May 27, 2025 • 22 mins
Could your grocery cart be just as important as your sunscreen drawer? In Part 2 of Rethinking Sun Protection, Dr. Katie Varman returns to explore how diet and supplements can boost your skin’s natural defense against UV damage.
We unpack how nutrients like carotenoids, polyphenols, and omega-3s reduce inflammation, DNA damage, and even sunburn risk—sometimes by as much as 40–50%. From tomatoes to carrots to niacinamide, what you eat can directly impact how your skin handles the sun.
Dr. Varman also dives into the balance between healthy sun exposure and personalized protection based on your skin type and lifestyle.
Tune in to learn how protecting your skin might just start in your kitchen.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to Dermot Trotter Don't Swear About Skin
Care where host Dr Shannon CTrotter, a board-certified
dermatologist, sits down withfellow dermatologists and
skincare experts to separatefact from fiction and simplify
skincare.
Let's get started.
Speaker 2 (00:19):
Welcome to the Dermot Trotter Don't Swear About Skin
Care podcast.
Today I have a special guestback on the show, dr Katie
Varmund.
She's a board certifieddermatologist and works in
private practice at ShineFunctional Dermatology in
Northern California.
Dr Varmund specializes intreating chronic skin conditions
like psoriasis and eczema, witha blend of conventional and
(00:40):
functional medicine practices.
She also has a passion forphotoimmunology or basically
again, how does light affect theimmune system?
How do they intertwine?
And she's also owner of ShineNutraceuticals.
Welcome back to the podcast,katie.
Speaker 3 (00:55):
Thank you so much for having me back.
Speaker 2 (00:57):
So for those of you that heard our previous podcast
again, you might have been alittle shocked to hear that
Katie and I were talking moreabout the benefits and yes, you
heard this the benefits of sunexposure.
So I think in dermatology beinga little bit of a bad
reputation and sometimes welldeserved we're really scaring
the bejeebers out of you andtelling you to stay out of the
sun because of all the dangersassociated with it.
But Katie really highlightedsome of those health benefits.
(01:20):
So we're going to lead intothis conversation.
We're going to lead into thisconversation.
We're going to talk a littlebit more about diet and maybe
supplements or what we call morenutraceuticals that you can do
for sun protection.
But first I'm going to haveKatie give a little preview
again of kind of those healthbenefits of sun exposure.
For those of you that missedthe last one.
Speaker 3 (01:36):
Perfect.
Thank you so much.
Yes, last time we had a greatdiscussion about some of the
benefits of sunlight exposureand we talked a little bit more
about things you know, reallytrying to find that balance
between over and under exposureto sunlight, because
overexposure, of course we areall very familiar skin cancer
and aging of the skin being thedetrimental effects.
(01:59):
But an inadequate sun exposureis also detrimental to people as
a whole, and so inadequate sunexposure can be associated with
one an increased risk ofall-cause mortality in general,
meaning you just have a higherchance of dying from any reason
if you have the lowest amountsof sun exposure.
Very yes, but then also there'san increased risk of
(02:21):
cardiovascular disease,autoimmune diseases like
multiple sclerosis and type onediabetes, inflammatory
conditions, things like eczemaand IBS, cerebral bowel syndrome
.
There's benefits for moodmetabolism, the microbiome we
talked about also, so a wholehost of things that are moderate
(02:43):
and, you know, an appropriateamount of sunlight can can help
for as far as a human being as awhole, and so we were talking
about how do we help bridge thatgap so that we can educate
people how to get enough for,you know, wellness, but not so
much that you're puttingyourself at unnecessary risk of
skin cancer and aging so muchthat you're putting yourself at
(03:07):
unnecessary risk of skin cancerand aging.
Speaker 2 (03:09):
So that's the good news, you guys can go out and
get some sun, although you'llhave to go back to that podcast.
Listen to some specificrecommendations because, as
Katie mentioned, it is balancethat we're trying to achieve
there, and part of the balance Ithink people are looking for
for some protection is reallykind of looking at our diet and
then also supplements.
I think supplements have reallycaught on.
You know people are looking fornatural alternatives to
maximize health.
(03:30):
So I wanted to talk aboutbefore even the supplements, you
know, because the diet's kindof, you know, tagged into that
with some of the ingredients inour diet that are very important
for some protection practices.
Let's talk more about the dietpiece.
What do you recommend from adiet perspective that might
actually be some protective fora patient?
Speaker 3 (03:48):
There are a couple of different classes of foods that
are very, very helpful.
But I wanted to take a stepback and talk about why each of
those classes are going to behelpful.
Because when you look at thetimeline kind of the
pathogenesis, that pathway fromsunlight to skin cancer, from
(04:09):
sunlight to photo aging of theskin, there's multiple different
steps where we can intervene,whether it's a diet or
nutraceutical or whatnot.
There's multiple differentsteps along that pathway and
that's really how we derivethese main classes of dietary
interventions to help, and soit's kind of important to know
what those steps are, becauseotherwise it's just kind of a
(04:30):
mess of you know, a mess of like.
It's like, okay, eat healthy, Iget it, but it really is much
more specific than that.
So, just to give like the oneminute overview, when you're
exposed to UV light, there'sthat whole cascade.
So there's oxidative stressthat occurs that damages DNA,
both directly and indirectly.
They're more directly fromlight.
(04:52):
Specifically, there'sinflammatory pathways that are
activated and all of thatinflammation is what you see on
the skin is sunburn and redness,and there is immunosuppression
that occurs in the skin aftersunlight exposure and that
immunosuppression is a reallyreally, really important
determinant of whether you'regoing to go on and get skin
cancer or not, because we knowpeople who are immunosuppressed
(05:14):
in general have a really highrisk of developing skin cancer
compared to people who aren'timmunosuppressed.
