ZOE Science & Nutrition - The 3 biggest myths about anti-aging skincare | Prof. John McGrath
Episode Date: June 12, 2025From collagen powders to $100 creams, the skincare industry thrives on promises. However, many of the products we rely on for younger, healthier skin are built on shaky evidence. In this episode, worl...d-renowned dermatologist Professor John McGrath breaks down what’s real and what’s not. We explore how skin truly ages, what happens beneath the surface, and why some popular treatments don’t do what they claim. John dismantles three of the biggest myths in skincare, including the truth about SPF, collagen, and “bio-active” ingredients that never make it past the top layer of your skin. Professor McGrath is a Professor of Molecular Dermatology at King’s College London and editor of the British Journal of Dermatology. His research has transformed how we understand genetic skin disorders and vitamin D’s role in skin health. This conversation is packed with surprising insights - and one daily step that really does support healthier skin as you age. 🥑 Make smarter food choices. Become a member at zoe.com - 10% off with code PODCAST 🌱 Try our new plant based wholefood supplement - Daily 30+ *Naturally high in copper which contributes to normal energy yielding metabolism and the normal function of the immune system Follow ZOE on Instagram. Timecodes 📚Books by our ZOE Scientists The Food For Life Cookbook Every Body Should Know This by Dr Federica Amati Food For Life by Prof. Tim Spector Free resources from ZOE Live Healthier: Top 10 Tips From ZOE Science & Nutrition Gut Guide - For a Healthier Microbiome in Weeks Mentioned in today's episode Genome-wide association study identifies 143 loci associated with 25 hydroxyvitamin D concentration, Nature Communications (2020) Topical tretinoin for treating photoaging: A systematic review of randomized controlled trials, Int J. Womens Dermatology (2022) Sunlight Has Cardiovascular Benefits Independently of Vitamin D, Blood Purification (2016) Have feedback or a topic you'd like us to cover? Let us know here. Episode transcripts are available here.
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Welcome to ZOE Science and Nutrition, where world-leading scientists explain how their research can improve your health.
Walk down any beauty aisle and you'll see the promise of younger skin.
Creams, powders, serums, all of them claiming to stop time with a bottle.
But does your skincare routine actually fight aging?
Or are you falling for a beautifully packaged lie?
Today we'll bust the three biggest myths in anti-aging skincare.
From wrinkle creams to sunlight and supplements, you'll learn what really reduces visible
aging and what doesn't work,
no matter the price tag. We'll also reveal the one product you should use,
along with a few others that could really help your long-term skin health.
Joining us today is Professor John McGrath, one of the world's leading dermatologists.
He's a molecular dermatologist at King's College London and editor of the British Journal of Dermatology.
His research has shifted the frontiers of genetics and skin disorders, and he's led
pioneering studies on vitamin D and its effect on skin health.
By the end of this episode, you'll understand the truth behind common skincare myths and
science-backed steps to take care of your skin.
John, thank you for joining me today. and science-backed steps to take care of your skin.
John, thank you for joining me today. My pleasure, Jonathan.
So we have a tradition here at ZOE
where we always start with a quick-fire round of questions
from our listeners.
We have some very strict rules
which are designed to be really hard
for scientists and doctors
because you can only say yes or no.
If you have to, you can give us one sentence, are you willing to give it a go?
Yes.
Is it a problem that our skin ages?
No.
Do anti-aging skin creams have to prove they work before they hit our shelves?
They don't.
Could certain genes create a natural sunscreen?
Yes.
Is collagen powder a silver bullet for better skin?
Definitely not.
Is there a way to reverse a sunburn in 24 hours?
Absolutely.
Ooh, that one I wasn't expecting.
You have a whole sentence now.
What's the biggest myth when it comes to aging skin?
The biggest myth is probably that people think there's a magic elixir they can just go out
and purchase that will turn back time.
And that just doesn't exist.
And we're going to get into what some of those are later in the episode.
Absolutely.
My wife is a dermatologist, so I live in this bubble where the only really interesting thing is skin.
And so because I often see what's on Justine's feed, I feel I'm constantly being sold like a 10-step
skincare regime or like some powder supplement with a fancy scientific name that promises to
stop my skin from aging. And I've now hit a certain age, so even I'm starting to get a little bit more
interested. But I do feel like it's impossible to understand what actually
works and you said this really interesting thing about how like skin
aging isn't necessarily bad so can we start there like what's actually
happening on the surface of my skin every day? Well this amazing organ that
you have the skin you know as an, you've got 1.8 square meters
of amazing carpet, which we recognize as this barrier
that keeps the outside out and the inside in,
and also has its own appearances too.
It's a very dynamic structure, you know,
the outer layer of your skin is replacing itself
every four weeks in reaction to the external environment.
You really have to build up this barrier to protect yourself.
And it's rather amazing what skin can do in terms of its function.
You know, it's there not only to look nice,
but it also protects you.
It protects you against inflammation, against infection.
It makes hormones, it makes vitamins,
it has its own immune system.
It's a fabulous organ.
And so it's worth thinking about and worth preserving.
And of course, over the course of our lifetime, it does change a little bit.
And sometimes it doesn't always work as well as it did in earlier life.
But that's part of a natural process for this amazing organ, our skin.
It's so funny, I'm listening to this and you sound just like my wife,
which is I could see you could talk about the skin forever and am I right that you think that skin is
probably the most important organ in our body?
Is there anything more important than skin?
Cardiologists might disagree, neurologists might disagree, but I think dermatologists
have got it right.
I love it.
Now one thing you didn't mention that I hear a lot more talk about than before is the microbiome
of the skin. So is it true? Does the skin have its own microbiome?
Absolutely. I mean your skin is made of 35 billion cells but on top of your skin
on the surface and down the hair follicles are 70 billion bugs. So the
microbiome really has twice the number of cells that there are in human skin.
And this microbiome, this ecosystem that we of cells that there are in human skin.
And this microbiome, this ecosystem that we have on our skin, is very important in helping
the function of the skin and also in deciding our susceptibility or resistance to various
diseases as well.
So it's amazing.
We are only really just starting to understand the skin microbiome.
It varies from region to region across our body. It's
influenced by the much more famous cousin, the gut microbiome. Of course, we know a lot
more about the gut microbiome. The skin microbiome and the gut microbiome interact. But it would
be really great for the future of dermatology if we could harness the power of this natural
ecosystem, and maybe think about treating skin diseases or preventing diseases by manipulating
the microbiome in the skin.
And also knowing what we can do to change it
in terms of topical products or diet,
or how do we actually get the best out of our skin microbes?
When I first started at ZOE eight years ago,
there was still a lot of skepticism
about even the gut microbiome really being very important.
