Dhru Purohit Show - A Skin Cancer Surgeon Shares His Holy Grail Product for Skin Aging, How Much Sun Exposure We Need, and How a Common Infection Can Drive Skin Cancer with Dr. Teo Soleymani

Episode Date: September 2, 2026

This episode is brought to you by One Skin, Dose, Branch Basics, and Momentous. Today on The Dhru Purohit Show, I sit down for round two with dermatologist and skin cancer and reconstructive surgery specialist Dr. Teo Soleymani to discuss the paradox of sun exposure. We explore the difference between sun exposure that accelerates skin aging and exposure that increases skin cancer risk. Dr. Teo also breaks down what the research reveals about who may be more likely to develop skin cancer, the surprising link between infections and certain cancers, and how we can protect ourselves. Plus, he shares his favorite skincare product and what he recommends avoiding. Dr. Teo Soleymani is a nationally recognized, double board-certified dermatologist and fellowship-trained Mohs Micrographic and Facial Plastic & Reconstructive Surgeon. A Stanford-trained physician and former clinical professor at UCLA, he specializes in treating complex, high-risk skin cancers and sun-damaged, aging skin. He now leads California Dermatology and Mohs Surgery Specialists in Pasadena, CA, and continues to contribute to academic research and innovation in dermatologic surgery. In this episode, Dhru and Dr. Soleymani dive into: (00:00) The Paradox of Sun Exposure (02:26) The Biggest Contributor to Skin Aging (04:59) Is Maximum Sunscreen Protection Necessary? (10:12) Does Tanning Cause DNA Damage? (13:14) Why Deadly Melanomas Can Develop on Sun-Naive Skin (21:10) Skin Aging vs. Skin Cancer: Two Different Pathways (25:48) Can Skin Damage in Your 20s Cause Cancer Later? (31:28) The Surprising Link Between Infections and Cancer (51:51) How Diet and Lifestyle Impact Skin Cancer Risk (55:41) Immune Suppression and Skin Cancer Risk (1:09:55) The Origin of Sun Powder (1:17:03) Indoor LED Light Damage (1:19:31) The “Holy Grail” of Skincare Products (1:34:44) Dr. Teo’s Final Takeaways Also mentioned in this episode: Sun Powder Try This Newsletter on Nonsmokers and Lung Cancer For more on Dr. Soleymani, follow him on Instagram, LinkedIn, and his Website. For more on Sun Powder: Facebook, Instagram, Threads, and TikTok,  This episode is brought to you by One Skin, Dose, Branch Basics, and Momentous. Right now, One Skin is offering my community 15% off; just go to oneskin.co and use the coupon code DHRU to save 15% and give your hair and skin the scientifically proven, gentle care it deserves. Support your liver with one simple daily habit. Visit dosedaily.co/DHRU and use code DHRU to get 35% off your first subscription. Branch Basics is now available nationwide at Target and Target.com. Shop their lineup of safer cleaning essentials including laundry detergent, surface cleaners, dishwasher tablets, and stain remover during your next Target run. And if you're grabbing the Premium Starter Kit, you can get 15% off at BranchBasics.com with my code DHRU. Right now, Momentous is offering our listeners up to 35% off their first order with promo code DHRU. Head to livemomentous.com and use code DHRU for 35% off your first subscription. Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Soleimani, welcome back to the podcast. Today we're talking about one of the biggest paradoxes in health. And that paradox is that the sun is great for you. It's healing. There are so many benefits to getting healthy sun exposure. And then the flip side is, as a skin care expert, a surgeon who literally takes out the worst forms of cancer that people develop skin cancer on their body, you also acknowledge the truth that the sun is one of the top things that can age the skin. What the hell is going on and how do we make sense of this paradox?

Yeah. I think this comes from a big idea of blanket statements in medicine that have become commonplace. So to backtrack a little bit, I don't think there is ever a time or place anywhere in medicine, not just dermatology, not just skincare, etc. where a one size fits all makes sense, whether we're talking about just patients in the U.S. or globally. Historically, the sun has had a lot of healing properties. There are benefits. Everybody talks about vitamin D synthesis, which you don't need that much time in the sun to develop.

But there's a lot of benefits aside from things that we can measure in a test tube like your vitamin D levels. There are endorphins that come out. You feel better when you're outside. the whole premise of seasonal effective disorder where people just don't feel like themselves, they feel down in the dumps when they're not in sunlight, has some truth to both physical wellness as well as mental wellness. The problem is, just like anything in medicine, too much of a good thing can be a bad thing. You know, you would never question whether drinking water is a bad thing for you, right? If you have eight glasses of water a day, you are hydrated more or less. If you drink

eight gallons of water a day, you're likely going to end up in the hospital. Same thing with sunlight. I think there are some benefits in which people can get sun safely. I think we shouldn't fear the sun. And somehow dermatology has gone so far on one end of the spectrum. And I think I know why, and we'll touch base on that later, that you are almost frowned or scorned upon if you go outside in the sun without taking multiple layers of protection. I think that's silly. I don't think you need to fear the sun. I don't think you need multiple types of sun protection for five minutes of exposure. I also don't think that you should be getting blistering sunburn. So how do we find that sweet spot of how much UV is too much and how much of it is a benefit? So the simplest things

we talk about, if you take a grape and you put it out in the sun, over time what happens? It turns it to a reason. If you take some hide and you put it out in the sun, it becomes tan leather. Same thing occurs with our skin. If we are going to ignore or like put aside the entirety of talking about skin cancer and carcinogenesis, let's just talk about aesthetics. Let's talk about aging of the skin where our skin breaks down collagen, breaks down elastin, starts to look wrinkly before it normally should otherwise. The sun's probably the single greatest implicating environmental factor in that. There's no doubt about that. How do we rectify that with all the benefits we can? get? Well, the simplest thing is we look at the UV index. Generally, the lower the UV index,

the safer it is to get sunlight. And sunlight is a spectrum. Struggle to define or distinguish sunlight and UV irradiation. The sun has visible light. It has UV light. It has infrared light, which is a form of heatly feel. And then there's some other wavelengths that don't really make it to the Earth's surface, but if you're a pilot or have you x-rays, gamma rays, etc. So sunlight is a spectrum of light. Early morning sunlight, very effective, helps circadian rhythm, helps balance sleep, cortisol levels, et cetera, long term. Early morning sunlight's great. Late afternoon sunlight's great. Midday sun can be okay as long as your skin isn't turning red or blistering. So you and I, for example, may be able to tolerate midday sun a little bit more than somebody who is blonde

haired blue-eyed, for example. Knowing your threshold is how much you can modulate the benefits before you get into the problems. I can tell you one thing for sure. If your skin starts to turn red or you start to burn, you've crossed that threshold. You are not in the category of getting the health benefits. You're in the category of premature aging, potentially carcinogenesis, etc. So every person is different. I think sunlight is a great thing. Do I wear sunscreen every single moment of every single day? No, most dermatologists and skin cancer surgeons don't because I know my skin and also the majority of my day is going to work before the sun comes out and coming home when the sun sets. So I know I'm not going to get a lot of UV radiation. But if I know I'm going to be outside for a

prolonged period of time, whether it's for premature aging or whether it's for skin cancer development, I will be cognizant of when I need to protect. That's really important. You said something that I think can kind of be a little bit controversial slash news to people. who are on social media, which is that you said most dermatologists and most, you know, skin cancer surgeons wouldn't be wearing sunscreen. When you scroll on social media, a lot of our female listeners will know especially because they tend to be more into skin health than, let's say, men, although that's changing a lot with young people, right? Young, young guys are now like super into skin health. You actually see a lot of statements from people that seem to come to the

surface on viral clips, like dermatologists, people that look well credentialed from, you know, top universities who actually say that even what we would consider, like what you said sounds, you know, balanced, you know, sounds like something that's realistic and sounds great. But they would say that, no, that is aging you and it's aging your skin rapidly. And you need to go out with a visor. And you need to go out always with SPF. So I know you said one size doesn't fit all. But how is that these seemingly super smart people are telling individuals that you're aging rapidly

just by getting what you call a balanced level of sun? Yeah, so it depends, again, on physician to physician, surgeon to surgeon. Many of my dermatology colleagues will say, I don't wear anything on my body, but I will put sunscreen on my face every single day because I don't want to get a wrinkle. and for them, their skin's threshold in sun tolerance and their thresholds for what is acceptable aesthetically may be different than mine, for example. I don't mind if I have a few wrinkles. I'm a guy. I'm a surgeon. My looks are not at the forefront of what I'm thinking about every single day. Now, if you're somebody who is absolutely diligent or vigilant about not aging, then perhaps you

protect a little bit more rigorously. And you also have to look, you know, a lot of my colleagues in the space are fairer than I am. So they may not be able to tolerate as much as my skin can tolerate. So person to person specifics, I truly do not think that every single person needs to photo protect with the intensity that we tell them to photo protect 24-7. I think most people in the U.S. tend not to be in a situation where they are going to burn every single day. People work outside, athletes, people who have photosensitive skin disorders, et cetera, totally different ballgame. But the majority of us, especially in big cities, which is where a lot of this conversation strikes, most people are working in office settings or indoors. Their travel commute is a short

period of time. I find it a little skeptical that that you absolutely need multiple forms of sun protection for that five-minute commute from your car to your office. We've leaned so much in one direction. And I think there's a reason for that. You know, we used to use, and we still do in dermatology, we use UV to treat skin disease. Before we had established data and wavelengths, we were using heliotherapy. This is dermatology in antiquity. And I'm not saying heliotherapy is what we use in modern-day dermatology, but we use UV light to treat skin disease. So we know UV isn't 100% bad. We use it to treat eczema, and psoriasis and vitiligo and a myriad of things. That being said, as cosmaceutical industries

got really entangled into dermatology and the aesthetics world came out, there is an incentive to push sun protection, both from a business standpoint, as well as patient standpoint. The more we tell people that they absolutely need to wear every form of sunscreen and wear their visors, the more we get skincare lines booming and business booming. No, I'm not saying that's an all in a bad thing because I do think we are aging less. We're wrinkling a little bit less. But we're also saying that the incidence of certain skin cancels, like we talk about, haven't changed in the population that is the most sunprotectin.

