Latest / Skin Anarchy / Unraveling Acne: Microbiome, Inflammation, and Cutting-Edge Treatments with Dr. Barbara Paldus of CODEX Labs

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Unraveling Acne: Microbiome, Inflammation, and Cutting-Edge Treatments with Dr. Barbara Paldus of CODEX Labs · Skin Anarchy

• 0:00
  SPEAKER_00: Hey guys, welcome back to Skincare Anarchy.
• 0:02
  SPEAKER_00: This is an episode in the wonderful masterclass with Codex Labs.
• 0:06
  SPEAKER_00: Last time we discussed the microbiome, gut health, probiotic treatments for acne, and modulating hormones for female hormonal acne.
• 0:14
  SPEAKER_00: Um, and this time, once again, we have Dr.
• 0:17
  SPEAKER_00: Barbara Palvis with us.
• 0:18
  SPEAKER_00: So welcome back, Barb.
• 0:19
  SPEAKER_00: I'm so excited to host you again.
• 0:21
  SPEAKER_01: Thank you, Ecta.
• 0:22
  SPEAKER_01: It's so great to be back here.
• 0:24
  SPEAKER_00: Yeah, I want to know.
• 0:25
  SPEAKER_00: So, what's new at Codex since last time we spoke?
• 0:28
  SPEAKER_01: So we've still been focusing on the skin gut brain microbiome axes and how they pertain to skin problems.
• 0:35
  SPEAKER_01: But we've just launched our first microbiome shifting live probiotic bio serum.
• 0:41
  SPEAKER_01: This is a product for professionals.
• 0:43
  SPEAKER_01: We also have some really exciting clinical results to share about the serum, especially when you use it together with our probiotic supplement.
• 0:50
  SPEAKER_01: So, um, you know, down the road, we definitely want to extend this concept to other skin conditions.
• 0:55
  SPEAKER_01: So this is just the beginning, but it's really neat to have basically an external and an internal probiotic.
• 1:01
  SPEAKER_00: That's so cool.
• 1:02
  SPEAKER_00: I love that.
• 1:03
  SPEAKER_00: And just to recap, if you don't mind, can we dive a little bit into the microbiome again for our listeners?
• 1:09
  SPEAKER_00: Um, and if you could remind us, Barb, um, you know, what is the microbiome and just the fundamentals?
• 1:15
  SPEAKER_01: Sure.
• 1:16
  SPEAKER_01: So um, in a nutshell, the microbiome is a complex community that lives on our bodies and in our bodies.
• 1:22
  SPEAKER_01: It comprises bacteria, fungi, archaea, viruses, yeast, molds, and the numbers are vast.
• 1:29
  SPEAKER_01: So call it 10 to 100 trillion estimated microorganisms.
• 1:34
  SPEAKER_01: They play key roles.
• 1:35
  SPEAKER_01: So, for example, they balance or drive our biochemical processes.
• 1:38
  SPEAKER_01: And then we have different internal microbiomes, say our mouth, our gut.
• 1:43
  SPEAKER_01: So, but what's interesting is what's in the mouth influences what's in the lung and in the gut.
• 1:48
  SPEAKER_01: Um, our external microbiomes, like our skin, our scalp, and these microbiomes change based on the location.
• 1:55
  SPEAKER_01: So, for example, external microbiomes in the armpit or the face are completely different and are further different from our feet.
• 2:02
  SPEAKER_01: So it's really neat that we are essentially play colony to all these different micro ecosystems.
• 2:08
  SPEAKER_00: I love that you brought that up, like the different areas of the body.
• 2:11
  SPEAKER_00: And but you know, since we're talking about acne here, can we talk about the skin microbiome again?
• 2:16
  SPEAKER_01: And we'll talk about mostly the face, but some acne can happen on the back, like acne.
• 2:21
  SPEAKER_01: So when you think about our skin microbiome, we get it at birth from our mother.
• 2:25
  SPEAKER_01: So that these first colonizing microbes, they help train our immune system and they tolerate commensal or beneficial organisms, and they remain alert to pathogens.
• 2:35
  SPEAKER_01: So the composition of this initial skin microbiome evolves from birth to adulthood.
• 2:40
  SPEAKER_01: And then in adulthood, it remains fairly stable over time, despite a lot of environmental perturbations.
• 2:46
  SPEAKER_01: And by that I mean pollution, what we wash with, sun exposure, et cetera.
• 2:50
  SPEAKER_01: So in many of these microbes are a thousand species on the human skin from about 19, what are called phyla or subgroups.
• 2:58
  SPEAKER_01: And most are found really in the superficial layers of the epidermis and the upper parts of our hair follicles, because we have hair follicles on our face.
• 3:06
  SPEAKER_01: The diversity of the skin microbiome is far, far poorer than the gut because there's far fewer nutrients, right?
• 3:12
  SPEAKER_01: When you think about it, we don't eat by putting food on our skin.
• 3:15
  SPEAKER_01: All of our nutrients go through our gut.
• 3:17
  SPEAKER_01: Also, the organisms are exposed to things that the gut is never exposed to, like UV pollution and a lot of washing, unless you drink bleach, which I hope you don't.
• 3:26
  SPEAKER_00: Yeah, let's hope we don't do that.
• 3:28
  SPEAKER_00: So, you know, you had talked about the skin microbiome.
• 3:30
  SPEAKER_00: Can you tell us like what is the skin microbiome?
• 3:33
  SPEAKER_00: Why is it important for us?
• 3:35
  SPEAKER_01: So it has kind of three core functions.
• 3:37
  SPEAKER_01: And if it's balanced, then it first of all helps us maintain our skin barrier.
• 3:41
  SPEAKER_01: You've heard me talking a lot about skin barrier.
• 3:43
  SPEAKER_01: It helps us regulate our skin hydration, which is really important.
• 3:47
  SPEAKER_01: And then most importantly, it protects us against outside infections, so pathogens.
• 3:51
  SPEAKER_01: On the latter point, you know, just like the microorganisms in our gut, um, our microorganisms on our skin play a very critical role in this protection.
• 4:01
  SPEAKER_01: They alert our immune system if we do get an infection.
• 4:04
  SPEAKER_01: They also help break down dead skin cells.
• 4:06
  SPEAKER_01: So if there is an imbalance, which we call dysbiosis in this microbiome, it's usually implicated in various skin conditions.
• 4:13
  SPEAKER_01: So, for example, we were just talking about acne.
• 4:16
  SPEAKER_01: So that's cutie bacterium acne's overgrowth.
• 4:18
  SPEAKER_01: But there's also fungal acne, which is a fungus called malesaa, which can look like white pimples on your forehead, for example.
• 4:26
  SPEAKER_01: In eczema, they can get staphoraeus infections, rosacea, they have they're colonized by demodex parasites, and many others.
• 4:35
  SPEAKER_01: So you can see that we do get pathogens.
• 4:38
  SPEAKER_01: We do get, you know, many women are also familiar with vaginal yeast infections.
• 4:42
  SPEAKER_01: So it's not just on the surface of our skin.
• 4:44
  SPEAKER_01: And so rebalancing this dysbiosis or this imbalance usually helps to prevent or to treat the disease.
• 4:51
  SPEAKER_01: In some cases, you do have to eradicate the parasite.
• 4:54
  SPEAKER_00: Interesting.
• 4:55
  SPEAKER_00: So maybe take a deeper look at the bacteria that are found on the skin.
• 4:59
  SPEAKER_00: You mentioned that they change based on the area of our body.
• 5:02
  SPEAKER_00: And just to clarify more, does that have to do with the local temperature or nutrients available?
• 5:07
  SPEAKER_00: Like, can you dive a little bit more into that?
• 5:10
  SPEAKER_01: Sure.
• 5:10
  SPEAKER_01: As we talked earlier about skin versus gut, when we look at the gut, it's very food-rich, it's always maintained at body temperature.
