Precision Care for Acne and Eczema with Oliver Liu of Hypothesis

In this episode of Skin Anarchy, Dr. Ekta Yadav sits down with Oliver Liu of Hypothesis to unpack one of the most misunderstood areas in skincare today: the microbiome. While the term has become a marketing staple, this conversation reveals just how early we still are in understanding the microbial ecosystems that shape skin health—and why most current treatments fail to reflect that complexity.

Oliver reframes common conditions like acne and eczema as problems of imbalance, not simple bacterial overgrowth. In eczema, a weakened barrier, immune dysregulation, and the presence of Staphylococcus aureus create a self-reinforcing cycle of inflammation and irritation. In acne, it’s not the presence of bacteria that drives breakouts—but which strains dominate. This shift challenges the long-standing idea that eliminating bacteria altogether is the solution.

That insight exposes a deeper flaw in traditional treatments. Broad-spectrum approaches like benzoyl peroxide and antibiotics remove both harmful and beneficial microbes, often leading to temporary relief followed by recurrence, increased sensitivity, and long-term imbalance.

The conversation then turns to a new model: precision skincare. Inspired by naturally occurring enzymes, Oliver explains how targeted approaches can selectively eliminate harmful bacteria without disrupting the surrounding ecosystem—preserving balance while addressing the root cause.

This episode ultimately reframes skincare as ecosystem management, not correction.

Listen to the full episode to hear Oliver break down the science of the microbiome and why the future of skincare lies in precision, not force.

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Transcript

Welcome And Why Microbiome Matters

SPEAKER_02 0:00

Hey guys, welcome back to Skin Anarchy. This is a very special episode because we're going to be covering a topic that I think we rarely get to sit down and speak about in detail and in full fullness in terms of the science. And so for decades, I know a lot of you um have heard about acne, eczema kind of the same way when it comes to the bacteria that are involved, the microbiome that's involved, but nobody dives into like what that actually means. I feel like we keep having this conversation and going in circles and not really getting to the nitty-gritty of all of it. So our guest today is going to do exactly that and really talk to us in depth about the microbiome and really what that means for these different skin conditions. So without further ado, please welcome Dr. Oliver Liu, who is the co-founder and CEO of Hypothesis. Welcome, Dr. Liu. I'm so excited to host you.

SPEAKER_00 0:48

Yeah, thanks for having me. Really excited to have this conversation.

SPEAKER_02 0:52

Yeah, I'm really excited to dive in. Um, I would actually love to start off with learning more about your background. I know you have such extensive experience in biochemistry,

Dr Liu On Metagenomics

SPEAKER_02 1:00

genetics, um metagenomics. I mean, I would love for you to dive into that and kind of walk us down memory lane and tell us about your background.

SPEAKER_00 1:06

Yeah, as you mentioned, uh, the bulk of my career since my PhD has been in uh what's called metagenomics. Uh, metagenomics is the study of communities of microorganisms, whether that be in the soil, in a hot spring, or on your body, like with the skin microbiome. The thing that makes metagenomics so interesting is that uh we honestly have barely scratched the surface of natural diversity. It's estimated that 99.9% of microbial diversity in the world has never been studied, primarily because we don't know how to grow them in the lab. That means almost everything we've learned, all these huge databases of species and genomic information, all these things, come from just a small sliver of natural diversity. And the thing that I and my fellow co-founders at Hypothesis have learned, both at Hypothesis as well as at Radiant Genomics, the previous company I co-founded, is that if you do have a biological challenge, nature has almost always come up with a more elegant and effective solution than anything scientists can come up with in the lab. The answers are out there, often in those huge swathes of natural diversity that no one has looked at before. And metagenomics is a way for us to uncover those solutions. When it comes to the skin microbiome, we have been following that field for a while. So we know now that a well-balanced, diverse skin microbiome is critical for skin health. It helps to strengthen the skin barrier, train the immune system, prevent pathogens from colonizing. And over the past 15 years or so, the tools that researchers have to study and characterize the skin microbiome have improved tremendously. And so now we can not only look at someone's skin microbiome and see the specific species of microbes that make up the skin microbiome and their relative percentages in different parts of the body. We also have a much better understanding of what can go wrong in the skin microbiome, particularly when you have skin conditions like acne or eczema. And what we see in both those cases is that specific species of bacteria can overgrow in the skin microbiome and cause or worsen these conditions. In the case of eczema, that bacteria is called staph aureus. In the case of acne, this bacteria is called C acnes.

SPEAKER_02 3:14

That's really interesting. And it really stood out to me what you said about how we don't know about a lot, most of what's out there in the world of microbes. I mean, that's really fascinating. I think that that really hits home for I think a lot of us because we often think that now that science is diving into like the gut skin access, the microbiome, like we it feels like we have it all figured out, but clearly there's so much to explore there. I I would love for you

Science Consumer Gap In Skincare

SPEAKER_02 3:40

to dive into like where did you see the biggest disconnect between what the science already knows, which I think you were talking about just now about the microbiome and what's actually available to consumers.

