The Food Medic - S1 E4 - No-Nonsense guide to skin health

Episode Date: July 2, 2018

Consultant dermatologist and author of ‘The Skincare bible’, Dr. Anjali Mahto, sits down with Hazel to discuss all things skin health including; the impact of our diet on skin, the best anti-ageing treatments, and natural vs. synthetic skincare. You can find Anjali on twitter @dranjalimahto or on instagram @anjalimahto. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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A well-marbled ribeye you ordered without even leaving the kiddie pool. Whatever groceries your summer calls for, Instacart has you covered. Download the Instacart app and enjoy $0 delivery fees on your first three orders. Service fees, exclusions, and terms apply. Instacart. Groceries that over-deliver. Hello and welcome to the Food Medic podcast. I'm Dr. Hazel Wallace, founder of the Food Medic. I'm a qualified doctor, personal trainer, blogger, and best-selling author of the books of Food Medic and the Food Medic for Life. I'm passionate about maximizing our health through how we live our

lives, including the food that we eat, physical activity and stress management We will hear from leading experts in their field who will be sharing evidence-based advice on how we can live healthier lives and we will cut through the confusing information that we find online I like to think of myself as one of the first of a new generation of doctors. Hey everyone, it's Hazel here and welcome back to the Food Medic podcast. First of all, I just want to say a huge thank you to everyone who has downloaded and subscribed to the podcast already. Thanks to you guys, we hit number one in the top podcast health charts last week and number three in all categories.

So, woohoo, thank you for that. So, today we're going to discuss all things skin health. And I'm very pleased to be joined by consultant dermatologist and author of the Skincare Bible, Dr. Anjali Mato. Anjali is also a spokesperson for the British Skin Foundation, blogger for the Huffington Post, and executive committee member of the British Cosmetic Dermatology Group. Anjali, welcome. Thank you for having me. Thank you for coming in. So first of all, I would love to start off the podcast by finding out a little bit more about you and if you could share with the listeners how you got to where you are today. Yeah, absolutely. So I

qualified as a doctor in 2004 in Cardiff and I finished university with a degree in pharmacology as well as my medical degree and then following that spent a lot of years as a junior doctor rotating around a whole load of jobs cardiology, respiratory, the whole lot and then decided that I really wanted to focus on becoming a dermatologist. Skin health was something that really interested me so having finished exams at the end of junior doctor years, I applied for a dermatology post. At that stage, I was still living in Cardiff, but I was quite keen to move to London and ended up getting a job in St. Mary's up in Paddington. And it really went from there. So I

completed my dermatology training and became a consultant about five years ago. And since then, I've been doing a couple of other bits and pieces. I've written a book. I'm quite actively involved with the Bruce Skin Foundation, just helped the launch of the British Association of Dermatologists Acne website. So yeah, lots of stuff going on. So many things. And you are really active. And it's really great to see evidence-based advice being given out online because there's so much advice on skincare that you could just Google. But a lot of it is nonsense, really. So absolutely love that I have you in today. And it's also really nice that you're also a Cardiff Uni graduate.

Okay, now our skin is a pretty important organ and probably one of the most important organs because we know it's the first line of defense. So we really need to look after it. And while we can't control our genetics, we can control certain environmental and lifestyle factors, including our sleep, diet, alcohol, and sun exposure. So let's talk a little bit about that and how we can improve our skin health through our lifestyle. So I thought we'd start off with my favorite topic, which is food. And how important is diet for good skin health? And are there any foods with proven skin benefits? So it's really interesting because I feel like there isn't a single diet that is good for your skin. A diet that is good for your general health.

