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Do topical antioxidants remain potent over time? · The Science of Skin

• 0:00
  SPEAKER_00: This episode is brought to you by Skinseuticals, the number one medical aesthetic skincare brand worldwide, and the leader in antioxidant science.
• 0:08
  SPEAKER_00: To learn more, visit www.skinseuticals.com.
• 0:22
  SPEAKER_02: Hi, I'm Dr.
• 0:23
  SPEAKER_02: Patty Ferris.
• 0:24
  SPEAKER_02: I'm a board certified dermatologist, and I'm your host for this episode of Skin Care Confidential.
• 0:29
  SPEAKER_02: We are so excited today to have with us Dr.
• 0:33
  SPEAKER_02: Giuseppe Velocki.
• 0:34
  SPEAKER_02: We're going to answer lots of burning questions that you might have as dermatologists and practitioners about the use of antioxidants.
• 0:42
  SPEAKER_02: Let me read you Dr.
• 0:43
  SPEAKER_02: Velocci's bio, and I think you'll understand why I'm so excited about this particular interview.
• 0:51
  SPEAKER_02: Giuseppe Velocki is a PhD.
• 0:53
  SPEAKER_02: He's the David H.
• 0:54
  SPEAKER_02: Murdoch's Distinguished Professor of Regenerative Medicine at the University of North Carolina and a professor of physiology at the University of Ferrara in Italy.
• 1:05
  SPEAKER_02: Additionally, he's an international scholar at Young Hee University in Seoul, South Korea.
• 1:10
  SPEAKER_02: He has a bachelor's degree, a master's degree, and a PhD in cellular physiology.
• 1:15
  SPEAKER_02: And he's heavily focused his research on inflammation, oxidative stress, the role of the exposome.
• 1:22
  SPEAKER_02: We're going to talk about all of this today, with a very special focus on skin and the gut-skin access.
• 1:29
  SPEAKER_02: He's also recently been involved in understanding the alterations in redox's involvement in the pathogenesis of Rhett syndrome and autism spectrum disorders.
• 1:38
  SPEAKER_02: And he's published over 350 peer-reviewed manuscripts, 20 book chapters, and four books.
• 1:44
  SPEAKER_02: You're a busy guy, Giuseppe.
• 1:46
  SPEAKER_02: You've got lots of awards, way too many things for me to read.
• 1:50
  SPEAKER_02: But your contribution to the medical literature on oxidative stress and its role in photoaging and environmental aging is really unparalleled by any other researcher.
• 2:00
  SPEAKER_02: So welcome to Skincare Confidential.
• 2:03
  SPEAKER_02: Thank you very much.
• 2:04
  SPEAKER_02: We're going to start maybe like a little on the simple side.
• 2:08
  SPEAKER_02: Let's talk about you've done so much research on the exposome.
• 2:11
  SPEAKER_02: Let's talk about the exposome.
• 2:14
  SPEAKER_02: I think when we think of the exposome as dermatologists, we immediately go to ultraviolet light, of course, but we now know there's longer wavelengths of light, and you've done so much great work on pollution.
• 2:24
  SPEAKER_02: So talk a little bit about that whole package of the exposome.
• 2:28
  SPEAKER_01: Yeah, I'm I like to start with uh a new word that is uh anthroposine.
• 2:35
  SPEAKER_01: So uh is the new era.
• 2:38
  SPEAKER_01: You know, the we uh divide the history in the eras.
• 2:43
  SPEAKER_01: And uh unfortunately, the eras that we study when we were in our historical book is changed.
• 2:51
  SPEAKER_01: Now there is a new era that has been approved, has been well uh well well uh defined, that is anthropocyan.
• 2:58
  SPEAKER_01: It means that we change the planet because of pollution, so it means that we cannot go back.
• 3:05
  SPEAKER_01: It's a new era.
• 3:07
  SPEAKER_01: And anthropocyan means that the pollution is with us, it lives with us, it cannot live anymore.
• 3:13
  SPEAKER_01: So we have to deal with that.
• 3:15
  SPEAKER_01: And I like to say that because especially now we are talking about uh skin, it's easy to understand that the skin is the main organ that is affected by what happens outside.
