September 23, 2025 • 22 mins
In this episode, dermatologist Dr. Katie Varmann explores advanced sun protection beyond sunscreen. From antioxidants like vitamin C and E to DNA repair enzymes, melatonin, and niacinamide, she explains how these ingredients fight oxidative stress, repair damage, and boost skin defense.
She also shares simple morning and evening routines tailored to your needs and budget. The takeaway: you don’t have to avoid the sun—just protect smarter with a layered approach.
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Episode Transcript
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Speaker 1 (00:00):
Welcome to Dermot Trotter Don't Swear About
Skincare 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 (00:21):
Welcome to the Dermot Trotter Don't Swear About
Skincare podcast.
Back on the podcast today oneof my favorite guests, dr Katie
Varmann.
She's a board-certifieddermatologist and works in
private practice at ShineFunctional Dermatology in
Northern California.
Dr Varmann specializes intreating chronic skin conditions
like psoriasis, as well aseczema, and she likes to do this
(00:43):
with a blend of conventionaland functional medicine
practices.
She also has a passion forphotoimmunology, or basically,
again like we've talked about,how does sunlight and the immune
system really interact?
And this has really been thefocus of a lot of our
conversations and we're going totalk more about that again
today, but on a different level.
Just also let you know she'salso owner of Shine
(01:04):
Nutraceuticals.
Welcome back to the podcast,katie.
Speaker 3 (01:07):
Thank you so much for having me back for round three.
Speaker 2 (01:11):
Of course I love having this series on, because
you know we've really startedwith one.
How does light benefit us froma health perspective, including
the skin, which I think a lot ofpeople found shocking.
And then also, too, then wetalked about well, can we eat
and supplement ourselves?
Back to you know, sunprotection, which you've been
able to, I think, educate us onboth.
(01:32):
I'm going to have you kind ofsummarize both of those, but
today we're going to pivot andtalk about, you know, what is
there topically to help us withsun protection beyond sunscreen,
because I think that's whatmost people just think of when
you think about puttingsomething on.
But first let's circle back andhave you kind of just, you know
, if you don't mind, summarizekind of the health benefits and
what we talked about a littlebit, about doing oral
(01:54):
supplements as well as diet andhow it can be sun protective for
us.
Speaker 3 (01:59):
Absolutely, and I like the series that we've done
because, you know, we firsttalked about some of the
benefits of sunlight exposure,which is really important
because it lays the foundationfor everything, right?
I mean, why would we spend somuch effort and energy thinking
about how to tolerate sunlightbetter when the answer is just
less sunlight exposure, right,and that's traditionally how
(02:21):
we've been kind of taught likeless is more, right, you know,
avoiding midday sun, sunprotection, sun protection, sun
protection reapply, reapply,with this like ultimate goal of
having like no sun exposure.
But so we talked about thebenefits of sunlight being that
there's a balance, right, ashuman beings, we need some
sunlight for optimal health andwellness, need some sunlight for
(02:46):
optimal health and wellness.
And the idea is to find thatbalance for you personally,
based on your skin type andwhere you live and all your risk
factors, like how much sunlightdo I need to have optimal
health, without overdoing it andincreasing the risk of skin
cancer and photo aging.
And there's, of course, ways toprotect high risk areas, so
that are maybe a little bit moreaesthetically important, like
your face, right, while alsogetting a little bit of gentle
sunshine on the rest of yourbody to get the benefits, and so
(03:08):
we talked about all of thesebenefits, including a reduced
risk of autoimmune andinflammatory disease, reduced
risk of cardiovascular diseaseand all-cause mortality in
general.
There's a benefit for mood, andwe talked about microbiome.
A benefit for mood and wetalked about microbiome, and I
(03:28):
don't even think we mentionedthe reduced risk of some very
serious cancers like breast andcolorectal cancer and all of
these things we used toattribute to vitamin D, but now
we're really recognizing,because of vitamin D studies not
panning out as well as we'dhoped, where supplementing
doesn't reduce the risk inmeaningful ways, that the
sunlight is giving us thesebenefits in ways that expand,
(03:49):
that go beyond just the vitaminD component to it, and so we
talked about those, and then wekind of led into well, what can
we do from a dietary perspective?
And then now, to finish it off,we can talk about topical
things, because some of thethings that work orally as a
nutraceutical and in our dietalso work if you apply them to
(04:09):
the skin.
So I think that's what we'redelving into today.
Speaker 2 (04:14):
Yes, yes, For the person like myself who doesn't
like carrots I can't get thosecroutons that way, I mean there
are other things I can, butmaybe it's just people they
don't really want to eat theirway through, or maybe they just
don't want to take supplements,but they want to do something
what I call sort of skindirected therapy.
It's like, hey, is there atopical you know something
(04:37):
beyond just maybe sunscreen thatI would typically use that
might help make my skin more sunprotective.
So I'll let you dive into someof the topical options that are
out there and maybe the benefitsthey offer.
Speaker 3 (04:44):
Right, and all of these things that we've talked
about aren't replacing sunscreenas a really important, powerful
tool.
But when you look at sunscreen,it's not one, you know, rarely
are we using it, maybe somepeople, but at absolutely all
times.
And, you know, maybe notreapplying it as often as needed
for all the benefits and sothey're, you know, and it's
(05:05):
really it's not blockingeverything.
So if you get your good ironoxides in there, yes, you can
get some more visible lightcoverage, but in general,
sunscreens are not like reallythat awesome at preventing, kind
of some of these longerwavelengths and into the visible
light spectrum.