So a diet that is high in good omega-3 fatty acids, that has got very colourful fruits and vegetables in it, lots of nuts, lots of seeds. That is good for your skin without specifically picking out nutrients that are going to be great for your skin. So there's no superfood you can eat that is going to make your skin younger or sort out any skin problems. It just doesn't work that way. Yeah. You see online like there'll be five top superfoods for skin like eat blueberries and your skin will look amazing. But that's not true. You mentioned omega-3 fatty acids. So there is quite a lot of evidence behind that. I know that before you've spoke about, and as well in your book, which is really useful if people haven't

had a look at it either, vitamin C, vitamin A, all of these antioxidant rich. Yeah, that's right. So vitamin C, for example, vitamin C is needed to produce collagen. And collagen is the main protein in our skin that gives our skin its support and its structure. So it is important to be making sure that you're getting adequate amounts of that in your diet. The problem is when you start over supplementing. So vitamin C is one of those vitamins that your body will absorb what it needs and the rest of it you will pee out. So it's important about getting the right dietary sources. Vitamin A is another one,

vitamin A, vitamin E, they're really good antioxidants. So they can help protect the skin from damage from pollution, and also damage from ultraviolet light potentially. And then omega-3 fatty acids, they are anti-inflammatory. And there are an awful lot of chronic inflammatory skin conditions, conditions like rosacea, conditions like acne, psoriasis, eczema, and actually making sure that you're increasing your uptake of those fatty acids can be beneficial. Okay, that's really interesting. And also interesting that you mentioned supplementing can give you too much of a good thing. So we're talking about food here.

And I think for me as well, that applies to most organs in the body. We can get enough from food if we have a good balanced diet. And like you mentioned, omega-3, you can get in oily fish, you can get it in walnuts, you can get it in flax seeds. And vitamin C, you can find in lots of citrus fruits and really colorful fruits and vegetables. And then we've got like vitamin E, which is more of a fat-soluble vitamin. You can find it in nuts, avocados, and things like that.

So, moving on. Many people, mostly women, ask me what food they should eat or avoid for various skin conditions, mainly acne. Sure. Is there any strong evidence that demonstrates a link between acne, for example, and food? Yeah, so it is really interesting because acne is an area that I like talking about a lot. And the evidence between diet and acne and that story has been so controversial over the years. So before the 60s and the 70s, it used to be standard advice that all dermatologists would say to their patients, don't eat fatty foods, don't eat sugar, don't eat fizzy drinks or drink

fizzy drinks, because all of those can aggravate your skin. And then two studies came along at the end of the 1960s and the early 1970s. And they seem to discredit any link that diet had any role to play in acne. And literally overnight, dermatology textbooks were just changed. And everything that was taught from that point on was that there's no link, so you can eat what what you want there will be no impact on your skin but over the past decade or so people have gone back and they've looked at those studies again and what they found is there's an awful lot of methodological flaws in the way the studies were carried out and what we are increasingly recognizing is that there does seem to be a link between refined sugar particularly foods that have got a high GI index in the development of acne. And the reason is that when you eat something that is very sugar laden,

it will cause a spike in your blood sugar or your glucose levels. And your body's response to that is it will produce a hormone called insulin and then another hormone called insulin growth factor 1, IGF-1. And IGF-1 acts directly on the oil glands in the skin to make them bigger and plumper and increase oil production, which is one of the reasons why acne can develop. And then dairy is the other one. Lots of people ask about dairy. And the link between dairy and acne actually is a lot weaker. And it seems to be the link is with low-fat dairy, not with full-fat dairy. That's interesting. Do you think that's because

you can't absorb as many fat-soluble vitamins with low-fat dairy? There's a couple of hypotheses, and I don't think we really know the answer, actually. That's a good suggestion. But one of the reasons people think is when the fat is removed, what it tends to leave is the concentrated sugar or carbohydrates yet again. So that's potentially what's driving it. The other issue is a lot of commercially produced milk does contain IGF-1, although it comes from cows. And there might be a relationship between full fat having slightly less proportionately to low fat, but we don't know. But one thing I would say is I wouldn't recommend that if you've got acne, you try and treat it with