• 3:30
  SPEAKER_01: And here comes the exosome.
• 3:32
  SPEAKER_01: That uh the exosome is like a the sum of all of what our body is exposed from where you are conceived to when you die.
• 3:45
  SPEAKER_01: And that makes it very difficult to study the effect of pollution because we are all different and we are exposed in a different way.
• 3:56
  SPEAKER_01: So uh maybe if there is a time later, I would like also to highlight a little bit uh the difficult of methodology to study the effect of pollution on the skin.
• 4:05
  SPEAKER_01: But just to go back to your question, we have been studying skin and pollution uh since I think the late 90s, when at that time I was uh in California, and in one of the best labs of oxidative stress at that time, and uh was a Lester Pater.
• 4:22
  SPEAKER_01: And uh when we start to study the skin and pollution was almost a joke for many because there was not too many people and was not a very serious issue.
• 4:35
  SPEAKER_01: Uh and I started with one that now is well defined as one of the most toxic uh environmental pollutants to which we are exposed any moment, even now.
• 4:46
  SPEAKER_01: I am exposed to ozone.
• 4:48
  SPEAKER_01: There is no way you can avoid it.
• 4:50
  SPEAKER_01: Uh as we know, it's made by photochemical smog, UV, and the car exhaust, but it's also made by our printer, you know, and uh uh and is uh is a is alloys in our room.
• 5:03
  SPEAKER_01: If you measure ozone in your room, you have some.
• 5:05
  SPEAKER_01: And I remember we start to study the the first time ozone effect on skin, and we found uh right after a paper that uh Jens Stiel, still in the same lab, published, we found that uh you have an increase of peroxidation and loss of vitamin E.
• 5:26
  SPEAKER_01: Now, here brings uh a concept where the skin is a very fantastic organ.
• 5:32
  SPEAKER_01: I mean, you know very well one of the best.
• 5:36
  SPEAKER_01: Yes, it's fun, but it's not all the same, as we know.
• 5:40
  SPEAKER_01: Right.
• 5:40
  SPEAKER_01: And uh what uh it happens to the skin is that we have uh a high concentration of antioxidants of molecules, let's call it defensive molecules, in the epidermis rather than in the dermis.
• 5:54
  SPEAKER_01: And then is uh actually the evolution that tells you that is a consequence of the epidermis being more exposed, and so it needs to be equipped with a very strong defense system.
• 6:10
  SPEAKER_01: Think that like ubiquinol is uh 900 times 900% more concentrated in epidermis than epidermis.
• 6:18
  SPEAKER_01: The same for vitamin C, vitamin E, and catalytic.
• 6:22
  SPEAKER_02: All up in the very top, right?
• 6:24
  SPEAKER_01: Yeah.
• 6:24
  SPEAKER_01: So what we found, we found that these are depleted.
• 6:27
  SPEAKER_01: So if you deplete these, it means that the skin is more susceptible.
• 6:32
  SPEAKER_01: And we were sh we were able to show in the middle of 2000 that when you hit the skin with a pollution, especially ozone, you have a cascade of effects that are not um they don't stay just in the epidermis, but actually they are able to uh to go through all the epidermis, arrive to the dermis, and even lead to a possible systemic effect through with bioactive molecules.
• 7:03
  SPEAKER_01: So you shouldn't think that the phytopollution is just skin damage directly but also indirectly.
• 7:11
  SPEAKER_01: Why?
• 7:12
  SPEAKER_01: Because when something gets through the bloodstream, it goes in the circulation and can get uptake again by the dermis and again hit the skin from the inside out, and that has been suggested, for example, for particular matter.
• 7:30
  SPEAKER_02: So just to remind myself, because uh you and I have had discussions on this before, ozone doesn't actually penetrate the stratum corneum, it does cause a lot of damage for something that really is not penetrating.
• 7:46
  SPEAKER_02: Now, particulate matter will penetrate, correct?
• 7:49
  SPEAKER_01: Okay, that is a big question, and that is a really is a big debate, and is and in science is beautiful when you have debates because there are different theories.