SPEAKER_00 3:50

Yeah. So as I mentioned, so on the one hand, we increasingly have this kind of very detailed mechanistic understanding of how specific bacteria can drive conditions like uh eczema or acne. You know, these these bacteria not just you know happen to be growing more, they are actually playing a central role in uh disease progression. On the other hand, you know, the products that we have to treat these conditions haven't changed in decades, right? We're still using the same ingredients we always have, and they either don't really address the skin microbiome, things like you know, colloidal oatmeal or stereo creams, or you have ingredients like benzoyl peroxide, antibiotics, disinfectants like hypochlorous acid that are meant to kind of try to control some of this causal bacteria, but they're broad spectrum, right? And they indiscriminately kill all bacteria, including the good bacteria your skin needs to stay healthy. So that's the gap that we saw when we founded Hypothesis. You have these skin conditions that are crying out for a precision approach that's more than simply carpet bombing your skin microbiome. And importantly, we also thought we had uh the solution. Uh, we were inspired by a class of high-specificity enzymes that are found in nature. And with these enzymes, we believed we could usher in what could truly be called precision skin care. And so over the course of two, three years of RD, that's what we worked on. We developed these high precision enzymes that can specifically target either staph aureus or C acne's without damaging or affecting the broader beneficial microbiome. One of the things you see is, you know, if some of these acne treatments aren't working for you, you know, the suggestion often is to use uh, you know, higher and higher concentrations of these treatments and harsher and harsher things. And you know, you're really starting to make a lot of trade-offs uh in terms of kind of collateral damage that you're doing.

SPEAKER_02 5:37

Right, right. No, and that that's exactly it. You just keep upping it. And it just that's never the solution. But I want to actually go back to what you were talking about. You were mentioning

Lysins And Precision Enzymes

SPEAKER_02 5:45

this new approach, this precision-based approach. Can you dive a little deeper into that? I mean, what like what enzymes? And like just tell us more about that.

SPEAKER_00 5:52

Yeah. So when we started hypothesis, we got really interested in a class of naturally occurring enzymes uh found in bacteria and bacteriophages called lysins. They're interesting for a couple of reasons. Uh, first is these enzymes are designed to bind to bacterial cell walls and chew them up very rapidly, causing the bacteria to burst and die. So kind of really rapid bacterial killing activity. It's like popping a balloon with a pin. The really interesting thing about lysens, though, is that because the structure of the cell wall can differ pretty significantly from species to species, depending on how an enzyme binds to that cell wall, it has the potential for very high specificity, down to a single genus species, or sometimes even a subspecies. And so that means potentially one of these enzymes could specifically target a single species of bacteria within a community of many different types of bacteria. And that potential for very high selectivity struck us as you know an incredibly powerful property. As we've talked about, you know, most ingredients with these antibacterial properties like antibiotics, hypochlorous acid, are broad spectrum. They kill all bacteria. And so the idea of being able to target a single species within the community seemed like, you know, honestly, like a superpower. And in particular, we thought the skin microbiome would be the perfect application.

SPEAKER_02 7:13

Yeah, that's, I mean, that's incredibly fascinating that you can really narrow it down to that level. I mean, I hope we can go in that direction with everything now that I'm thinking about it when it comes to skin health. Now, I want to dive a little bit deeper because we started the conversation

Eczema Drivers And Itch Cycle

SPEAKER_02 7:25

talking about acne and eczema. And I think it's important for all of us to kind of revisit like eczema and really understand what's happening here. Can you break down the three-driver model for eczema so we can just kind of get our you know brains around this?

SPEAKER_00 7:39

Yeah, sure, absolutely. Um I think the best way to understand eczema is through uh what dermatologists call the itch-scratch inflammation cycle. So if you have eczema, you know, that that term sounds familiar and this process sounds familiar, right? It starts with, you know, you have a patch of irritated skin, it might be a bit inflamed, it itches, you scratch it, uh, and that scratching ends up causing more damage to the skin, uh, which unfortunately triggers more inflammation, uh, which triggers more itching and then more scratching, and you have that cycle that repeats uh getting worse each time. And once it gets going, it can be uh it can be really hard to stop. And before you that initial itch has turned into a full-blown flare-up. So we now know that three interconnected factors really drive that cycle and keep it going. The first factor is a weakened skin barrier. The outermost layer of your skin is supposed to act like a seal, right? It keeps moisture in and irritants, allergens, bacteria out. In people with eczema, this barrier is often compromised. Sometimes it's genetic. A lot of people with eczema have a mutation in a protein uh called phylagrin that's important for building a strong barrier. But the barrier can also be damaged by things like physical irritation, inflammation, and uh even bacterial activity. So that's one factor. Uh the second factor is an overactive immune system. Eczema prone skin uh tends to overreact, tends to kind of overreact to things that generally are should be considered safe. And so it's prone to inflammation that can damage the skin and drive itch. This inflammation also makes the skin more hospitable to harmful bacteria like staph aureus. And finally, the third factor, which is um the piece that's really been uh uncovered over the past five, ten years and has been generally overlooked in eczema care previously, which is the microbiome imbalance, uh specifically an overgrowth of staph aureus. Staph aureus produces toxins and factors that break down the skin barrier, increase inflammation, increase itching, and you can see how this directly feeds into uh the other two drivers. And so that's what's so challenging, right? These three drivers don't exist in isolation. They feed on each other to drive that itch-scratch inflammation cycle. And once that's established, it tends to start reinforcing itself.