just your diet alone. The diet has got a part to play, but I don't think it's the only thing that we should be focusing on. Yeah, I come across a lot of people who have very severe acne and they're kind of desperate. And it's understandable. And then they end up cutting out a lot of dairy, sugar, gluten, whatever seems to be triggering it. But I guess what you're saying is the best thing that you can do is limit the amount of refined sugar and that would be you know typically those foods like sugary cakes or chocolate or white flours which are breads pastas things that are stripped of their fibrous coat so you're going to get a bit more of a spike in your glucose level quicker than you would if you had whole grains and brown versions of these foods that's not to say you have to cut them out completely. That's right. With dairy, again, we don't really know. Is that

what you're saying? We're not sure. And some people might kind of trigger an inflammatory response, which will make your symptoms worse. Yeah, that's exactly right. It seems to be that in a small select group of people, dairy is likely to have a part to play. The problem is we don't have a simple blood test to know who that person might be. So the kind of advice I tend to give in clinic is if you know that every time you eat dairy, your skin breaks out, you might be one of those people, in which case you might want to switch to alternatives. But it's not a one size fits all. And it's one of those things I don't think everybody is going to have a problem with dairy. Yeah. And how about dairy and eczema? Because I grew up with quite a few allergies, severe asthma, hay fever, everything. And I

remember one doctor recommending to my mum, you should try cut out dairy. Because, you know, it's linked to all of these conditions and particularly eczema. And I don't think at the time that was really considered the right advice to give. And my mum never went through with it. She didn't, you know, take dairy out of my diet. But it was something that I found interesting, you know, speaking to her after that. And I know lots of mums ask me about it. You know, should I cut out dairy from my child's diet?

And I'd be interested to hear your opinion. So one of the things is that eczema itself is such a common condition. So about 20% of kids will suffer with eczema itself is such a common condition. So about 20% of kids will suffer with eczema at some point in time. And kids that have eczema are more likely to have other allergies. And that could be food allergies, or that could be what we call contact allergies. So things that are coming directly into the contact with the skin. So things like nickel, for example. But one of the things I would say is that simply cutting things out of diet yet again, particularly in a child that is growing, is potentially dangerous. So firstly, it should

be done with the guidance of a registered dietitian. Secondly, is it a good idea or not? Well, I think the answer to that is, generally speaking, allergy tests that we carry out on children, they're not very accurate. They have what we call a very high false positive or false negative rate. So what that means is if you screen a whole load of people that have got eczema, in some of those blood tests, it will look like they've got an allergy when they don't really. And in others, they may have a genuine allergy, but the blood test won't pick it up. So we rely very, very much on the history and what we're told. So if somebody comes in and they say, every time my child has dairy, I notice their eczema gets worse.

It may be worth at that stage doing a blood test and then something called a skin prick test to look a little bit further to see if it's a genuine allergy or not. But just doing the allergy tests alone isn't beneficial without that story of whether or not it's causing a problem. So advice would be unless you see there's a real clear dietary link, keep a food diary for a period. But if you don't see a link, then cutting out dairy is not a good idea. Okay, great. Got that. And now what about rosacea? Because I know at medical school,

we're told that, you know, tell the patient to avoid alcohol. And that's as far as the lifestyle advice goes. I want to know what else we should be avoiding. So rosacea actually is one of the few conditions that I feel like actually there are a lot of lifestyle factors that we can really talk about. And one of the main triggers often can be alcohol. So reducing the amount of alcohol that is consumed. I mean, you know, life is also for living to cut out altogether. If that's impossible, you know, don't do it, but try and limit what you're having. The second thing is that a lot of spicy foods, foods that contain capsaicin, they can be a trigger. So things like

red peppers, bell peppers. So if you notice that, that might be something else that you may want to limit from your diet. The third thing is foods that contain cinnamaldehyde. So actually chocolate potentially could be a trigger in some people as well. But the other thing with rosacea, just talking sort of more widely about the lifestyle aspect of it, is the fact that about 80% of people that have rosacea, their condition is triggered by sunlight. So it is so important to wear sun protection factor 50 every single day if you have rosacea. So that's the skincare part as well as the dietary part as well as the alcohol intake part of what you're doing. So there's lots of lifestyle factors in there. Absolutely. And how about exercise? Does that

trigger it? So the problem is heat can trigger it. So sometimes people have hot drinks or they will go from a cold room to a hot room, get out of the shower, go into a cooler room, and it can trigger that. So the same with exercise, you know, as your body is heating up as you're exercising, it can cause flushing. But there, I think, you know, the advice is exercise is definitely good for us. And as far as rosacea is concerned, if you're triggered by it, it is unfortunate. But please don't stop exercising. Yeah, absolutely.