And I've noticed that the science on that has really developed a great deal over those
last eight years. But there could be some bugs on our skin just because it's the outer surface but
they don't really matter very much for our health right they're just sort of landing there. How do
we know whether it actually has any important role in our skin? That microbiome is established
in early life you know as soon as you're, you will start to get a microbiome.
And then it will become more established.
It will change a little bit as you go through life, particularly during puberty,
when you get new lipids, things on your skin.
But then in adult life, it's fairly fixed.
It will vary according to you have more moist or sweaty parts of your body or
drier parts of your skin, but it's relatively fixed.
You know, as dermatologists, we would really love to be able to use the microbiome to treat skin diseases,
you know, such as dry skin or even conditions like eczema or psoriasis, but we don't have that power
and knowledge at the moment. It's the future, I think.
So, like, you know it's important, but at this point, there isn't like, there's not treatments
that specifically understand how to support your microbiome
or maybe repair it if it's damaged or something like that.
It's off where it was.
I think we're at that stage of being curious
about what's going on.
You know, there are some odd examples
where manipulating the gut microbiome
can impact on diseases of the skin.
And for example, who would have thought that changing part of your gut microbiome could
make your hair grow back if you've got one of those autoimmune hair loss disorders?
So hang on. You said I can change my gut microbiome and my hair might grow back.
Yes, that's true. There's a very common autoimmune skin condition called alopecia areata, where
the body develops antibodies that attack the hair follicles. And of course, conventionally
and quite effectively, dermatologists will use steroids and other immune-suppressing
drugs to try and get rid of those antibodies and get the hair growing back again. But there
are reports now coming out, and again, it's just a few reports, but changing
part of the gut microbiome, for example, sounds a little bit obscure, but using a fecal microbiome
transplant or fecal transplant can make your hair grow back again.
Shocking news, I guess.
I think that's absolutely fascinating.
So you're saying swapping out my gut bugs and suddenly I can get my hair back sounds crazy and I love the way
that science keeps figuring this stuff out. So I know I pulled
us off to talk about the microbiome and I feel like
probably you were going to talk a little bit about what happens
as our skin ages.
Yes, that's right. I mean, classically, dermatologists will
talk about two sides of skin aging. One of them is the
intrinsic aging just old father them is the intrinsic aging,
just old father time as the clock ticks by.
And then the other one is extrinsic aging,
which is to do with all those environmental triggers
which might impact on the rate of aging.
So things like sunlight and smoking and pollution
and various other toxins that we might encounter.
So those are the two aspects and both of them can overlap
and both can contribute to the process we know as skin aging.
What is aging?
Of course, it is to many people,
it's just the appearances of the skin.
The skin becomes drier.
It becomes a little bit more scaly.
It can then start to get more prominent blood vessels in it.
It can start to sag. It can start to sag.
It can start to become wrinkled.
I'm not doing a very good job for selling aged skin,
I think, at the moment,
but these are mostly the sort of disappointments
that we have in life of our skin just changing.
And we think, really, is this what I have to cope with?
And maybe that is what fuels people's interest
and appetite for trying to do something about it.
But these are natural processes.
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Okay, back to the show.
I mean, none of the things that you described are things that anyone wakes up and says,
oh, I'd really like to have more saggy and wrinkled skin.
Not attractive, is it really, to most of us?
And is any of that a cause of any ill health,
or is this entirely sort of superficial
and it isn't really causing any thing that's going wrong,
or is this sort of like a sign
that somehow your skin is not as effective
as it is, you know, as I think about my children?
If you just focus on the appearances,
then you can think of it in fairly straightforward terms.
It's just the appearances. But of course you can think of it in fairly straightforward terms.
It's just the appearances. But of course, there's a lot more things going on.
You know, we're accumulating damage in our skin as we get older.
And some of that damage may not just be benign.
It may start to promote the development of skin cancers, particularly in people with a paler skin.
So we're fighting this battle of the appearances, yes,
but also this accumulation of damage,
which can partly be repaired.
But as we get older, our repair processes in the skin
and in the body in general deteriorate a little bit.
And therefore we have other aspects of skin aging,
which can be more medical rather than just social
and their appearances.
And John, why is it that my skin is starting to sag, that it starts to become more wrinkled?
You know, as far as I know, my heart is still doing a good job and it's like working the same way that it was,
hopefully, when I was little, but clearly my skin is really changing. What's going on there that's causing that?
Yes, again, just like the visible changes are there, there's all sorts of rather depressing changes going on there that's causing that? Yes, again, just like the visible changes are there,
there are all sorts of rather depressing changes
going on structurally in your skin.
So you're losing collagen.
Your elastic tissue, which is important for the recoil
in your skin, the stretchiness in your skin,
is losing its function.
The fat that we have in our skin, you know,
80% of your body fat is in the skin.
But as we get older, it starts to redistribute.
And part of that redistribution can affect the way the skin appears.
Our bones change a little bit as we get older as well, so that can affect the overall scaffolding that we have in our skin.
So each layer of the skin, from the outer epidermis through to the underlying dermis where those
collagens and elastic tissue are right down to the underlying fat and bone will be changing,
remodeling, reducing in some of their vital components.
And that's part of the story of aging.
That's really interesting.
So one of the things you're saying that's happening is that I have less stretchiness
because I don't have as much collagen as I used to have.
Do we understand why that's happening?
Well, collagen is produced by some cells in the dermis part of your skin called fibroblasts,
and they produce a lot of the collagen in earlier life.
But as those fibroblasts age, they lose their ability to keep generating lots of new collagen fibres.
And the elastic tissue, the recoil, is quite interesting because what happens
there it's not necessarily just a lack of elastin. You can produce quite a lot
of the elastic tissue but it just doesn't work in the way it used to. So, skin will
not stretch and recoil in the way that it did when you were young. So, it's an
accumulation of lack of some fibers and other
fibers that just aren't working as well as they used to.
And is everybody aging at the same rate? And I asked that question sort of feeling pretty
confident that it doesn't seem that way as I look around, I don't know, the people who
I went to school with and I'm now 50, you know, what do they look like? I feel like
there's a very wide distribution, in fact, of how they appear to have aged.
I think that's right.
I mean, we wonder on one level
whether it's just the clock ticking all the time,
but people do age at different rates.
And that applies to both their innate biological aging
and also the way they look.
So yes, everybody does differ in their appearances
and their actual aging.
Do you understand why skin might be aging at different rates and therefore
potentially can think about things we might do differently?
Partially, I think we've got some ideas about some of the processes. The genetics
is important. We know that there are key factors that control our metabolism that
will be important.
Everybody is aware of antioxidants and the processes they do to try and mop up some of the
damaging chemicals that we have in our skin and other tissues, things that are called free radicals.