The reason I bring this up and the reason it's important to me is dermatology is probably the last specialty in which we guilt patients into feeling like they did whatever their outcome is to themselves. And perhaps in the aesthetic space, in the beauty space, there's some truth to that. You tan too much, you're wrinkled, you got sunspots, you aged prematurely, you smoked, etc. But in the medical space, when we talk about skin cancer, skin cancer development, your risk, It's not that nuance. And I think guilting patients into thinking that what they did in their 20s contributes to what they're dealing with in their 50s and 60s is not the right way to go.

I hate making patients feel guilty. Last time we did this was with smoking in the 80s. We said, you know, smokers, lung cancer, et cetera. Now the most common cause of lung cancer is in young women who are non-smokers. Adinocarsin with lung, surpassed smoking-related squamous cell carcinoma of the lung. And we don't have an answer to that. So we've stopped guilting people. but in dermatology we still do that.

Yeah. You know, I would imagine if you probably ask, just because I've seen some of the content from those individuals in this field, these dermatologists, they say that, hey, it's not just about aging. I'm actually protecting you from getting skin cancer. All this protection is going to help you

to avoid skin cancer in the future and then something I learned from you and fact check me if I got this wrong, skin cancer is one of the leading causes of death. amongst young women? Yeah. Yeah, it's number two. Melanoma is the number two cause of cancer-related deaths.

Cancer-related deaths. And women ages 28 to 35. Yeah, cancer-related deaths. So melanoma, specifically, cancer-related deaths, the number two cause. So can you help us separate out of what's there, what's real? What do we kind of misunderstanding? I don't think that tanning equals DNA damage. That's nonsense.

And I'd be happy to go to bat with anybody on this. tanning does not equate DNA damage in every person. Why is that the case? And we're going to backtrack because you see a lot of dermatologists, a lot of stuff online saying, if you ever get a tan, that equals DNA damage. No, it absolutely does not. I tan very easily and I can assure you that my ability to tan

does not mean my skin is getting a lot of DNA damage the way an Irish person who's attempting to tan will. And the reason for that is we have different skin cells. we have keratinocytes which make up our skin cells, and then we have melanocytes, which are the cells that produce the pigment of our skin. A tan is the melanocytes response to UV. It produces more melanin in these little packages called melanos and puts them out in the skin

to act as a shield or a sink for UV. Just because you're producing more melanin doesn't mean your keratinocytes or your skin cells are undergoing DNA damage change. Now, a lot of people in the U.S. and worldwide have to get red first before they tan. That's where we run into a problem. If you need to burn first before you tan, then for sure. That's the case. My suspicion is you probably don't burn.

You can tan very easily without a single burn. Same with me. So I hate this blanket statement of tanning equals DNA damage. That's nonsense. Yeah, the tanning is an issue. It's the burning can be an issue. Exactly. Exactly.

And if you're attempting to tan in a tanning bed, it's a little bit of a different story because you're picking a specific wavelength of UV irradiation and really focusing that on your skin. I don't like tanning beds to begin with. If you're outside and getting sunlight, there's some benefits to all the other wavelengths that I can say, okay, like, I would rather you get sunlight than tanning bed light. But if you are attempting and constantly needing to get red and burn before you tan, that's where your problem is. But people tan inadvertently without even attempting to it. That's not all DNA damage. Unfortunately, I am an expert in seeing some of the worst cancers in the United States.

I just finished my 11,000th surgery in my career, which is an astronomic number. But what I've seen in real world settings is that skin cancer develops in all places of the body. I operate on the face, the hands, the back, the chest, the genital region of men and women. It's not a one-size-fits-all. And in fact, the majority of skin cancers that end up killing people don't have the same UV mutation signatures that are garden variety sun damage skin bear. Unpacked. I'm not sure everybody understands what you mean by that. I don't consider myself a super vain person.

But there are certain things that as I get older, 40 plus I'm 44 now that I genuinely want to feel good about my muscle, my skin, and my hair. And I've noticed changes to my hair over the past few years. it's not as full as it used to be. And because of that, I'm always looking for ways to support natural hair growth and fullness, which is why I was excited to try One Skin's OS1 hair. OS1 hair is designed to work where healthy hair begins. The scalp, it's powered by their proprietary OS1 peptide,

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And after you purchase, they'll ask you where you heard about them. Please do us a favor by supporting the show and let them know we sent you. We hear the word detox thrown around all the time. But your body already has an incredible detoxification system and it starts with your liver. So instead of thinking about some crazy cleanse, I'm much more interested in the simple things that I can do every day to support the organ that's already doing the bulk of the work. Your liver helps process which you eat and drink and metabolizes hormones, supports digestion and energy production, and it's involved in more than 500 different functions in your body.

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every single day. If you're ready to give your liver some extra love today, head over to dose Daily.co slash Drew and use the code Drew, D-H-R-U, to get 35% off your first subscription. Again, that's D-O-S-E-D-A-I-L-Y. Dot C-O-L-R-U for 35% off your first month's subscription. When we look at skin cancers that are really bad, because skin cancer is just like any other cancer come in a spectrum of badness. Some are slow growing and not really going to hurt you. Some can kill you in a month.

slow-growing ones that don't hurt you, is a lot of that more likely to happen on the face? Yeah, a lot of the slower-growing ones that tend to be less harmful tend to be related to cumulative sun damage. It's like the body just couldn't keep up with the years and years of DNA damage from a variety of things, sun being one of them, smoking, et cetera, and it gave up on its ability to fix itself so skin cancers develop. So a lot of the slow-growing ones, a lot of ones that are not as intense, not the most likely to kill you. They're more. likely to happen on the face because the face overall in the body is going to get worse on.

Yeah. Now I'm not saying you can't get lethal ones very quickly growing on the face or hands, but generally speaking, the skin cancers that tend to develop on sun-exposed areas are either slower growing or more indolent, meaning they're less lethal in a fast manner. Even when we look at our most deadly forms of skin cancer, which is melanoma historically, melanoma comes in a variety of flavors and the majority of the ones that occur in sun-exposed areas tend to be less lethal than the ones that occur in sun-naive areas. And in fact, when we look at patients who have metastatic disease, melanoma that's spread inside the body into the lymph nodes, other organs, the majority of melanomas that are metastatic arise in sun-naive skin without

the same genetic UV-mutation profile that the melanomas is. that occur in sun damage, wrinkly older skin do. And just to pause there. Yeah. How do you know that you send in for biopsies? This data has been studied extensively at places like Stanford where I train by some incredible labs that have dedicated their life 50 years of. Got it.

So it's well established. Well established. And we're still understanding more. But even if you leave the melanoma realm, when we look at squamous cell carcinomas, basal carcinomas, these are one in four to one in five Americans will develop these common skin cancers. In that category, the ones that tend to go really rogue, really fast, the ones that end up spreading inside the body and hurting patients have less of a UV signature in their tumor genes than the ones that are more garden variety that occur in,

you know, wrinkly, sun damage, crusty skin. The skin cancers that tend to be the most deadliest for people. Yeah. Tend to not show up on the face as much as other parts of the body. And then when you look at them, it's not easy to say that, hey, this is UV light from the sun. 100%. That's the primary thing that has caused this to show up in the first place. The majority of melanomas, just in general, not even, we're not even talking to lethality, just majority of melanomas arise on the sun protected back of men and sun protected back or legs of women. If they were 100% sun-related or sun-caused, then they should occur. 99% of them should occur on the nose,

the ears, the forehead, the hands, but they don't. Yeah, so something else is going on. So the something else is genetic predisposition, so family history, your genetics. And why we make a big stink about the sun is because your genetics loads the gun and then the environment will pull the trigger. What is the environment?

Mainly sun. So dermatologists fight this battle all the time saying, listen, I can't control your genetics, but let's not make the environment be the trigger puller. there's a lot of truth to that, but a lot of nuance to that. And what ends up happening is patients either feel guilty that they cause their melanoma. I had a 26-year-old girl who has metastatic disease everywhere.

You know, she's going to die of her melanoma. It occurred under her arm where she's never seen, she's pasty white as it is. It's hard for me to consciously, in good conscience, say, hey, put on your sunscreen because that's what caused your melanoma. I think that the... I think when you start to get into older age and you, had a lot of sun wrinkles, I can say, okay, you know what, Drew, you like baked at the beach. You're going to get something here because your entire skin is all wrinkly and leathery.

Totally different ball games. Why I think that's relevant is because I think you can get sun safely and not have to worry about dying from skin cancer. Or I think you can get sun safely and limit your fear of skin cancer, especially if you know your genetics. So the next layer of this that I'd like to unpack, we have one side of the camp, let's say, the dermatologists that are sort of anti-scentralic. Sun and are telling people that if they don't go out with SPF 50 all over their body and wear a visor when they're going for a walk, not only are they're going to age, you're going to increase their likelihood of cancer. Then you have this other side, which is what I would call like sun maxing individuals who say there's not enough healthy sun. And because you're more likely to get cancers of other types. You have an increased rate of cancer, maybe not melanoma, but other cancers. Other non-skinned related cancers and other disease.