Because exercise has so many other benefits in the long run. And it's also anti-inflammatory as well. So you did mention SPF with rosacea and wearing SPF every day. But one of the things you told me that I should be wearing SPF every day and that it's the best anti-aging thing that you can do. That is correct. So should we all be wearing SPF every day and why? So SPF is important for two reasons. The first reason is that it is going to limit your risk

of developing skin cancer in the future. We know that ultraviolet light from the sun is implicated in the development of skin cancers. We also know that the rate of skin cancer has been increasing as we travel further. As a lot of people want to look tanned, there is that kind of celeb culture that goes around it as well. But the second reason is if you're not worried about skin cancer and you are worried about your skin aging, about 80% of people, the reason why they start developing signs of aging in their skin,

so think fine lines, wrinkles, pigmentation, sagging of your skin, that occurs directly because of ultraviolet light exposure. So wearing SPF on a daily basis or sunscreen, actually, I should say on a daily basis is really important. So wearing SPF every day, will that impede vitamin D production in the skin? So interesting question. And actually, I should probably say, we should probably refer to SPF as sunscreen because SPF is only a marker of ultraviolet B protection from the sun, whereas most sunscreens are broad spectrum and they block against both ultraviolet A and ultraviolet B. If you are adequately blocking your skin, and the truth is most of us don't because we tend, A, not to use enough protection, and B, we don't tend to reapply anywhere near as often as we should be to get the factor on the bottle there is a theoretical chance you could block your vitamin d but what studies have actually shown in practicality is that that's not always the case

and that's partly because of the under application and the under utilization of these products but also because your skin only makes a finite amount of vitamin d from the sun so a lot of people will say well i'm sitting out in the sun. So a lot of people will say, well, I'm sitting out in the sun, I'm topping up my tan. The thing is, your skin will have made the vitamin D that it needs in a period of time and then sitting out for longer than that. So sitting out for hours on end isn't suddenly going to then increase the amount of vitamin D that you have. Okay, that is good. I'm glad we got to the bottom of that. And one other question is, now you can get spf in your moisturizer

and also your makeup or your foundation is that enough unfortunately not and particularly if you are worried about skin aging or skin cancer and that's because sunlight is made up of ultraviolet a ultraviolet b ultraviolet c and then two other wavelengths of light infrared and high energy visible light but the spf is only a marker of UVB protection. Yeah. So if you have got foundation or makeup that's got an SPF 30 in it, that's a great marker of your ultraviolet B cover, but not of your UVA cover. And UVA is present all year round, and it penetrates window glass and it penetrates cloud cover.

Yeah. At medical school, we used to think UVA aging, UVB burning. And I still remember that to this day. Now moving on to plastic surgery and social media. Yes. Because I feel like plastic surgery or these small invasive procedures like lip fillers and Botox and lots of other bits and pieces, you see them more commonly now and maybe people are talking about them a little bit more. And what I feel as a blogger is that it seems to be widespread on social media. The American Academy of Facial and Reconstructive Surgery recently conducted a poll on the influence of social media on plastic surgery.

And what they found was that plastic surgeons are experiencing a 30% rise in the number of clients interested in cosmetic surgery through social media. So I mean, that's a very small study. And I don't know how robust it was. But basically, it's giving us a survey that people are becoming more interested in changing their appearance because of social media, which is kind of scary. And what I want to know is, I know that you aren't doing plastic surgery per se, but are you seeing a rise in kind of reconstructive things or fillers and Botox in your practice? Yeah, absolutely. So I'm not a plastic surgeon, but I do do non-injectable treatments. So I do things like Botox, filler, laser treatments.