So there are different ways of monitoring that damage that's building up and it varies from person to person.
Some people get a lot, some people don't get much.
And there are already people doing things to try
and impact on that through things they might take
in their diet, maybe things they might do in their lifestyle,
other ways that they might influence the appearances
and that underlying ticking clock that we all have.
Now, let's say you're 50 or 60 or something.
So you've been an adult for quite a long time.
Like what are the key things in one's lifestyle
that are likely to lead to sort of faster skin aging
than average?
Yes, that's the challenge, isn't it?
If we could just pick out all of those key factors
and then say, yeah, stop those,
and I will stay young and look younger.
So what can we do?
Are they the stories about things like sleep
and hydration and stress?
Maybe to some extent.
But I think most doctors are gonna focus
on some of the things that may be relevant
like smoking and sunlight.
And maybe those are the bits that we can affect
our lifestyle to try and influence a bit.
So those are having some real impact.
Like if you smoke, it's not just a story, it is actually affecting your skin over time.
So I'll give you a little bit of science on that one because what happens when you smoke
is it activates a destructive enzyme in your skin called a matrix metalloproteinase.
So these are enzymes that will actually break down collagen fibers.
So if you smoke, obviously it will do things in terms of nicotine and some of the other potentially damaging agents in that cigarette.
But it will actually in your skin activate matrix metalloproteinase, which will break down your collagen, produce wrinkly, sagging skin.
So if you do smoke and you don't want to have wrinkles,
don't smoke.
What about vaping?
Yes, I suppose that is slightly less studied.
One looks that that might be a safer alternative,
but I think you'll also find activation
of these destructive enzymes from vaping too.
So there is no escape.
Don't smoke, don't vape.
So that's interesting. So you think that vaping would also So there is no escape. Don't smoke, don't vape. So that's interesting.
So you think that vaping would also have an impact
on your skin?
Because I think often I consider it something
that's a safe alternative to cigarettes.
Less well studied, less science,
but potentially the same destructive effects might apply.
So I think you're telling me this story
that it's sort of normal for my skin to age,
that sadly I haven't got as much collagen as my children, which I sort of know,
but now you're helping to understand why it is that they're like,
daddy your skin's a bit saggy, isn't it?
My daughter said recently, I was like, thank you.
But there's this enormous industry that's trying to slow that down
or even tell you that you can reverse the skin aging.
So today I'd love to talk about like what actually helps with this slow that down or even tell you that you can reverse the skin aging.
So today I'd love to talk about what actually helps with this and what is just hype.
And I have three myths that our listeners put forward as the things they were most interested
to ask one of the world's leading dermatologists about.
The first one was expensive creams can erase wrinkles. So, I see ads for them
everywhere. Do they work?
Well, that would be a wonderful thing if they did, wouldn't it really? Part of the challenge
with all of these creams that you might see that claim to actually treat wrinkles is that they don't really.
They are cosmospaticals by and large.
What is a cosmospatical?
It's not a drug, it's a product.
That's something that might impact on your skin.
It sounds like a made up word which is partly cosmetic
and partly a pharmaceutical.
But these are compounds that don't really have to prove
that they work on the underlying problems in aging.
They really just have to prove that they are safe.
Now, some of them may have some benefit on the skin.
They certainly, in terms of what they actually do to the anti-aging process, they work in the lab.
If you set up some amazing cell culture model or model of aging skin in the lab,
and you test high concentrations of many of the ingredients
of these anti-wrinkle products, they might do something.
But then the reality is when you make a product,
is the concentration the same?
And most importantly, can you deliver it
to where it needs to be delivered in the skin?
I've already mentioned that the skin
is a very effective barrier.
If you're putting a cream onto the outside, then is it really going to penetrate right
the way through the epidermis, into the dermis, to get down to where your sagging collagen
fibers might be, where it actually needs to do its effect?
I suspect mostly not.
The other thing just to mention about those creams, of course, is if you notice notice the advertising they no longer claim to treat wrinkles or to improve wrinkles
The advertising actually now says may improve the appearance of wrinkles
Which might tell you something that you're having a more superficial impact rather than getting really deep down to where the skin is
Contributing to actual wrinkles John could you paint me a bit more of a picture?
Cause I can't tell my epidermis from my dermis.
I think like everybody else
who's actually thinking about buying these creams.
I'm like, well, that makes sense.
The wrinkles are on the surface.
I put it in, hey presto, isn't it like builder's putty,
just filling it all in and problem solved.
If only, that's right.
So the epidermis is a brick wall
on the outer part of your skin.
And literally that does not contribute directly
to the appearances of wrinkles.
What you have underneath are the collagen fibers,
the elastic fibers, and these are the ones
which are affecting the texture of your skin.
So the epidermis over the top is really just
like a protective barrier, a layer of carpet the texture of your skin. So the epidermis over the top is really just like
a protective barrier, a layer of carpet
that's just over the top of your dermis
where these destructive aging changes are taking place.
So there are some changes in the epidermis
as you get older that contribute to dryness and so on,
but really those things that we see as wrinkles
are deeper down.
And so for an effective treatment, you're going to need to be able to get down to those deeper parts of the skin.
And topical preparations are not really going to get there in most cases.
You're saying you've got this protective barrier, this epidermis,
and basically I'm putting these creams on and they're just preventing it getting through. I mean, it's doing its job by being, I'm thinking about it almost like the waterproof
coat on my flat roof in the house is this sort of like paid good money to make sure
the rain can't get through and this is sort of what the outer layer of my skin is doing.
Absolutely. The skin is doing a good job. Of course, as we get older and it gets a little
bit drier, maybe there are a few leaks in that particular tarpaulin that you've got that are there. You're quite familiar with my flat roof,
I can see. But mostly, of course, the skin will just do its job and keep the outsides out.
What many of those products do, of course, is that they actually feel good on the skin.
And there are some products which are cheap and cheerful, and others which are much more expensive.
And it's usually in those more expensive products.
There is a particular preparation, the way it's put together, that actually
makes it feel expensive, luxurious, and it ought to work, shouldn't it?
At that price.
So there is a real difference in feel and that can be part of your experience
to enjoy it, but it isn't necessarily going to change its ability to actually
penetrate sort of deep enough into the skin to have the impact on aging that you're looking for.
That's a very good summary.
I mean, you as the buyer have to determine whether you think paying 200 times more for
one of those more luxurious creams is really worth it.
It'll make you feel better, I hope.
So I feel like we see more and more creams in white bottles with lots of scientific ingredients.
I feel like there's definitely been a shift where, despite what you're telling me, it
all feels a lot more scientific than it used to.
Is that true?
And if so, what's going on?
Yes, you might think the marketing is very important in terms of how you package things
and bottle things up.
