Her Discussions by Dr Faye - Healthy Skin 101: This Is What A Dermatologist Wants Every Woman To Know

Episode Date: May 18, 2026

This video is not an ad, but Doctor Lucy does partner with La Roche-Posay in her clinical project.In today’s episode, we’re joined by Dr Lucy Thomas, ConsultantDermatologist leading the way in innovation, supporting the advancement and implementation of world-first AI technology where she works at Chelsea and Westminster Hospital NHS FT. So far across the UK, this technology has already helped assess over 260,000 patients.We talk about what dermatologists wish people would stop doing when it comes to sun protection, the truth about whether SPF is actually toxic, and the simple habits every woman should be adding to her daily routine to support her skin as she ages.You’ll learn:🌞 a new take on the 2-finger SPF rule🔎 when you should actually get a mole checked🧴 how to choose the right SPF for your skin type🥪 the sandwich technique for starting retinol💭what nobody tells you about After SunResources & links mentioned:Dr Lucy Thomas - https://www.instagram.com/drlucythomas/Chelsea and Westminster Hospital NHS FT - https://www.instagram.com/chelwestft/Disclosures:Dr Lucy Thomas is a clinical advisor to Skin Analytics Ltd. She has previously worked as a paid independent consultant for NHS England and received grant funding for NHS projects from La Roche-Posay, NHSX, and CW+.In addition, she has received honoraria for educational talks and meetings from L’Oréal Dermatological Beauty, Eucerin, and UCB Pharma, as well as funding to attend conferences and dermatology meetings.During this podcast we will be discussing AI technology developed by Skin Analytics and its use in NHS settings. This project was in partnership with @larocheposay.Links to subscribe / follow:Apple Podcasts: ⁠https://podcasts.apple.com/gb/podcast/her-discussions-by-dr-faye/id1835829612⁠Spotify: ⁠https://open.spotify.com/show/5viLYizHD4Zy6J42iqtPRo⁠Can I ask you a BIG favour? 💙Please leave a review or rating. It helps us grow the podcast and bring you more amazing guests.Share with someone who needs this; it might help them live a happier, healthier life.Follow us on social media or join the broadcast channel to send us your questions for our guests. I'll leave the link here: ⁠https://www.instagram.com/channel/AbY4liwxlLnewx4H/?igsh=MWhuaXFweGtucTB3cA==⁠ ⁠https://www.instagram.com/channel/AbY4liwxlLnewx4H/?igsh=MWhuaXFweGtucTB3cA==⁠🛑 Disclaimers: Opinions are my own. This content is for educational / entertainment purposes and not medical or financial advice.

If you used a sunbird, you have a 20% increased chance of developing melanoma. Today's guest is a globally recognised skin expert, helping shape world-first AI technology for the diagnosis of skin cancer. Imagine yourself in 20, 30 years' time, which side of the face would you like to have? Dr. Lucy is a consultant dermatologist, so if you've ever worried about a mole, wondered whether your SBF routine is actually doing anything. This one's for you. The biggest alarm valve that you should go and get that checked out.

I've used sunbeds as well. Terrible. When it comes to skin care, having a much simpler routine, fewer items is going to give you far more consistent results than... But first, if you could do me a huge favour and click the subscribe button or leave a five-star review, it will literally take you two seconds and it really helps us keep bringing you guests to help you live a happier, healthier life. Thank you. Hi, I'm Dr Lucy and welcome to her discussions podcast. Dr Lucy, this is the episode that Faye, when she was 18, really, really, really needed. And I'm going to tell you a story that you may, if you feel the urge to reach across and slap me across the face, I'm not going to blame you. When I was 18, there was a sunbed shop around the back of my local shopping centre. And me and my friends, we'd just got our driver's licenses. So our parents would never find out almost every single day after school, we would go on the sunbeds.

And now, obviously, as a doctor, I'm like, Faye, why did you do that? So, but the reason I wanted to start off the episode with telling that story is there's a statistic that came up when I was researching the episode. And it was something like 40, 40 plus percent of 18 to 25 year olds use a sunbed. And I sometimes worry that conversations around SPF, skin cancer, mole prevention can feel a little bit preachy. So I want it to start off the episode by saying, guys, if you're using a sunbed right now, I've been there and it was a silly decision, but it doesn't mean that we can't welcome you on to the side of SBFs. Please, if you want to tell me off, you're allowed to tell me off. Absolutely not. You know, I've used sunbeds as well. Terrible. I used them when I was in my early 20s. It was just the thing that people did. I don't think we had the same awareness that we do now. It feels like the risk is a long.

way off at the time if you are even aware of it. And I think the important thing now is to encourage younger generations to not make those mistakes again. So I think that statistic of 46% is shocking. It really worries me. I can't believe that we still have sunbed shops on our high streets. in Australia they banned commercial sunbeds in 2016 and we now know that they are hugely damaging for the skin both in terms of skin cancer risk but also in terms of skin ageing and here we are spending you know thousands of pounds on things to make our skin look brighter, shinier, smoother

and yet people are still going out using sunbeds it feels crazy So somewhere in there there's a message for people to hopefully understand why it's so important to look after your skin, protect it from the sun, not use sunbeds, but don't beat yourself up about it. You know, what's happened happened. And we'll hopefully have some tips today about what you can do to try and negate some of that risk. Yeah, we've had so many questions about how to use SBF daily, not knowing how to do it using makeup, over makeup, mole anxiety. to get checked. Also some really interesting questions about AI and actually the fear that AI may replace doctors. So we'll be able to come on to the incredible project that you're working on, which is very exciting. But first, I love to start off the podcast, especially when I'm talking to a woman

