in your skin's
(18:21):
natural healthy oils, and sothe idea is we put them on
topically and you're givingyourself more of that secret
ingredient and that does help.
But the actual evidence isbetter that taking them as an
oral supplement does even morethan that blind
placebo-controlled trials thatyour skin is more hydrated,
fewer lines and wrinkles, betterglow and better barrier
(18:47):
function.
So that all probably comes backto the hydration that the
ceramide supplement decreaseswater loss from your skin.
So now your skin's morehydrated and looks better.
So I recommend that one inparticular to people with atopic
dermatitis, but just in general.
I think it makes people's skinlook better.
I do that.
(19:08):
I do the omega-3 probiotics.
There's one probiotic inparticular.
So anytime somebody says,should I take a probiotic, that
is quite honestly the equivalentof somebody with an infection
saying should I take anantibiotic?
Yes, you should, but you shouldtake the right antibiotic.
(19:28):
Like if you've got a UTI andyou take an antibiotic that is
for a boil on your forehead,that antibiotic is not going to
help the UTI at all.
And so probiotics are the sameway.
You've got to take the rightprobiotic for the right problem
for skin, and in particular,we've actually got reasonably
(19:51):
good evidence for both atopicdermatitis and psoriasis and
acne.
But the one that I recommend isfrom a brand called Now N-O-W.
So first, the fish oil that Irecommended that I recommend is
called from a brand called now NO W.
So first, uh, the fish oil thatI recommended that I talked
about was, uh, I think it'sabout 15, 20 bucks a month.
The ceramide I also I recommendis also from life extension,
(20:13):
again about $17 a month.
Uh, the probiotic is from acompany called now N O W,
probiotic 10, meaning it's got10 different strains in it and
it's got the four strains thathave been proven to be helpful
in atopic dermatitis.
So we have multiple randomized,double-blind placebo-controlled
trials.
I recommend that for a lot ofpeople.
(20:35):
Those are probably the bigthree that I recommend most, but
then there are a few others.
So, for hyperpigmentation,there's some evidence that
melatonin helps no idea why, butrandomized, double-blind
placebo-controlled trial.
So three to five milligrams ofmelatonin at night, especially
(20:59):
for melasma, but that can helpwith hyperpigmentation.
Collagen so in particular,there's a collagen called
Verisol V-E-R-I-S-O-L.
It's an ingredient, not aproduct.
So you go on Amazon and yousearch Verisol and a bunch of
(21:20):
them come up.
It's an ingredient, not aproduct.
So you go on Amazon and yousearch Averisol and a bunch of
them come up.
I tend to recommend one from acompany called Horbach, which is
like H-O-R-R-B-A-C-H or someweird spelling like that, but
it's a powder and I recommend itbecause it's about 30 bucks for
a four month supply and thatcollagen has been shown to help
(21:40):
with fine lines and wrinkles.
But the other interesting placethat I find it useful is for
people who are getting easybruising, especially on their
forearms, which we you know, asyou and I know that's related to
the combination of age andultraviolet light and it's
because you lose the collagenthat is protecting and acting as
(22:01):
a cushion for your bloodvessels.
Nothing in the literature aboutthis, but as I put some people
on the collagen for you knowjust skin beauty, I saw over
three to six months their easybruising get better.
So I use that collagen both forcosmetics and for easy bruising
(22:21):
.
And then there's one particularkeratin that I recommend that
has randomized double bondplacebo controlled trials.
It is called cinitineC-Y-N-A-T-I-N-E, cinitine HNS it
is from news.
It is hydrolyzed wool from NewZealand sheep.
(22:44):
Now does that matter at all?
No idea.
But I know that this particularkeratin has randomized
double-blind placebo-controlledtrials showing that it makes
your hair thicker, so theindividual hairs like bigger
diameter and more resistant tobreakage, and it makes your
fingernails stronger and moreresistant to breakage and so
(23:10):
these are extended.
I need this okay yeah, so that,and again it is pretty cheap.
So it's about the one that Irecommend.
Uh is called true hns.
True hns again you get it onamazon.
It's about True H-N-S, t-r-u-eH-N-S Again you get it on Amazon
.
It's about $20 a month.
That's the keratin that Irecommend.
Those are the big ones.
(23:32):
Just a couple of other that areworth mentioning really quickly.