And one of the interesting things from some of my colleagues
around the world, they investigated what sort of packaging
are consumers going to be most interested in for skincare products.
And just to cite some research from colleagues in Thailand,
they studied male toiletries, cosmetics, things that were to do with anti-aging, and they packaged them in all sorts of different bottles,
formats, creams, gels, but mostly the study was around the packaging,
working out whether the color, the style of packaging really works.
And what they found, perhaps to people's surprise, because you might think
for male toiletries, cosmetics, something chunky, bold, silver, grey, graphite type of appearances might be most appealing to
consumers. Actually they found that it was products in white bottles, white
products, white tubes, where people sort of assumed some medical relevance or
impact from these cosmeceutical products and so those were the ones with greatest
appeal. So packaging and marketing can contribute to the overall experience and expectation
of what one might get from what's actually inside those bottles or tubes.
You're making me laugh because all the skin creams that have survived on my side of the
bathroom are basically in white tubes, quite low-key.
I'm just a victim of marketing like everybody else.
You are indeed, Jonathan.
There we are.
Yeah, yeah, yeah.
So I just want to pick up on one other thing that you mentioned in the quickfire round
the questions, which I found very surprising.
I asked about whether they need to prove that these creams work before they're able to sell
them.
That's right.
A cosmeceutical does not need to have scientific proof that is actually doing something in the skin which is reversing or treating or preventing some of the aspects
of aging.
And so most companies will actually just produce something that is safe and then it goes back
to the feel of the product and the consumer reaction to it.
There are some cosmeceutical products in which the manufacturers, in collaboration with their scientists and dermatologists, have gone the extra step and maybe have sampled part of the skin to look at some of the fiber changes that occur after placing products on the skin.
And they have demonstrated at, albeit low scientific resolution, some changes in the skin that might show a slowing down
or reversal of some of the aging products.
So it's putting a little bit of proof onto a story
where it isn't actually required.
And of course, for a consumer, you may take that and say,
wow, this is amazing.
There is some science here.
This must be a credible product.
But it's unlikely to be anything like those studies
I've mentioned in the lab where you can make a model of skin
or use some cells and use a higher concentration
of the active ingredients.
There is limited data on this.
Maybe some products have a small amount of data.
And the evaluation tools are not necessarily the ones
that we would use in pure science.
But there's a small
story for some of those products and I wouldn't want to dismiss it completely.
You've been very careful John, I can hear. Last question around there, so you said
that these expensive creams can't really erase wrinkles. I do definitely see ads
where they sort of show a before and after of putting some sort of cream on
and people say, oh you know you can't see as many wrinkles as before.
Is that totally untrue?
Not completely, but I would encourage
everybody who looks at some of those adverts to look
carefully at the before and after pictures and think,
has the lighting changed?
Is it more oblique?
Is the photograph directly comparable?
Is it exactly the same angle that's being shown there?
Is the subject wearing different makeup? Are they wearing different clothes?
Is there anything else to enhance appeal between the before and after pictures?
And you know if somebody calls their cream a creme,
then probably you're more in the marketing sphere rather than anything more efficacious.
But improves the appearances of wrinkles can take on many meanings and marketing opportunities.
That's brilliant. I'd like to move on to the second myth, and we had so many questions around this.
The sun is the enemy, is I think how I would describe this in simple.
What happens when sunlight hits our skin?
So sunlight, as we know, is composed of lots of different wavelengths
and these will penetrate the skin. Many of your listeners will have heard of UVA,
UVB, UVC, visible light, and all of these will have different penetration
capabilities through your skin. But ultimately what they're doing is either
causing damage to your genetic material, the DNA, or directly some of the structures and fibers in your skin.
So it is an enemy on one level, but actually in moderation, sunlight is good for you.
There have been many epidemiological studies that show sunlight is really good for your
heart.
So cardiovascular health can be improved by sunlight exposure.
So that probably means next time you're not in the gym
and you're lying on the beach and somebody phones you up,
and you say, just doing a bit of cardio.
It actually may be telling the truth.
So dermatologists are always worried about DNA damage,
about cancer, about molds turning malignant,
what we call melanoma, and some other skin cancers.
But there are other clinical and human health issues that are beneficial.
We all feel good, of course, because of the endorphins that sunlight releases into our
skin.
I was actually going to ask, John, could you explain for a minute how can sunlight be good
for my heart?
And in fact, then I'd love you to explain how sunlight can make me feel good,
because it definitely does.
What's going on?
So let's take the skin part first of all.
So when you shine sunlight on your skin, it is damaging the DNA in your skin.
So tanning, I prefer the word DNA damaging.
So you're actually damaging the DNA.
But when you have damaged DNA, it will produce a chemical,
which we call POMC, Pro-Opio Melanocortin.
And Pro-Opio Melanocortin, POMC, is then broken down
into various other sub-chemicals,
some of which will stimulate the suntan,
something called alpha melanocyte stimulating hormone.
But one of the other breakdown products of POMC, believe it or not, is beta endorphins.
So everybody knows about endorphins being a sort of stimulus to making us feel good,
to feel better.
Exercise can stimulate endorphins.
Other things can stimulate your endorphins.
Sunlight can stimulate beta endorphin in the skin.
And maybe this is one reason why people like lying in the sun or going to tanning
salons because you're becoming almost a natural junkie with your endorphin
release in the skin.
And so that's why we feel good to some extent.
In terms of your cardiovascular health, it's the chemistry and the science is much more
deep than that. You're controlling inflammatory chemicals called nitric oxide and other destructive
antioxidant quenching as well can be useful. We don't know it for sure, but from population studies,
we know it's good for your heart. You can save a lot of lives from cardiac ill health by having sun exposure.
Do we understand how the sunlight is contributing to my heart health? I mean, is it as simple
as just, I definitely feel much happier on the days when the sun is shining and somehow
I'm just overall, you know, it's reducing my stress or is there something else going
on? There's going to be some science there. I think the simple way to think about sunlight is you have this double-edged sword.
You have when sunlight gets shined on your skin, it quenches various toxic chemicals
that could be destructive to your general health, including your heart.
So you have the benefits of quenching those damaging chemicals. Offset against that is the DNA damage in your skin,
which could promote the acceleration and development of skin cancer.
So that's kind of the double-edged sword of sunlight, I think.
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I think it's really interesting. So there's a sort of balancing act here.
Potentially some of the messaging we've all been getting for the last 30 years of like all
sun is dangerous because you're going to get skin cancer. There's also you're losing out on some benefits
which we're talking about for heart health, for our mood or the rest of it. And so, is it possible to have a middle ground?
Is it possible to have a situation where
you shouldn't be avoiding sun all the time?
That would be my recommendation.