• 5:17
  SPEAKER_01: Our body keeps the pH between six and seven, so close to neutral.
• 5:21
  SPEAKER_01: In contrast to that, our skin is pretty much a hostile environment.
• 5:25
  SPEAKER_01: So they have to make do with whatever nutrients they can get, which are basic proteins and lipids.
• 5:31
  SPEAKER_01: Um, they're not given carbohydrates necessarily.
• 5:34
  SPEAKER_01: They have to survive often in a desiccated, like a dry, acidic environment.
• 5:38
  SPEAKER_01: Most of our skin pH is four and a half to five and a half, and they're exposed to air.
• 5:43
  SPEAKER_01: They're exposed to cold air, they're exposed to hot air, they're exposed to UV.
• 5:47
  SPEAKER_01: And so the resident skin microorganisms have adapted to this hostile environment, so to speak.
• 5:53
  SPEAKER_01: They can survive temperatures below zero.
• 5:55
  SPEAKER_01: They can feed on, you know, basically our sweat, our sebum, which is our skin oil, dead skin cells, other bits of organic matter that we carry around, or each other.
• 6:05
  SPEAKER_01: So the diversity and composition of these microbiomes, I would say depends primarily on the physiology, the physiology of the skin site.
• 6:13
  SPEAKER_01: And then the relative abundance of this different types of bacteria, which we call taxa, depends on the type of the microenvironment.
• 6:20
  SPEAKER_01: Is it moist, like under your armpit, dry, for example, like your hands, oily if you have acneic skin?
• 6:28
  SPEAKER_01: Um, and so they're going to be bacteria usually going to be the most abundant.
• 6:31
  SPEAKER_01: Fungi, um, thank God, are usually the least abundant because we don't want fungal infections.
• 6:36
  SPEAKER_01: Um, and then moist areas, for example, bends of the elbows, bends of the knees, our feet, you know, because we wear socks, um, support a lot of species like Staphylococcus or corniobacterium.
• 6:49
  SPEAKER_01: Whereas the oily or sebaceous sites tend to be dominated by more um oil-loving or lipophilic uh species like propionibacterium, which is a friend of C acnes.
• 7:00
  SPEAKER_01: Um, C acnes used to be called propionibacterium acnes.
• 7:03
  SPEAKER_01: They renamed it to Cutie Bacterium acnes.
• 7:06
  SPEAKER_01: And then dry areas, say forearms, um, tend to be more barren uh with more viruses.
• 7:12
  SPEAKER_01: So when you contrast the bacterial communities, the fungal community composition is actually quite uniform.
• 7:19
  SPEAKER_01: It's quite similar across core body sites, regardless of the physiology, which is interesting.
• 7:24
  SPEAKER_01: So the bacterial types, the species, and the phyla change, but the fungi kind of stay the same.
• 7:29
  SPEAKER_01: So malassasia, which I mentioned earlier, fungal acne, they tend to dominate the core body and arm sites.
• 7:36
  SPEAKER_01: Um, feet are typically colonized.
• 7:38
  SPEAKER_01: I know this is kind of gross by more diverse microbial composition because there's more going on in your feet, including maleasia, but also Aspergulus, Cryptococcus, and others.
• 7:48
  SPEAKER_01: Um, and overall, the fungal abundance on the feet is low, even though the diversity is high.
• 7:54
  SPEAKER_01: So I don't want to alarm anybody that, you know, you're automatically going to get a fungal infection on your feet.
• 7:59
  SPEAKER_00: Yeah, that's really interesting though, because fungus is very interesting to me how it like lives on skin, and it's a lot harder to get rid of as well.
• 8:08
  SPEAKER_01: So at least foot, and then there's jockage.
• 8:10
  SPEAKER_00: So yeah, very hard to get rid of infections too.
• 8:14
  SPEAKER_00: Like they're really hard.
• 8:15
  SPEAKER_00: And I'm so I'm glad you said that earlier that it we're it's good that we don't have to deal with fungus as much as we do, you know, because they're very hard infections to treat.
• 8:23
  SPEAKER_00: But um, going back to, you know, the face and acne, um, in a case like acne, certain bacteria that are ordinarily beneficial to their host can become pathogenic and lead to dysbiosis in the hair follicle, leading to pimples.
• 8:37
  SPEAKER_00: Can you tell me more about TD bacterium acne?
• 8:40
  SPEAKER_01: Sure.
• 8:41
  SPEAKER_01: So the main culprit causing acne, and it's actually a more complicated situation than just saying it is this bacterium.
• 8:48
  SPEAKER_01: So even though it sounds like a bacteria that'll trigger the worst acne, it is actually a natural part of our skin's microbiome and microflora.
• 8:56
  SPEAKER_01: And it actually does play an important health in general in maintaining our skin health.
• 9:01
  SPEAKER_01: So it is one of the most abundant organisms in healthy adults.
• 9:05
  SPEAKER_01: The issue is that there are different strains.
• 9:08
  SPEAKER_01: So you can think of it, there's the species, cutibacterium acne, but then there's strains.
• 9:12
  SPEAKER_01: Um, there's commensal strains, so basically beneficial strains.
• 9:16
  SPEAKER_01: These are strains that are labeled, for example, 1A1, 1B2, 1B3, or 2.
• 9:22
  SPEAKER_01: But then there are the pathogenic strains, which have now been correlated to inflammatory acne.
• 9:28
  SPEAKER_01: And those would be strains like 1A2 and 1B1.
• 9:31
  SPEAKER_01: So there's a big difference.
• 9:32
  SPEAKER_01: You know, you can say, oh, okay, there's the 1A series of strains and the 1B series of strains, and then there's type 2.
• 9:37
  SPEAKER_01: But actually within the 1A and the 1B, there are pathogenic and commensal strains.
• 9:42
  SPEAKER_01: So the stamina that C acne causes acne, while correct, you know, overall is an overgeneralization because there's all these different strains.
• 9:51
  SPEAKER_01: We know of about seven now, there may be more.
• 9:53
  SPEAKER_01: And we have to look deeper into the microbiome.
• 9:56
  SPEAKER_01: Like, why are certain strains beneficial and actually help us?
• 10:00
  SPEAKER_01: So, why does some C acne help prevent acne while others become virulent and cause inflammation?
• 10:06
  SPEAKER_01: And under certain conditions, for example, you know, in your plugged hair follicle, which is depleted of oxygen and filled with your sebum, why basically does it change its behavior in this environment and cause infections and pimples?
• 10:19
  SPEAKER_00: It's very interesting, though, that they are coexisting together and causing different effects.
• 10:23
  SPEAKER_00: So when it comes to inflammatory lesions like pimples, I mean, can we dive a little bit more into that?
• 10:29
  SPEAKER_00: Like how does C acne really lead to this inflammatory process of causing pimples?
• 10:34
  SPEAKER_00: Yeah.
• 10:34
  SPEAKER_01: Sure.
• 10:34
  SPEAKER_01: So basically you get your overproduction of sebum because you have oily skin.
• 10:38
  SPEAKER_01: Something happens, you know, basically in people with acne, they tend to genetically be more prone to having cell death in the hair follicle, which creates the plug.
• 10:46
  SPEAKER_01: So now it's full of sebum.
• 10:47
  SPEAKER_01: And then some of these strains, like the 1A2 and 1b1, basically start acting like an anaerobe, which means because they don't need oxygen, they start multiplying a lot.
• 10:58
  SPEAKER_01: And so how do they do this?
• 10:59
  SPEAKER_01: They use what's called a protease to extract the amino acid arginine from the skin proteins and lipases.
• 11:06
  SPEAKER_01: So basically from our proteins and skin fats, and they degrade that to triglyceride lipids from the sebum.
• 11:12
  SPEAKER_01: And that allows them to release free fatty acids.
• 11:15
  SPEAKER_01: That allows them to adhere to the wall, like basically, and to each other, so that they can create either films or they can stick to the follicle wall.
