Latest / Skin Anarchy / Dr Loretta Ciraldo Interview

Transcript

Dr Loretta Ciraldo Interview · Skin Anarchy

0:34
SPEAKER_01: Hey guys, welcome back to another episode that's going to go to stuff like that.
0:39
SPEAKER_01: Today I will very, very special guests.
0:42
SPEAKER_01: I am so excited to introduce you guys to Doctor's Lord after all those a pioneer in the field of dermatology, especially cosmetic dermatology, and has contributed to the very school resource that led to things like the static skill, which is used by every dermatologist these days.
0:59
SPEAKER_01: She was one of the first pioneers in dermatology, especially as a woman of her generation.
1:06
SPEAKER_01: And I'm just so honored to speak to it with us.
1:08
SPEAKER_01: So without further ado, I want to introduce you guys to Dr.
1:11
SPEAKER_01: Scarldo.
1:11
SPEAKER_01: Dr.
1:11
SPEAKER_01: Geraldo, thank you so much for joining us.
1:14
SPEAKER_01: Can you get us started by telling us about your background and your career and just everything that led to where you are today?
1:25
SPEAKER_02: And thank you so much for having me.
1:27
SPEAKER_02: So, yes, I I would love to share uh really my journey, which I hope will inspire a lot of women and men.
1:36
SPEAKER_02: So I'm gonna start really uh by saying that I was born way back in 1953.
1:42
SPEAKER_02: I was uh born to a very, very Italian family.
1:46
SPEAKER_02: Neither of my parents, although they'd been born in Harlem, neither of them spoke a word of English before they started first grade.
1:54
SPEAKER_02: They both only spoke Italian at home.
1:56
SPEAKER_02: So they were born to Italian immigrants.
1:59
SPEAKER_02: And uh basically, when I was a young kid, when I was nine, my parents split up.
2:04
SPEAKER_02: So I was raised by a single mom.
2:06
SPEAKER_02: And I sort of always loved biology, and I remember thinking, you know, I'd really like to go to medical school.
2:13
SPEAKER_02: And um, you know, I was very, very fortunate because first of all, in those days, so this was I went through the New York City public school system.
2:22
SPEAKER_02: I graduated from Hunter College, which is part of the city university, and um, in those days, honestly, so this was when I was applying to medical school, it was 1974, and there really were not all that many women, it was about 20 to 25 percent women in any medical school class.
2:42
SPEAKER_02: Wow, yeah, these days it's much more like 50 percent, and in some schools, even over 50 percent.
2:48
SPEAKER_02: Yeah, it's like majority these days, yeah.
2:51
SPEAKER_02: Exactly.
2:51
SPEAKER_02: So I was fortunate enough to uh be admitted to a place called Downstate, which is part of the State University of New York in Brooklyn, and I started there, and after my first year in medical school, I found out, or during my first year, I found out that her our school would give a research stipend to anyone, any student, a first-year student who could find a very good research project.
3:16
SPEAKER_02: So I wanted to live in Boston that summer.
3:19
SPEAKER_02: My one of my brothers had just had his first baby and the whole family, and I really wanted to live near him.
3:25
SPEAKER_02: And I was also very fortunate because that brother was also had finished his dermatology residency up at Harvard.
3:32
SPEAKER_02: And he said, you know, Loretta, I had I have to tell you, I had no interest in dermatology after my first year.
3:38
SPEAKER_02: Just like all of the women in my class, we all entered medical school really feeling that our only two alternatives were truly to become pediatricians or obstetricians.
3:50
SPEAKER_03: It was oh wow.
3:52
SPEAKER_02: Yeah, people were not very open to going to women doctors.
3:55
SPEAKER_02: But I wait, what about surgery?
3:57
SPEAKER_02: Were you guys like it was surgery bad too?
3:59
SPEAKER_02: So I have to tell you, I absolutely loved surgery.
4:02
SPEAKER_02: And you know, in the days when I was in medical school, which was 1974 through 1978, we even had a little saying, do one, see one, teach one.
4:12
SPEAKER_02: And so I was very lucky that I got to do thick cesarean sections and an appendectomy as a medical student.
4:21
SPEAKER_02: So I loved it.
4:21
SPEAKER_02: And so, very sort of long story short, what happened to me was I took this summer job, not really knowing exactly what it would be like, but the very first day I go up to Harvard Medical School, and the very first day the man whose lab I work in says, you know, he they called me Dr.
4:37
SPEAKER_02: Seraldo.
4:38
SPEAKER_02: It was very formal, even though I had just finished my first year of medical school.
4:41
SPEAKER_02: I said, Dr.
4:41
SPEAKER_02: Soraldo, I want you to take this box and I want you to put it out on the lawn, and I want you every hour to just record what the needle here says because it was a meter.
4:54
SPEAKER_02: Honestly, I didn't really understand all that much what it was, but it said UVA meter.
5:00
SPEAKER_02: And what you've got to understand is at that time, so this was 1975.
5:05
SPEAKER_02: Yeah.
5:06
SPEAKER_02: 1975, there was no such thing as a sunscreen that covered UVA.
5:11
SPEAKER_02: As a matter of fact, we didn't think that UVA could do much damage to the skin.
5:16
SPEAKER_02: But the study that I was doing, the first part of the study, was to see if we could, there was a pill that we could give people that could make them sensitive to UVA.
5:26
SPEAKER_02: And so I got all these measurements of the UVA, and then the next day they gave me quote unquote patients.
5:34
SPEAKER_02: These were people who had psoriasis, and they came in bathing suits, and we decided, okay, it looks like the UVA is about the strongest.
5:42
SPEAKER_02: It was very similar to the UVB uh time, you know, uh standard, so it was sort of the strongest around noontime.
5:49
SPEAKER_02: So we gave these people pills to make them a little sensitive to UVA, and we had them sit with the pill in their system under the sun for an hour.
5:59
SPEAKER_02: Well, unfortunately, as one of the very first investigators ever, ever, ever to study the effects of UVA from the sun on human skin.
