Peptide buzz, Bro Skincare, A Melanoma Breakthrough and the Dreaded White Cast

In this episode of “Derm & Dumber,” we discuss proposed new relaxed restrictions on some peptides (BPC-157, TB-500, KPV, MOTS-c, Epitalon, Semax) while noting conflicts of interest and minimal human data about them. Research out of UCLA is reshaping non-nano zinc to reduce the horror of mineral sunscreen white cast! We get into man-themed skin care. and share some good news on the topic of melanoma. Of course, there's some dumb social media trends and listener questions too. Enjoy!

ABOUT DERM & DUMBER

Derm & Dumber is a podcast hosted by board-certified dermatologist Dr. Brooke Jeffy and her husband, where skincare, relationships, internet trends, and questionable opinions collide.

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DISCLAIMER

The information discussed on this podcast is intended for educational and entertainment purposes only and should not be considered medical advice. Listening to this podcast does not establish a doctor-patient relationship. Always consult your own physician or qualified healthcare professional regarding medical concerns, diagnoses, or treatment decisions.

Transcript

SPEAKER_02 0:24

Hey everybody. Welcome to a new episode of Derman Dummer. Let's get into this. What are we talking about today, this week, Doctor?

SPEAKER_04 0:36

I want to start with talking about some regulatory changes in the world of peptides that potentially are coming up.

SPEAKER_02 0:43

Right. Okay. So we're we're talking government agencies here and how great of a job they're doing, I bet.

SPEAKER_04 0:51

I don't know if I'd go that far.

SPEAKER_02 0:53

All right, I'll wait to hear what you have to say.

SPEAKER_04 0:55

Yeah. But you know, I do think it's, you know, peptides, people might listeners might not think initially are something related to dermatology, but some of them are because they have, you know, uh anti-aging, anti-inflammatory healing, wound healing type of benefits. Okay. So they definitely fit in this space.

SPEAKER_01 1:16

Right. Okay.

SPEAKER_04 1:17

But also, you know, teens are using these a lot, being influenced to use them for various, you know, ways to enhance themselves. So I think parents need to know about them. Right. And, you know, we've talked a little bit about this before with influencers peddling their pet tide links.

SPEAKER_02 1:38

Right. Impressionable kids. Yeah. And it's crazy that even kids can just get a hold of these things now. No. So I guess it makes sense that the FDA should get involved and help us out as parents trying to navigate this space, right?

SPEAKER_04 1:53

Yeah. So the FDA this week, um, the FDA Pharmacy Compounding Advisory Committee recommended relaxing restrictions on the compounding of six unapproved peptides.

SPEAKER_02 2:09

Okay. And I'm guessing they chose to go that direction because of all the fantastic studies and data that they were presented with.

SPEAKER_04 2:17

Well, obviously not. Because this isn't this is not FDA approval we're talking about.

SPEAKER_00 2:24

Right.

SPEAKER_04 2:25

This is an advisory committee that um is trying to make it so that compounding pharmacies can make these versus how you get them now, which is from like random places and you're getting peptides that are for research purposes only. Right.

SPEAKER_02 2:45

Okay. So this I remember talking about that last week.

SPEAKER_04 2:48

Yeah. So by if this goes on to be approved and accepted, then compounding pharmacies can legally make these.

SPEAKER_00 2:57

Okay.

SPEAKER_04 2:57

So it's a little bit of a step in the right direction because they would have more regulatory, you know, oversight.

SPEAKER_00 3:03

Sure.

SPEAKER_04 3:03

These wouldn't remain just like research only. They would actually be under the realm of some oversight from a pharmacy.

SPEAKER_02 3:11

Okay.

SPEAKER_04 3:12

You know, regulatory body.

SPEAKER_02 3:13

So far, so good.

SPEAKER_04 3:14

So anyway, they've just recommended that these restrictions be lifted. So they approved six or they recommended uh six to uh peptides to be allowed to move forward. They rejected one of them. Um, but as you know, you were kind of alluding to, is the FDA like some amazing, you know, doing their job, bringing this in. Um, you know, this comp this particular committee recently had eight new members put on, six of which have really heavy peptide industry ties or wellness clinic connections.

SPEAKER_02 3:55

Right. Yes, of course. So yeah, look into this and peel back one layer of this, and you immediately are disturbed by how corrupt this probably is.

SPEAKER_04 4:06

Yeah. I mean, this is like a billions of dollars, you know, industry waiting to be like exploited, tapped into. So uh, you know, these companies are ready to take, you know, advantage, advantage of that.

SPEAKER_02 4:22

There's money to be made, quick, line our pockets.

SPEAKER_04 4:25

But the crazy thing is, these are still all very unstudied, not FDA approved by any means. You know, again, this is just allowing compounding pharmacies to make them. Um, doesn't mean they're FDA approved. FDA scientists still like adamantly oppose, you know, the use of these peptides, um, because they they haven't been studied to any sort of remotely, you know, rigorous standard, and in fact, essentially like zero studies. Um, so the ones that were recommended, um BPC 157, TB500, KPV, um these three reduce inflammation, improve and improve wound healing, anti-inflammatory effects, MOT C, which improves endurance. So a lot of you know, your kids might be seeing this and thinking about how that might improve their sports, their sports and training. Uh, there's one called epitolon, which is for anti-aging, CMAX for cognition, and the one they rejected is a sleep-enhancing peptide called emadeltide. So anyway, things to kind of like be aware of. I think, you know, we all kind of need to be aware of these things. Um and, you know, I just want to, again, like reiterate how insane it is that people are willing to inject these.

SPEAKER_02 5:58

Um, just at home based on almost nothing.

SPEAKER_04 6:02

Nothing. Yeah. So like one of these that I was, because I don't I don't know a ton about these um specifically, but one that is very common and people ask me about all the time patients, BPC 157. Um, you know, I did a deep dive to just kind of see like how much research is, you know, actually out there. And there's basically three studies even involving humans, and it's a total of 30 people. Wow. And these are crappy studies too, like no control group, right? Just done for kinetic, you know, pharmacokinetics to kind of determine like how, you know, the levels that are reached in the body, or what of them was done and the treatment that they the condition they were treating, they were also treating with the standard FDA approved treatment. So there's like no way to know what benefit they got from the peptide versus, you know, standard treatment. Right. So again, I'm just reiterating why are you willing to do these things, which we just don't know the consequences of. Right. And, you know, this is obviously different from um like the GLPs. I mean, those are peptides that are super common now that people are really aware of. Right. But those have been studied.