It's a question of just where you set that line,
and it will vary from person to person.
But I think an important message is that
some sunlight is good for most people.
And when you look around what most people
might be doing in the Western world, whether
that's the States or the UK or France or whatever, are most people protecting their skin enough
from your perspective?
Too much or not enough?
If I put my dermatologist hat on, I would say probably not enough because it's really just the start of education for people, I think,
in terms of how to look after your skin. People have been aware of this, you know, since the
rising incidence of skin cancer in the 1960s and 70s, people really started to understand that the
sun wasn't always our friend, particularly when it was taken in excess.
And gradually, different parts of the population around the world are getting the message.
It seems that older men are still slow to get the message about protecting your skin
health.
But, you know, in some countries around the world, New Zealand, Australia, the message
has been there for 40 years plus and people are sensible,
take action, know what to do in terms of good behavior and bad behavior and I
think it's important to keep the message going that there are things we can do to
look after our skin, to protect our skin, to reduce the incidence of aging and skin
cancer. But at the same time all of us need to enjoy a bit of sun every now and
again. Now you mentioned writing the quickfire again, something that I was very surprised by, because
you said that it was possible for those of us who might have been in the sun for too
long and got sunburn, there might be some way to reverse it.
And I'd always assumed that that was an old wives tale.
And if you were burnt, you were burnt.
It's possible to do something about this?
Yes.
I mean, this is not mainstream science at the moment,
but what we have are some new ideas about treating sunburn.
None of us should really get sunburned.
We should all be sensible, shouldn't we?
But what tends to happen is that people will go out on the beach,
maybe it's a nice day, maybe they'll stay there too long,
and then come the evening, people will think, oh no, I've overdone it.
My skin's going red.
I'm going to have a terrible night.
It's going to be blistering.
I'm going to be peeling.
I'm going to be in agony.
The rest of my holiday is ruined.
Where's the doctor?
What can I do?
I haven't got any aloe vera or something like that
to put on my skin.
Can I get some steroids of some sort to calm it down?
So John, you've painted a beautiful picture.
I'm going to really tease our listeners because I want to come on to my myth number three before we tell the answer,
because I know you're going to give us actionable advice.
You're going to tell us the answer for what to do in that horrible situation?
Yes. Hang on in there. I'll tell you the answer soon.
Don't normally do this. Let's see what the feedback is.
Because I would like to go on to myth number three before we switch to really all the actionable advice.
It's interesting. We had a lot of questions about this
and I feel it's a topic that five years ago
I hadn't really even heard about and it's collagen powders.
And so we had lots and lots of questions
which were all basically the same, which is,
is it true that collagen powders, you know,
if I eat them, drink them, can sort of plump my skin
from the inside out.
Maybe start with a theory of how they should be doing this and then tell me, does it work?
So the challenge, of course, is people think that what happens when you age is that you lose collagen in your skin.
And most people will think, well, if I lose collagen, can I just replace collagen?
And how do I replace collagen?
Ah, there are these supplements out there.
It says collagen.
Is it just a question of taking something from the pot and putting it into my skin?
That would be really great if that happened.
But it makes no sense for us as doctors and scientists because this collagen protein,
what happens?
You take it by mouth, it goes into your acidic stomach, and it's into what we call the digestive
system and that's exactly what it does.
It digests this complex polypeptide protein into individual amino acids or tiny little
peptides and many of those will then be absorbed somewhere through the gut and they will contribute to the protein diet that you are taking.
But what's going to happen to them? Can we really expect those little individual amino acids, peptides to know what to do?
Are they really going to go into your bloodstream, circulate around and think, ah, this is a nice place, the skin where there's missing
collagen. Let me land here and start assembling myself into a collagen fiber to replace what is
missing. It just doesn't seem logical and there is no science to support that idea at all.
There may be some types of collagen where people have a little bit of evidence. I see no proof.
Of course, what they can do is if you're taking protein diet, some of it may finish up in
the skin, some of it may complex into bigger protein structures.
Some of those may then absorb water or contribute to increased hydration in the skin, which
might give a plumper appearance.
So it might improve some of the appearances, but actually we should dispel this myth
that a collagen supplement will lead to more collagen
in the skin.
That simply cannot be true.
That was pretty strong,
because people are selling these, they're expensive.
So people are choosing to do this versus
buy something else, maybe a better diet.
You sound like you really just believe this is junk and doesn't work.
I will believe good science when I see it.
As I mentioned, maybe there's a little bit of something around some of those marine collagen,
but it's not great restorative, anti-aging, new skin skin dynamism type of results. I think it's
safer at this stage to say case not proven and just be careful if you go out
and think about buying some of these collagen supplements because very little
of it and perhaps none of it will finish up in your skin. You're being a bit tough
on on the myths so I'd love to actually talk about what people can actually do if they want to keep their
skin both as effective as possible, because you've talked about how important it is as
this barrier, but also hopefully, you know, looking as young as possible.
I think the obvious place to start is sort of skincare routine.
Should there be a daily skincare routine? And and if so what really should be in it?
There is such thing as a good skincare regime and it's typically divided up into three bits
and most dermatologists will give similar advice.
The first one is about cleansing and what sort of thing you do to cleanse
and there are a whole range of cleansers out there.
For those of us who are quite naive on this, what do I need to cleanse it for?
Well, just to get rid of any dirt and grit and dead skin on the surface that
you may have accumulated over the previous few hours, it just removes
some of the products there.
I think most people will just probably use something in the shower or quick
wash in the basin, but that still constitutes cleansing to some extent.
But there are a number of products which are out there as cleansers.
But you're not sitting here saying, oh, that's all a bad idea.
I'm stripping my skin of what you shouldn't do.
Like, actually, cleansing gets the thumbs up.
Cleansing of some sort is probably a good idea for most people.
And then the second stage after that is around moisturizing.
And this is, again, a little bit contentious because some people just don't need a moisturizer.
But probably about two thirds of the population would benefit from putting a moisturizer onto
their skin. Choose one that's more creamy perhaps than greasy, particularly if you have
a spot or acne prone skin. Grease can make things worse and nobody wants to look ultra
shiny after putting that on. But some moisturiser may be helpful after that cleansing,
particularly as the cleanser may dry the skin to some extent.
And John, what does a moisturiser do?
So it's just providing some hydration
to the superficial part of the skin.
Again, it's not penetrating.
It is just providing you with some lipids
or some other related moisture retaining compounds
on the surface to
improve your appearances of your skin, to maybe reduce the amount of water loss that naturally occurs
through your skin and to deal with any dryness that might be there. So it can be a good idea and it's a very personal choice about what
moisturizer you use and sometimes some of the cheaper products are just as good as some of the more expensive ones. So
moisturize would be phase two and then the next phase I think that
dermatologists will lobby hard about is the sunscreen and
it is a good idea to put sunscreen on.