SPEAKER_02 9:55

So, what is this like with staph uh or specifically, like you said, this is a really like this is the critical one, the bacteria and eczema. Can you dive deeper into that? Like, what

How Staph Aureus Fuels Flares

SPEAKER_02 10:05

about it exactly is making things worse?

SPEAKER_00 10:07

Yeah. So, this is a great example of how we have learned uh so much about the skin microbiome over the past uh 10 years. Dermatologists have long known that staph aureus is more likely to be found on individuals with eczema. So studies show that you know, 70 to 95% of individuals with eczema are colonized with staph aureus, while only about 10 to 30 percent of the general population is. The question has always been, you know, what does this mean? Is this correlation or is this causation? In 2012, there was this great paper that came out of the NIH that looked at how the levels of staph aureus change in people with eczema as they go through flare-ups. And what they found was that the level of staphorus on the skin uh is not static. Instead, the amount of staphoras actually spikes dramatically right before and during flare-ups. And the more staphorius that you have, the worse your symptoms tend to be. And so this finding was um was really important. It kind of indicated that staphoras isn't just you know this bystander on the inflamed skin, but is actually an active participant, is actually one of the big drivers and triggers that amplifies uh these flares. Since that study, other researchers have not only confirmed those results, they begin to uncover exactly how staph aureus uh drives that itch scratch cycle. It actually produces toxins, enzymes, molecules that break down the skin barrier, drive inflammation, crowd out other microbes. Um, there was a paper that came out a couple years from Harvard Medical School that actually identified the specific enzyme that staph aureus produces that can uh can activate a nerve cell uh that that drives itch. And so this is the first time actually that they they found a microbe that could directly trigger itching. And so it basically accelerates all the drivers of this itch-scratch inflammation cycle. So it turns out staph aureus is really like is more it's like the fuel on the fire, right? It's really what's revving up the itch-scratch inflammation cycle. It turns that initial trigger into that full-blown flare-up.

SPEAKER_02 12:06

That's so fascinating. Like, I mean, especially with the the nervous system integration that you just explained, that's really interesting. Now, in terms of like, now, I mean, staff, that's that's very interesting for acne, but I know with acne we hear about bacteria a lot more, especially with C acne. It's like can we dive into acne as well and and talk about what we've been told about acne thus far, right? It's caused by bacteria, but you say it's actually about balance. So can you kind of walk us through that? Like, what does that mean for

Acne Is Strain Imbalance

SPEAKER_02 12:35

acne?

SPEAKER_00 12:35

Yeah, no, absolutely. Um, as you mentioned, in the case of acne, most people know that bacteria play a role, right? It's it's why you know you you do see things like benzyl peroxide or or why dermatologists prescribe antibiotics, why you see a lot of like antibacterial being a selling point. Um, but just as with eczema, it's not all the skin bacteria that's involved in acne. It's driven by imbalance of a specific uh bacteria called QD bacterium acnes or or C acnes. And and actually, even in the past you know, five five years, our understanding has gotten even more nuanced than simply saying you have too much C acnes. In the past, it was thought that acne was caused simply by an overgrowth of C acnes. But now that we have much more detailed genetic studies of the skin microbiome, we know that people with clear skin often have just as much C acnes as those with acne. And C acne is a normal permanent resident of your skin. Uh, it's actually one of the more abundant bacteria to face. We now know the problem is not necessarily how much C acne you have in the skin, but instead, you know, what subtypes or phylotypes of C acnes dominate the population. In people with clear skin, these subtypes exist in kind of a relatively balanced distribution. They kind of keep each other in check. There's a lot of strains that are less inflammatory, but in acne-prone skin, that balance shifts. And so there's one subtype in particular, known as 1A1, which becomes dominant. And so it can make up 95% of the C acne's population on acne-prone skin versus 30 to 40% in non-acne skin. And this inflammatory subtype, you know, produces more lipases that break down sebum into irritating fatty acids, and they generate more inflammatory metabolites. They're more likely to form biofilms. And so it's not necessarily, in the case of acne, it's not necessarily that C acne as a species is overgrowing. In general, it's more that there's a specific subtype of C acne that has taken over the population.

SPEAKER_02 14:36

That's really, I mean, that's really fascinating to learn about because I mean it really makes you then question this whole idea of what we were originally talking about, where it's like the whole kill everything model, like just nuke everything. Um can you talk to us a little bit more about that now in terms of like why that doesn't really make sense then, now that we know this?