• 11:24
  SPEAKER_01: Then after that, for those who have oilier skin, they'll have a greater abundance of these bacteria, and that increases the chance of developing pimples.
• 11:31
  SPEAKER_01: But also, you know, again, we should note that not all people with oily skin have breakouts either.
• 11:36
  SPEAKER_01: It depends on their microbiome.
• 11:38
  SPEAKER_00: That makes sense.
• 11:39
  SPEAKER_00: That's interesting, though.
• 11:40
  SPEAKER_00: It's really interesting because we all have um the same acne bacteria on our skin.
• 11:46
  SPEAKER_00: So why do some people with oily skin break out while others don't?
• 11:50
  SPEAKER_01: Right.
• 11:51
  SPEAKER_01: So basically, all of us are colonized, as I mentioned, with C acne's.
• 11:55
  SPEAKER_01: Um, and as you said, only a minority will develop acne.
• 11:57
  SPEAKER_01: Not everybody has acne.
• 11:58
  SPEAKER_01: So if we look at this in a broader context, that includes genetics, our immune system in general, skin barrier strength or skin barrier defects, the microbiome, which is affected by products we use or antibiotics, our general lifestyle, and the overall environment, it's actually a group of factors that correlate to having acne as well that determine how severe it can be.
• 12:19
  SPEAKER_01: So, for example, if you look at increased sebum secretion, so if you're producing a lot of sebum, the secretion rates typically correlate with the severity of the clinical symptoms.
• 12:28
  SPEAKER_01: If you have that dominant strain of C acne on the skin, it will also correlate to having a higher probability of getting acne.
• 12:36
  SPEAKER_01: You know, in the literature, those phylogroups have been consistently correlated with acne across studies.
• 12:41
  SPEAKER_01: Why?
• 12:42
  SPEAKER_01: Because they increase inflammatory potential.
• 12:45
  SPEAKER_01: And so they have these virulence factors.
• 12:47
  SPEAKER_01: They also affect bacterial adhesion like biofilm forming and how your immune system responds because you're the host.
• 12:53
  SPEAKER_01: Another example is vitamin B12 supplementation, has also been associated with acne, but again, only in a subset because of genetics.
• 13:01
  SPEAKER_01: Some people basically have repressed vitamin B12 biosynthesis in acne, and that can increase the production of porphyrins.
• 13:10
  SPEAKER_01: And porphyrins, again, can induce skin inflammation, and skin inflammation leads to acne development.
• 13:15
  SPEAKER_01: So, what's interesting though is that those C acne strains that we were talking about that are associated with acne formation are found to be the ones who actually produce substantially higher levels of these inflammation-causing porphyrins.
• 13:27
  SPEAKER_01: So we're starting to get a good idea of kind of this inflammatory cascade.
• 13:31
  SPEAKER_01: But again, it's very, there are many different factors.
• 13:34
  SPEAKER_00: That's very interesting.
• 13:35
  SPEAKER_00: You mentioned porpharins.
• 13:36
  SPEAKER_00: I mean, I'm wondering if that also has to do with like sun sensitivity as well, because a lot of people with acne complain about that.
• 13:43
  SPEAKER_00: I'm just wondering, you know, because porpharines are involved in that.
• 13:47
  SPEAKER_01: So right, could well be, could well be.
• 13:50
  SPEAKER_01: There's there's still so much science that we have to do.
• 13:53
  SPEAKER_00: Yeah, yeah, I know I know.
• 13:54
  SPEAKER_00: Now you mentioned inflammation several times, and I love that you're diving into inflammation.
• 13:59
  SPEAKER_00: In the context of C acne's uh produced porphyrians and in the context of increased sebum production by inflamed sebocytes, can you tell us more about this acne inflammosome?
• 14:09
  SPEAKER_00: I think it's been coming up a lot as well.
• 14:11
  SPEAKER_01: Sure.
• 14:11
  SPEAKER_01: So we can kind of summarize the pathophysiology.
• 14:14
  SPEAKER_01: So really, there's four key factors that have been identified at this point in the research.
• 14:19
  SPEAKER_01: So one is, as we mentioned, excess skin oil or sebum production.
• 14:23
  SPEAKER_01: Two is the overgrowth of our acne bacterium.
• 14:26
  SPEAKER_01: Inflammation is definitely implicated.
• 14:29
  SPEAKER_01: And then people who tend to have more acne also have what's called hyperkerotinization.
• 14:34
  SPEAKER_01: And that's essentially when cells of the follicle become cohesive, so sticky.
• 14:39
  SPEAKER_01: And so they don't shed normally on the skin surface.
• 14:42
  SPEAKER_01: Like you know, that most people turn their skin over in three to four weeks every month.
• 14:48
  SPEAKER_01: And so basically, when the dead skin cells kind of become stuck, that's when you start getting plugged pores.
• 14:54
  SPEAKER_00: Interesting.
• 14:55
  SPEAKER_00: So talking about the skin barrier again, because I think that's something everyone, you know, really hears about a lot.
• 15:00
  SPEAKER_00: You know, you've talked a lot about the importance of keeping the skin barrier healthy and intact, especially in the context of dehydration and uh reactive oxidative species, including the breakdown of collagen and aging.
• 15:11
  SPEAKER_00: Can you tell us a little bit more about the skin barrier in terms of acne?
• 15:16
  SPEAKER_01: Sure.
• 15:16
  SPEAKER_01: So let me go back a little bit to the acne inflammation first, and then we'll talk about the skin barrier.
• 15:21
  SPEAKER_01: So, as you mentioned, the acne inflammosome has a significant role because it activates this inflammatory response within the skin, including the skin barrier.
• 15:30
  SPEAKER_01: So when this inflammosome is activated, it releases what are called pro-inflammatory molecules.
• 15:36
  SPEAKER_01: They promote inflammation, they promote more excess sebum production.
• 15:41
  SPEAKER_01: You can start seeing where this is going.
• 15:43
  SPEAKER_01: That disrupts the normal shedding of the skin cells.
• 15:46
  SPEAKER_01: And this basically biological perfect storm leads to clogged pores, excess of acne bacteria, and your pus-filled pimples.
• 15:54
  SPEAKER_01: So the issue is that if you look at severe acne, the chronic inflammation in immune cell are caused by the body's internal pro-inflammatory molecules.
• 16:04
  SPEAKER_01: And this starts to compromise the skin barrier and negatively affect its ability to protect the body.
• 16:09
  SPEAKER_01: So then when you get this compromised skin barrier, you start seeing that as one, increased transepidermal water loss.
• 16:16
  SPEAKER_01: So you're losing more moisture, you're getting more dehydrated.
• 16:20
  SPEAKER_01: All of a sudden, even though you have oily skin, it's dry and dehydrated.
• 16:25
  SPEAKER_01: Two, this impaired barrier function, you know, it goes back to the inflammation because a weaker skin barrier is more permeable, so porous, which means it allows more irritants and allergens and bacteria to go through it, which increases the inflammation further.
• 16:39
  SPEAKER_01: So you can start seeing this really bad positive feedback loop, which then leads to more skin damage.
• 16:45
  SPEAKER_01: And then it can also delay healing because a damaged skin barrier will hinder the natural healing process.
• 16:51
  SPEAKER_01: And so the acne lesions may take longer to heal or may be more prone to infection.
• 16:55
  SPEAKER_01: You know, sometimes that pimple just grows bigger and bigger and bigger, and then you have this massive scar once you finally get rid of it.
• 17:01
  SPEAKER_01: So getting a healthy skin barrier back is also really important in managing acne.
• 17:07
  SPEAKER_00: So interesting, though, how all of this like eventually leads to the breakdown of the skin barrier, you know, because I think that, you know, just as a side note, a lot of people like to jump straight there.
• 17:16
  SPEAKER_00: You know what I mean?