Lycamato L-Y-C-A-M-A-T-O hassome evidence for, again, dark
spots and hyperpigmentation.
It's extract of, like tomatoesfrom lycopenes.
Rutin R-U-T-I-N and again youget all these on Amazon rutin
(24:05):
R-U-T-I-N.
That helps bruises to go awayfaster.
So, again, for the solar purpurapatient who's getting easy
bruising on their forearms, thecollagen will reduce the bruises
, but they still take two tothree weeks to go away.
Collagen will reduce thebruises, but they still take two
to three weeks to go away.
The rutin will make the bruisesgo away, usually in a few days
or a week instead of two tothree weeks.
So I recommend the rutinrelatively frequently as well,
(24:27):
and I think those are all of thebig ones that I end up
recommending.
And again, all of those arecheap.
And so, for all of ouraesthetics patients, if you're
spending money on Botox andfiller and laser and whatever,
you should be taking thecinitine keratin, the varisol
(24:51):
collagen, and you should betaking the ceramide because all
of those we have randomizeddouble-blind placebo-controlled
trials.
They are going to make yourskin look better and they're
probably going to help keep itlooking better long-term and
they're cheap and safe andprobably have other benefits as
(25:12):
well.
Speaker 1 (25:15):
Wow, that was fantastic, the information,
because I think you know peopleare overwhelmed.
Like you said, diet like isthere some perfect diet that's
going to fix everything?
And what you really showed usis no.
I mean, I think you still canenjoy, you know, that Shake
Shack hamburger you want, butyou can even supplement your way
to better skin with some of therecommendations that you met,
but it still doesn't replace,you know, following a
(25:36):
well-balanced diet.
From the standpoint of theMediterranean diet, it may be
the fix for everything or safeway to go when people are yes.
Speaker 2 (25:43):
And you and you don't .
If you want to follow theMediterranean diet, it's not
like, oh, you can't have the,you know you can't have the fat.
Like, is it better if you'dnever, if you didn't sure?
Is it better if you never, ifyou didn't, sure, but it's, it
is the general.
You are generally eatinghealthy, and then if you throw
in a couple of things thataren't so great, that's not, but
(26:06):
it's, it's not.
Like that eliminates thebenefit, right, it's.
It's kind of like if you'llwork out four days a week and
then one week you're like I'mtired, I'm not going to work out
this week, I'm only going towork out three times.
Was it better if you had gone?
Sure, but you're still gettingthe benefit of what you're doing
(26:29):
most of the time.
And that's where the real it'snot an all or none, but there
are no just like simple, eatthis, don't eat that and you'll
be fine.
Like it's the general diet thatyou eat over time that really
matters.
Speaker 1 (26:47):
Exactly, and you got to cheat every once in a while.
I mean, it's stuff inmoderation, right?
We're all human.
You got to enjoy life.
There's dermatologists thatstill get you know another
conversation but get sunburned.
Are they perfect?
No, it happens.
Does it negate all this actionThey've done now?
So I think that's reasonable tooffer people.
Well, thank you so much forcoming back on.
I don't know about you, but I'mhungry now lunchtime, so you
definitely got that going,Definitely going to look at some
(27:09):
of those supplements.
So I think that's somethingthat we could all add into our
routine that may have thatbenefit.
For those of our listeners thatwant to find you, you've got a
podcast.
Please share that with them ifthey may be interested.
I know it's more fromdermatologists, dermatologists,
but also I know where they canfind you online, but you still
may not be anywhere.
But please share with ouraudience.
Speaker 2 (27:27):
Yes, so my podcast is called Derms on Drugs right,
derms D-E-R-M-S on drugsD-R-U-G-S.
And yes, it is more targeted atdermatologists, nurse
practitioners and physicianassistants practicing in
dermatology, medical students,dermatology residents.
(27:49):
It is entertaining.
So it's three of us that havebeen friends for 20 years from
residency, so we like make funat each other and poke back and
(28:10):
forth.
For most people who are notprofessionals dealing with skin
disease, if you're like, oh, I'msuper into skin health, I
listen to all kinds of, you'restill not going to know it's.
We're talking aboutpathophysiot.
We're not talking about makingskin healthy.
We're more talking about makingskin not sick.
Uh, that has like a knowndisease.
So, but it is interesting.
And for you know, any of yourlisteners who are in the field
or or are medical but not inDERP, they probably would find
(28:31):
it useful and interesting.