SPEAKER_00 14:54

So,

Why Broad Antibacterials Backfire

SPEAKER_00 14:55

as we mentioned, yeah, most molecules that kill bacteria, uh, treatments like benzyl peroxide, antibiotics, they indiscriminate kill all bacteria, right? Including the good bacteria. Yeah. Um so obviously you're losing out on the benefits of a diverse, well-balanced skin microbiome. All the the good bacteria that you're that your skin needs to stay healthy are being wiped out. I think it's also worth noting that wiping out you know large portions of your microbiome has other downstream effects. You're actually removing a lot of the healthy competitors that keep bad bacteria like staphoros in check. So once you stop using these treatments, the bad bacteria can actually come back even stronger because their their natural competitors are gone. And so, and then I think we talked about uh about the harshness of like uh benzo peroxide. One other thing to note around antibiotics is that there's a lot, there's also a lot of issues with antibiotic resistance, right? So studies show anywhere from like 60 to 90 percent of C acne strains are resistant to some antibiotic. So, you know, that's both a public health problem and and uh and a practical problem uh for patients when their antibiotien.

SPEAKER_02 16:02

What is your opinion on why the industry hasn't been able to embrace this more precision-based model so far? Like why have we been stuck in this like nuke everything mode?

SPEAKER_00 16:12

Yeah, honestly, uh it's because, in my opinion, and I think it's it's because creating precision ingredients that actually can be highly selective for a single species of bacteria is actually a really hard biological challenge. You need an ingredient that somehow can tell the difference between different bacteria, can kind of distinguish between one bacteria from another, or you need to find some vulnerability that only your your target bacteria has. And that's not that's not easy to do, uh, particularly with like simple chemicals like benzoyl peroxide or hypochlorous acid. It's not even easy uh to do with more complex molecules like like antibiotics. And so this is where we you know we really took inspiration from nature, because of course nature has solved this biological challenge in the form of these high-specificity enzymes. And you really do need the kind of the biological complexity of a large molecule, like an enzyme, that can actually distinguish between different bacteria. And so, you know, when we learn more and more about lysins, the more we thought, yeah, this would be the key to precision microbiome skincare.

SPEAKER_02 17:21

Yeah, I mean, it makes a lot of sense, honestly. And I I like that you brought up the point about how there isn't a vast amount of resources required to create technologies like this. I mean, this is really worth noting, is that it takes a lot of dedication and years and decades of science to come to this kind of understanding. So, I mean, that's huge. And I'm I'm glad that I'm glad that you guys are doing it, honestly. Yeah, because we we need this approach. And now, how are technologies like TPZ01 and CUT O2 different from traditional actives?

SPEAKER_00 17:50

Right. So TPZ1 and CUDO2 are our two patented uh

Building TPZ01 And CUDO2

SPEAKER_00 17:55

and proprietary precision enzymes. Uh TPZ1 is designed to specifically target Staph aureus, while CUT O2 is designed to specifically target C acne's. We spent two to three years developing these enzymes. Um I mentioned they're based on enzymes that are found in nature that we discovered uh in our research. But we tested over 800 variants of these enzymes to find ones that kind of met the criteria and specificity that we wanted. Uh so in our laboratory testing, both of these enzymes kill 99.99% of their target bacteria while having no measurable impact on uh a broad panel of beneficial skin bacteria. So they have very strong and very selective activity. And because they only bind to their target bacteria and don't really interact with human cells, TPZ01 and CUDO2 are incredibly gentle. They don't cause irritation or affect the skin barrier. We have done uh both tests on panels of sensitive uh people with sensitive skin or looked at 3D models of human skin tissue. And what we see, we confirm the enzyme has no effect on human skin cells at all, even at even at really high concentrations. And so these have very few side effects, they're non-irritating. In our clinical testing backset up, 95 of particip 95% of participants that use our acne serum for eight weeks said it was non-irritating. They had no issues.

SPEAKER_02 19:22

Wow, that's that's amazing. And that's really amazing that they're so precise. Like they're not interacting with the skin in any negative way. That's really that's very fascinating. Now, I I'm curious though, like what is the biggest challenge? Because I always wonder, right, with like proprietary ingredients, like it's gotta be hard bringing that to like mass scale and putting in skincare. So, what were some of the biggest challenges that you faced bringing these enzymes over into skincare products?

SPEAKER_00 19:44

Yeah, it wasn't easy. So we're we're not the first group to think about using license to to manipulate the skin microbiome. Uh other other labs, other groups, other companies have have have looked into it. I think historically there have been three kind of big challenges in turning these enzymes into effective products. The first is that specificity. And there are a lot of license, you know, you can find license, and while licensed have the potential for specificity, it can be really hard to find one that actually has a specificity you want, right? So, for example, there are a number of enzymes that have been found that target the genus Staphylococcus broadly. But finding an enzyme that can distinguish between Staph aureus and its uh closely related uh species, Staph epidermidis, uh, which is actually a good bacteria, is really hard. And so, you know, finding that specificity and figuring out ways to distinguish between those uh can be uh quite challenging. Uh, in the case of acne, no one has previously been able to find an enzyme that effectively targets C acne's. So CUT O2 is really the first enzyme that even really targets uh C acnes in this class. So specificity is the first challenge. I think the second challenge is that even if you can find an enzyme with the right specificity, you still need more from that enzyme, right? Uh you need an enzyme that has high activity, it works that you want it to work at the right pH. You know, skin is ideally uh slightly acidic, and most importantly, it is highly stable. You're probably familiar, enzymes are notoriously fragile. They're sensitive to heat, they can be damaged, they can be degraded, they just fall apart over time. And of course, when it comes to skincare products, shelf life is really important, right? So you you want a long shelf life at room temperature so that's both convenient for customers. Um, also lets, you know, you need that long shelf life to let you sell through different channels like retail or or Amazon. So we had to work really hard to develop enzymes with very high stability and develop formulations that really protected these enzymes so we could achieve that two-year shelf life. Third challenge, uh I think you alluded to is that you need to be able to produce these enzymes uh at large scale and cost effectively. You know, we work really hard to increase the increase the production yields of our enzymes so that we can sell at uh at accessible price points.

