Derm-it Trotter! Don't Swear About Skincare.
Feeling frustrated or overwhelmed with everything skin? Does the skinformation overload make you want to swear about skincare? Join Dr. Shannon C. Trotter, board certified dermatologist, as she talks with fellow dermatologists and colleagues in skincare to help separate fact from fiction and simplify the world of skin. After listening, you won’t swear about skincare anymore!
Derm-it Trotter! Don't Swear About Skincare.
Eating Your Way to Better Skin
What if your best skincare tool isn’t in your bathroom, but in your kitchen?
In this episode, Dr. Matt Zirwas, a board-certified dermatologist and leading researcher, breaks down how diet directly impacts your skin. From the link between acne and foods like skim milk and chocolate to the benefits of the Mediterranean diet, he simplifies what really works.
We also dive into surprising dangers in processed foods, like emulsifiers, and explore affordable, evidence-backed supplements like omega-3s, ceramides, and collagen.
No gimmicks, no perfection required, just smart, science-based tips to help your skin glow from the inside out.
What do you tell people about diet and acne and what can make it better or maybe worse?
Speaker 2:Yes, so an acne, interestingly, is one of the relatively unique ones. So if you want to make a food, a processed food, that has both oily stuff as an ingredient and watery stuff as an ingredient, you got to put emulsifier in there. My bet is that, long-term, we're going to find out that that stuff bet is that, long term, we're going to find out that that stuff increases our risk for neurodegenerative disease. So the individual hairs like bigger diameter and more resistant to breakage, and it makes your fingernails stronger and more resistant to breakage.
Speaker 3:Welcome to Dermot Trotter. Don't swear about skincare. Where host Dr Shannon Cot Trotter? Don't Swear About Skin Care. Where host Dr Shannon C Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.
Speaker 1:Welcome back to the Dermot Trotter Don't Swear About Skin Care podcast. I've got Dr Zyrus back here with me here today, who's an expert in everything skin, so I'm excited to have his thoughts and comments with us. But if you know Dr Matt Zyrus, you know he's been an expert in the eczema field for over 20 years. He's written a textbook, he's published over 200 peer review articles and lecture to thousands of dermatologists and he's been on our podcast before to really reach out to you guys out in the public and our patients. His passion is really distilling topics down, making them into simple concepts so all of us can understand what we're even talking about. So welcome back to the podcast, matt.
Speaker 2:Rude to be here. Dr Trotter, how are you?
Speaker 1:I am doing fantastic and always better because you're now here with us. So you know, I think you know, as we've talked about different things in dermatology. You know there's really people that are focusing on diet. Now everything's about what we eat nowadays, whether we're trying to lose weight, we're trying to look good, just feel better about ourselves, and so you know, I really want to know your answer to this question Can we really eat our ways to getting better skin? Do you think we can eat our way to better skin.
Speaker 2:Yes, with some qualifiers, so I would, if you include so first. If we say can we get some diseases doing better, yes, and if you say, if you include, can we take some natural supplements, then definitely yes, it goes beyond just can we get certain diseases better to? Can we get people's skin looking better? Yeah, there are a number of really cheap supplements that have really strong data. The biggest thing I would tell patients about the supplement stuff if they're expensive, you're wasting your money Because the good stuff you can get cheap on Amazon, but the diet by itself I don't. Maybe, right, Maybe is the way that I would put it, Maybe.
Speaker 1:No, I agree with that, because really to get everything you need, or maybe in the right quantities, I mean, who can really design a diet that's perfect around that and realistically do it every day? I mean, sometimes you just want to go to Taco Bell late at night, right, and you're not going to get those nutrients that you want. So that makes sense. So maybe if we can't eat our way, maybe we can supplement our way. But you know, if you look at sort of different skin conditions, I think one of the ones that gets a lot of attention and maybe diet playing a role is acne.
Speaker 1:So I'd love to hear what do you tell people about diet and acne and what can make it better or maybe worse.
Speaker 2:Yes, so, and acne, interestingly, is one of the relatively unique ones. So with because acne, we actually do have some very specific like don't eat chocolate and don't eat skim milk, right, those are the two things that have really been shown in particular. Now the questions become well, why? Why chocolate and why skim milk? And we can also add into acne sort of sugar and so high glycemic index things, and the belief here is that anything that spikes your blood sugar subsequently spikes your insulin, and insulin can activate something called the insulin-like growth factor receptor, which is involved in acne pathogenesis, and so this might fall somewhat into the category of hormonal effects of acne, the category of, you know, hormonal effects of acne. And so that's the very specific things that I would say about acne, chocolate and skim milk. We have very good evidence for both of those.
