A Skin Cancer Surgeon Shares His Holy Grail Product for Skin Aging, How Much Sun Exposure We Need, and How a Common Infection Can Drive Skin Cancer with Dr. Teo Soleymani

Dhru Purohit (0:00)

Dr. Soleymani, welcome back to the podcast. Today, we're talking about one of the biggest paradoxes in health. And that paradox is that the sun is great for you. It's healing. There are so many benefits to getting healthy sun exposure. And then the flip side is as a skincare expert, a surgeon who literally takes out the worst forms of cancer that people develop, skin cancer on their body, you also acknowledge the truth that the sun is one of the top things that can age the skin. What the hell is going on? And how do we make sense of this paradox? Yeah, I think this comes from a big idea of blanket statements in medicine that have become commonplace. So, to backtrack a little bit, I don't think there is ever a time or place anywhere in medicine, not just dermatology, not just skincare, etc., where a one size fits all makes sense, whether we're talking about just patients in the US or globally.

Historically, the sun has had a lot of healing properties. There are benefits. You know, everybody talks about vitamin D synthesis, which you don't need that much time in the sun to develop. But there's a lot of benefits, aside from things that we can measure in a test tube, like your vitamin D levels. There are endorphins that come out. You feel better when you're outside. The whole premise of seasonal affective disorder, where people just don't feel like themselves, they feel down in the dumps when they're not in sunlight, has some truth to both physical wellness as well as mental wellness. The problem is, just like anything in medicine, too much of a good thing can be a bad thing. You would never question whether drinking water is a bad thing for you. If you have eight glasses of water a day, you are hydrated more or less. If you drink eight gallons of water a day, you're likely going to end up in the hospital. Same thing with sunlight. I think there are some benefits in which people can get sun safely. I think we shouldn't fear the sun and somehow dermatology has gone so far on one end of the spectrum. I think I know why and we'll touch base on that later, that you are almost frowned or scorned upon if you go outside in the sun without taking multiple layers of protection. I think that's silly. I don't think you need to fear the sun. I don't think you need multiple types of sun protection for five minutes of exposure. I also don't think that you should be getting blistering sunburn. So how do we find that sweet spot of how much UV is too much and how much of it is a benefit? So the simplest things we talk about, if you take a grape and you put it out in the sun, over time what happens? It turns into a raisin. If you take some hide and you put it out in the sun, it becomes tanned leather. Same thing occurs with our skin. If we are going to ignore or put aside the entirety of talking about skin cancer and carcinogenesis, let's just talk about aesthetics, let's talk about aging of the skin where our skin breaks down collagen, breaks down elastin, starts to look wrinkly before it normally should otherwise. The sun is probably the single greatest implicating environmental factor in that. There's no doubt about that.

How do we rectify that with all the benefits we get? Well, the simplest thing is we look at the UV index. Generally, the lower the UV index, the safer it is to get sunlight. Sunlight is a spectrum. Struggle to define or distinguish sunlight and UV irradiation. The sun has visible light, it has UV light, it has infrared light, which is a form of heat we feel. And then there's some other wavelengths that don't really make it to the earth's surface. But if you're a pilot, what have you, X-rays, gamma rays, etc. So sunlight is a spectrum of light. Early morning sunlight, very effective, helps circadian rhythm, helps balance sleep, cortisol levels, etc. Long-term. Early morning sunlight is great. Late afternoon sunlight is great. Midday sun can be okay as long as your skin isn't turning red or blistering. So you and I, for example, may be able to tolerate midday sun a little bit more than somebody who is blonde-haired, blue-eyed, for example. Knowing your threshold is how much you can modulate the benefits before you get into the problems. I can tell you one thing for sure. If your skin starts to turn red or you start to burn, you've crossed that threshold. You are not in the category of getting the health benefits. You're in the category of premature aging, potentially carcinogenesis, etc. So every person is different. I think sunlight is a great thing. Do I wear sunscreen every single moment of every single day? No, most dermatologists and skin cancer surgeons don't because I know my skin and also the majority of my day is going to work before the sun comes out and coming home when the sun sets. So I know I'm not going to get a lot of UV or radiation, but if I know I'm going to be outside for a prolonged period of time, whether it's for premature aging or whether it's for skin cancer development, I will be cognizant of when I need to protect. That's really important. You said something that I think can kind of be a little bit controversial slash news to people who are on social media, which is that you said most dermatologists and most skin cancer surgeons wouldn't be wearing sunscreen. When you scroll on social media, a lot of our female listeners don't know especially because they tend to be more into skin health than let's say men, although that's changing a lot with young people. Young guys are now super into skin health. You actually see a lot of statements from people that seem to come to the surface on viral clips, like dermatologists, people that look well credentialed from top universities who actually say that even what we would consider, like what you said sounds balanced, you know, sounds like something that's realistic and sounds great. But they would say that no, that is aging you and it's aging your skin rapidly. And you need to go out with a visor and you need to go out always with SPF. So I know you said one size doesn't fit all. But how is that these seemingly super smart people are telling individuals that you're aging rapidly just by getting what you call a balanced level of sun? Yeah, so it depends again on physician to physician, surgeon to surgeon. Many of my dermatology colleagues will say, I don't wear anything on my body, but I will put sunscreen on my face every single day because I don't want to get a wrinkle.