How to do it? What to choose? These can be personal choices, but most dermatologists would recommend
you don't use a sunscreen with a low sun protection factor. Thirty plus is the minimum that most
dermatologists would recommend. Sometimes fifty plus. When you look at the label on
it, look for something that gives ultraviolet UVA protection as well. And on most sunscreen
products there's a little logo. It says UVA in a well. And on most sunscreen products there's a
little logo it says UVA in a circle and that's so something to look at. So
you're looking for something factor 30 plus with a UVA logo on. And then it's
important to think how much do I actually put on? Well if you're putting on
your entire body, obviously most people won't be doing that because they'll be
dressed and ready to go, but if you were to cover your entire 1.8 square meters of adult
skin, well so that's like 10-12 square feet, yes it would be quite a lot
wouldn't it really, then you would need at least six teaspoons worth of
sunscreen. Another analogy people sometimes think is a shot glass full of
sunscreen, that would be enough shot glass full of sunscreen.
That would be enough for one application of sunscreen.
Which is quite a lot of sunscreen, isn't it?
Yes, because I think one of the big problems we have, you look at something it says SPF 30, SPF 50 or something like that,
but actually how those numbers were calculated is quite different from what we do in practice. So those SPF numbers were calculated in
laboratory by putting a certain amount of sunscreen onto
a square centimeter or quarter inch of skin and shining light on it,
and then generating numbers and showing what an SPF can mean in the lab.
But actually, none of us, myself included,
ever put sunscreen on as thickly as it was
done in those laboratory calculations.
Is that right?
It's like put on really thick to show you that it works really well and then in reality
we just put like a little dab on.
It's a standardized laboratory approach, but we actually just dab and smear, don't we really?
And that comes on to the next point of sunscreen application is that you should really try
and think about putting it on repeatedly throughout the day.
Every two to three hours is a good idea. So once before you dash out of the house is not enough.
Every two to three hours you should be thinking about putting your sunscreen on.
And that is a good regimen. Cleanse, moisturise, sunscreen, and you're done.
Can I ask about the sunscreen a little bit more?
Because you just talked also about the balancing factors between the risk of cancer on one side and some of these other benefits.
So maybe my first question is, is the only benefit of sunscreen to avoid the risk of cancer?
Or does it also help against the sort of some of the skin aging that you've been talking about previously? Both.
So sunscreens will protect you against both aspects
of that type of problem.
So the aging aspects and also the malignancy, the cancer risk
that everybody can experience with sun exposure.
So a double hit.
Is aging only about this damage to collagen
or is there other things that are going on?
Because I definitely see this, I definitely notice, I'm old enough now to notice that friends of mine who really love the sun
definitely look older today than those who have had what I now consider a Japanese attitude to sun.
And I say that because I went to Japan once on holiday, I had a wonderful time
and I was really struck by the fact we're on this trip with quite a lot of Japanese people and
Certainly all the women basically had an umbrella in the Sun over the head as we walked around to make sure they didn't get Sun on
Their face, which I guess is even better
Presumably than wearing SPF. So I consider that the extreme
I definitely feel like I've noticed a difference in sort of the visible aging but I realize that's not a scientific experiment
Is that real or am I just sort of putting visible aging, but I realize that's not a scientific experiment.
Is that real or am I just sort of
putting things together in the wrong way?
No, you're right.
And in fact, many of those people in hot countries,
in Asia for example, will be putting sunscreen on
as well as using some sort of protection.
A UV umbrella is what they tend to go for.
I grew up in Japan myself,
so maybe there is some legacy for me too, but for most
people I think the idea should be when should you start putting sunscreen on. Obviously
if you're going on holiday as a child, that's fine to put your sunscreen on, but those regular
sunscreen applications, mid-20s, early-30s is probably when you should start doing that
regular, everyday sunscreen application.
That's interesting because I feel like one of the things that you're most told to do
is put sunscreen on your children when they're little, and yet you're saying actually I shouldn't
worry about that as much?
If they're going on holiday or they're going outside a lot, yes, but if they're just running
around let them have a little bit of sunshine.
I don't see any problem, but do stop them getting burnt.
So it's more like if it's really sunny
and they're gonna be out all day,
then sunscreen is a good idea even if they're five or 10,
but if it's not particularly sunny,
they're not going to get burnt.
You're saying you probably don't need to worry so much?
Worry less, I would think,
but obviously you do need to think about clothes.
You need to think about the amount of time
that kids are spending out in the sun and avoid them
getting burned. But what we're really saying about the regular sun
application is part of this cleanse, moisturize and apply every day approach
from your mid-20s onwards.
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We're recording this podcast in London and England. It's very gray and wet outside right now and for
much of the winter it's pretty dark. Do I need to wear sunscreen on my face every
day or only you know in the summer when there's more light around?
This is going to vary from country to country of course but as you say we're
in gray rainy rainy London.
And if you look at where the sun sits in the sky
and the potential damaging rays,
I think, Jonathan, we can let you off
between November and March,
as long as you're not disappearing off
for a sunny holiday somewhere in between.
But the sun is so low at that time
and the number of rays that are coming through
and potentially damaging the skin is low.
So even I will give it a rest between November and March.
I think it's really interesting. Do you feel that as a dermatologist, your advice on this
is less absolute than it would have been 20 or 30 years ago? I feel like I've been hearing
slightly more balanced advice about this than maybe I was getting in the past.
I think that's right. All dermatologists will focus on not letting kids or adults get burnt,
but a little bit of sun exposure is good for you and
common sense and regular applications of the sunscreens is also common sense.
So it's this balanced approach to life. Nobody wants to stop people enjoying the sun,
but we have to take a sort of sensible attitude. And I think a lot of people have taken that on as
part of their regular lifestyle. Now they know the sun is both wonderful and potentially harmful.
What about if I didn't put my sunscreen on and I lay out in the sun in Florida all day and now
I've gone a beautiful lobster and it's
starting to hurt. You suggested them, obviously I should have worn the sunscreen, that's very
clear, I've heard it loud and clear, but if I didn't, you said there might still be something
I can do?
Yes, I'm reprimanding you for that behaviour Jonathan, for that sunburn.
I feel reprimanded.
Yes, very good. So that's it. You're sitting there and you've gone red
and you're going to blister
and you know the next few days are going to be
in really a very uncomfortable
and there's not much you can do about it or is there?
I guess before we get to that,
we probably ought to think
what has actually happened in your skin, Jonathan?
Now you've been lying on the beach.