So that plays a reallyimportant role as well.
And so, when you're kind oflooking at all these different
layers, we want to treat thatoxidative stress, so those
little free radicals floatingaround causing damage to
structures in DNA.
We want to address inflammatorypathways, because when things
(05:36):
are inflamed it creates what wecall a pro-growth, a pro-tumor
environment and activates tumorprogression.
We also want to make sure thatwe're addressing DNA damage as
much as possible and preventingthat immunosuppression that
occurs from sunlight.
And so the reason for all thesedietary interventions is
because we want to target all ofthose steps and kind of plug
(05:59):
all the holes.
So, just to kind of name thetop ones, we can talk more about
carotenoids really importantantioxidants, just to kind of
name the top ones, we can talkmore about um carotenoids really
important um, antioxidants andthose kind of go with like it's
anti-inflammatory as well, um,cause it's a lot of the
polyphenols, omega-3s hugely,hugely important Um, and then um
isoflav or the, the um likephytoestrogens.
(06:21):
So people think of soy um canactually play an important role
also, but the big ones are goingto be the omegas, the
antioxidants, theanti-inflammatory and the
carotenoids.
Speaker 2 (06:32):
Wow.
And so when you think of likesome of those groups and diet
wise, are there particular like,more specific, like foods, you
would say, hey, grab a bunch ofblueberries or you know what
would you recommend just to bemore practical?
Somebody's like what should Ireally add in?
Not that you might get the fullvalue, because obviously you're
looking at a variety of thosethings, but what things tangibly
?
Would you recommend somebodypick up at the grocery store to
(06:54):
accomplish some of those dietaryneeds Angibly?
Speaker 3 (06:56):
would you recommend somebody pick up at the grocery
store to accomplish some ofthose dietary needs?
The easiest way, if you justwant to take kind of the
overview would be colorful foods.
So color is an indication ofpolyphenol content, and what's
neat about foods is they have alot.
They're rich in all sorts ofdifferent polyphenols, and so if
you're getting the rainbow inyour grocery cart, your blues
(07:17):
and your reds and yellows andoranges, you can pretty much
guarantee you're going to begetting a lot of these beautiful
polyphenols and carotenoids aswell.
The big hitters for carotenoidsthat are kind of in everybody's
diet are going to be carrotsand tomatoes.
Those are the easiest ones toget and it's not like you have
to eat 100 carrots a day.
We're talking like two carrots.
And it's not like you have toeat a hundred carrots a day.
Speaker 2 (07:38):
We're talking like two carrots and and like God, I
hate carrots.
I gotta be honest with you.
Speaker 3 (07:41):
Well, it doesn't have to be carrots, but you know
something, orange, right, andyou can get your.
I like.
I think I literally turn orange, like every summer because I
eat so many tomatoes.
I love summer foods, but it'skind of fun when you think about
the design of everything.
It's such that right in thesummertime when you need support
is when all of these beautifulfruits and vegetables are
(08:04):
available for your body, and soit's like the plants need it,
and then you eat the plants andthen you need it and so so
there's plenty of ways to getcolor.
You know whether you're talkingabout bell peppers, and there's
lots of options for orange too,but carrots are kind of the
easiest one that people can getdown.
And tomatoes, you know there's.
There's a study like thelycopene, specifically in
(08:25):
tomatoes.
There's a study that looked at16 grams of lycopene daily,
dosing for anything about 10weeks or so, which is the
equivalent to like one and ahalf tablespoons of tomato paste
.
So it's not like an insaneamount.
Um resulted in a 40% reductionin what we call the minimal
erythema dose.
So how much UV light it takesto burn your skin is really
(08:47):
dramatically reduced by likereally not a whole lot of tomato
paste, Um, and and so thesekinds of levels that we see in
studies that visibly, veryclearly increase your skin's
tolerance to sunlight,specifically ultraviolet light,
are not exorbitant amounts.
Like it's not.
You're not having to takesupplements and blends and
(09:07):
things like that in order to getit.
If you're having, you know, atomato and like a carrot and
maybe a cup of spinach, you'regetting a ton of lutein,
lycopene and beta caroteneenough for like your day's
amount.
So, as long I tell people, aslong as you're eating, like,
check the list.
Like, did I eat somethingcolorful today?
And then, when it comes topolyphenols, we're thinking more
(09:30):
about, like you're saying,blueberries.
The berries are really rich inpolyphenols.
Pomegranate is a very popularone that's very, very rich in
several different amazingpolyphenols.
So doing a fruit and avegetable that are colorful, I
mean that's really a great goalfor the day.
And then you've got to eat youromega threes for the day, which
most people are aware of.
You know fatty fish, the salmonand whatnot, but you do flax
(09:52):
and walnuts.
And you just Google, searchhigh omega foods, Um, and you
just you just look at the list.
You're like, did I eat one ofthose things today?
Done.
If you didn't, then there'ssupplements, and if you're high
risk, then there's supplements.
But in general, did you eatsomething colorful?
Did you eat an omega-3?
That's kind of the easy answerfor a daily goal.
Speaker 2 (10:13):
No, I love that Cause .
I mean I'm not a big fan of faddiets and tell people to do
this extreme or that extreme.
And I do think it getsoverwhelming for patients
because, like gosh, I gottaremember to eat this or how much
, or you know I don't have time,or you know I don't care for
that particular vegetable orfruit.
But I think that makes it morerealistic.
And you know and I tend to fallback on to when people are
asking for you know particular,you know diet are asking for you
(10:35):
know particular, you know diet.
