Hey, what is your skin type?
In this week's episode of the Less Stressed Life Podcast, Dr. Raja Sivamani of Pacific Skin Institute and I chat about dealing with different skin issues and its integration to ayurvedic medicine approach.
Here are some of the key takeaways:
Mentioned in this episode:
Dr. Raja Sivamani is a researcher, board-certified dermatologist as well as an Ayurvedic Practitioner. He focuses on general and integrative dermatology including medical, surgical, and cosmetic services with training in bioengineering, Allopathic and Ayurvedic medicine. He merges modern research and science with a personalized approach to each patient. His training in Ayurvedic medicine lets him take a more humanistic approach to patient care, science, and research. Dr. Sivamani has over 100 peer-reviewed publications and leads many studies that focus on the impacts of foods, nutrition, the microbiome, and the gut-skin axis as well as studies on standard Western medications and devices.
This is the fourth episode of SKIN-month and I'm happy to share with you my book The Eczema Relief Diet & Cookbook is shipping April 14th and is available for pre-order on Amazon.
Assess your Adrenals, Detox or Get my Guide
Join us on Instagram
instagram.com/anti.inflammatory.nutritionist/
Shop our Favorites
Loving the podcast? Leave us a review!
Hey, what is your skin type?
In this week's episode of the Less Stressed Life Podcast, Dr. Raja Sivamani of Pacific Skin Institute and I chat about dealing with different skin issues and its integration to ayurvedic medicine approach.
Here are some of the key takeaways:
Mentioned in this episode:
Dr. Raja Sivamani is a researcher, board-certified dermatologist as well as an Ayurvedic Practitioner. He focuses on general and integrative dermatology including medical, surgical, and cosmetic services with training in bioengineering, Allopathic and Ayurvedic medicine. He merges modern research and science with a personalized approach to each patient. His training in Ayurvedic medicine lets him take a more humanistic approach to patient care, science, and research. Dr. Sivamani has over 100 peer-reviewed publications and leads many studies that focus on the impacts of foods, nutrition, the microbiome, and the gut-skin axis as well as studies on standard Western medications and devices.
This is the fourth episode of SKIN-month and I'm happy to share with you my book The Eczema Relief Diet & Cookbook is shipping April 14th and is available for pre-order on Amazon.
Assess your Adrenals, Detox or Get my Guide
Join us on Instagram
instagram.com/anti.inflammatory.nutritionist/
Shop our Favorites
Loving the podcast? Leave us a review!
spk_1: 0:00
medications are powerful, but they're not an agent for a global change in someone's lifestyle, or how you might love yourself are how you might do it. Better relationships with food or how you might sleep better or how you might actually become more interested in yourself as a person. I feel like that's how you cure people.
spk_0: 0:15
Welcome to the less stressed life podcast, where our only priority is providing those ah ha moments toe up level your life, health and happiness. Your host Integrative dietitian nutritionist Krista Bigler, helps health conscious women reduce the stress and confusion around food, fatigue, digestive and skin issues at less stress. Nutrition dot com Now onto the show Okay, today on the less stress life we have. My new favorite dermatologist, Dr Raja Ceremony Dr Rogers of the Money is a researcher, professor of dermatology and private practice integrative dermatologist at the Pacific Skin Institute. He's also the founder of Jeeva factory dot com, which will get into with training in bioengineering, al empathic and Arya Vedic Medicine. He emerges modern research and science with a personalized approach to each patient. He's authored over 100 peer reviewed papers and 10 text book chapters and is a wealth of information. Welcome, Dr Seaver. Money.
spk_1: 1:11
Oh, Krista, I'm so happy to sit here and talk to you about anything and everything. Skin and beyond. Love it.
spk_0: 1:16
Yeah, skin is of wide. Why topic? Big, big organ. I work a lot of exam. Oh, we're gonna be talking a lot about that. I don't know if we can call it an epidemic. I feel like it's a little bit of an epidemic level when you got one in five kids up to that air dealing with it. So we will be going all over things. So how did you get into? I mean, people are looking for an integrative dermatologist. All the people I talk to you wish they could find one. How does that happen? How do you become an integrative dermatologist instead of How do you decide? What's the change that happens?