SPEAKER_00 7:17

Oh, yeah.

SPEAKER_04 7:18

The ones that are FDA approved. Extensively. Extensively studied for years.

SPEAKER_02 7:22

Yeah.

SPEAKER_04 7:22

So it's a different situation. Right.

SPEAKER_02 7:24

Um so but people see the near miracle status of this other GLP peptide, and they're thinking, peptide's good.

SPEAKER_04 7:33

Right.

SPEAKER_02 7:33

Let's go. Everybody, get on the peptide train.

SPEAKER_04 7:36

Right. And I mean, there's no shortage of people who will say, you know, hey, I've been using this, I feel this effect, whatever. But I mean, placebo is well documented.

SPEAKER_00 7:47

Right.

SPEAKER_04 7:48

And uh, you know, it takes much more than just those kind of random, you know, statements to say that something is working. And then also just the risk of it. You know, most of these peptides, I guess I shouldn't say most, but at least the ones I'm most familiar with, one thing they do is they increase blood flow.

SPEAKER_00 8:09

Right.

SPEAKER_04 8:09

You know, that's how they work to be anti-inflammatory or to uh help with wound healing. Right. And so that's that's called angiogenesis. And, you know, that's also how tumor cells.

SPEAKER_02 8:23

So I can see the benefit of that.

SPEAKER_04 8:26

Right. But also a risk.

SPEAKER_02 8:29

Right.

SPEAKER_04 8:29

You know, if you don't know that you have a malignancy brewing somewhere, then you could just be feeding it. Mm-hmm. Mm-hmm.

SPEAKER_02 8:37

While trying to think that you're helping this wound. Because you can't control just the injection site, right? I mean, right.

SPEAKER_04 8:45

I mean it's a systemic when you inject it.

SPEAKER_02 8:48

Right. It's it goes everywhere and feeds everybody.

SPEAKER_04 8:50

Yeah, or you're taking it, you know, orally or something. Right. So I mean, and and so I again um this isn't based on a study, but you can think of the flip side of it, where if you decide to use this and something happens, you're never gonna know. Did you induce it? I mean, this actually happened to me. So as I think everyone knows, I recently had an early melanoma removed, and I'm sure it was from decades of tanning use, but tanning bed use, but I was doing a peptide called GHKCU, which is a regulated peptide. It's made in um, you know, compounding pharmacies. It's not one of these research-only ones, but um it can be found in topicals. It does have some fairly proven benefits on skin when used topically, but now you can take it systemically with an injection or like a troche, an oral thing that, you know, dissolves in your mouth.

SPEAKER_01 9:49

How are you taking it?

SPEAKER_04 9:50

And I would say you with a troche. Right. So um that's when my melanoma occurred.

SPEAKER_02 9:57

Uh but you know, again, that's how correlation is not causation. So we need to always hammer that home because there's so many people out there who misinterpret correlation as causation. But in your case, you don't know.

SPEAKER_04 10:14

Yeah. But could these be life-changing? Sure. We just we don't know enough yet.

SPEAKER_02 10:19

Right. Yeah. That's why drugs take so long to uh develop.

SPEAKER_04 10:24

Yeah.

SPEAKER_02 10:24

And why we should be okay with that.

SPEAKER_04 10:27

Yeah. So I think, you know, the moral is you gotta really think about it. Know what you're, you know, have these conversations with your kids. Um because who knows what they're buying online from their favorite infl favorite influencers link, and it's a crazy world out there.

SPEAKER_00 10:47

Mm-hmm. Yeah.

SPEAKER_02 10:49

Well, uh that's kind of disturbing.

SPEAKER_04 10:55

Yeah, and disturbing how these things are moving forward and you know, circumventing FDA approval and still going to be large scale available potentially. So Right.

SPEAKER_02 11:06

So yeah. Next time your kid comes up to you and says, I need four new peptides. Quick, mom, place this order.

SPEAKER_04 11:16

But it's not only kids, believe me. I have plenty of adults ask me, hey, I'm thinking about starting this.

SPEAKER_02 11:24

Yeah. It's best to just not give your kid a phone.

SPEAKER_04 11:27

Well, that's definitely true.

SPEAKER_02 11:28

Let's just start there. But that's a whole other You can't nah, but then the problem is you still have the adults who think just like a child.

SPEAKER_04 11:36

I mean, I guess you have that, yeah. All right.

SPEAKER_02 11:39

Yeah.

SPEAKER_04 11:40

Could go on a long tangent there.

SPEAKER_02 11:42

I know. That's easy to get off topic. Um, okay. So that's peptides and FDA. We um yeah, that's okay. A lot of money to be made there. What um what else went on this week? Should we talk about this uh news out of UCLA? I know this is a little happier news for you because it's about sunscreen and a new development.

SPEAKER_04 12:05

Yeah, it's been like a good year so far for suns in you know, in the sunscreen world.

SPEAKER_02 12:12

Right. I mean, in terms of developments. Right. There's a brand new filter, first of all, not on the market yet, but coming soon.

SPEAKER_04 12:19

Yeah, hopefully we'll see those first products in the next like month or so using B Motrisanol, which was the recently approved filter.

SPEAKER_02 12:29

But then shortly on the heels of that, we have this news.

SPEAKER_04 12:32

Yeah. So out of UCLA, um, some scientists have been working to develop a mineral sunscreen with less white cast.

SPEAKER_02 12:45

Right. Because right now, for people who want to use sunscreen and prefer the mineral over the chemical, just because they have a strong feeling about whatever the chemicals and whatever.

SPEAKER_04 12:56

Mm-hmm. The safety, the absorption.

SPEAKER_02 12:58

So they move to mineral, yeah. But then they run into the problem of horrible white cast. Right. That you're you call it. Okay. Right. So this deals with that.