And I did a talk last year at the British Association of Dermatologists annual meeting and one of the things that I found was having done my research one of the fastest growing areas of cosmetic dermatology is actually injectable treatments like fillers in the millennial population and there is this idea that a lot of it is being driven firstly by information being so accessible so previously people didn't know what these treatments involved it seemed to be something that was left for celebrities or, you know, famous people would have them done. But now you can just log on to Instagram. You can see your favorite celeb having the treatment done. So the kind of mystique around it has gone.

It feels like something we can all do. That's one thing. I think the second thing is the fact that, you know, we are seeing that rates of depression and issues with self-esteem and body image are rising, particularly in females. And I think this kind of culture that we've got, where everybody needs to be preened and perfect, that drives it even further. And a lot of these treatments now, you know, if they're not being done by a consultant dermatologist or a plastic surgeon, they're being done for very, very cheap by people that aren't very qualified to do so. So the expense factor has gone as well. Yeah, absolutely. And I mean, you see now that there's lots of beauty clinics providing these types of treatments and they

undergo, you know, a short weekend course to administer Botox. And I'm thinking, like, I've been through medical school and another degree, and I've done serious anatomy training. And even I would be like, I don't feel comfortable doing this. And these people have no idea of underlying anatomy or what could go wrong if they were to administer it in the wrong place, the wrong time, or what the consequences could be. And that just blows my mind that people will trust someone who's not a qualified dermatologist to do these yeah you know it's utterly frightening actually because you know some of you know when things don't go wrong it's fine but it's that five percent of the time that things go wrong you need to know what you need to be able to do so

the risk for example of having fillers around your eyes one of the risks is blindness that's a pretty big deal so I have to be honest as well I kind of feel that like people need to really research the people that are injecting their faces and yeah it really should be somebody that is properly qualified to do so and I would say a consultant dermatologist or a consultant plastic surgeon yeah you heard it here okay I know my mum will absolutely kill me if I don't ask you what are the best anti-aging treatments out there and what actually works? Yeah, so if we look at just skincare alone, there isn't that much. Unfortunately, people are not going to be very happy with me saying this,

that you can achieve with skincare. And the simple reason for that is if your skincare product was genuinely changing the structure or function of your skin, by legal definition, it would be a drug and it would not be a cosmetic. A cosmetic is not able to do that. So the next time you read that your cosmetic product is improving like lines, wrinkles, sagging, that's a slight kind of exaggeration of the truth. That said, there are a couple of skincare products that can help.

Vitamin A-based creams like retinoids can be particularly helpful. They have been shown repeatedly in studies to help fine lines and pigmentation and uneven skin tone and boost collagen production. Now, we lose about 1% of our collagen per year after the age of about 25. So incorporating a vitamin A- based cream like a retinoid after you're about late 20s or so, that is a really good place to start. And they should be used at nighttime. They can make you quite sensitive to the sun. They're quite strong creams and their use should be built up gradually. But if you're using a retinoid at night and you're using a sunscreen in the morning,

that is a pretty good anti-aging routine. Really? Yeah. Because, I mean, you just see 10 different products in one range and I'm like, do I need to start doing that? Yeah. But one thing you did mention was collagen. Yes.

And what's really trendy now, particularly in London, is like collagen drinks. Oh, yes. And I get asked this question every day and I'd love if you could answer. Is there any evidence to collagen drinks and the collagen magically going to your skin and giving you very plump, beautiful skin? No, unfortunately there's not. So collagen is a protein.