spk_1: 1:42
Yeah. You know, this
spk_0: 1:43
is one of
spk_1: 1:43
those things that I wish I could tell you. I had a clear path that I had planned for. I had a time, and then we worked through it. But it was definitely nothing like that. It kind of just fell in out of necessity. So and this is kind of just a quick overview on the path that was an engineer when I first started, and I knew I wanted to do something with medicine. But I really liked engineering and thinking about the building blocks of just how anything in general. How do you take something and break it down into its building blocks and then build it back up? And then that way you can have new ways of building things. And I think that really triggered my journey integrative medicine, because when I went through medical school, we had one lecture on nutrition, and I remember sitting there thinking, Gosh, there's got to be more to this than one lecture on nutrition Now I loved my medical education, love getting into the biochemistry path of physiology. All that stuff was really, really, really good. But I felt like there was something about lifestyle that was a big area that I needed to grow in, and that's when I got into higher basic medicine and diabetic medicine. It's, ah, traditional form of medicine from India. At first blush, it might seem, Wow, this is very different, but actually they have building blocks to and the way it translates over to Western medicine. I kind of had to figure out how I could translate it for dermatology. But once we started working through it and we've been doing research in the area started putting them all together. Really, the reason I journeyed into integrative medicine This is almost a necessity, cause I wanted to be able to talk to people about something beyond giving them medication. Medications are powerful, but they're not. Agent for a global change in someone's lifestyle, or how you might love yourself are how you might do it. Better relationships with food or how you might sleep better or how you might actually become more interested in yourself as a person. I feel like that's how you cure people is. You get them thinking about who they are and how they can become better not by giving them a pill as the only way to approach things or a cream. So that was really the journey that took me into integrative medicine.
spk_0: 3:28
I also appreciate that you mentioned you had one lecture on nutrition because dietitians love to talk about that. How it's you know, you have to kind of have partners or were always excited about doctors that want to learn more about nutrition because it is a big piece, right? This is the piece that we're consuming food every day. So to think that it's not related to anything is kind of an oversight.
spk_1: 3:45
Yeah, you know, when I first went to residency, remember when we were talking about acne originally and I was a resident? I did my basic training during residency, too. So just because I felt like, hey, I didn't have enough to do during residency. Let me add on an extra better training. Why not? But again, it was just that passion inside of me that drove it so I never thought of it. Is extra work I just thought of as the needed things that I needed to do to get to where I wanted to go. We were teaching each other that I had no role in acne at the time. It was based on one study, and now it's almost silly to even think of that even have entertained that concept of silly because there's so many studies now, epidemiological some perspective studies showing that absolutely it makes a difference. What you eat absolutely makes a difference. And so I think, you know, kudos to Western medicine because they realized that they probably missed the mark there. And they've transitioned to now realize that you know what diet does make a difference in the conversation is totally shifted. And now I think you'd be far pressed to find anyone saying that acne doesn't have a component that's controlled by diet. And, you know, it wasn't that long ago that I went to residency, so sometimes these landscapes shift. I wish we had more dietitians that worked with us, though, so that is definitely something that I would say needs to happen. Watch more in medical education.
spk_0: 4:54
Well, and just to stand back from, I'm gonna talk about skin. And she does have a friend who has a skin podcast, and she says she has a hard time finding. I think you've been You're going to be on her show. She said. She has a hard time finding experts in this because a lot of people understand skin kind of superficially like meeting some Omegas, and there's a couple other things. But skin is an interesting creature, right? We might call something examine. It presents in so many different ways, so we can't really treat it the same on the outside. Do you agree that, like depending on how that exam A is presenting or how it looks or where it's presenting at, does give you clues about what's going on? Underneath the surface? Skin
spk_1: 5:29
is one of the most personal windows into someone's not only their physical state of being with their emotional state of being and not talking about religion but spiritually speaking, just their sense of awareness, of themselves, sense of confidence. I think it's just such a big window. And yes, I'm biased all over the place as a dermatologist. But the reason I went into dermatology, Yeah, to talk to your question about Exuma. There are so many forms of exam of the word. Exuma itself is not an actual diagnosis within dermatology. If you look at Exam A, really is an umbrella term that takes on many different forms of things, and just to give a snapshot of this, you can have a topic dermatitis, which is the classic example related disease that we all could locally called Exuma in Children as they go through their very itchy it's Ah, full body can be devastating not only to the child. I think it's really important to realize that when a child is sick, the mom isn't sleeping. That dad isn't sleeping. Sometimes the siblings on aren't sleeping, and so it becomes a familiar process. And so if the child gets better, everyone gets better. And so you know you have a topic dermatitis. You have other conditions, though. Like, say, you run into some poison ivy. We call that exam a, too, but that's called contact dermatitis. Or say you have scaling on the scalp, dandruff scaling around behind the ears and the nose. You know, you go to a dermatologist, make sure you get that diagnosis correct. But that's called separate dermatitis, and that sometimes you can have these weird rashes on the hands and feet so you can call that hand and foot dermatitis. So there's so many forms of Exuma, so you're absolutely right. And if you look at it even from the air basic perspective, they type out the different eggs mas, based on what might be the triggering factor. Is it inflammatory oil that, like in the case of separate dramatized or is it just purely dry skin as you get older and older and we're using too much soap on our scans because we don't make natural oils as much. Then you get this other condition called erotic dermatitis, meaning dry skin dermatitis. So, Krista yeah, is talk about just a flavorful area in terms of all these little nuances. Be absolutely right. There's just so much to know about skin, but at the same time, gotta take a holistic approach. I mean, how can you do this with the cream? One cream that's gonna manage it all. It's impossible.
