Podcast Rewind: The Secrets to Healthy Skin

Dr. Robert Rountree:

This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet supplements and lifestyle approaches to good health. I'm Dr. Robert Rountree, chief medical advisor at Thorne and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the food and drug administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease. 

Hi everyone, and welcome back to The Thorne Podcast. We're really really glad you're here, and we're excited to talk about some fascinating topics for you today. I'm joined again by a friend of the pod and Thorne's executive director of medical affairs, Dr. Amanda Frick. How are things going, Amanda? How's life in South Carolina?

Dr. Amanda Frick:

Going great. We had a lovely cold snap for a couple of days, but we're back at 75. I got to say, I think I'd rather have the little bit chilly weather, but other than that, things are great.

Dr. Robert Rountree:

What's a cold snap in South Carolina? Is that 65 degrees? That's winter, 65?

Dr. Amanda Frick:

I think we had 40s at night.

Dr. Robert Rountree:

Oh.

Dr. Amanda Frick:

And the coldest day was 50-something during the day. But it, cold enough for a scarf, which is fun.

Dr. Robert Rountree:

Well, we're in our usual wide swing weather in Colorado where it could be 75 degrees one day and 39 the next day, literally. And we've got a little bit of snow on our hiking trails and the ski country is opening up. So people who are fond of skiing, take out your winter clothes and your sweaters and get ready because it looks like it's going to be a great ski season. And that actually kind of segue's into our topic for this podcast. We're going to talk about skin health, and certainly being out on the slopes can be pretty rough on the skin, not to mention the high altitude sun exposure. But you got the wind and the cold and all that kind of stuff. So where do you think we should start talking about skin? What are some of the basic principles you think of when it comes to keeping your skin healthy for long periods of time? 

Dr. Amanda Frick:

I think that there's the external and internal sort of aspect. So diet, what you're taking in, hydration. But also the protection from the outside, which could be lotion, could be some kind of therapeutic treatment, could be some sort of physical treatment, but also protection. So sunscreens, which I think will come up a bit later, and other things repair and kind of protect from the outside.

Dr. Robert Rountree:

I'm sure you've seen this scenario, but having originally come from North Carolina where cigarettes are, at least they used to be, close to God and country. That it was considered patriotic to smoke in North Carolina, at least when I was growing up. And I bring this up because I see people who are really concerned about their skin and they're using creams and all that kind of stuff, but then they smoke a pack of cigarettes a day. You think that's a good idea?

Dr. Amanda Frick:

I don't think it would be my favorite idea.

Dr. Robert Rountree:

And so what's the concern? What does cigarette smoking do that would have such a big impact on the skin?

Dr. Amanda Frick:

I think it's back to our original principle of internal, external. So you have some exterior damage immediately from the smoke coming out or onto your hands. People get finger staining and damaged that way, literally right on their fingers, without even having to inhale.

Dr. Robert Rountree:

Yep.

Dr. Amanda Frick:

But then of course the oxidative damage and how you're affecting your body systemically by oxygen burden by smoking, and I think that that's part of it too, let alone the sort of toxic effects in the long over time.

Dr. Robert Rountree:

It seems to me like, I read an article a number of years back that said the thing that can age your skin the fastest is smoking cigarettes. And so it really gets back to this issue you're talking about, internal health, that people get this idea that I can do anything I want as long as they have the right cream. But it's not true. If your body is aging more wrapped because you're doing something like smoking or drinking a lot of alcohol, which can also raise oxidative stress, putting a burden on the liver, that things that cause that kind of internal damage are obviously going to be age accelerant's. It just drives home the point about lifestyle, how the very first thing you can do if you want to keep your skin healthy is to live a healthy lifestyle. What about laying in the sun? What are your thoughts on sun bathing and beach bathing, because it is one of the favorite pastimes for people that live in coastal cities?

Dr. Amanda Frick:

I think it's, I think there's a bit the controversy, and maybe I don't want to give my opinion because who know's who's going to slam my hand. When I was growing up in Michigan, it's cloudy 70% of the time. So if there was a sunny day I remember purposefully being out in the yard with baby oil, just trying to char yourself on purpose, which I don't think a lot of people are doing anymore. But there's upside and downside. I think a lot of dermatologists would say even if you wanted to be out in sun bathing on purpose for the joy, for the vitamin D, for whatever it is you're trying to accomplish, you should still wear some level of sunscreen because at least you're protecting from some sort of UV rays, even if you want them on purpose. But I sort of have a mentality of nothing should be ever completely off limits because life and joy are important. So if that's something that brings you joy and you can moderate it and protect in whatever way that you can, I would hate to take it away from someone.