Again, I'm not a fan of a dietbut I usually tell you you know
eating Mediterranean diet orlifestyle, really, you know,
does hit some of these majorfood groups and things that we
do need, I think, for overallgeneral health.
But it's amazing, from the sunprotection piece, like that,
some of the things are includedin that diet.
You know the omega threes, thefish diets, you know that high
in those Mediterranean dietsthat are high in fish.
(10:56):
And you know vegetables andfruits.
I mean it's amazing how youkind of can capture both.
So I was totally one in doubt.
I think you're safe to go thatroute, but really, again, it's
about balance to achieve that.
So you know, beyond kind of thethe food aspect of it, you know
, if they jump away and say, youknow, I'm just not going to do
it, I don't have time, I, youknow I buy vegetables, they're
bad in a day so I don't even buythem.
(11:18):
What if they're looking to dothis more from the nutraceutical
side, or maybe what most peoplemight think of as more like
supplements?
And you know, and if you feellike there's a distinction there
between true nutraceuticals andsupplements, feel free to kind
of comment on that too, becauseI think people use it often
interchangeably, and what typesof things should people look for
in those categories as well?
Speaker 3 (11:38):
and and that's how I like the word supplement, you
know, I think, is correct, right, it's really to supplement your
, your diet, and so that's how Ikind of describe it to people,
right, I'm like, look at whatyou ate that day and you know,
for a low-risk person, right,we're talking about somebody who
hasn't had a ton of sunburns,they're're not immunosuppressed,
they don't have, you know, very, very fair skin that feckles
(11:59):
easily, and they live inCalifornia.
Um, you know, for somebodywho's not low risk, the idea is
like, try to eat it, becausethat's good for you anyways
right.
Because these fall.
It's not just good for yourskin, it's good for your
vascular system and your entirebody, but, um, but if it's
really something that's hard forthem, like, do your best to eat
those foods, but if not, that'swhen you put a supplement in
(12:21):
and you can do it from day today.
You know how did you eat thatweek?
Do you need to add a littleextra supplement?
Um, and, and that's an okay wayto do it too, for low risk
people.
And so the goal with omegas, um, I'm a huge fan of omegas.
I usually use two grams ofomega-3 fatty acids a day.
It's not the easiest to get.
(12:42):
You end up taking some prettyhearty pills, but the omega-3
fatty acids are undoubtedlyphotoprotective.
There is zero doubt.
The literature is robust.
Yes, a lot of it is animalmodels, because there's just not
, uh, you know, as robustinformation in humans, but
there's, you know, when we'retalking about minimal erythema
(13:05):
dose, it's a really, really niceway and that's an easy way to
test and see.
Is a supplement photoprotective?
Um, and there's studies usingthree grams um, uh, omega-3s
daily, which will, um, willincrease that minimal erythema
dose by 50%.
So even just an omega by itselfhas kind of have a profound
impact, and that's because theyare so, so anti-inflammatory.
(13:27):
Now, when your cells are madeup with omega-3s as opposed to
omega-6s, and then you put insome beautiful carotenoids in
there too, because if you lookat the structure of a carotenoid
, it's this long, lovelystructure and it wedges itself
right in that cell membrane whenthose cells are stressed,
whether it's whatever kind ofstressor, whether you're talking
(13:49):
about pollution, which we knowcontributes to skin cancer,
whether you're talking aboutsunlight or whatnot, when those
cells are under stress, theycreate much less inflammation
than a cell that's made up ofomega threes and devoid of of
like carotenoids and otherantioxidants and things like
that.
And so just thatanti-inflammatory aspect of it
(14:11):
um is protected from um, thedevelopment of skin cancer and
skin aging, um.
And so I love the omegas andthat's an easy thing to
supplement.
They're everywhere.
You obviously want a veryreputable brand, so you're not
getting nasty rancid oil butomega-3s, right?
If you didn't eat threeservings of fish, if you're not
getting flax or walnut and allthese other kind of precursors
(14:33):
for omega-3s, if you're notgoing to get in your diet
supplement easy.
Same with carotenoids If youhate carrots and you hate things
that are red and orange, youcan take a beautiful mixed
carotenoid supplement, and thenice thing about carotenoids is
you don't really have to worryabout vitamin A as far as, like
um, overdoing it, because youcan very much overdo it with
vitamin A, but carotenoids don'treally have an upper limit.
(14:53):
There is some safety concernwith really high doses of beta
carotene in patients who smoke,but these are very high levels
and so in general you reallyhave a hard time overdoing it
with carotenoids.
And so a nice mixed carotenoidsupplement with lutein, lycopene
and I love astaxanthin is onethat's showing up in the
(15:14):
literature a ton.
But you can get nice blends andyou can just supplement it if
you need to.
And then same thing goes forantioxidants, and we'll touch
about niacinamide in a minutetoo.
But from a dietary supplementyou know the carotenoids, the
omegas and the antioxidants youknow you can do shots of.
I mean there's beautiful blendslike powders for polyphenols
(15:36):
and stuff you can get now.
There's a lot of stuff outthere, mm.
Speaker 2 (15:41):
So you mentioned niacinamide or nicotinamide that
we definitely want to touch onand some of the other things
that I know that have been outthere in the literature maybe
people have heard of, like pinebark, you know, green tea.
I mean, how many people have acup of green tea every day or
love green tea shampoo or someother health benefit they use it
for?
But what are some of the othernutraceuticals that you would
(16:02):
want to highlight that you thinkpeople need to have on their
radar that might be someprotective as well.
Speaker 3 (16:07):
Yes.
So for people who are moderateor high risk, or you're just
outside in the sun all the timebecause you're an athlete and
you need to compliment yoursunscreen or whatnot, there are
things that you wouldn'tnaturally find maybe in your
diet.