So if you drink collagen, then it will be broken down by your gut into its component amino acids. And there isn't really evidence that it's going to end up in your skin. You may as well have like a piece of steak or a big chunk of protein instead. Now, there are some companies that are producing what they call hydrolyzed collagen, which is slightly different. And hydrolyzed collagen is broken up little bits of collagen rather than the intact protein itself. And their argument is that if you drink broken bits of collagen, it fools your body somehow into thinking that an injury has taken place. And your body's response to seeing these broken bits of collagen

is to produce new collagen. Oh, my God. Now, again, I would say the data is very sketchy. The problem is the data is always carried out or funded by the people that are making these products. That's one issue. The second issue is they never use enough patients in their trials that you can actually prove it's of any benefit. The third thing is that if somebody is taking collagen drinks, you can probably presume that they're a self-selecting group that actually look after their skin anyway. So the fact that they think they're doing something

positive for their skin, they might actually just be eating better, or they might actually just be making sure they're wearing more sunscreen or other products that they're using. So it's very, very hard to actually tease out those confounding factors. Yeah, that's the thing. So what you're basically saying is we don't need to worry about it. I wouldn't waste your money, guys. And while we're on the topic of skincare products, it's very trendy now to go natural organic products from food and also in our skincare. Is that a better way? Should we be going natural as opposed to some products that we've been using for years? Yeah, I think this is one of the real issues with sort of like wellness and people wanting to go for natural organic. One of the big issues with that is with synthetic products

or synthetic chemicals that we use, they get a lot of bad press, unfortunately. But one of the things that we do know is there is very strict European guidance on what ingredients can be used and what concentrations they can be used in our skincare. So if you buy a synthetic product, you know exactly what you're getting. You know, it will say it on the tin and that's what it will be. The problem with natural skincare is it's not subject to exactly the same guidelines.

There's a lot of variations that you can get in natural skincare. So the first problem is a lot of it contains a lot of essential oils. Essential oils are one of the commonest causes of skin allergy. So they can still cause allergic reactions. The second thing is that there is a lot of quality variation. So if you're getting a product from a plant, you don't know that all of the plants have been grown in the same way, that they receive the same amount of sun, they were harvested at the right time. You don't know if the right bit of the plant was used to harvest to use

in your skincare product. You don't know how that plant was transported, whether or not it was at the right temperature. And then you also don't know how it was extracted or what solvents they use and maybe they use chemicals to do that as well so i kind of feel that there is this myth that natural is somehow safer or better and there are studies from the new england journal of medicine from probably over 10 years ago which show that using lavender oil in prepubescent boys cause breast growth. So, you know, there are complications that we don't think about. So I would always say to somebody that if you want to use natural products, no one's going to judge you. That's your choice and that's your decision to make. But make that decision based on knowledge and not on fear of

the synthetic products. Yeah, I think that's a really powerful statement. It's really interesting because I can almost compare that to the drug industry and the supplement industry, because drugs undergo like same vigorous regulation and they come under almost a food supplement and under the food standards agency and then we have people who are they're kind of fearful of taking medication but they're totally comfortable taking supplements because they feel like that's more natural when actually it can be more dangerous. And I think, again, that comes back down to sometimes we have to realize that we do need chemicals and there's chemicals in everything for us to be well. So that's an important note.

We've kind of talked about the things that we don't really need like supplementing and having collagen drinks in our diet. But what are the things that we should all have in our skincare armory? I mean, back to basics. I know that you and I sat down a couple of months ago and you were stripping out everything that I had, all this extra stuff that was sent to me. And I was just using it because it sounds amazing and I want to have glowy skin. So it would be great to know what are the basics that we should all really be kind of keeping in our... I think it's interesting because just because there's 50 products out there

doesn't mean we need to be using all 50 of them. You increase your risk of developing allergies as well because these products aren't necessarily made to be used together or they're not tested together. So in terms of really, really basic skincare, number one, you should be cleansing morning and evening. If you wear makeup, you wear sunscreen, you live in a polluted city like London, even more important that you take