• 8:01
  SPEAKER_01: Particulate matter it depends on the size.
• 8:04
  SPEAKER_01: Okay, so big sizes cannot penetrate a perfect skin.
• 8:11
  SPEAKER_01: The tiny ones, very ultra fine particles below one uh micro um micrometer, zero one zero point one micrometer, uh can penetrate, at least has been suggested that can penetrate either using the hair follicle as uh to go through the hair follicle, or they may not be able to penetrate itself, but what is in the particle that malia hydrocarbons can be absorbed by the skin.
• 8:44
  SPEAKER_01: Right.
• 8:45
  SPEAKER_01: So think of this are kind of carriers.
• 8:48
  SPEAKER_01: Yes, so think of this as a very tricky mechanism.
• 8:52
  SPEAKER_01: If you think a particle drops on your skin, what is attached gets absorbed by the skin.
• 8:59
  SPEAKER_01: It damages the skin.
• 9:01
  SPEAKER_01: And uh it's been shown that affects filagrine expression and um you know all the time junction, so these get absorbed, induce inflammation.
• 9:10
  SPEAKER_01: This inflammation is not only localized but will affect that part of the skin.
• 9:15
  SPEAKER_01: And now the skin is even more susceptible.
• 9:17
  SPEAKER_01: So then another particle that will drop on the skin now can get subtable even faster because the skin has this clinical inflammation that is more susceptible to penetration, even pathogen.
• 9:30
  SPEAKER_01: This happens, it's like a change.
• 9:32
  SPEAKER_01: That's why it's very important to keep your skin clean.
• 9:36
  SPEAKER_01: And another thing that I like to mention sometimes is not too many people mention that.
• 9:42
  SPEAKER_01: We know that the skin is around two meters square, okay, in our body, it depends on you know your size, but it's actually bigger.
• 9:50
  SPEAKER_01: Because our skin is not as flat as a sheet of paper, but has a lot of little wrinkles, a lot of little, you know, it's not really it has been shown that if you stretch the skin to the maximum, and so it becomes like a a sheet of paper, the skin is actually 10 times bigger.
• 10:13
  SPEAKER_01: So you have to think that inside of all these uh uh um you know little loops, particles of pollution can sit and uh continue affect the skin as well.
• 10:25
  SPEAKER_01: Kind of a reservoir effect.
• 10:27
  SPEAKER_01: Yes.
• 10:28
  SPEAKER_02: Interesting.
• 10:29
  SPEAKER_02: So talk about, I know you've done studies looking at the sort of synergistic effects of sun exposure and pollutants and you know how all that works with the downstream damage that occurs to the to the skin.
• 10:44
  SPEAKER_01: So UV light, we know, you know, UVB merely epidermis, UVA more, and we know how the mechanism is this.
• 10:52
  SPEAKER_01: But why is it important to know their mechanism?
• 10:55
  SPEAKER_01: Because biology teaches us that if two insults use the same pathway, this pathway will be saturated.
• 11:06
  SPEAKER_01: And at that point, you cannot have additive effect.
• 11:09
  SPEAKER_01: But if they use different pathways, you have additive effect because they affect the skin independently from their pathways.
• 11:17
  SPEAKER_01: And that is the problem.
• 11:18
  SPEAKER_01: As you said, ozone doesn't penetrate, but the damage is due by a cascade of molecules that can be oxidants or lipid or peroxidation products that affect the skin.
• 11:30
  SPEAKER_01: UV instead can penetrate directly and can generate ROS already inside the skin.
• 11:36
  SPEAKER_01: And this is easy to understand that that will lead to an additive, if not synergistic, effect of multipollutants effect.
• 11:45
  SPEAKER_01: And we did a study in the past where we actually did a super pollutant, uh multipollutant uh uh study.
• 11:54
  SPEAKER_01: We use uh diesel exhaust, we use uh UV light, and we use uh ozone.
• 12:01
  SPEAKER_01: And we found that all three had additive effects to the skin.
• 12:06
  SPEAKER_01: So that is the bad news.
• 12:07
  SPEAKER_01: But the good news is that you can prevent this.