in STEM. What is the origin story of how did you become Dr. Lucy Dermatologist? So right from an early age, I don't know. I just knew that I wanted to become a doctor. I think it was something about being able to make people better. I wasn't actually really great at science subjects, but I did them because I knew that was the route to doing medicine. And then I did my A-levels and I missed my grades and I didn't get my place at med school and I was devastated. And I ended up studying pharmacy in Cardiff and I had the most amazing time. I absolutely loved the degree. It was fascinating. I learned so many skills that I even use every day now as part. part of my medical work. But when I started work as a pharmacist, actually at Chelsea and Westminster,

where I am now, it just didn't feel quite right. And I had to just scratch that medicine itch. And so I went and did a fast track medical degree up in Birmingham. It was a pretty intense few years. But as part of that, as you'll know, you get to rotate around and do lots of different specialties. And when I had the opportunity to do dermatology, I just knew immediately that I'd found my home. This was my calling. I absolutely love dermatology. It's a fascinating subject. It has huge variety. There are over 3,000 skin conditions. We're all very proud as dermatologists to say that. But we also get the chance to look after adults and kids. We get to prescribe amazing medicines, but we also get to do surgery and procedures. But I think what's most important to me as to why I love

Dermatology is the visible nature of skin disease. You know that it's hugely stigmatizing for people. It can have a massive effect on their quality of life. It affects things like being able to form relationships, even succeed in the workplace. It influences what clothes people wear, how they style their hair, and of course, how they feel about themselves. And so if you have the privilege of being able to treat patients, and then you and that patient can see their skin visibly improving in front of your eyes, it is hugely rewarding and it has so many positive outcomes in terms of their whole sort of quality of life. So it's a fabulous specialty and I would encourage anyone to get into it if they were thinking about it. It's so wonderful because I've struggled with my skin.

I had really quite bad hormonal acne a couple of years ago and I remember like not missing days of uni because on days where I'd wake up when my skin was just so unbelievably painful but also I I felt so insecure that it affected my mood so much that I, you know, I've missed, missed days of uni. It's debilitated and often minimised to just purely aesthetics. Yeah. Yeah. When, yeah, it's so, so, so impactful. But AI is quite a new concept in general. When did that become an area of interest for you? So I've always been interested in innovation. I hate to see things that don't work well, they're not slick or they don't run as well as they could do. And at Chelsea and Westminster, we pioneered the first teledermatology service for urgent skin cancer referrals in the UK.

And pretty much as soon as we'd set that service up, we started hearing rumors about AI. And I was thinking, this could work really well in skin disease and particularly for skin lesions. And so that's when I started my work with a company called Skin Analytics, and they have then produced this device, which we will probably go on to talk about in a bit more detail, but is now being used across the UK in a number of NHS hospitals to help triage urgent cancer referrals from GPs. One of the most, like the number one question I get from my friends,

you start your first year at medical school, and suddenly it's can you look at my mole? And my response is always exactly the same every single time go and see your GP. But because what am I going to do from the other end of a blurry WhatsApp picture, you know? So I'm going to show you a piece of paper. And I would love to know whether you would buy this product or whether you would say bye-bye to this product. Daily SPF. A hundred percent yes.

Not surprisingly. There is so much evidence now that protecting your skin has multiple benefits. so importantly reducing your risk of developing skin cancer, but also protecting you against sunburn and also the aging sort of process that we are now so sort of tied into and trying to fight on a daily basis. I think when it comes to SPF, there's lots of things that people don't necessarily do too well. And there's a bit of a debate about whether you should do it all year round or just through the summer. Typically, it's essential between sort of the months of around March to October time. And in particular, if the UV index is three or more.

And it's really helpful that actually on your weather app on the phone, it actually shows you the UV index so you can see. But I think the important thing is that actually trying to form habits is difficult. And so if we just do something part of the year, it can be difficult to get back into the routine of remembering to do it. You should definitely do it all year round if you're worried about hyperpigmentation, if you're at higher risk of skin cancer, or if maybe you spend a lot of time outdoors or particularly travelling, then those would be reasons to definitely use it all year round. But I think sometimes it is just easier to keep things simple. Now, I know a lot of the listeners will be thinking I have not been able to find an SPF that works for me. They're all too greasy. They break me out.

they don't blend properly. What would be your top recommendations for finding an SBF? Make sure that you find a product that you really like. I typically like to use the La Roche-Ferset, the Anthelios range. It's a really, really popular product. Loads of my patients use it. I get really positive feedback. It's really light and it soaks into the skin really quickly,

which are things that I find help to improve compliance. But there's also, I think, with a product like this, It's really helpful because it shows some certain things that you can look for when you're wanting to try and find a high quality sunscreen. So if you think about the UV rays that we get through the atmosphere that reach the Earth's surface, it's mainly UVA and UVB rays. And so UVA rays, about 95% of the rays that come through. And they tend to penetrate deeper down into the skin and they can pass through clouds and glass. and those are the rays that typically are associated with skin aging. And so if you're looking for your UVA protection, there's a little sign on here.

So it's got UVA written in capital letters with a circle around the edge. And so if you see that, you know that there's good UVA protection. And other brands will use a star rating and you want to be looking for five star UVA protection. And then you've got your UVB rays. So these are the ones we're probably more familiar with. A lot of them get filtered out in the atmosphere, but those that do get through can penetrate into the upper layers of the skin. So they typically cause more of your sunburn type reactions. And so the rating that you want to be looking at for that is your SPF, your sun protection factor.