6:08
SPEAKER_02: Unfortunately, in that first group of 10 people, we had to admit one to the burn unit of Massachusetts General Hospital.
6:16
SPEAKER_02: So what we found out was yeah, there is a significant amount of UVA that reaches the surface of the earth.
6:23
SPEAKER_02: And as a matter of fact, UVA does cause biologic change in the skin.
6:30
SPEAKER_01: Wow.
6:31
SPEAKER_01: I mean, talk about a discovery.
6:32
SPEAKER_01: That's amazing.
6:33
SPEAKER_02: Yes, yes.
6:34
SPEAKER_02: It was uh just a very wonderful time that I had there, and then I did another project studying the effects of different pills that you could take on how sensitive you might become to the sun and whether you were more sensitive to UVA or UVB.
6:49
SPEAKER_02: So, truly back in 1975, I really got to do the pie some of the real pioneering research of the effects of UVA on human skin.
7:01
SPEAKER_02: Uh, I then went on to, you know, finish medical school, really decided I did a big fourth-year research project again at Harvard, and I really decided that I had to become a dermatologist.
7:12
SPEAKER_02: In the meantime, I had married one of my classmates, and um yes, it was very nice.
7:18
SPEAKER_02: We went on, he was he's also Italian.
7:20
SPEAKER_02: I wanted to have six kids, but we stopped with and so I went on to have the very nice practice.
7:26
SPEAKER_02: I started, we moved to Miami for my husband to do his cardiac surgery fellowship, and I uh had my family, I started a practice there, and right at that time in the 19, sort of around 1990, I had also started at the University of Miami a cosmetic dermatology fellowship.
7:48
SPEAKER_02: Well, not really fellowship, but a rotation.
7:50
SPEAKER_02: Because honestly, it wasn't until about 1990 that we really, really had enough to develop true cosmetic dermatology.
8:01
SPEAKER_03: No, yeah.
8:02
SPEAKER_02: In 81, we started to have the injectable collagen as an injectable filler.
8:08
SPEAKER_02: It didn't last that long.
8:10
SPEAKER_02: By the mid to late 80s, we started to do glycolic peels and more acid peels.
8:15
SPEAKER_02: And so I approached the chairman at the University of Miami around actually, I guess more in the late 80s, and asked them if I could start a cosmetic value, cosmetic rotation.
8:25
SPEAKER_02: So dermatologists didn't just learn about rashes, they also really learned more about skin care and peels and all this.
8:35
SPEAKER_02: And oh, really?
8:36
SPEAKER_01: So it was taught then during the curriculum, then.
8:38
SPEAKER_02: Well, that we were one of the very first departments in the country to start to do that.
8:43
SPEAKER_01: My whole Wow, and you spearheaded that.
8:45
SPEAKER_02: You spearheaded that effort because no, I think that that was sort of that evolved, I think, from me being a woman.
8:53
SPEAKER_02: I you know, I have to tell you, this is a very personal thing, but um when you do your residency, they pick someone to become what's called the chief resident who would be more in charge of the teaching in the last year.
9:06
SPEAKER_02: But to tell you really sort of what a different world we lived in then, as far as how women were perceived in medicine.
9:14
SPEAKER_02: Uh the chairman called me into his office one day and he said, you know, Dr.
9:18
SPEAKER_02: Seraldo, I'm gonna, that's my mariname is I'm gonna pick you to be the chief resident.
9:23
SPEAKER_02: At which point, I'm ashamed to tell you, I started to cry.
9:28
SPEAKER_02: I'm like, oh, I said, Doctor, I've got to tell you I'm three months pregnant because I thought that would be the end, you know, that I would not be picked.
9:36
SPEAKER_02: Yeah, yeah.
9:43
SPEAKER_02: I didn't pick you for your gestational status, you still get the position.
9:49
SPEAKER_02: Oh my god.
9:50
SPEAKER_02: Yeah, so you know changed.
9:53
SPEAKER_02: And and I think that that we women, in my opinion, we've become so much more empowered.
9:59
SPEAKER_02: Of course, we still have a long road to go, but even the fact that I was sort of able to come to Miami and talk to the chairman and say, listen, dermatology shouldn't just be about rashes.
10:11
SPEAKER_02: Our patients really do want to look better, not only, you know, uh to get rid of a rash or a skin cancer, but they also want to approach aging in a more attractive way.
10:25
SPEAKER_02: And I think that um I think that we've really come a very, very long way.
10:30
SPEAKER_02: And basically what happened then was that by the early 1990s, I started to actually formulate products for all the work that I had done up at in the lab, the research that I had done, and also, you know, doing the clinical stuff with the cosmetic dermatology at University of Miami, I started to formulate products, my own peels, pre and post-peel and laser care, all sorts of skin care for just for professionals, for other doctors.
11:00
SPEAKER_01: May I ask you a question?
11:01
SPEAKER_01: May I ask you a question about that?
11:02
SPEAKER_01: Because at that time when peels were really um coming into the the you know view, right?
11:08
SPEAKER_01: Uh scientifically, did you guys um use them with in your patient care?
11:13
SPEAKER_01: Like was it part of the you know protocol for you know prescribing something?
11:18
SPEAKER_01: Or I mean, how did that what was that like, like in terms of actually putting skincare into that, you know, clinical setting?
11:24
SPEAKER_02: Yes.
11:25
SPEAKER_02: So I have to tell you that there were very few doctors really in all of America who were doing that many PLs.
11:35
SPEAKER_02: And um, I I will say that as I remember it, as sort of the profile of dermatologists changed, and we started to have women, you know, in many programs, the majority of the dermatology residents are women.
11:51
SPEAKER_02: We had more and more of I'm almost gonna sort of say like an openness between doctor and patient.
11:59
SPEAKER_02: So that uh, and that's exactly what I taught, by the way, when I made the cosmetic dermatology clinic, I taught the residents how to perform peels because in my whole residency, we really uh I guess maybe in all of my residency, I may have once been taught how to do the trichloroal uh acetic acid peel.