You know, we know that autoimmune diseases are tend to arise in places where people get less sun exposure. But not only should you not get a healthy level of sun, which is what you're talking about in the middle, you should also maximize the amount of sun that you're getting as well to, which, you know, depending on the person that you're listening to, it can be different levels. You know, it's like you should be primarily working outside. You should try to get, you know, X amount of hours a day inside of the, inside of the sun. And so, you know, the question I have, right, because you're talking about this young girl, right, who it's genetic, right? And then we'll talk about the sun maxing group in a second. If for some people it is genetic that's there, wouldn't the dermatologist say, well, if for a lot of people it's genetic, then you've got to be sun protective in general.

Yeah. Because we actually, let's control the variable that we know that we can control, right? Is that kind of their argument? So, yes. And I'm going to unpack it a step further. Please, please. Sun is here. We can all agree that some form of sunlight is good for you.

The relationship between sun and skin cancer and the relationship between sun and aging and aesthetics are not the same. So that's very important to understand. It's much more linear and predictive, too much sunlight, and. aging. But just because you go down the premature aging and wrinkling route doesn't necessarily mean you're going to fall into the skin cancer route. And that's the part people have a really tough time like wrapping their head around. It's, what do you mean? If I get too much sun, I'm going to wrinkle. If I get too much sun, doesn't mean I'm going to get cancer. Maybe. And the maybe is an asterisk. Where to fall in that spectrum. Do I think you need to avoid the sun 24 hours a day? Do I think you need

to dress like a beekeeper? Do I think you need to wear sunscreen? S.B. have 50 all the time? No, I don't. The sun does have a lot of benefits. There's a lot of well-documented benefits in physical health, in mental health. There's a study that, and there's a lot of nuance to this that showed that women who avoided the sun for fear of melanoma, that big Swedish study that came out in 2016, women who avoided the sun for fear of melanoma had an equivalent all-cause mortality, the same as pack a day smokers from cardiovascular disease. A lot of nuances to unpack as to why that's true, why some of that's not true and people, you know, lean really heavily in on that study. But there is truth to the fact that people who are living in mid-latitude equators versus

people who live in northern or southern latitudes have lower incidence of autoimmune diseases, namely multiple sclerosis is a good one. People who live in the poles tend to have more autoimmune diseases and it's thought to be something related to sun, vitamin D, etc. So I think getting some sun is good. In the camp of sun maxing, I think that's ridiculous. It goes back to the drinking eight gallons of water in a day. You're not, you know, you're not going to do yourself any good. You have a headache. You take two Tylenol. You're fine. Have 18 of them see what happens to you. Same thing with sun. I think too much of a good thing could be a bad thing. And there's this, there's this like trend that I see every once in a while come out, which is perineum panning,

which people lay out and they expose their genital region to the sun thinking there's going to be some symbiotic relationship that they're going to be empowered with. I've operated in that area more times that I'd like to mention. And that is miserable. And there is no need for you to get sun in that area that you cannot get anywhere else. So stop doing that. That's number one. I don't think tan maxing is a legitimate thing.

I think everything should be relatively control. Listen, we're also human. You go on vacation, you miss a day of sunscreen, or you wash off and you forgot to reapply and you get a sunburn, it's not the end of the world. I think when it becomes a consistent habit is when it's a problem. The other thing that I don't agree with, and maybe I'm in the, there's going to be another controversial thing, I don't think all the time that the blistering sunburns you got in your 20s or teens are the contributing factor to cancer in your 60s or 70s.

And every dermatologist will tell you that, but I think that's nonsense. We have phenomenal DNA repair mechanisms in our body. That's literally what our immune system does. We have new skin every 28 days. We don't carry those mutations over. That's complete hogwash. The problem is patterns tend to continue decades over decades. So if you're not sun aware in your 20s and 30s,

you're probably not going to be sun aware in your 40s or 50s. And as our immune system gets weaker, the way you lived in your 20s is not the way you can live in your 40s and 50s. That's when things catch up. To answer the other question that you asked, which is the young person who maybe has a genetic predisposition to melanoma, should they be sunprotectant? By the way, is there any way to test for that? Like if somebody wants to see you or is it typically like, hey, look, if you're lighter skin, those are the people have to test. but if your family ancestry or origin and other stuff is typically a little bit browner, blacker, whatever it might be, you know, the likelihood is not as high.

So you don't need to test. Yes, there's an answer to that. And I'm going to backtrack to answer that young. So my 26-year-old patient who has metastatic melanoma, if you practice enough, you're going to see the stuff that makes you scratch your head as to what we're telling patients and whether everything we think is real is right, you know. There is truth to her falling into the camp that you mentioned. the sun protective camp, which you're saying, hey, there is some genetic risk to you developing

a bad cancer. So let's not let the environment pull the trigger of your loaded genetic gun. 100% agree. The question is, how far do you take it? Do you tell them they can't go outside every single day without sunscreen because they're going to get a melanoma? No, I don't think that's the case. They can enjoy the sun safely. They can be outside safely. It's when you start getting blistering sunburns, which are a problem. In fact, that girl's probably not thinking about putting sunscreen here, which you got her melanoma to begin with, along the brawl line underneath her arm. So it goes against the camp of, yeah, if I listen to pure sun protection, then I should be covering my face and my hands, but she developed in an area that normally is covered by clothing to begin with.

So you should be cognizant of your genetic risk. You should take some form of sun protection. It shouldn't change the way you live. When I trained on the East Coast, my East Coast colleagues had much more apprehension with the sun than my West Coast colleagues, even in the same field. You know, my dermatology colleagues in New York dress like, like I said, beekeepers, like covered, whereas I have Durham colleagues I surf with in California who are out in the sun all the time. And maybe that's just a, we're probably happier. Yeah, it's a paradigm difference, but you bring up something. Yeah, there is a truth to that. The sun does bring some happiness, which equates. to well-being that we should not forget about.

You feel better. Here's the other part that we talked about in our first conversation. I want to bring back into this because it fits right perfectly. So the thing that you talked about last time is that, hey, there also seems to be, and the evidence is emerging and it's continuing to build, that it's not just about the sun. Yeah, 100%. And it's not just about genetics. 100%.

There seems to be other factors that are going on. environmental exposures, triggers, something new that I learned from you, potentially even viruses. Yes. In some instances. We'll talk about that in a second. Yeah.

And also food, we chatted about that a little bit. You have some interesting theories about that. And an interesting parallel, you know, that I want to bring up to sort of set up that conversation is you mentioned lung cancer, right? Non-smokers lung cancer is one of the most growing, aspects of lung cancer. So these are people that don't smoke. It's the most common form. And 60 to 70 percent of it, if I understand correctly, from looking it up last week for a newsletter that we wrote,

impacts women. And, you know, there's different theories. One of the theories that's there, you know, and we need more evidence on this, but mechanistically there's some data to support this. one of the theories is that women traditionally are the ones who do the bulk of cooking and are often between cooking, being at home more, also having more cosmetic, hair treatments, other stuff. They tend to be exposed to worse air quality than inhalation hazards than men. outside of, let's say, men that are working in very sort of occupational hazards like fabrication of materials and indoor environments. This is a theory. These are just ideas that are there. When it comes to cooking, it's, you know, high heat and oil and then also gas stoves, those contributing to also, you know, increased air pollutants that are there. And that's one of

the theories, inhalational hazards that are there. And that caused. causing certain DNA damage, endothelial damage, and other mechanistic effects that can have that. You have a similar idea that there could be something like that that's going on when it comes to skin. Talked you about that. When we talk about the skin, sun for certain, probably the single greatest environmental trigger that we can pinpoint our finger to. Definitely for aging, but you're saying also for cancer. That we can point to from the environment. Yeah.

as you can point to. Or at least that we know of and we've tested for. There are other things for certain. We talked about viruses. The most common cause of skin cancer anywhere in the general region is actually not sun. It's the HPV virus. Talk about this because I heard you share about this recently.

And I thought, wow, you know, so many people don't know about this. And it's not just an issue for women. It's an issue for men as well, too. Huge. I operate on vulvae, I operate on the penis. I operate on the perineum, all from skin cancers that are constantly. caused by the HPB virus, and we know because we stain for the virus, and we find the type of virus and the risk status virus in the skin. These are not people who tan this area.

Viruses are huge. Actually, in fact, tangentially, that virus is now the number one cause of head and neck throat cancers in America. From like oral sex. Oral sex, yeah. For men and women. For men and women, Michael Douglas famously came out that his like oral cancer was from oral sex. And it used to be smoking in the 80s and 90s, oral pharyngeal cancers. Now they're caused by HPV. So there's a whole conglomerate of environmental factors that we are just elucidating. Interestingly enough, there were several dermatologists, well-known dermatologists. We used to burn warts off. We didn't freeze them. Now you go to the derm's office, they'll usually freeze a kid's work off and you go back a few times to freeze it. We used to burn them, cauterize them,

and they were very effective. You usually burned them once and they ever came back. And then we saw the plume of smoke contained not only the virus particles, but also the environmental pollutant toxins that came from cauterized skin. And there's been a few well-known cases of very well-known physicians getting oropharyngeal papillomas from the inhaled warts that they were cauterized. Are they surgeons or dermatologists? Surgeons and dermatologists, yeah, which is why one of the- getting, yeah, we wear masks. We double mask just to like do anything that's HPV related. Dude, unrelated, but there's a whole series of people that I'm super worried about when it comes to

this and like I was going to a biological dentist, functional dentist, like she's in LA. I believe she's like Harvard trained like and I was getting an oral appliance for expansion. Sure. And you know, they have to modify these because they adjust over time. They have to fix them. And she was manually adjusting it by like shaving it. You know, she has like a drill and has to fix it. So it fits in my teeth a little bit better. Amazing.