And so we know that different people will take different amounts of time to burn depending on how pigmented their skin is, the racial background, and the sort of intensity of sun that they might be exposed to. but the SPF is sort of the amount of time that you can spend out in the sun in addition to your normal burn time. So if, for example, you'd normally burn after 10 minutes in the sun and you put an SPF 15 on, then you could stay out 15 times that 10 minutes, so 150 minutes in total, before you would get that same burn. But it is reliant on you using the right amount of sun cream in order to get that protective effect. There's a couple of other things that are quite helpful to look at on the bottle. So you want to make sure that it's in date.

A really big mistake is, you know, seeing that maybe it's out of date. They sometimes smell a bit funny as well when you put them on. So that can be a bit of a telltale sign, but they should all have an expiry date on. And also they'll have a little sign. So there's a little pot here that's got 12M in. And that means that once it's been opened, you have to get rid of it after 12 months. So it's no longer as effective after 12 months of being open. And they can break down more quickly if they're kept in warm places.

So if you leave it in the glove box of the car or something like that, then you do have to be extra careful. Lots of information on here that you might not necessarily otherwise think to look at, but really helpful when you're trying to choose a good quality sunscreen. A common complaint is it doesn't go well in Jamaica or it makes me break out. What advice do you have for people who they just can't find that SBF that works for Yeah, so we all have different skin types. And fortunately now we've got an increasing range of sunscreen options. So for somebody who's got slightly more oily skin, you want more of a fluid.

So something like this sort of product or something that says it's for oil control or non-comedogenic. Those sorts of things can be really helpful for more oily skin. If you've got drier skin, you might want to go for a more cream type version. So the Anthelios ones comes in a tube. So it looks quite different, but it's slightly thicker, it's more hydrating, so it can be a bit more nourishing for the skin. If you've got more sensitive skin, then obviously looking for sort of more fragrance-free products is helpful as well. Trying it and seeing what it feels like, I think under your makeup is really important and also thinking about how you top up afterwards as well. This is an extremely important conversation at the moment. There's been a huge rise in social

media posts talking about how SBFs are toxic. Have you seen any of these videos yourself? Because I certainly didn't. It was one of my friends who came to me and she said, you know, well, SBF causes, you know, all sorts of diseases. What would you say to people who see that content? I think it's really worrying that this content is out there. I think you need to be looking at, you know, where that information is coming from, where the evidence is. As far as I'm aware, there's no evidence that the compounds that are used in current sunscreens available from reputable brands in the UK have any link to cancer or other diseases. This is an area that is very tightly regulated. In the past, chemicals and things have been removed, you know,

from all sorts of products if they're found to be harmful. And they go through really quite rigorous testing these days to make sure that they are safe to use on the skin. So, With the evidence that we have, I think it's, you know, there's no, there's no suggestion that there are harmful effects. And I would really urge people to not engage with that kind of content. The other thing on SPF, what would you say to people who say, I need the sun for my vitamin D? Great question. So the sunlight is important for us to help us synthesise, make vitamin D, which is important for our general health. But you don't. need to have that sun exposure without any protection on your skin. So you'll still be getting

sun exposure through sunscreen and evidence shows that you should get enough, particularly in this summer months, in order to be able to do that. A lot of people in the UK might be deficient in vitamin D during the winter, especially office-based jobs, etc. There are also supplements available that you can, you know, take over the counter to help top that up. But there's certainly not a reason to be going out in the sun without protection. Tinsidastbe, I love it. It's a great product. I think it can really help with compliance.

So getting people to incorporate a good quality sunscreen into their skincare routine. It can act like a light foundation or a BB cream, so it can reduce redness. It can sort of even out imperfections on the skin, like you would expect with some kind of cover-up or makeup. you get that added really high quality sun protection, particularly if you look at brands where you've got that broad coverage. So looking at that UVA, UVB. Tinted versions of a lot of sunscreens

will also help protect against visible light as well. And we're starting to understand that that's more of an issue in certain skin diseases and certainly in pigmentary disorders. So things like post acne marks and melasma. So tinted versions of sunscreens can be really helpful. And also if you're using a mineral type of sunscreen. So sunscreens come in two forms. They can be chemical or mineral. Mineral sunscreens typically contain titanium dioxide or zinc oxide. They tend to be a bit thicker. Overall, they have fewer ingredients, so they can be better for people with more sensitive skin. There's fewer things for your skin to react to. But because of those ingredients that they contain, they can leave a bit of a white cast on the skin. And so if you have a tinted version of that, it's much more cosmetically acceptable,

you get a much better result. Nice. After send. Interesting. I used a lot of this as a child, which was slightly worrying now that I look back on it. You shouldn't need after sun, because if you've protected your skin properly, then you shouldn't be needing to apply anything to cool or soothe the skin. And so my problem with after sun is that it's almost encouraging as unsafe sun practices.

And by buying it, you're almost giving yourself permission to go and expect to maybe burn a little bit or overdo it in the sunshine. We know that sunburn happens because of UVB rays, as we've talked about, penetrating the upper layers of the skin. And it leads to redness and swelling, pain, itch. And in severe forms, you can get blistering and even feel quite unwell with sort of chills and shivers. And so if that does happen, then a lot of the treatments that are around are there to actually just relieve symptoms. So they're not actually going to change the overall severity of the sunburn or shorten its duration. And so often it's things like taking painkillers, having cool baths, and potentially using soothing moisturizers and lotions. And often a lot of the aftersons will contain some of those sort of more cooling, soothing ingredients like aloevira and menthol.