12:22
SPEAKER_02: And um, we were still doing, we did do a little bit with, you know, you've heard of microderm abrasion.
12:28
SPEAKER_02: Well, we used to use a machine that was actually a derm abrasion machine, and it was like a wire brush, and people just really ended up looking sort of like I hate to say chopped meat at the end.
12:41
SPEAKER_02: So, you know, um in the beginning, there was this sort of sense, I'd say even in the early 80s, I finished my residency in '82, there was sort of a sense, well, you know, doctors, if they're gonna do something, it's got to be something that's sort of deep and that there's almost a risk of disfigurement, if that would be why you'd go to the doctor, right?
13:03
SPEAKER_02: Then there started to be research that came out that said, no, you know what?
13:07
SPEAKER_02: If instead of doing something that's very deep and runs the risk of sparring, if instead you do a milder peel, but you do it in a series of peels, in the end, and they sort of proved some of this with skin biopsies, in the end, you can have just as much benefit from doing a series of milder peels compared to something, you know, one time deeper peel.
13:34
SPEAKER_01: Yeah, it's like a titration, basically.
13:36
SPEAKER_01: It's like you have to titrate it up.
13:38
SPEAKER_01: Wow.
13:38
SPEAKER_01: Yeah, that's amazing.
13:41
SPEAKER_01: I can't imagine just watching all of this in front of, you know, I mean unfold in front of you.
13:45
SPEAKER_01: So what do you like when you look at skincare now?
13:47
SPEAKER_01: I mean, yeah, you're right, it has come so far.
13:49
SPEAKER_01: We've cut we've come so far.
13:50
SPEAKER_01: I mean, right now I think it's taking such a cool turn because I think it's going back to its origins um in terms of like being more science-backed.
13:58
SPEAKER_01: Um so when you look at it, how do you how have you like looked at skincare, like just as it's developed in the industry, like from your perspective?
14:05
SPEAKER_02: Right.
14:06
SPEAKER_02: So basically, I've got to tell you that for me, even when I started to formulate way back in 1993, it really had to do with some of the research that had been done on the benefits of glycolic acid.
14:22
SPEAKER_02: And and also probably really retinol, because those were two things that we realized could be used at home on a very regular basis with you know minimal, minimal risk to the patient of even having redness or irritation or peeling.
14:43
SPEAKER_02: And over time, people could see really the whole spectrum of anti-aging, uh, really sort of skin uh fading and evening of skin tone, and even some good anti-acne results.
14:57
SPEAKER_02: So I think that that that's really sort of what started things off.
15:03
SPEAKER_02: And um, you know, in the beginning, really uh many dermatologists started to feel, geeways, instead of my patient trying to go and pick something up at the drugstore that was uh over the counter, then I tried to guide them.
15:20
SPEAKER_02: And I think that, you know, that sort of gave rise to this whole sort of term medical grade skincare.
15:27
SPEAKER_02: Yes, yeah, because really sort of what was going on, and I think that glycolic was really sort of like the gateway product, right?
15:36
SPEAKER_02: So what was going on was that they started to make products that you could buy at the drugstore that either had a very low percentage of glycolic, like one or two percent, or they might be advertised as five or ten percent, but they had neutralized or buffered out the actual acid so much that there was really hardly any like nothing, yeah.
16:03
SPEAKER_02: And I think that that sort of then became the call to action amongst a lot of dermatologists and plastic surgeons to say, gee, is instead of my my patient going to the drugstore and getting something that's so watered down, yeah.
16:22
SPEAKER_02: Making up glycolic acid peels that were like 70% for doctors to use in their office, and then dispense something much milder for them to give for their at-home care to their patients.
16:34
SPEAKER_02: And you know, I think that glycolic, uh, retinol, and vitamin C have probably been really the three sort of mainstays, the cornerstones of what became known as the cosmosceutical trend and the medical grade skincare.
16:52
SPEAKER_01: That's interesting.
16:53
SPEAKER_01: That's interesting you say that, and especially with the glycolic acid, because I feel like um skincare has been highlighting that ingredient specifically more in the last year or so.
17:03
SPEAKER_01: I know there are a few brands that came out with like, you know, glycolic acid toners, they were, you know, putting more information out there.
17:09
SPEAKER_01: So I really think it's coming full circle in a way.
17:12
SPEAKER_01: We're we're going back to the basics, you know.
17:14
SPEAKER_02: I agree.
17:15
SPEAKER_02: And I think also, honestly, with what's happening, you know, in the last just about almost a year now with COVID and all, and the economy really taking a plunge, I think that consumers are really getting very wise and getting very cautious about how they spend their dollar.
17:35
SPEAKER_02: And I think that uh, you know, sometimes we even have a little more time because, for instance, if you're able to work virtually so that you don't have your commute time and stuff like this, I think that a lot of consumers, skincare consumers are really spending the time to educate themselves.
17:52
SPEAKER_02: And I'm all for that.
17:55
SPEAKER_01: Right, right, exactly.
17:56
SPEAKER_01: And there's this, and I think a lot of the dermatology community has really stepped up.
18:01
SPEAKER_01: Um, you know, it's like I I obviously you're see your work and it's it's so fundamental to what we're you know working with now, right?
18:09
SPEAKER_01: But then it's like to see younger dermatologists come in and you know try to add on to it is just it's a beautiful movement in the medical community, I think, you know, right now, because they're they're coming out.
18:19
SPEAKER_02: And I agree.
18:21
SPEAKER_02: I I so agree.
18:22
SPEAKER_02: I'm gonna say the one thing that I am sometimes just a little bit cautious about is uh like something that's come up a little bit recently, and frankly, I have to tell you that I'm not even sure of every source of it, but there's been sort of a little bit of a pushback about, you know, G Ways, uh, you know, does blue light really harm the skin?
18:44
SPEAKER_02: Doesn't it?
18:45
SPEAKER_02: And I think that um I think that sometimes, and I I'm definitely in the camp that there is damage from blue light.