Like polypodium leucotomus is afern.
It's probably not finding itsway into your diet, and higher
doses of niacinamide ornicotinamide are also not
(16:28):
finding their way into your diet, but are very, very
photoprotective.
And so if you consider yourself, if you're high risk just
because of tons of exposure, orif you're high risk because
immunosuppression or other skincancers and whatnot, that's when
those kinds of supplements canbe.
Um can be very helpful.
A lot of dermatologists areaware of niacinamide, based on
(16:49):
on-track trials from a few yearsago, um, which demonstrated uh,
you know, a modest butstatistically significant
decrease in skin cancer andprecancers in high risk people
over the course of a year.
Um and niacinamide is one of myfavorite tools because, um,
because of the mechanism of howit works, it is unique from all
(17:09):
the other things that we talkedabout.
So, omega-3s beinganti-inflammatory, carotenoids
absorbing light, especially bluelight, right, something
sunscreen doesn't do very wellLuton actually, like it's,
specifically absorbs blue light,so it works really well for
your eyes and your skin.
But the carotenoids absorbstuff and then you have your
antioxidants.
But niacinamide is very uniquein its mechanism.
(17:31):
So when your skin is exposed tosunlight it has somewhat of an
energy crisis, meaning themitochondria can kind of go a
little bit into shockmomentarily and that lapse in
energy that's being producedprevents DNA from being repaired
very well and that downstreamleads to immunosuppression in
the skin.
And what niacinamide does as acofactor for energy production
(17:54):
is it prevents that crisis fromhappening and promoting DNA
repair and preventingimmunosuppression.
So that little cascade ofevents.
It's very, very clear bothtopically and orally in humans
and in animals, that you do notget that degree of
immunosuppression in the skinwhen you have niacinamide on
board, or nicotinamide is theother name for it.
(18:15):
You'll also see studies withfrom like the biohackers, you
know longevity people with likeNR andN um and they're also down
the road and maybe even moreeffective Um.
But right now the studies indermatology anyways are with
niacinamide.
So that's um.
You know, that's usually whatI'll recommend Um, but it is
(18:35):
higher doses when you're talkingabout high risk patients.
So a lot of the studies doeither 500 or 500 twice a day,
um milligrams, and it's probablya little bit less effective for
people who are immunosuppressed, because the mechanism of
action is that it supports theimmune system and so if they
don't have an immune system tobegin with, it's going to be a
little bit less effective.
So that's why some of thestudies are mixed is because
(18:57):
some are immunosuppressedpopulations and some are not.
But it is a really, really,really amazing tool because it
is unique and immunosuppressionplays a very big role in
development of skin cancer, andI've had excellent results when
we do these blends with mypatients.
Speaker 2 (19:18):
Any other and, like the last couple minutes, we have
supplement wise dietaryrecommendations you would make
for somebody who's trying tomaximize their sun protection
but really looking for you know,kind of that natural
alternative, just simply what weeat and what we can actually
get, you know, maybe at thevitamin store, the grocery store
, that might be able to help usa little bit more.
Speaker 3 (19:37):
So well, the one thing we didn't mention.
The last thing I would add tothe ones that we talked about
was the polypodium leucotomus,and polypodium leucotomus is a
burn.
It's been used and studiedextensively for its
photoprotective roles and it hasall sorts of mechanisms of how
it works.
Being an anti-inflammatoryantioxidant supports DNA repair,
(19:58):
but it's really, reallyeffective.
Like the other things, like allof the things I've mentioned,
we have human studies in humansthat demonstrate it increases
how much light it takes to burnthe skin, um, but then there's
other benefits, um, with youknow, um, preventing DNA damage
with things like green teaextract you mentioned and pine
bark extract, um, and all ofthese others that can also
(20:18):
support um, you know differentparts of that pathway.
So, um, me personally, I liketo blend thing and I, instead of
doing mega doses of one thingyou know, we support in all
these different ways, um, andit's personalized, which means
some person might need omegasand somebody else might not need
omegas because they eat fishyou know, three or four times a
week.
So it's personalized, and it'salso personalized to the person
(20:39):
sitting in front of you as faras how much sun they get and how
much support that they need.
Because somebody who has, youknow, type six, very, very, you
know somebody who's very darkskinned, they, you know, need
more sunlight and so you couldprotect with all these beautiful
antioxidants and things likethat, but actually encourage
more sunlight, versus somebodywho's very fair skinned, you're
going to, you know, be like okay, you need more sunscreen, we
(21:01):
need to protect and we're goingto pull up, we're going to pull
out all the tools.
So it's very much apersonalized approach that I
like to take.
Speaker 2 (21:10):
And I think that's the goal for each patient that
when they come in, you know wejust do an information overload.
I know with all the great tipsyou just shared, it can be
overwhelming, I think you knowcircling back to their
dermatologist, their familydoctor, if they're talking about
supplements, really devising aplan that just meets their needs
.
Really good point to sort ofend on here so you can kind of
show us we can sort of eat andsupplement our way back to skin
(21:34):
protection from the sun or sunprotection.
I should say so that'sfantastic.
But thank you again for justkind of highlighting, you know,
other ways we can protectourselves, because I think we
all get pigeonholed with justsunscreen and some protective
clothing and common sensemeasures about when we do things
, but we forget about some ofthe basics, which is our diet
and then ways we can maximizesupplements.
(21:54):
So thank you for coming on andhighlighting those on the
podcast today For our listeners.
Katie, if they want to find you, where can they find you out
there on the web?
Speaker 3 (22:02):
Yes, and thank you so much for having me.
I'm not very active on socialmedia.