They can feel nice and cooling, especially if you keep them in the fridge. It can feel nice on the skin. But they're not ultimately going to change that sort of sunburn process. And sunburn typically starts around two to four hours after that sun exposure. It peaks around 12 to 24 hours and then you start to get that horrible peeling around four to seven days afterwards. It's interesting though, though. There are some actual treatments which have been shown to help sunburn. So things like taking aspirin has actually been helpful, which I think is fascinating.

Using topical steroid creams on the skin, provided there's no infection there, can really calm inflammation. And there was a study relatively recently that showed taking a dose of really high vitamin D, so around 100,000 units, so really high, just as a one-off dose within sort of as soon after the sunburn as it's happened, can really reduce the severity, which I think is fascinating. We don't properly understand all of the effects behind that, but really interesting, but not a reason to put yourself into that position. There's also an oral supplement, which is called Polypodium leukatomas. Have you heard of it? No, I have not. Okay, so it comes from a tropical fern that grows in Central and South America. And it's got antioxidant and sun protective effects. And so it's actually marketed. It's available in the UK.

and you can take it regularly and it will also help to protect your skin from sunburn. But obviously combined with the SPF, the hats, the glasses, etc. It can have benefits in that area and it can also be beneficial for some skin diseases. So things like Vitiligo, if it's used in combination with light therapy when people are undergoing that sort of treatment and maybe even for conditions like melasma, if people are also using SPF. Wow. I didn't know any of that. That's really, really interesting. On the topic of Aftercent, I can just hear my mum's voice when I was a kid, you know, saying, oh, well, your burn will turn to tan. Oh, full advice. I think so many people will remember that as well from their childhoods.

It's really scary. And the sorts of sun creams that we used as well, you know, start with factor 15 and maybe beyond two by the end of the holiday. in some kind of coconut smelling oil. It's, yeah, it's pretty, it's pretty shocking. Yeah, to thank God's times are changing. Mole mapping, this is a personal, personal one for me. I would like to also, all my friends who ask me about their moles, mole mapping. Skin monitoring, yes, okay.

But not everyone needs mole mapping. Okay, so mole mapping is where you use sequential photography to track skin lesions and moles and look for change. It's generally needed for people who are at higher risk of skin cancers or have lots of moles to keep an eye on so it can be quite tricky. The process of mole mapping isn't just going and having some photos taken and then going home and then pitching up a year later and seeing if anything's changed.

Done properly, it involves going to see a dermatologist, then taking a full history, assessing your risk factors for skin cancer, asking about any moles or lesions that you're particularly worried about, and then doing a full head-toe skin examination. And as part of that, we use one of these devices here. So this is called a Dermatoscope. It has a light, and it's a magnifying lens, and you place it directly onto the skin over any moles that you want to see in a bit more detail.

And it provides this really high-quality magnifying. view so that you can then, it improves our diagnostic yield. So it helps to give us more information about the lesion that we're looking at and the risk of that being something that needs to, there needs to be something done about. And so we'll do an examination using one of these. And then we will highlight any moles that we're potentially worried about. The patient goes and has full body mapping photos, so get to stand in lots of funny poses to expose all the different areas of the skin and then close up images are taken of any moles that have been flagged as being more worrying. And then the patient comes back at intervals and has those checks. So it's a bit of a

baseline. It's interesting because it doesn't always pick up every single mole. So, you know, there are hidden sites like on the scalp, on the genital area, etc., where you might not catch a mole. Some features of skin cancer can be really quite subtle early on. And so it might not be picked up with mole mapping. Some cancers can be really aggressive. And so in that time between appointments, you can develop a cancer and it can spread quite rapidly. And it's not been picked up. It may encourage a bit of complacency because people just rely on going for that check and not on monitoring their own skin. And so that's why I say it's really important to get to know your skin, to know what moles and things you've got. It can be helpful for you to take your own photos.

so that you can track changes. And obviously it's helpful, particularly for areas like the back where it's difficult to view and you might need somebody to help you check. But essentially, you're then just spotting the difference. So you're trying to see, is there anything new that suddenly appeared or is there something there that's changed? Does it change shape, size, colour, etc? And so I would encourage people to do that every three to four months. And then if they pick up a concern, go and get it checked out because that way you're much more likely to pick out something early before it has devastating consequences. I've got three moles in almost like a perfect straight line along my back, which are a nightmare to keep an eye on. It's really tricky. So two

questions. First one is how would someone know if they should be possibly going down the route of getting their moles mapped? So there are different rules about mole mapping in different countries and mole mapping is not available everywhere in the NHS. It tends to be reserved more for people who've either had two melanomas or more in the past, if there's a very strong family history of melanoma or pancreatic cancer. If they have more than 50 moles or more than five, what we call atypical moles, so moles that don't look quite right, but aren't necessarily cancerous, those would be the main sorts of criteria. Often if people are immunosuppressed, they may have more skin lesions and that can sometimes be really helpful for helping to monitor their

skin. There are lots of services available privately, but they vary hugely in terms of who's delivering that service, what their qualifications are, how much experience they have, and also the sort of technology that's being used. And it can be really difficult as a consumer or as a patient to try and navigate that and really understand what are they offering, what does it entail, what's the evidence behind it. Are they using technology? What's the regulation behind that technology? So it can be quite difficult to navigate your way through that, but it is a service that's available. The second question I had, you mentioned if a mole starts looking a little bit different or funny. Are there any other pointers you'd give for anyone monitoring their own moles and knowing when to go see

their doctor? Yeah, this is really important. So this is something that you can go and tell your friends and pass on because it's one of those things that I think the more people that know the better. So firstly, any new or changing skin lesion is something that you should be keeping an eye on. It can be normal to have new moles up to the age of 40. So just because you get a new mole, it doesn't mean that it's immediately cancerous. And there are lots of pigmented things that we get on the skin, which don't have any cancer risk at all. So it can be a bit tricky.