We're learning more and more thedamaging effects of blue light,
especially as far as causingsunspots and more of the
(05:27):
photoaging effects and oxidativestress even from visible light
actually plays a very big role.
And so if you're just usingsunscreen, then you're
potentially getting a lot moreexposure than you're recognizing
just because you're not burning.
Right, you're not gettinginflammation, so you're not
burning, but you're getting DNAdamage and oxidative stress that
can cause photoaging down theroad.
(05:48):
And so using things likenutraceuticals whether orally or
really incorporating into yourdiet or using them topically,
kind of fills in these holes soit helps prevent DNA damage.
It reduces oxidative stress, itreduces these inflammatory
pathways, and then it supportsthe energy crisis that occurs
after light, which reduces theseinflammatory pathways, and then
it supports the energy crisisthat occurs after light, which
(06:08):
reduces how much the sunimmunosuppresses in the skin,
and so using these other agentscan help fill in those holes and
give you added benefits tosunscreen alone.
Speaker 2 (06:22):
And so, for some of these type of ingredients, what
types of things would yourecommend that people you know
be looking for?
You know, from the standpointof like antioxidants, if you
don't mind explaining again likewhat an antioxidant really does
, because I think a lot ofpeople have heard of
antioxidants before.
Yeah, my doctor said, you know,eat some blueberries every day.
It's full of antioxidants.
You know it's good for you formultiple health benefits, but
(06:45):
specifically for the skin.
What are some of the favoriteyou know antioxidant ingredients
that you recommend, and arethere particular products that
you recommend you know gettingthem from topically?
Speaker 3 (06:55):
Yep, and and it's important to like know why
you're doing things like you'resaying to you like, what's the
point of the antioxidant and whyis it different than an
isinamide?
And so when your skin isexposed to UV light invisible
light, but UV light, inparticular UVB is kind of going
not too far into the skin but itcauses a lot of direct DNA
damage.
And then UVA is going a lotdeeper into the skin and it
(07:23):
causes indirect DNA damage.
But then it also causes a wholehost of what we call oxidative
stress or free radicals.
And so there's these moleculesfloating around.
They're very unstable and whenthey hit things whether it's a
cell membrane or otherstructures or DNA they cause
damage and they cause the DNA tostick to other stuff and stick
to itself, and so it just causesa lot of damage.
And then, when you're talkingabout things like collagen, you
know we want to preserve a lotof these structures, and so what
(07:45):
antioxidants do is you know wewant to preserve a lot of these
structures, and so whatantioxidants do is you know you
have natural antioxidants, justkind of like in our bodies, but
then you can also eat them andyou can put them on your skin,
and so, no matter how they getthere, the antioxidants are in
the skin and then, instead ofthat little reactive molecule
causing damage to your collagenor DNA, the antioxidant subdues
(08:06):
it and makes it calm andbalanced again.
And so, orally, antioxidantsabsolutely make their way to the
skin and are very, very helpful.
And in a diet, we're looking atthings that are very colorful
as an indication of goodantioxidant properties, from
polyphenols specifically, and sothe antioxidants are in there,
(08:26):
kind of gobbling up that.
But you can also put them onthe skin.
The problem is and this iswe're talking about like vitamin
C, e, and now there's likeferulic acid and fluorotin and
some of the others the problemwith the skin is always that you
can put anything you want onthe skin, but is it going to get
down into it where it needs togo?
And that's where it gets alittle bit trickier and why some
(08:47):
products may demonstrate greatbenefit and other ones not so
much.
Antioxidants are inherently veryunstable, and so it takes a lot
of smart scientists to figureout how to make them very stable
and to get where they need togo.
And so the CE for Rulic andFluoritin.
Those are the ones that we havereally clear studies in humans
that demonstrate if you put themon the skin and shine light on
(09:11):
it, specifically UV light youget less damage and less burning
of the skin and so very clearlycan protect from the stress
that sunlight causes.
From those types of topicalantioxidants and they have to be
applied before, so morning is agreat time to use antioxidant
serums.
Speaker 2 (09:31):
Yeah, I think people forget about that.
I think we've kind of ingrainedin people using other types of
antioxidants, like a form ofvitamin A, like a retinol over
the counter, or maybe they'reusing a prescription like a
tretinoin form.
We always tell people you needto use this at nighttime and I
think people forget during theday because of sun exposure,
because of pollution exposure.
(09:51):
Doing an antioxidant in themorning is important.
I think as dermatologists wekind of know this.
But I think patients sometimesare kind of surprised like, oh,
I would do something during theday, like I thought, you know, I
just cleanse, maybe moisturize,put my sunscreen on and I'm
good to go.
So I, like you know making thatpoint again that like the
morning application is goodbecause you're you're fighting
(10:11):
off some of that damage thatyou're getting sort of acutely
throughout.
You know your day, whetheryou're driving to and from work,
whether you're out walkingaround in the city, you know
whatever you happen to be doing.
Really good points for that aswell.
And from some of these two, youknow, I think one of the ones I
wanted to highlight because Ithink a lot of patients might
already take this orally is sortof the role of melatonin.
(10:32):
I think this has been somethingthat's been a little bit
exciting.
Some of the more data comingout, you know, from the
anti-aging or photo protectionstandpoint of melatonin.
A lot of people think, oh, Ithought people would just take
that to help them go to sleep.
What are your thoughts on thedata with melatonin and its role
in helping with sun protection?