SPEAKER_02 22:08

Well, no, that sounds incredibly like a true feat to be able to accomplish this. Yeah, I mean it it's really I think that's one of my biggest um I'm always like in awe of that when when you look at innovation in the space and how it's brought to life in skincare, like it's always very inspiring to see how much work goes into that because scaling is yeah.

SPEAKER_00 22:28

I was like, I mean, this is um and one of the reasons we also wanted to found hypothesis is that we we did feel like we had with our experience with metagenomics, uh, with harnessing natural diversity, with our background in engineering biology, we felt like we had a new way and a new approach to try to overcome these historical hurdles. And so, as you can

Clinical Results For Eczema Acne

SPEAKER_00 22:50

imagine, a lot of the ways we've been able to overcome these challenges is by looking to find better enzyme candidates and better starting points, kind of by looking broadly in natural diversity where where no one else has looked before.

SPEAKER_02 23:02

Yeah. No, I mean, I think I think that's very fascinating. I'm glad you I'm glad you're also highlighting that there is so much in nature that we can still use. I think that gets lost a lot of times is that we can really go there and find solutions still. We just have to, you know, do the science. Like you gotta do the, you gotta do the work, you gotta look into technologies that can bring that out. But I want to dive uh deeper into your clinical results. I know you have an immense amount of clinical data really backing up um what you're doing. Can you dive into the clinical studies and what they revealed about how effective this approach actually is?

SPEAKER_00 23:34

Yeah, so I think this is where the kind of proof is really in the pudding, right? Um it's great to be able to show specificity and activity in the lab, but the question really is what happens when you apply it to the skin? So we have run a number of clinical trials. Uh, in the case of eczema, we ran what's called a dual arm formulation controlled clinical study. So we split the our participants into two groups. One group used our eczema precision hydrogel, which contains uh our TPZ01 precision enzyme. They used it twice a day for two weeks. We then had a we also had a second group, which is our control group, which used an identical formulation. Uh, contained kind of the same OTC levels of colloidal oatmeal, you know, same pro-vitamin B5. The only difference is that it did not contain the enzyme. Again, that control group used the that control formula formulation uh twice per day. We looked at eczema symptoms. We had them clinically scored by experts using the SCORAD rubric uh at baseline one week and two weeks. After two weeks, the control group saw a 25% decrease in eczema symptoms on average. The group that used the eczema precision hydrogel saw a 61% decrease in symptoms. So simply adding TPZO1 uh to the formulation improved results uh over two and a half times. Importantly, when we looked at the microbiome, the amount of staph aureus decreased by 85% in the group using our hydrogel, while there was no significant change in the control group. So we think you know this study was really a nice set of data that that ties and demonstrates the performance of TPZ1 uh with its benefit.

SPEAKER_02 25:16

Yeah, that's that's really huge. That's really, really good. Yeah.

SPEAKER_00 25:22

Yeah. In the case of acne, we ran longer eight-week trials. Uh so improvement in acne is generally uh more gradual. Uh, and actually a lot of trials go out even longer, 16, 24 weeks.

SPEAKER_01 25:33

Yeah.

SPEAKER_00 25:33

Um so we had participants use our acne precision serum, which contained CUDO2 once per day nightly for eight weeks. In these trials, we saw that 93% of participants saw improvement by week two, but with the most kind of substantial improvements accruing over kind of weeks four through eight. We saw significant improvements in all the symptoms that we tracked, including lesion count, redness, tenderness, skin tone. We didn't do a head-to-head with traditional treatments, but when we compare our clinical trial results to clinical trials in the literature that are testing first-line treatments like you know, combinations of antibiotics, benzo, peroxide, and retinoids, the magnitude and pace of improvement that you see with the acne precision serum is is comparable. So, so comparable,

Simple Routines And Steroid Use

SPEAKER_00 26:20

good efficacy, but with much less irritation, much better tolerance.

SPEAKER_02 26:26

Wow. That's really fascinating because yeah, because the the protocol for acne just feels so daunting. So it's that's really, really promising to hear that. Now, in terms of like, I want to really put this in in context for our listeners in terms of routines, because I think that's where a lot of us get stuck, right? Is like figuring out how to incorporate novel tech into our routine. So if somebody's using hypothesis products, what is a realistic routine that they can follow?