Dr. Robert Rountree:

You know, it's interesting because I heard Dr. Michael Holick speak a number of years ago. He's the researcher at Boston University that actually discovered the active form of vitamin D, the 125 dihydroxy D, which is made in actually immune cells. We used to think that it was only made in the kidneys, and Dr. Holick showed that it was made in the kidneys and in immune cells and could get activated when immune cells were activated. But Dr. Holick is a big advocate of small amounts of sun exposure. So he says, "Yo, we should all be out in the sun, but we should just not do it in the middle of the day. We should only do it in the morning and the afternoon," and he wrote that in a couple of medical journals, and he got slammed for saying that. And he got slammed by people in the dermatology department at Boston University who said, "Well no amount of sun exposure is good for you." 

And so Dr. Holick's response was that the dermatologists have gone over to the dark side. And then in the lecture I heard him give, he actually showed a picture of Darth Vader, and he said that this is where the dermatologists were coming from, that they were so afraid of skin cancer that they were telling people to hide in a closet all day. It's a interesting paradox because you do get more skin cancer if you have a lot of sun burns, but actually sun exposure decreases your overall cancer risk. Isn't that true?

Dr. Amanda Frick:

Well it's just like anything else. Too far in one direction, and then what's it getting you anymore?

Dr. Robert Rountree:

My question is doesn't that age your skin rapidly if you're doing this too much? So there's clearly a bell curve there. There's an optimal amount, which Dr. Holick talks about, and then there's the people that overdo it, and those are the people that end up with the leather skin and all of that. Do we know the mechanism is behind that? All that excessive sun exposure, what's it doing?

Dr. Amanda Frick:

I think the UVA, UVB radiation actually causing some damage externally is probably the biggest factor. I think there's other things that can go along with it. Some people can probably get away with it because they're genetically blessed or they have other mitigating factors, but the actual UVA, UVB rays are what's doing the damage to the skin.

Dr. Robert Rountree:

Yeah. So it's a... Again, it's back to the oxidative stress. So it's the same kind of thing that happens with cigarette smoking. Maybe not as bad. Are you aware of the research on sulforaphane for, as a skin protective agent? I'm wondering if you have any comments on that or do you want me to to chime in on it? 

Dr. Amanda Frick:

I think you should chime in on that.

Dr. Robert Rountree:

I could chime in on it. So what we know is that the sulforaphane, which is found in broccoli seeds and broccoli sprouts, and actually Thorne as a product... I guess I could say that. We've got a product that's called Crucera that has that broccoli seed extract, activates protective enzymes, and those protective enzymes actually work like antioxidants. So there's this kind of longstanding notion that antioxidants are good for you, vitamin A, C, E, zinc, selenium, that they're good for you. But there's some research showing that if you take them by mouth, they don't always work the way you think they should work.

Whereas, if you take things like sulforaphane from broccoli seeds, then you actually get this long-acting antioxidant effect and that can manifest in the skin. And they actually did a study with these nude mice. But they, these nude mice, when they expose them to UV radiation, they get skin cancer like crazy. So what they did is they ground up broccoli sprouts and made a cream out of it and put it on the skin of these mice, and then they radiate them. They zap them with ultraviolet radiation, and it dramatically dropped the amount of skin cancer they got, and it did it for days. 

Dr. Amanda Frick:

They literally put the paste.

Dr. Robert Rountree:

Yep.

Dr. Amanda Frick:

So you're getting some kind of physical block. I mean, arguably you have a physical block too, right?

Dr. Robert Rountree:

Right. Okay. So I hear what you're saying. You could say, "Well, maybe it was just a good sunscreen. Why is it different than zinc oxide?" The difference is that they put the cream on, because this great question you're asking, and I haven't asked that before, and the people that did this research which I think was at John's Hopkins found that the effect lasted for three days. And that was the proof of principle, is it wasn't just a block effect. It was actually activating the enzymes in the skin through this mechanism called Nrf2. 