• 12:12
  SPEAKER_01: You can prevent this with a daily and constant topical application of uh defensive molecule, antioxidant as you want to call it.
• 12:24
  SPEAKER_01: I say this because if 20 years ago or 30 years ago, maybe the topical application was important but not uh uh you know mandatory, I think that today you should teach to your kids, to anybody, like you brush your teeth in the morning, you need to use protection for your skin.
• 12:48
  SPEAKER_01: Because the environment, as I mentioned in the beginning, we are in the anthropocene.
• 12:52
  SPEAKER_01: We are exposed to so many pollutants and stressors that our skin cannot really take it without help.
• 13:01
  SPEAKER_02: Yes, and and I know you've studied a lot of the combination antioxidants and their protective effects against pollution and combination uh environmental assaults, let's cause it, call it.
• 13:15
  SPEAKER_01: And uh so what I say is that in my opinion, is Alice better to use a mix of uh defensive molecules of nutrients of uh antioxidants of polyphenols, because also in this case they use different mechanisms and they can have a better defense effect on the skin.
• 13:36
  SPEAKER_01: And as we know, uh one thing is to use a molecule that uh sacrifice itself directly, let's say vitamin E, to the off fission.
• 13:49
  SPEAKER_01: But then there are molecules that we know that derive from uh plants, many are polyphenols, that they do not really react directly with uh in a redox reaction.
• 14:01
  SPEAKER_01: But what they can do, they can induce an endogenous cellular defense that we know all the NRF2 pathways, and that is a long-lasting effect.
• 14:13
  SPEAKER_01: So from one side it's good to have some molecules that protect you directly, sacrificing that cell.
• 14:19
  SPEAKER_01: But from the other, it's also to have something that kind of increment and implement the antioxidant uh defense, endogenous antioxidant defense.
• 14:28
  SPEAKER_02: So you get boosting of your own endogenous, primarily the enzymatic antioxidants with the NERV2 pathway.
• 14:36
  SPEAKER_02: Perfect, like catalase, uh oxidase, superoxidismase, that are very so that so the combination products make sense there.
• 14:47
  SPEAKER_02: Let's talk about one of the one of the sort of difficulties of combination antioxidants is their stability.
• 14:54
  SPEAKER_02: And we've all kind of lived through the vitamin C era when it was very difficult to stabilize.
• 15:00
  SPEAKER_02: And obviously, some of these combination antioxidants have greater stability than others.
• 15:04
  SPEAKER_02: And I know you did some recent work looking at CE ferulic and sort of the role of ferulic acid in stabilizing vitamin C and vitamin E, which are inherently not all that stable.
• 15:14
  SPEAKER_02: So talk about that study.
• 15:16
  SPEAKER_02: Um, it's it's very interesting, and I think it'll also answer a question a lot of derms have, which is how long do these topical antioxidants last in the bottle?
• 15:25
  SPEAKER_01: So I think everybody that buys C ferrulic, you know a test that if you get it for Christmas and then you put on a drawer, and uh because you want to finish first what you are using up, and then let's say two months, one month, three months after you go get it, you open, and you see that the color is a little bit darker, is not right.
• 15:49
  SPEAKER_01: So the question is these herbos products uh still active, do they still work or not?
• 15:56
  SPEAKER_01: So we did this study where we it was a fun study, I really really like it.
• 16:01
  SPEAKER_01: We took sipherulic, six months old bottle, so fresh made freshly made, six months old bottle, 12 and even 36, three years that was in the drawer.
• 16:16
  SPEAKER_01: And we we uh uh added to skin, we did visa in a skin expense, we expose to UV light 100, 200, and 400 millijoules, so to have also a range of millijoules with the skin, and we measure some uh uh markers related to oxidation and also to skin uh uh morphology and barrier.
• 16:42
  SPEAKER_01: And we found that very surprisingly, even 36 months syphilic unsealed, it was very effective.
• 16:53
  SPEAKER_01: Maybe lost si five to ten percent effectiveness, but was really fantastic results.
• 17:00
  SPEAKER_01: So let's say sealed, it was really uh uh really um uh efficient.