Speaker 3 (10:49):
Yeah, melatonin is one of the most ancient, like
archaic, old, powerfulantioxidants that our body has
and like all living organisms, Ithink probably have melatonin.
But it's a really verybeautiful thing because you go
to sleep and then your body getslike showered with this
(11:09):
powerful antioxidant, um, and soyou know, we can take it, yes,
as a sleep agent, but there are,you know, it does.
It does serve as an antioxidantas well.
Um, topically, um, same thingas the, as the you know, like
vitamin c and e's and whatnot.
Topically it also protects fromsun exposure, but, same as
(11:29):
antioxidants, it only works veryclear, it only works before the
sun exposure.
Once the cat's out of the bag,it doesn't help.
So it's another one of thosethings that would need to be
used before sun exposure.
I am not aware of any humanclinical trials where it's given
orally and they've done minimalerythema dose studies to see if
(11:50):
you take it orally, if itreduces or increases how much
light it takes to burn your skin.
I have not seen that study.
It might be out there, butdefinitely topically, we know
that it is photoprotective.
Speaker 2 (12:02):
So for somebody that might also be thinking about
other topicals, you might seesome products that kind of get
this label more generically likea DNA enzyme repair cream.
Is that anything that'sdifferent than what we've talked
about before?
Is it sort of a different, youknow, concoction of different
things, or is it really just anantioxidant blend?
I mean, a lot of people arelike what exactly does it?
(12:24):
Mean it sounds good, but whatis it really?
Speaker 3 (12:26):
Yeah, and this is one of those things where you go
all through residency and you'rein training and you're with
your colleagues and DNA repairenzymes never came up until I
was doing all this research onsupporting the skin with
nutraceutical and whatnot.
But DNA repair enzymes are outthere and they actually really
work and there's very robustclinical trials and, yes, it's
(12:47):
all funded by you know theindustry and the people make it,
but they're very like, like youknow, clear, like benefits, and
they've done studies withpeople who have genetically just
make skin cancer constantlywhen exposed to uv light because
they can't repair their dnawell and it shows that it
prevents skin cancers andprecancers from forming pretty
(13:08):
dramatically in this population.
And then the studies that we'veused with these DNA repair
enzymes are usually incombination with sunscreen in
our studies and what it shows isthat when you combine DNA
repair enzymes with sunscreen,it way outperforms sunscreen
alone when it comes to what wecall field cancerization.
So there's little precancerseverywhere and it reduces DNA
(13:32):
damage, which is something thatyou can't see on the skin.
You have to sample it right.
So if you use sunscreen withDNA repair enzyme and sunscreen,
both people won't burn becauseof the sunscreen.
But if you take a biopsy, youhave less DNA damage because
it's being repaired when you addthe DNA repair enzymes and what
they are is very unique.
These DNA repair enzymes are notfound in human biology.
(13:55):
There's this theory that thegene that makes them, that was
kind of outsourced and now it'slike a photoreceptor for blue
light.
We don't have it anymore, butwe get it from organisms and
they make it so that it's fatsoluble, so it gets down and
gets where it needs to go and itactually appears to be able to
repair human DNA.
And it's really cool andthere's you can find it in
(14:18):
sunscreen and you can find itindependently, and that is
something that you can use aftersun exposure.
And so there are things that youneed to use in the morning your
antioxidants, obviously, yoursunscreen right, you need to
have on board before, but thenthere's things that you can use
at night for repair.
Dna enzymes are one thing thatdo appear to be very helpful, um
, although they haven't reallymade their way into like derm
(14:40):
literature as much.
Um and then, um, the otherthing would be topical
niacinamide.
That can be helpful afterwards,um, so that's usually how I
kind of divide up a topicalregimen.
If we're specifically targetingphoto protection.
Speaker 2 (14:58):
So just when you talk about a regimen there, I think,
a lot of good information thatwe've been talking about.
But for people that might be alittle overwhelmed or thinking,
okay, all this is great, butwhat practically should I do or
what would you recommend?
But what practically should Ido or what would you recommend,
and maybe that's different basedon, obviously, patient needs or
sun exposure.
Or maybe you might recommend anoral supplement version versus
(15:19):
topicals.
But say this person's coming toyou and this patient's asking,
or person's saying, hey, I wantto do something topically, how
would you recommend maybeintegrating one or two of these
types of topicals, or maybe more, just what would be a simple
recommendation, because I thinkthat's what a lot of people want
.
It's sort of like a tangibleanswer.
(15:42):
Okay, I get that.
You know these can be helpful.
The CE Ferulic I get that.
Maybe the DNA enzyme repair,but like I can't have, I can't
be putting five things on myface in the morning, five at
night Is there a basic regimenyou might recommend morning,
five at night Is there a basicregimen you might recommend?
Speaker 3 (15:54):
And again, based on needs.
Maybe it's different for thepatient.
Yeah, and that's really what itis.
It's very patient dependent andeverything needs to be based
off of what the person in frontof you is telling you, because,
I think we said before, somepeople want a list of four
things they put on morning andnight.
Other people want to takethings orally.
Other people are like I want todo it completely with diet, and
so you really have to tailoryour recommendations based off
(16:14):
of what that person's actuallygoing to do and what they you
know what they want to do andtheir finances right, because a
DNA repair is very expensive, aCE for like it's very expensive,
and so you have to take allthat into account.