So you have got this red skin
and what's going on in your skin. If you could put
a microscope into your skin you would see inflammatory cells, cells called macrophages
and neutrophils would be starting to come into your damaged skin. They would be releasing lots
of inflammatory chemicals, one called TNF alpha, Tumor Necrosis Factor Alpha, that would be starting to be expressed in your
skin.
This would cause your blood vessels to dilate and leak and other inflammatory cells would
be recruited.
You'd be activating other pathways in the skin which could be potentially damaging.
Nitric, Oxide, Synthase, all of this damage is starting to go on, this raging inflammation
that's going on your skin.
And in fact, one piece of recent research that some of my colleagues in the US have helped generate
is to show that single high dose vitamin D3 can do amazing things in restoring your damaged skin. So how does it work? Well, vitamin D3 is something that will activate directly
on inflammatory cells in the skin called macrophages.
It turns them from pro-inflammatory
to anti-inflammatory.
It calms down the other neutrophils, the chemicals,
that are driving this particular inflammation.
So it has direct anti-inflammatory effect.
It's nothing to do with being a vitamin,
a vitamin that will actually impact your bone health
or anything.
We're using it as an anti-inflammatory approach,
but we're not talking about the same dose
that you might do for a supplement
that somebody might take every day.
What we're talking about here
is a single high-dose treatment
where you can actually switch the fate of these macrophage
inflammatory cells.
And most importantly, by the following morning,
your skin should be pretty much back to normal.
No steroids, no aloe vera, no other chemicals at all,
just the simple anti-inflammatory effects of high-dose vitamin D3.
Don't worry about your calcium levels, your phosphate levels, because your kidneys will protect you against all of that.
The benefits are directly onto those inflammatory cells, and it helps, and it will actually improve your skin.
And you'll be ready enough to have a second day
in the sun, albeit this time Jonathan I think with applying some sunscreen. Firstly the description
of what happens is rather terrifying when you burn yourself. Secondly this sounds magical,
I guess two practical questions. What is a high dose and are there any risks? Because I know we've
done a couple of podcasts around vitamins and one of the things I discovered from that is that ultra-high levels of vitamins can actually be dangerous, which shocked me.
Yes, I think that's right. So, a caution about vitamins. Many vitamin supplements,
many doctors will question whether they do any good at all for people's health.
But you're right, there are some vitamins which are fat soluble, vitamin A, D, E and K are fat
soluble and potentially you could build up high levels of those.
But we're talking about a single dose.
Now, the supplement dose that most people take
is something like 1,000 international units,
or 25 micrograms.
So that's the same 1,000 international units
is 25 micrograms.
The dose we're talking about here for sunburn
is something like 50 times that, maybe 100 times that. So 50,000 units, international units of
vitamin D would be a useful place to start. Many of us would recommend taking 100,000 units just
as a single dose. And this could be taken any time between one to 12 hours
after the sunburn.
So that would be the effective window
of taking this single high dose vitamin D3.
So that's the high dose.
What about the safety of this high dose vitamin D3?
There is no need to worry.
As I mentioned, your kidneys protect you
from surges in calcium and phosphate, and no other potentially adverse effects have been demonstrated.
You know, there are other medical indications that we use this for beyond sunburn,
but in terms of sunburn, this is a very useful thing to do.
So I think what I'm hoping you will do, Jonathan, for your holiday is pack your SPF factor 50,
Jonathan, for your holiday is pack your SPF factor 50,
but alongside that maybe you will also pack some vitamin D3 that you've picked up at the health food shop.
That would be a good combination to take,
but please don't burn yourself.
Brilliant, and presumably you shouldn't do this
if you're not healthy, so you're saying it's fine
if your kidneys are fine.
There may be some caveats and it may be worth taking
some additional medical advice, but
for the vast majority of people, this will be a great remedy for your acute sunburn.
Now, I think we talked about actionable advice in terms of sort of cleansing and moisturizing
and sunscreen.
The one product that I haven't heard you talk about, which comes up a lot, is retinol.
Could you start by saying what retinol is and then tell me your view about whether or
not there's something real and actionable that you can do there?
Yes, so retinol is a derivative of vitamin A. It's part of a group of compounds that
dermatologists use in their practice called retinoids.
Many listeners will have heard of retinoic acid, which we can use as dermatologists use in their practice called retinoids. Many listeners will have heard of retinoic acid,
which we can use as dermatologists in either cream or gel form,
and apply to the skin for acne,
for aging, anti-aging effects as well.
Retinol is another version of that,
which is not necessarily requiring a prescription.
It's something that is in a lot of products,
can be bought over the counter,
and may have some of the same benefits as retinoic
acid. So it is something which can have anti-inflammatory effects on the skin
and may have some benefits for improving the appearance of aging and maybe even
reversing some of the effects of aging. So it's out there in products and
something that people can apply off prescription.
And so unlike some of the things you were talking about before, you know, like the collagen powders,
the sort of real science behind this, this actually does something.
I think so because what most of us do in dermatology is to look at the literature
and to see what sort of clinical trials or comparative studies have been performed. We know that there is 60 years history of retinoic acid being used for
anti-aging and acne and other dermatological indications.
But we know that there have been comparative studies using retinol to ask the question,
is it similar to retinoic acid?
Is it more effective? Is it less effective?
Does it have similar side effects, different side effects? And most of us then will look at the
information and in the literature there are a number of well detailed studies
which we call systematic reviews where people have actually gone through
thousands of scientific papers and studies, filtered them to get only the
most robust findings out, analyzed those studies, and then made some conclusions.
Those conclusions suggest that retinol can be as effective as retinoic acid in some studies.
It can cause less side effects like dryness or irritation,
and it can have some anti-aging properties.
But at the same time, there are also some other studies which show that it is less
effective than retinoic acid and may not have
much benefit at all. So even the robust studies are giving us some slightly conflicting data
but there may be benefits to using this vitamin A derivative retinol.
You're saying it's not as strong maybe as the retinoic acid that you're gonna get prescribed by your dermatologist.
Is that what I'm understanding? So it's sort of like a weaker version that you can get off the shelf,
and that's, hence, you're being a little bit
more cautious, is that?
Yeah, so the percentages of retinol,
just like they can for retinoic acid,
in any product can change,
and that will alter some of their effectiveness
in terms of what they're being used for.
But usually, retinol is a better tolerated,
a less irritant product than retinoic acid, and it may have
some of the same benefits.
And we had quite a lot of questions about at what age someone should start using retinol
and this discussion about the fact that there's this huge growth in using all sorts of skincare,
even amongst early teenagers or younger,
because of what they're seeing on social media.
What are your thoughts here?
For retinol, it's probably the same sort of story.
Mid-20s, early-30s would be a reasonable sort of time to start thinking about it.
You know, I have dermatologist colleagues applying retinoic acid or retinol
onto their skin for 30, 40, 50, 60 years.