the time to cleanse your skin properly at night, not just to remove makeup and sunscreen, but dirt, grime, pollution, which has also been implicated in aging of the skin properly before you go to bed at night. The second thing is, and we've talked about this quite a lot as well, but sunscreen. You know, sunscreen is going to prevent premature skin aging, and it is also going to prevent potentially skin cancer developing as well further down the line. So wearing a good quality sunscreen, minimum factor 30, providing broad spectrum cover against UVA and UVB is really, really important. Once you've got that into your routine, if you want to build on it, then vitamin A based creams at nighttime, hugely beneficial from your late 20s onwards. And then lastly, you can think about using an antioxidant skin serum. And these can

be used in the morning before your sunscreen. So probably the most tested antioxidant serums contain either vitamin C or vitamin E. So if you're choosing a product, there's lots of antioxidant serums on the market, but maybe go for one that's got vitamin C in it. And look for L-ascorbic acid as your active ingredient, at least at a concentration of about 15%. So they would be the key things. Antioxidant, sunscreen, and a retinoid okay i hope

everyone's taking notes i know i am and same advice would apply to a man yeah so i think sunscreen again equally as important for men it's interesting because men actually their facial skin does age better than women and there are studies to show this and that's because men have facial hair so their skin is much more robust and there's more collagen there so they're not subject to aging quite in the same way that us women are i didn't know that yeah it's really interesting actually so unfair yeah and also because they're shaving they're also mechanically exfoliating the skin repeatedly as well so that's why they will age better than women will. But yes, absolutely. Cleansing and sunscreen, absolute basics. Okay. And something I'm really interested in is gut health.

And we were just discussing probiotics before we came in here. What I've noticed is, A, a lot of people talking about taking probiotic supplements for skin health and also overall health. But also, B, there's a lot of probiotic skincare products where there's actual probiotics in the skincare. And for those who are unfamiliar with probiotics, by probiotic we mean live bacteria. Is there evidence behind this? So we'll deal with the skin separately to the gut.

Because the gut has a microbiome of bacteria, viruses, yeast that naturally live there, but so does the skin. And the skin microbiome is actually very different to the gut microbiome. So if we touch on topicals first, a lot of probiotic skincare products are based on probiotic bacteria in the gut. So things like lactobacillus and bifidobacterium, which have shown to have benefits in the gut. The thing is, they haven't necessarily been tested for the skin microbiome because your skin's natural bacteria are very, very different to what's sitting in your gut.

The second issue is that you can't have live bacteria in skincare products, simply because, firstly, the bacteria will run out of food source in about 48 hours or so if there is live bacteria in there. Secondly, if there is live bacteria in there, you are putting yourself at risk of potentially causing eye infections, skin infections. So we have to use preservatives in skincare to prevent that. You know, every time you open your product or you stick your finger in it or whatever else it might be. But if you are actually putting preservatives into your skincare, the purpose of the preservatives is to stop bacterial growth. So that's slightly at odds. So I guess what I'm saying is you need to be a little bit skeptical of these products because you can't have live bacteria in your

skincare. If you did have live bacteria in your skincare, the preservative would kill it off. So the way that a lot of companies get around this is they use freeze-dried bacteria, or they use mushed-up bacterial cell walls. So they use things called lysate, and that's often what you'll find on the ingredients. The thing is, there's no evidence that dead, mushed-up lactobacillus being smeared onto your face is going to do anything for your skin's natural microbiome. So there is emerging science, but the beauty industry has taken that science and it's run away with it. And we don't really have the evidence to kind of show that topical probiotic skincare is that beneficial.

Yeah. Oh my God. And I imagine next we're going to see probiotic like hair care and everything. So what we're saying is get your probiotics from food, but don't be putting it on your face. Yeah. So if we are getting a lot of probiotics in our diet, and that can be through like live yogurt, kombucha, kefir, any of the fermented foods that contain probiotics, they will benefit our gut bacteria or add to that so that we have like a good populated and healthy microbiome. Will that offer benefits for our skin health? Because we know it offers benefits for digestive health, our brain health, even our cardiovascular health.