But we tend to use the ABCDE approach. when we're thinking about assessing our skin lesions. So A is for asymmetry. So does one side of the lesion look the same as the other? If it does, that's great. B is for border. So does the edge of the lesion, is it nice and smooth and round? Or does it have sort of jagged edges or angulated edges?

C is for colour. So is it one nice, smooth colour? Or does it have lots of different colours within it? Or is the colour changing, getting darker or getting lighter? that can both be signs to watch out for. D is diameter. So is it greater than 6 millimeters or is it growing? And E, is it evolving?

Is it changing? And finally, my biggest tip is the ugly duckling sign. So does it look like any other lesion that you have on your body? If it does, if it's got a friend, that can be quite reassuring. If it's standing out as being really different, that is the biggest alarm valve that you go and get that checked out because that I think is one of the most helpful things to pass on and that is easiest to be objective about and think actually, yeah, I need to do something about this. That's really helpful. And yeah, if that is assigned, send the episode to anyone to a loved one.

Make sure that everyone knows those signs. Then, yeah, do that now. Retinal. Bye. Definitely. Definitely. Again, lots of evidence for this. So the retinol products are part of the vitamin A family. They are used on prescription to treat conditions like acne, but they've been shown to have massive anti-aging benefits as well if used consistently over periods of time. There are over-the-counter versions that you can use. There are also prescription strength versions. So generally we say to use retinal products at night time because they can cause

your skin to be a bit more sensitive to the sunshine. So they work by increasing collagen production, but they also increase cell turnover. And so you get shedding of that outermost layer of the skin. So the upper layer of the skin is thinner. And so it means you're more susceptible to sunburn. And so that increased sun sensitivity means obviously it's better to use it at nighttime. And you absolutely must, must, must use a good broad spectrum as sun cream in the morning. They can also be inactivated by sunlight. So if you put them on in the morning, they just get broken down. So you don't see the benefits of them. They can be a little bit irritant. So generally it would avoid them if you've got quite sensitive skin, exma, certain types of rosacea, perioral dermatitis. You have to be much

more careful about using retinal type products in those scenarios. But if not, generally start with quite a low strength, build it in gradually. So start maybe two nights a week for a few weeks, then build it up to every other night and then if you're still tolerating it okay then every night. Use about a pea-sized amount for the face. Spare that delicate eye area and around the lips because that can be a common area to get rashes and sensitivities. And it can be normal to get a bit of skin shedding in the first few weeks of treatment. But if you feel like your skin is tight or sore or raw when you go to put the retinol at night time, that's a sign you should definitely take a day or two off. If you are strolling,

to introduce it can be quite helpful to use the sandwich technique. I'm sure we've probably heard about it before, but just put a thin layer of moisturiser on underneath, then apply the retinol and then apply a thicker moisturiser afterwards. And that can really help improve tolerability. I recently had to stop using my retinal. I've used retinal for like four years. And then I went away for three weeks and I wasn't using it for three weeks. And then I came back and I think it was a lot of long haul flights as well. So my skin was just probably quite dry. And I came back. And I came back, I used my retinal. For weeks afterwards, I was just getting the crustiest nose, crusty eyes, crusty mouth, everything. And I was in complete denial. Retinal until I went for a facial

and my facialist was like, you need to stop. You need to stop and put the retinal down. And I think because retinol has just been drilled into us as this incredible product, I was completely refusing. Anyway, so I cut it out for a little bit and then now I've been introducing it back in. But with sandwich with a good old layer of sycamplast. The building it up thing, I think, on social media when it's really pushed as this hero product, you don't necessarily always hear about the bad reactions. Slow and steady definitely wins the race when it comes to retinoids and other sort of slightly more abrasive treatments. I think it's quite interesting as well because people get quite nervous about using retinoids in the summer because of the sort of the sun sensitivity. But actually,

most people tolerate it much better during the summer months. And actually it's the winter when sometimes you do have to step down because it's cold, it's dry, the skin dries out. You often have sort of dry cracked lips, etc. So it can be actually that's the time also to sometimes step back, maybe not use it quite so often. I think we all love to have a routine and we don't like to deviate from it. But it's really important that you just get into that habit of just feeling,

how does my skin feel tonight? Okay, yeah, it feels good. I'm okay to put my retinoid on or actually it's a bit tight, it's a bit sore, it was a bit stingy this morning, I'm just going to take a day or two off and actually just let the skin settle down and your skin looks so much better for it. The listening to your skin thing, that is an extremely important lesson. I learned way too late. I don't know if you remember there was a trend a couple of years ago with a red acid. It was a red serum. It looked like a vampire serum and it was an AHA or a BHA. And I got that when I was going through like a really

period of acne, you know, my skin was like crying out for, for help. It was just constantly read, constantly painful. Me finds this AHA, BHA extremely abrasive, peel, peeling product. And I just refused to listen to my skin. I was applying this, leaving it on, you know, feeling my skin burning and still reading the back of the label saying, well, leave it on for 10 minutes so I'm in actual pain still leaving it on for 10 minutes and yeah it's it's it's awful isn't it how we've been taught to ignore our skin yeah absolutely last but not least oh sunbeds back to sunbeds again sunbeds bye or bye bye no question bye bye I think that's we can leave that one there absolutely bye Bye. I'm going to come on to some community questions, but first, I would love to talk to you about the Chelsea and Westminster project that you're working on. Could you tell me a little bit about that?