SPEAKER_00 26:50

Yeah, great, great, great question. I think this is this is really where science becomes kind of really practical for people, right? So for our eczema line, uh the routine is designed to be simple, uh consistent. We recommend starting with either our eczema precision, precision hydrogel, or our precision healing spray. Both contain TPZ01 in same concentrations and uh and are applied directly to the eczema prone skin. These are kind of the primary products for keeping staph aureus in check. You would apply them twice daily, uh morning and evening possible, and at least twice daily to the areas where you tend to flare. I think it's it's really kind of personal preference whether you use the hydrogel, the spray, or both. Some people find the spray easier to apply to hard-to reach areas or to use on the go. Some people find it easier to apply to children, while other people like kind of a more traditional gel format. So we have kind of that uh piece that controls uh staph aureus. We also have an enzema therapy cream, uh, which we recommend you follow on uh to any of the TPZ1 products. And so this therapy cream contains cloto oatmeal, three essential ceramides. It's uh designed to moisturize and and really strengthen and repair the skin barrier alongside the TPZ01 products. So now that your chance has a your skin has a chance to calm down, you can address both the sapphoreus as well as kind of the skin barrier driver of eczema. If you do have active inflammation, you know, I think that people should feel free to use a topical steroid as directed by a dermatologist if you're comfortable with it. Um ideally, we think as you kind of get into the routine with the hypothesis products, you should be using any kind of steroids less and less over time as the microbiome stabilizes.

SPEAKER_02 28:35

Yeah, and I would imagine it's a really good way to like kind of wean off of those kind of medications also and not compromise your results and not compromise. Yeah, that's that's really, really interesting. I mean, I think this is where I get very fascinated also because this is where I I think I said this before on the podcast where it's like we're really bridging at this point with dermatology in the skincare space. Like, this is that kind of tech that's going to bridge that gap and it's giving going to give you an actual solution that's not just going to be like another product in your routine. This can actually replace something that maybe you think is too harsh for your skin, or that it's just not maybe you've plateaued. You plateau with your results. And sometimes consumers don't know where to go after that. Even doctors don't know what to prescribe at that point. So yeah.

SPEAKER_00 29:17

In the case of Staph aureus, I think dermatologists are increasingly really appreciating the the role of Staph aureus. There was a some recent papers from from a leading group of pediatric dermatologists that that uh cited staph aureus as kind of the the most critical driver of the age scratch inflammation cycle and and contributing to to eczema progression, and that is is one of the highest kind of unmet needs uh in terms of eczema care management. So I think there's there's really been this gap of how do you um even when you control kind of the the skin barrier or you kind of control inflammation, as if you have all this staph aureus on your skin, uh it either can keep a cycle going on its own or it it's like priming the skin to at the at the most you know simple provocation, it's just gonna kick that cycle back up again.

SPEAKER_02 30:07

And so yeah, and staff is our staff is very aggressive too. I mean, it's like wherever you see it in any pathology, it's an incredible, incredibly strong driver of pathology in every all places of the body. Like, yeah, I mean, this is this is huge. I mean, in in a lot of ways, because I mean controlling something, a bacteria like staph is very different than something that is not as aggressive. And and I think that's important for consumers to understand is that that's probably why eczema treatments like have been failing for so long. Because like we have never addressed that root cause. So this is this is huge, yeah.

SPEAKER_00 30:40

Yeah, and and as opposed to Cacnes, there's really no reason you want staph aureus on your skin. Uh, and so you definitely just you want to get it uh removed if you can. Uh, and I think the other thing to that, you know, as we get more and more data and information on other skin conditions, you know, there's there's increasing evidence that staphoras is a contributor to all kinds of of skin problems.

SPEAKER_02 31:01

Right. No, I want to talk about this because I really like products um

Microneedle Patch Versus Hydrocolloid

SPEAKER_02 31:05

like this personally, especially dealing with adult acne. Precision, the precision micro dart blemish patch. Can you talk about what makes this different than any other patch on the market?

SPEAKER_00 31:15

Yeah, so so for our acne line, we have three products. Uh so we have a daily acne cleanser, which is kind of a gentle silk acid and glycolic acid cleanser that helps clear pores and prepares the skin for CUDO2. We also have that acne precision serum, which is kind of the hero, right? It delivers CUT O2 directly to the skin. So those two products uh act as a kind of daily routine that you're gonna be uh using. What we've also developed, as you mentioned, are these precision micro dart blemish patches. And so this is actually a pretty hard technical feat, but we were able to figure out a way to formulate these microneedle patches with CUDO2 and have our enzyme kind of survive that formulation process. And so these patches, you know, as opposed to most pimple patches like hydrochaloid patches that kind of work passively, you know, they they they sit on the surface of the skin and absorb fluid from a pimple to kind of accelerate this healing process. Our precision micro dart plant patches are work differently. So they they use these dissolvable micro needles to deliver CUDO2 into the pore where acne develops. And so they're particularly effective at stopping the development of kind of early stage and under-the-surface pimples that haven't come to a head yet. It's those pimples that you can start to feel under your skin. You kind of know they're coming, there's a tender, but it hasn't really emerged yet. In our clinical testing, uh, when people use our patch to kind of actively address those early stage pimples, uh, 88% said the patch completely stopped the progression of the pimple. 97% said that it worked to flatten that under-the-surface pimple. So, so you know, whereas you use kind of hydrocholi patches for white heads and pimples that have already kind of uh gone to the surface and you're really just trying to protect them and get them kind of healed, these uh precision micro dart patches are really to kind of address and get at those early stage pimples and try to keep them from uh even developing um in the first place.