Personally, I mean, if somebodyis not very high risk, for me
diet, like all day long, likediet, is the best way to get all
(16:37):
of these things, because weknow so much about all these
beautiful polyphenols andmolecules and how they absorb
sunlight and absorb oxidativestress and repair DNA, yada,
yada, yada.
But if you imagine, like, howmuch is probably in that plant
that we don't even know aboutyet, I think that diet and
consuming whole foods andseasonally for me makes the most
(16:59):
sense.
But there are people who havesun damage, who want to do more
or who are high risk for skincancer, in which case we need to
bring out more tools and soreally hitting the marks on the
dietary stuff, like we talkedabout before, and the oral
supplements that can be helpfulthe polypodium, the niacinamide,
the omegas, the carotenoids,and then topically, the regimen.
(17:20):
Again, it's going to depend onhow much the person wants to do
and wants to spend.
In a perfect world, you'redoing a nice studied CE-fru
liquor, fluortin in the morning,followed by, in my opinion,
mineral sunscreen, and then inthe evening it's a niacinamide
or a DNA repair enzyme or both.
They don't have any evidencethat they interact, although I
(17:41):
don't know that the study hasreally been looked at.
But those would be the two inthe evening as the repairs the
morning's prevention and eveningis repair.
And then if people are getting alot of sun, I'll have them use
their retinae, their tretinoins,in the winter only because it
doesn't just increase your riskof irritation and burning, it
actually increased the damagecaused by sunlight, and so
(18:01):
sometimes we'll put a hold on it.
If somebody's like I'm atriathlete and I'm in the sun
all the time You're like okay,we'll tell it to you.
So that would be like theperfect regimen if you were just
talking about sun protection,um, if we just wanted to pick a
couple pieces.
Um, obviously, the sunscreen isgoing to be the biggest thing
for your book, um, but I love, Ilove a nice, you know vitamin,
(18:22):
you know vitamin c for look, orfloritin, um in the morning and
then, um, the niacinamide, Ithink, is indispensable because
of the mechanism of action.
It is unique in how it worksand how it protects your skin
from sunlight, and so the ideais that you stack right, you
stack these different layers,different ways to prevent that
(18:44):
progression from sunlightexposure to skin cancer and
photo aging, and so using toolsfrom different categories is
really important.
Speaker 2 (18:54):
I think this is just amazing.
Like I love having theseconversations with you because I
feel like you're somebodythat's telling us too that you
can.
You know you can have your cakeand eat it too.
You can live your life.
You can, like you said, youmentioned that person who's out
and training for that marathonor triathlon and what their
needs are.
You can have the person thatworks indoors all day.
You can have somebody that's,you know, an agriculture.
(19:16):
Maybe they're a farmer, ormaybe it's a teenager that's a
lifeguard, you know, and out allsummer getting a lot of sun.
I think what's really important,and where you see dermatology
shifting a little bit, is justwe're practical now.
We know people have to livetheir lives.
I think we're understanding thesun is not this evil entity.
It has multiple health benefitsbut, like anything else, too
(19:36):
much of a good thing can be abad thing.
But you're giving peopleoptions From the series we've
done here you can talk about howdo you just practically protect
yourself from the sun?
How can we incorporate dietsupplements, non-topicals and,
as you mentioned, you can mixand match or do this layering to
go after different ways thatthey can actually help our skin.
You know, I think, live in aworld where we can do the things
(19:58):
we want, but also try tominimize risk, cause I think
that's what that's about, butalso living our lives to our
fullest too, which may mean forthat person that's doing that
marathon or gardening every day,or, unfortunately, for me, to
sneak out whenever I can with mykids yeah, the sun, and there's
hope for people like me thatdon't like carrots and other
things too.
So there's good, good thingswith us.
(20:18):
But thank you so much forcoming back on and sharing your
expertise and knowledge, becauseI think this is empowering for
patients to be aware of theseoptions that are out there and
that these aren't just thingsthat we kind of throw out people
.
There's data to support whatwe're recommending and giving
people, you know, I think, toolsand empowering them to live
their best lives, and that'sgoing to be potentially out in
(20:39):
the sun, but balancing that, youknow, with, obviously, risk and
things we can do to correctthat damage.
So thanks again, katie, forcoming on and sharing all this
information with us.
It's been fantastic.
Speaker 3 (20:56):
For our listeners that want to find you.
Do you mind sharing whereyou're at online in case they
want to track you down?
Yes, and thank you again somuch for having me.
I've really enjoyed ourdiscussions.
I love sharing the informationand just teaching people how you
can really live in harmony withsunlight and not overdoing it
and not making it okay to go outand fry and not doing that kind
of behavior, but to get anadequate amount just for overall
wellness and to reduce the riskof all these chronic
(21:18):
inflammatory diseases that arereally plaguing our society now.
And sunlight, like we talkedabout in some of our other
episodes, is a really importantway to kind of tame an
overreactive immune system.
But you want to do it withoutgiving yourself skin cancer and
sunspots and all those things,and you really really can.
(21:38):
But it has to be personalized.
So thank you so much forinviting me on to talk about
that.
I am not terribly active onsocial media.
We do have an Instagram accountfor my clinic it's shine
underscore dermatology, and ourwebsite is shinefunctionalmedcom
, and so we are, you know,becoming a little bit more
(21:59):
active out there, so you canfollow along and I'll make sure
to share other podcasts andother things that we're up to.
Speaker 2 (22:09):
Well, thanks again for coming on and, for those of
you out there, stay tuned forthe next episode of Dermot
Trotter.
Don't Swear About Skin Care.