Thank you for that. But now I'm seeing all these particulates, microplastics in the air. And I'm okay, fine. It's a little bit of exposure for me, although I don't want that. But I'm so worried about her. Yeah. Every single day, five days a week for 30 years. For 30 years.

Right? And it's like, bro, you're in wellness, right? We need to get air filter in there. We need to get like a really strong mask. Anyways. Yeah. This is a problem. Environmental things that can contribute to skin cancer are things that we haven't recognized yet.

Viruses are now being recognized pretty prominently. And in fact, it's like a big cause of certain skin cancers or certain areas. There's all this controversy out there about the HPV vaccine, giving it to like young women. They're not sexually active. And I think a lot of people who are smarter like, great, I'm not going, if I'm a little bit nervous about giving any excess medical intervention, whatever it might be. Okay. My young daughter, she's not, you know, she's not sexually active. Great.

I'm going to give it to her later on, right? Because there's something there. And then some people that are extreme are like, I don't believe in any vaccines and they have to deal with whatever that's there. But here we are talking about, you're hearing it from somebody. You are pretty pro-wellness and you probably even have a little bit of like a natural bias in your life. But you also have the surgical training. You've done 11,000 skin procedures, surgical procedures. that are there. You have your degree from Stanford, and you know the deal when it comes

of skin cancer. And you're hearing live from you that the HPV virus in men and women is causing cancer. Huge problem. Right. Or being the initial trigger, at least, that is setting that cancer off. Yeah. Huge problem. So if somebody here today is listening, and they're like, oh, man, I never got the vaccine or I didn't, you know, I don't know if I have an issue with it. Uh, should people get tests? What's the best way to get tested? I am a reasonable surgeon. Like if a new vaccine comes out, I take a second before I recommend it for my patients.

I like to see some outcomes data. Which, by the way, that might sound controversial, people, but you can apply that to anything. If the new medicine comes out. Yeah, yeah. If a new trend comes out, if a new supplement comes out, you should always take a beat and actually really get a chance to know what's going on.

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That's live-M-M-M-M-M-M-E-N-T-O-U-S dot com and use the code D-H-R-U. That's me, to save 35% off today. And I will tell you this from personal experience. So I used to be a professor at a very well-known academic center here in Los Angeles, and we were obligated to get COVID vaccines to be able to work. I got the vaccine five times. I still got COVID. It changed my perspectives on the politicization of medicine in the United States nowadays.

When we were kids, we got measles, mumps, rubella. We never saw the disease. I still have a few patients who have polio who are quadriplegic. They're in their 90s. They got polio. They were, they didn't, they got polio before the vaccine was available. So I see the benefits of the older generation vaccines. You know, I had, when I was just a medical student, I had a young kid unfortunately succumb to the consequences of spinal degeneration from measles.

Which is very rare. It's very rare. But as soon as you see it and you experience it and you deal with that patient and changes your perspective. So I'm not like a, you need every vaccine under the sun. I'm like middle ground. I think the stuff that can kill you, it's better to vaccinate against than the stuff that won't kill you. That's number one.

Number two, I think hastily developed things are questionable. But when you start to operate a lot on cut out areas of the body that could be prevented or risk reduced. It's not a guarantee. Nothing is guaranteed in medicine, but we can risk reduce through a studied vaccine that's It's been around for actually 40 years. The HPV vaccine? Yeah.

It's been either in phase testing or available for 40 years. That's a low hanging fruit for me. My head and neck colleagues, and I bridge the gap between head and neck oncology and dermatology. I fall in this middle ground. I do a lot of bad tumors. As soon as you see a few cases when you're taking out somebody's tongue and voice box, because of HPV-related squamous cell, your tune changes a little bit.

If I could reduce that burden of disease with a vaccination that hasn't been shown to cause the controversies that we're seeing with other vaccines, namely nowadays, COVID vaccine, etc., it's easy for me to recommend. I can confidently say the consequences of getting high-risk HPV-associated tumors are far worse. Your life will be miserable with these tumors, whereas your life may not change. at all with HPB vaccination. Now, do you have to absolutely get it at a young age? I don't think so. I got my series in fellowship. I was operating every single day. There was plumes of smoke from

cauterization every single day. I knew there was HPB in the air every week that I was working. I'm going to get vaccinated. Most head and neck surgeons in the U.S. are vaccinated. Whether they got it later or earlier, it was whenever the vaccine was available. But once you start to see the consequences of or the ramifications of what happens in a preventable disease, it changes your tune. I'm in the camp of pro-HPB vaccination. It's one of the few vaccines that reduces cancer risk. Serbical cancer was the number one killer in young women and from a cancer. Now it's not even in the top 10. Crazy. And it's not because people aren't having sex anymore. Right. It's because we have a way to kill off the virus that can cause this mutagenic change.

If you are somebody listening today and you haven't had the vaccine. Yeah. Obviously, it's very straightforward to get it, right? You can talk to your private care provider and get it. If somebody's interested and wants to know if they have it, like I know that my wife during her normal OBGYN appointments that were there in preparation of pregnancy and everything, you know, they test for a whole bunch of stuff. And, you know, I'm always looking at it. We're always putting in a chat GPT to make sense of stuff. And, you know, that was one of the things that was there.

She's negative. A lot of people who do get tested regularly for or like when they're younger if you're sexually active. Yeah. You're like, hey, listen, I want to make sure that I don't have any STDs. It's just part of my normal screening or you were in a long-term partnership. And then that ended. Yeah.

And then, you know, you're about to get another one. You know, it's recommended for people to make sure they don't have any STDs, especially you're bringing that into a next relationship. that HPV is standard in your typical STD screening or no? No. No. So you have to specifically go get it. And there is not an easy test for it.

There's not an easy test for it. So generally women, when they go to their gynecologist to get a pap smear, the pap smear looks for cellular changes in the cervix. And if that's seen, then they look to see why the cause is. So they do genotyping and expression profile testing of why those changes. occur and if they find HPV, they look for the strains. So HPV is a family of viruses, like 200 strains. The most common strains are the ones that cause common warts in kids and adults. HPV strains 1, 2, and 4 cause warts on our hands and fingers, like the stuff you pick up at the gym or

yoga mat or what have you. That's HPV. HPB strains 6 and 11 cause genital warts. Those are not dangerous. There's a few strains that are silent, HPV strains, 16, 18, 31, 33, and a few other ones that cause cancer. It's hard to test for that. There is no test in men. There's no swab in the oropharyngeal flora. And the only test that we have happens to be indirect testing from pap smears in women. So this is why the vaccine is helpful, because, you know, Because you have no idea if something is developing in the crypts of your tonsils from oral sex that you've had in your life. Most people will clear the virus on their own. About 80 to 90% of people in the U.S., if you screen their blood, have antibodies against some form of HPB. Most people will clear it, just like a normal virus. So there's nothing unique about this virus with the

exception of the high-risk strains can evade your immune system and cause changes. That's why the vaccine is so important. If I could screen you easily and I can say, hey, Drew, like, I tested, I found HPV here. Let's like get rid of it. I don't think the vaccine would be as powerful because I can find it, eradicate it, not worry about it. It's like the sleeping danger that makes a vaccine so powerful. Is there a way to test for the antibodies that are related to the silent ones that are there or it's not a perfect test? that's a great question. I don't know if we have commercially readily available

testing for antibodies against the strains that cause cancer. That cause cancer. Now, you probably have an indirect test, and that's the results from your wife's guine exams. But I guess the other challenges is that most likely, you know, I've never been

tested for, there's not a good test that's out there. I haven't gotten the HP vaccine. Most likely I don't have it because she didn't have it through her testing that was there. not that it can screen for these silent cancer ones. Assuming you had the high risk strain, you would pass it on to her. Yeah, yeah. And she would have cervical changes that you would see.

Now, it's not a guarantee. If she had it, then it'd be likely that I had it and I could have given it to her or vice versa. So most of the time, people clear it. I have a patient couple. They're an older Asian patient couple. They're in their 80s. I just operated on him about a month ago for HPV-related squamous cell carcinoma of the penis. large sight took it out. The viral changes extended far beyond where the cancer was.

Fixed it all up. And every time I had a conversation with the wife, she couldn't speak because her voice box was removed. And I said, hey, what happened? She said, I had squamous cell carcinoma of my throat. I was like, when did that happen? She's like 15 years ago. Were you ever a smoker? No. in my head, I'm like, oh my goodness, my guess is they had probably a ping pong effect. They've been monogamous for 50 years. Yeah. She had an oropharyngeal carcinoma that's likely HPB related because she was a non-smoker. And her husband now has peanut cancer that's a verified HPV related.

So when you start to see things like this in real world practice, you're like, do you just get the vaccine. I promise you, you don't want to be on that. If somebody already has it. Yeah. And let's say it's not at the level where. it's sort of shown up as cancerous, to a degree that they've noticed anything. Does the HPV vaccine get rid of it?

Yeah, and it helps reduce common warts. So if you're like somebody who has like a lot of warts or you're predisposed to getting wards, and there's some genetic predisposition to that, vaccination actually reduces your warp warden. Okay. It covers those strains too. I guess the other aspect is that if you're young and healthy,

which a lot of people who are listening to this podcast, you know, they're healthy, they get their son, you know, they take supplements, maybe even a lot of them bought sunpowder after your last, you know, appearance that's there? Is there a chance that the virus could be dormant? It's in the body. It's dormant.

And then it's not an issue until you a lot older. Like, for example, a lot of older people end up with shingles. Yeah, like this couple. The guy's 80 years old. They've been monogamous and he just now shows it. So is that also a possibility? It is. It is.