Dr. Amanda Frick:

Do you get the same activation by taking them internally?

Dr. Robert Rountree:

Yep. Yes. That's, and that's really where we're going, is there are not any commercial skin creams that I know of that have broccoli sprouts in them. I would guess that they would have an interesting smell or-

Dr. Amanda Frick:

Yeah. That's where I was going. 

Dr. Robert Rountree:

Yeah. That there's stability issues. I think there's been attempts to do that, and I, in the past I have seen short-lived products that had broccoli oil that you could then mix into your sunscreen. But I think it's been a real problem coming up with a stable form of it. And so that brings us to using, something like Crucera, using it by mouth as a skin-protected agent. We know that sulforaphane is protectant of all kinds of things. They're generally good for your health and longevity, but this is something that not a lot of people know about, which is that eating broccoli sprouts or extracts from broccoli seeds can activate the same mechanisms, and they definitely play out in the skin. 

Dr. Amanda Frick:

I think that's great. I think we can add a tagline that says "Crucera-SGS, not just for detox support."

Dr. Robert Rountree:

Not just for detox. Well, almost for, it's like you're detoxing your skin. It's the same pathways that are involved in overall detox, but it's specifically good for the skin. So it, again, brings us back to this whole idea of you want healthy skin on the outside, you got to start on the inside. So I'm wondering what other nutrients that you advocate for healthy skin. What kind of things would people want to take as a supplement, or if we're saying, "Well, it's not that you can get away with anything if you just use the right cream," what would people want to take that... What should they include as part of their regimen?

Dr. Amanda Frick:

Well, you can approach that from so many different levels. I mean, I think anything that's good for reducing oxidative damage and keeping inflammation down, it's going to be good for your skin. We're talking about things that support a normal level of inflammation, like omega three fatty acids found in fish oil. There are certain B vitamins that are really important for skin integrity, other water soluble vitamins like vitamin C, that promote collagen restoration and the health of collagen. And then of course you can use things that directly are made for skin effect like collagen, collagen itself. Collagen supports the integrity of the skin. It makes it, it sort of keeps its structure. So it's what makes it plump and have a hydrated feel and keeps the thickness in a normal state so you're not showing signs of early aging. 

And then we actually have a, plug time, great product called Collagen Plus that has collagen as a base. I think what makes it really special and different from anything else you're going to find on the market is it has an addition of nicotinamide riboside, which we've all heard about in other places, probably could be its own podcast, for healthy aging support and protection from DNA damage and oxidative stress and healthy cells. But also we have two botanicals in that formula that have specific claims for skin aesthetics and skin structure. Like we were talking about before, when you have these sort of damage on the outside, it's really difficult to treat things like hyperpigmentation, wrinkles, oxidative damage, skin sagging and laxity, without using a topical application. 

I think there's plenty of companies that would say they have a good approach, but some of them are very difficult to treat in any case, like Malasma or hyperpigmentation issues from sun damage. And there are even less options for internal use support for those kind of complaints. And so what we've got that we've added to Collagen Plus are two botanicals that support skin texture, skin tone, can help with evening skin pigment, and then peach ceramide, which actually helps retain moisture in the outer layers of the skin. So you've got that hydration aspect. So if you want to get fancy about it, then we're talking about skin, skin plumping, skin glowing, and then evening out that pigmentation and healthy skin. Pretty special stuff.

Dr. Robert Rountree:

Yeah, really special stuff. So I, let's just talk about something really basic. What's the big deal about collagen? Why of all the proteins you could give people, why collagen, and is there good evidence to support it? Is there actually research on it?

Dr. Amanda Frick:

There is. There's actually a lot of research on it. 

Dr. Robert Rountree:

A lot of research.

Dr. Amanda Frick:

A lot. I wouldn't say all of it agrees with the other sets of research, and some may argue that there's more science backing for particular uses of collagen than others. I think because it's a direct component of skin structure is what part of that argument would be. It's easy to absorb because it's usually coming in a hydrolyzed format. It's in really basically small pieces that your body can take in easier than having a full protein. And not only for skin, there's research supporting collagen for gut integrity, gut lining integrity, joint health, and some other things. So yeah, I do think there's research back, especially for particular formats of collagen.