• 17:17
  SPEAKER_00: Like the integrity of the skin barrier.
• 17:19
  SPEAKER_00: And we don't understand all this wonderful information you're providing right now, like all this, the what leads to that, you know, like all of the processes that lead to that.
• 17:27
  SPEAKER_00: So that's very fascinating.
• 17:28
  SPEAKER_00: So basically, you're saying that we need to treat acne without damaging our skin barrier.
• 17:33
  SPEAKER_00: And we all know that when it comes to, for example, like benzyl peroxide, we know it's very potent.
• 17:38
  SPEAKER_00: It can be prog, it can be problematic for sensitive skin.
• 17:41
  SPEAKER_00: I personally react very uh negatively to benzyl peroxide.
• 17:45
  SPEAKER_00: And if it's used in the long term, it can lead to oxidative stress in the skin barrier and potentially damage it.
• 17:49
  SPEAKER_00: So, can you tell us a little bit more about that?
• 17:52
  SPEAKER_01: So essentially, benzyl peroxide oxidizes.
• 17:55
  SPEAKER_01: So it's a really good oxidizer.
• 17:57
  SPEAKER_01: It's you can think of it as it's a really good bleach.
• 18:00
  SPEAKER_01: And so, yes, it's excellent at killing acne.
• 18:03
  SPEAKER_01: It will also kill the rest of your skin microbiome.
• 18:06
  SPEAKER_01: And then, as you said, it will basically this this um active peroxide will also oxidize everything around your skin cells in your skin barrier.
• 18:17
  SPEAKER_01: And so that's why it basically damages the skin barrier because it's as if you're bleaching your skin or as if you're exposing it to free radicals from UV.
• 18:26
  SPEAKER_01: So it's no different.
• 18:27
  SPEAKER_01: But yes, it's very good at killing acne, but the problem is it does have long-term side effects.
• 18:33
  SPEAKER_00: I've never been a huge fan of it, to be honest, because it's for me, it causes sensitivity, you know?
• 18:39
  SPEAKER_01: Everywhere though, right?
• 18:40
  SPEAKER_01: What's interesting is that in Europe it's used a lot less.
• 18:42
  SPEAKER_01: Like it's used kind of again as a like with isotretinoin, those are things of last resort.
• 18:47
  SPEAKER_01: Because I think in in Europe they kind of have they've had a lot of bad experiences with Accutane-like or isotretinoin-like treatments and benzoyl peroxide.
• 18:55
  SPEAKER_01: So actually in Europe, it's by prescription only.
• 18:57
  SPEAKER_01: You have to have a doctor's prescription, you have to pick it up from a pharmacy.
• 19:01
  SPEAKER_01: You can't just pick it off, pick it up off of a shelf at Target like you can in the US.
• 19:06
  SPEAKER_00: Interesting.
• 19:06
  SPEAKER_00: I think that's that's definitely something we need to gravitate towards that, in my opinion.
• 19:10
  SPEAKER_00: Like at the end of the day, because you know, just because it's just so much sensitivity that I see.
• 19:15
  SPEAKER_00: I mean, for me, it's immediate.
• 19:16
  SPEAKER_00: Like as soon as it touches my skin, immediate redness.
• 19:19
  SPEAKER_00: Like it's like immediate redness, exactly.
• 19:20
  SPEAKER_01: But you're basically oxidizing, right?
• 19:22
  SPEAKER_01: You'd get the same effect if you'd put, you know, a bleach or something else on your skin.
• 19:27
  SPEAKER_01: Exactly.
• 19:28
  SPEAKER_00: Exactly.
• 19:28
  SPEAKER_00: Yeah.
• 19:29
  SPEAKER_00: So moving on to the new microbiome balancing serum, um, could you tell us a little bit more that about it and then going into the context of everything that we've discussed?
• 19:40
  SPEAKER_01: Um, sure.
• 19:42
  SPEAKER_01: So basically, for decades, like ever since I can remember, antibiotics have been widely employed for treating acne.
• 19:49
  SPEAKER_01: The issue is that there's now a fear of antibiotic resistance, of overusing antibiotics in general.
• 19:56
  SPEAKER_01: And so if we look at phage therapy, for example, that's been around for five or seven years for acne specifically in terms of products.
• 20:04
  SPEAKER_01: That's one very promising strategy that is definitely there to prevent antibiotic resistant bacteria.
• 20:10
  SPEAKER_01: And just for your listeners, the bacteriophage or phage for short is essentially a virus that infects and replicates within bacteria like C acnes and kill it.
• 20:20
  SPEAKER_01: So phage therapy essentially involves or their lytic proteins.
• 20:24
  SPEAKER_01: So these are proteins that you can think of it like they lys or they blow up the bacteria to kill them.
• 20:29
  SPEAKER_01: And these then infect the bacteria, kill the bacteria at the site of infection, and there's now several products there on the market for that.
• 20:36
  SPEAKER_01: So that's not our bio serum.
• 20:38
  SPEAKER_00: Yeah, I was gonna ask you.
• 20:39
  SPEAKER_00: I was like, how is the bio serum different?
• 20:41
  SPEAKER_00: I've seen the phage related advancements in the skin space, and it's it seems promising to me, but it's also kind of scary.
• 20:47
  SPEAKER_00: I'm not gonna lie, because I always think of, you know, what can it really lead to, you know, down the road?
• 20:51
  SPEAKER_00: Because it is their bacteriophages are, you know, they're targeting bacteria, but there's also evidence of resistance developing because of overexposure to them.
• 21:00
  SPEAKER_00: So I'm just curious how that goes, you know, in the long run.
• 21:03
  SPEAKER_00: But let's talk about your biosterum.
• 21:06
  SPEAKER_00: How is that different?
• 21:06
  SPEAKER_01: So going back to their phages, um, first of all, the safety of these bacteriophage approaches, as you said, ECTA, it's still being evaluated by the regulatory bodies, both in the US and in Europe.
• 21:17
  SPEAKER_01: Although they have been developed and are used frequently, you know, in Eastern Europe or Russia for many decades with success.
• 21:23
  SPEAKER_01: But the other issue is the specifications on the characteristics of these phages also now has to be defined.
• 21:29
  SPEAKER_01: So these include, you know, the genes that are indicative of their ability to insert their genome into that of the host, all the known toxins.
• 21:38
  SPEAKER_01: I think that's 40 CFR 725421, what virulence genes they have, what antibiotic resistant genes, what their host sequences are.
• 21:47
  SPEAKER_01: So there's a lot of genomic work still to be done on the phages and their potential to transduce their genomic material into the host, i.e., us.
• 21:56
  SPEAKER_01: Because right now they're transmitting this genetic material to bacteria.
• 22:00
  SPEAKER_01: It's great, but the problem is that they also have the potential to start killing those beneficial or commensal bacteria.
• 22:06
  SPEAKER_01: And so those are actually some of the biggest concerns with their large-scale deployment.
• 22:10
  SPEAKER_01: Although, I mean, a lot of studies, you know, there's been studies between 2021 and 2023 showing promise of safety, but it's basically not guaranteed.
• 22:19
  SPEAKER_01: We decided to go slightly differently.
• 22:20
  SPEAKER_01: We decided to go microbiomodulation with bacteria that we actually already have both in us and on us, and bacteria that are beneficial.
• 22:30
  SPEAKER_01: So in our biocerum, we deliver a bacterium called Lactobacillus plantarum directly to the skin as a serum.
• 22:37
  SPEAKER_01: So this species is known to reduce the inflammatory cascade.
• 22:40
  SPEAKER_01: So we talked about the acne inflammation.
• 22:42
  SPEAKER_01: It also reduces lipid production in sebicytes.
• 22:45
  SPEAKER_01: So basically, this overproduction of sebum.
• 22:48
  SPEAKER_01: Then we basically added a gut probiotic that reduces also the systemic inflammation and rebalances the dysbiosis to help regulate, again, lipids so that you don't have too much lipids in your bloods.