SPEAKER_02 33:17

Also, this is actually you're kind of debunking one of the misinformations out there too, because for a long time I think people were using hydrocoolid patches as preventative when they're not. I mean, like that's I've seen a lot of people do, I know I've done it where it's like you just put them on because you think, oh, I'm gonna get a I'm gonna get a pimple right here, but then that's not doing anything for to actually prevent it from developing. So this is huge. I mean, it's a totally different way of thinking about it. That's very cool. I want to actually ask you though, because I know that with microbiome-focused like skincare, there's been a very big gap, I think, in the industry as far as the education around what we can realistically expect in terms of like our routine and like the efficacy and the timelines, right? For like resolution

Realistic Timelines And Mindset

SPEAKER_02 34:00

or whatever it might be. Um, can you kind of walk us through what users can realistically expect when they're starting a microbiome-focused uh routine? And how should we really be approaching this like from a psychology standpoint?

SPEAKER_00 34:12

Yeah, that's a great question. Because I think um I think setting the right expectations is actually one of the most important things we can do for our customers. Because acne and eczema are conditions where people are just eager for products that that work for them, right? Um and so you know, I think the first thing to know is that you know, results will build gradually, uh, particularly with acne. This isn't a treatment that's going to work overnight. The skin's microbiome, the microbial ecosystem takes time to rebalance the you know, the acne lesion life cycle means that pimples that are kind of already developing beneath the surface before you start a new routine will still appear in the early weeks. Uh and so you know, when you look at our acne clinical trial, most people do start to see a meaningful improvement within one to two weeks. But really, kind of the best results build over that kind of full eight weeks of consistent use. So the trajectory uh can be encouraging early, but really the full benefit uh takes time to develop. In the case of eczema, uh setting expectations can honestly be a little trickier because there are definitely a percentage of our uh of our users that actually do see a fairly dramatic improvement uh within just a few days. And these individuals are probably in a point in their eczema flare cycle where staphorous is at its peak and really driving symptoms, and TPZ1 can can bring that down fairly quickly. And you know, of course, we we we celebrate those results, and it's incredibly fulfilling to know that our products provide such relief. But honestly, I think the mindset you really need around eczema care is that this is a this is kind of really a long game. Eczema is generally a chronic condition that's going to ebb and flow. And your long-term goal really should be how do you manage those three drivers of the itch scratch inflammation cycle that we talked about. If you can create a routine where you're pushing back against those drivers consistently, uh you can keep that flare cycle in check. You know, you can reduce the occurrences of flare-ups, you can reduce the severity of flare-ups. Our products can have dramatic results in some cases, but it's it's not meant to be necessarily to be a magic bullet, right? It's another tool in your toolbox, in your dermatologist's toolbox to help you target a driver of eczema symptoms, you know, staph aureus, that's previously been uh kind of completely unaddressed. And then the the important, the most important thing is like consistency, right? When when you're trying to kind of maintain kind of good microbial balance, like you need kind of sustained daily effort. Um, it doesn't rebalance if from like occasional use. It's not think of it less like taking a medication for you know when when things are going poorly, but uh when symptoms flare, and more like kind of building a habit that kind of supports your your skin's long-term health.

SPEAKER_02 37:02

Absolutely. Yeah, I think that we should be doing that anyways. At this point, like as much money as we invest in our skincare, you guys, like we shouldn't be doing that because that's how things work. I mean, no, honestly, like I think that's also like I think that's why also like I I gravitate so much towards trying to understand the microbiome personally as a consumer myself, because it's really like at the heart of like understanding how your skin functions. And that takes time, it takes persistence and like consistency in your you know your routine. And I feel like this specific niche of skincare is addressing a serious problem consumers have had for so many decades, where we're like just bombard my skin, what I mean, and then I'm gonna do nothing for the next week. And it's like we can't do that, it's an organ.

SPEAKER_00 37:45

So yeah. Absolutely. And I think what we're really excited about is we we are finally kind of bringing the products and tools that allow you to do that type of you know, precision skincare and gentle skincare that um I think people have always wanted, but you know, that just hasn't been available.

SPEAKER_02 38:00

Absolutely. Now, do you think, like I just want to get your opinion on this, like in going into the

Personalized Microbiome Care With AI

SPEAKER_02 38:05

future and seeing how skincare is evolving, do you think it will eventually come to a point of being as personalized as something like what we study in genomics or just precision medicine at large? I mean, do you think we're cut in there?