SPEAKER_04 13:09

Yeah. So yes. So again, people like the zinc because it doesn't get absorbed. Um but it has that white cast. So companies up until, you know, to deal with the white cast, they have to either put a tent in to make it, you know, less white. Or um there was this push after um, you know, using the plain zinc for a while to, hey, we gotta make this more acceptable for people to use. So there was the development of what we call nano zinc, which is still zinc, but a smaller version of that molecule.

SPEAKER_02 13:49

So, you know, the limb down GLP zinc.

SPEAKER_04 13:54

Okay, that's confusing. Yeah, I know. There's no GLP on this zinc. I know. Yeah. But um, you know, you get the white cast because zinc is a big molecule. That's why it's maybe not as readily, well, I shouldn't say maybe, that's why it's not read as readily absorbed in the skin. But um, you know, that allows it to scatter visible light more, so we see it as that white cast.

SPEAKER_00 14:16

Right.

SPEAKER_04 14:17

So then scientists develop, or cosmetic chemists developed, um, nano zinc, so smaller, so these particles um clever name do not reflect, scatter as much of the light, so you don't see as much of the white, you know, white tone to it. But with that came this backlash of, well, now that it's smaller than nano zinc, is that actually getting absorbed to some degree? And so there was like a backlash to that. And so now sunscreens, there's a lot of them that market themselves as like non-nano zinc.

SPEAKER_02 14:56

Right.

SPEAKER_04 14:57

Like that's what you know is is safer.

SPEAKER_02 15:01

Right. So then people see this and they're like, oh, well, that other one I was using must have been using big old regular molecules zinc. And I can't have that.

SPEAKER_04 15:12

Yeah, exactly.

SPEAKER_02 15:13

Or no, I need to go back to that. I mean, I need to go back to that. Because this nano this nano one I was using is too little. That sounds too futuristic. Right. It's gotta be like give me them big ol' molecules.

SPEAKER_04 15:25

Yeah, exactly. So uh anyway, what these guys are doing. I mean, so the bottom line with that is then like people are less likely to use it because they don't want to put enough on because it's gonna look more I mean, you there's just so many problems. So anyway, these guys working to try to make a the the zinc in a different shape so that it is not nano zinc, but the shape is just different, so it doesn't reflect the same way.

SPEAKER_02 15:52

Okay.

SPEAKER_04 15:53

So it's a change to the molecule.

SPEAKER_02 15:57

So we should be interpreted about being able to stick with our favorite mineral.

SPEAKER_04 16:01

Right.

SPEAKER_02 16:02

It's not nano and also have it rub in nice and clean. Less test. Right.

SPEAKER_04 16:07

Yeah. So this this is still just early, you know, research. There's no like product available anywhere near of having this. But, you know, again, just a step to make, you know, if you have a issue.

SPEAKER_00 16:21

Yeah.

SPEAKER_04 16:22

If you how to overcome those concerns so that you can protect yourself.

SPEAKER_02 16:26

Yeah. Well, how exciting. You remember the that was uh like the stereotypical 80s lifeguard.

SPEAKER_04 16:33

Yeah.

SPEAKER_02 16:34

And they would just be like this like buff, super tan dude, uh-huh, but then also have like a completely white nose. Right. That's that zinc stuff, right? Yeah. That's that was old school zinc.

SPEAKER_04 16:47

That was old school zinc that works great.

SPEAKER_02 16:48

Yeah, yeah, it works great.

SPEAKER_04 16:50

And you can't use that on a day-to-day basis.

SPEAKER_02 16:53

Right.

SPEAKER_04 16:53

I mean, maybe it was okay, you're a lifeguard and you have the white nose, but like nobody is really doing that otherwise. Right. So then that was where there was this push to make the nano zinc so that it could be, you know, less less white.

SPEAKER_02 17:08

Got it. Yeah. That's funny. I always wondered what that was as a kid. Yeah. It's like what why is why is this why is he only protecting his nose? Right.

SPEAKER_04 17:18

But I mean, would it otherwise you're looking like a ghost.

SPEAKER_02 17:21

Yeah.

SPEAKER_04 17:22

I guess.

SPEAKER_02 17:22

I guess if you were tried to do that everywhere, then you'd be in whiteface. Okay. Can't have that. Yeah. Then you get canceled. Oh wait. Anyways. All right. Uh so okay, cool. Sunscreen developments. Speaking of sunscreen, there's a bottle sitting in front of us here. Um why'd you bring this in? Well you want to talk about this?

SPEAKER_04 17:47

I do. Because this company I thought was pretty interesting. You know, we get we get a lot of I get a lot of products.

SPEAKER_00 17:56

Yep.

SPEAKER_04 17:57

And um one thing that I definitely think is a white space in the market is just overall skincare for men. But also, you know, within that sunscreen for men. And this was a super unique product, I thought. So it's this brand called Foreskin.

SPEAKER_02 18:17

Oh. Spicy. But it's not, it's, it's, it's, okay. It's it's the number four.

SPEAKER_04 18:24

Right.

SPEAKER_02 18:25

Number four and then skin.

SPEAKER_04 18:28

Right. But obviously they're making it a little cheeky.

SPEAKER_02 18:32

Right. I do love a good pun. So we're looking at this bottle here, and it says four skin morning rub.

SPEAKER_00 18:40

Mm-hmm. Uh-huh.

SPEAKER_02 18:41

So the puns keep going. I mean, there's all kinds of double entendres here.

SPEAKER_04 18:45

Yeah. Um, so really cool, I think, marketing. Uh, you know, interesting. Right.

SPEAKER_02 18:52

Because inside the bottle is just a basic sunscreen. What does this say? It's a it's just a basic broad spectrum non-mineral sunscreen.

SPEAKER_04 19:00

It's right, it's just well, it has it's a hybrid sunscreen, so it has mineral and chemical filters. So a broad spectrum sunscreen. Um, it is a moisturizer and sunscreen kind of combination product. Um, but you know, they're they're trying to make it appealing to men who largely ignore their skin. Ignore ignore their skin.

SPEAKER_02 19:23

Right. When it comes to everything, including sunscreen.