Speaker 2:But then the second part, and it becomes a really interesting thing, because when you say diet, people often want a like eat more avocados, like, which is complete, like any simple dietary recommendation of eat this, don't eat that immediately. You should think this influencer is a moron and I should never listen to anything they have to say again. So what has been shown with diet is there's one particular diet right, the, the Mediterranean diet, which is fruits, vegetables, nuts, legumes and fish, and that diet is good for everything. So when people are like, oh, whole food or whole 30 or anti-inflammatory protocol or whatever.
Speaker 2:Fine, I don't care there. Maybe it helps, maybe it doesn't, don't know, but I know the only diet I really have evidence helps in everything is the Mediterranean diet. Because if you follow the Mediterranean diet, you're going to be eating low glycemic index foods, right? So in in ancient Italy and ancient Greece, right, they weren't eating chocolate. They probably weren't eating milk, right? So if you're following the Mediterranean diet, you're like it's really easy, that's for every. Any time any patient ever asked you anything about diet, the right answer is Mediterranean diet. Now the other part that is interesting and this is fascinating to me so gets into the processed food idea. And right, because you're hearing more and more about processed foods and we're getting some answers about processed foods from there's this big study in France called like the Sante NutriNet study or something. It was like millions of people they're following prospectively and monitoring their diet and so with processed foods, right, which you normally hear from people is like well, if you can't tell what it is, then it's a processed food and the water, sure, okay.
Speaker 2:However, the real interesting thing with me at this point with food, are there particular ingredients and we're finding out. Yes, in particular, it's probably emulsifiers, and so emulsifiers allow oil and water to mix, and so if you want to make a food, a processed food, that has both oily stuff as an ingredient and watery stuff as an ingredient, you got to put emulsifier in there, and emulsifiers seem to maybe break down our intestinal lining, and so they're finding certain emulsifiers seem to have a unique correlation with cardiovascular disease and cancer. So we've got pretty good, getting pretty good data around that, so that it's not just because, if you say, okay, you can't tell what it is, well, hell, you can't. Bread like whole grain, totally natural bread. You can't tell what that is. Or you know a chip made out of chickpeas, where it's chickpeas and nothing else, and they make it into a chip. You can't tell what that is, does that? No, that's, it's got nothing in there. That's bad for you.
Speaker 2:So I now think of emulsifiers as a big issue, and then all of the stuff that's not listed on the label, so meaning the potential for pesticides, and not just like, oh, you wash your food and you're fine, like the pesticides that were in it before it got made into whatever it is the hormones, the antibiotics, you know, the herbicides, that kind of stuff. My bet is that long-term we're going to find out that that stuff increases our risks for neurodegenerative disease and for autoimmune disease. So I think it's going to be emulsifiers. Now this is all think, right, not like, but I think there's enough evidence now to say emulsifiers likely cardiovascular disease and cancer, and then antibiotics, hormones, pesticides, what you would call contaminants, autoimmune and neurodegenerative. Now, I bet there's a lot of overlap and everything else, but if I was motivated enough, 100%, I would be eating a Mediterranean organic diet.
Speaker 2:I think that that is as good as you can with the data we have. I think that is, if you did Mediterranean organic, I think that's as good as you could possibly do. Uh, and it's super simple, right? So it's, it's, I mean, it doesn't mean it's easy, right, but it's super simple, Mediterranean organic. I think that's the best you can do. And for everything, I don't care what you're talking about. I have this, okay, do that. I don't want to get this, okay, do that. Whatever, it is organic, mediterranean diet. I don't think you can do any better than that. So every other anti-inflammatory blah, blah, blah, blah, blah. Mediterranean organic. That's it, you're fine. Why don't you hear that? Because people can't make money off of saying that. I can't write a cookbook, I can't have a gut health podcast around. Eat Mediterranean organic. Okay, bye, everybody. That's this week's episode. Next week I'll say that same thing. Like you can't do that, but that's the truth. That's what we have, what I would call re the the reasonable evidence for reasonable evidence.
Speaker 1:So you probably scared the hell out of a lot of people talking about those emulsifiers and what can happen. Now we're going to have another conversation on those in more detail. But I think that's great, you know, kind of thinking around those and the impact it may have, because, who knows? But the evidence is suggesting, you know, I think there is concerns about those and the role they play in our processed foods. And of course processed foods are all the good foods, they're the fun foods that we all enjoy eating. You know, at times I'm sure we consumed a lot last night at the Super Bowl as well.