spk_0: 7:29
Well, on this no, You were really interested in dermatology. It also sounds like you like going to school forever. And you're a strategist. How did you decide to go into dermatology? Did you have something going on in your life as well or something? Did you see something in your family?
spk_1: 7:40
I grew up with Exuma, and it was something that I struggled with and going through different sorts of products that were available. I noticed that certain products I when I stopped using them, I would flare if I didn't use them from day to day. There's this whole notion of getting addicted to not all moisturizes but certain type of ingredients in moisturizers. I didn't understand this at the time, and sometimes I'd switch the creams around and I realized, Oh, other days when I didn't use the moisturizer every day, sometimes my skin would stay a bit more bolstered. I definitely saw that when I ate certain things that my skin would flare. I love love, love, sour foods and Citrus foods. It's something that I'm just drawn to, not so great for my skin. So I've learned Thio control that aspect of things. But to answer the question of why I went to dermatology, it was totally a mentor. There was just inspiration. I did not get into medical school when I first applied, and it was probably the best thing that ever happened to me. The worst thing that I felt happened to me at the time. When I look back, it was the absolute best thing that could have happened. Sometimes these failures you get stuck into thinking, Oh my God, that's it. I had my shot and it's over. But that's not how life works. You just have to keep an open mind and realize that life's gonna take you in different paths and you just stay optimistic and positive and good things happen. So what happened is I met a mentor named Howard May back at UCSF when we started working on skin bioengineering related research. I was down. I was in the pits, but he said, Hey, come on. And why don't you start working on some things? And he told me something that really impacted me. You know, my first meeting, He sat down and looked at me and looked at my resume, and I went to Berkeley and I had, like, a 3.97 g P a and engineering and, you know, it was just I did really well. But I was missing that personality point of things. I was a little bit too tucked into the academics, and I remember him looking at me and saying, Roger, you know what? You were really close, and I can't tell you how much confidence that gave me for him to just say you were really close. It made me feel like hacking land on my feet again and go after this. And it was my first intro to holistic approaches to caring for people because, you know, that sense of confidence was probably worth more than just looking at my resume. And then he pulled into his clinic and I started seeing how he dealt with patients and how he bridged research with dermatology. And that was the reason I went into dermatology. It was purely this man that took a chance on me, and that made all the difference on I think it changed my perspective on just what it means to succeed and what it means to fail and what it means to have mentors.
spk_0: 9:54
You were talking about the emotions around this and even how emotions relate to skin. So my question for you is. And maybe you had already kind of resolve your exam About the time you got to school. Did your skin get worse in school? That's a thing I hear ah, lot very often. And maybe you already passed the point and already realize will work well for you. I hear that a lot because I think that this physiology of what's going on with stress deplete certain nutrients can cause examine flair and ever I mean there could be a Mary out of what's going on. Did that happen to you?
spk_1: 10:19
Yeah, I didn't. In fact, you know, the type of exam I had is known as no Mueller dermatitis, and I still have it. Christa didn't go away completely, and so I constantly have to just be mindful of where I am so stressed definitely would flare, especially when I don't get enough sleep and people say, Hey, do you get enough sleep now? Somehow, nowadays, when I get sleep more well rested, even though I don't get as much sleep, I wake up pretty rested and I don't know why, but my mom is in the same category. She sleeps four hours and she's good to go for the rest of the day. And she's been doing that for her entire life.