• 17:09
  SPEAKER_01: Now, I unfortunately I don't have the data, but maybe next time I will show to you, we are doing now another study that is a consequence of this.
• 17:18
  SPEAKER_01: What happens if you have it open?
• 17:22
  SPEAKER_01: So, what happens uh over time if you have a cipheric that has been open for six months, and then you want to see if it's still effective, and that would change also the color.
• 17:35
  SPEAKER_01: Uh, we don't have a result yet, but that is another uh data that we will bring maybe in a few months.
• 17:41
  SPEAKER_01: We are running experiments now.
• 17:43
  SPEAKER_01: So the take-home message is that uh the color seems to not affect the efficiency and efficacy of uh of the compound, and that was uh was really uh surprisingly from one side.
• 17:56
  SPEAKER_02: Yeah, that that's such an important finding because we get asked that question as practitioners all the time, and that that's a very important uh finding that has great clinical application for us.
• 18:10
  SPEAKER_02: What about topical antioxidants in combinations with sunscreens?
• 18:17
  SPEAKER_02: I mean, I think you and I both are sort of on the same page.
• 18:20
  SPEAKER_02: Like I use my topical antioxidant, and then I'll use a sunscreen or a moisturizer with a light sunscreen.
• 18:26
  SPEAKER_02: I use that sort of as two layers, but there are a lot of products coming into the marketplace now that incorporate both.
• 18:34
  SPEAKER_01: So the the the difficult here is uh to have uh a stabilized antioxidant in the science in the sunscreen.
• 18:43
  SPEAKER_01: So uh say is very easy, but under the formulation point of view, it's very difficult.
• 18:51
  SPEAKER_01: Uh because as we know they act differently.
• 18:55
  SPEAKER_01: The sunscreen absorb the UV light, the antioxidant should either quench uh ROS, I mean oxidation, or stimulate the endogenous response.
• 19:09
  SPEAKER_01: So I still think that uh some data are really uh uh really clear to have two layers of uh uh compounds and means to have a sunscreen, uh you know, nice uh mineral sunscreen and a good antioxidant mix, I think is the best approach at the moment.
• 19:35
  SPEAKER_00: This episode is brought to you by Skin Suticles, the number one medical aesthetic skincare brand worldwide, and the leader in antioxidant science.
• 19:44
  SPEAKER_00: To learn more, visit www.skinseuticals.com.
• 19:51
  SPEAKER_02: Let's talk a little bit about metals.
• 19:54
  SPEAKER_02: And I know that there are metals that come in with pollutants and how metal ions can upregulate ROS, and how does that whole thing play in?
• 20:04
  SPEAKER_02: And then this kind of gets us into the discussion of chelation, which I know is something you and I are both interested in.
• 20:10
  SPEAKER_01: Yeah, I think that uh the iron part is one of the most uh uh important and uh with the open debate in the skin.
• 20:20
  SPEAKER_01: We know that UV can actually release uh iron from the storage, and uh we know that uh iron, free iron, is uh is kind of dangerous for the cells because it can lead to the so-called phenom reaction when it reacts with hydrogen peroxide.
• 20:38
  SPEAKER_01: And remember, hydrogen peroxide is formed inside the cells continuously.
• 20:42
  SPEAKER_01: We have enzymes like uh NIDPH oxidase that makes hydrogen peroxide because hydrogen peroxide is very important as a signaling.
• 20:51
  SPEAKER_01: This leads to a formation of a compound that is called hydroxyl radical, that is the most noxious ROS ever formed in our cells, it just destroys your lipids, leading to lipid peroxidation.
• 21:06
  SPEAKER_01: So, being able to quench, to kale it this effect is very important, especially when you are really exposed to UV, because you know that you will release a lot of uh uh eye.
• 21:20
  SPEAKER_01: So, this is for sure a very good approach, and we have shown in the past, actually, we did even still with sipherulic, that a killant and sipherulic were really able to prevent totally the damage of UV on the skin.
• 21:38
  SPEAKER_01: I think two years ago.
• 21:40
  SPEAKER_01: So the showing that the kill be able to chelate iron is one of the most important things.