18:53
SPEAKER_02: Uh, there were some very good studies done at Henry Ford Hospital up in Detroit where um they looked at just the effects of the dose of blue light, you know, you're out in the sun, right?
19:06
SPEAKER_03: Why is the sky blue?
19:08
SPEAKER_02: The sky's blue because it emits more blue light than UVA and UVB combined.
19:14
SPEAKER_02: So, what they were able to do in the dermatology department at Henry Ford was that they got a blue light and they put the amount of blue light that a person would get if they were out in noonday sun.
19:28
SPEAKER_02: They put that on people's backs, and then they put a different white source that was just the amount of UVA that you'd get if you were out in the noonday sun.
19:36
SPEAKER_02: And lo and behold, what they found is that the blue light causes much more damage, visible damage, than the UVA.
19:46
SPEAKER_02: So there is no doubt that this is something where we really need to be cautious.
19:53
SPEAKER_02: And uh I lectured last year in uh September of 2019, there was the biannual sunscreen symposium that's given by the cosmetic chemists of the South of Southeast or of South Florida.
20:07
SPEAKER_02: We had, I think, just about every member of the FDA sunscreen division there, chemists from all over the world really were there.
20:14
SPEAKER_02: And I got to lecture with the dermatologist perspective.
20:18
SPEAKER_02: And basically, what uh what we all were in agreement about is that the new movement in sunscreen does have to also include blue light.
20:27
SPEAKER_02: Now, what I see uh on sometimes what I'm seeing on social is even some of the people who are commenting, you know, may still be sort of like in their residency or out a year or two.
20:41
SPEAKER_02: Yeah, but I know to be a fact, I'll be honest with you, is my patients broke this up to me before even I recognized it.
20:50
SPEAKER_02: When patients started to say probably eight to ten years ago, well, you know what, Dr.
20:56
SPEAKER_02: Soraldo, I got the old acne marks, but wow, I only have got the bad brown stains, and I'm only getting really red and swollen right where I put my phone up to my face.
21:08
SPEAKER_02: Right.
21:08
SPEAKER_02: Yeah, but you know, right there.
21:10
SPEAKER_02: And some of the patients would say, Oh, you know, do you think it's bacteria on the phone?
21:13
SPEAKER_02: I'd say, no, it can't be that because that's not going to give you the hyperpigmentation.
21:17
SPEAKER_02: So we're seeing it.
21:20
SPEAKER_02: And, you know, I think I think that it's just very important.
21:24
SPEAKER_02: I agree with you for all physicians, and by the way, I think that many of the physicians in my age group, where I've been, you know, I started my residency uh 42 years ago, right, in ceremontology.
21:40
SPEAKER_02: Many of the people on my side of the uh spectrum there are not even necessarily wanting to address all the cosmetics issues.
21:50
SPEAKER_02: And then I think that sometimes some of the younger folks uh are they don't always have all of the clinical experience to really.
22:00
SPEAKER_02: Be sure of some of the comments that are made.
22:03
SPEAKER_02: So I think what we almost need is much more of like an open dialogue between you know the very experienced practitioners and maybe really some of the younger practitioners who I think, especially in the case of really the men and the women I've seen on social, they are really very much wanting to converse with their patients, with the consumer, so that we we need a lot more dialogue.
22:32
SPEAKER_01: I completely, completely agree with you.
22:35
SPEAKER_01: I think communication and really a collaborative effort in dermatology right now could go so far in terms of like just discovery-driven skincare.
22:43
SPEAKER_01: You know, it's just like solid science behind it.
22:46
SPEAKER_01: Now, I do have a question, a couple questions for you.
22:49
SPEAKER_01: Um, first, I wanted to ask you um what's your opinion on nanotechnology in sunscreen is?
22:55
SPEAKER_01: I mean, have you come across like a lot of papers about that?
22:58
SPEAKER_01: Because this actually got brought up um for me a little bit ago, and I genuinely had no idea what they were talking about.
23:04
SPEAKER_01: So yeah.
23:06
SPEAKER_02: Yes, so I want to tell you that uh really we don't like nanoparticles in sunscreen, because what a sunscreen is really meant to be is a screen, right?
23:20
SPEAKER_02: Like either if it's it's a if it's a chemical sunscreen ingredient, the way that that works is that it absorbs, you know, it's really basically sort of staying in the very uppermost layer of the skin, almost more the dead layer, just the interface of dead versus living.
23:37
SPEAKER_02: And when we talk about the chemical active sun, the sunscreen ingredients that are chemical, what they do is that they absorb the rays before they ever get into our cells.
23:47
SPEAKER_02: When we talk about the zinc and the titanium, and that's what's become a little more nano, the nanoparticles are available, especially for zinc, that's just meant to stay on the uppermost surface of the skin and reflect off the light.
24:03
SPEAKER_02: If it's a nanoparticle, well, the problem is that it's going to be a very tiny particle.
24:09
SPEAKER_02: And at first they made the nano because the feeling was that zinc could look too chalky.
24:16
SPEAKER_02: So said, okay, we'll make nano.
24:17
SPEAKER_02: Nano is just terrific because nano is very tiny, so it's not as visible.
24:22
SPEAKER_02: But the problem with that is it doesn't necessarily do the right job because it can penetrate deeper, so it's not going to be able to reflect off as well, right?
24:34
SPEAKER_02: You know, because it's not a real, like almost like a mirror is the way that that uh that really a good zinc works.
24:41
SPEAKER_02: And then there's also concern that these nanoparticles not only will they penetrate into deeper living layers of the skin, but they can get into our organs because they bloodstream, yeah.
24:54
SPEAKER_02: Exactly to get into the bloodstream.
24:56
SPEAKER_02: So we are, I would say all of the dermatology community is really opposed to the nanoparticles.
25:03
SPEAKER_01: See, that's that's exactly why I was so confused because I was like, when I thought of nanotechnology, I was thinking about more like gene editing, you know, technology.