On Instagram, our clinic hereis shine underscore dermatology,
and our website is shinefunctional med medcom, where we
do try to stay active, so thosewould be the best places at this
time.
Speaker 2 (22:22):
Well, thanks again for coming on the podcast and
stay tuned for the next episodeof Dermot Trotter.
Don't swear about skincare.
Speaker 1 (22:31):
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.
Welcome to Dermot Trotter Don't Swear About Skin
Care where host Dr Shannon CTrotter, a board-certified
dermatologist, sits down withfellow dermatologists and
skincare experts to separatefact from fiction and simplify
skincare.
Let's get started.
Speaker 2 (00:19):
Welcome to the Dermot Trotter Don't Swear About Skin
Care podcast.
Today I have a special guestback on the show, dr Katie
Varmund.
She's a board certifieddermatologist and works in
private practice at ShineFunctional Dermatology in
Northern California.
Dr Varmund specializes intreating chronic skin conditions
like psoriasis and eczema, witha blend of conventional and
(00:40):
functional medicine practices.
She also has a passion forphotoimmunology or basically
again, how does light affect theimmune system?
How do they intertwine?
And she's also owner of ShineNutraceuticals.
Welcome back to the podcast,katie.
Speaker 3 (00:55):
Thank you so much for having me back.
Speaker 2 (00:57):
So for those of you that heard our previous podcast
again, you might have been alittle shocked to hear that
Katie and I were talking moreabout the benefits and yes, you
heard this the benefits of sunexposure.
So I think in dermatology beinga little bit of a bad
reputation and sometimes welldeserved we're really scaring
the bejeebers out of you andtelling you to stay out of the
sun because of all the dangersassociated with it.
But Katie really highlightedsome of those health benefits.
(01:20):
So we're going to lead intothis conversation.
We're going to lead into thisconversation.
We're going to talk a littlebit more about diet and maybe
supplements or what we call morenutraceuticals that you can do
for sun protection.
But first I'm going to haveKatie give a little preview
again of kind of those healthbenefits of sun exposure.
For those of you that missedthe last one.
Speaker 3 (01:36):
Perfect.
Thank you so much.
Yes, last time we had a greatdiscussion about some of the
benefits of sunlight exposureand we talked a little bit more
about things you know, reallytrying to find that balance
between over and under exposureto sunlight, because
overexposure, of course we areall very familiar skin cancer
and aging of the skin being thedetrimental effects.
(01:59):
But an inadequate sun exposureis also detrimental to people as
a whole, and so inadequate sunexposure can be associated with
one an increased risk ofall-cause mortality in general,
meaning you just have a higherchance of dying from any reason
if you have the lowest amountsof sun exposure.
Very yes, but then also there'san increased risk of
(02:21):
cardiovascular disease,autoimmune diseases like
multiple sclerosis and type onediabetes, inflammatory
conditions, things like eczemaand IBS, cerebral bowel syndrome
.
There's benefits for moodmetabolism, the microbiome we
talked about also, so a wholehost of things that are moderate
(02:43):
and, you know, an appropriateamount of sunlight can can help
for as far as a human being as awhole, and so we were talking
about how do we help bridge thatgap so that we can educate
people how to get enough for,you know, wellness, but not so
much that you're puttingyourself at unnecessary risk of
skin cancer and aging so muchthat you're putting yourself at
(03:07):
unnecessary risk of skin cancerand aging.
Speaker 2 (03:09):
So that's the good news, you guys can go out and
get some sun, although you'llhave to go back to that podcast.
Listen to some specificrecommendations because, as
Katie mentioned, it is balancethat we're trying to achieve
there, and part of the balance Ithink people are looking for
for some protection is reallykind of looking at our diet and
then also supplements.
I think supplements have reallycaught on.
You know people are looking fornatural alternatives to
maximize health.
(03:30):
So I wanted to talk aboutbefore even the supplements, you
know, because the diet's kindof, you know, tagged into that
with some of the ingredients inour diet that are very important
for some protection practices.
Let's talk more about the dietpiece.
What do you recommend from adiet perspective that might
actually be some protective fora patient?
Speaker 3 (03:48):
There are a couple of different classes of foods that
are very, very helpful.
But I wanted to take a stepback and talk about why each of
those classes are going to behelpful.
Because when you look at thetimeline kind of the
pathogenesis, that pathway fromsunlight to skin cancer, from
(04:09):
sunlight to photo aging of theskin, there's multiple different
steps where we can intervene,whether it's a diet or
nutraceutical or whatnot.
There's multiple differentsteps along that pathway and
that's really how we derivethese main classes of dietary
interventions to help, and soit's kind of important to know
what those steps are, becauseotherwise it's just kind of a
(04:30):
mess of you know, a mess of like.
It's like, okay, eat healthy, Iget it, but it really is much
more specific than that.
So, just to give like the oneminute overview, when you're
exposed to UV light, there'sthat whole cascade.
So there's oxidative stressthat occurs that damages DNA,
both directly and indirectly.
They're more directly fromlight.
(04:52):
Specifically, there'sinflammatory pathways that are
activated and all of thatinflammation is what you see on
the skin is sunburn and redness,and there is immunosuppression
that occurs in the skin aftersunlight exposure and that
immunosuppression is a reallyreally, really important
determinant of whether you'regoing to go on and get skin
cancer or not, because we knowpeople who are immunosuppressed
(05:14):
in general have a really highrisk of developing skin cancer
compared to people who aren'timmunosuppressed.
So that plays a reallyimportant role as well.
And so, when you're kind oflooking at all these different
layers, we want to treat thatoxidative stress, so those
little free radicals floatingaround causing damage to
structures in DNA.