Speaker 1:But if you talk about kind of the non-inflammatory diet I heard you mention that a couple of times Can you explain a little bit more? When people are like, well, what the heck is that? I've kind of heard of it, but what does it really mean? Like what things can I eat? And how has it been implicated? Because I know for psoriasis a lot of patients come in like I read this diet, like this is what I'm supposed to call non-inflammatory diet. How do you respond to that?
Speaker 2:So, in general, when people are talking about a non-inflammatory diet or an anti-inflammatory diet, they're talking about kind of avoiding seed oils, avoiding high glycemic index and processed foods and processed foods and then eating things that are rich in antioxidants and prebiotics. Now, there's a lot of unique and specific anti-inflammatory diets people can use that don't really have any evidence showing that they do anything but a diet that is high in a variety of fruits, vegetables, nuts, legumes and fish, and probably whole grains as well, but whole grains are probably the least important part of it. But you need somewhere to get calories, because it's hard to get enough calories eating nothing but fruits, vegetables, nuts, seeds and legumes. So then your calories. The rest of the calories you need should be coming from whole grains and fish, again, anything beyond that. So whenever you hear anti-inflammatory diet, if you're doing what I just said, right, mediterranean diet, fruits, vegetables does it like, oh nightshades, should I avoid that? No, it's a fruit or a vegetable. You can eat it, right, it it really. You know the, the concept, say the paleo diet. The concept of it makes a lot of sense to me because, right, we evolved to eat certain stuff and so it makes sense to me that, like. You eat the stuff you evolved to eat. That's going to be good for you. But again, mediterranean diet is what we like. If you're following Mediterranean organic, you're getting all the benefit of a paleo diet and you're getting all the benefit of the anti-inflammatory diet and you're getting and so those foods rich in antioxidants, uh, and low in what what it's easiest to describe as stuff that nobody was eating 20,000 years ago, like, probably you could say stuff that nobody was eating a hundred years ago would be fine. But it's even easier to say stuff nobody was eating 20,000 years ago. But that's when, when we say anti-inflammatory, those are the big things that people think of as potentially driving inflammation.
Speaker 2:I'd say the ingredient, the particular, like substances that I think really matter. Number one I do think antioxidants matter. Now, what antioxidants are in your body? All of our cells have lots of oxygen in them. Your cells need oxygen to survive and create energy, but that oxygen can oxidize and so attach to a molecule, a protein or a lipid in your cell membrane and cause cellular damage, and that's oxidation. Antioxidants sort of soak up that extra oxygen before it can damage your cells.
Speaker 2:Now, the problem with antioxidants is that, to my knowledge, there are no good studies that taking an antioxidant supplement actually does anything. So eating a diet high in antioxidants absolutely does. But, for example, oxidation is how your body fights cancer Oxidation right. So literally you can think of it as your body's immune system oxidizes the cancer cells, or your body's immune system that's how it fights infections by oxidizing and damaging the thing that's infecting you. And so part of it is just that if you take too much antioxidant, it might actually stimulate the development of cancer or infections. But it's also probably that it's too simplistic to just think I can take a resveratrol pill or I can take a blueberry extract or whatever. It's only been shown, to my knowledge, that antioxidants are helpful when they are obtained through eating the right dietary foods. So I never recommend an antioxidant supplement.
Speaker 2:I don't tell people not to take them because I haven't really seen evidence that says they're bad for you. But if people say, should I take one, I'm like I don't know, don't know, maybe they're, maybe they're good, maybe they're bad. I wouldn't waste my money on it unless I knew it was good. So I don't tell people to take antioxidant supplements, but I do have. We have good evidence that omega-3 helps with acne. We have good evidence that omega-3 helps with the side effects from Accutane. We have good evidence that omega-3 helps with atopic dermatitis, and omega-3 is linked to a whole bunch of health benefits, right, cardiovascular in particular, and so it's the only supplement that I personally take is high omega-3. I have no link with the company, but in particular I take one from a company called Life Extension. It's like their super omega-3, whatever, and I use theirs in particular because there's an organization called consumerlabcom that does independent testing and pricing of supplements to make sure they have what they say they have, and then they figure out okay, here's the cost per unit, and so they tell you what has the right stuff and what is the cheapest way to get it. So that's why I take the Life Extension Omega-3. It's got the good stuff in it and it's reasonably cheap. So that's the only one I take myself.