Speaker 1 (22:18):
Thanks for listening to Dermot Trotter.
For more about skin care, visitDermotTrottercom.
Don't forget to subscribe,leave a review and share this
podcast with anyone who needs alittle skin care sanity.
Until next time, stay skinsmart.
Welcome to Dermot Trotter Don't Swear About
Skincare 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 (00:21):
Welcome to the Dermot Trotter Don't Swear About
Skincare podcast.
Back on the podcast today oneof my favorite guests, dr Katie
Varmann.
She's a board-certifieddermatologist and works in
private practice at ShineFunctional Dermatology in
Northern California.
Dr Varmann specializes intreating chronic skin conditions
like psoriasis, as well aseczema, and she likes to do this
(00:43):
with a blend of conventionaland functional medicine
practices.
She also has a passion forphotoimmunology, or basically,
again like we've talked about,how does sunlight and the immune
system really interact?
And this has really been thefocus of a lot of our
conversations and we're going totalk more about that again
today, but on a different level.
Just also let you know she'salso owner of Shine
(01:04):
Nutraceuticals.
Welcome back to the podcast,katie.
Speaker 3 (01:07):
Thank you so much for having me back for round three.
Speaker 2 (01:11):
Of course I love having this series on, because
you know we've really startedwith one.
How does light benefit us froma health perspective, including
the skin, which I think a lot ofpeople found shocking.
And then also, too, then wetalked about well, can we eat
and supplement ourselves?
Back to you know, sunprotection, which you've been
able to, I think, educate us onboth.
(01:32):
I'm going to have you kind ofsummarize both of those, but
today we're going to pivot andtalk about, you know, what is
there topically to help us withsun protection beyond sunscreen,
because I think that's whatmost people just think of when
you think about puttingsomething on.
But first let's circle back andhave you kind of just, you know
, if you don't mind, summarizekind of the health benefits and
what we talked about a littlebit, about doing oral
(01:54):
supplements as well as diet andhow it can be sun protective for
us.
Speaker 3 (01:59):
Absolutely, and I like the series that we've done
because, you know, we firsttalked about some of the
benefits of sunlight exposure,which is really important
because it lays the foundationfor everything, right?
I mean, why would we spend somuch effort and energy thinking
about how to tolerate sunlightbetter when the answer is just
less sunlight exposure, right,and that's traditionally how
(02:21):
we've been kind of taught likeless is more, right, you know,
avoiding midday sun, sunprotection, sun protection, sun
protection reapply, reapply,with this like ultimate goal of
having like no sun exposure.
But so we talked about thebenefits of sunlight being that
there's a balance, right, ashuman beings, we need some
sunlight for optimal health andwellness, need some sunlight for
(02:46):
optimal health and wellness.
And the idea is to find thatbalance for you personally,
based on your skin type andwhere you live and all your risk
factors, like how much sunlightdo I need to have optimal
health, without overdoing it andincreasing the risk of skin
cancer and photo aging.
And there's, of course, ways toprotect high risk areas, so
that are maybe a little bit moreaesthetically important, like
your face, right, while alsogetting a little bit of gentle
sunshine on the rest of yourbody to get the benefits, and so
(03:08):
we talked about all of thesebenefits, including a reduced
risk of autoimmune andinflammatory disease, reduced
risk of cardiovascular diseaseand all-cause mortality in
general.
There's a benefit for mood, andwe talked about microbiome.
A benefit for mood and wetalked about microbiome, and I
(03:28):
don't even think we mentionedthe reduced risk of some very
serious cancers like breast andcolorectal cancer and all of
these things we used toattribute to vitamin D, but now
we're really recognizing,because of vitamin D studies not
panning out as well as we'dhoped, where supplementing
doesn't reduce the risk inmeaningful ways, that the
sunlight is giving us thesebenefits in ways that expand,
(03:49):
that go beyond just the vitaminD component to it, and so we
talked about those, and then wekind of led into well, what can
we do from a dietary perspective?
And then now, to finish it off,we can talk about topical
things, because some of thethings that work orally as a
nutraceutical and in our dietalso work if you apply them to
(04:09):
the skin.
So I think that's what we'redelving into today.
Speaker 2 (04:14):
Yes, yes, For the person like myself who doesn't
like carrots I can't get thosecroutons that way, I mean there
are other things I can, butmaybe it's just people they
don't really want to eat theirway through, or maybe they just
don't want to take supplements,but they want to do something
what I call sort of skindirected therapy.
It's like, hey, is there atopical you know something
(04:37):
beyond just maybe sunscreen thatI would typically use that
might help make my skin more sunprotective.
So I'll let you dive into someof the topical options that are
out there and maybe the benefitsthey offer.
Speaker 3 (04:44):
Right, and all of these things that we've talked
about aren't replacing sunscreenas a really important, powerful
tool.
But when you look at sunscreen,it's not one, you know, rarely
are we using it, maybe somepeople, but at absolutely all
times.
And, you know, maybe notreapplying it as often as needed
for all the benefits and sothey're, you know, and it's
(05:05):
really it's not blockingeverything.
So if you get your good ironoxides in there, yes, you can
get some more visible lightcoverage, but in general,
sunscreens are not like reallythat awesome at preventing, kind
of some of these longerwavelengths and into the visible
light spectrum.
We're learning more and more thedamaging effects of blue light,
especially as far as causingsunspots and more of the
(05:27):
photoaging effects and oxidativestress even from visible light
actually plays a very big role.