25:11
SPEAKER_01: And it was like, what are we or like delivery methods for like you know, pharmaceuticals like into the blood food?
25:17
SPEAKER_01: So I was really confused about that.
25:19
SPEAKER_01: So thank you so much for clearing that up.
25:20
SPEAKER_01: Um I I I do I want to ask you this question because this is so so confusing for me personally, um, in terms of different strengths of SPF.
25:30
SPEAKER_01: So you know how we can buy things that are like you know, 30 SPF or like some brands now are doing 100 or you know, whatnot.
25:37
SPEAKER_01: What is what do you feel in terms of the the dosing of SPF?
25:41
SPEAKER_01: Like how should we be approaching that?
25:43
SPEAKER_01: You know, everyone says keep reapplying sunscreen.
25:46
SPEAKER_01: Well, at what point do you have to not do that?
25:49
SPEAKER_01: You know, that kind of thing.
25:50
SPEAKER_01: Like how do you feel?
25:52
SPEAKER_02: Okay, so I want to first start by saying, you know, I'm a fellow of the American Academy of Dermatology.
25:58
SPEAKER_02: And when we talk about sun protection, it really always has to be three-pronged.
26:05
SPEAKER_02: Number one, try not to go out in the sun between the hours of 10 and 2.
26:11
SPEAKER_02: We think that's very important.
26:12
SPEAKER_02: Okay.
26:13
SPEAKER_02: Secondly, wear sun protective clothing as much as you can, even including things like wearing a hat.
26:21
SPEAKER_02: If you're out on a boat, get a hat that has flaps over the ears, all of this.
26:25
SPEAKER_02: And then the third thing is wearing sunscreen.
26:28
SPEAKER_02: But why we say that it's three-pronged is because you're really hitting on something that's very important.
26:35
SPEAKER_02: We really don't want you to be putting sunscreen all over your body every two hours.
26:40
SPEAKER_02: Because the truth is that that could have a potentially harmful effects, it just hasn't been studied well enough.
26:48
SPEAKER_02: Now, what do I think about the SPF number that you should use?
26:52
SPEAKER_02: Well, as a corollary to what I just said, if you use a number 100 SPF, that's got a lot more concentration and higher percentages of all the sunscreen actives.
27:07
SPEAKER_02: So we don't really love that.
27:08
SPEAKER_02: It's not going to give you that much more protection from the sun.
27:13
SPEAKER_02: So when you get up to about an SPF 45, you're at about 99% blockage of the UVB, right?
27:22
SPEAKER_02: You've got to remember the SP only refers to how protected you're going to be from UVB, which are the more uh common or instantly burning ways.
27:35
SPEAKER_02: But now, and I honestly you may have to hold on to your seat for this because I'm going to tell you that is very fascinating.
27:43
SPEAKER_02: It has to do with the chemistry of sunscreens.
27:46
SPEAKER_02: And I truly am not enough of a chemist to understand it, but I've got to tell you this.
27:51
SPEAKER_02: When sunscreens are tested, and if you get a sunscreen that says it has broad spectrum protection, and I think honestly, you know, you want to have a sunscreen that's been registered with RFDA and all this, then it has to have two tests.
28:07
SPEAKER_02: It's not only the SPF test, it also has to have a test that's called the critical wavelength.
28:14
SPEAKER_02: And that test is a test to be sure that it's protecting you enough from enough UVA.
28:21
SPEAKER_02: This is the hold on to your seat.
28:24
SPEAKER_02: This is through the chemistry of sunscreens, it turns out that almost no sunscreens sold in America today that have an SPF above 60 give you very good UVA protection.
28:41
SPEAKER_02: What?
28:42
SPEAKER_02: Yes, and as a matter of fact, the FDA is considering banning sunscreens that have SPF more than 60.
28:54
SPEAKER_01: Do you think that's the reason we're seeing these like cases of like skin cancer now because of SPF use or whatever?
29:00
SPEAKER_01: Like you know, that whole thing is.
29:02
SPEAKER_02: So I want to tell you, we really we don't know for sure.
29:06
SPEAKER_02: Okay, that is 1000% for sure.
29:09
SPEAKER_02: I think that what I originally said about like that three-pronged approach, I wish everybody would do it.
29:14
SPEAKER_02: You know, try not to go out there when the sun is so bad, you know, between 10 and 2.
29:20
SPEAKER_02: Use clothing.
29:21
SPEAKER_02: Clothing is so good.
29:23
SPEAKER_02: You know, one thing about the sunscreens, it may be that I don't want to fault anything.
29:28
SPEAKER_02: You know, uh, in my talk that I gave to the cosmetic chemist, I said if a patient asked me, Dr.
29:33
SPEAKER_02: Seraldo, what sunscreen should I use?
29:36
SPEAKER_02: I always say use one that you really like, right?
29:38
SPEAKER_02: Because a lot of people will go to the beach, their wife or husband will have a sunscreen, they'll try it, they don't like the smell, they don't even use it, right?
29:46
SPEAKER_02: So I don't want to fault the sunscreens, but we do need to do more fine-tuning.
29:50
SPEAKER_02: I think there's a few reasons why we're seeing more skin cancer.
29:55
SPEAKER_02: Now, one is for sure, for sure, the popularity of tanning collars.
30:03
SPEAKER_02: And you know, many people who go off college is when you go to college and the orientation package, you're given some free treatments at a you know, free pass to tanning salons.
30:17
SPEAKER_03: Right, right.
30:17
SPEAKER_02: We are we dermatologists are very opposed to them.
30:20
SPEAKER_02: That's the super strong UVA that really does lead to melanoma.
30:26
SPEAKER_02: So I think the popularity of tanning polars is one reason.
30:31
SPEAKER_01: You know, I've been always surprised they didn't regulate those.
30:34
SPEAKER_01: I was always wondering, you know.
30:37
SPEAKER_02: Right.
30:37
SPEAKER_02: We dermatologists actually, our lobbyists in Washington, the American Academy of Dermatology, we lobby very strongly to try to outlaw them.