SPEAKER_04 19:27

Yeah, yeah. And so they've kind of like tried to take it next level on the sarcasm and you know, jokes.

SPEAKER_02 19:34

Make it fun, and maybe the men will use it.

SPEAKER_04 19:36

Yeah, exactly.

SPEAKER_02 19:38

Like, hand me my bottle of four skin morning rub, please.

SPEAKER_04 19:41

Yeah.

SPEAKER_02 19:42

I need to go outside for a moment.

SPEAKER_04 19:45

So I was just, I mean, I was wondering for from your perspective, like, do you feel like you need like a product, like a sunscreen marketed to men? Like, do you care? Is that something?

SPEAKER_02 19:59

No. I don't really care.

SPEAKER_04 20:01

Um I mean, but I think there are probably some people that do.

SPEAKER_02 20:05

No, there certainly are. I mean, because there's other bigger, you know, established companies like Dove that has huge lines of products for men from just bars of soap or whatever to, you know, their hair products in their shampoos and in theirs. Do they have sunscreens? Maybe they do. I don't know. I don't I'm in a position where I don't really have to think about it because we have endless bottles of sunscreen, and I know the stuff inside is virtually all the same.

SPEAKER_04 20:30

Yeah. I mean that's that's a good point, like we've talked about before.

SPEAKER_02 20:33

Um, the white labeling?

SPEAKER_04 20:35

Yeah.

SPEAKER_02 20:35

Yeah. I I mean just slap your label on an already established compound of Right.

SPEAKER_04 20:41

Or make a small change. Um, but then it's just kind of all about who you're trying to market to and what your story is and how you're trying to like appeal. Um but yeah, I thought this was entertaining. And I think you liked you liked the product.

SPEAKER_02 20:57

Yeah, you had me try it once you first got it, just rub it in and on my hand a little bit. It's a perfectly good product. It rubbed in, it didn't leave a mark, and it didn't smell too strong, which is also my problem. Yeah. My nose is very sensitive to the smell of sunscreens, and I don't enjoy it.

SPEAKER_04 21:10

Yeah, the smell kind of faded really quickly. Yep. You know, I think for for men, the key is like it is really hard to use a mineral sunscreen when you're male and like you have areas where you're trying to rub it in over hair. Oh, yeah. I mean, whether it's nano zinc or regular zinc, like it's harder to rub in. So um, you know, relying more on a chemical sunscreen or a combination product um is what I recommend for hairy men. Male patients.

SPEAKER_02 21:45

Anybody who wants to rub it in why there's hair. Yeah. Yeah. It's I remember I mean, before I understood the difference between the two, I can remember times where I would rub in. Just reach for something and be like, oh, and then I I mean, and then at the end of the day, you're in the shower, like just with like sandpaper trying to rub that stuff off. Right. It's yeah.

SPEAKER_04 22:05

Yeah. And the other thing, like, you know, you mentioned kind of, you know, don't really do much for your skin is combination products are nice for men. So, you know, there's a lot of sunscreens now, this one included, that it's a moisturizer and the sunscreen in the same step. So you don't have to do two products.

SPEAKER_02 22:23

Right. Well it's called Well, look, I don't want to we're not advertising for these people. They're not paying us, but it's foreskin. It's fun to it's not just for the foreskin.

SPEAKER_04 22:37

Important to know.

SPEAKER_02 22:39

Because you can put this on any part of your skin. If you have skin, it can go on it. It's called foreskin, but it's not just for the foreskin.

SPEAKER_04 22:50

Yes. And that that might be So if you're going out without bottoms and just grab anything that's nearby.

SPEAKER_02 22:58

It doesn't have to be this stuff.

SPEAKER_04 22:59

Right. I mean, I guess you you you know you could use I don't know if it's been tested on the foreskin. I don't know how comfortable that is, but but uh you know then I was also looking at other products that these guys carry and you know they have this this product called the s called the taint defender.

SPEAKER_02 23:15

Oh. Which Taint Defender. Yeah, those guys who like to sun their buttholes. You've seen those trends in those videos, right? Oh yeah. Yeah, you've even made a spoof of one.

SPEAKER_04 23:27

I made a spoof of one, yeah. Uh but this product is just their like to go version. So you can have like a little packet of sunscreen in your gym bag or you know, whatever. That's just what they call their little taint defender.

SPEAKER_02 23:41

You know, little in on the uh the humor and the the the almost inappropriate pun stuff. Okay.

SPEAKER_04 23:51

But you know, there's like you know, if it's a little too much for you on the branding of this one, you know, there's like more, like you mentioned, Dove. I think they do have some sunscreens in the men's line. Um, but you know, there's brands that try to go a little more, you know, have a more upscale feel, if that's the kind of dude you are. So, you know, like um Jack Black.

SPEAKER_02 24:12

The comedian? An actor?

unknown 24:14

Yeah.

SPEAKER_04 24:15

I think so. I think it's his line. It's been out for a long time. Wow. Uh Clinique. Good for him. Our son is super into like Dr. Squatch for things. I didn't honestly even know they had sunscreen, but I didn't either. I realized they have sunscreen.

SPEAKER_02 24:31

Okay, so a couple people are in this space now. Did we miss the boat? Should we have tried to make a product?

SPEAKER_04 24:36

For men? Well, I mean, you know, I have actually worked doing some consulting.

SPEAKER_02 24:42

Oh, yeah. That's right. I remember companies trying to get into the men's skincare space.

SPEAKER_04 24:48

Yeah.

SPEAKER_02 24:48

It's didn't go so well.

SPEAKER_04 24:50

Well, at least not the ones that I was consulting for. I just I think it's a hard market. I mean, obviously you have men who are into it.

SPEAKER_02 24:59

Yeah, but if any of them are even a fraction like me.

SPEAKER_04 25:01

Yeah. Then you're just using whatever your significant other throws your way.

SPEAKER_02 25:06

Yes. And I am in the position where my significant other has endless amounts of products laying around. So I don't ever have to think about it.

unknown 25:15

Yeah.

SPEAKER_02 25:15

I certainly I don't even go down those aisles at the store.