Dr. Robert Rountree:

Now does it matter where it comes from? 

Dr. Amanda Frick:

Well, that's where I was going to go next. Not every collagen is created equally, especially if you're deriving collagen for a raw material from gelatin, which is one of the common sources. It takes-

Dr. Robert Rountree:

Is that horses hooves? 

Dr. Amanda Frick:

Well I think it's horse hooves and some other parts, cow, other parts as well, and it takes a lot of chemicals to extract the collagen out of gelatin. And there isn't a lot of chemical processing to extract collagen from the hydes. So we're using a collagen format and collagen sourcing that uses a water-based extraction technique so we don't have chemicals left over in the finished product for collagen peptides, and only grass fed bovine sources as well. So that's not what you're going to get everywhere. You can definitely find it elsewhere, but a lot, I think that's a lot of what makes the collagen that you use in a good product, makes it different.

Dr. Robert Rountree:

I guess I need to ask this because I've seen some companies claiming that marine collagen is better. Is there anything to stand on when they say that? It seems to me like the extraction process and the way they break it down is more important than anything else.

Dr. Amanda Frick:

Yeah. I think if you can't accomplish a vegan source, then you're getting to the nitty gritty of do you need it to be pescatarian for those who are having their lifestyle and dietary concerns on that level? But again, I think you're right. If you have to have product that's animal-based, it's really going to be how it's processed and what it can offer. From a consumer standpoint and a reality standpoint, there's a cost difference. You have a lot of material you can extract from a larger source and marine collagen can carry a more significant cost associated, as far as the raw material goes. And so you're getting a peptide delivery in the same material that's higher in a bovine source than in a marine source.

Dr. Robert Rountree:

So it's a more efficient source is what you're saying.?

Dr. Amanda Frick:

Right, exactly. 

Dr. Robert Rountree:

And when, you mentioned the word peptide, which we've already said that... So collagen, the proteins are pretty good size molecules and they have to be broken up into smaller pieces. This is what we call hydrolyzation, or hydrolysis I guess is the correct term. So when we're talking about collagen supplements, is it always collagen peptides?

Dr. Amanda Frick:

I think it normally is, but it is a function that you should look at if you're purchasing a product just to make sure. But I do think the majority of collagen on the market, at least in a powder format, is offered in a peptide form.

Dr. Robert Rountree:

Okay. Here's an obvious question. What do those pep... What does it taste like? I mean, do you have to do something to it?

Dr. Amanda Frick:

Well, well what does Thorne's taste like?

Dr. Robert Rountree:

Well, yeah. What does Thorne's- 

Dr. Amanda Frick:

Or what does collagen taste like?

Dr. Robert Rountree:

Well, I mean in general what do they taste like, and then what does Thorne's... Okay, I'll be honest. I've tasted some collagen products that were just disgusting.

Dr. Amanda Frick:

Yeah. So have I.

Dr. Robert Rountree:

I mean, and you open the can and it's just, it's the smell is the first thing that hits you. So it's not really appealing. So Thorne must have somehow worked magic on this. 

Dr. Amanda Frick:

Well, we didn't work magic, but we were super picky like we are about just about everything. We source the material that dissolves into water nearly clear. You can almost not tell that it's in liquid dissolve so efficiently, and it doesn't have taste or smell variables that go along with it. I think some people are more sensitive than others, but we, when we were doing some quality tests and taste tests for organoleptics, when we were looking through the materials, we had people outrightly refuse because they've had such negative experiences with collagen before that they were scared to even try it, and we got it past them. So the good thing is, we... This is a flavored product because it does have botanicals in it. So it's got a passion fruit berry flavor, passion-berry flavor, which is really pleasant, and to me it has no aftertaste of anything other than the intended flavor and it doesn't have any sort of unpleasant smell, which is, it makes it even easier and more palatable. Though I will say, if you took all of that out and just put our collagen straight into water, which I have, it has basically no smell, no taste.

Dr. Robert Rountree:

So does that, is that a reflection of how clean the product is?

Dr. Amanda Frick:

I do. I do think that's part of it. It's the efficiency of the processing, to remove, get your clarified source material, and also what you use to process it. The harsh chemicals you need to use to extract collagen from gelatin, even if you're processing them out, are still going to leave some sort of residue. And I think they do have an effect on the overall material taste and smell.