We want to address inflammatorypathways, because when things
(05:36):
are inflamed it creates what wecall a pro-growth, a pro-tumor
environment and activates tumorprogression.
We also want to make sure thatwe're addressing DNA damage as
much as possible and preventingthat immunosuppression that
occurs from sunlight.
And so the reason for all thesedietary interventions is
because we want to target all ofthose steps and kind of plug
(05:59):
all the holes.
So, just to kind of name thetop ones, we can talk more about
carotenoids really importantantioxidants, just to kind of
name the top ones, we can talkmore about um carotenoids really
important um, antioxidants andthose kind of go with like it's
anti-inflammatory as well, um,cause it's a lot of the
polyphenols, omega-3s hugely,hugely important Um, and then um
isoflav or the, the um likephytoestrogens.
(06:21):
So people think of soy um canactually play an important role
also, but the big ones are goingto be the omegas, the
antioxidants, theanti-inflammatory and the
carotenoids.
Speaker 2 (06:32):
Wow.
And so when you think of likesome of those groups and diet
wise, are there particular like,more specific, like foods, you
would say, hey, grab a bunch ofblueberries or you know what
would you recommend just to bemore practical?
Somebody's like what should Ireally add in?
Not that you might get the fullvalue, because obviously you're
looking at a variety of thosethings, but what things tangibly
?
Would you recommend somebodypick up at the grocery store to
(06:54):
accomplish some of those dietaryneeds Angibly?
Speaker 3 (06:56):
would you recommend somebody pick up at the grocery
store to accomplish some ofthose dietary needs?
The easiest way, if you justwant to take kind of the
overview would be colorful foods.
So color is an indication ofpolyphenol content, and what's
neat about foods is they have alot.
They're rich in all sorts ofdifferent polyphenols, and so if
you're getting the rainbow inyour grocery cart, your blues
(07:17):
and your reds and yellows andoranges, you can pretty much
guarantee you're going to begetting a lot of these beautiful
polyphenols and carotenoids aswell.
The big hitters for carotenoidsthat are kind of in everybody's
diet are going to be carrotsand tomatoes.
Those are the easiest ones toget and it's not like you have
to eat 100 carrots a day.
We're talking like two carrots.
And it's not like you have toeat a hundred carrots a day.
Speaker 2 (07:38):
We're talking like two carrots and and like God, I
hate carrots.
I gotta be honest with you.
Speaker 3 (07:41):
Well, it doesn't have to be carrots, but you know
something, orange, right, andyou can get your.
I like.
I think I literally turn orange, like every summer because I
eat so many tomatoes.
I love summer foods, but it'skind of fun when you think about
the design of everything.
It's such that right in thesummertime when you need support
is when all of these beautifulfruits and vegetables are
(08:04):
available for your body, and soit's like the plants need it,
and then you eat the plants andthen you need it and so so
there's plenty of ways to getcolor.
You know whether you're talkingabout bell peppers, and there's
lots of options for orange too,but carrots are kind of the
easiest one that people can getdown.
And tomatoes, you know there's.
There's a study like thelycopene, specifically in
(08:25):
tomatoes.
There's a study that looked at16 grams of lycopene daily,
dosing for anything about 10weeks or so, which is the
equivalent to like one and ahalf tablespoons of tomato paste
.
So it's not like an insaneamount.
Um resulted in a 40% reductionin what we call the minimal
erythema dose.
So how much UV light it takesto burn your skin is really
(08:47):
dramatically reduced by likereally not a whole lot of tomato
paste, Um, and and so thesekinds of levels that we see in
studies that visibly, veryclearly increase your skin's
tolerance to sunlight,specifically ultraviolet light,
are not exorbitant amounts.
Like it's not.
You're not having to takesupplements and blends and
(09:07):
things like that in order to getit.
If you're having, you know, atomato and like a carrot and
maybe a cup of spinach, you'regetting a ton of lutein,
lycopene and beta caroteneenough for like your day's
amount.
So, as long I tell people, aslong as you're eating, like,
check the list.
Like, did I eat somethingcolorful today?
And then, when it comes topolyphenols, we're thinking more
(09:30):
about, like you're saying,blueberries.
The berries are really rich inpolyphenols.
Pomegranate is a very popularone that's very, very rich in
several different amazingpolyphenols.
So doing a fruit and avegetable that are colorful, I
mean that's really a great goalfor the day.
And then you've got to eat youromega threes for the day, which
most people are aware of.
You know fatty fish, the salmonand whatnot, but you do flax
(09:52):
and walnuts.
And you just Google, searchhigh omega foods, Um, and you
just you just look at the list.
You're like, did I eat one ofthose things today?
Done.
If you didn't, then there'ssupplements, and if you're high
risk, then there's supplements.
But in general, did you eatsomething colorful?
Did you eat an omega-3?
That's kind of the easy answerfor a daily goal.
Speaker 2 (10:13):
No, I love that Cause .
I mean I'm not a big fan of faddiets and tell people to do
this extreme or that extreme.
And I do think it getsoverwhelming for patients
because, like gosh, I gottaremember to eat this or how much
, or you know I don't have time,or you know I don't care for
that particular vegetable orfruit.
But I think that makes it morerealistic.
And you know and I tend to fallback on to when people are
asking for you know particular,you know diet are asking for you
(10:35):
know particular, you know diet.
Again, I'm not a fan of a dietbut I usually tell you you know
eating Mediterranean diet orlifestyle, really, you know,
does hit some of these majorfood groups and things that we
do need, I think, for overallgeneral health.
But it's amazing, from the sunprotection piece, like that,
some of the things are includedin that diet.
You know the omega threes, thefish diets, you know that high
in those Mediterranean dietsthat are high in fish.