We don't know the dormant. we have theories of the dormancy period, but it's over months to years. So that's unique. The other thing is, if you're young and healthy, there's a good chance you're going to clear it. So I don't want to sound alarmist. But if 10% of the population doesn't clear it and 80% have HPV, that's still a huge number of cancers that are preventable. Yeah. Yeah. So I don't want to be alarmist, but I think it's a low-hanging fruit in which you can prevent a preventable mutilating type cancer. Yeah. No, dude is scary. You don't get to be a lot. You don't get to be alarmedist. your flu shot, who am I to say otherwise? You don't get your COVID shot. If you're young and

healthy, you're likely not going to succumb from those. Yeah. And that goes back to the environment. Yeah. So we were, I'm glad we went on that tangent because I think it's important to hear from somebody who's in the, you know, in the weeds of it. Good friend of my, I was on the podcast recently, Dr. William Lee. He's a cancer researcher. He's the angiogenesis foundation. You know, he was one of the first people to tell me, you know, back in the day, he's like, listen, you know, if you've had oral sex before, this is something that you have to pay attention. to as a guy and we don't talk about it as enough and, you know, this is something that's there and it's on the rise and it's something that, you know, we all need to be talking about and pay

attention to. So zooming back out. This is part of the landscape of things that are other contributors besides genetic potential and just the sun as to why, you know, in modern society, at least, we're seeing some of these cancers in a way that we're not seeing them from my understanding in, you know, societies that are not as modern. Now, they have their own issues, right? Like people in where the country that I'm from, Kenya, if they're in the rural area, right, they actually have a lot of asthma. I don't know what the cancer rates are. I don't know if we have formal data on that because a lot of them cook indoors using like charcoal or like patties from cow dung. And that's a big problem in India as well too. So it's not like these

other places are perfect, but they seem to have less of some of these environmentally based, you know, known cancers that are there. So viruses are a part of that equation. What's the next thing that you want to get a chance to go into on the landscape of things that potentially are impacting, you know, skin cancer? Lifestyle and diet. It's huge. So why I think this is important, because every month or every week, depending on what source you look at and who you listen to, you'll find something online. Shout out Gabriel Lyon who put this up and I want to have a discussion about this. She found a PubMed article that said lycopene from tomatoes helps reduce skin sensitivity to UV light. Does that mean you should start taking tomato supplements?

Yes and no. Usually no. I saw another study that said, okay, if you have high omega-6 to omega-3 fatty acid ratios in your blood, you burn easier than if you had an omega-3 to 6 ratio. Does that mean that fish oil supplementation will reduce your sunburn risk? No. But what all of these little nuances are pointing at is that the Western lifestyle and diet, which tends to be pro-process, pro-inflammatory, is not allowing your body to do the things it normally should do, which is tolerate environmental damage and insults. So I do think the crappy processed diet, sedentary lifestyle, indoor lack of sun lifestyle does break down immune function, immune regulation, and immune tolerance. That's really the big picture. How do we hone that? It's really hard. I don't think

there's an isolated ability to say, okay, purple carrots are what you need to eat so you never get skin cancer. Unlikely, but if you're eating tomatoes and carrots and your omega-3-6 ratio is good, you're probably also one that's paying attention to your hydration status, exercise status, your sleep, all of those allow our immune system to function the way it should so that if we do have environmental insults, we can fight them better than a crippled immune system. You've even gone as far to say is that is a lot of what we're seeing in modern day life where we're seeing this explosion of skin cancer, even though we live in one of the most sun-protected societies that is around, how much of that is an immune problem and our immune

system being suppressed by our modern-day lifestyle and then environmental pollutants, etc. It's 90% an immune problem. It's why, generally speaking, cancers are a problem of adulthood and older years, not of childhood. It's because our immune system is an incredible machine that fights and finds, DNA changes, cancer cells. All of us have a certain percentage of circulating cells that are cancerous or not normal. Does that mean everybody here has cancer? No, our immune system does an incredible job at finding them. The problem is when we start to do things to our bodies, mainly through lifestyle and diet, that can be modulated, where we are in a pro-inflammatory state. We're not eating the way we should and the foods we should.

We're not sleeping the way we should. We're not healing the way we should. Our immune system is weakened. It's like a weakened police force. That's when things go awry and we scratch our heads. We are, at least the generation maybe younger than me, whatever. I don't know, it's alpha Z. I'm terrible at that.

But the generation younger than me and around my age are some of the most sun-protected compared to boomers and generations beyond. Yet, the incidence of skin cancers continues to trek upwards. How do we scratch our head and say, that's all sun? We can't. Another interesting fact that sort of builds to this, if I understood correctly, you've talked about the fact that if somebody has an autoimmune condition, right? Yeah.

And there's a whole bunch of them that are out there. You talked about multiple sclerosis. We have Graves disease, Hashimoto, is. etc. Did I hear accurately that they're 65 times more likely to get skin cancer? Yes and no. So patients who are immunosuppressed. Immunosuppressed. So those who are either transplant recipients, so solid organ, heart transplant, lung transplant, kidney transplant, etc. who are on immunosuppressive medications or patients who have immunosuppressive disease states, HIV, lupus on immunosurricular,

autoimmune diseases on immunosuppressants. They have a 65 to 100 times likelihood. So that's 100,000 percent likelihood of getting a greater likelihood of getting skin cancer than somebody who is not. In fact, when we look at transplant patients, all bets are off. And the transplant patient population is an excellent petri dish to understanding immune system and cancer. You can put a bunch of transplant patients completely out of the sun and they will still develop skin cancers at a rate far beyond what a person who was immunocompetent would.

So that's huge and that's another environmental thing that nobody ever talks about. If somebody's on immunosuppressants. Yes. Not everybody who has an autoimmune disease is on immunosuppressants or if somebody was recently had

a transplant that was done. Should they be far more sun protective? Absolutely sun protective. They should be seeing a dermatologist, usually it's twice a year, if not more frequently, because all bets are off. Our ability to fix the skin from DNA damage that we get from the sun is gone. And outcomes are very different. In fact, and this is like something the young dermatologist don't necessarily know,

historically, the number one cause of death in solid organ transplant patients in the late 80s, early 90s when transplants were being optimized and the drugs were being optimized, that was not related to transplant failure was metastatic skin cancer. Totally different ballgame. But you bring up something about autoimmune disease that is actually interesting. Patients who have, for example, Vidaligo, which is an autoimmune disease in which our immune system attacks the cells that produce our skin color. Do you have a family member who has that?

They have a reduced risk for skin cancer. Interesting. Now you would think, hey, there's patches of white. You're going to burn easily here. Like, what's going on? It's because the immune system is really. overactive in the skin. And as a byproduct or an inadvertent byproduct, it also eliminates some of the damage that contributes to skin cancer that you wouldn't otherwise be able to. So when we look at

cohort studies, patients with Vitaleigo actually have a reduced risk for garden variety skin cancers than matched controls. So that was kind of cool. So that's the immune play. That's why I like, I have so much beef with this blanket statement of sun. You know, too much is a problem. Too little is a problem, but I don't think everybody should fear it. But the immune system and our ability to modulate it is so, so important. You know, it's interesting because, you know, we've had, like, for example, Terry Walls on this program. I don't know if you know about her work, but she's the creator of the Walls Protocol. She's a medical doctor.

She works at the VA. She was diagnosed with autoimmune condition, multiple sclerosis, the really bad type. I think it's called, like, progressive something. And then she also had something called trigeminal neural neuralgia, like crazy pain. through nerve pain. You know, we've talked about on this podcast how there seems to be some connection, you know, observationally that those are in very more sun-deprived areas have more likelihood of MS. That's what we were talking about, northern latitudes and southern latitudes compared to mid-equator for sure. Right. But then the next layer is, uh, what I'm hearing

from you is that, you know, a lot of these, uh, patients, they're on, you know, disease-modifying therapeutics, in addition to the lifestyle, right? She's not against things like disease-modifying therapeutics in the case of MS. But she's really big on like, well, a lot of this has to do with the three-legged stool theory of autoimmunity. And so she focuses on like increasing your fiber, getting eating a cleaner diet, reducing your pesticide exposure, making sure you address nutritional deficiencies. And I think she's even talked about the benefits and other people have as well, too, of like, you know, making sure you get a healthy amount of sun.

You should. But I'm hearing, you're also saying, but yes, and if you are on an immunosuppressant, MS patient, somebody else that you had, you know, lupus, you know, those patients that have lupus, go to your dermatologist more regularly because you want to make sure that some of these therapeutics you're on are not putting you in a position where you can't clean up the mess and of DNA damage your body would normally be doing. A lot to unpack about that. 100% agree. There's actually really cool data that shows, and this data has been corroborated,

if you were born in a sun-deprived area, northern latitude or, you know, very south, at the poles of the world, and you migrated to a sunny area before a certain age, your MS risk went down to the sunny area's environmental risk. If you lived in those poles and you migrated beyond a certain age, then your risk remained as if you lived in that area longer. And that has to do with something about sunlight, vitamin D, immune modulation, immune tolerance development. I have a lot of MS patients. MS is very near and dear to my heart for a variety of reasons, but everybody should be getting a healthy amount of sunlight. And it makes them feel good. It also increases vitamin D and all the things that we can do for immune.

modulation through phototherapy. The older drugs for diseases like MS, lupus, used to be kind of global immunosuppressive drugs, a big one with steroid prednisone. We know patients on prednisone have an increased risk for skin cancer that's 65-fold. Now, medicines evolved so much that we have such targeted pathways of immunosuppression that it doesn't have a trickle-down effect as much. It's not a shock and approach. It's more like a sniper bullet. And that, like the risk is much lower there. But still, you should see your dermatologist and talk to either your neurologist or your rheumatologist, whoever's prescribing these drugs, to make sure you're not on one of the ones that are well known to increase your skin cancer risk. But for sure, some sunlight,

100% agree. Everybody should get it. And it depends on how photosensitive you are. For example, the lupus patient can't tolerate that. They get really sun sensitive with just a little bit of UV. It's one of the cardinal signs of lupus. Whereas with MS, sun exposure, in a healthy amount, not blistering sunburns, but sun exclusion in a certain amount is good for you. Okay, great. Yeah. That's super helpful.