SPEAKER_00 25:18

Yeah.

SPEAKER_02 25:19

Where men's health or skincare products would be sold.

SPEAKER_01 25:22

So anyway.

SPEAKER_04 25:23

Yeah. Well, I another product that I thought was kind of interesting was, or this brand that I thought was interesting as I was looking up some of this was apparently um caring for your bald head. A company has identified that as a even more niche within the men's. Yeah. So um it's called Bald Bald Bro or B L D B R O. And it they just have a line, a pretty simple line of skincare products that are including sunscreen that they just market for your bald head.

SPEAKER_02 25:58

So just scalp products. Yeah. But look, real quick, dumb question. The skin on our head, our scalp, is not different than the skin on our own.

SPEAKER_04 26:07

You could use yes.

SPEAKER_02 26:08

Okay. This is just any good facial moisturizer can creep up into the scalp if you need it to. Or your sunscreen. Or your sunscreen.

SPEAKER_04 26:16

Yes, exactly. So this is just a fun marketing.

SPEAKER_02 26:19

Clever marketing thing to hey bald guys. Right. Of which there are a few.

SPEAKER_04 26:24

Of which, as a dermatologist, I see a lot of problems on men's bald heads in terms of sun damage.

SPEAKER_00 26:33

Yeah.

SPEAKER_04 26:34

Skin cancers, precancers, pigment. So, you know, the bald head needs a sunscreen. And if you feel like if men are more likely to pick up one because it says for the bald head, feel free.

SPEAKER_00 26:47

Yeah. Good. Yep.

SPEAKER_02 26:49

Any product to protect your skin is good in your eyes. Yeah. For the most part. Fair enough. So I could take my foreskin morning rub and put it on my scalp if I wanted to. Got it. Okay. I just can't stop saying it. I'm looking at this bottle. Morning rub.

SPEAKER_04 27:08

Yeah, you guys should go. I mean, again, foreskin, if you guys want to sponsor us.

SPEAKER_02 27:12

Yeah.

SPEAKER_04 27:12

Cool.

SPEAKER_02 27:13

Yeah. I'll go even harder. I will talk about foreskin every episode if we You will experiment, maybe?

SPEAKER_04 27:19

Do like an experiment and see how well it protects the actual foreskin.

SPEAKER_02 27:23

Yeah. You'll just don't look in my backyard. I'll be out there in the back conducting experiments.

SPEAKER_04 27:32

Yeah. But again, we're not trying to specifically promote this. I just thought, you know, a conversation about men's products. Anyway, all right, let's move on.

SPEAKER_02 27:39

Moving on. So, all right. Uh that is that's a lot going on. We we well, all we did is talk about peptides in the news and then this new sunscreen and the idea of sunscreen for men. Okay, uh, what what else? What else? Just just like the quick, real quick this week that's worth mentioning.

SPEAKER_04 27:58

Yeah, so um in melanoma news, um, there was a clinical trial that was recently reported on um using an mRNA vaccine in patients with stage three melanoma, and it improved the chances of five-year cancer-free survival versus standard therapy.

SPEAKER_02 28:23

So uh real quick for the for the people and for me, what is stage three means it's gotten to what point?

SPEAKER_04 28:30

Stage three means it's gotten to your lymph nodes.

SPEAKER_02 28:33

Okay.

SPEAKER_04 28:33

Stage four means it's in like other organs.

SPEAKER_00 28:38

Okay.

SPEAKER_04 28:38

Um, so stage three, um, you know, and beyond used to be like pretty, you know, poor outcomes. Um, but with the development of immunotherapy, yes, um definitely led to, you know, decent improved survival rates. So anyway, that's the standard of care for stage three, is you excise the melanoma and go on immunotherapy.

SPEAKER_03 29:03

Okay.

SPEAKER_04 29:03

Um, which is a drug called ctruda primarily. And so basically what this study did is took people who had stage three, did the normal treatments they would get, but then in some of them gave them an um a vaccine made from their own melanoma tumor.

SPEAKER_02 29:20

Oh, yes, yes, yes. Immunotherapy based on your own. Your actual We have some experien uh experience with that.

SPEAKER_04 29:29

Yeah, we do.

SPEAKER_02 29:30

Um in the form of uh our canine.

SPEAKER_04 29:34

Yes. Rory.

SPEAKER_02 29:35

Our dog.

SPEAKER_04 29:37

Yes. So yeah, obviously things can be a little more, I don't know, what's the word, flexible when you're using pets, I guess, right? You don't have to go through all this like rigorous whatever, but um so Rory had a sarcoma, a soft tissue sarcoma on her leg. Right. Really early stage.

SPEAKER_00 29:58

Right.

SPEAKER_04 29:58

Um, and they tend to just be like locally aggressive. Like if you don't get them totally cut out, they just recur at that site. They don't train tend to like metastasize and stuff. So surgery, if you can cut it all out as curative or which is the first thing we did, or amputate, but like we didn't want to do that.

SPEAKER_02 30:15

Yeah.

SPEAKER_04 30:15

Um, because she's an older dog, and we just kind of were like, What could we get away with not? So we try to do surgery.

SPEAKER_02 30:22

Plenty of happy three-legged dogs out there, of course.

SPEAKER_04 30:24

But yes, and this is a common cause of three-legged dogs because this is a really common tumor, apparently. Um so we did this initial surgery, didn't get it clear, debated about amputation, decided to do radiation, which has a very high success rate.

SPEAKER_02 30:42

Right. Surgery coupled with radiation is supposed to be near curative.

SPEAKER_04 30:46

Yeah. Except for that did not happen for Rory.

SPEAKER_02 30:50

She decided to regrow it a year later.

SPEAKER_04 30:52

Or many thousands of dollars later. Um, Rory.

SPEAKER_01 30:58

Yeah. Decided she liked to that.

SPEAKER_04 31:01

So yeah. So then our vet, who's super sweet, was like, I want to try again to like get it clear, cut it out, but did not get clean margins. So yeah, we decided, okay, we want to do something, try to keep saving the leg, and there's this company called Torrigen that makes um these vaccines based on the tumor. Tumor that your dog grew. That your dog grew. And so we did that. She had a couple, I can't remember how many injections over a couple of weeks, and it's now been a year.