Speaker 1 (28:33):
And are you still a ghost online?
Speaker 2 (28:35):
Otherwise, I assume still a ghost online.
Otherwise, I do not want uh,and part of that is that I don't
want to.
I don't want any chance that myrecommendations anywhere are
ever perceived as like he'strying to sell stuff, like I
don't want to sell anything toanybody.
I want to stay.
Uh, want to sell anything toanybody.
I want to stay able to make.
(28:56):
Just here's what I think, right?
Yeah, that's my deal.
Speaker 1 (29:02):
Well, and if you want to find Matt, just Google him.
You can find Dr Cyrus.
Just hit Google and you'll findhim somehow.
Thanks again for coming on.
It's always great to have youon the podcast.
I'm sure we'll have you back inagain.
You're like one of my futureguests, you know, here on the
podcast.
I appreciate all your input.
It's always enlightening and wealways learn so much.
So thanks again for coming onand stay tuned for the next
(29:23):
episode of Dermot Trotter.
Don't swear about skincare.
Speaker 3 (29:27):
Thanks for listening to Dermot Trotter.
For more about skincare, visitDermotTrottercom.
Don't forget to subscribe,leave a review and share this
podcast with anyone who needs alittle skincare sanity.
Until next time, stay skinsmart.
What do you tell people about diet and acne and
what can make it better or maybeworse?
Speaker 2 (00:05):
Yes, so an acne, interestingly, is one of the
relatively unique ones.
So if you want to make a food,a processed food, that has both
oily stuff as an ingredient andwatery stuff as an ingredient,
you got to put emulsifier inthere.
My bet is that, long-term,we're going to find out that
that stuff bet is that, longterm, we're going to find out
(00:26):
that that stuff increases ourrisk for neurodegenerative
disease.
So the individual hairs likebigger diameter and more
resistant to breakage, and itmakes your fingernails stronger
and more resistant to breakage.
Speaker 3 (00:39):
Welcome to Dermot Trotter.
Don't swear about skincare.
Where host Dr Shannon CotTrotter?
Don't Swear About Skin Care.
Where host Dr Shannon C Trotter, a board-certified
dermatologist, sits down withfellow dermatologists and
skincare experts to separatefact from fiction and simplify
skincare.
Let's get started.
Speaker 1 (00:58):
Welcome back to the Dermot Trotter Don't Swear About
Skin Care podcast.
I've got Dr Zyrus back herewith me here today, who's an
expert in everything skin, soI'm excited to have his thoughts
and comments with us.
But if you know Dr Matt Zyrus,you know he's been an expert in
the eczema field for over 20years.
He's written a textbook, he'spublished over 200 peer review
(01:18):
articles and lecture tothousands of dermatologists and
he's been on our podcast beforeto really reach out to you guys
out in the public and ourpatients.
His passion is reallydistilling topics down, making
them into simple concepts so allof us can understand what we're
even talking about.
So welcome back to the podcast,matt.
Speaker 2 (01:36):
Rude to be here.
Dr Trotter, how are you?
Speaker 1 (01:40):
I am doing fantastic and always better because you're
now here with us.
So you know, I think you know,as we've talked about different
things in dermatology.
You know there's really peoplethat are focusing on diet.
Now everything's about what weeat nowadays, whether we're
trying to lose weight, we'retrying to look good, just feel
better about ourselves, and soyou know, I really want to know
your answer to this question Canwe really eat our ways to
(02:03):
getting better skin?
Do you think we can eat our wayto better skin.
Speaker 2 (02:09):
Yes, with some qualifiers, so I would, if you
include so first.
If we say can we get somediseases doing better, yes, and
if you say, if you include, canwe take some natural supplements
, then definitely yes, it goesbeyond just can we get certain
(02:34):
diseases better to?
Can we get people's skinlooking better?
Yeah, there are a number ofreally cheap supplements that
have really strong data.
The biggest thing I would tellpatients about the supplement
stuff if they're expensive,you're wasting your money
(02:54):
Because the good stuff you canget cheap on Amazon, but the
diet by itself I don't.
Maybe, right, Maybe is the waythat I would put it, Maybe.
Speaker 1 (03:09):
No, I agree with that , because really to get
everything you need, or maybe inthe right quantities, I mean,
who can really design a dietthat's perfect around that and
realistically do it every day?