Yeah, so we've got a really exciting and unique partnership with La Roche Posse, who have been supporting us with our education and research to build on a lot of the innovative work that we've been doing over the last 10 years to increase access to skin health for patients. And the idea behind this partnership, which is just, really so unique and special is that we want to bring together the sort of clinical expertise, the patient access and the trusted sort of voice of the NHS with the resources, know-how and global reach of La Roche per se. And by doing that, we want to generate novel, important evidence. We want to be able to educate at scale. We want to raise awareness and we want to really bring about tangible change on the front line for patients and clinicians so that we can really increase access to dermatology care and we can improve outcomes for patients. Could you tell me a little bit about the AI technology that you're working with? Yeah. So actually a lot of this partnership is

building on the work that we've been doing to incorporate artificial intelligence as a medical device into our urgent cancer pathway. You may know that urgent cancer referrals have tripled in the last 10 years or so. And dermatology sees the most urgent cancer referrals of any specialty. So it's a really big volume. At the same time, we've got a shortage of dermatologists. And so in order to try and keep pace with that demand, we've been deploying this artificial intelligence technology to help us triage these urgent skin cancer referrals. And the device that we're using is called Derm, which stands for deep ensemble for the recognition of malignancy. and it's made by a company called Skin Analytics.

And so what happens is if a patient is worried about a mole or a lesion on their skin, they'll see their GP as usual. And if the GP's concerned, they will refer them into the hospital in the usual way on an urgent suspected skin cancer pathway. And then before the patient actually comes for their appointment, they'll receive a text message. And in that, there'll be a link to the Skin Analytics platform where they can access information about the service,

but they can also fill in information about what their concerns are, what their risk factors for skin cancer are, so we can collect together really important information when we then go on to assess them. And then rather than attend an appointment in a clinic with a dermatologist, they'll come in and attend a photography hub, which is run by our medical photographers. And they will take photos, I've got here, using a smartphone with this special dermoscopic lens attachment and that's just placed lightly on the skin and photos are captured and then the AI will actually assess that close up magnified image and it will deliver a diagnosis and a management plan within seconds. So it's hugely impressive. If it determines that the lesion is harmless,

benign, then the patient is actually discharged back to their GP with self-monitoring and sun protection advice, but no clinician reviews that case. If Durham determines the lesion to be high risk, so potentially cancerous, then it will be referred on to one of me or my team. We will look at that case remotely. So we'll review the information that's been provided by the patient along with all the images, and then we'll decide what the likely diagnosis is and what management plans needed. So at that point, we could still say, actually, this can be discharged or this is the treatment that the GP can provide. Or we might book them straight for surgery to have the lesion removed so that we can

analyse it or we might book them an appointment to see them in the clinic. I think a lot of listeners will hear the word AI and doctors in the same sentence and feel a little bit uneasy. What can you say to anyone who is a little bit worried? Yeah, I think it's completely understandable. You know, the speed with which AI has changed over the last few years has been incredible. and probably quite rightly a lot of AI is under quite intense scrutiny at the moment, and I think that's really important. But the device that we're using is actually a medical device. So it has the highest regulatory clearance.

So it has a class three CE marking. So that's similar to the regulations approval for like a pacemaker or an insulin pump. So it's been through really very rigorous testing. In addition to that, we have. used it in the first instance, we had dermatologists actually reviewing every single case that the AI reviewed. And it has been built specifically with this task in mind. So over 260,000 patients in the UK have actually been down this AI pathway and at about 25 different sites around the UK, which is incredible. And they're all NHS patients as well, which means that it's applicable to most of the populations that we serve in the UK. We found that since we've deployed the technology, we've seen around 6,000 patients at our trust with it working

autonomously, so without a clinician in the loop. And as a result of that, the AI has been able to discharge a quarter of those patients. And also when a dermatologist goes on to review a case, it means that it takes probably less than half the time that it would have a conventional face-to-face appointment. And it also means that we're able to get outcomes to patients earlier. So relieving anxiety for those patients that are sat waiting on these urgent cancer pathways, which is really important. We've also seen that it's reduced the number of operations that we do.

That's really important. And combined together, we see the capacity generated as around 63% from a clinician perspective. And so that's 63% extra clinician time that can be then diverted to those people who are more likely to have skin cancer, but also those patients who will, we're sat on routine pathways, often with complex debilitating skin diseases like acne, eczema, psoriasis. And so we can get to see them sooner. We can start really effective treatments and we can really start to improve outcomes for all of our patients across the board.

That's an incredible, having worked in the NHS and realizing that there's only so many of you and there always just seems to be too many people. So it's an extremely valuable tool in your toolbox. Moving on to some community questions. we have got a question saying reapplying SBF feels almost impossible when you've got a full face of makeup on. Is it something we really need to be doing? It is important, but particularly if you are outside and it's peak of the day, it's middle of summer. Reapplication is really important. Also, if you're doing sports, you're sweating or you're swimming, that sort of thing, really important to reapply sunscreen. The advice is every two hours.

