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.
Rethinking Sun Protection Part 3: Sun Protection Beyond SPF
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.
Welcome to Dermot Trotter Don't Swear About Skincare 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 2:Welcome to the Dermot Trotter Don't Swear About Skincare podcast. Back on the podcast today one of my favorite guests, dr Katie Varmann. She's a board-certified dermatologist and works in private practice at Shine Functional Dermatology in Northern California. Dr Varmann specializes in treating chronic skin conditions like psoriasis, as well as eczema, and she likes to do this with a blend of conventional and functional medicine practices. She also has a passion for photoimmunology, or basically, again like we've talked about, how does sunlight and the immune system really interact? And this has really been the focus of a lot of our conversations and we're going to talk more about that again today, but on a different level. Just also let you know she's also owner of Shine Nutraceuticals. Welcome back to the podcast, katie.
Speaker 3:Thank you so much for having me back for round three.
Speaker 2:Of course I love having this series on, because you know we've really started with one. How does light benefit us from a health perspective, including the skin, which I think a lot of people found shocking. And then also, too, then we talked about well, can we eat and supplement ourselves? Back to you know, sun protection, which you've been able to, I think, educate us on both. I'm going to have you kind of summarize both of those, but today we're going to pivot and talk about, you know, what is there topically to help us with sun protection beyond sunscreen, because I think that's what most people just think of when you think about putting something on. But first let's circle back and have you kind of just, you know, if you don't mind, summarize kind of the health benefits and what we talked about a little bit, about doing oral supplements as well as diet and how it can be sun protective for us.
Speaker 3:Absolutely, and I like the series that we've done because, you know, we first talked about some of the benefits of sunlight exposure, which is really important because it lays the foundation for everything, right? I mean, why would we spend so much effort and energy thinking about how to tolerate sunlight better when the answer is just less sunlight exposure, right, and that's traditionally how we've been kind of taught like less is more, right, you know, avoiding midday sun, sun protection, sun protection, sun protection reapply, reapply, with this like ultimate goal of having like no sun exposure. But so we talked about the benefits of sunlight being that there's a balance, right, as human beings, we need some sunlight for optimal health and wellness, need some sunlight for optimal health and wellness. And the idea is to find that balance for you personally, based on your skin type and where you live and all your risk factors, like how much sunlight do I need to have optimal health, without overdoing it and increasing the risk of skin cancer and photo aging. And there's, of course, ways to protect high risk areas, so that are maybe a little bit more aesthetically important, like your face, right, while also getting a little bit of gentle sunshine on the rest of your body to get the benefits, and so we talked about all of these benefits, including a reduced risk of autoimmune and inflammatory disease, reduced risk of cardiovascular disease and all-cause mortality in general.
Speaker 3:There's a benefit for mood, and we talked about microbiome. A benefit for mood and we talked about microbiome, and I don't even think we mentioned the reduced risk of some very serious cancers like breast and colorectal cancer and all of these things we used to attribute to vitamin D, but now we're really recognizing, because of vitamin D studies not panning out as well as we'd hoped, where supplementing doesn't reduce the risk in meaningful ways, that the sunlight is giving us these benefits in ways that expand, that go beyond just the vitamin D component to it, and so we talked about those, and then we kind 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 the things that work orally as a nutraceutical and in our diet also work if you apply them to the skin. So I think that's what we're delving into today.
Speaker 2:Yes, yes, For the person like myself who doesn't like carrots I can't get those croutons that way, I mean there are other things I can, but maybe it's just people they don't really want to eat their way through, or maybe they just don't want to take supplements, but they want to do something what I call sort of skin directed therapy. It's like, hey, is there a topical you know something beyond just maybe sunscreen that I would typically use that might help make my skin more sun protective. So I'll let you dive into some of the topical options that are out there and maybe the benefits they offer.
Speaker 3:Right, and all of these things that we've talked about aren't replacing sunscreen as a really important, powerful tool. But when you look at sunscreen, it's not one, you know, rarely are we using it, maybe some people, but at absolutely all times. And, you know, maybe not reapplying it as often as needed for all the benefits and so they're, you know, and it's really it's not blocking everything. So if you get your good iron oxides in there, yes, you can get some more visible light coverage, but in general, sunscreens are not like really that awesome at preventing, kind of some of these longer wavelengths and into the visible light spectrum.