Speaker 2:A couple of other supplements, though, that I think are really that I recommend regularly for dermatology patients. So number one, an oral ceramide. And so ceramides, right, are kind of used in a lot of topical products because they're the secret ingredient in your skin's natural healthy oils, and so the idea is we put them on topically and you're giving yourself more of that secret ingredient and that does help. But the actual evidence is better that taking them as an oral supplement does even more than that blind placebo-controlled trials that your skin is more hydrated, fewer lines and wrinkles, better glow and better barrier function. So that all probably comes back to the hydration that the ceramide supplement decreases water loss from your skin. So now your skin's more hydrated and looks better. So I recommend that one in particular to people with atopic dermatitis, but just in general. I think it makes people's skin look better. I do that.
Speaker 2:I do the omega-3 probiotics. There's one probiotic in particular. So anytime somebody says, should I take a probiotic, that is quite honestly the equivalent of somebody with an infection saying should I take an antibiotic? Yes, you should, but you should take the right antibiotic. Like if you've got a UTI and you take an antibiotic that is for a boil on your forehead, that antibiotic is not going to help the UTI at all. And so probiotics are the same way. You've got to take the right probiotic for the right problem for skin, and in particular, we've actually got reasonably good evidence for both atopic dermatitis and psoriasis and acne.
Speaker 2:But the one that I recommend is from a brand called Now N-O-W. So first, the fish oil that I recommended that I recommend is called from a brand called now N O W. So first, uh, the fish oil that I recommended that I talked about was, uh, I think it's about 15, 20 bucks a month. The ceramide I also I recommend is also from life extension, again about $17 a month. Uh, the probiotic is from a company called now N O W, probiotic 10, meaning it's got 10 different strains in it and it's got the four strains that have been proven to be helpful in atopic dermatitis. So we have multiple randomized, double-blind placebo-controlled trials. I recommend that for a lot of people. Those are probably the big three that I recommend most, but then there are a few others. So, for hyperpigmentation, there's some evidence that melatonin helps no idea why, but randomized, double-blind placebo-controlled trial. So three to five milligrams of melatonin at night, especially for melasma, but that can help with hyperpigmentation.
Speaker 2:Collagen so in particular, there's a collagen called Verisol V-E-R-I-S-O-L. It's an ingredient, not a product. So you go on Amazon and you search Verisol and a bunch of them come up. It's an ingredient, not a product. So you go on Amazon and you search Averisol and a bunch of them come up. I tend to recommend one from a company called Horbach, which is like H-O-R-R-B-A-C-H or some weird spelling like that, but it's a powder and I recommend it because it's about 30 bucks for a four month supply and that collagen has been shown to help with fine lines and wrinkles.
Speaker 2:But the other interesting place that I find it useful is for people who are getting easy bruising, especially on their forearms, which we you know, as you and I know that's related to the combination of age and ultraviolet light and it's because you lose the collagen that is protecting and acting as a cushion for your blood vessels. Nothing in the literature about this, but as I put some people on the collagen for you know just skin beauty, I saw over three to six months their easy bruising get better. So I use that collagen both for cosmetics and for easy bruising. And then there's one particular keratin that I recommend that has randomized double bond placebo controlled trials. It is called cinitine C-Y-N-A-T-I-N-E, cinitine HNS it is from news. It is hydrolyzed wool from New Zealand sheep. Now does that matter at all? No idea. But I know that this particular keratin has randomized double-blind placebo-controlled trials showing that it makes your hair thicker, so the individual hairs like bigger diameter and more resistant to breakage, and it makes your fingernails stronger and more resistant to breakage and so these are extended.
Speaker 2:I need this okay yeah, so that, and again it is pretty cheap. So it's about the one that I recommend. Uh is called true hns. True hns again you get it on amazon. It's about True H-N-S, t-r-u-e H-N-S Again you get it on Amazon. It's about $20 a month. That's the keratin that I recommend. Those are the big ones.
Speaker 2:Just a couple of other that are worth mentioning really quickly. Lycamato L-Y-C-A-M-A-T-O has some evidence for, again, dark spots and hyperpigmentation. It's extract of, like tomatoes from lycopenes. Rutin R-U-T-I-N and again you get all these on Amazon rutin R-U-T-I-N. That helps bruises to go away faster.