I think that's probably quite ambitious. But, you know, if you can reapply in the middle of the day, then that really can make a big difference, particularly if you're using one of those broad spectrum sunscreens. I think the most important thing, though, when it comes to sort of, you know, applying over makeup, etc., is the importance of having that really good base layer. So making sure that you're using enough first thing in the morning

when you go and put it on as part of your skincare routine. So we typically say a good half to full teaspoon of sunscreen for the face neck ears. I like to do sort of two long fingers across my hand and then another short one. And I'll put the first finger on first, let it soak in so it doesn't feel too thick and greasy. And then do the second one over the top. And then I use the final one for the backs of my hands, which is a really common area that people miss. So that's quite a helpful tip because it's also an area that's really susceptible to skin aging as well. So getting that initial application right is really important.

Then thinking about using maybe tinted sunscreens and then they're easier to top up rather than instead of makeup. So if that's an option for you, that can be really helpful. Also simplifies things. So it makes that skincare routine a little bit easier. But if you are wearing makeup and then you want to apply later in the day, then if you actually rub the sunscreen sort of into your tips of your fingers and your hands, and then actually just sort of pat it around the face, rather than rubbing and let it just soak into the skin slowly.

You won't disrupt the makeup underneath so much, and so you can often achieve a much better result. There are some top-up products as well that you can use, so there's various sprays, compacts and things that you can sort of dab over the top. They won't necessarily give you the same amount of protection, but it's definitely better than nothing. I would say just make sure that you combine it with other methods. So, you know, wearing your sunglasses, your wide-brimmed hats, etc.

And seeking shade is really important. The tip that you gave about doing one finger first and then the other, that is the best SBF tip I have ever had because when you put SBF and it feels too heavy or it just goes up into balls. Yeah. Because I always used to have that with SBF. And then as soon as someone said to me, you can, you don't have to do all the fingers at once.

You can do one finger at a time. It completely revolutionised my SBF application, you know? Yeah, it's amazing how quickly it sinks in, actually, when you do it like that. And also, there's more chance that you're not going to miss areas when you put it on twice. So you're going to cover up those, those areas more effectively. The tip that you gave about dabbing over makeup, that's going to be the next SBF tip that I had. Because I do struggle. And also, I'm getting married next summer.

And I'm thinking, oh, my God. How am I going to, you know, how am I going to keep my SBF done all the day all day? And that sounds like, well, I mean, I'll try it out over the next, over the next few months and see. You have to give me some feedback. Yeah, yeah. That's a good tips add to my toolkit.

Next community question. As we get older, how should we change up our skincare routines? Good question. You actually don't need to change your skincare routine too much. So when it comes to skincare, having a much simpler routine, fairly paired back, fewer items is going to give you far more consistent results than hundreds of different products, which people then get into a real mess with. So I like to think of it probably in your 20s is the

real focus needs to be on prevention. So not using those sunbirds, using your daily SPA and all the nice safe sun practices. In your 30s, you want to maintain that, but there might start to be the odd thing that starts to creep through that you maybe want to target. And then once you get into your 40s, you might then start to want to be doing some repair to any damage that's occurred whilst also continuing to protect the skin. And so obviously the number one is good broad spectrum sunscreen, applied consistently in a good enough quantity. We've talked about reapplication, making sure you don't forget the lips as well.

We haven't really talked about that. But having a good lip balm with good SPF in is really important. And then you want to think about maybe adding in. targeted ingredients for whatever the particular area of concern is. So we've talked a bit about retinoids. They have huge benefits in terms of increasing collagen synthesis, cell regeneration. They can be really helpful for pigmentation and marks, evening out skin tone and texture. So there's lots of evidence for them.

Also things like antioxidants like vitamin C or it's called escorbic acid in some preparations. that can be really helpful for brightening the skin and helpful for pigmentation as well. Azalec acid is another great one, really like that for pigmentation. And again, for smoothing out the complexion. So there can be targeted ingredients that you can then incorporate, but probably only one in the morning and maybe one in the evening maximum. You don't want to combine too many because often it can just lead to increased irritation. And then we really want to focus on thinking about the skin barrier.

So making sure that you're using a nice, creamy sort of cleanser, thinking about a nice moisturiser. As you get older, you might want something a little bit more thicker, a bit more nourishing. Generally, oil production goes down as we get older, so skin can appear a bit dry or dull. And so adding that moisture into your skincare routine can be really helpful, particularly at night time. And then it's sort of lifestyle factors. So I don't think we really talk about this enough, but, you know, smoking really, really, important. So don't smoke. That can have a massive impact on wrinkles, making sure we stay

well hydrated, that we get good amounts of sleep. So we get those repair processes, which we know go on overnight, eating lots of antioxidants, having a good, varied diet, lots of fruit and vegetables, nuts, seeds, etc. Really just ensuring that you get that consistency. Because consistency over time is what will really give you the best benefits in terms of antibiotics. aging and a good healthy glow complexion. Gorgeous. Nice and stripped back, I think. Sometimes it becomes very, very, very easy to complicate it,

especially when there's a gazillion and one products on the market. Yeah. Less, again, is definitely more. Final community question. And then we are going to move on to the section called Real or Not Real. I'm going to show you an image and I'd love to hear your thoughts. What facials slash treatments are actually worth the money? Oh, good question.