So you were talking about the dietary piece of things. Yeah. Right? Yeah. And how, you know, there's all these signals that are out there of this phytonutrient or this chemical and tomatoes or this. Yes. These are all things that help you fight the likelihood of cancers.

Yeah. And in some cases, skin cancers that are there, right? so that to ignore, and this is probably where the biggest beef is with like, you know, the wellness community and traditional dermatology is that there's no conversation really about diet. Yeah. And you're somebody that's saying that, look, we don't have, you know, the most amount of evidence that's out there, but there's enough that shows us that if we're not serious

about cleaning up our diet, moving away from, ultra-processed foods. Last time we talked about the challenges of certain oils that you're concerned about as well too, right? You do have some concerns about seed oils and highly processed oils that are there.

That if we're not serious about paying attention to that, we're going to be taxing our immune system unnecessarily and just like HPV virus essentially is like a tax on your immune system. A lot of these viruses are... Imparing your immune system. You're curing your immune system.

Yeah. So you can impair your immune system through viral load, right? You can impair your immune system through diet, lifestyle, sleep, et cetera. Even sun. Sun is another one. We use it to modulate the immune system in the skin. But you bring up a really interesting point. I trained up at Stanford.

And Stanford was like very forward thinking and recognizing in science and medicine and technology and what have you. And during my training is when a lot of the work in recognizing. the gut skin connection and the modulation of the immune system came about. This is like probably 10, 15 years ago. Before that, the premise that you could affect the way your skin looked through what you did internally was like hogwash. Everything was treated like you put a medicine on here or you take a prescription pill for a disease state. But our ability to maintain skin health wasn't really considered until some really good elaborate research came out saying, hey, our gut

actually talks to our skin through the immune system in each organ system. So that's where the whole plethora of, okay, how can we change skin biology with diet and supplementation and things like that? At the very minimum, we recognize that you can control the most common things people go to the dermatologist for, which is acne, psoriasis, eczema. You can control some of it with just lifestyle changes. We know that acne can be exacerbated with either high glycemic index foods, so sugary foods, cola, candy, etc. Or non-fat dairy products. Ironically, not whole-fat dairy products, but non-fat.

And the theory behind that was the emulsifiers and a lot of the non-fat processed foods have an insulin sensitivity response in the body. So you actually, the emulsifiers that they put to give the mouth feel of full fat will spike your insulin level. So a sugar does. And they're not great for the gut lining either. Exactly. So we found that you can modulate some acne, inflammatory acne with diet. We found that anti-inflammatory diets, and there's a variety of ones I tend to like either Mediterranean or

paleo, somewhere in that mix, can improve your eczema severity and your psoriasis severity, irrespective of whether you're using medicine or not. So that was like awesome. So me being like somebody in like the more cancer realm, like can we do this for? skin, skin health, DNA damage, skin cancer. And, you know, I have two variants of a supplement here that I would love to touch baseball about, but one of the craziest things that came out was a study in 2015 in the New England Journal of Medicine

that showed that patients who supplemented with just a derivative of vitamin B3 called nicotinamide had a reduced risk for new skin cancers that was almost 30%. And this is for squamous cell carcinomas, basal cell carcinomas, and pre-cancers, called actinic carotosis, the most common skin cancers. Fast forward last year, a follow-up study came out in a journal called JAMA, which is one of our Pinnacle journals as well,

that looked at 33,000 patients who took the same supplement over 20 years, and their risk for skin cancer, namely squamous cell carcinoma, was reduced by 50%. And now we're like, holy mackle, not only can we modulate skin health, we can actually make like meaningful changes. And if you look at the studies, we were able to find out last month

that that protective effect extends to melanoma as well. So now we're like, holy moly, we're in this infancy where lifestyle and diet is not just this like fringe area of medicine that isn't accepted by Western physicians. there's like a lot of truth to that, partly because we've gone so far awry in the U.S. with crappy diets, crappy processed foods and crappy lifestyles

that just reverting back to midline shows a lot of truth. And in fact, if you look at the studies for this, and nicotinamide is something that's near and dear to my heart because I see a lot of skin cancer patients, the protective effect was equal to or greater, depending on which study you looked at, for skin cancer prevention than sunscreen. nobody questioned sunscreen. And I don't question it either. But in terms of risk reduction for

just cancer, so lo and behold, like that's where we created a product called sunpowder that I give to all of my patients, but that premise behind our ability to use diet, our ability to use supplementation to fix things that you can see came about. It's been like 15 years in the science, but only two or three years till the everything boiled down to figure out, hey, this works, this works, this works. Yeah. So what I'm hearing from you is like on top of, you know, like a whole food diet, tailored to like the things that are like right for you, how can we use targeted supplements? 100%, which we already do all the time. Right? People know about B12 to support the nervous system and the consequences of having really low B12. Magnesium. Magnesium.

It works the same as like a single dose antidepressant in terms of changing mood. And it's a supplement that's over the counter that a lot of people are often deficient in. Like so many things that because of our Western lifestyle and diet has fallen away from normal that we've figured out how to modulate. There's so many things in there. Using targeted supplements, nutrients to boost our ability to be resilient to the sun. Yeah, 100%. But also some signals that could we also reduce our risk of cancer, which is also exciting as well too. Last time you're on the podcast, you're talking about sunpowder.

You're talking about also the origin being that there's this, I forgot if it was a leaf or a fern. A fern. Yeah, a fern. Tell our audience that story because that was pretty cool. So separate from the cancer point, like there was no concept that you could protect your skin from the sun using something from the inside out. It's always been apply something to the skin to shield it from the outside in. About 15 to 20 years ago, some data emerged about a fern from originally found in the Amazon rainforest called Polypodium leukotomous. And it's a fern that was found historically from indigenous populations who would go.

go on fishing expeditions or hunting expeditions that would eat this fern before their three or four day fishing trip to reduce their likelihood of burning while being on the boat. Crazy. It's crazy. Then we figured out, okay, what is in this fern? And we kind of over the years figured out the dosing and supplementation necessity. But this fern extract that comes from the leaf of polypodium leukotomas has been shown to increase the time you can be outside or increase the amount of UV you can talk.

tolerate before your skin gets a sunburn. It's like an internal shield. And in dermatology, we use it as not only an adjunct or a, literally a supplement to supplement your sun protective measures. It's not like a replacement for sunscreen or other methods, but it boosts it. But we actually use it to treat certain skin diseases like polymorphous light eruption, sun sensitivity with people who have lupus or vitiligo, women who have melasma, which is the same. this mask of pregnancy or dispigmentation from childbearing or birth control or just genetics, polypodium decreases the darkening. It improves this severity or intensity of melasma and dispigmentation because of its ability to shield the skin from visible and sunlight damage.

So there's a fern, a plant here. There is a vitamin B3 derivative here. And then something that's not as common in the dermatology world, but well recognized in the wellness community is an antioxidantone called astazanthan, huge in one of the most powerful antioxidants and free radical species scavengers. Astazanthan has a benefit in the skin. And recognizing all these things, we put together a comprehensive supplement. I'm one of the founders in a product called Sunpowder. And it's like a daily supplement that I give to my patients. I give to anybody who wants to keep their skin protective from the sun and it does all the things that each of these ingredients do in a single daily serving. I just, I tell people mix it into water and drink once a day.

That's awesome. You know, the thing that I write about a lot in my newsletters, I write about how now a lot of us that are, you know, in our late 30s, 40s, early 40s, you know, which is, you know, where I'm at. And obviously, this applies to a lot of people. As you get older, you are now also in charge of sort of your parents' help. It can be a little bit challenging. as just as I'm sure many of us were challenging to our own parents growing up.

But we're trying to nudge them in the right direction. We're trying to, if you have any sort of awareness, you're trying to support them, but also not be in the process and create resentment. And you're hopefully trying to step into a little bit of a friendship with your parents. Right. That's really what we're all looking for and hear about different stories and the sacrifices that they made.

And however parent is doing their best, right? Doing their best with what knowledge and information they have. But one of the things I think about is that one of the best decisions I made is getting my parents right before the pandemic, which is really great to move out to California. But my dad, one of the best things he's doing now is like he walks every day. He walks every day. He has a walking group. And he's spending a lot of time in the sun. And now you can see for the first time in his life, you know, he has a like, you know, a couple of sun spots.

We should, we should just check it out. Yeah, yeah. You know, go to your local dermatologist down there at Kaiser. just make sure everything's good. But I also think about like, wow, I'm so happy that my parents are getting more son. And also, too, because we know that skin cancers and cancer in general are a byproduct of, you know, aging tend to be. It's also something I'm like, guys, this is a no-brainer. Let's just toss this into your smoothie, right?