And so if you're just usingsunscreen, then you're
potentially getting a lot moreexposure than you're recognizing
just because you're not burning.
Right, you're not gettinginflammation, so you're not
burning, but you're getting DNAdamage and oxidative stress that
can cause photoaging down theroad.
(05:48):
And so using things likenutraceuticals whether orally or
really incorporating into yourdiet or using them topically,
kind of fills in these holes soit helps prevent DNA damage.
It reduces oxidative stress, itreduces these inflammatory
pathways, and then it supportsthe energy crisis that occurs
after light, which reduces theseinflammatory pathways, and then
it supports the energy crisisthat occurs after light, which
(06:08):
reduces how much the sunimmunosuppresses in the skin,
and so using these other agentscan help fill in those holes and
give you added benefits tosunscreen alone.
Speaker 2 (06:22):
And so, for some of these type of ingredients, what
types of things would yourecommend that people you know
be looking for?
You know, from the standpointof like antioxidants, if you
don't mind explaining again likewhat an antioxidant really does
, because I think a lot ofpeople have heard of
antioxidants before.
Yeah, my doctor said, you know,eat some blueberries every day.
It's full of antioxidants.
You know it's good for you formultiple health benefits, but
(06:45):
specifically for the skin.
What are some of the favoriteyou know antioxidant ingredients
that you recommend, and arethere particular products that
you recommend you know gettingthem from topically?
Speaker 3 (06:55):
Yep, and and it's important to like know why
you're doing things like you'resaying to you like, what's the
point of the antioxidant and whyis it different than an
isinamide?
And so when your skin isexposed to UV light invisible
light, but UV light, inparticular UVB is kind of going
not too far into the skin but itcauses a lot of direct DNA
damage.
And then UVA is going a lotdeeper into the skin and it
(07:23):
causes indirect DNA damage.
But then it also causes a wholehost of what we call oxidative
stress or free radicals.
And so there's these moleculesfloating around.
They're very unstable and whenthey hit things whether it's a
cell membrane or otherstructures or DNA they cause
damage and they cause the DNA tostick to other stuff and stick
to itself, and so it just causesa lot of damage.
And then, when you're talkingabout things like collagen, you
know we want to preserve a lotof these structures, and so what
(07:45):
antioxidants do is you know wewant to preserve a lot of these
structures, and so whatantioxidants do is you know you
have natural antioxidants, justkind of like in our bodies, but
then you can also eat them andyou can put them on your skin,
and so, no matter how they getthere, the antioxidants are in
the skin and then, instead ofthat little reactive molecule
causing damage to your collagenor DNA, the antioxidant subdues
(08:06):
it and makes it calm andbalanced again.
And so, orally, antioxidantsabsolutely make their way to the
skin and are very, very helpful.
And in a diet, we're looking atthings that are very colorful
as an indication of goodantioxidant properties, from
polyphenols specifically, and sothe antioxidants are in there,
(08:26):
kind of gobbling up that.
But you can also put them onthe skin.
The problem is and this iswe're talking about like vitamin
C, e, and now there's likeferulic acid and fluorotin and
some of the others the problemwith the skin is always that you
can put anything you want onthe skin, but is it going to get
down into it where it needs togo?
And that's where it gets alittle bit trickier and why some
(08:47):
products may demonstrate greatbenefit and other ones not so
much.
Antioxidants are inherently veryunstable, and so it takes a lot
of smart scientists to figureout how to make them very stable
and to get where they need togo.
And so the CE for Rulic andFluoritin.
Those are the ones that we havereally clear studies in humans
that demonstrate if you put themon the skin and shine light on
(09:11):
it, specifically UV light youget less damage and less burning
of the skin and so very clearlycan protect from the stress
that sunlight causes.
From those types of topicalantioxidants and they have to be
applied before, so morning is agreat time to use antioxidant
serums.
Speaker 2 (09:31):
Yeah, I think people forget about that.
I think we've kind of ingrainedin people using other types of
antioxidants, like a form ofvitamin A, like a retinol over
the counter, or maybe they'reusing a prescription like a
tretinoin form.
We always tell people you needto use this at nighttime and I
think people forget during theday because of sun exposure,
because of pollution exposure.
(09:51):
Doing an antioxidant in themorning is important.
I think as dermatologists wekind of know this.
But I think patients sometimesare kind of surprised like, oh,
I would do something during theday, like I thought, you know, I
just cleanse, maybe moisturize,put my sunscreen on and I'm
good to go.
So I, like you know making thatpoint again that like the
morning application is goodbecause you're you're fighting
(10:11):
off some of that damage thatyou're getting sort of acutely
throughout.
You know your day, whetheryou're driving to and from work,
whether you're out walkingaround in the city, you know
whatever you happen to be doing.
Really good points for that aswell.
And from some of these two, youknow, I think one of the ones I
wanted to highlight because Ithink a lot of patients might
already take this orally is sortof the role of melatonin.
(10:32):
I think this has been somethingthat's been a little bit
exciting.
Some of the more data comingout, you know, from the
anti-aging or photo protectionstandpoint of melatonin.
A lot of people think, oh, Ithought people would just take
that to help them go to sleep.
What are your thoughts on thedata with melatonin and its role
in helping with sun protection?
Speaker 3 (10:49):
Yeah, melatonin is one of the most ancient, like
archaic, old, powerfulantioxidants that our body has
and like all living organisms, Ithink probably have melatonin.