So I think there's no doubt that facials are a lovely, relaxing thing to go and have done. But I would say that you're probably going to get far more benefit from a consistent daily good skincare routine used over time than you will necessarily see from any specific facial. And so if you enjoy it because it feels nice, it will give you some immediate. brightening effects, a lot of the facials. But in terms of that long-term benefit, it's really about getting the skincare routine right. There are procedures like microneedling, which can be helpful for sort of fine lines, mild acne scarring and mild pigmentation changes. It's got a pretty low down time. It's pretty safe. You do usually need between four and six sessions pretty well tolerated, and some people really swear by it. There are hundreds.

of different lasers out there, and I'm not a laser expert, but they can be really helpful for specific targeted concerns. So, for example, redness is something that's usually very effectively managed with certain types of laser. When you get resurfacing type of lasers that are a bit deeper into the skin, they can be really helpful for deeper wrinkles, more sort of skin damage, sun damage and pigmentary changes. But with that comes increased cost, increased downtime and increased risk and so you do have to make sure that if you're going for one of those that you're with somebody who's really experienced who knows what they're doing and particularly if you have darker skin there's much greater risk of pigmentation as a result of that so you do need to be extra

careful now we have this section called real or real now normally we have a social media clip that I would show you and get your opinions on but today we actually have an image so I would just like you to have a look at the image and tell me what is it about this image that we could all learn from in terms of sun damage. Have you seen this guy? Yes, I've seen this picture before. It's a really famous picture. It came from, I think, it was a publication in the New England Journal of Medicine. It was a case report. And what's so special about it is that it is probably one of the best demonstrations of the effects of UV radiation on the skin. And so this driver, He drove his truck for around sort of 25, 30 years, with the left-hand side of his face,

constantly exposed to the UVA rays coming through the glass window. The other side was in the shadow, and so didn't have that sun exposure. And so what it's shown us is the importance of UVA. So even though you're indoors, you're inside, that you're still at risk of sun damage. And then it really nicely demonstrates the difference. in aging as a result of that sun exposure because it's his own kind of case control. The other side he's had, you know, all the other effects of his lifestyle have been exactly the same on both sides of his face except for that UV exposure.

And so what you can see from that image is you can see deeper wrinkles. You can see thickened, leathery skin. You can see a loss of elasticity and tone of the skin. And you see this really marked asymmetry. And so I think if you can imagine yourself in, you know, 20, 30 years time, which side of the face would you like to have? And that's where your sun protection really comes in. So if there's a visual that people take away from today, I think that's really, really powerful. Next, before asking you the final question that I've been asking all the guests on the podcast, I wanted to touch on a statistic that was actually quite shocking that one in 47 women in the UK will be diagnosed with, melanoma, but that is rising. And actually, 81% of 18 to 25 year olds couldn't identify any of the

signs of a melanoma. Why do you think that number is rising? What advice would you give people going away? Yeah. So it's a shocking statistic and it's really concerning that the rise in melanoma in the UK is because of a multiple different reasons. So first of all, we have an aging population and we know that skin cancers occur more frequently as you get older. So naturally we will expect to see more skin cancers. In addition, we've got that cumulative sun exposure. So we now spend a lot more time outdoors. There's a lot more foreign travel, cheap flights, those short bursts of intense sun exposure, which are thought to be more damaging for the skin. We're also seeing the knock-on effect of the sunbeds.

So as we talked about, they were really popular in the 90s, 2010s, sort of time. And that then knock-on effect takes many years before we then start to see it come through. And we know that if you used a sunbird, that you have a 20% increased chance of developing melanoma. and if you used a sunbed before 35, then it goes up to 59%, which is really, really worrying. So all of those factors are important, but also on a positive note, we're getting better at detecting it. We're seeing that increase in number of patients coming through, even though only 5% of those that have referred in will turn out to have an urgent skin cancer. So we're seeing more people, we're checking more people, we're diagnosing more melanoma, and hopefully. Hopefully we're diagnosing it at an earlier stage when it can be dealt with much more quickly and easily.

But melanomas can be a really devastating condition. It can spread quickly to other areas in the body if it's left untreated and it can even be fatal. And I think part of the problem is that there just isn't this awareness. There's a bit of a disconnect about the reality of that. I know some people maybe use sun cream because they're worried about skin aging and they see that around them. more, it's more in the media, but they don't necessarily know somebody who's had a melanoma. And I think once you start to understand the real risk that's involved, then it can, you know, start to change practices.

But, I mean, ultimately, whatever the reason for using SPF, whether it's down to vanity or whether it's developing skin cancer, then it all ends up with the positive result. And we really need to hammer home these messages because we don't want this statistic to continue to worsen. and we want to start to bring that number down. Fab. Well, I think that brings us really neatly on to the last question that I've been asking all the guests on the podcast.

That is Dr. Lucy, what do you wish every woman knew by the time she was 25? I think that you don't need to have it all figured out from the beginning is really helpful. It's great to have goals and direction, but make sure that you enjoy the journey and the process of getting there. Say yes to lots of opportunities because you just never know where they're going to take you. And I think something that is a bit of a sweeping statement, but generally we as women, we underestimate our abilities. And I would say from experience that men are the opposite. So don't underestimate yourself, push yourself forward, have confidence that you can achieve your dreams.

And do whatever it is that you enjoy because you'll make a success out of it. And of course, make sure that you use sunscreen every day because when you're 40 or 50, you'll really thank yourself for it. You out to get that. That's an absolutely beautiful message to end for the audience. And just on behalf of all of them, thank you so so much for coming on the podcast. Thank you for having me.