I mean, sometimes you just wantto go to Taco Bell late at
night, right, and you're notgoing to get those nutrients
that you want.
So that makes sense.
So maybe if we can't eat ourway, maybe we can supplement our
way.
But you know, if you look atsort of different skin
(03:31):
conditions, I think one of theones that gets a lot of
attention and maybe diet playinga role is acne.
So I'd love to hear what do youtell people about diet and acne
and what can make it better ormaybe worse.
Speaker 2 (03:42):
Yes, so, and acne, interestingly, is one of the
relatively unique ones.
So with because acne, weactually do have some very
specific like don't eatchocolate and don't eat skim
milk, right, those are the twothings that have really been
shown in particular.
(04:02):
Now the questions become well,why?
Why chocolate and why skim milk?
And we can also add into acnesort of sugar and so high
glycemic index things, and thebelief here is that anything
that spikes your blood sugarsubsequently spikes your insulin
(04:25):
, and insulin can activatesomething called the
insulin-like growth factorreceptor, which is involved in
acne pathogenesis, and so thismight fall somewhat into the
category of hormonal effects ofacne, the category of, you know,
(04:50):
hormonal effects of acne.
And so that's the very specificthings that I would say about
acne, chocolate and skim milk.
We have very good evidence forboth of those.
But then the second part, and itbecomes a really interesting
thing, because when you say diet, people often want a like eat
more avocados, like, which iscomplete, like any simple
dietary recommendation of eatthis, don't eat that immediately
(05:12):
.
You should think thisinfluencer is a moron and I
should never listen to anythingthey have to say again.
So what has been shown withdiet is there's one particular
diet right, the, theMediterranean diet, which is
fruits, vegetables, nuts,legumes and fish, and that diet
(05:33):
is good for everything.
So when people are like, oh,whole food or whole 30 or
anti-inflammatory protocol orwhatever.
Fine, I don't care there.
Maybe it helps, maybe itdoesn't, don't know, but I know
the only diet I really haveevidence helps in everything is
the Mediterranean diet.
(05:54):
Because if you follow theMediterranean diet, you're going
to be eating low glycemic indexfoods, right?
So in in ancient Italy andancient Greece, right, they
weren't eating chocolate.
They probably weren't eatingmilk, right?
So if you're following theMediterranean diet, you're like
it's really easy, that's forevery.
(06:14):
Any time any patient ever askedyou anything about diet, the
right answer is Mediterraneandiet.
Now the other part that isinteresting and this is
fascinating to me so gets intothe processed food idea.
And right, because you'rehearing more and more about
(06:35):
processed foods and we'regetting some answers about
processed foods from there'sthis big study in France called
like the Sante NutriNet study orsomething.
It was like millions of peoplethey're following prospectively
and monitoring their diet and sowith processed foods, right,
which you normally hear frompeople is like well, if you
(06:56):
can't tell what it is, then it'sa processed food and the water,
sure, okay.
However, the real interestingthing with me at this point with
food, are there particularingredients and we're finding
out.
Yes, in particular, it'sprobably emulsifiers, and so
emulsifiers allow oil and waterto mix, and so if you want to
(07:20):
make a food, a processed food,that has both oily stuff as an
ingredient and watery stuff asan ingredient, you got to put
emulsifier in there, andemulsifiers seem to maybe break
down our intestinal lining, andso they're finding certain
emulsifiers seem to have aunique correlation with
(07:44):
cardiovascular disease andcancer.
So we've got pretty good,getting pretty good data around
that, so that it's not justbecause, if you say, okay, you
can't tell what it is, well,hell, you can't.
Bread like whole grain, totallynatural bread.
You can't tell what that is.
Or you know a chip made out ofchickpeas, where it's chickpeas
(08:08):
and nothing else, and they makeit into a chip.
You can't tell what that is,does that?
No, that's, it's got nothing inthere.
That's bad for you.
So I now think of emulsifiers asa big issue, and then all of
the stuff that's not listed onthe label, so meaning the
potential for pesticides, andnot just like, oh, you wash your
(08:30):
food and you're fine, like thepesticides that were in it
before it got made into whateverit is the hormones, the
antibiotics, you know, theherbicides, that kind of stuff.
My bet is that long-term we'regoing to find out that that
stuff increases our risks forneurodegenerative disease and
(08:55):
for autoimmune disease.
