Transcription
Dr. Tarbox: Welcome to Skincast. This is the podcast to help you take the very best care of the skin you're in. This is Dr. Michelle Tarbox, and I'm a dermatologist at Texas Tech University Health Sciences Center in beautiful, sunny Lubbock, Texas. And joining me is . . .
Dr. Johnson: My name is Dr. Luke Johnson, and I am a dermatologist at the University of Utah.
Dr. Tarbox: Luke and I are both dermatologists. Luke, what is a dermatologist?
Dr. Johnson: A dermatologist is a physician. So we went to school for a long, long time. And then even after all of that school, we then did this training called a residency where we learned about skin from a medical standpoint. And now we're dermatologists, so we are doctors who specialize in the skin. I am a pediatric dermatologist as well, so I'm specially trained to take care of kids with skin issues, though I also see adults.
Dr. Tarbox: And I'm a general dermatologist and a dermatopathologist with a special interest in cosmetic dermatology and skin of color and pigmented skin lesions.
We are making this podcast to help people understand how to care for their skin. Sometimes we will mention specific products, but we are not sponsored or supported by any manufacturer of any topical product, or any manufacturer of any medications, or actually by anyone other than our home institutions.
Dr. Johnson: Yes. Thanks to the University of Utah and to Texas Tech University Health Sciences Center for supporting us.
Dr. Tarbox: We plan to release a podcast every two weeks to help people understand how to best take care of their skin, and to share that knowledge that we acquired over that long period of education to become a dermatologist.
So, Luke, what do you like about being a dermatologist?
Dr. Johnson: I like so many things about being a dermatologist. One of the best jobs in the world. So I like that I get to see kids and adults. I like that we take care of people with acute issues, meaning they have a problem right now and they need somebody to help. And we take care of people with chronic issues as well, like skin disease, like eczema that unfortunately we can't cure, but we can keep it under control. That allows me to see patients over and over again and develop relationships.
I like that our treatments are pretty effective for the most part, so I like making people better. I like that dermatology encompasses a lot of different ways to treat patients, so I like talking to patients and parents and providing them with education about things. We can take samples if we need to from people's skin to try to figure it out. We look at stuff under the microscope. It's good stuff.
Dr. Tarbox: I think that is absolutely one of the strengths of the field, is that it's a very broad field and we have a lot of tools to help us maximize the impact we can have on the health and wellness of people in our specific organ system, which is the skin. We like to say it's one of the most important organs in the body.
So how can a dermatologist help you? We all, of course, have skin. It's a very important part of our bodies. It's actually what defines and protects what is uniquely us. And a dermatologist takes care of all parts of that outer part of our body. So the hair, the skin, and the nails. Luke, when do you think patients should see a dermatologist?
Dr. Johnson: Well, of course, if you think there's something wrong with your skin, or hair, or nails, or mucous membranes, it might be a good idea to get in touch. One of the things dermatologists focus a lot on is skin cancer. So anything on your skin that is new or changing, it's probably a good idea to see one of us. A lot of times, it's not going to be a big deal, which is great, but the times when it is a big deal, you'll definitely be happy that you came in.
Dr. Tarbox: Another thing that can sometimes cause an important impetus for somebody to come see a dermatologist is any kind of rash on the skin, especially one that's not getting better, or any rash that's particularly painful or uncomfortable because some of those can be serious. So while fortunately most rashes most people will have in their lifetime are benign and self-limited, some of them can require more specific care, and dermatologists are expert in that type of care.
Dr. Johnson: And if you don't feel like coming into the clinic . . . we're recording this at what I sure hope is the tail end of the COVID pandemic. But one of the silver linings of the pandemic world is that it's opened up the gates to a lot more telemedicine. So dermatologists have been doing a lot of teledermatology, so kind of like a Skype or FaceTime call. So if you are unable to come in because you live three hours away, or you can't take time off of work, or you don't feel safe coming in because there's still this virus running around, a lot of us are doing teledermatology, so that might be an option for you.
Dr. Tarbox: I think that's so important to emphasize right now, and I think that one of the first steps that we can take in helping our listeners take better care of their skin is helping them understand what it actually does. A little Dermatology 101 if you will. So, Luke, what are some of the functions of the skin?
Dr. Johnson: I once heard a song by John Lithgow, "I like my skin because it keeps my insides in." Of course, that's part of it. It keeps other stuff in as well. It keeps water in most importantly, and a lot of times these functions aren't particularly obvious unless they're not working right. So if your skin is not keeping water in properly, then you might have eczema, which is called atopic dermatitis, for example. Then your skin can get pretty dry and inflamed.
Dr. Tarbox: Absolutely. Whenever you have an organ system that's functioning properly, the wonderful luxury of good health is that you don't have to notice it or pay attention to it. But my goodness, when it's not functioning properly, it's hard not to think about it. I think that one of the things that we can do as dermatologists is help to get that organ system back online and back to an area where we can enjoy the rest of the things life has to offer.
Dr. Johnson: The skin does a lot of other cool stuff, too. So in addition to keeping water and the rest of your insides in, it also keeps everything else out. So you can imagine if we didn't have skin, first of all, we'd look awfully strange, and also there would be a bunch of stuff from the outside world coming into contact with parts of the body that would not do well.
Dr. Tarbox: Absolutely. That protection role is very important, and also that immune role where our skin is actually our outer wall of defense against the entire world. It is sort of like the wall in "Game of Thrones," if you will. So you have to maintain the watch, and our skin does a beautiful job of that when it's healthy.
Dr. Johnson: It also helps regulate our temperature. So human beings are pretty amazing. We can live in most environments on earth, and our skin does a decent job of keeping our temperatures about the same.
Dr. Tarbox: So what things help us to get our skin in its best shape to do these important roles? And what things actually cause some problems?