(10:56):
And you know vegetables andfruits.
I mean it's amazing how youkind of can capture both.
So I was totally one in doubt.
I think you're safe to go thatroute, but really, again, it's
about balance to achieve that.
So you know, beyond kind of thethe food aspect of it, you know
, if they jump away and say, youknow, I'm just not going to do
it, I don't have time, I, youknow I buy vegetables, they're
bad in a day so I don't even buythem.
(11:18):
What if they're looking to dothis more from the nutraceutical
side, or maybe what most peoplemight think of as more like
supplements?
And you know, and if you feellike there's a distinction there
between true nutraceuticals andsupplements, feel free to kind
of comment on that too, becauseI think people use it often
interchangeably, and what typesof things should people look for
in those categories as well?
Speaker 3 (11:38):
and and that's how I like the word supplement, you
know, I think, is correct, right, it's really to supplement your
, your diet, and so that's how Ikind of describe it to people,
right, I'm like, look at whatyou ate that day and you know,
for a low-risk person, right,we're talking about somebody who
hasn't had a ton of sunburns,they're're not immunosuppressed,
they don't have, you know, very, very fair skin that feckles
(11:59):
easily, and they live inCalifornia.
Um, you know, for somebodywho's not low risk, the idea is
like, try to eat it, becausethat's good for you anyways
right.
Because these fall.
It's not just good for yourskin, it's good for your
vascular system and your entirebody, but, um, but if it's
really something that's hard forthem, like, do your best to eat
those foods, but if not, that'swhen you put a supplement in
(12:21):
and you can do it from day today.
You know how did you eat thatweek?
Do you need to add a littleextra supplement?
Um, and, and that's an okay wayto do it too, for low risk
people.
And so the goal with omegas, um, I'm a huge fan of omegas.
I usually use two grams ofomega-3 fatty acids a day.
It's not the easiest to get.
(12:42):
You end up taking some prettyhearty pills, but the omega-3
fatty acids are undoubtedlyphotoprotective.
There is zero doubt.
The literature is robust.
Yes, a lot of it is animalmodels, because there's just not
, uh, you know, as robustinformation in humans, but
there's, you know, when we'retalking about minimal erythema
(13:05):
dose, it's a really, really niceway and that's an easy way to
test and see.
Is a supplement photoprotective?
Um, and there's studies usingthree grams um, uh, omega-3s
daily, which will, um, willincrease that minimal erythema
dose by 50%.
So even just an omega by itselfhas kind of have a profound
impact, and that's because theyare so, so anti-inflammatory.
(13:27):
Now, when your cells are madeup with omega-3s as opposed to
omega-6s, and then you put insome beautiful carotenoids in
there too, because if you lookat the structure of a carotenoid
, it's this long, lovelystructure and it wedges itself
right in that cell membrane whenthose cells are stressed,
whether it's whatever kind ofstressor, whether you're talking
(13:49):
about pollution, which we knowcontributes to skin cancer,
whether you're talking aboutsunlight or whatnot, when those
cells are under stress, theycreate much less inflammation
than a cell that's made up ofomega threes and devoid of of
like carotenoids and otherantioxidants and things like
that.
And so just thatanti-inflammatory aspect of it
(14:11):
um is protected from um, thedevelopment of skin cancer and
skin aging, um.
And so I love the omegas andthat's an easy thing to
supplement.
They're everywhere.
You obviously want a veryreputable brand, so you're not
getting nasty rancid oil butomega-3s, right?
If you didn't eat threeservings of fish, if you're not
getting flax or walnut and allthese other kind of precursors
(14:33):
for omega-3s, if you're notgoing to get in your diet
supplement easy.
Same with carotenoids If youhate carrots and you hate things
that are red and orange, youcan take a beautiful mixed
carotenoid supplement, and thenice thing about carotenoids is
you don't really have to worryabout vitamin A as far as, like
um, overdoing it, because youcan very much overdo it with
vitamin A, but carotenoids don'treally have an upper limit.
(14:53):
There is some safety concernwith really high doses of beta
carotene in patients who smoke,but these are very high levels
and so in general you reallyhave a hard time overdoing it
with carotenoids.
And so a nice mixed carotenoidsupplement with lutein, lycopene
and I love astaxanthin is onethat's showing up in the
(15:14):
literature a ton.
But you can get nice blends andyou can just supplement it if
you need to.
And then same thing goes forantioxidants, and we'll touch
about niacinamide in a minutetoo.
But from a dietary supplementyou know the carotenoids, the
omegas and the antioxidants youknow you can do shots of.
I mean there's beautiful blendslike powders for polyphenols
(15:36):
and stuff you can get now.
There's a lot of stuff outthere, mm.
Speaker 2 (15:41):
So you mentioned niacinamide or nicotinamide that
we definitely want to touch onand some of the other things
that I know that have been outthere in the literature maybe
people have heard of, like pinebark, you know, green tea.
I mean, how many people have acup of green tea every day or
love green tea shampoo or someother health benefit they use it
for?
But what are some of the othernutraceuticals that you would
(16:02):
want to highlight that you thinkpeople need to have on their
radar that might be someprotective as well.
Speaker 3 (16:07):
Yes.
So for people who are moderateor high risk, or you're just
outside in the sun all the timebecause you're an athlete and
you need to compliment yoursunscreen or whatnot, there are
things that you wouldn'tnaturally find maybe in your
diet.
Like polypodium leucotomus is afern.
It's probably not finding itsway into your diet, and higher
doses of niacinamide ornicotinamide are also not
(16:28):
finding their way into your diet, but are very, very
photoprotective.