SPEAKER_02 31:37

So far. So far, so good, I think. No lumps.

SPEAKER_04 31:40

Not so good. So pretty, pretty exciting. Okay, so you have a lot of things. Yeah, and then in the study, similar thing is happening right now. Same exact thing. And um, you know, in these patients, uh, 68% who got the vaccine were cancer free at five years, the vaccine and the normal therapy, right? Uh, versus 49% who just had the typical therapy. So pretty cool.

SPEAKER_02 32:06

Good sign. You know, good news.

SPEAKER_04 32:07

Advancements in science. Um, the other thing that was uh came out uh within the last couple of weeks in the land of melanoma is a new potential risk factor.

SPEAKER_02 32:17

Oh, what did they find?

SPEAKER_04 32:19

So this would be something that is kind of like correlated with an increased chance of having melanoma.

SPEAKER_02 32:26

So love to look for correlation.

SPEAKER_04 32:36

Or, you know, genetics, or like the amount of sun exposure and blistering sunburns that you've had, those sorts of things, tanning baggies. So this is um the presence of satellite Nevi. So Nevi, medical term for moles.

SPEAKER_02 32:54

Um can't just call them moles, huh? No. You guys with your weird words.

SPEAKER_04 32:59

Nevis, a single one, Nevi, plural.

SPEAKER_02 33:01

Yes, Latin.

SPEAKER_04 33:02

Yeah. So anyway, this uh study, people who had Nevi that were like two Nevi that were within five millimeters.

SPEAKER_00 33:11

Right.

SPEAKER_04 33:11

This was um found to be associated with increased risk of melanoma. So just something to be on the lookout for. I mean, I'm someone who has, I don't know, a lot, a good number of moles.

SPEAKER_00 33:26

Yeah.

SPEAKER_04 33:26

It's sometimes hard to tell, you know, for some people, I think what's a mole versus like just a freckle or a sunspot or whatever. But um, you know, I did kind of look over the moles I could easily see and honestly didn't really find any that were within five millimeters.

SPEAKER_02 33:41

So people get your ruler out.

SPEAKER_04 33:43

But yeah, grab a ruler.

SPEAKER_02 33:45

And just start measuring your moles. And if any of them are within five millimeters of each other, just say hey, and you can have a leg up when you get to your dermatologist and be like, hey, listen, I heard that if I've got these things this close, I need you to pay a little extra attention.

SPEAKER_04 33:59

Yeah.

SPEAKER_02 34:00

How impressed would your dermatologist be?

SPEAKER_04 34:02

I mean, very impressed.

SPEAKER_02 34:03

Right? If they're they may not even have read about they they maybe haven't.

SPEAKER_04 34:07

That would be something where like I tell my patients they get like a gold star if I'm like really impressed with like their sun protection they walk in with, or they have a hat.

SPEAKER_02 34:16

Right. And then you mark their chart, and then after like five gold stars, they get like a like a like a lollipop at the end of the visit.

SPEAKER_04 34:24

Yeah, I don't know.

SPEAKER_02 34:28

Yeah. That's that's fun. Let's develop a reward program.

SPEAKER_04 34:32

Okay. Okay.

SPEAKER_02 34:32

But it's just like stickers as if they were in kindergarten.

SPEAKER_04 34:36

Okay. We'll work on that. Sweet. All right. So in the land of social media.

SPEAKER_02 34:44

Okay. I didn't really see that. So we're moving on from real news and real things that happened to crap you saw on social media this week.

SPEAKER_04 34:51

Yeah, I didn't really see anything like so super exciting, with the exception of one thing, and that was tan maxing with Coke.

SPEAKER_02 35:00

Are we talking the drinkable beverage or the illegal drug?

SPEAKER_04 35:07

Hmm. That'd be interesting. Tan maxing with the Coke you snort. Right. Or whatever else you do with it. Right. Clearly not a drug user. Uh no, this was Coca-Cola. Oh, okay. Uh and I think I saw also people using like Coke Zero. I don't know. I think it just has to be like a dark cola.

SPEAKER_01 35:30

Okay.

SPEAKER_04 35:31

Right. But anyway, they're pouring this on and then going outside and tanning.

SPEAKER_02 35:34

Right. Because they're just like, I think I should be sticky, sweet.

SPEAKER_04 35:39

Yeah, I want to be covered in flies.

SPEAKER_02 35:41

Right. I want, yeah, I want things to land on me.

SPEAKER_04 35:44

Yeah, it sounds disgusting. Sounds awful.

SPEAKER_02 35:46

Yeah. Ants? Yeah. It's just, let's get them all.

SPEAKER_04 35:50

Yeah. So I mean, there's no mechanism by which this would enhance tanning. I mean, the only thing that I can like think of would be that like the caramel color maybe kind of like stains your skin a little bit.

SPEAKER_02 36:02

Well, but they already have good products out there that just stain your skin and literally look like a tan.

SPEAKER_04 36:07

I know. It's all for the shock value, I guess.

SPEAKER_02 36:12

It's just, it's just, yeah, I needed something to get views and likes and clicks and whatever. It's more attention-seeking garbage.

SPEAKER_04 36:21

So I guess it's kind of along the lines of like, you know, you know, like if you there's there's products for sun, you know, they market, like put on and go outside in the sun, but it's kind of like a similar thing. There's other products that like uh use carotene. So, you know, what's in carrots.

SPEAKER_02 36:39

Right. Yeah, yeah, yeah. Um, because you can just pound like pounds uh and pounds of carrots and change your skin color from the inside.

SPEAKER_04 36:48

Yeah, you can get kind of like an orangey yellow carrot color. Yeah. I mean, I don't know why people think that's attractive, but uh but there are brands that, you know, put a little bit of that in their topical, be like, you know, kind of kind of like bronzing gel or something. And I guess it's the same kind of thing. It's gonna just like stain your skin a little bit. All right. Great. So anyway, dumping the cola on.