Speaker 3:We're learning more and more the damaging effects of blue light, especially as far as causing sunspots and more of the photoaging effects and oxidative stress even from visible light actually plays a very big role. And so if you're just using sunscreen, then you're potentially getting a lot more exposure than you're recognizing just because you're not burning. Right, you're not getting inflammation, so you're not burning, but you're getting DNA damage and oxidative stress that can cause photoaging down the road. And so using things like nutraceuticals whether orally or really incorporating into your diet or using them topically, kind of fills in these holes so it helps prevent DNA damage. It reduces oxidative stress, it reduces these inflammatory pathways, and then it supports the energy crisis that occurs after light, which reduces these inflammatory pathways, and then it supports the energy crisis that occurs after light, which reduces how much the sun immunosuppresses in the skin, and so using these other agents can help fill in those holes and give you added benefits to sunscreen alone.
Speaker 2:And so, for some of these type of ingredients, what types of things would you recommend that people you know be looking for? You know, from the standpoint of like antioxidants, if you don't mind explaining again like what an antioxidant really does, because I think a lot of people 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 for multiple health benefits, but specifically for the skin. What are some of the favorite you know antioxidant ingredients that you recommend, and are there particular products that you recommend you know getting them from topically?
Speaker 3:Yep, and and it's important to like know why you're doing things like you're saying to you like, what's the point of the antioxidant and why is it different than an isinamide? And so when your skin is exposed to UV light invisible light, but UV light, in particular UVB is kind of going not too far into the skin but it causes a lot of direct DNA damage. And then UVA is going a lot deeper into the skin and it causes indirect DNA damage. But then it also causes a whole host of what we call oxidative stress or free radicals. And so there's these molecules floating around. They're very unstable and when they hit things whether it's a cell membrane or other structures or DNA they cause damage and they cause the DNA to stick to other stuff and stick to itself, and so it just causes a lot of damage.
Speaker 3:And then, when you're talking about things like collagen, you know we want to preserve a lot of these structures, and so what antioxidants do is you know we want to preserve a lot of these structures, and so what antioxidants do is you know you have natural antioxidants, just kind of like in our bodies, but then you can also eat them and you can put them on your skin, and so, no matter how they get there, the antioxidants are in the skin and then, instead of that little reactive molecule causing damage to your collagen or DNA, the antioxidant subdues it and makes it calm and balanced again. And so, orally, antioxidants absolutely make their way to the skin and are very, very helpful. And in a diet, we're looking at things that are very colorful as an indication of good antioxidant properties, from polyphenols specifically, and so the antioxidants are in there, kind of gobbling up that. But you can also put them on the skin. The problem is and this is we're talking about like vitamin C, e, and now there's like ferulic acid and fluorotin and some of the others the problem with the skin is always that you can put anything you want on the skin, but is it going to get down into it where it needs to go? And that's where it gets a little bit trickier and why some products may demonstrate great benefit and other ones not so much.
Speaker 3:Antioxidants are inherently very unstable, and so it takes a lot of smart scientists to figure out how to make them very stable and to get where they need to go. And so the CE for Rulic and Fluoritin. Those are the ones that we have really clear studies in humans that demonstrate if you put them on the skin and shine light on it, specifically UV light you get less damage and less burning of the skin and so very clearly can protect from the stress that sunlight causes. From those types of topical antioxidants and they have to be applied before, so morning is a great time to use antioxidant serums.
Speaker 2:Yeah, I think people forget about that. I think we've kind of ingrained in people using other types of antioxidants, like a form of vitamin A, like a retinol over the counter, or maybe they're using a prescription like a tretinoin form. We always tell people you need to use this at nighttime and I think people forget during the day because of sun exposure, because of pollution exposure. Doing an antioxidant in the morning is important. I think as dermatologists we kind of know this. But I think patients sometimes are kind of surprised like, oh, I would do something during the day, 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 that point again that like the morning application is good because you're you're fighting off some of that damage that you're getting sort of acutely throughout. You know your day, whether you're driving to and from work, whether you're out walking around in the city, you know whatever you happen to be doing. Really good points for that as well.
Speaker 2:And from some of these two, you know, I think one of the ones I wanted to highlight because I think a lot of patients might already take this orally is sort of the role of melatonin. I think this has been something that's been a little bit exciting. Some of the more data coming out, you know, from the anti-aging or photo protection standpoint of melatonin. A lot of people think, oh, I thought people would just take that to help them go to sleep. What are your thoughts on the data with melatonin and its role in helping with sun protection?
Speaker 3:Yeah, melatonin is one of the most ancient, like archaic, old, powerful antioxidants that our body has and like all living organisms, I think probably have melatonin. But it's a really very beautiful thing because you go to sleep and then your body gets like showered with this powerful antioxidant, um, and so you know, we can take it, yes, as a sleep agent, but there are, you know, it does. It does serve as an antioxidant as well. Um, topically, um, same thing as the, as the you know, like vitamin c and e's and whatnot. Topically it also protects from sun exposure, but, same as antioxidants, it only works very clear, it only works before the sun exposure.