Dr. Robert Rountree:

What's in jello?

Dr. Amanda Frick:

Gelatin.

Dr. Robert Rountree:

Yeah. So they must do something to the jello to give it a particular flavor. 

Dr. Amanda Frick:

I think they probably add some flavor and maybe a little bit of color, possibly color.

Dr. Robert Rountree:

So somebody might ask, "Well, couldn't I just take jello and wouldn't I get the collagen benefits from that?" What's the difference of doing the collagen peptide as your formula?

Dr. Amanda Frick:

Yeah. So I think that goes back to your original... I think some people do supplement with gelatin for particular reasons, but then you're back to the larger protein structure. So you're not in the peptide. It hasn't been hydrolyzed. And so you still have to break it apart. Arguably you can get some of the benefit out of it, but you're not having it in that predigested form for optimal absorption and utilization.

Dr. Robert Rountree:

Wonderful. That's really helpful. So I think it's time for us to take a short break, and then when we come back we'll take some questions from our listeners.

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And we're back. So now it's time to answer some questions from the community. Our first question this week comes from a listener who ask why do we need things like lotion and creams? Shouldn't our skin naturally be healthy on its own? What do you think, Amanda?

Dr. Amanda Frick:

I think that's a mixed bag. So I think that we all have some sort of internal weakness for some reason or another. But yeah, I think we should be, if we should have naturally healthy skin, but that all's going to take place from what you're doing internally, right? So we're back to healthy diet, exercise, hydration. I think we hear a lot, you can't out exercise a bad diet. You can't out cream a bad diet either for your skin health. So maybe you do, and maybe you don't need lotion and creams, but I think almost everyone would say you do need some sort of protection from the sun. So a sunscreen if you consider that a lotion or cream, and then if you need assistance or you feel like you want to have some level of improvement, if you're making good choices and wise choices about the preservatives in your products, I don't think I have necessarily anything against them as long as they're considered an adjunct to the healthy diet and internal health.

Dr. Robert Rountree:

I totally agree with you, and I would think there's two parts to this response. One is the environment can have a big impact. In Colorado it gets pretty darn cold and dry in the winter. Even though we have these big snow storms, we also have long periods of time where it's windy and cold and dry. And man, my skin, especially my hands and a bit on my face, gets really trashed come about January, February, cracking, drying, and I can't imagine not putting some kind of cream or something on there at bedtime. I often use a manuka honey cream that works really well. It's a challenge to find stuff that's not messy.

Dr. Amanda Frick:

Well, are you mixing your honey cream with your broccoli seed extract? So-

Dr. Robert Rountree:

Well, I probably could. No, but I actually buy a manuka honey cream that works really well. And I get cracked feed in the winter. It dries out in the pool. So in other words, I think there's scenarios where it's really appropriate to use some kind of moisturizer to stop that cracking, because otherwise you can get in a bad cycle where you get cracking and then it bleeds and then it gets infected, and so I think it can certainly justify then. People that I think are using lotion in hopes that it's going to reverse a bad lifestyle I think are not being rational. And there's a phrase you had about that, about internal versus external.

Dr. Amanda Frick:

Yeah. You can't out lotion a bad diet.

Dr. Robert Rountree:

You can't out lotion a bad diet. So I think that's a really important take home, is it starts with what's going on internally. And then there's another part of the response which is really important. When people ask me about creams, and I do get asked about this all the time in my practice, and they say, "What about this brand or that brand?" The first thing I say is, "Would you eat it?" And that seems like a bizarre question, but if you put something on your skin, you're eating it, right? It's going into your body, and they have done studies of creams that had say methylparabens and parabens that put the stuff on their chest or on their face and they find that in the lymph nodes in the arm. So we're absorbing all those estrogen-like compounds that are in those creams. So you really want to use a super clean product. If you're going to use a lotion, you have to think, "Well, I am eating this. It is going to get in my body." So that- Yeah.