Speaker 2:So, again, for the solar purpura patient who's getting easy bruising on their forearms, the collagen will reduce the bruises, but they still take two to three weeks to go away. Collagen will reduce the bruises, but they still take two to three weeks to go away. The rutin will make the bruises go away, usually in a few days or a week instead of two to three weeks. So I recommend the rutin relatively frequently as well, and I think those are all of the big ones that I end up recommending. And again, all of those are cheap. And so, for all of our aesthetics patients, if you're spending money on Botox and filler and laser and whatever, you should be taking the cinitine keratin, the varisol collagen, and you should be taking the ceramide because all of those we have randomized double-blind placebo-controlled trials. They are going to make your skin look better and they're probably going to help keep it looking better long-term and they're cheap and safe and probably have other benefits as well.
Speaker 1:Wow, that was fantastic, the information, because I think you know people are overwhelmed. Like you said, diet like is there some perfect diet that's going to fix everything? And what you really showed us is no. I mean, I think you still can enjoy, you know, that Shake Shack hamburger you want, but you can even supplement your way to better skin with some of the recommendations that you met, but it still doesn't replace, you know, following a well-balanced diet. From the standpoint of the Mediterranean diet, it may be the fix for everything or safe way to go when people are yes.
Speaker 2:And you and you don't. If you want to follow the Mediterranean diet, it's not like, oh, you can't have the, you know you can't have the fat. Like, is it better if you'd never, if you didn't sure? Is it better if you never, if you didn't, sure, but it's, it is the general. You are generally eating healthy, and then if you throw in a couple of things that aren't so great, that's not, but it's, it's not. Like that eliminates the benefit, right, it's. It's kind of like if you'll work out four days a week and then one week you're like I'm tired, I'm not going to work out this week, I'm only going to work out three times. Was it better if you had gone? Sure, but you're still getting the benefit of what you're doing most of the time. And that's where the real it's not an all or none, but there are no just like simple, eat this, don't eat that and you'll be fine. Like it's the general diet that you eat over time that really matters.
Speaker 1:Exactly, and you got to cheat every once in a while. I mean, it's stuff in moderation, right? We're all human. You got to enjoy life. There's dermatologists that still get you know another conversation but get sunburned. Are they perfect? No, it happens. Does it negate all this action They've done now? So I think that's reasonable to offer people. Well, thank you so much for coming back on. I don't know about you, but I'm hungry now lunchtime, so you definitely got that going, Definitely going to look at some of those supplements. So I think that's something that we could all add into our routine that may have that benefit. For those of our listeners that want to find you, you've got a podcast. Please share that with them if they may be interested. I know it's more from dermatologists, dermatologists, but also I know where they can find you online, but you still may not be anywhere. But please share with our audience.
Speaker 2:Yes, so my podcast is called Derms on Drugs right, derms D-E-R-M-S on drugs D-R-U-G-S. And yes, it is more targeted at dermatologists, nurse practitioners and physician assistants practicing in dermatology, medical students, dermatology residents. It is entertaining. So it's three of us that have been friends for 20 years from residency, so we like make fun at each other and poke back and forth. For most people who are not professionals dealing with skin disease, if you're like, oh, I'm super into skin health, I listen to all kinds of, you're still not going to know it's. We're talking about pathophysiot. We're not talking about making skin healthy. We're more talking about making skin not sick. Uh, that has like a known disease. So, but it is interesting. And for you know, any of your listeners who are in the field or or are medical but not in DERP, they probably would find it useful and interesting.
Speaker 1:And are you still a ghost online?
Speaker 2:Otherwise, I assume still a ghost online. Otherwise, I do not want uh, and part of that is that I don't want to. I don't want any chance that my recommendations anywhere are ever perceived as like he's trying to sell stuff, like I don't want to sell anything to anybody. I want to stay. Uh, want to sell anything to anybody. I want to stay able to make. Just here's what I think, right? Yeah, that's my deal.
Speaker 1:Well, and if you want to find Matt, just Google him. You can find Dr Cyrus. Just hit Google and you'll find him somehow. Thanks again for coming on. It's always great to have you on the podcast. I'm sure we'll have you back in again. You're like one of my future guests, you know, here on the podcast. I appreciate all your input. It's always enlightening and we always learn so much. So thanks again for coming on and stay tuned for the next episode of Dermot Trotter. Don't swear about skincare.
Speaker 3:Thanks for listening to Dermot Trotter. For more about skincare, visit DermotTrottercom. Don't forget to subscribe, leave a review and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.