Dr. Johnson: What great questions, Michelle. I think those are the questions that we're primarily going to be dealing with over the course of this podcast. Everybody wants their skin to work right. And again, you don't really notice your skin too much unless it's not working right, and we can certainly help. But people pay a lot of attention to their skin, and presumably to other people's skin as well. So there are a lot of things out there that people use to try to make their skin healthy and keep it healthy. We're going to be talking about some strategies over the course of things here.
One of the most important, of course, is dealing with the sun.
Dr. Tarbox: Absolutely. My nemesis. Just kidding. The sun is very important, and here in beautiful, sunny Lubbock, Texas, it is a part of life. But we do have to think about the impact the sun can have on our skin's health.
Dr. Johnson: Yes, dermatologists have a bit of a love-hate relationship with the sun, though it's probably like 90% hate, and the main reason is that it's directly responsible for quite a lot of skin cancer.
Dr. Tarbox: Skin cancer is one of the things that we take care of as dermatologists that we would like the most to prevent for our patients, because sometimes it requires us to do surgery on a person's skin. And if we can keep people from having to go through skin cancer surgery, we sure would like to. What strategies can people use to protect their skin from the sun?
Dr. Johnson: Well, there's actually a lot. You're probably thinking I'm going to say sunscreen. And you're right, I'm going to say it. Sunscreen. So sunscreen is good. It's helpful. I think we're going to have another episode where we talk in more detail about sun protection.
So as a pediatric dermatologist right now, I'll say though that if you have little kids, then I like to recommend mineral-based sunscreens. So the active ingredients are only zinc or titanium, because we know that other sunscreen products can get absorbed into the blood. We don't know that they do anything bad, but just to be on the safe side, I think it makes sense to use zinc and titanium, which we know do not get absorbed into the blood, at least for kids. For me, I just put on whatever.
Dr. Tarbox: And I think that a very important factor about sunscreen is that it's comfortable for you to use. You like the smell and feel of it. I'm looking forward to that sun protection episode. I think it's going to be very helpful for our listeners.
You also want to think about other behavioral things you can do, and we'll talk about that more in-depth. But trying to avoid areas and times of extreme sun exposure, and thinking about the protective role that clothing can play can also help you to have a very nice skin protection strategy.
So what kind of clothing items, briefly, do you think could be helpful, Luke?
Dr. Johnson: Well, big old hats. So wide-brimmed hats can be good. A baseball cap, that's all right. I mean, it's probably better than all right, but we like the hats that go all the way around your head. Down in beautiful, sunny, Lubbock, Texas, hopefully you have people wearing cowboy hats. There's a reason that cowboys wear cowboy hats, and it's not just because they looked cool. It's because they help prevent the sun from beating down on them so much.
Dr. Tarbox: I love to see a cowboy hat, and I always compliment my patients on them because they have that beautiful wide brim. A baseball cap will protect the front part of your forehead and some of your nose. And as we like to say down here in Texas, it is mejor que nada, better than nothing, but a broad-brimmed hat does provide better protection. Staying in the shade can be good.
And what about those beautiful peepers? How do we protect those?
Dr. Johnson: My beautiful peepers I protect with sunglasses.
Dr. Tarbox: I think sunglasses are very important. Sometimes contacts have some UV protection as well.
Sometimes when people are trying to care for their skin, they make some mistakes that actually cause complexes or problems with the skin that compromise its essential functions. One of the ones I see sometimes is the way people use soap.
Dr. Johnson: I was just thinking that. I don't know how much we want to get into this. I sometimes talk to my parents of kids with eczema about this. And again, because you see problems with the skin . . . when there's a problem, that's when you appreciate the functions of the skin. A lot of people can use whatever kind of soap wherever on the body and it's not a big deal. But especially if you have a tendency toward more irritable skin, I think that it helps to be conscious of which soap you're using and how you're using it.
The way I explain this to parents of little babies and little kids with eczema is human skin doesn't really need soap, except in the problem areas. And we don't develop problem areas until we become smelly teenagers. So, especially for little kids with more sensitive skin, I like just baths in plain water with no soap at all, but you can shampoo the hair if you want.
Dr. Tarbox: I think that's a great way to instruct parents. I think one of the problems is we all learned how to do that self-care kind of from popular media in a way. And a lot of the popular media depictions of people showering or using soap is you get sudsy all over the body and it looks very fun and it's portrayed in especially those little commercials . . . I think of the Irish Spring commercial where the guy has got the lather all over his arms and all the way up his neck and onto his face.
But we really don't need to actually have thick layers of soap in all of those areas. So we'll have a special episode, of course, dedicated to the barrier function of the skin. But definitely some important food for thought.
How do people feed their skin in general for good health?
Dr. Johnson: Well, I think moisturizing it is helpful. Sunscreen is helpful. Again, if your skin seems to be fine without any of this stuff, then that's great. But a good moisturizer, especially on the hands because they are the ones that get washed and get exposed to soap, can keep your hands healthy and not dry and cracked. Nobody wants dry, cracked hands.
Dr. Tarbox: Maintaining appropriate hydration, eating a good varied diet full of fruits and vegetables, multiple colors of things that grow up out of the earth, or things that walk around up on them, can also help improve our skin health and decrease the problems that we experience with our skin.
We're looking forward to having so many more specific episodes about different areas of skincare so we can help people understand how to take the very best care of the skin they're in. We hope that you'll listen to us soon, and thank you for your attention.
Dr. Johnson: Those of you who are particularly dermatology nerds might be interested in the fact that Michelle and I actually co-host another podcast. It's really directed at dermatologists and those who are dermatologically curious. It's called "Dermasphere." So if you've got an enthusiasm for both dermatology and podcasts, you might want to check it out. We'll see you guys next time.