Dr. Amanda Frick:

I think we have a take-five daily blog on thorne.com that talks about endocrine disruptors, which you're really commonly going to find in beauty products, which reviews some of those different things like you're talking about, like phthalates and parabens, and I think you're absolutely right. I think the other part was you mentioned the environment, about being cold and dry, but also people live in toxic environments where air pollution is an issue. So you could be doing everything right, or potentially have a very healthy diet, and genetically really naturally healthy skin, but you still can't combat what's in the air or have control over that. So...

Dr. Robert Rountree:

Good point. What about sunscreen? I know when I was in Australia a couple of years ago, I saw big signs about this. And then I was actually in Hawaii right before the pandemic and I saw similar signs that were talking about protecting the coral. So coastal areas are really getting super aware about the fact that you get a lot of snorklers and surfers and people out there that are lathering on the sunscreen and that it's actually harmful for wildlife. So are there environmentally responsible alternatives to sunscreens that hurt the coral or the fish?

Dr. Amanda Frick:

Yeah. I think we're back to, the good thing is the best choices for you are probably the best choices for the environment and for the coral and coral bleaching. So the chemical versus physical sunscreen argument of not using these chemicals that work under your skin by changing how you react to the UVA and UVB rays, whereas a physical block sits on the outer surface of your skin to deflect those rays. And those ones that sit on the outside have little impact on the environment and are probably the best health choice options. Though I did want to bring up because you were saying would you eat it, if you wouldn't eat it don't put it on your skin. I wouldn't eat titanium dioxide, but I would put it on my skin, or titanium oxide.

Dr. Robert Rountree:

What about zinc?

Dr. Amanda Frick:

Yeah, same, zinc oxide. These are on our no lists. We would never put them in a Thorne supplement. It's something that we just will never use for internal use, but yet I think I would advocate for external use. So how about going back to your lymph node story? Is it the particles too big that you can't absorb it through your skin or what makes it okay to put on the outside but not on the inside? 

Dr. Robert Rountree:

I have to say that I don't use a lot of sunscreen even though I spend quite a bit of time outdoors in Colorado. But what I do is wear long sleeve, thin long sleeve shirts, a really big sun hat. Sometimes I even wear gloves, very light gloves in the summer, if it's a super sunny day. So my preference is just to not get too much sun. I'm still getting it because I tan a little bit. So what fruits are good for skin glow? Are there particular fruits? And I assume the person is asking about the hydroxy, the fruit hydroxy acids which are in a lot of skin products. Maybe that, and or is there something, is there another magic ingredient in fruit that we should know about?

Dr. Amanda Frick:

Well, I think every fruit could be good for skin glow, right? So you're contributing to antioxidant support, polyphenols are really important for skin health. Ceramides, which we don't usually think of for skin glow, are really important for, if you want to call glow a hydration, glow being a portion of the hydration in the outer surface of your skin, that's what ceramides are really doing. They're sort of holding water in that layer of your skin. Usually that, not from a fruit. I think most often when we're taking those internally, they're coming from a wheat source because they're, it's really high in those ceramides. But then you have a potential gluten issue there. So white peach actually has some really good studies and specific study on an ingredient called hydropeach, which is ceramide. So you can go and eat a lot of peaches if you like, but I don't think you're going to get as far as if you're using some really good, clean, fruit-based ingredients for that purpose to get your ceramides in. 

Dr. Robert Rountree:

So the fruit extract might actually be better. 

Dr. Amanda Frick:

Yeah, exactly. More potent at least.

Dr. Robert Rountree:

So here's a question, and it's very common, what causes acne and what can we do about it? Is there, are there dietary things that do it now? I'm guessing you're going to say well, there are different kinds of acne.

Dr. Amanda Frick:

Yeah. There... That's exactly true. There are different kinds of acne. I think some are more in control of the person who's experiencing the acne than others. There's some level of genetic component to how much oil your skin produces. When I was younger, it was you had acne because you ate pizza and you ate fatty things and your diet was bad, but I'm not sure-

Dr. Robert Rountree:

So greasy food made greasy skin was the thought?

Dr. Amanda Frick:

Exactly. Yeah, exactly, which we know better now. Though, that doesn't mean you should go out and have some pizza if you have acne because there may be other things about pizza that are not great for your skin. I think you were talking to me about simple carbohydrates in that aspect, right?