But it's a really verybeautiful thing because you go
to sleep and then your body getslike showered with this
(11:09):
powerful antioxidant, um, and soyou know, we can take it, yes,
as a sleep agent, but there are,you know, it does.
It does serve as an antioxidantas well.
Um, topically, um, same thingas the, as the you know, like
vitamin c and e's and whatnot.
Topically it also protects fromsun exposure, but, same as
(11:29):
antioxidants, it only works veryclear, it only works before the
sun exposure.
Once the cat's out of the bag,it doesn't help.
So it's another one of thosethings that would need to be
used before sun exposure.
I am not aware of any humanclinical trials where it's given
orally and they've done minimalerythema dose studies to see if
(11:50):
you take it orally, if itreduces or increases how much
light it takes to burn your skin.
I have not seen that study.
It might be out there, butdefinitely topically, we know
that it is photoprotective.
Speaker 2 (12:02):
So for somebody that might also be thinking about
other topicals, you might seesome products that kind of get
this label more generically likea DNA enzyme repair cream.
Is that anything that'sdifferent than what we've talked
about before?
Is it sort of a different, youknow, concoction of different
things, or is it really just anantioxidant blend?
I mean, a lot of people arelike what exactly does it?
(12:24):
Mean it sounds good, but whatis it really?
Speaker 3 (12:26):
Yeah, and this is one of those things where you go
all through residency and you'rein training and you're with
your colleagues and DNA repairenzymes never came up until I
was doing all this research onsupporting the skin with
nutraceutical and whatnot.
But DNA repair enzymes are outthere and they actually really
work and there's very robustclinical trials and, yes, it's
(12:47):
all funded by you know theindustry and the people make it,
but they're very like, like youknow, clear, like benefits, and
they've done studies withpeople who have genetically just
make skin cancer constantlywhen exposed to uv light because
they can't repair their dnawell and it shows that it
prevents skin cancers andprecancers from forming pretty
(13:08):
dramatically in this population.
And then the studies that we'veused with these DNA repair
enzymes are usually incombination with sunscreen in
our studies and what it shows isthat when you combine DNA
repair enzymes with sunscreen,it way outperforms sunscreen
alone when it comes to what wecall field cancerization.
So there's little precancerseverywhere and it reduces DNA
(13:32):
damage, which is something thatyou can't see on the skin.
You have to sample it right.
So if you use sunscreen withDNA repair enzyme and sunscreen,
both people won't burn becauseof the sunscreen.
But if you take a biopsy, youhave less DNA damage because
it's being repaired when you addthe DNA repair enzymes and what
they are is very unique.
These DNA repair enzymes are notfound in human biology.
(13:55):
There's this theory that thegene that makes them, that was
kind of outsourced and now it'slike a photoreceptor for blue
light.
We don't have it anymore, butwe get it from organisms and
they make it so that it's fatsoluble, so it gets down and
gets where it needs to go and itactually appears to be able to
repair human DNA.
And it's really cool andthere's you can find it in
(14:18):
sunscreen and you can find itindependently, and that is
something that you can use aftersun exposure.
And so there are things that youneed to use in the morning your
antioxidants, obviously, yoursunscreen right, you need to
have on board before, but thenthere's things that you can use
at night for repair.
Dna enzymes are one thing thatdo appear to be very helpful, um
, although they haven't reallymade their way into like derm
(14:40):
literature as much.
Um and then, um, the otherthing would be topical
niacinamide.
That can be helpful afterwards,um, so that's usually how I
kind of divide up a topicalregimen.
If we're specifically targetingphoto protection.
Speaker 2 (14:58):
So just when you talk about a regimen there, I think,
a lot of good information thatwe've been talking about.
But for people that might be alittle overwhelmed or thinking,
okay, all this is great, butwhat practically should I do or
what would you recommend?
But what practically should Ido or what would you recommend,
and maybe that's different basedon, obviously, patient needs or
sun exposure.
Or maybe you might recommend anoral supplement version versus
(15:19):
topicals.
But say this person's coming toyou and this patient's asking,
or person's saying, hey, I wantto do something topically, how
would you recommend maybeintegrating one or two of these
types of topicals, or maybe more, just what would be a simple
recommendation, because I thinkthat's what a lot of people want
.
It's sort of like a tangibleanswer.
(15:42):
Okay, I get that.
You know these can be helpful.
The CE Ferulic I get that.
Maybe the DNA enzyme repair,but like I can't have, I can't
be putting five things on myface in the morning, five at
night Is there a basic regimenyou might recommend morning,
five at night Is there a basicregimen you might recommend?
Speaker 3 (15:54):
And again, based on needs.
Maybe it's different for thepatient.
Yeah, and that's really what itis.
It's very patient dependent andeverything needs to be based
off of what the person in frontof you is telling you, because,
I think we said before, somepeople want a list of four
things they put on morning andnight.
Other people want to takethings orally.
Other people are like I want todo it completely with diet, and
so you really have to tailoryour recommendations based off
(16:14):
of what that person's actuallygoing to do and what they you
know what they want to do andtheir finances right, because a
DNA repair is very expensive, aCE for like it's very expensive,
and so you have to take allthat into account.
Personally, I mean, if somebodyis not very high risk, for me
diet, like all day long, likediet, is the best way to get all
(16:37):
of these things, because weknow so much about all these
beautiful polyphenols andmolecules and how they absorb
sunlight and absorb oxidativestress and repair DNA, yada,
yada, yada.
But if you imagine, like, howmuch is probably in that plant
that we don't even know aboutyet, I think that diet and
consuming whole foods andseasonally for me makes the most
(16:59):
sense.