spk_0: 10:49
Don't teach people to do this, you
spk_1: 10:51
know, this is not the way to do things that I think this is such an anomaly, and I've learned to pause and say, Wait a minute. I need to just have a good sleep hygiene habit and I've extended my sleep hours now, believe it or not. So it's one of those things that I've learned TOC that it's important stress. Not only that, though, when I go to conferences, if I traveled to somewhere, that's, say, New Mexico, it's a higher altitude or Denver, Colorado. My skin will flare to this day and so I have to just be ready for that and realize that environment plays a role. It's not just everything that's internal. There's this question. Play with everything around me and you have to constantly realize that there's gonna be some harmonizing that needs to happen as you go through life and as you go through different geographic areas and there's so many factors involved. So I still to this day flair with Exuma if I'm not careful about it, and so I've been better about it. But it's something that still think about
spk_0: 11:39
Does it move around to different places or just generally flare in the same place For me? It
spk_1: 11:43
I'd rarely affects my face. It's really the body, so my trunk and legs and arms tends to be those areas, and I think the reason for that is my oil glands are a bit more active, so basis lines a bit more active on my back, upper back and upper chest and face. But definitely when it comes to my arms and legs, they will flare much more so that's typically the spots that get it.
spk_0: 12:04
So you were talking about emotions I often will talk to someone about. For me, working with skin issues is more challenging and difficult than working with digestive issues, because that we know is internal and on objects lying. Hey, there's probably this other component going on when you're working with the skin issue. As you're well aware, in dermatology, we're definitely looking at the outside and a lot of us wanna look at the side. Not everyone wants to look at the inside so inside outside. But I also talked to people and say, Let's look at this from a triad perspective. So there's a structural piece, maybe an international peace in an emotional piece, and you really spoke to that emotional piece at the beginning. Do you want an example or a story or two about how you've seen emotions really affect someone's skin? What's going on? I mean, just you flaring in school is one example, But have you seen that with your clients, where the emotions have really been kind of the priority that they needed to control or change or deal with.
spk_1: 12:54
No question. You look at acting as an example and you see this a lot. Now we see acne extending into adulthood much more. But if you look at teenagers and folks that are in college, we have, ah, funny term for one of my teachers and residency. Even usedto label that this the acne bloom that occurs around finals. So any time you have a lot of stress, whether it's lack of sleep again going back to that or just the brain skin connection with stress or stress eating. Even sometimes people stress eating that will trigger some flares on the skin, too. But we know for sure in acne. If you're having a very stressful periods and you're not settled emotionally and you're dealing with a lot of anxieties and things, keep your mind in an unsettled state of frame. Your acne will get worse, there's no question, and we've seen that acne gets worse around finals, probably gets a little bit better on vacation time, and that's a classic example. But there's so many other conditions I could talk about psoriasis stress has a component. There's a condition known as hydrogen itis. Separate TVA recurrent boils, very devastating in the armpits in the growing area. Socially, very debilitating worsens with stress. And you know what stress you have all these other networks that trigger together with it. So when you have bad stress, you have bad sleep, as I mentioned. But that diet components huge because people cope with their stress with eating. And that isn't always the healthiest way to approach things. And so we talk about this when we see patients in the clinic. Yes, we'll give them treatments about, you know, that are topical. But then we wanna have, ah, conversation about how you dealing with their stress, what the anxieties that you're dealing with. I mean, I just had a patient that came pretty recently, and we quickly went over what the treatment would be. But the majority of the conversation was, How's school going? And are you getting bullied? And we had a really good conversation about how they're trying to deal with different sorts of new stress, is entering into high school, and that was probably the bigger deal in the whole visit. Then the fact that they had acne. It was really the acne was a symptom to something else going on much deeper. And I think it's really important. Explore those aspects. So there's no question that emotions play a role in skin.
spk_0: 14:50
I was reading some research the other day, and I was talking about 60% of kids talk about sleep disturbances when they have exam and 80% talk about sleep disturbances when they have a flair. So when you're talking about affecting the whole family, that's the primary thing we see is like Everyone's going crazy because if they can't sleep right there, not getting to sleep because of the scratching And the night was asleep. Big deal and dio, is he retarded? Diet, I was thinking. So you're saying I should need a black of cheese and crackers? If I didn't have a lunch plan in Stratton? I'm just It'll definitely cause of acne flare for me, for sure. So it kind of cracked me up. You were talking about the recurrent boils, so I have seen this a little bit, but you talked about some interesting areas. Armpits in the grain. So where were we have lymphatic nodes. Do you see a relationship with where skin stuff is presenting in relationship till emphatic system ever?