So I think it's going to beemulsifiers.
Now this is all think, right,not like, but I think there's
enough evidence now to sayemulsifiers likely
cardiovascular disease andcancer, and then antibiotics,
(09:17):
hormones, pesticides, what youwould call contaminants,
autoimmune and neurodegenerative.
Now, I bet there's a lot ofoverlap and everything else, but
if I was motivated enough, 100%, I would be eating a
(09:38):
Mediterranean organic diet.
I think that that is as good asyou can with the data we have.
I think that is, if you didMediterranean organic, I think
that's as good as you couldpossibly do.
Uh, and it's super simple,right?
So it's, it's, I mean, itdoesn't mean it's easy, right,
(10:01):
but it's super simple,Mediterranean organic.
I think that's the best you cando.
And for everything, I don'tcare what you're talking about.
I have this, okay, do that.
I don't want to get this, okay,do that.
Whatever, it is organic,mediterranean diet.
I don't think you can do anybetter than that.
So every otheranti-inflammatory blah, blah,
(10:22):
blah, blah, blah.
Mediterranean organic.
That's it, you're fine.
Why don't you hear that?
Because people can't make moneyoff of saying that.
I can't write a cookbook, Ican't have a gut health podcast
around.
Eat Mediterranean organic.
Okay, bye, everybody.
That's this week's episode.
Next week I'll say that samething.
(10:44):
Like you can't do that, butthat's the truth.
That's what we have, what Iwould call re the the reasonable
evidence for reasonableevidence.
Speaker 1 (10:57):
So you probably scared the hell out of a lot of
people talking about thoseemulsifiers and what can happen.
Now we're going to have anotherconversation on those in more
detail.
But I think that's great, youknow, kind of thinking around
those and the impact it may have, because, who knows?
But the evidence is suggesting,you know, I think there is
concerns about those and therole they play in our processed
foods.
And of course processed foodsare all the good foods, they're
(11:17):
the fun foods that we all enjoyeating.
You know, at times I'm sure weconsumed a lot last night at the
Super Bowl as well.
But if you talk about kind ofthe non-inflammatory diet I
heard you mention that a coupleof times Can you explain a
little bit more?
When people are like, well,what the heck is that?
I've kind of heard of it, butwhat does it really mean?
Like what things can I eat?
And how has it been implicated?
Because I know for psoriasis alot of patients come in like I
(11:37):
read this diet, like this iswhat I'm supposed to call
non-inflammatory diet.
How do you respond to that?
Speaker 2 (11:43):
So, in general, when people are talking about a
non-inflammatory diet or ananti-inflammatory diet, they're
talking about kind of avoidingseed oils, avoiding high
glycemic index and processedfoods and processed foods and
then eating things that are richin antioxidants and prebiotics.
(12:05):
Now, there's a lot of uniqueand specific anti-inflammatory
diets people can use that don'treally have any evidence showing
that they do anything but adiet that is high in a variety
(12:27):
of fruits, vegetables, nuts,legumes and fish, and probably
whole grains as well, but wholegrains are probably the least
important part of it.
But you need somewhere to getcalories, because it's hard to
get enough calories eatingnothing but fruits, vegetables,
(12:48):
nuts, seeds and legumes.
So then your calories.
The rest of the calories youneed should be coming from whole
grains and fish, again,anything beyond that.
So whenever you hearanti-inflammatory diet, if
you're doing what I just said,right, mediterranean diet,
fruits, vegetables does it like,oh nightshades, should I avoid
(13:11):
that?
No, it's a fruit or a vegetable.
You can eat it, right, it itreally.
You know the, the concept, saythe paleo diet.
The concept of it makes a lotof sense to me because, right,
we evolved to eat certain stuffand so it makes sense to me that
(13:32):
, like.
You eat the stuff you evolvedto eat.
That's going to be good for you.
But again, mediterranean dietis what we like.
If you're followingMediterranean organic, you're
getting all the benefit of apaleo diet and you're getting
all the benefit of theanti-inflammatory diet and
you're getting and so thosefoods rich in antioxidants, uh,
(13:54):
and low in what what it'seasiest to describe as stuff
that nobody was eating 20,000years ago, like, probably you
could say stuff that nobody waseating a hundred years ago would
be fine.