Speaker 3:Once the cat's out of the bag, it doesn't help. So it's another one of those things that would need to be used before sun exposure. I am not aware of any human clinical trials where it's given orally and they've done minimal erythema dose studies to see if you take it orally, if it reduces or increases how much light it takes to burn your skin. I have not seen that study. It might be out there, but definitely topically, we know that it is photoprotective.
Speaker 2:So for somebody that might also be thinking about other topicals, you might see some products that kind of get this label more generically like a DNA enzyme repair cream. Is that anything that's different than what we've talked about before? Is it sort of a different, you know, concoction of different things, or is it really just an antioxidant blend? I mean, a lot of people are like what exactly does it? Mean it sounds good, but what is it really?
Speaker 3:Yeah, and this is one of those things where you go all through residency and you're in training and you're with your colleagues and DNA repair enzymes never came up until I was doing all this research on supporting the skin with nutraceutical and whatnot. But DNA repair enzymes are out there and they actually really work and there's very robust clinical trials and, yes, it's all funded by you know the industry and the people make it, but they're very like, like you know, clear, like benefits, and they've done studies with people who have genetically just make skin cancer constantly when exposed to uv light because they can't repair their dna well and it shows that it prevents skin cancers and precancers from forming pretty dramatically in this population. And then the studies that we've used with these DNA repair enzymes are usually in combination with sunscreen in our studies and what it shows is that when you combine DNA repair enzymes with sunscreen, it way outperforms sunscreen alone when it comes to what we call field cancerization. So there's little precancers everywhere and it reduces DNA damage, which is something that you can't see on the skin. You have to sample it right. So if you use sunscreen with DNA repair enzyme and sunscreen, both people won't burn because of the sunscreen. But if you take a biopsy, you have less DNA damage because it's being repaired when you add the DNA repair enzymes and what they are is very unique.
Speaker 3:These DNA repair enzymes are not found in human biology. There's this theory that the gene that makes them, that was kind of outsourced and now it's like a photoreceptor for blue light. We don't have it anymore, but we get it from organisms and they make it so that it's fat soluble, so it gets down and gets where it needs to go and it actually appears to be able to repair human DNA. And it's really cool and there's you can find it in sunscreen and you can find it independently, and that is something that you can use after sun exposure.
Speaker 3:And so there are things that you need to use in the morning your antioxidants, obviously, your sunscreen right, you need to have on board before, but then there's things that you can use at night for repair. Dna enzymes are one thing that do appear to be very helpful, um, although they haven't really made their way into like derm literature as much. Um and then, um, the other thing would be topical niacinamide. That can be helpful afterwards, um, so that's usually how I kind of divide up a topical regimen. If we're specifically targeting photo protection.
Speaker 2:So just when you talk about a regimen there, I think, a lot of good information that we've been talking about. But for people that might be a little overwhelmed or thinking, okay, all this is great, but what practically should I do or what would you recommend? But what practically should I do or what would you recommend, and maybe that's different based on, obviously, patient needs or sun exposure. Or maybe you might recommend an oral supplement version versus topicals. But say this person's coming to you and this patient's asking, or person's saying, hey, I want to do something topically, how would you recommend maybe integrating one or two of these types of topicals, or maybe more, just what would be a simple recommendation, because I think that's what a lot of people want. It's sort of like a tangible answer.
Speaker 2: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 my face in the morning, five at night Is there a basic regimen you might recommend morning, five at night Is there a basic regimen you might recommend?
Speaker 3:And again, based on needs. Maybe it's different for the patient. Yeah, and that's really what it is. It's very patient dependent and everything needs to be based off of what the person in front of you is telling you, because, I think we said before, some people want a list of four things they put on morning and night. Other people want to take things orally. Other people are like I want to do it completely with diet, and so you really have to tailor your recommendations based off of what that person's actually going to do and what they you know what they want to do and their finances right, because a DNA repair is very expensive, a CE for like it's very expensive, and so you have to take all that into account.