Dr. Robert Rountree:

Yeah. Loren, Dr. Loren Cordain, who's here in Colorado, did a interesting study I think in the South Pacific where he looked at kids in one island that were eating a lot of refined carbs and kids on another island that were same age, same kind of physical environment, that were not eating refined carbs, and he was able to show that the ones eating the refined carbs had a lot more acne. And that the whole theory was that increased your blood sugar, which increased your insulin, and that insulin had effect on reproductive hormones, and the reproductive hormones then caused overproduction of oil in the skin. So it's a whole chain of events that comes about as a result of eating junk food basically, which is interesting because the dermatologists for years maintained that diet had nothing to do with acne, and I think that's been thoroughly disproven. It's pretty clear that diet makes a difference.

Dr. Amanda Frick:

I'd welcome a debate with anyone who tells me that diet has no effect on basically anything. If you give me of some sort of physical condition other than pure genetics that you can convince me that diet doesn't have any effect on, and I'll sit for that.

Dr. Robert Rountree:

It always plays a role. 

Dr. Amanda Frick:

Yeah. 

Dr. Robert Rountree:

Yeah. Always plays a role. So what about water? Is water good for your skin? I mean, it sounds like kind of an obvious thing, but it, but maybe not. I mean what, why is water important?

Dr. Amanda Frick:

Well I mean, I think water's important for so many things. Of course you're going to contribute to hydration in all of your tissues, which would include your skin. Water helps you process basically everything. You couldn't appropriately detox things from your body without that water. That could be an entire conversation, was what water does in your body, although I don't think anybody needs any kind of lecture about drinking water at this point. But from the opposite side of that, which we hadn't talked about before, is exercise is part of a healthy diet, but physically sweating and releasing that water through your skin, that's a direct impact of skin health. That's your sort of physical detoxification mechanism from the inside out. You have to have water to efficiently sweat. And so of course that becomes important from that aspect, not just internally, but in a way, in an external way.

Dr. Robert Rountree:

So sweat is good. 

Dr. Amanda Frick:

Sweat is good. 

Dr. Robert Rountree:

Yes. So we talked about the benefits of collagen. One of our listeners asked what destroys collagen? What's bad for collagen?

Dr. Amanda Frick:

I think lots of things could be bad for collagen, but the most important thing, which it's sort of that evil term that's bad for everything is oxidative stress. Oxidative damage sort of breaking down collagen, messing with the integrity and the skin layer or the gut layer or any other place that you really want it to be strong, and the oxidative damage is back to all the same things. We're kind of a broken record. Bad diet, bad environment, and cigarette smoking-

Dr. Robert Rountree:

Cigarette smoke, air pollution.

Dr. Amanda Frick:

Yep, exactly, some in your control and some not. And oxidative damage is a natural part of even a healthy diet. It's just how your body's going to be processing what it's doing. It's just how much can you handle at once? How much can your body handle as a normal process, and what's damaging and what's not?

Dr. Robert Rountree:

So what about eczema? A listener has a question about tips for dealing with eczema, and they're wondering about advice they've heard, like does it help to soak your hands in milk or bleach or oats, which I have to say when you first hear that you think that's bizarre, but actually there's data on oats and bleach. So maybe you could give us a little bit of perspective on what eczema is?

Dr. Amanda Frick:

From a naturopathic perspective, or I think even a functional medicine perspective, we talk about skin health being intricately connected to gut health. I used to talk to my patients about how embryonic development works and you're just one big tube that's inside-out on itself and turned in on itself. So in a sense, your tissues come from the same place. The same tissue on the inside of your gut is what's on the outside of your body. So affect, anything that's affecting your gut integrity is also affecting your skin. So in my practice, I would commonly treat eczema by treating the gut, balancing the gut, removing food sensitivities. 

If there is a leaky gut component or gut inflammation, having that be a major part of what's going on there. And then of course, anything that you can use to treat from an external standpoint is like you were talking about, soaking in oats. I can't get on team bleach no matter what, but I'd be willing to accept oats. And then anything else that's helping to manage inflammation like we were talking about before. So omega-3 fatty acids can assist with that and anything that's going to help build up the integrity of the external layers of the skin.