30:48
SPEAKER_02: Uh unfortunately, this has been going on for the whole 40 years that I am since I started my residency.
30:56
SPEAKER_02: And I hate to say it, it's almost like tobacco and alcohol.
30:59
SPEAKER_02: But you know, that is one problem.
31:01
SPEAKER_02: Okay.
31:02
SPEAKER_02: The next problem, I think, is believe it or not, a very simple thing about sunscreens, that a lot of people don't put them on that evenly.
31:13
SPEAKER_02: And you know, that's that's a real problem.
31:17
SPEAKER_02: Um, and you know, you just need to get that very even coverage.
31:21
SPEAKER_02: Uh, lately in my practice, because you know, I have some new patients I've been seeing for years, a lot of skin cancer patients, and what I'm finding lately is that a lot of the skin cancers that I'm seeing are in people's hairlines.
31:36
SPEAKER_02: So now, and even for all of you listeners, I'd love everybody to go with their sunscreen and actually just put it right through into your hairline because I think that a lot of times we'll just sort of don't want to mess up their hair, and so they don't, you know, they sort of like avoid all that rim of the face.
31:56
SPEAKER_02: And you know, I really have got my patients very sold on using sunscreen, and so so many of my long-term patients are only getting it probably where they just sort of skipped it.
32:07
SPEAKER_02: So I think that's you know, another reason.
32:09
SPEAKER_02: Um, so you are 100% right.
32:12
SPEAKER_02: The incidence of skin cancer is increasing.
32:15
SPEAKER_02: The good news though is that the death rate from skin cancers, and it's almost all from melanomas, that has leveled off.
32:24
SPEAKER_02: And very recently we're even seeing a little decline because of very good new immunotherapy treatments and all for advanced melanomas.
32:33
SPEAKER_01: So thank goodness.
32:35
SPEAKER_02: Yeah, right.
32:36
SPEAKER_01: Yeah, thank goodness for scientific advancement, like honestly.
32:40
SPEAKER_01: Well, you know, you know, Dr.
32:42
SPEAKER_01: Aldo, I really want to ask you about your product because you know, I'm not gonna lie, ever since I got your sunscreen, I really haven't been using any of this.
32:50
SPEAKER_01: So I mean, I'm gonna trust the experts here, right?
32:53
SPEAKER_01: So it's like I want you to just really tell us the nitty-gritty behind what your thought process was when you were formulating um that specific product.
33:01
SPEAKER_01: Um, and also just, you know, whatever product you think is the most important or the most, you know, I think all of them are, but you know what I mean.
33:08
SPEAKER_02: Yeah, just absolutely, and thank you for the opportunity, really.
33:11
SPEAKER_02: Okay, so basically, you know, like I said, for years I'd been making products for professionals.
33:17
SPEAKER_02: And then how I started the Dr.
33:18
SPEAKER_02: Loretta line really had to do in very large part with two of my four children saying that they would come and work with me to make a product to go to the public.
33:29
SPEAKER_02: So I said, okay, well, this is just a great idea.
33:32
SPEAKER_02: We'll call it Dr.
33:33
SPEAKER_02: Loretta.
33:33
SPEAKER_02: I want everyone to know that this is a woman dermatologist behind it, but I didn't think that it was enough just to say, well, okay, it's a product from a dermatologist.
33:43
SPEAKER_02: So I said, you know, really what I'd love to do is I'd really love to focus on what I've seen in my 40 years of practice.
33:52
SPEAKER_02: You know, I guess it's now 37 years that I'm practicing down in South Florida, so I do see so much sun damage and skin cancer.
34:00
SPEAKER_02: So what I've noticed from, you know, really seeing tens of thousands of patients where I've done total body exams is that when we do these body exams, even in someone who has very advanced aging changes on their face, right?
34:19
SPEAKER_02: So you can take someone, I've got some pictures of like a woman of 92, where she has sagging, she has age spots, she has wrinkles, like you wouldn't believe, but then this would be all on her face.
34:32
SPEAKER_02: Then on her buttocks, she has the buttocks of a 20-year-old in terms of a close-up of the skin.
34:38
SPEAKER_02: So yeah, so one of the things that's so striking to me as a dermatologist for all these years is that it's actually the skin that we take the most care of, right?
34:50
SPEAKER_02: I I don't know, I certainly have never had a patient tells me that they use five skincare products on their products, right?
34:57
SPEAKER_02: Right, right, but it's the skin that we take all the care of that ages the worst, right?
35:03
SPEAKER_02: So, you know, through the years in teaching and doing research and formulating myself, you know, I've really, really sort of focused on what is it really that is aging the skin that gets exposed to the elements.
35:19
SPEAKER_02: And through the years, there's been research that's shown, for instance, that age spots probably are caused more by pollutants than by UV.
35:30
SPEAKER_02: Oh wow.
35:31
SPEAKER_02: Yeah, and in fact, there's a whole school of uh medicine, and then it breaks down into dermatology, that's called the exposome theory of aging, and for the skin, it's called the skin exposome.
35:45
SPEAKER_02: And basically what that says is that what happens as we age, it's really not genetics that predetermines it, it's really what we get exposed to.
35:56
SPEAKER_02: And so, you know, and and when it comes to things like the exposome, when we think about cancer, you know, that has to do with stress levels and all sorts of things.
36:05
SPEAKER_02: But when it comes to the skin, because there's this huge disparity between the skin that's exposed to the ailment and the skin that's covered by clothing, like the button, it's really just four main factors.
36:20
SPEAKER_02: First one, you know, we know it's the sun, but we've got to remember it's the blue light of the sun, not just UVA and UVB.
36:28
SPEAKER_02: So it's definitely sun.
36:30
SPEAKER_02: Next pollution for sure.
36:33
SPEAKER_02: In fact, years ago, there was a study done that looked at the amount of wrinkling in New York City versus Miami, and it was found that New York has a higher average wrinkle score than Miami, and this is attributable to higher levels of pollution in New York City than in Miami.