SPEAKER_02 37:12

All right. Well, if your kid asks for a couple extra two liters, he should raise an eyebrow and get suspicious. Yeah. One to drink, one to dump on my body when I go outside. Gross.

SPEAKER_04 37:24

Anyway. Stupid. Well, I wanted to ask you something. This was an interesting uh question I got from a patient this week who had been traveling.

SPEAKER_00 37:34

Uh-huh.

SPEAKER_04 37:35

He was out of the country and s in some like duty-free shop or something, someone gave him a sample of this eye cream.

SPEAKER_02 37:44

Okay. Which Right. We talked about eye cream recently. I actually just learned what it is. It is not for your eye. Well, it's the eye skin. Oh.

SPEAKER_04 37:53

Skin around your eye. Oh my gosh. Yeah.

SPEAKER_02 37:56

Look, I am dumb, remember? Clearly. It's in the name of the podcast.

SPEAKER_04 38:00

You would actually think about like seeing a cream and dunking it into your eye.

SPEAKER_02 38:05

Right. Because I want to blur my vision while it absorbs into my retina. Okay.

unknown 38:09

Yes.

SPEAKER_04 38:10

For skin around the eye.

SPEAKER_02 38:11

Obviously, I'm not shoving cream in my eye, but I'm just saying the title is misleading.

SPEAKER_04 38:15

Okay. All right. All right.

SPEAKER_02 38:16

Go on. Okay. So the guy comes to you. He's like, hey, I was traveling and I saw this eye cream. Somebody gave me a sample of.

SPEAKER_04 38:23

Yeah. And he's just like, what are your thoughts on it?

SPEAKER_02 38:25

So you looked it up.

SPEAKER_04 38:26

Yeah. So I I looked it up and um in insanity, really. Like, so just kind of a typical moisturizing product, had some like botanical agents in it. Um, and then uh a peptide. Uh so there are peptides. We talked about peptides obviously earlier today. Um, there are peptides that are commonly used in skin products, different from the peptides we talked about as injectables. Okay, these are like different things, and they are very well researched topically. Um, so kind of a different, somewhat different category here. But uh peptides definitely do have, there's various ones, they definitely do have different benefits in the skin. So um, I do think peptides are are great to be using in your topical skincare. But anyway, that's all this was a moisturizer, um, essentially with this one peptide. How how much would you what do you think your max is for paying for like a cream for the skin? So of your your an eye cream.

SPEAKER_02 39:31

Yeah. Well, me personally, uh I would zero. I would pay none dollars.

SPEAKER_04 39:36

Yeah, because you've learned, right, that there's really nothing magical.

SPEAKER_02 39:41

Right. About a cream or a moisturizer that is essentially like just for one portion of the skin on your face.

SPEAKER_04 39:48

Right. I mean, you can just use whatever else you're using.

SPEAKER_02 39:51

Everywhere else on your face. Exactly. Go ahead and put some under the eye too. But I get why they market to that because people do struggle with like the bags that appear under their eyes. Yeah. And you want to target that.

SPEAKER_04 40:02

Yeah. And there are like so if you have a specific problem on that area, like a bag or um pigment, there are eye creams that specifically would maybe address that potentially. I mean, you might still have an ingredient, an active in your face cream. That could do that as well. Exactly. But like, for example, caffeine is one that is common in eye creams. And I, you know, that could have a legitimate, you know, you could have a legitimate reason, but largely if you're just trying to like kind of maintain things, keep the skin moisturized, you do not need a separate cream.

SPEAKER_02 40:38

A separate cream for the eyes. Okay.

SPEAKER_04 40:40

But anyway, okay, so you said zero dollars essentially.

SPEAKER_02 40:42

But that's mean. You're kind of asking the wrong. I mean, maybe there's somebody out there who's like, I don't know, I guess 1999 would be my price for a specific cream.

SPEAKER_04 40:51

This cream, $1,500. Okay.

SPEAKER_02 40:55

Well, there's a sucker born every minute. Please tell me. I I mean, kudos, props to this guy for coming to you first to get your opinion and a professional's advice on this. And I'm guessing you have since reached back out to him and say, hey, I looked this up.

unknown 41:10

Yeah.

SPEAKER_04 41:11

And I was like avoided. Please do not spend 50% of the things.

SPEAKER_02 41:14

You could give me half of that and I'll treat your eye skin.

SPEAKER_04 41:19

Yeah. We could do something that might actually make a more noticeable difference.

SPEAKER_02 41:24

So that's crazy.

SPEAKER_04 41:26

Yeah. And this brand is created by an orthopedic surgeon.

SPEAKER_02 41:30

Right. Because when you think of your skincare and your the yeah, the health of your skin in your face, you think of the guy who just hacks up and saws on people's bones all day.

SPEAKER_04 41:42

Well, it's just an example of everyone wants to get into the aesthetic space. Right. You know?

SPEAKER_02 41:47

What could you do to reach into the orthopedic space?

SPEAKER_04 41:50

Yeah, that's the thing.

SPEAKER_02 41:52

Where's that crossover? How's that go?

SPEAKER_04 41:54

I don't have a crossover for that.

SPEAKER_02 41:55

No, but they feel like they can just answer your space. By just slapping their name on it. Well, people just see MD. They don't bother to look them up on the uh, you know, the available uh directories to find out where they practice, if they're licensed, what their specialty is.

SPEAKER_04 42:10

People just see MD and say, well, Or they don't even see MD these days, they just see doctor, and it can be like chiropractor.

SPEAKER_02 42:18

Chiropractor, you know, whatever. Yeah, people gotta be real careful about that.

SPEAKER_04 42:23

Yeah. So anyway, you know, if you're my patient who asked me this question, you know, no shade or anything. I'm just like ill illustrating this as, you know, definitely ask questions, definitely have doubts about products that cost as much as procedures.

SPEAKER_01 42:41

Yeah, you know, in the office. So all right. Well, good for you. If you're a listener.