• 23:01
  SPEAKER_01: And then this dual solution then restores what we call balance or homeostasis to both the gut and the skin, and most importantly to the sebicytes, these sebum-producing cells in your follicles, and downregulates, if you remember, these inflammatory cytokines, these pro-inflammatory molecules of the acne inflammation.
• 23:19
  SPEAKER_01: So basically, we're trying to reduce inflammation, reduce lipid production, so not have the skin be too oily.
• 23:26
  SPEAKER_01: And that then basically, and also shift microbiome away from the total dominance of C acne.
• 23:31
  SPEAKER_01: And so shifts it somewhat in the favor of S.
• 23:34
  SPEAKER_01: epidermitis, which is another bacteria that's a commensal that's also on our skin today.
• 23:39
  SPEAKER_01: And what we've basically seen is we've been able to shift this ratio, say from acnes to epidermitis, from about five to one in acneic skin to two to one, which is more like normal skin.
• 23:48
  SPEAKER_01: So again, we're not trying to shift anything or completely get rid of it.
• 23:52
  SPEAKER_01: We're just trying to shift it in a way that is more typical of a healthy skin.
• 23:56
  SPEAKER_01: Because it's already a natural part of your skin microbiome, it has zero risk of killing commensal bacteria.
• 24:02
  SPEAKER_01: And because it's not a phage, it's not going to insert its genetic material into any host cell, like a phage.
• 24:08
  SPEAKER_01: Plus, on top of that, we've been using it.
• 24:10
  SPEAKER_01: You know how I always talk about, you know, all these fermented foods.
• 24:13
  SPEAKER_01: So L plantarum, as opposed to L.
• 24:15
  SPEAKER_01: acidophilus, which is used in yogurt, has been used in pickles, sauerkraut, kimchi, um brined olives, our sourdough bread here in San Francisco, and other foods like I've recently discovered Nigerian OG, I hope I'm pronouncing that correctly, and cheeses, sausages, stockfish.
• 24:35
  SPEAKER_01: So basically, we've been using this bacterium for thousands of years, like acidophilus and food production.
• 24:41
  SPEAKER_01: Um, we've been eating it on a regular basis.
• 24:43
  SPEAKER_01: So this goes back to kind of inside-outside safety and skin gut brain microbiome.
• 24:48
  SPEAKER_00: Oh, that's really fascinating.
• 24:50
  SPEAKER_00: You know, you always take it back to the food grade ingredients with what Codex delivers, you know, and that's very interesting to me.
• 24:55
  SPEAKER_00: And I love that because that really speaks to the safety of the products, you know.
• 24:59
  SPEAKER_00: And so, in terms of this new serum, um, that takes it to another level, it seems.
• 25:04
  SPEAKER_00: Um, and where you're delivering actually a live probiotic when you apply it.
• 25:08
  SPEAKER_00: So, in that regard, can you tell me more about how you use it?
• 25:12
  SPEAKER_01: Sure.
• 25:13
  SPEAKER_01: So I just want to give a shout out to our partner from Europe, BioArt.
• 25:18
  SPEAKER_01: And basically, we're distributing this novel serum.
• 25:21
  SPEAKER_01: It's topically applied.
• 25:23
  SPEAKER_01: So it comes basically as dry powder and you constitute it with water.
• 25:28
  SPEAKER_01: So it's basically powder in a syringe.
• 25:30
  SPEAKER_01: You add water and you kind of mix it.
• 25:32
  SPEAKER_01: What's really cool is because they're a microbiology lab and they also do a lot of microbiome analytics, they basically, this was fully developed and intended to restore the skin microbiome balance.
• 25:42
  SPEAKER_01: And as I mentioned, decrease oil production, reduce irritation, reduce inflammation, clarify.
• 25:48
  SPEAKER_01: Um, they actually published um their data um in 2023.
• 25:53
  SPEAKER_01: Um, it's a publication with the main author Padrini from Italy, Topical Administration of Lactobacillus plantarum skindo serum, improves anti-acne properties.
• 26:03
  SPEAKER_01: So it's in the journal microorganisms.
• 26:06
  SPEAKER_01: Um, and so as we discussed before, it allows us, along with the gut probiotic, a very comprehensive way to treat acne.
• 26:13
  SPEAKER_01: And so when we combine this probiotic serum with the live lactobacillus plantarum, and then we have our clear skin gut probiotic that reduces gut inflammation and strengthens the gut barrier and also reduces general inflammation.
• 26:26
  SPEAKER_01: And then for people with hormonal acne, you even add in the de-stress supplement to balance hormones, reduce cortisol, sebum production, and chronic inflammation.
• 26:35
  SPEAKER_01: So, you know, you can get sebum production either from inflammation or from hormonal imbalance, as those people with PICOS well know.
• 26:42
  SPEAKER_01: Um, it becomes basically the perfect external complement.
• 26:45
  SPEAKER_01: So to me, the serum is the complement to our shant ingestibles.
• 26:50
  SPEAKER_01: And also, I'm gonna recall everybody's um attention that because our shant collection was designed to not change the microbiome, it's microbiome certified.
• 26:59
  SPEAKER_01: You can use it to wash, to scrub, to tone your pores, to restore your skin barrier, to moisturize, you know, whatever function you need for your type of skin without shifting the microbiome with our topicals.
• 27:12
  SPEAKER_01: So this is actually the perfect complement because the serum shifts your microbiome, and then our products leave that shifted microbiome in place.
• 27:22
  SPEAKER_01: They don't basically shift it further.
• 27:25
  SPEAKER_01: And then obviously, we have the supplements for the inside out.
• 27:28
  SPEAKER_00: Wow, that's really, really fascinating.
• 27:31
  SPEAKER_01: So it's the first of its kind, I think.
• 27:33
  SPEAKER_01: Yeah, it's the first solution of its kind.
• 27:36
  SPEAKER_01: It's a whole system.
• 27:37
  SPEAKER_01: That's amazing.
• 27:38
  SPEAKER_01: It is, it's taken us three years to get there, but it's really cool to see it now when all the pieces come together.
• 27:44
  SPEAKER_00: Yeah, this is very, very, very novel.
• 27:46
  SPEAKER_00: I mean, this is exciting for me because you know, whenever I look at medicine, I always think, you know, this people always say, you know, we want a holistic approach, holistic approach, but I mean, this is it, right?
• 27:56
  SPEAKER_00: This is the holistic approach to acne treatment.
• 27:59
  SPEAKER_00: So that's really cool.
• 28:00
  SPEAKER_00: Very, very cool.
• 28:01
  SPEAKER_00: So, how does the skin duobiot serum shift the skin microbiome exactly?
• 28:06
  SPEAKER_01: So basically, if we recap, you know, again, acne is a skin condition, blockage or disruption of your sebaceous gland or pylosabaceous units, as they're called by dermatologists, in the hair follicle.
• 28:18
  SPEAKER_01: It's basically characterized by the dominance of these distinct strains of acne that lead to imbalance and dysbiosis.
• 28:26
  SPEAKER_01: And so our goal is basically to lower the C acne's abundance and to change its ratio with the epidermitis commensal, and this rebalances the hair follicle microbiome.
• 28:36
  SPEAKER_01: We don't want to affect S.
• 28:38
  SPEAKER_01: epidermitis abundance in general because it's commensal.
• 28:41
  SPEAKER_01: So it helps maintain our skin balance and homeostasis, and it also fights opportunistic pathogens.
• 28:47
  SPEAKER_01: So basically, BioArt developed an in vitro model, which is really neat because no animal testing again, with C acne and with inflammatory characteristics of acne, specifically in the sebicytes, basically the sebum-producing human cells.
• 29:01
  SPEAKER_01: So they have a 2D cultured sebacyte model with acnes on it, and then they looked at activity assays against specific classes of acnes, and it was shown to statistically decrease about 50% in abundance after the application of the bioserum.