Don't think about it. You're going to get other benefits that are there to, in addition to my own interest in wanting to, you know, take it too. You're a good son. And it's awesome that you're thinking about your parents because now you're playing this role of you are a parent for your child. You're going to be tending to their health. And now you are watching your parents because the roles have reversed. And I think one, the fact that you're thinking about your parents' skin health is awesome. I think of this is the way I would think about brushing my teeth or wearing deodorant if you wear it or taking your blood pressure medicine or wearing sunscreen.

it's a simple, effective way to reduce your risk for short-term and long-term consequences of being in the sun. Whether it's reducing your risk of burning or actually fixing the damage that's occurred over years with the nicotinamide in there. Which, by the way, just everybody knows, it has nothing new with nicotine. No, absolutely not. No, no, totally different. People have written in in the past and said, why are you guys recommending this? No, nicotinamide, which is a B3 derivative. It's an amy derivative of vitamin B3. It's not vitamin B3, so don't mistake it for niacin, but it's a vitamin B3 derivative. And, you know, another way that I think about this, and hopefully you'll experience this

very shortly, like my oldest is an active swimmer. He swims competitively. I put a bunch of sunscreen on the kid before he jumps in the water. The swim meets are four hours. Mineral-based sunscreen, which you're a fan of. You talked about what's the right sunscreen? What sunscreen is to stay away from? Chemical, not as great because of the cause for concern around issues, but there's plenty of mineral-based sunscreens that are out there. Totally. Yeah. So you use that for your son. Yeah.

He jumps in the water. He has a four-hour swim meet. In 35 minutes, that sunscreen's off. And I can't get the kid out of the water to pat him dry enough to reapply. So he actually takes a scoop of this before his swim meets. And it's safe for kids six and older. So there's ways that we can do things that are easier on the lifestyle or at least easier in terms of compliance.

I can't get my dad to wear sunscreen. He just doesn't understand it. He's like older. He's tan. He's like, I've done this for something. 70 years. I'm not putting anything on my nose now. I'm like, dad, okay, like, can you mix this into water? He goes, yeah, it's kind of nice. It's like my morning juice. I'm like, all right, I got some victory here, you know? I see the changes. I actually took off an early skin cancer on the door, some of his nose.

And he's like, whatever, I have you. I'm like, you can't think like that. Do something. So he works outside. He's a contractor. That's an easy way. I love this product. But you bring up, you know, mineral sunscreens. It's not a replacement for sunscreen. So I want people to understand that. And it is not an oral sunscreen. It does increase the time you can be outside. It actually doubles the time that you can be outside. So it does have some sun protective benefits, but it's not a sunscreen. Yeah. No, that's important. The other thing that I think about is that I record probably like once or twice a week, but you know, we're in a studio. There's like tons of LED lights. People don't realize that the screen from your laptop and the LED lights, they also age you. You don't have to be in the

sun. Because you're getting a particular spectrum of light and you probably know the science I don't. That light is also very aging. This is why some dermatologists on this other side have said, no, no, this is why even if you don't go outside, you need sunscreen because a lot of us live in this culture where we're surrounded by LED lights. Is that, is there a truth there? I won an award for a study I did when I was at NYU that actually showed that the light coming out of our screens, iPads, computer screens, desktops, laptops, these lights can actually pigment your skin. And that wasn't recognized before. Yeah. So these lights, particularly fluorescent, but even LED incandescent. Even incandescent. Oh, 100%. Okay. Can pigment your skin. And it's actually a

a hidden culprit of why women's malasma tends to flare or be persistently a problem despite people saying, I'm never outside or as soon as I go outside, I wear a broad-brimmed hat. We know visible light, indoor artificial visible light, and even sun visible light, makes pigmentary change worse. Why that's also important is that we know that chemical sunscreens do a poor job at blocking visible light's effect on the skin. You actually, you need mineral and sometimes mineral with added iron oxides, usually the tinted format, they do a better job at blocking visible light.

And that's actually where this product comes into play. Polypodium, which is that fern we talked about, does a really good job at decreasing pigmentary change from visible light. And that's been published in the medical literature. On the camp of the, you got to wear sunscreen all the time, my asterisk to that is the majority of the sunscreens don't do a great job at blocking visible light. You should do something, especially if you have a lot of pigmentary change, or especially if you're worried about aging, which goes back to the topic of light and aging

versus light in cancer. But there are better ways than the majority of sunscreens. So something to keep in mind. The sun is like the fuel for like our mitochondria, right? There's so many, beneficial aspects about it. And if we can be smart about it and also too, we live in a world of aesthetics, even if people are not necessarily being judged in their career by their face. A lot of people feel like there is very important for them to look and hopefully feel that's the most important thing. Youthful. So a lot of our audience is on the side of like, hey, listen, I want healthy medicine. I know it's protective. I know it's important to my mitochondria. I know it's important to so many other aspects of reducing all cause mortality that's there. And I want to be

smart, diet, nutrients. Now you got me, you know, thinking I need to go and book an appointment and get an HPV vaccine, right? I don't want, you know, cancer. And the right target is, I also want to look good. Yeah. Sunpowder, right, targeted nutrients that are there, being smart about these things. I have a mineral sunscreen on right now. You know, the days that I record with all these LED lights, I'm very well aware. And then, because I often feel a little bit tired after like recording, you know, being in a closed room, probably high carbon dioxide levels and then all these LED lights, I go out in the sun and I feel great. You feel great. I feel great. Totally. But where I was going is that in addition to all those things,

you also, because you take care of people who want their skin to look great. Yeah. You also talk about the benefits of how a simple protocol, simple skin care protocol can be very, very powerful. We touched on this a little bit last time, but I want to go a little bit deeper. Yeah, let's do it. I want to start off with something that we didn't talk about last time. Let's do it. Okay? We didn't talk about retinal and how you say that retinol is so powerful in helping our skin look and feel and actually be more youthful over time and protect our skin.

That it's so powerful that you jokingly said it should be in the water. Yes. Tell us why. Yeah, we didn't do much discussion last time. We had so much to unpack in the last episode that we didn't get a chance to dive into the whole aesthetics. in appearance realm of dermatology. We talked about lasers, which was nice. That was cool.

I love retinoids. And there's a difference between retinodes and retinol, which we'll go into. But I think if I were to pick one holy grail product thing, medicine that I would pick in dermatology, it would be a topical retinoid. Okay. And for those that don't know, break it down. What is it? Retnoids are a family of medicines. they come in oral and cream or topical form, gel, what have you,

that are derived from vitamin A. They are a derivative of vitamin A, and I want to emphasize this because I see a lot of knuckleheads online saying you can eat your retinoid, which you cannot, and if you eat too much vitamin A, it can affect your brain and liver, and I've seen this happen to patients. So it is not vitamin A. It is a derivative of vitamin A.

and retinoids work on the skin, they increase your skin turnover. So instead of taking 28 days for you to have new skin, it takes about seven to 10 days for you to get new skin. So it increases cell turnover. In doing that, it also allows you to grow new collagen and elastin. It's the only medicine that we have in all of medicine that can grow new collagen and elastin. This has been verified for 50 years and multiple.

studies. So it's the only truly anti-aging medicine we have. The third thing that it helps do is it helps shrink or decrease pylosebaceous units of our skin, which are the pores, oil glands, and oil-bearing hair follicles. So it actually dries your skin out or helps reduce the size of the appearance of your pores. Why this is relevant and what are the most common medicines? Isotrachinone is the pill version of this and there's a few other variants. Isotretanone is known by the brand name Accutane. A lot of discussion about Accutane. I think 99% of what's written online is rage clickbait.

I love Accutane. I've given it in my practice to thousands of patients and have excellent results. Accutane is an oral retinoid that we use primarily to treat acne and acne-related diseases. It is also our only cure to acne. Everything else we do for acne is a temporizing measure until your body grows. out of it. And I don't think people recognize that. And we don't have to get into it, but the concern was some connection to depression or suicidal ideation? There's a lot of discussion about that. That, it can be taxing on the liver, so we have to monitor that. It's a powerful drug. The connection with

mental health, depression, suicidality has a lot of asteris to that. The original premise came from congressman's child who had severe cystic acne, who had underlying depression, who started acutane and committed suicide shortly thereafter. And there was a big lobby saying it was the medicine that caused the suicidality. When we look back and look back at signals and what have you, the signals were all there from the get-go, but it got that stamp, et cetera. I've given it to many of patients who have underlying depression, anxiety, and they've done well. You just have to monitor. Yeah, I have a few friends who, honestly, even with all the knowledge that they had, all the things they tried in the wellness space,

they still were dealing with acne, ended up trying acutane, just gone, and then they were able to get off of it. Yeah, you're not supposed to be on it for life. It's a period of time you cure your acne. It's also the only medicine that will improve acne scars, improve traumatic scars, improve the appearance of your skin. So it's a great drug, but it's a big drug,

so it has things you've got to watch out. Yeah, you have to monitor. Then there's topical retinoids. The most common names are tretinoin or adapylene. There's also tazerotene, which is less commonly known, but those are the three big prescription retinodes. Now, these drugs are prescriptions because, namely for the fact that they can affect a developing fetus in utero. The creams theoretically don't penetrate the skin, but there is some suggestion that if you put on too much, it'll absorb so you can get the same consequences. But definitely the pill can affect the fetus.

and affect meaning like significant birth defect while you are on it. That is why these are prescription. Well, when we saw the benefits of the skin, cosmaceutical industry said, shit, we need to get this over the counter. I need to sell a hell of a lot of this. How do we work around the fact that it's a prescription? How do we work around the fact that this birth defect thing is an issue?

Out came retinoles with an O. Retinoles are actually inactive forms of retinoid drugs. So everything that you see at Nordstrom, Sephora, what have you, wherever you buy your skin care, if it has retinol in it, it is an inactive pro drug that requires your body, your skin, to have a certain amount of an enzyme to convert it into an active retinoid. That's how Cosmastew companies can get it over the counter. It's not to say that it's ineffective, it's less effective, and it's also variable as to who will respond or convert the retinal into retinoid. It's an extra step.