Speaker 3:Personally, I mean, if somebody is not very high risk, for me diet, like all day long, like diet, is the best way to get all of these things, because we know so much about all these beautiful polyphenols and molecules and how they absorb sunlight and absorb oxidative stress and repair DNA, yada, yada, yada. But if you imagine, like, how much is probably in that plant that we don't even know about yet, I think that diet and consuming whole foods and seasonally for me makes the most sense. But there are people who have sun damage, who want to do more or who are high risk for skin cancer, in which case we need to bring out more tools and so really hitting the marks on the dietary stuff, like we talked about before, and the oral supplements that can be helpful the polypodium, the niacinamide, the omegas, the carotenoids, and then topically, the regimen. Again, it's going to depend on how much the person wants to do and wants to spend. In a perfect world, you're doing a nice studied CE-fru liquor, fluortin in the morning, followed by, in my opinion, mineral sunscreen, and then in the evening it's a niacinamide or a DNA repair enzyme or both. They don't have any evidence that they interact, although I don't know that the study has really been looked at. But those would be the two in the evening as the repairs the morning's prevention and evening is repair.
Speaker 3:And then if people are getting a lot of sun, I'll have them use their retinae, their tretinoins, in the winter only because it doesn't just increase your risk of irritation and burning, it actually increased the damage caused by sunlight, and so sometimes we'll put a hold on it.
Speaker 3:If somebody's like I'm a triathlete and I'm in the sun all the time You're like okay, we'll tell it to you. So that would be like the perfect regimen if you were just talking about sun protection, um, if we just wanted to pick a couple pieces. Um, obviously, the sunscreen is going to be the biggest thing for your book, um, but I love, I love a nice, you know vitamin, you know vitamin c for look, or floritin, um in the morning and then, um, the niacinamide, I think, is indispensable because of the mechanism of action. It is unique in how it works and how it protects your skin from sunlight, and so the idea is that you stack right, you stack these different layers, different ways to prevent that progression from sunlight exposure to skin cancer and photo aging, and so using tools from different categories is really important.
Speaker 2:I think this is just amazing. Like I love having these conversations with you because I feel like you're somebody that's telling us too that you can. You know you can have your cake and eat it too. You can live your life. You can, like you said, you mentioned that person who's out and training for that marathon or triathlon and what their needs are. You can have the person that works indoors all day. You can have somebody that's, you know, an agriculture. Maybe they're a farmer, or maybe it's a teenager that's a lifeguard, you know, and out all summer getting a lot of sun.
Speaker 2:I think what's really important, and where you see dermatology shifting a little bit, is just we're practical now. We know people have to live their lives. I think we're understanding the sun is not this evil entity. It has multiple health benefits but, like anything else, too much of a good thing can be a bad thing. But you're giving people options From the series we've done here you can talk about how do you just practically protect yourself from the sun?
Speaker 2:How can we incorporate diet supplements, non-topicals and, as you mentioned, you can mix and match or do this layering to go after different ways that they can actually help our skin.
Speaker 2:You know, I think, live in a world where we can do the things we want, but also try to minimize risk, cause I think that's what that's about, but also living our lives to our fullest too, which may mean for that person that's doing that marathon or gardening every day, or, unfortunately, for me, to sneak out whenever I can with my kids yeah, the sun, and there's hope for people like me that don't like carrots and other things too.
Speaker 2:So there's good, good things with us. But thank you so much for coming back on and sharing your expertise and knowledge, because I think this is empowering for patients to be aware of these options that are out there and that these aren't just things that we kind of throw out people. There's data to support what we're recommending and giving people, you know, I think, tools and empowering them to live their best lives, and that's going to be potentially out in the sun, but balancing that, you know, with, obviously, risk and things we can do to correct that damage. So thanks again, katie, for coming on and sharing all this information with us. It's been fantastic.
Speaker 3:For our listeners that want to find you. Do you mind sharing where you're at online in case they want to track you down? Yes, and thank you again so much for having me. I've really enjoyed our discussions.
Speaker 3:I love sharing the information and just teaching people how you can really live in harmony with sunlight and not overdoing it and not making it okay to go out and fry and not doing that kind of behavior, but to get an adequate amount just for overall wellness and to reduce the risk of all these chronic inflammatory diseases that are really plaguing our society now. And sunlight, like we talked about in some of our other episodes, is a really important way to kind of tame an overreactive immune system. But you want to do it without giving yourself skin cancer and sunspots and all those things, and you really really can. But it has to be personalized. So thank you so much for inviting me on to talk about that. I am not terribly active on social media. We do have an Instagram account for my clinic it's shine underscore dermatology, and our website is shinefunctionalmedcom, and so we are, you know, becoming a little bit more active out there, so you can follow along and I'll make sure to share other podcasts and other things that we're up to.
Speaker 2:Well, thanks again for coming on and, for those of you out there, stay tuned for the next episode of Dermot Trotter. Don't Swear About Skin Care.
Speaker 1:Thanks for listening to Dermot Trotter. For more about skin care, visit DermotTrottercom. Don't forget to subscribe, leave a review and share this podcast with anyone who needs a little skin care sanity. Until next time, stay skin smart.