36:50
SPEAKER_02: So pollution is bad, and believe it or not, the WHO tells us that levels of pollution are higher indoors than outdoors, so we're exposed to that 24-7.
37:01
SPEAKER_01: Wow.
37:02
SPEAKER_02: Yeah.
37:03
SPEAKER_02: So basically, I wanted to create a line that would use unique actives at active levels to get the benefits that would guard our skin from light, pollution, also irritants, right?
37:19
SPEAKER_02: In my own practice, I'd say the majority of patients that I see with facial complaints, they need to change what they're using on their face.
37:29
SPEAKER_02: And our Academy of Dermatologists said about 61% of all facial skin complaints like irritation, redness, broken vessels, dryness, hyperpigmentation, 61% of those kinds of complaints on the face relate, at least in part, to irritants and the products the person is using.
37:51
SPEAKER_02: And sort of these four factors that my line is trying to protect you from.
37:56
SPEAKER_02: So it's again sun and light, right?
37:58
SPEAKER_02: Because it could be even your computer light.
38:00
SPEAKER_01: Yeah, like anything, phones, computers, tablets.
38:03
SPEAKER_02: Exactly, exactly.
38:05
SPEAKER_02: So light, pollution, irritants, and last of all, climate situations.
38:11
SPEAKER_02: And what I mean by that is whether we're talking about climate change because of greenhouse emissions, which is a lot of carbon-free radicals that are getting generated by all of the climate change and greenhouse emissions, or whether we're talking about something as sort of pedestrian as right now I'm sitting in climate control and it's sucking the moisture out of my skin, we've got to be thinking about climate conditions.
38:36
SPEAKER_02: So when I created the Dr.
38:38
SPEAKER_02: Loretta, every product we try to formulate in a way that would really address these issues.
38:47
SPEAKER_02: So, for instance, you know, I think that cleansers are important.
38:51
SPEAKER_02: That sort of sets the stage for the rest of you know our whole skincare regimen.
38:56
SPEAKER_02: So we made our gentle hydrating cleanser, and basically that's got in a marine allergen, it's a marine extract that's able to absorb pollution particles that are 20 to 30 times smaller than our pores before they get into the living skin where they cause all of the damage or promoting age spots and wrinkles and stuff.
39:22
SPEAKER_02: We used hydrating peptides because I know that we're especially now even indoors more than ever.
39:29
SPEAKER_02: You know, we really sort of try to address in each product as much as we could all of the things that not not just sort of like calling out one ingredient, but to address really what it is that's aging our skin.
39:47
SPEAKER_02: It's it's certainly not chronologic aging because I can tell you that you know, I've been pretty fortunate.
39:52
SPEAKER_02: I'm gonna be 68 years old, and you know, I look pretty darn good.
39:57
SPEAKER_02: And a lot of it's because I have really been focusing on skincare since I started to make things for professionals when I was 40.
40:07
SPEAKER_02: And I believe in skincare.
40:09
SPEAKER_02: I believe that if you sort of really shield yourself from the damage, the same way that sunscreen can be the shield for the or screen, right, for damaging rays, we need to almost think of all of our skincare products as the screen or the shield for all of the factors that are damaging our skin.
40:30
SPEAKER_01: No, one thing I want to ask you, especially about the screen component, like of this whole idea, is that you know, I know a lot of dermatologists love Vaseline.
40:39
SPEAKER_01: So now what is it about Vaseline that like you know is so good in terms of making that shield?
40:46
SPEAKER_01: And did you use something similar, like you know, molecularly when you were, you know, crafting your own products?
40:52
SPEAKER_02: Okay, yeah.
40:53
SPEAKER_02: So I'm glad you mentioned that because you know, Vaseline is petroleum jelly.
40:57
SPEAKER_02: And I've got to tell you that that's something that sometimes then I love Vaseline, okay, and that's something that sometimes has been put down on social media very unfairly.
41:09
SPEAKER_02: Okay, yeah.
41:10
SPEAKER_02: What vaseline can do, first of all, it's sort of very inert, right?
41:14
SPEAKER_02: It's really uh big molecular structure, so we do not have to worry that this is penetrating into living layers of skin and causing any changes there.
41:26
SPEAKER_02: But what it's really doing is providing a barrier so that uh, for instance, I've been saying to a lot of my patients with all the hand sanitizers that we're using during the day, you can sleep in Vaseline or maybe a little more shishi product would be like aquifore healing lightments, which is really just petroleum jelly as well.
41:49
SPEAKER_02: And what that's gonna do is it's gonna trap in the moisture, right?
41:53
SPEAKER_02: Because really our skin is just characteristically very moisture-rich compared to internal and outdoor environment.
42:02
SPEAKER_02: Because all of the alcohol that we're using, we're really getting rid of, we're destroying a lot of these healthy skin oils that were there to begin with, that were trapping in moisture.
42:13
SPEAKER_02: The only thing that I don't like about Vaseline is it's not very cosmetically elegant.
42:20
SPEAKER_02: So, for instance, what we do in um a product that we make called the Dr.
42:25
SPEAKER_02: Loretta Intense Replenishing Serum that I know has been used, I won't drop names, but I know like some movie stars, some models, they have been on social saying that they love it.
42:37
SPEAKER_02: And that is, first of all, uh what we call bioidentical skin lipids.
42:42
SPEAKER_02: So it's the the healthy oils of the skin, and it's in a silicone base.
42:48
SPEAKER_02: Again, I'm a big fan of silicone.
42:50
SPEAKER_02: We use it for years topically for scars and stuff like this.
42:55
SPEAKER_02: And silicone, like petroleum jelly, it's not going to penetrate into the living layers of the skin.
43:01
SPEAKER_02: And that's again gonna give you that barrier.
43:05
SPEAKER_02: So the barrier does a couple of things.
43:07
SPEAKER_02: It traps the moisture in, right?
43:09
SPEAKER_02: But it also doesn't let the bad stuff, even pollutants and stuff, cannot get in as easily.