But it's even easier to saystuff nobody was eating 20,000
years ago.
But that's when, when we sayanti-inflammatory, those are the
big things that people think ofas potentially driving
(14:17):
inflammation.
I'd say the ingredient, theparticular, like substances that
I think really matter.
Number one I do thinkantioxidants matter.
Now, what antioxidants are inyour body?
All of our cells have lots ofoxygen in them.
Your cells need oxygen tosurvive and create energy, but
(14:41):
that oxygen can oxidize and soattach to a molecule, a protein
or a lipid in your cell membraneand cause cellular damage, and
that's oxidation.
Antioxidants sort of soak upthat extra oxygen before it can
(15:01):
damage your cells.
Now, the problem withantioxidants is that, to my
knowledge, there are no goodstudies that taking an
antioxidant supplement actuallydoes anything.
So eating a diet high inantioxidants absolutely does.
But, for example, oxidation ishow your body fights cancer
(15:26):
Oxidation right.
So literally you can think ofit as your body's immune system
oxidizes the cancer cells, oryour body's immune system that's
how it fights infections byoxidizing and damaging the thing
that's infecting you.
And so part of it is just thatif you take too much antioxidant
, it might actually stimulatethe development of cancer or
infections.
(15:46):
But it's also probably thatit's too simplistic to just
think I can take a resveratrolpill or I can take a blueberry
extract or whatever.
It's only been shown, to myknowledge, that antioxidants are
helpful when they are obtainedthrough eating the right dietary
(16:09):
foods.
So I never recommend anantioxidant supplement.
I don't tell people not to takethem because I haven't really
seen evidence that says they'rebad for you.
But if people say, should Itake one, I'm like I don't know,
don't know, maybe they're,maybe they're good, maybe
they're bad.
I wouldn't waste my money on itunless I knew it was good.
(16:29):
So I don't tell people to takeantioxidant supplements, but I
do have.
We have good evidence thatomega-3 helps with acne.
We have good evidence thatomega-3 helps with the side
(16:52):
effects from Accutane.
We have good evidence thatomega-3 helps with atopic
dermatitis, and omega-3 islinked to a whole bunch of
health benefits, right,cardiovascular in particular,
and so it's the only supplementthat I personally take is high
omega-3.
(17:12):
I have no link with the company, but in particular I take one
from a company called LifeExtension.
It's like their super omega-3,whatever, and I use theirs in
particular because there's anorganization called
consumerlabcom that doesindependent testing and pricing
(17:35):
of supplements to make sure theyhave what they say they have,
and then they figure out okay,here's the cost per unit, and so
they tell you what has theright stuff and what is the
cheapest way to get it.
So that's why I take the LifeExtension Omega-3.
It's got the good stuff in itand it's reasonably cheap.
(17:55):
So that's the only one I takemyself.
A couple of other supplements,though, that I think are really
that I recommend regularly fordermatology patients.
So number one, an oral ceramide.
And so ceramides, right, arekind of used in a lot of topical
products because they're thesecret ingredient in your skin's
(18:21):
natural healthy oils, and sothe idea is we put them on
topically and you're givingyourself more of that secret
ingredient and that does help.
But the actual evidence isbetter that taking them as an
oral supplement does even morethan that blind
placebo-controlled trials thatyour skin is more hydrated,
fewer lines and wrinkles, betterglow and better barrier
(18:47):
function.
So that all probably comes backto the hydration that the
ceramide supplement decreaseswater loss from your skin.
So now your skin's morehydrated and looks better.
So I recommend that one inparticular to people with atopic
dermatitis, but just in general.
I think it makes people's skinlook better.
I do that.
(19:08):
I do the omega-3 probiotics.
There's one probiotic inparticular.
So anytime somebody says,should I take a probiotic, that
is quite honestly the equivalentof somebody with an infection
saying should I take anantibiotic?
Yes, you should, but you shouldtake the right antibiotic.
(19:28):
Like if you've got a UTI andyou take an antibiotic that is
for a boil on your forehead,that antibiotic is not going to
help the UTI at all.
And so probiotics are the sameway.
You've got to take the rightprobiotic for the right problem
for skin, and in particular,we've actually got reasonably
(19:51):
good evidence for both atopicdermatitis and psoriasis and
acne.
But the one that I recommend isfrom a brand called Now N-O-W.