It's an extra step and an unpredictable step and it's obviously less powered than the prescription. If there is one category of drugs or medicines or creams that I would pick for my skin health, it would be retinoids. You'd apply it at night. Yes. Let me give you a very simple protocol for skincare. And I'm a less is more type of guy. I think nobody needs to have a seven or eight or nine-step skincare routine, the less steps, the more likely you're going to be compliant and do it every day, the less likely you're going to have consequences with different chemicals interacting with your skin and having an undesired outcome or an allergy or a reaction. But in the morning, something that is non-negotiable for me is my sunpowder.

I take it every morning. You put in water, you add it to a smoothie. No, water. I like it a little concentrated. It's sweet for me when it's concentrated. I just drink in the morning, that's my morning thing. Yeah. In terms of topicals, I wash my face in the morning, simple wash.

And then if I'm going to be outside for a period of time that I know that is longer than my skin will turn red. Like if I'm not going to my clinic or the operating room that morning, I will put on a mineral sunscreen. Usually for me, it's somewhere where I need to be outside more than 45 minutes or an hour. And that for me is as much for anti-aging as it is for skin. cancer prevention. Some people, anybody who wears makeup, you would do your sunscreen and then your makeup. If you wanted icing on the cake, and I'll talk about why it's icing on the cake, you can consider a vitamin C serum. And I have a love-hate relationship with vitamin C, and I'll talk about that afterwards. So that morning should be simple. Evening, I washed my face, I put on a prescription

retinoid. That's it. Moisturizer, I tend to be on the oilier side, so I don't need to a moisturizer. Retinoids will inadvertently dry your skin. That's what they do. So if you are one that's noticing dryness from retinol or retinoids, then use a moisturizer. And you want to look for one that says non-comitogenic, meaning it's been tested not to clog your pores. That's it. I don't think there is a necessity to have multiple caustic agents, caustic meaning like burning. So a lot of people use acids, alpha hydroxy acids, beta hydroxy acids. Beta hydroxy acids. a retinoid, which inadvertently acts like a chemical peeling agent, vitamin C, which is acorbic acid,

and they come to the clinic with all these reactions, perioral dermatitis, rashes around their face. I'm like, hold on, you're like trying to peel the skin off your face. It's too much. The reason why I say asterisk to vitamin C. So morning you should have a wash and a sunscreen, fundamental minimum, and if you ask me, sunpowder in there. If you have your evening to be a wash and a retinoid and a moisturizer,

That's like you're building your cake. The retinoids work even with the moisturizer in the evening? Yeah. Okay. So the reason we pick retinoids in the evening, the quintessential retinoid, which is tretinoin, is photolabile, meaning if you get UV, it inactivates it.

So we use it in the evening so that you don't run that consequence. A dappoline, which is now over the counter called differing gel, is not photolabile. It's also a little less potent than tretnoan. But if you're using adapoline, you can use it in the morning. The reason we also do evening is a lot of acne treatments, a lot of acne topicals. We have patients do twice a day. The morning gets complicated when you add a retinoid in the morning.

Generally, it should be in the evening. Vitamin C is an excellent antioxidant that you can use to help reduce environmental pollutants damage, aging, et cetera. The reason why I think vitamin C I have a love-hate relationship with is one, it's expensive. Good vitamin C is expensive. It expires. It can go rancid pretty quickly. And number three, it is a under-recognized cause of perioral dermatitis and women.

So women who break out and rashes in this area, almost like little acne. If you're using vitamin C, it's often a culprit. And most of the time, you really don't need it unless you're, you know, you have a lot of sun damage. You're outdoors a lot. There's a lot of environmental hits coming to your skin. Then you can use it. But most people don't need it. Some people do.

I think it's been overutilized. or over-glorified. That's it, man. That's it. That's it. You stick to that consistently day in and day out, and I assure you your skin will look much better. It will be healthier. You will have a glow.

Now, one important thing with retinids, anybody who's of acne-prone age, the first month that you use a topical retinoid, your acne may come out. So something to keep in mind. And also, there's an acclamation period. Because it turns the skin over, it, you won't feel the effect until a week later.

So I say start slowly. You start with just a pea-sized amount once a week at night. Because you could see some peeling or things. Yeah. And you don't see it until a little bit later. So if you start right away every night, you're going to be like, I can tolerate it. I can tolerate it. Then a week and a half later, you're like, dude, I'm peeling. Like, when do I stop?

So once a week at night, then twice a week at night, then three. Goal is to get to nightly. Some people can tolerate it. Some people can't. I could probably use a retinoid three times a day. I'm so oily. my wife like maxes out at two times a week. Like you can fry a chicken cutlet on my forehead by the afternoon.

I max out my retinoid to dry my oil glands out. My wife like despite all her moisturization, like twice a week is what her skin can tolerate. So you've got to kind of see that. That's great. You know, the reason I really want to talk about that is that anytime you hear somebody with the experience that you have is like, look, this thing is so powerful.

If we're talking about being sun smart and also protecting our skin. Yeah. Which also means from the modern day world that we live in that, you know, we have some clearance of stuff that's there. Totally. The first podcast we had, we talked about lasers and microneedling, different types of micritorating.

Anybody who has questions about that, please tune in that podcast. That was great. We did a deep dive and I think from what I've seen from your content, all that stuff still holds true. And what's the stuff that you can do on a daily basis at home to make sure that that foundation is set? 100%. So that way we can enjoy the sun, get all the benefits that come along with it,

You know, have all the improvements and all cause mortality and all the incredible data that people talk about on this podcast that you talk about as well, too. And not having to feel like so depressed being inside or being so scared to walk out, which unfortunately you see a lot in LA. You see people in these beekeeper outfits. Yeah, they're like hands are covered. Their eyes are covered. Which to each their own.

Yeah. But, you know, you got to also know the science around it from somebody who knows the science and is a true skin cancer expert. I don't know if the people that I'm seeing outside have photosensitive dermatoses, you know, illnesses that, you know, by all means, like, please protect yourself if that's what you're dealing with. But if you're dealing with it because everybody told you the sun is going to kill you, it is not. Yeah. I love retinoids.

And to add on the retinoid part, they've also been shown to reduce your skin cancer risk. Oh, that's huge. And to reduce the sun damage, pigmentary change, sun spots, melasma. they, because they turn the skin over, they can kind of rectify some of the damage that we do every day. So if you miss a day of sunscreen, if you forget to reapply on a vacation, it's okay. If you're consistent with all the other things that'll keep your skin protected, particularly topical retinids, which I love, you have a defense mechanism against that. Like, there is, I'd be shocked to find a dermatologist that doesn't use a retinoid. I will be able to find dermatologists

who are completely sun avoidant. I will find dermatologists who are completely sun avoidant. I will find dermatologists who love the sun. I will find dermatologists who don't believe a laser. I had dermatologists who believe, but the retinoids are unifying. Every day down with the red noise. Yeah, because we've seen 50 years what it does for your skin. Dr. So, Molly, this has been fantastic. There's been such an incredible second foundation of information you've brought to the first podcast that we've had. And you've left our audience with so many important tools to improve their skin help today. And it means the world because it's not just about looking younger, which is also important. You know, I got into health and wellness

because I had really bad acne and I was trying to figure out what was going on. And that led me down this whole rabbit hole that was there. So nothing wrong with vanity. And also we want to be truly healthy as well too. You know, we want to avoid these cancers. We want to be smart about our modern life and the, you know, consequences that come with it. As we're winding down here, first, let's talk about how do people find you and sunpowder and the great stuff. And also you wrote a fantastic book, you and your team have put together a book called Skin Protocols. Let's mention that as well. It's an honor to be here. I love being on this podcast. I'm sorry I keep running over. I have so much to talk about it. I love what I do. The audience. Thanks for having me here.

I, you bring up something that I think is important. I think there's nothing wrong with the discussion of the intersection between health and aesthetics and wellness. I think if you feel good, you look good. If you look good, you feel good. So there's that myriad. And fortunately, my specialty allows me to explore all of those avenues. I have an active practice. I practice in Pasadena, California. I used to be a full-time professor here at UCLA. People can find me on my social media platform, which is just my name, last name, MD, Teo Soleimani, MD, if you have any questions. Sunpowder is an incredible supplement. There's nothing like it on the market. It's a, it's the first comprehensive supplement for skin health. If you think about other supplements that are encapsulating health or the gut or the little,

liver, this is the first of its kind for skin health. You can find out information about it on drink sunpowder.com. And in fact, I believe in it so much that we ran a multi-center preliminary clinical trial on human patients where we irradiated their skin before and after sunpowder with the equivalent of eight hours of mid-equitorial sun. Like, evidence is key for me. And we published that with the product. So it's not, I don't want to say snake oil, but there's so much data and all that data is published on our website if anybody's interested. This book we wrote, this is like my fundamental skin protocols for how I think about the sun, how I think about skin health, and how I think you can utilize basics to make your skin look better. It's free for everyone.

Anybody who's interested in the digital copy, just shoot us a message. You can message us on our drink sunpowder platform and we'll send you the link. That's our Instagram platform, drink sun powder. Everybody can have it. The more that people can learn about skin health from a basic standpoint, the better my job will be to fine tune it. So if I can provide help to anybody, please let me know. Well, you did it today on the podcast, and you're definitely doing it every day through the work that you do. So just so much appreciation for the knowledge you bring to the table.

And it's been fantastic to get to know you. Likewise, man. Yeah, absolutely. Happy to be here. Thank you for coming on the podcast. Please check out Sunpowder and we'll link to Skin Protocols in the show notes below. Dr. Solmani, thank you. again. Thanks, man.

Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it's the number one thing that you can do to support this podcast is share with a friend, share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter. And it's called try this. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover

everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole-body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-O-H-I-T dot com and click on the tab that says try this.