But there are people who havesun damage, who want to do more
or who are high risk for skincancer, in which case we need to
bring out more tools and soreally hitting the marks on the
dietary stuff, like we talkedabout before, and the oral
supplements that can be helpfulthe polypodium, the niacinamide,
the omegas, the carotenoids,and then topically, the regimen.
(17:20):
Again, it's going to depend onhow much the person wants to do
and wants to spend.
In a perfect world, you'redoing a nice studied CE-fru
liquor, fluortin in the morning,followed by, in my opinion,
mineral sunscreen, and then inthe evening it's a niacinamide
or a DNA repair enzyme or both.
They don't have any evidencethat they interact, although I
(17:41):
don't know that the study hasreally been looked at.
But those would be the two inthe evening as the repairs the
morning's prevention and eveningis repair.
And then if people are getting alot of sun, I'll have them use
their retinae, their tretinoins,in the winter only because it
doesn't just increase your riskof irritation and burning, it
actually increased the damagecaused by sunlight, and so
(18:01):
sometimes we'll put a hold on it.
If somebody's like I'm atriathlete and I'm in the sun
all the time You're like okay,we'll tell it to you.
So that would be like theperfect regimen if you were just
talking about sun protection,um, if we just wanted to pick a
couple pieces.
Um, obviously, the sunscreen isgoing to be the biggest thing
for your book, um, but I love, Ilove a nice, you know vitamin,
(18:22):
you know vitamin c for look, orfloritin, um in the morning and
then, um, the niacinamide, Ithink, is indispensable because
of the mechanism of action.
It is unique in how it worksand how it protects your skin
from sunlight, and so the ideais that you stack right, you
stack these different layers,different ways to prevent that
(18:44):
progression from sunlightexposure to skin cancer and
photo aging, and so using toolsfrom different categories is
really important.
Speaker 2 (18:54):
I think this is just amazing.
Like I love having theseconversations with you because I
feel like you're somebodythat's telling us too that you
can.
You know you can have your cakeand eat it too.
You can live your life.
You can, like you said, youmentioned that person who's out
and training for that marathonor triathlon and what their
needs are.
You can have the person thatworks indoors all day.
You can have somebody that's,you know, an agriculture.
(19:16):
Maybe they're a farmer, ormaybe it's a teenager that's a
lifeguard, you know, and out allsummer getting a lot of sun.
I think what's really important,and where you see dermatology
shifting a little bit, is justwe're practical now.
We know people have to livetheir lives.
I think we're understanding thesun is not this evil entity.
It has multiple health benefitsbut, like anything else, too
(19:36):
much of a good thing can be abad thing.
But you're giving peopleoptions From the series we've
done here you can talk about howdo you just practically protect
yourself from the sun?
How can we incorporate dietsupplements, non-topicals and,
as you mentioned, you can mixand match or do this layering to
go after different ways thatthey can actually help our skin.
You know, I think, live in aworld where we can do the things
(19:58):
we want, but also try tominimize risk, cause I think
that's what that's about, butalso living our lives to our
fullest too, which may mean forthat person that's doing that
marathon or gardening every day,or, unfortunately, for me, to
sneak out whenever I can with mykids yeah, the sun, and there's
hope for people like me thatdon't like carrots and other
things too.
So there's good, good thingswith us.
(20:18):
But thank you so much forcoming back on and sharing your
expertise and knowledge, becauseI think this is empowering for
patients to be aware of theseoptions that are out there and
that these aren't just thingsthat we kind of throw out people
.
There's data to support whatwe're recommending and giving
people, you know, I think, toolsand empowering them to live
their best lives, and that'sgoing to be potentially out in
(20:39):
the sun, but balancing that, youknow, with, obviously, risk and
things we can do to correctthat damage.
So thanks again, katie, forcoming on and sharing all this
information with us.
It's been fantastic.
Speaker 3 (20:56):
For our listeners that want to find you.
Do you mind sharing whereyou're at online in case they
want to track you down?
Yes, and thank you again somuch for having me.
I've really enjoyed ourdiscussions.
I love sharing the informationand just teaching people how you
can really live in harmony withsunlight and not overdoing it
and not making it okay to go outand fry and not doing that kind
of behavior, but to get anadequate amount just for overall
wellness and to reduce the riskof all these chronic
(21:18):
inflammatory diseases that arereally plaguing our society now.
And sunlight, like we talkedabout in some of our other
episodes, is a really importantway to kind of tame an
overreactive immune system.
But you want to do it withoutgiving yourself skin cancer and
sunspots and all those things,and you really really can.
(21:38):
But it has to be personalized.
So thank you so much forinviting me on to talk about
that.
I am not terribly active onsocial media.
We do have an Instagram accountfor my clinic it's shine
underscore dermatology, and ourwebsite is shinefunctionalmedcom
, and so we are, you know,becoming a little bit more
(21:59):
active out there, so you canfollow along and I'll make sure
to share other podcasts andother things that we're up to.
Speaker 2 (22:09):
Well, thanks again for coming on and, for those of
you out there, stay tuned forthe next episode of Dermot
Trotter.
Don't Swear About Skin Care.
Speaker 1 (22:18):
Thanks for listening to Dermot Trotter.
For more about skin care, visitDermotTrottercom.
Don't forget to subscribe,leave a review and share this
podcast with anyone who needs alittle skin care sanity.
Until next time, stay skinsmart.
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