• 21:47
  SPEAKER_01: Also, why, as you mentioned, particular mother itself is not a damage, it is not that dangerous to us.
• 21:56
  SPEAKER_01: What makes a particular mother noxious is what is attacking.
• 22:00
  SPEAKER_01: Attached to a particular metal.
• 22:02
  SPEAKER_01: And in alloys, you have iron, you have metals.
• 22:06
  SPEAKER_01: And these metals, when they get incorporated in the skin, then they can lead to this phenomenon reaction and oxidative damage.
• 22:14
  SPEAKER_01: So again, chylation is very important to work on that.
• 22:18
  SPEAKER_01: But on the other hand, as a biologist, you know, you need to be careful to not over-chylate your iron because, as we know, it's very important.
• 22:29
  SPEAKER_01: The iron metabolism is very important for the skin homeostasis.
• 22:33
  SPEAKER_01: So it should be, you know, we are in the era of precision.
• 22:38
  SPEAKER_01: There is precision nutrition, there is uh uh precision uh medicine, and also I think uh it wouldn't be bad to have a precision skin care in the sense that based on what what you are exposed, or let's say you travel to China, you know, you will be exposed to a lot of particular matter, you should take an extra care of what of products that can prevent the pollution damage.
• 23:07
  SPEAKER_01: And uh and that can be done if you are going to in the mountain and you know where you will be exposed to a lot of UV.
• 23:13
  SPEAKER_01: So maybe an extra kilant could be useful as you will have more free iron release in your cells and tissues.
• 23:24
  SPEAKER_02: So interesting.
• 23:25
  SPEAKER_02: It it's such an intertwined pathway, isn't it?
• 23:30
  SPEAKER_02: You coined the term ox inflammation, which I did not know until I read your bio, but we've published and talked about ox inflammation.
• 23:38
  SPEAKER_02: So explain that because I think it's such an important concept.
• 23:42
  SPEAKER_01: Yes, so this is a chicken egg puzzle, in the sense when you have an oxidative uh oxidative stress phenomenon, E.
• 23:51
  SPEAKER_01: alias uh binds to a correlate to inflammation.
• 23:56
  SPEAKER_01: So what uh we think what uh we that's why so it's very hard to say you have an inflammatory response, but you don't have an oxidative response because you have both together.
• 24:07
  SPEAKER_01: So uh it happens that sometimes you have an oxidative response but you don't see a clear inflammation, but it's there, and that we call subclinical inflammation.
• 24:18
  SPEAKER_01: So in this case, what happens is a positive feedback that the oxidative compounds lead to more inflammatory response through, as we know, a redox sensitive transcription factor such as NFKB, and this will increase even more the oxidative stress because we know the inflammation can recruit inflammatory cells, and then you have a burst of, for example, neutrophils where they release a lot of oxidants, and this will increase the oxidative stress, and this will even more activate an FKB, and then you have a positive feedback.
• 24:57
  SPEAKER_01: And remember, in uh in biology, we have very few positive feedback in nature, and this is one of them, usually are negative feedback, right?
• 25:10
  SPEAKER_01: You know, because uh what you try in your body's always to have a high response and then to quench it.
• 25:16
  SPEAKER_01: But in this case, we have an actually positive feedback, a natural positive feedback.
• 25:21
  SPEAKER_01: That is one of the few that we have in physiology.
• 25:24
  SPEAKER_02: Super interesting.
• 25:26
  SPEAKER_02: Talk a little bit about your work that you've done on nutritional antioxidants and the sort of gut-skin connection.
• 25:35
  SPEAKER_01: Oh, that is uh I think one of the most fascinating uh aspects now in uh in physiology.
• 25:43
  SPEAKER_01: So as a physiologist, you study all the connection among all the organs, as you know.
• 25:50
  SPEAKER_01: So it was it's beautiful now that has been well cleared the connection gut skin.
• 25:58
  SPEAKER_01: Okay, we didn't need really this.
• 26:01
  SPEAKER_01: We knew already, because we know that if one night you drink a little bit more or you eat a little bit heavier, when you wake up in the morning, you don't look great.