spk_1: 15:40
Yeah, in this case, it more than lymphatic system. It's, ah, related to specialized glands. You know what's so amazing about the body? It is a landscape that is so well manicured by nature. Somehow it is so well coordinated. This fascinating blows my mind. I mean, you have people that grow hair on the head, then you're working your way down and you have all these oil glands everywhere. And then when you get to the armpits in the growing area, one of the things that's really specialize about that area is that you have these specialized sweat glands. We have sweat glands all over body. They're called e crying sweat glands. But in the specialized areas such as the armpits and the growing, you have another set of specialized oil glands known as African oil glands. And with this condition called hydrogen itis separate Eva, we don't still understand exactly what triggers it. There's still a lot of research being done, so we don't know if it's those particular glands, but there is no specialized glands that tend to get inflamed. The hair follicles tend to fall out of their natural anatomy, and you get quite a bit of inflammation. Recurrent boils. You get what are known as Sinus tracks, and you can get terrible, terrible scarring in the area and folks that have it really badly. And it's a far underappreciated condition. I mean, for anyone that's listening. If you have recurrent boils and the growing or and the armpits realize that they're not just boils in many cases, there is another condition that's out there, and it's debilitating, Krista. I mean, you can imagine this affects people when they're young, affects people as they gain more weight because there was more friction in those areas. And so diet plays a huge role in exercise. And, you know, it's easy to just tell someone Oh, go exercise. But if it's so painful, hurry, good exercise. How are you gonna move? You need tohave initial steps to get them towards a goal. And so understanding the skin isn't just saying, Oh, there's a boil there. It's understanding. Oh, that Boyle is gonna keep you from being with the exercise that Boyle is gonna be able to keep you from being socially vibrant and going out meeting people and the sexual effects of it that is going to keep you from being sexually open. If that's an important aspect of your life because you're embarrassed about it and all of these things, you say it's a skin finding. But that skin finding has so many factors that tie into who that person is a human being, that you have really have to hit all of those and be very thoughtful and mindful and honestly, a little gentle with people when people come in. I think the worst thing you can just say is that, Oh, you're overweight, You need to lose weight. Yet they know that this isn't something that's like a great uncovering for them. What they want to know is, how do I deal with it, like, how do I address that? And so I think them tools to do that rather than just saying you need to lose weight. They know that they want to know how they don't want to know what, and so I think these things tie in. But yeah, Hydra Tonight, a separate Eva. It's getting more conversation now, thankfully, but ties into a very, very important aspect of how skin affects everything in the body.
spk_0: 18:15
Yeah, there's so many emotions tied to this. I mean, I had eczema all over my face kind of pretty significantly when it came to a head. I talked to someone yesterday who said, Oh, I was embarrassed to send you pictures of how my skin looked because I was alarmed when I saw them and deleted them. Yeah, I saw a photo the other day of a man coming off of topical steroid withdrawal. And you hear a lot of things I don't want to like, Say it here. There were some weird therapies that they were trying because of the using, and I mean, it was like a shocker. And that's the movement. Now people are coming out and wanted to show the skin because people are so used to hiding and it's really uncomfortable. This is what people are thinking about all day long, right?