• 29:17
  SPEAKER_01: So we can really see in this 2D model the effect of the bioserum directly on C acne on these inflamed, pissed-off sebicytes.
• 29:26
  SPEAKER_01: Now, given the promising results from the model, then the microbiome modulation was actually performed on 40 patients.
• 29:33
  SPEAKER_01: So 18 to 45 male and female with grade two or three acneic skin according to the GES scale.
• 29:40
  SPEAKER_01: So they applied the serum to their faces for 28 days.
• 29:44
  SPEAKER_01: We measured the composition of their skin microbiome.
• 29:47
  SPEAKER_01: This was done using 16 amplicon sequencing on day zero and day 28 with Oxford nanopore technology.
• 29:54
  SPEAKER_01: And then when observed, we basically looked at the phenotypic effects of acne and we saw the microbiome profile change.
• 30:00
  SPEAKER_01: So basically, the day 28 profile showed a similar 50% reduction in C acnes and a 50% increase in F-sepidermitis and a 600% increase in lactobacillus plantarum.
• 30:13
  SPEAKER_01: So basically, it means we had implanted this bacterium, which had actually been low in these people because they had too much C acnes.
• 30:20
  SPEAKER_01: And that basically showed us that the bioarit serum effectively targets at the pathogenic C acnes level, restores us epidemitis, and that's basically how it works.
• 30:30
  SPEAKER_01: So we truly shift the microbiome.
• 30:32
  SPEAKER_01: We've done it both in 2D culture as well as on actual people.
• 30:36
  SPEAKER_00: That's amazing.
• 30:37
  SPEAKER_00: I love that.
• 30:38
  SPEAKER_00: That's really cool.
• 30:39
  SPEAKER_00: And so basically it's a lot more sophisticated than just killing off C acnes, as we see a lot of.
• 30:45
  SPEAKER_01: Exactly.
• 30:45
  SPEAKER_01: Whether it's like prophylactically with benzoyl peroxide, where you just kill everything, you know, kind of that old quote, you know, kill them all and let God sort it out.
• 30:53
  SPEAKER_01: Or I'm basically having the phage that, you know, you're hoping that it only kills the bacteria.
• 30:59
  SPEAKER_00: Now you had mentioned sebum production.
• 31:01
  SPEAKER_00: How does the skin duo biosterm help with reducing sebum production?
• 31:06
  SPEAKER_01: So basically it appears again that C acnes certain strains of C acne bacteria appear to directly participate in actually increasing the production of sebum.
• 31:15
  SPEAKER_01: So again, when we go back to this 2D seebocyte model, um, and if after incubation, uh, we basically saw that the uh serum decreased the lipid production by about 43%, as opposed to when the sample was left untreated.
• 31:32
  SPEAKER_01: And so then we basically uh the lab decided to kind of motivate the sebicytes to produce even more sebum with um liposaccharides.
• 31:41
  SPEAKER_01: And basically these liposaccharides will induce the expression of antimicrobial peptides and pro-inflammatory cytokines.
• 31:48
  SPEAKER_01: So you're basically pissing off the sebacytes even more, but the serum treatments still decrease the lipid production in this case by 57%, which also shows you that the lactobacillus has an anti-inflammatory effect.
• 32:01
  SPEAKER_01: So even when it's aggravated in the presence of liposaccharides, we we were still able to, they were still able to reduce it.
• 32:07
  SPEAKER_01: In fact, they reduced it by 14% more.
• 32:09
  SPEAKER_01: And then they also uh this was done by immunofluorescence staining.
• 32:13
  SPEAKER_00: That's really fascinating.
• 32:15
  SPEAKER_00: Wow.
• 32:15
  SPEAKER_00: So lactobacillus plantarum helps with the inflammatory cascade in the skin.
• 32:20
  SPEAKER_00: Exactly.
• 32:21
  SPEAKER_00: Exactly.
• 32:22
  SPEAKER_00: So can you explain to us how the biosterm helps manage this acne inflammosome, like just as a recap or an overview?
• 32:30
  SPEAKER_01: Sure.
• 32:30
  SPEAKER_01: So we're gonna now talk about these pro-inflammatory cytokines.
• 32:34
  SPEAKER_01: Um, so basically, again, acne being an inflammatory condition, you have your environmental factors, your pollution in your UV, you have your hormonal factors, you know, puberty, pregnancy, menopause, and lifestyle factors, diet, sleep, alcohol, stress, caffeine, smoking.
• 32:51
  SPEAKER_01: So, how does the acne cause the hair follicle inflammation?
• 32:54
  SPEAKER_01: To use, you know, some technical words here, it produces a dynamic shift in the follicular microenvironment.
• 33:00
  SPEAKER_01: So it essentially changes the environment in your hair follicle, and that changes the transcriptional response.
• 33:07
  SPEAKER_01: So basically, acnes in a lipid-rich, hypoxics, and no oxygen environment will promote anaerobic fermentation and produce shortchain fatty acids that activate what's called this epigenetic mechanism of TLR2-mediated production of these cytokines, specifically IL-6, IL8, and tumor necrosis factor alpha in human keratinocytes.
• 33:30
  SPEAKER_01: So basically, what that means is that the acne bacteria triggers an inflammatory response and triggers the expression of these genes, IL1 alpha, IL6, and IL8, to significantly be upregulated.
• 33:45
  SPEAKER_01: That increases the inflammation.
• 33:46
  SPEAKER_01: And so then we can look at the upregulation and expression of these genes if we apply the bioserum again.
• 33:53
  SPEAKER_01: So we go back to our 2D model of our primary sebicytes, we infect them with C acnes and a sepidermitis, and then we look at the secretion of the cytokines, specifically IL1A, IL6, and IL8.
• 34:06
  SPEAKER_01: Then we treat it with serum, then we measure these secretion levels again, and we saw that they were decreased in 24 hours by over 90%.
• 34:15
  SPEAKER_01: And to be specific 16 to 17 times.
• 34:19
  SPEAKER_00: Wow.
• 34:20
  SPEAKER_00: So it's like the typical pro-inflammatory cytokines, then exactly.
• 34:24
  SPEAKER_01: And it's so you basically, this is how you prove that it's anti-inflammatory.
• 34:28
  SPEAKER_01: So you're hitting the lipid production problem in acne, you're hitting the inflammatory cascade in acne.
• 34:34
  SPEAKER_01: So you can now see why this serum works so well.
• 34:36
  SPEAKER_00: This is really, really interesting.
• 34:38
  SPEAKER_00: And you had mentioned earlier about the shot collection and the probiotic supplement.
• 34:42
  SPEAKER_00: Can you explain a little bit more how you know it is the ideal complement to the new skin gut microbiome modulation solution?
• 34:50
  SPEAKER_01: Absolutely.
• 34:51
  SPEAKER_01: So, as we talked about previously, you know, gut skin access has started to be now studied very extensively.
• 34:57
  SPEAKER_01: And we now know that numerous skin diseases are associated with altered gut microbiomes, you know, starting with eczema, for example.
• 35:04
  SPEAKER_01: And because our gut barrier regulates our uptake of fluids, electrolytes, nutrients, prevents again, penetration of pathogens that may be in our food, any dysfunction or imbalance in this intestinal microbiome will cause excess growth of pathogenic bacteria.
• 35:20
  SPEAKER_01: Basically, there's nothing left to defend us against them.
• 35:22
  SPEAKER_01: And so, again, pathogenic bacteria cause inflammation, either local or systemic.
• 35:28
  SPEAKER_01: And then systemic inflammation will affect skin physiology.
• 35:32
  SPEAKER_01: Um, we've observed this inflammatory cascade in research papers.
• 35:35
  SPEAKER_01: The exact mechanisms, unfortunately, ECTA, we don't fully understand yet.