• 26:10
  SPEAKER_01: Your skin doesn't work.
• 26:12
  SPEAKER_02: Simple experiment conducted thousands of times.
• 26:16
  SPEAKER_01: But it's true, and that is because the connection gut uh skin.
• 26:22
  SPEAKER_01: How is this connection made?
• 26:23
  SPEAKER_01: It's mainly made by, and now we know, the microbiome, but not the microbiome as a uh uh population, as a mediators of the microbiome.
• 26:34
  SPEAKER_01: Microbiome release a lot of metabolites, many of them are really neurotransmitted, and they can stimulate skin.
• 26:43
  SPEAKER_01: As been shown, for example, there was a study some time ago that if you uh give uh carotenoids topically and carotenoids through the diet, they show that the one through the diet pre were much more protected to the skin from UV than the one topically.
• 27:02
  SPEAKER_01: And that makes sense because uh you have a more systemic effect.
• 27:08
  SPEAKER_01: So, what I want to say is that is don't think that if your diet is awful, if you add a good product on your skin topically, you have a good you will have a good skin.
• 27:22
  SPEAKER_01: You need to cure the skin also with your diet.
• 27:25
  SPEAKER_01: So you have to have a good diet and you have to apply topically.
• 27:30
  SPEAKER_01: This is important because they have an additive effect.
• 27:33
  SPEAKER_01: What you add topically will lead to a cascade of metabolite and activation pathways that is different if you eat products.
• 27:44
  SPEAKER_01: Uh a classic example is resveratrol.
• 27:46
  SPEAKER_01: If you eat it, it disappears very fast.
• 27:50
  SPEAKER_01: You need tons of resveratrol to the diet.
• 27:54
  SPEAKER_01: You should be drunk every day to have enough resveratrol in your bloodstream to prevent you.
• 28:00
  SPEAKER_01: But topical is very effective, although it's very difficult to penetrate.
• 28:03
  SPEAKER_01: So I think that uh uh nutrition and topical application are very good approaches that can prevent skin damage from the anthropocene exposome era.
• 28:17
  SPEAKER_02: So you like the inside out combined with the outside in approach, which makes total sense.
• 28:23
  SPEAKER_02: Maybe just as a wrap-up, because we are almost out of time.
• 28:27
  SPEAKER_02: I I'm interested in what you think about the future of regenerative medicine as it relates to dermatology.
• 28:34
  SPEAKER_02: You know, this is such an emerging field right now, Giuseppe.
• 28:37
  SPEAKER_02: It's so top of mind with practitioners, and we're seeing more things in the literature, and now we've got exosomes and all kinds of technologies coming at us.
• 28:47
  SPEAKER_02: Are we are we getting ahead of ourselves a little bit?
• 28:50
  SPEAKER_02: Or are we re is this ready for prime time?
• 28:53
  SPEAKER_01: I think uh uh, and please just don't judge me for what I say is I think it's more, I feel it's more a gold hunting period where everybody comes up with a new idea, new technology, new proposal.
• 29:13
  SPEAKER_01: Uh, and they are all good, but unfortunately, I don't see a very solid standardization of the protocols.
• 29:23
  SPEAKER_01: So, what I think is that we are there, we are very close to have something that will be then uh the gold standard for regenerative medicine, but I still don't see that yet, at least uh for the paper and the conference that I attend.
• 29:43
  SPEAKER_02: Yes, it's I think I think you're right.
• 29:46
  SPEAKER_02: I think we're we're getting there.
• 29:48
  SPEAKER_02: We we're just about that close.
• 29:50
  SPEAKER_02: But it's such an exciting field, and you've been right in the middle of it for a very long time.
• 29:55
  SPEAKER_02: So I want to thank you for joining me today.
• 29:58
  SPEAKER_02: It's so much fun always to talk to you, just hopefully I learned so much.
• 30:01
  SPEAKER_01: Thank you.
• 30:04
  SPEAKER_00: This episode is brought to you by Skin Pseudicles, the number one medical aesthetic skincare brand worldwide, and the leader in antioxidant science.
• 30:13
  SPEAKER_00: To learn more, visit www.skinseuticals.com.