spk_1: 18:48
Yeah, they are. It's a big deal for people because the skin isn't just something that's personal to them. Just as a physical ailment, it's how they present to the world, and especially it's on your face. You can't hide it. It is kind of nice that people are taking that by the horns and talking about it openly so that they're kind of cutting out that taboo nous about it. But there's a lot of folks that are shy, a lot of folks that are really concerned about how other people react. And the truth is, I'll tell you, Krista, when you talk to someone, if you have something on your face there, definitely look, it's a natural reaction. And so people notice that especially in conversations if you need to have something that even requires some social connection or social conversation, if you have something that showing on your arms or on your face or what not it is going to affect you. And so I think you reporting that this person was very embarrassed about sending a picture over. This is something that we here day in, day out, especially monster
spk_0: 19:34
patients. So as a dermatologist, when I read dermatology research, it's like skin barrier skin barrier. By the way we think Phil a grand, by the way, blah, blah. This is something I forgot to say earlier you were talking about. Yeah, I'm kind of bouncing around their asses. You were talking about exercise earlier. I was reading this article in and I said exercise, but it may flare things. So not too much. I'm like these were like those contradictory statements like Let's make this is gray as or vanilla as we can possibly make it. And so in your research, what is the current research that you're working on? And then also, Waters have been some of the most surprising outcomes you because you've done a lot of research papers. So would have been some of the more spun findings or more interesting findings that you found in past research. And then kind of what you working on now? Yeah, maybe
spk_1: 20:22
we couldn't talk about exam, actually, and I can talk about some of the research we've done there with eggs, but there's so many factors, it's multifactorial. That's hard to pinpoint. Any one thing I mean, I think exercise is a good thing. I think it's good to get up and move, and I think is hidden in that message is just be mindful of the environment. If it's really cold and dry outside and you go and exercise in that, then just realize your skin is going to take that on, and it may flare as a result of that. And so maybe when it's really cold outside. If you have a tendency towards examine, you need to be in a climate controlled setting, so joining a gym might make a little bit more sense. Or having a home gym if that's even a possibility or doing some exercise at home where you might have some climate control would make more sense. If it's, ah, exceptionally humid. Or if it's something that your skin loves, get out there and, you know, sweat it out a bit. I think some of the concern is, you know, if you sweat too much this way, sweat too much that way. You know you don't want to get caught in this zone of paralysis by analysis. We know that exercise is important. As one example, just try to realize that the environment plays a role. So, you know, play around with that. Yes, you may have some flares here and there along the way, but it's important to figure out what's gonna be a good fit for you. Realizing that exercise globally is a good thing, because it's not just about the skin mean you have your heart, you have your muscles. I mean, there's a lot of things that benefit from exercise, that globally are a good thing.
spk_0: 21:40
I'm sure of something that I learned from you when I heard you speak at a Microbiome conference in September. Something you had said was, I'm just throwing in this other piece. There can be a fungal component to some skin conditions, right? And so sometimes we have wonderful results. Only do antifungal. But you had talked about taking an antifungal and then exercising because it gets through to the skin. And I think that's such an interesting concept. And I think sweating can be such an interesting thing for me. Using infrared Sana was such a huge piece of my healing journey getting things out through the skin. So I just want to throw that in there as well as we're talking about exercise. But also what else is going on sweating and an elimination of garbage essentially right? And also like how we get things out?
spk_1: 22:19
Yeah, no, there's no question. I mean, sweating is a way that you can release certain things from the body so and you can use that for good. What you're referring to is sometimes when people have a fungal infection or something like what's known as tin universe, a color will give them some, in some cases, an aural anti fungal, and the weights delivered to the skin is through the sweat. And so you wait 30 minutes to get let it absorb, and then you sweat it out. And so just again speaks to this gut skin connection that we have a very robust, rich network of communication, and the skin is part of that communication. And then going back to the exam A in terms of like, what are the different sorts of factors that are gonna come into play? You know, there's no one size fits all, I think, with a topic dermatitis. Let me kind of streamline the word Exuma down with a topic dermatitis. We know that there many different subsets. Some people with heavy skin bears some people. It's heavy immune system. And there was a very nice study that came out pretty recently this past year when they looked at people that had a flagon defect, which is one of the proteins that's important for the skin barrier and with eczema. But then there are other folks that they also studied that didn't have that flag Rin defect and had eczema, atopic dermatitis. First of all, right there it goes to show a flattering defect is involved in actually the majority of people that have a topic dermatitis like like a full on mutation. They probably have some deficiency in their skin berry along the way. But what was really interesting in that study is that the folks that had the flag and defect were much more sensitive to things like detergents that were being used to wash their clothes or if they were going to get exposed to hard water. Because there's been all these mixed results with hard water versus soft water. But I think part of the problem has been it's just been a big amalgam of everyone. We just call them a topic dermatitis instead of basically sub setting those folks into different forms of a topic dramatized because it turned out the people that didn't have the flag and defect and had a topic dermatitis. They