SPEAKER_00 38:17

Yeah, and I think um that is kind of the long-term goal, right? Is this personalization. At some time, at some point, you want to be able to profile your skin microbiome, uh, understand, you know, the specific distribution of different species and strains, uh, and then be able to kind of select from the treatments and that are tailored to your kind of specific imbalance. I think that's where we're gonna get to, but I do think it's gonna take um quite a bit of work for it to be a real thing. I think one of the challenges is that there right now there's really no concept of an ideal skin microbiome, right? You know, people with healthy skin can have very different uh skin microbiomes. So there's a lot of ways that a microbiome can be right. Now we've made a lot of progress understanding how the skin microbiome can go wrong, and that's where we can make a big impact now. And I think in the near term, it's also going to be easier and more reproducible to remove a species from the microbiome than to consistently add species uh to an established microbiome, given the kind of dynamics and competition in the skin microbiome. But yes, you know, and I think as we generate more and more data on the skin microbiome of both healthy individuals and those suffering from skin issues, our understanding of individual microbial profiles and how we can give them a nudge here and there to a to a healthier state is only going to improve. And I think with tools like our precision enzymes, with probiotic approaches where we're you know maybe able to introduce beneficial strains, I think we can get to a point where we can kind of provide routines and make uh recommendations with confidence. And you know, of course, no conversation can end without a mention of AI. I do think AI could play a really important role here as we kind of really accumulate large, kind of vast amounts of microbiome data.

SPEAKER_02 40:12

Yeah, absolutely. No, I'm really excited about this space, honestly, and watching it grow because this could technically replace an entire area of allopathic medicine. Like if you really think about it. Like, like all of the drugs that are circulating in the acne space, like just right now, I'm not saying we need to get rid of them just saying it could really make you re-examine like what needs to be prescribed. And I would love to see a world where we can get more precise with dermatology drugs, because I've said this before on the podcast where it's like we you're like what you said was very fascinating, by the way, about the antibiotics, like how dermatologists are the largest prescribers of this. But at the same time, it's like I feel like dermatology drugs at large are really dated. And that's genuinely my opinion. Like, I feel like when I look at the rest of the medicine and I see how like quickly we adapt technologies, I don't know why we're not doing that in dermatology. And so it would be really cool to have a world one day where we can say, okay, listen, we can get way more precise and we don't need to compromise other organ systems in the process of treating things like acne.

SPEAKER_00 41:14

So and I do think one of the more near-term opportunities is going to be kind of expanding the breadth of these types of uh of uh microbiome approaches, um, where we've started with acne and eczema because kind of our understanding of the microbiome is the the most developed there. We kind of we understand which specific bacteria are driving those uh conditions, but there's a lot of research going on, and skin microbiome is implicated in a you know growing number of conditions beyond just those two. I mean, you look at psoriasis, rosacea, seborrae, dermatitis. There was even a paper on the skin microbiome and and wrinkles and aging. So I think as the science develops, we get a clear understanding of kind of the microbial signatures of these conditions. Um precision approaches become more relevant there as well.

SPEAKER_02 42:00

Absolutely. Now, in closing, Dr. Lou, I would love for you to give us just like impart

Closing Takeaway And Where To Buy

SPEAKER_02 42:05

some closing wisdom on us about like what is one thing you would like people to know about acne and eczema. And like if you were to give us like one thing we should keep in mind always.

SPEAKER_00 42:15

Yeah. Let's see. I mean, what I would say is that these conditions are not about eliminating bacteria broadly, right? They're about restoring balance in the skin's microbial ecosystem. Your skin has its own ecology as bacteria that has co-evolved uh over millions of years to protect us, regulate our immune system, keep harmful organisms in check. And when we treat those conditions by kind of carpet bombing that ecosystem, we're really working against the biology uh rather than with it. And so what excites me about where we are with hypothesis is that for the first time, we have tools precise enough to work with the skin's biology. Uh, we can reduce the specific bacteria driving harm without kind of dismantling everything around that. And I think that's fundamentally a new approach to skin care that's only possible with our with the enzyme technology that we've developed, uh, and one that can kind of really be called precision skincare. So I I genuinely believe I genuinely believe it's going to change how people think about the experiences uh um um and how they think about and experience uh acne and eczema care. And I'm excited for people to try it.

SPEAKER_02 43:25

Absolutely. Now, I really, really urge you guys definitely check out the brand. If you have not already, you can get all the information in the show notes of this episode. So scroll down if you're listening anywhere and make sure you go check out the website, check out the brand. I mean, I really urge you guys, I mean let's really vote with our dollars when it comes to technologies like this, because I think that we can shift, we move the needle a lot. We can really move the needle as consumers. And I think if we make a statement in that way, like it really goes a long way for allopathic medicine. Like, I can't say that enough times. Like, I personally myself, I really believe that when you see real innovation, like get behind it because that's will immediately impact how physicians and practitioners day to day are working with these diseases. And so I just I'm just so excited about this, Dr. Lou, what you guys are doing. It's very, very exciting. And I really applaud your team for coming out with something so innovative.

SPEAKER_00 44:13

So thank you for sharing that with us. Yeah. Thank you. Thank you for for your kind words and thank you for having me.