SPEAKER_02 42:48

Yeah. All right. Should we wrap it there and move on to some questions? Let's do it. Okay. Real quick, we're gonna do, let's just do two questions this week. We've got, oh, so okay, we're gonna do a question from a guy who has asked questions before. Love this guy, you know who you are. All right, question number one. Is it true that the sun's harmful rays are worse between 10 o'clock and two o'clock? So that if I'm walking my dog or I'm going to be outside from, say, seven o'clock to nine o'clock, I don't really need to worry too much about my sunscreen. What's the answer? Yeah, I mean I know what you're gonna say.

SPEAKER_04 43:27

Yeah. But I know there's this is a legitimate. Yeah, I mean, this is kind of like a dogma thing that people would like say is like, okay, just be careful from like 10 to 2 or 10 to 4, whatever it was. Right. And um, you know, you don't have to worry so much the rest of the time. Um, and obviously, uh, you know, the sun is more over overhead and beating down between those hours. Um, but we have this great little tool now that we can use called the UV index.

SPEAKER_00 43:54

Uh-huh.

SPEAKER_04 43:55

And I think it's much more important to utilize that when you're trying to decide the level of protection, if any, that you know, you need.

SPEAKER_02 44:02

And what's the number we need to look for that in what does it mean?

SPEAKER_04 44:06

Yeah. So like three or more is what most people kind of say. And you definitely need to be like protecting.

SPEAKER_02 44:12

Right. And so just load uh open your smartphone, tap the weather app, whi whatever one, and most likely, along with temperatures, highs, and forecasts, you're gonna see a UV.

SPEAKER_04 44:22

Yeah, a UV index basically. On like where you are.

SPEAKER_02 44:25

Right. So if you the elevation. Two or three or higher.

SPEAKER_04 44:29

Yeah. I mean, yeah, two or three, I would say, definitely three above, you need to be protecting. Um, but you know, if it's one or two, you could probably, you know, go out for a while and not worry about burning. Not worry about, you know, burning. So, um, so yeah, I don't I don't think the time Right.

SPEAKER_02 44:51

Time matters less than just straight up UV index. All right. There you go. There's your answer. Use the UV index on your smartphone. Yeah. Cool. Uh question number two. This person wants to know what you think is the most important skin care step. So how many steps do most people have? I mean, that's I mean if you're me, it you have one step. Do you even have one step? I wash my face. Oh. Every day. Well, it's just a skincare step. Yeah. I wash my face. Every day.

SPEAKER_04 45:26

Yes. Oh, okay.

SPEAKER_02 45:28

Am I reaching for the best skin face so? Maybe not.

SPEAKER_04 45:33

Okay.

SPEAKER_02 45:33

But I'm washing my face.

SPEAKER_04 45:35

Okay. I did not know that.

SPEAKER_02 45:36

I thought you So if I were to s if I were to say the most important step would be that one. Yeah. The one where I wash. Because that's the only one I do. I don't really moisturize very much. I'm getting better at it. I do it here and there. But okay, where they want your answer.

SPEAKER_04 45:53

Really? Okay.

SPEAKER_02 45:55

I mean, I can go on, I guess.

SPEAKER_04 45:57

Well, I mean, I definitely do think that cleansing is right up there. I struggle with like cleansing is super important because obviously you want to get the oil, the dirt off your skin. I mean, especially if you're prone to breakouts or you're using other products, you need to get that off.

SPEAKER_02 46:12

Because if you're not washing that, then you're inviting a skincare problem that requires even more steps.

SPEAKER_04 46:17

Right, exactly. And then, you know, pollution from the air sitting on your skin causing, you know, inflammation and accelerating aging processes. So I mean, there's reasons to wash your face that are good. Uh, and then obviously sun protection. So I think that's, you know, it's hard for me to say one of these is more important than the other.

SPEAKER_00 46:37

Sure.

SPEAKER_04 46:38

And then also when you're doing those things, you know, you're cleansing your face. A lot of times you need to maybe replace a little moisture. So uh lotion.

SPEAKER_00 46:46

Right.

SPEAKER_04 46:47

So I don't know. It's hard for me to, I kind of think sun sunscreen and cleansing are tied, and then like right there is moisturizer behind it.

SPEAKER_02 46:57

Right. Um because if you've got healthy skin, right, you don't need much more than just clean it, then moisturize it, then protect it from the sun.

SPEAKER_04 47:05

Yes, exactly.

SPEAKER_02 47:05

And if that works and you're not having breakouts or you're not suffering from any other, you know, unfortunate skin condition, then that's it. Those are your steps, and they all work together to but I know that you guys, especially as you're aging, you start adding more steps. And that might be what this person's asking about. Well, I mean, because they've hit the maybe they're middle-aged and they started having to add like four more steps, put their serums and their oils and their retinols and their right.

SPEAKER_04 47:35

So that's like the basic regimen that anyone should be doing. You know, the cleansing, the moisturizer, the sunscreen. And then like if you have something you're trying to address. So like if you're middle-aged and you're trying to you're worried about lines, or you're worried about pigment, or you've got rosacea, or you've got melasma, you know, then you add, you know, maybe a product that addresses that concern.

SPEAKER_02 47:59

Right.

SPEAKER_04 48:00

Right. Um Okay.

SPEAKER_02 48:02

Well, that yeah, okay. So but that's a different thing.

SPEAKER_04 48:04

But like, yeah, I don't know what your concern is and what that but still the most important things are the basics. And then you build on top of that.

SPEAKER_02 48:13

Okay. Easy enough. Yeah. Hard to say. There's no thing that really is the most important. Well, those three things are the most important. I know, but I'm just saying there's no one thing. Yeah. Those things, those three things really blend to become the one step.

SPEAKER_04 48:27

Right.

SPEAKER_02 48:27

Do those things right. All right. Right. There you go. I imagine you get that question a lot.

SPEAKER_04 48:33

I do get that question a lot.

SPEAKER_02 48:35

So Alright. Well, there you go. Hope that helps. So, all right, let's wrap it up. Hey, guess what?

SPEAKER_00 48:42

What?

SPEAKER_02 48:43

That was our tenth episode.

SPEAKER_00 48:45

Wowzers.

SPEAKER_02 48:47

Thanks for listening, guys. That's ten down. Here's to I don't know, ten more. Alright, well, we'll see you next week. Uh that was probably the best podcast we've ever done. Bye.