didn't react to the detergents as much didn't react to the hard water as much. And so we're starting to understand now that, yes, we have this big disease term. But they're different subgroups in there, and the subgroups, they're going to react differently. And you might not know what your sub group is. If you have a topic dramatized in, you're gonna have to figure it out as you go along. So be wary of one size fits all kind of approaches to anything. It doesn't work. You have to take a bit more of a personalized approach and realize that your body is going to be unique from studies. So I do want to talk about one study that we did to. And the first thing is, when you look at clinical studies, we're trying to take an average result and apply it to everybody. And there is a lot of value in that because then what you can do is you can develop theories based around a scientific principle and then try to apply it knowing that we're generally human beings and have generally the same sort of functioning physiology overall. But the truth is, we're not all the same, and we know that because there are spreads We have things known as out liars and clinical studies. So realize that yes, When you take an average result and try to apply to everyone, there gonna be a lot of Mrs in that and it may not be 100%. Mrs may be a Mrs basically Oh, it didn't work for me as well. And that's the kind of thing that we see that if something is validated, it will probably have some effect. But it may not have as much of an effect for you as it did for the person next to you. You can't guarantee it on. So that's why you always have to have that open conversation and realize that like this study, I just talked about where they looked at different defects. You're going to the next level and saying, OK, now we're gonna take this condition and realize that maybe they're different facets to this condition and let's look at that. And I think that's where bringing in Eastern philosophies and makes a huge difference because they already have a paradigm that allows you to start sub setting people within a diagnosis. And I think this is where Western Eastern medicine can come together to form innovative research. One of the studies that we did stepping away from this integrated kind of research. We looked at something as simple as dilute bleach baths and we exposed people. And I just wanna also mention the lead investigator on this, who's an integrative dermatologist as well. She's at the University of Arizona, Dr B. V and she amazing person. Krista, you should have on the podcast. Sometimes she's really cool to talk to, but we did a study looking at bleach bats. And does that affect the skin? Because a lot of people got concerned owed that Will this make the skin worse off because you're exposing it to dilute which and we did. The studies was fine. The skin held up, there were no issues, and it's basically like dunking into a swimming pool. And we actually talked to people with exam about this so that we can help control the microbiome on the skin. There's been some more research coming out that has been a little controversial of Is it? Do you need to actually do a bleacher out there? Can you do a bleach wash? That's delude bleach. So you know the jury's still out on what's the best way to do this? But the idea that you're doing something to the skin that isn't necessarily it's part of your bathing regimen. You know it's not something that you're putting on is a treatment, but we build it into a bathing regimen again. Another important aspect. Hi, you bathe. That's another fast it that's really important. How do you soap what soaps to use? Do you even need to use soap? What about body wash? Are they more gentle? Well, it turns out, actually, if you have really dry skin, the body wash is still going to strip natural oils off your skin. So you know the ingredients that use matter a lot. So really, there's multiple facets involved.
spk_0: 27:04
I have a question about your bleach bath study. How long did you monitor that? And how often were they doing the bleach paths? I usually recommend that people alter if they're gonna do an anti microbial bath like a bleach bath with something else. Like, there's a magnesium flake that I really that's got some silicon and Emma Samms really skin softening, so it's really like soothing and healing, So I like to complement it with that and do kind of alternate. So I'm wondering how long you looked at this and if it was an adults only, or your thoughts and Children because we think about the Children and correct me. We think about them having a thinner skin barrier, right, or they absorb more per because of weight to surface area ratios. So what are your thoughts there?
spk_1: 27:36
So when we did the study, it was in adults, and it is true when you have really young Children, you have to be a bit more careful about how their skin absorbs and how their skin is a bit more sensitive. Even in that group that can say clinically, we don't like to do the bleach bats too often the way we do it, Is it just a quick dunk into a bathtub or if they're gonna go swimming? That's great, cause that's kind of built into the routine once a week. We don't do much more than that, And your point about basically like things like dead sea salts, magnesium. There have been some early studies showing that that's actually helpful to in helping with the skin barrier recover and whatnot. So but with the bleach fats, it's really once a week. If that sometimes once every other week is kind of the approach that I've taken and it's worked out well so that you don't put too much burden on the parents as well. You know, that's another facet, By the way, it's easy to give recommendations. Executing the recommendations all fall on the parents. You got to read what's available for the parents and how they can do it with their Children or even read the person itself, cause now we're seeing it, a topic dramatized lasting into adulthood much more. I don't know what the reason for that is. I don't know if it's because we're diagnosing it more for a soap culture and where our skin is just irritated a bit more. Or if the immunology of justice hygiene hypothesis theory is also just now taking hold much more as we become more and more industrialized, I don't know what the reasons are, but the fact that we have a lot more folks that are dealing with eggs. Emma, you have to take into account their lifestyle, too. So if you're gonna do bleach bats I do Ask them. Hey, do you have a bathtub if you don't have a bathtub at home? So I'm gonna happen unless you know they can go swimming. So you have many different factors involved.