Dr. Robert Rountree:

So just to throw in a comment about the bleach, I know my good friend Dr. Kara Fitzgerald, who you probably know, she's a naturopath in Connecticut, has her own blog, and is a big supporter of Thorne. She gives a great lecture for IFM on eczema and she talks about the people that have really advanced disease, and what's happening there is that the skin barrier has been broken down for so long that it can't keep the normal bacteria out of the tissue. And so you end up with this low level infection that causes inflammation. And so what that bleach does, when you're using very dilute bleach, and I, that's important to point out, but it's very very dilute bleach, it basically is just kind of disinfecting and rebooting the skin microbiome. 

So it sounds bizarre, but it actually can be really helpful for people with eczema, especially of the hands. I wouldn't recommend a whole body bleach soak, but just so people know that there is a rationale behind it. And similarly with oats, there are beneficial ingredients in oats, including beta-glucans. Beta-glucans are the same active ingredients you find in mushrooms, and that we know that they're good for priming the immune system, but topical beta-glucans like the ones that you find in oats actually help with wound healing. So there are a number of oat-based products that are soaps, creams, et cetera, that are actually pretty darn good for eczema.

Dr. Amanda Frick:

What about the, so I know that you can use vinegar, diluted vinegar soaks for tinea or other kind of skin fungal infections. Would it have, have the same effect to substitute the bleach with vinegar? Or is it not going to have enough-?

Dr. Robert Rountree:

Yeah. I think it's very- No, I think it's the same idea. It's a very, you want to use very dilute, because you don't want to stink things up. So-

Dr. Amanda Frick:

Pickle feet. 

Dr. Robert Rountree:

Yeah, yeah. Pickle feet. We got a couple more questions I want to dive in more quickly. What about Botox? What do you think about people that use Botox? Is that a good thing or bad thing? Is it unhealthy? Is it dangerous? What are your thoughts on that? It's very popular obviously.

Dr. Amanda Frick:

Yeah, it is. I will reserve my personal thoughts. I have no judgment for anyone who would prefer to use Botox. I think that feeling good about yourself on the outside is really integral to having a happy life, and you do you. Whatever makes you happy, makes you feel confident, is a really important thing. But there are other ways you can approach. So I don't think that there are a lot of natural options that can give you that immediate effect that you can get from Botox. And so there's that, but Botox is working by sort of inhibiting something, right? It's making muscles lax on purpose. It's causing basically a downscale and it works. And it creates a visual that people are seeking. 

Alternatively, you could think of it from the opposite direction, right? So instead of breaking down or stopping a process, maybe you support creation of new tissue to plump up that area, or you think about adding to instead of subtracting. And so options for that are of course supplements, that we've talked about. Healthy diet we've discussed, but other things that can create tiny damage which makes your skin repair itself and can help it plump back up. So micro-needling techniques, which you can get from dermatology or aesthetic practices, and then aesthetic acupuncture has a lot of really great data actually, specifically causing tissue growth in your wrinkles because you can target them so specifically with very small needles. So needle Botox, needle acupuncture, but totally different approach. A build instead of a takeaway.

Dr. Robert Rountree:

So no big red flags about long term toxicity of Botox. You're just wondering if there might be a better way to accomplish the same thing without having to go to a pharmaceutical.

Dr. Amanda Frick:

Yeah, I think that's part of it. I think the other part of it is even if we were 100% sure that those toxins are staying locally and only having a small effect, once it's done, it's done. So if you're unhappy with that result, there's not really any going back. You can do some things to try to help it come back a little sooner, but it's there and you're stuck with it as long as it's going to last. So definitely works for people and not so much for others, and always good to have options in two directions.

Dr. Robert Rountree:

Okay folks. That's all the time we have this week. Be sure to leave a comment and subscribe to the show. We'd really appreciate it if you do that. Thank you for listening everyone, and thank you Amanda for coming back on the show and podcasting with me.

Dr. Amanda Frick:

Of course. Happy to be here. Thanks for having me.

Dr. Robert Rountree:

Thanks for listening to The Thorne Podcast. Make sure to never miss an episode by subscribing to the show on your podcast app of choice. If you've got a health or wellness question you'd like answered, simply follow our Instagram and shoot a message to @thorneresearch. You can also learn more about the topics we discussed by visiting thorne.com and checking out the latest news, videos, and stories on Thorne's take-five daily blog. Once again, thanks for tuning in, and don't forget to join us next time for another episode of The Thorne Podcast.