• 35:39
  SPEAKER_01: But essentially what we do know is that the combination of the probiotic serum and the gut probiotic supplement really is bioengineered to modulate the skin and gut dysbiosis, so this microbiome imbalance simultaneously, and to restore basically, again, homeostasis, like downregulating these inflammatory cytokines both on the skin and the gut.
• 36:00
  SPEAKER_01: So we're essentially reducing the overall inflammation in both the skin and the gut with both antioxidants in the supplement, lipid regulating actives in the supplement.
• 36:09
  SPEAKER_01: So we're trying to kind of overall bring down lipid levels, bring down sebum production, and bring down inflammation.
• 36:15
  SPEAKER_01: And so, in that regard, the clear skin supplement that we have, because it has both the Google and the green tea, so kind of the lipid regulating and the antioxidant, along with the probiotics that are also anti-inflammatory and pathogen fighting, it basically is the perfect complement.
• 36:33
  SPEAKER_01: And then we have our topicals that, as I mentioned earlier, they preserve the microbiome diversity and they support microorganisms like this live probiotic.
• 36:41
  SPEAKER_01: And so they can basically be combined.
• 36:43
  SPEAKER_01: You can think of it, you know, with impunity with our supplements.
• 36:47
  SPEAKER_01: And then you can also balance out your hormones, reduce stress, et cetera.
• 36:51
  SPEAKER_01: But this is all about fortifying the skin and gut barrier, reducing inflammation, reducing lipid production, and just managing that acne inflammosome.
• 36:59
  SPEAKER_00: This is really fascinating because I mean, you're really talking about the inflammation, and inflamma aging is a buzzword that comes up a lot.
• 37:07
  SPEAKER_00: But I think when we're discussing how the immunology of the body works, it isn't just a topical solution.
• 37:13
  SPEAKER_00: It has to be multifaceted.
• 37:15
  SPEAKER_00: And so the fact that you guys are targeting it from all these different angles, I mean, that's really, really interesting, the synergy of all of these products.
• 37:23
  SPEAKER_01: We got 60% or 58% improvement with just the ingestibles, like we talked about last time with just the probiotic or the hormone balancing supplements.
• 37:32
  SPEAKER_01: So definitely you have to balance the gut out.
• 37:35
  SPEAKER_01: You have to reduce gut inflammation.
• 37:36
  SPEAKER_01: You can't just do the topical.
• 37:37
  SPEAKER_01: The topical will get you a third of the way there, but the gut will get you the other way, the other rest of the way.
• 37:44
  SPEAKER_00: Yeah, no, that makes so much sense.
• 37:45
  SPEAKER_00: More sense, I think, from the scientific viewpoint, you know, than uh traditional treatments.
• 37:50
  SPEAKER_00: So that's very, very exciting data that you shared.
• 37:53
  SPEAKER_00: Um, now for our listeners, I would love for you to offer some recommendations from the Codex Basic Acne Skincare lineup in addition to the probiotic bio serum.
• 38:02
  SPEAKER_01: This is really easy.
• 38:03
  SPEAKER_01: So makeup removal, washing your face in general, our foaming cleanser doesn't dehydrate, it has glycolipids again.
• 38:09
  SPEAKER_01: It's not going to bother, you know, basically your cells that have a tendency to want, you know, to die because of the tumor necrosis factor.
• 38:17
  SPEAKER_01: And then we also suggest the clay mask once a week, but don't let it dry.
• 38:21
  SPEAKER_01: That will remove about 72% of your dead skin cells.
• 38:24
  SPEAKER_01: Again, fewer dead skin cells, fewer clogged pores.
• 38:27
  SPEAKER_01: And then if you do have more acneic skin, basically there's the pore purifying face scrub with 2% salicylic acid.
• 38:34
  SPEAKER_01: That's great for cleaning pores.
• 38:35
  SPEAKER_01: And then our oil control cream with the 1% Bacuchiol to increase um skin turnover and to reduce scarring.
• 38:43
  SPEAKER_01: And then not to um forget the spot hero, which is based on sulfur rather than benzoyl peroxide and exfoliating fruit acids is great for treating spots.
• 38:52
  SPEAKER_01: So I would say, you know, probably the go-to would be the face scrub and the spot hero.
• 38:56
  SPEAKER_01: And then depending on how badly you scar the oil control cream for with the Bacucciol.
• 39:02
  SPEAKER_00: That's really, really cool.
• 39:03
  SPEAKER_00: And so, you know, I just want to clarify for our listeners, we can't use just any skincare line, right, with the new bio serum.
• 39:09
  SPEAKER_00: I mean, yeah, I know you had gone into this with how it is a holistic approach.
• 39:13
  SPEAKER_00: So can you explain that to us just for clarity?
• 39:16
  SPEAKER_01: So I'm not gonna stop anybody from using any other product with you know with our bio serum, but all I can say is that our products, the Sean Collection, have the same pH as human skin.
• 39:28
  SPEAKER_01: So it's between four and a half to five and a half.
• 39:30
  SPEAKER_01: So you have to make sure that this other product has that pH.
• 39:33
  SPEAKER_01: We've done a lot of work with my microbiome to ensure that it doesn't change microbiome diversity.
• 39:38
  SPEAKER_01: So, you know, if you are going to look for another product, definitely try to get that seal on it.
• 39:43
  SPEAKER_01: And so, therefore, we know, like as opposed to, you know, if you say, Can I use this?
• 39:47
  SPEAKER_01: My first answer will be, I don't know the product, I don't have the data, I don't know.
• 39:50
  SPEAKER_01: I know with our products that they won't counteract the benefits of applying the probiotic serum and they won't counteract this shift with the microbiome.
• 39:59
  SPEAKER_01: We also know that lactobacillus likes to grow in a pH range of about 3.4 to 8.8.
• 40:05
  SPEAKER_01: So it's well suited to the natural skin pH of four and a half to five and a half, and therefore the shot products.
• 40:10
  SPEAKER_01: So, again, if you're putting very alkaline products on your skin, I can't guarantee you're not gonna, you know, just kill it off.
• 40:16
  SPEAKER_01: And then you've paid a lot of money for nothing.
• 40:18
  SPEAKER_01: Um, there's a lot of harsh acne products out there.
• 40:21
  SPEAKER_01: They also will kill a phage drum.
• 40:23
  SPEAKER_01: Phages prefer a neutral pH.
• 40:25
  SPEAKER_01: And that's another difference that our treatment likes the low skin natural skin pH versus the phages, which prefer a neutral pH.
• 40:32
  SPEAKER_01: So that's why a lot of phage companies add their own cleanser and moisturizer as well.
• 40:36
  SPEAKER_01: So we're not the only ones to be doing this.
• 40:38
  SPEAKER_00: I really encourage, though, for the listeners, if you're really going to go into this, I mean, really stick to the system because this sounds very fascinating.
• 40:46
  SPEAKER_00: I mean, honestly, at the end of the day, like I think a lot of dermatologists have taken this approach too.
• 40:51
  SPEAKER_00: I mean, if you go to a derm, they're gonna give you kind of a system to follow, whether that's antibiotics or or whatever, you have to kind of stick to a regimen.
• 40:58
  SPEAKER_00: And so, Barb, I mean, everything you've explained here, all of the, you know, the molecular science and and all of the details, it really makes sense why all these products work together.
• 41:07
  SPEAKER_00: So I'm very excited to see that.
• 41:09
  SPEAKER_00: And I hope, you know, for all the listeners out there, if you are looking for a true acne treatment system, I mean, you do I think you should really kind of you know invest in all of the products rather than just like one or two to make sure it's all working very well together.
• 41:24
  SPEAKER_00: Any other tips you have for us, Barb, in terms of keeping our pores clean and staying acne-free?
• 41:29
  SPEAKER_01: Sure.
• 41:30
  SPEAKER_01: So we'll kind of do the quick list of, you know, the basic common sense stuff.