And so if you consider yourself, if you're high risk just
because of tons of exposure, orif you're high risk because
immunosuppression or other skincancers and whatnot, that's when
those kinds of supplements canbe.
Um can be very helpful.
A lot of dermatologists areaware of niacinamide, based on
(16:49):
on-track trials from a few yearsago, um, which demonstrated uh,
you know, a modest butstatistically significant
decrease in skin cancer andprecancers in high risk people
over the course of a year.
Um and niacinamide is one of myfavorite tools because, um,
because of the mechanism of howit works, it is unique from all
(17:09):
the other things that we talkedabout.
So, omega-3s beinganti-inflammatory, carotenoids
absorbing light, especially bluelight, right, something
sunscreen doesn't do very wellLuton actually, like it's,
specifically absorbs blue light,so it works really well for
your eyes and your skin.
But the carotenoids absorbstuff and then you have your
antioxidants.
But niacinamide is very uniquein its mechanism.
(17:31):
So when your skin is exposed tosunlight it has somewhat of an
energy crisis, meaning themitochondria can kind of go a
little bit into shockmomentarily and that lapse in
energy that's being producedprevents DNA from being repaired
very well and that downstreamleads to immunosuppression in
the skin.
And what niacinamide does as acofactor for energy production
(17:54):
is it prevents that crisis fromhappening and promoting DNA
repair and preventingimmunosuppression.
So that little cascade ofevents.
It's very, very clear bothtopically and orally in humans
and in animals, that you do notget that degree of
immunosuppression in the skinwhen you have niacinamide on
board, or nicotinamide is theother name for it.
(18:15):
You'll also see studies withfrom like the biohackers, you
know longevity people with likeNR andN um and they're also down
the road and maybe even moreeffective Um.
But right now the studies indermatology anyways are with
niacinamide.
So that's um.
You know, that's usually whatI'll recommend Um, but it is
(18:35):
higher doses when you're talkingabout high risk patients.
So a lot of the studies doeither 500 or 500 twice a day,
um milligrams, and it's probablya little bit less effective for
people who are immunosuppressed, because the mechanism of
action is that it supports theimmune system and so if they
don't have an immune system tobegin with, it's going to be a
little bit less effective.
So that's why some of thestudies are mixed is because
(18:57):
some are immunosuppressedpopulations and some are not.
But it is a really, really,really amazing tool because it
is unique and immunosuppressionplays a very big role in
development of skin cancer, andI've had excellent results when
we do these blends with mypatients.
Speaker 2 (19:18):
Any other and, like the last couple minutes, we have
supplement wise dietaryrecommendations you would make
for somebody who's trying tomaximize their sun protection
but really looking for you know,kind of that natural
alternative, just simply what weeat and what we can actually
get, you know, maybe at thevitamin store, the grocery store
, that might be able to help usa little bit more.
Speaker 3 (19:37):
So well, the one thing we didn't mention.
The last thing I would add tothe ones that we talked about
was the polypodium leucotomus,and polypodium leucotomus is a
burn.
It's been used and studiedextensively for its
photoprotective roles and it hasall sorts of mechanisms of how
it works.
Being an anti-inflammatoryantioxidant supports DNA repair,
(19:58):
but it's really, reallyeffective.
Like the other things, like allof the things I've mentioned,
we have human studies in humansthat demonstrate it increases
how much light it takes to burnthe skin, um, but then there's
other benefits, um, with youknow, um, preventing DNA damage
with things like green teaextract you mentioned and pine
bark extract, um, and all ofthese others that can also
(20:18):
support um, you know differentparts of that pathway.
So, um, me personally, I liketo blend thing and I, instead of
doing mega doses of one thingyou know, we support in all
these different ways, um, andit's personalized, which means
some person might need omegasand somebody else might not need
omegas because they eat fishyou know, three or four times a
week.
So it's personalized, and it'salso personalized to the person
(20:39):
sitting in front of you as faras how much sun they get and how
much support that they need.
Because somebody who has, youknow, type six, very, very, you
know somebody who's very darkskinned, they, you know, need
more sunlight and so you couldprotect with all these beautiful
antioxidants and things likethat, but actually encourage
more sunlight, versus somebodywho's very fair skinned, you're
going to, you know, be like okay, you need more sunscreen, we
(21:01):
need to protect and we're goingto pull up, we're going to pull
out all the tools.
So it's very much apersonalized approach that I
like to take.
Speaker 2 (21:10):
And I think that's the goal for each patient that
when they come in, you know wejust do an information overload.
I know with all the great tipsyou just shared, it can be
overwhelming, I think you knowcircling back to their
dermatologist, their familydoctor, if they're talking about
supplements, really devising aplan that just meets their needs
.
Really good point to sort ofend on here so you can kind of
show us we can sort of eat andsupplement our way back to skin
(21:34):
protection from the sun or sunprotection.
I should say so that'sfantastic.
But thank you again for justkind of highlighting, you know,
other ways we can protectourselves, because I think we
all get pigeonholed with justsunscreen and some protective
clothing and common sensemeasures about when we do things
, but we forget about some ofthe basics, which is our diet
and then ways we can maximizesupplements.
(21:54):
So thank you for coming on andhighlighting those on the
podcast today For our listeners.
Katie, if they want to find you, where can they find you out
there on the web?
Speaker 3 (22:02):
Yes, and thank you so much for having me.
I'm not very active on socialmedia.
On Instagram, our clinic hereis shine underscore dermatology,
and our website is shinefunctional med medcom, where we
do try to stay active, so thosewould be the best places at this
time.
Speaker 2 (22:22):
Well, thanks again for coming on the podcast and
stay tuned for the next episodeof Dermot Trotter.
Don't swear about skincare.
Speaker 1 (22:31):
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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