How about our skin health? Yeah, so data is sketchy, but there's some papers that show there is a benefit and some papers that show there isn't. So I guess that the two conditions that I can think of that are immediately springing to mind is eczema is one of them. So for example, there was a paper that came out earlier this year in one of the dermatology journals that showed that if you gave, I think it was children aged between four and 17 years, and they were given probiotics, and then there was a control group that weren't. And what they found at the end of that test period is the group that had received probiotics, their eczema severity scores improved, i.e. their skin

improved, but also they needed to use less topical steroid to control their skin condition as a result of it, compared to the group that wasn't given probiotics. Now, the issue is that for every study you find in support, you'll find one that doesn't. But the one thing that I can say is there seems to be some evidence that if you have probiotics in the latter part of your pregnancy and whilst you're breastfeeding, you may reduce the risk of eczema development in high-risk infants okay so if you're not at high risk i.e you've got no family history of the condition it's probably not going to be of benefit but if you've got a lot of allergic conditions in your family there may be some benefit in taking

probiotics in that last part of your pregnancy and whilst you're breastfeeding okay that's interesting now i obviously love busting myths when it comes to food and nutrition, but I'd love to know, what's the biggest skin slash skincare myth that you would love to bust? The biggest skincare myth that I hear is that people spend a lot of money

on their skincare products. And there's this idea that the more expensive a product is, somehow it's better for you or it's better for your skin. And that's not true. If you look at a very cheap moisturizer and a very expensive moisturizer, the skincare ingredients are usually exactly the same in the cheaper product and the more expensive product. And when you buy a product, the bulk of the product is going to be the top

three to five ingredients. So that's really what you want to focus on. After ingredient number five, everything else in that product is present in such small quantities, it's probably not doing anything. Yeah. And you go into ingredients in your new book. Yeah. Which is the skincare Bible available now. So before we finish, I ask every guest three healthy habits they believe that we can do to kind of improve our health. It doesn't have to be about skincare. It can be about anything really. So I'd say number one is SPF and sunscreen. I do think wearing sunscreen is incredibly beneficial from a skin health, but also from a skin aesthetic point of view as well. So from the aging and the skin cancer point of view. The second thing I would say is try and eat well and not eat well for your skin but eat well for your general health so make sure

you are getting those omega-3 fatty acids you're eating the rainbow you're getting loads of nuts and seeds yeah and then i'd say number three is actually consider a vitamin d supplement in the winter months between october and march if you live in the uk we know that we don't get enough ultraviolet B light during those months because of our northerly latitude. So chances are most of us are going to be deficient. So that is probably the only supplement that I think there is benefit in taking. Yeah, I agree. I wrote a little section in my book on supplements and vitamin D is kind of like my caveat. I'm like, you don't really need supplements if you're getting a balanced diet.

But there is one exception, which is vitamin D. So check out the book if you want to get more information on that. But thank you so much for joining us today. I think we actually got through a lot of stuff. But before we go, can you tell us where to find you and also where we can get your amazing book? Yeah. So I work at the Cadogan Clinic in Chelsea and 55 Harley Street. And I'm on Instagram at Anjali Marto. And the book is available on Amazon and Waterstones and other bookstores. Amazing. Amazing. Well, thank you so much for joining us. And thanks to everyone for listening. Make sure to subscribe and keep giving me those reviews and ratings so we can stay

at the top of the charts. Thanks so much. Thank you so much for tuning in to the Food Medic podcast. Please do subscribe so that you are the first to hear about any new episodes. And if you are enjoying them, please leave us a five-star rating and a review so that we can reach as many people as possible. Check out my website, thefoodmedic.co.uk where you can find tons of recipes and articles. Follow me on social media, Instagram, Twitter and Facebook at The Food Medic. And my new book The Food Medic for Life is out now which is packed full of loads of recipes,

nutritional advice, myth busting and feature pages on topics such as sleep and mindfulness. You can grab both my books on Amazon or in any good bookstore. Thanks for listening and I'll see you next time. Thank you.