So first, the fish oil that Irecommended that I recommend is
called from a brand called now NO W.
So first, uh, the fish oil thatI recommended that I talked
about was, uh, I think it'sabout 15, 20 bucks a month.
The ceramide I also I recommendis also from life extension,
(20:13):
again about $17 a month.
Uh, the probiotic is from acompany called now N O W,
probiotic 10, meaning it's got10 different strains in it and
it's got the four strains thathave been proven to be helpful
in atopic dermatitis.
So we have multiple randomized,double-blind placebo-controlled
trials.
I recommend that for a lot ofpeople.
(20:35):
Those are probably the bigthree that I recommend most, but
then there are a few others.
So, for hyperpigmentation,there's some evidence that
melatonin helps no idea why, butrandomized, double-blind
placebo-controlled trial.
So three to five milligrams ofmelatonin at night, especially
(20:59):
for melasma, but that can helpwith hyperpigmentation.
Collagen so in particular,there's a collagen called
Verisol V-E-R-I-S-O-L.
It's an ingredient, not aproduct.
So you go on Amazon and yousearch Verisol and a bunch of
(21:20):
them come up.
It's an ingredient, not aproduct.
So you go on Amazon and yousearch Averisol and a bunch of
them come up.
I tend to recommend one from acompany called Horbach, which is
like H-O-R-R-B-A-C-H or someweird spelling like that, but
it's a powder and I recommend itbecause it's about 30 bucks for
a four month supply and thatcollagen has been shown to help
(21:40):
with fine lines and wrinkles.
But the other interesting placethat I find it useful is for
people who are getting easybruising, especially on their
forearms, which we you know, asyou and I know that's related to
the combination of age andultraviolet light and it's
because you lose the collagenthat is protecting and acting as
(22:01):
a cushion for your bloodvessels.
Nothing in the literature aboutthis, but as I put some people
on the collagen for you knowjust skin beauty, I saw over
three to six months their easybruising get better.
So I use that collagen both forcosmetics and for easy bruising
(22:21):
.
And then there's one particularkeratin that I recommend that
has randomized double bondplacebo controlled trials.
It is called cinitineC-Y-N-A-T-I-N-E, cinitine HNS it
is from news.
It is hydrolyzed wool from NewZealand sheep.
(22:44):
Now does that matter at all?
No idea.
But I know that this particularkeratin has randomized
double-blind placebo-controlledtrials showing that it makes
your hair thicker, so theindividual hairs like bigger
diameter and more resistant tobreakage, and it makes your
fingernails stronger and moreresistant to breakage and so
(23:10):
these are extended.
I need this okay yeah, so that,and again it is pretty cheap.
So it's about the one that Irecommend.
Uh is called true hns.
True hns again you get it onamazon.
It's about True H-N-S, t-r-u-eH-N-S Again you get it on Amazon
.
It's about $20 a month.
That's the keratin that Irecommend.
Those are the big ones.
(23:32):
Just a couple of other that areworth mentioning really quickly.
Lycamato L-Y-C-A-M-A-T-O hassome evidence for, again, dark
spots and hyperpigmentation.
It's extract of, like tomatoesfrom lycopenes.
Rutin R-U-T-I-N and again youget all these on Amazon rutin
(24:05):
R-U-T-I-N.
That helps bruises to go awayfaster.
So, again, for the solar purpurapatient who's getting easy
bruising on their forearms, thecollagen will reduce the bruises
, but they still take two tothree weeks to go away.
Collagen will reduce thebruises, but they still take two
to three weeks to go away.
The rutin will make the bruisesgo away, usually in a few days
or a week instead of two tothree weeks.
So I recommend the rutinrelatively frequently as well,
(24:27):
and I think those are all of thebig ones that I end up
recommending.
And again, all of those arecheap.
And so, for all of ouraesthetics patients, if you're
spending money on Botox andfiller and laser and whatever,
you should be taking thecinitine keratin, the varisol
(24:51):
collagen, and you should betaking the ceramide because all
of those we have randomizeddouble-blind placebo-controlled
trials.
They are going to make yourskin look better and they're
probably going to help keep itlooking better long-term and
they're cheap and safe andprobably have other benefits as
(25:12):
well.
Speaker 1 (25:15):
Wow, that was fantastic, the information,
because I think you know peopleare overwhelmed.