• 41:34
  SPEAKER_01: You know, we know oil, dirt, and makeup lead to clog pores.
• 41:37
  SPEAKER_01: So basically remove makeup before bed.
• 41:40
  SPEAKER_01: You know, don't go to bed with your makeup on.
• 41:42
  SPEAKER_01: Cleanse twice a day, but make sure that the cleanser is oil-free and it doesn't dehydrate your skin.
• 41:48
  SPEAKER_01: Moisturizer, make sure it's non-kemetogenic.
• 41:50
  SPEAKER_01: Ideally, it also helps reduce your pore visibility.
• 41:53
  SPEAKER_01: Deep clean your pores with either a clay mask or salicylic acid once a week.
• 41:58
  SPEAKER_01: Exfoliate dead skin cells.
• 41:59
  SPEAKER_01: You know, don't overexfoliate, but definitely exfoliate and tone.
• 42:03
  SPEAKER_01: Uh, a toner can also be beneficial.
• 42:06
  SPEAKER_01: And then Bacuchiol cream, I know a lot of people love retinol Bacuchiol because even though it works more slowly, it's far more gentler on skin.
• 42:13
  SPEAKER_01: Again, use it a few times a week to improve skin turnover, shed those dead skin cells.
• 42:18
  SPEAKER_01: And for pimples, I would just say use something gentler than benzoyl peroxide.
• 42:23
  SPEAKER_00: That really makes sense.
• 42:24
  SPEAKER_00: So, in summary, kind of summarize again for us the impact of acne and maybe give us some statistics if you could.
• 42:30
  SPEAKER_01: Oh, I love numbers.
• 42:32
  SPEAKER_01: So acne, it's a very common chronic inflammatory skin disease.
• 42:36
  SPEAKER_01: Um, we mostly associate it with adolescents, but there are many, many women.
• 42:41
  SPEAKER_01: In fact, there are more and more women suffering from adult hormonal acne.
• 42:45
  SPEAKER_01: Um, globally, um, it's about at 9.4% of the population, so about one in 10 people.
• 42:51
  SPEAKER_01: It's actually the eighth most prelevant disease.
• 42:53
  SPEAKER_01: Um, and it is um still characterized as a disease because of all the um psychological trauma that it can induce.
• 43:00
  SPEAKER_01: Data from recent decades basically see this increase in older adults.
• 43:04
  SPEAKER_01: Um, not as much men.
• 43:06
  SPEAKER_01: We don't know yet why this is happening.
• 43:07
  SPEAKER_01: You know, is it microplastics?
• 43:09
  SPEAKER_01: Is it pollution in general, et cetera?
• 43:11
  SPEAKER_01: Is it uh hormones in our food?
• 43:12
  SPEAKER_01: But what we do know is according to the American Academy of Dermatology, so here I'm gonna quote them, it is the most prevalent uh common skin condition in the US.
• 43:20
  SPEAKER_01: It affects about 50 million people annually, and it's increasing year on year.
• 43:25
  SPEAKER_01: So even they see that um in their day-to-day work.
• 43:28
  SPEAKER_01: Um, it begins in puberty, um, it still continues affecting many uh young adults, um, about 85% of people.
• 43:36
  SPEAKER_01: So it's pretty much the vast majority between 12 and 24 will at least experience the least minor acne.
• 43:42
  SPEAKER_01: So very few people escape it completely.
• 43:45
  SPEAKER_01: And it can occur at any stage in life.
• 43:47
  SPEAKER_01: And the thing with for women, it can continue up to menopause.
• 43:50
  SPEAKER_01: So even though it occurs in 80 to 85% of adolescents, it still affects about 15% of women, and that number may be closer to 20%.
• 43:59
  SPEAKER_01: So it's because Becoming more and more prevalent.
• 44:01
  SPEAKER_01: And then just to give people some ideas of how it impacts, you know, general economics.
• 44:06
  SPEAKER_01: Now, this data is about 10 years old.
• 44:08
  SPEAKER_01: This is from 2013.
• 44:09
  SPEAKER_01: And this is kind of treatment and lost productivity.
• 44:12
  SPEAKER_01: Costs of acne exceeded$1.2 billion.
• 44:16
  SPEAKER_01: 20% of it is moderate to severe.
• 44:19
  SPEAKER_01: Adult acne in general can affect up to 40% of the population at a given point in their life.
• 44:26
  SPEAKER_01: Over 5 million people sought medical treatment for severe acne 10 years ago.
• 44:31
  SPEAKER_01: And the lost productivity among patients and caregivers was about 400 million.
• 44:35
  SPEAKER_01: So it's an expensive disease.
• 44:37
  SPEAKER_01: So anything we can do, and also, you know, with all this talk of antibiotic resistance, anything we can do to basically help manage it is going to make a big change for a lot of people.
• 44:48
  SPEAKER_00: Absolutely.
• 44:49
  SPEAKER_00: Gosh, yeah, it's a very expensive disease.
• 44:52
  SPEAKER_00: And I it's really sad to see that, you know, we're still obviously you're at the cutting edge here, you know, with solutions, but it's just sad to see that people are are being misled, also.
• 45:01
  SPEAKER_00: You know, that always kind of breaks my heart a little bit because acne is a very serious condition.
• 45:06
  SPEAKER_00: It impacts a lot of people.
• 45:07
  SPEAKER_00: Like, you know, you just listed off all the stats, but I mean, every day, I mean, even me myself, like as an adult, I still deal with acne, you know, from not every day, but it whenever it happens, it's very annoying.
• 45:18
  SPEAKER_00: So I know we all have it in our lives in some way, shape, or form, regardless of what age we are.
• 45:24
  SPEAKER_00: So it's very fascinating to hear that.
• 45:25
  SPEAKER_00: Just to round out the interview, you know, we've certainly covered acne pathogenesis today from gut microbiome dysbiosis to C acne's colonization, sebum overproduction, and inflammation, how the skin gut brain solutions and novel bio serum can address all these clinical symptoms.
• 45:42
  SPEAKER_00: And I'm excited to see that you guys are kind of closing this therapeutic circle from the time, you know, I tried the Shant clay mask.
• 45:49
  SPEAKER_00: I remember telling you about that, you know, how excited I was to see the results.
• 45:52
  SPEAKER_00: And now we're discussing the whole shot collection in a roundabout way.
• 45:56
  SPEAKER_00: Like I would love for you to tell us what's next, any other data, any trials coming up that you could tell us about.
• 46:02
  SPEAKER_01: So we're gonna be benchmarking the system against antibiotics and spirinolactone.
• 46:07
  SPEAKER_01: So that's our next big, big, big study.
• 46:09
  SPEAKER_01: Double blind, very expensive, probably a year in the making.
• 46:13
  SPEAKER_01: But um, we're super excited now that we have the base data to go out there and actually try to truly change how we treat acne.
• 46:19
  SPEAKER_00: That's so cool.
• 46:20
  SPEAKER_00: I'm looking forward to to hearing about it and seeing it.
• 46:24
  SPEAKER_00: That's really fascinating.
• 46:25
  SPEAKER_00: Well, Barb, thank you so much.
• 46:27
  SPEAKER_00: And for those professionals, especially aestheticians and dermatologists who are interested in working with Codex Labs on this new probiotic bio serum for acne, please feel free to reach out to us or email support at codexlabcorp.com.
• 46:41
  SPEAKER_00: And I will put all of this in the show notes for this episode.
• 46:45
  SPEAKER_00: So you'll have all that information.
• 46:46
  SPEAKER_00: But thank you for tuning in, Barb.
• 46:48
  SPEAKER_00: Thank you always for really educating us.
• 46:51
  SPEAKER_00: I always love our interviews because you really, really drop the knowledge, you know.
• 46:55
  SPEAKER_00: So thank you.
• 46:56
  SPEAKER_00: Thank you, ECTA.
• 46:57
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• 48:04
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