And they have beautiful skin, almost wrinkle-free skin,
but a small price to pay, I think, I suppose,
or maybe it's a big price to pay for having to do that
on a regular basis.
And would you have any concerns about applying it
if your skin were, if you were 12 years old?
Yes, I wouldn't advise applying retinol at that age.
I think that children, teenagers, young adults
should really avoid all of these products on their skin. We've mentioned
that some of those other skincare routines need to kick in much later. So I
think it's an important message for anybody who's really maybe under the age
of 25 is don't be taken in by a lot of advertising, by a lot of social media
trends as well. You don't really need to be doing a lot of things to your skin at that age.
You're in a wonderful time when your skin can just work at its best and do great things for you.
So don't spoil it, don't damage it, just let it be.
And if there's parents listening to this who I think I would,
you know, I'm probably maybe in that group that worry that potentially this might cause harm. So it's not just that it's a waste of money, but actually it might
actually be harmful. Can they be relaxed or are they right to worry about this?
Most of the time it won't do any harm apart from probably to the parents wallet, I think,
or credit card. But to the kid themselves or the young person themselves, I don't think
there'll be any sustained benefit. But there may be peer pressure, there may be social media pressure, people may need
to try things.
But if you are in a position just to say no and forget about it and just get on with life,
then that would be a much better option for you.
Brilliant.
We haven't mentioned anything about nutrition.
Is there any food that I could add to my diet tomorrow that could actually have an impact on my skin?
It would be wonderful. There'll be many listeners hanging on to see
what is going to be recommended at this stage.
Or is it going to be the usual thing of talking about oily fish,
nuts and seeds, fermented products, leafy green vegetables?
Probably it's going to be more of the latter in terms of where we are.
For your skin, it's the same sort of trends that go through, avocados, cucumbers, other
types of product may be there.
And some of this may be just be driven by social media rather than science.
There are many fruits out there which could have remarkable effects on the skin, but I would probably be guilty by promoting one or more of them.
But we could start a trend, maybe, Jonathan.
Let's say I'm quite interested in the GAC fruit,
because it is incredibly high in some amazing chemicals called lycopene,
which will protect you against the sunlight.
And it's very high in beta-carotene,
which will mop up various free radicals in your skin.
The gac fruit, also known as a baby jackfruit,
is amazing in terms of its potential.
And there are people across Southeast Asia
who are using it all the time in their cooking and so on, but it's not really out there at the moment. But maybe we can set
a trend and say that fruit, that food that will give you the anti-aging properties could
be gac fruit, but it might be something different next week. But I think the good advice that
Zoe has given around a healthy diet for your gut can also apply to your skin as well. A varied diet, a mixed diet, but stick to the oily fish and the grains, the fermented stuff,
and the leafy green vegetables, and your skin should at least show some improvement.
John, that was fascinating. We covered a lot. I'd like to try and do a summary.
The thing that immediately comes to mind is this idea that we can all be natural junkies by just lying in the sun,
because the sunlight goes onto our skin, like it starts damaging the DNA, which sounds bad,
it's going to make me look old and wrinkly and maybe get skin cancer, but it can produce this chemical which you call PMOC,
and that then gets broken down and gives me endorphins.
So basically, I could do something really hard, like run a marathon, or I could just lie in the sunshine
and I get this natural high.
And this is part of why we all love it
when the sun comes out and suddenly we get
the sun on our skin.
And did I get that right?
Absolutely, you're a convert to that story, yeah.
Well, I love this idea that now the science understands
what's going on.
What you said though is it isn't just about feeling good.
There's actually real evidence that this helps our heart health and that the sunlight we
can also see is sort of, you said, quenching these toxic chemicals.
So we talk a lot about fighting inflammation on this show and it sounds like you're saying
the skin itself has this role if it gets the sunlight on it.
And so we've all heard the story that sunlight is bad for you because it causes skin cancer.
And I know that's very serious and people die from it,
but you're saying there is also these benefits.
And so we now need to think a bit more
in a balanced way between those.
The other thing that I of course picked up on is
that the skin microbiome is real.
You said there are billions of these bugs
and that although we're only just starting to understand it,
you know, we might be doing this show in 10 years time
and really talking about ways to
treat people specifically.
Then we started talking about all of these myths and my big takeaway was that
my skin is a really good barrier.
And you talked about this thing being the epidermis and I think about it as
being almost like this sort of waterproof like layer, like I might put on, on my
house.
And so pretty much the creams that you put onto your skin
can't really get below that.
So actually most of their claims,
you have to treat with a grain of salt,
probably can't really work just because they can't get down
to where they need to.
And what I understood is where they really need to get to
is into this collagen.
Sadly, I have less collagen than I did when I was younger.
This is why my skin is starting to look saggy and more wrinkles.
There are lots of ways to make the collagen worse.
So you said you know too much sunshine, smoking or vaping, you know it sounds like a really
bad diet wouldn't help.
Unfortunately just popping a collagen pill isn't going to fix this.
So that was definitely thrown out with the myths.
And similarly there isn't some magic cream that's going to fix this. So that was definitely thrown out with the myths. And similarly, there isn't some magic cream
that's going to fix it, because actually it's
more that they do clever things with their advertising
than that actually it breaks through this epidermis
and gets to where the real wrinkles are.
Perfect summary.
What you did say is there is skincare routine that matters.
So like cleansing is a good idea.
Get the dirt off your skin, moisturizing.
I think you said two thirds of us would benefit,
make sure you choose something that's more creamy
than greasy, because that hydration matters.
Sunscreen, despite the discussion before
about how a bit of sun is good,
we had a very long discussion
about putting lots of sunscreen on.
So I think you're still allowed to be a dermatologist.
And you said like 30 plus is minimum, make sure it protects against
UVA. But interestingly, you were saying a lot of this is think about this, you're into
your 20s or your 30s. You know, if you're younger, then certainly you shouldn't be worrying
about putting retinol on but also you're saying, you know, don't be completely paranoid about
the sunscreen, there's benefits to the sun as well. So you know, if they're at risk of
getting burnt, put it on, but
otherwise you don't need to worry as much.
And you said if you live somewhere that is cold and dark, so that's London
or Canada or, or wherever, then actually in the winter months, you probably
don't need to wear this sunscreen.
So you said, you know, in London, like November to March, I could actually
be allowed not to, not to put it on. Quite right. And then the final thing, which I'm sure anyone
listening to is really struck by is if you do get burnt, there is something you can do.
You can take this super high dose of vitamin D3. I think I wrote down 50,000 or even 100,000
international units, you know, fast, like within 12 hours,
and you wake up the next day and you're all fixed.
Try it and see. Wonderful.
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