Like you said, diet like isthere some perfect diet that's
going to fix everything?
And what you really showed usis no.
I mean, I think you still canenjoy, you know, that Shake
Shack hamburger you want, butyou can even supplement your way
to better skin with some of therecommendations that you met,
but it still doesn't replace,you know, following a
(25:36):
well-balanced diet.
From the standpoint of theMediterranean diet, it may be
the fix for everything or safeway to go when people are yes.
Speaker 2 (25:43):
And you and you don't .
If you want to follow theMediterranean diet, it's not
like, oh, you can't have the,you know you can't have the fat.
Like, is it better if you'dnever, if you didn't sure?
Is it better if you never, ifyou didn't, sure, but it's, it
is the general.
You are generally eatinghealthy, and then if you throw
in a couple of things thataren't so great, that's not, but
(26:06):
it's, it's not.
Like that eliminates thebenefit, right, it's.
It's kind of like if you'llwork out four days a week and
then one week you're like I'mtired, I'm not going to work out
this week, I'm only going towork out three times.
Was it better if you had gone?
Sure, but you're still gettingthe benefit of what you're doing
(26:29):
most of the time.
And that's where the real it'snot an all or none, but there
are no just like simple, eatthis, don't eat that and you'll
be fine.
Like it's the general diet thatyou eat over time that really
matters.
Speaker 1 (26:47):
Exactly, and you got to cheat every once in a while.
I mean, it's stuff inmoderation, right?
We're all human.
You got to enjoy life.
There's dermatologists thatstill get you know another
conversation but get sunburned.
Are they perfect?
No, it happens.
Does it negate all this actionThey've done now?
So I think that's reasonable tooffer people.
Well, thank you so much forcoming back on.
I don't know about you, but I'mhungry now lunchtime, so you
definitely got that going,Definitely going to look at some
(27:09):
of those supplements.
So I think that's somethingthat we could all add into our
routine that may have thatbenefit.
For those of our listeners thatwant to find you, you've got a
podcast.
Please share that with them ifthey may be interested.
I know it's more fromdermatologists, dermatologists,
but also I know where they canfind you online, but you still
may not be anywhere.
But please share with ouraudience.
Speaker 2 (27:27):
Yes, so my podcast is called Derms on Drugs right,
derms D-E-R-M-S on drugsD-R-U-G-S.
And yes, it is more targeted atdermatologists, nurse
practitioners and physicianassistants practicing in
dermatology, medical students,dermatology residents.
(27:49):
It is entertaining.
So it's three of us that havebeen friends for 20 years from
residency, so we like make funat each other and poke back and
(28:10):
forth.
For most people who are notprofessionals dealing with skin
disease, if you're like, oh, I'msuper into skin health, I
listen to all kinds of, you'restill not going to know it's.
We're talking aboutpathophysiot.
We're not talking about makingskin healthy.
We're more talking about makingskin not sick.
Uh, that has like a knowndisease.
So, but it is interesting.
And for you know, any of yourlisteners who are in the field
or or are medical but not inDERP, they probably would find
(28:31):
it useful and interesting.
Speaker 1 (28:33):
And are you still a ghost online?
Speaker 2 (28:35):
Otherwise, I assume still a ghost online.
Otherwise, I do not want uh,and part of that is that I don't
want to.
I don't want any chance that myrecommendations anywhere are
ever perceived as like he'strying to sell stuff, like I
don't want to sell anything toanybody.
I want to stay.
Uh, want to sell anything toanybody.
I want to stay able to make.
(28:56):
Just here's what I think, right?
Yeah, that's my deal.
Speaker 1 (29:02):
Well, and if you want to find Matt, just Google him.
You can find Dr Cyrus.
Just hit Google and you'll findhim somehow.
Thanks again for coming on.
It's always great to have youon the podcast.
I'm sure we'll have you back inagain.
You're like one of my futureguests, you know, here on the
podcast.
I appreciate all your input.
It's always enlightening and wealways learn so much.
So thanks again for coming onand stay tuned for the next
(29:23):
episode of Dermot Trotter.
Don't swear about skincare.
Speaker 3 (29:27):
Thanks for listening to Dermot Trotter.
For more about skincare, visitDermotTrottercom.
Don't forget to subscribe,leave a review and share this
podcast with anyone who needs alittle skincare sanity.
Until next time, stay skinsmart.
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