43:17
SPEAKER_02: Harmful bacteria, all of this.
43:20
SPEAKER_02: Uh, the I think the thing about the Vaseline, petroleum jelly, aquifor, whichever you pick up at the drugstore or the grocery store, they're really sort of all the same, right?
43:29
SPEAKER_02: Vaseline, petroleum, jelly, aquifor.
43:31
SPEAKER_02: You know, what when we really started to use that was way back when we used to do those derm abrasions where people did sort of look like chopped meat, or even some of the very early resurfacing lasers where people were like burn victims.
43:49
SPEAKER_02: And you know, our natural test is oh, let's put on cortisone cream, let's do this, let's do that.
43:54
SPEAKER_02: No, it turned out you needed something like very inert that would just sit on the surface of the skin.
44:00
SPEAKER_01: Right.
44:00
SPEAKER_01: And just let it heal, kind of like exactly.
44:03
SPEAKER_02: Yes.
44:03
SPEAKER_02: Yeah.
44:03
SPEAKER_02: So you know, one thing I didn't get to, I just want to really put a plug in, and I'm very happy we just got the Refinery 29 Innovation Award for our sunscreen, which is called the Urban Antioxidants, yeah, SPF, uh sunscreen SPF 40.
44:19
SPEAKER_01: Congratulations.
44:20
SPEAKER_01: That's amazing.
44:21
SPEAKER_02: Thank you.
44:22
SPEAKER_02: We're very excited.
44:23
SPEAKER_02: And, you know, basically with that, what we did was we said, okay, we're gonna block out the light, not just UVA and UVB, but what's sometimes termed HEV, which is the blue light, screen light, digital light, blue light from the sun.
44:37
SPEAKER_02: So we use Indian ginseng for that.
44:39
SPEAKER_02: Then why we use the word urban antioxidant is because we uh just like I said before, the urban centers have the most pollution.
44:50
SPEAKER_02: And what pollution does too is it depletes our skin's natural antioxidant content.
44:56
SPEAKER_02: So we use in that sunscreen an antioxidant called lipocomin, which is 11 times stronger than any other antioxidant on the market.
45:09
SPEAKER_02: So we're very proud of that.
45:11
SPEAKER_02: And then we have some foaming peptides because I think that sometimes the motivation to put on sunscreen can be as simple as, hey, if it's gonna make my skin look better, uh, you know, and and I think, do you find that you like it just putting it on?
45:26
SPEAKER_02: I use it oftentimes as a little tint, so I use it instead of like a cosmetic foundation.
45:32
SPEAKER_01: Yeah, yeah, it has a beautiful tint.
45:34
SPEAKER_01: I was gonna say actually, um, about your the sunscreen because I noticed the tint and I was putting it on and I was thinking, you know, I the white cast thing is a big problem I've always had, you know.
45:46
SPEAKER_01: And so when I was putting it on, I was like, this is like I feel like helping that not even occur.
45:51
SPEAKER_01: You know what I mean?
45:52
SPEAKER_01: Because even if the tint is isn't exactly my skin color, it doesn't matter because it's avoiding that white cast, you know.
46:00
SPEAKER_02: So yeah, I really exactly it.
46:03
SPEAKER_02: Thank you so much for sharing that because I think that that's something when I was sort of saying, you know, people have to use a cigar sunscreen that they like, not only the feel of it, the smell of it, but how you look when it's on your face.
46:15
SPEAKER_02: And so we did that so that you wouldn't get that whitish cast.
46:19
SPEAKER_02: So thank you.
46:20
SPEAKER_02: That chocolate look.
46:22
SPEAKER_01: Yeah, well, it's beautifully.
46:23
SPEAKER_01: I mean, your whole mind is beautifully cra uh crafted.
46:25
SPEAKER_01: I mean, to say the least.
46:27
SPEAKER_01: I I'm just I'm so honored that you agreed to come on to our little show.
46:31
SPEAKER_01: This has been so amazing.
46:32
SPEAKER_01: I would actually love for you to come back because I have so many questions for you.
46:38
SPEAKER_02: Thank you, really.
46:38
SPEAKER_02: No, I I love it.
46:40
SPEAKER_02: I I really want to thank you for giving me the opportunity to share, you know, some of my beliefs, my my whole philosophy with everyone.
46:49
SPEAKER_01: No, I'm honestly, Dr.
46:50
SPEAKER_01: Geraldo, can I please just say this?
46:52
SPEAKER_01: Like, I honestly am one of those women that always knew I wanted to go into medicine.
46:56
SPEAKER_01: And I when I was growing up, I always wanted to find mentors like you.
47:00
SPEAKER_01: You know what I mean?
47:01
SPEAKER_01: Or people to I could talk to because you guys have really thank you, because I'm actually a woman in medicine because of women like you.
47:09
SPEAKER_01: So I really want to do that.
47:11
SPEAKER_01: Yeah, no, I mean it so much.
47:12
SPEAKER_01: You've made my day, really.
47:14
SPEAKER_01: No, thank you so much.
47:16
SPEAKER_01: And everybody listening out there, please, please, if you have not already, go check out Dr.
47:20
SPEAKER_01: Loretta's beautiful, beautiful skincare line.
47:23
SPEAKER_01: It is, you know, science at its finest, uh, to say the least.
47:26
SPEAKER_01: So please give them a follow.
47:28
SPEAKER_01: Um, and I will leave leave any comments or questions you have for Dr.
47:32
SPEAKER_01: Straldo in our cover art comment section, and I will pass them along to her team.
47:37
SPEAKER_01: Thank you so much, Dr.
47:38
SPEAKER_01: Storaldo.
47:39
SPEAKER_01: This has been so great.
47:40
SPEAKER_02: So much.
47:40
SPEAKER_02: Stay safe and healthy, and thank you very much.
47:43
SPEAKER_02: Thank you so much.
47:44
SPEAKER_01: Bye-bye.
47:45
SPEAKER_02: Bye-bye.
47:51
SPEAKER_01: Hey guys, so I hope you love that episode.
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