spk_0: 29:02
Yeah, And as you talk about personalizing things and things being different, agree that the research is there that bleach bags worth because we think that there's the topical skin Microbiome can get overrun with. Staff is the common blame. But don't mention that my eggs my flare came from bleach bath. Essentially, it was like from swimming for seven days in a row that it was like got crazy vengeance. So that's why I love that you just said, Hey, it's a dunk once a week because it kind of controls the topical stuff. And this is important, regardless, because if there is topical staff, I don't really care what I'm doing to help someone on the inside. It pretty much doesn't seem to matter if there's a topical infection going on, so that is a huge issue. So addressing it from that aspect, I mean, I'm fully supportive, but I just like being doubles advocate a little bit like kind of ah perturbed mine, but I didn't because that's why they're not all the same, right? So this worked really well when there's topical staff. But my Brokaw's is a little different, so it wasn't very helpful. So I just throw that in there as well.
spk_1: 29:54
Yeah, Krista, I think that's it. That's a very good point, because when you have folks that are swimming regularly and even with the dilute bleach bats, you need to do a rinse to make sure you take all that stuff off, you do a final rinse with water. But even what swimming? One of the things that people have to realize is if you're gonna go swimming every day and you have asthma, yes, it'll help control. Now we know this. We didn't know this, like 10 years ago are like 20 years ago, when we didn't have the concept of the microbiome. What we know it can potentially help with controlling the overgrowth of staph aureus as you mentioned. But one
spk_0: 30:22
of the
spk_1: 30:23
other things is, if you do swimming regularly, you need to moisturize you to shower. Rinse it all off you two moisturizer after you get out of the pool and even then Sometimes doing it too often can be harsh on your skin, like you say. So it is a personal journey. All these things are personal journeys, in addition to the overarching research findings that we're getting still a personal journey. And I do want to make a point with dermatologists, especially. It's not algorithmic medicine. And sometimes I see this being talked about even from alternative approaches or folks that don't realize that Western doctors aren't just algorithmic alchemists that just say, I'm gonna follow this regimen. I'm gonna give ah, medicine all the time. In fact, there's a lot of grayer decisions that need to be made in a room because we have to take into account what they can and can't do what they can and can't build into a schedule. So there is a lot of personalization that occurs within a treatment room and within a consultation that people might not realize that first blush. Even without being an integrative dermatologist, they're still trying to take into a lot of different factors. So this is why I think that we always talk about the art of medicine. It's definitely there, even if you're not taking a quote integrative approach. I just think having an integrative approach takes that to the next level, because now you have a lot more tools in your toolkit that you can deal with.
spk_0: 31:35
You talk about the importance of moisturizing, and once the skin is stripped, making sure we put something back on. So that way, that's a protective barrier. So the skin barrier isn't greater susceptibility to breaking down. What are some of your favorite go twos to put on topically? Minor, very plain things. Yeah,
spk_1: 31:52
well, I'll come and stick to ingredients because there's so many products out there that I don't really like to do product recommendations, because again, it's very personalized. But I like the ingredient aspect of things. So you want to think about two aspects when it comes to a topic dermatitis. Actually, even if you have any form of exam alike, you have dry skin dermatitis, any form of Exuma. If you're gonna get it treated with medicines, that's important. But on top of the moisture ization, the global approach is really the ingredients that you want to try Doing. Art fall into two categories. For the most part, one isn't inclusive. It helps to just re create a barrier cause your skin has to have a barrier that protects you not from the outside world on Lee, but also from losing water from the inside because you want to trap that hydration in so that's known as an inclusive can be helpful. So this could be anything that can range from coconut oil. Thio, petrol autumn and many people don't realize, but white petrol Autumn is a pure form of petrol arm, a lot more gentle on the skin, it actually glides across the skin much better. It's also known as petrol Adam USP. You'll find it in many products. If you look for it, should say white petrol autumn It wasn't just a random thing that people stuck the word white in front of petrol Honor actually has a meaning. Shea butter is another one, so there's many kind of things that a reclusive that just blocked the skin, and sometimes people just focus on that. But you also have to have something that's a humid and Hugh Mech. Tin is an ingredient that will grab and hold onto water and keep it in the epidermis and also grab and hold on to it in the Durmus so that you can keep the skin hydrated. It's one thing to prevent water loss, but then you're still depending on your skin to naturally get the hydration into the skin. And so getting water into the skin is really important. So one of the aspects that's really important there is he met since, like glycerin is a classic, classic example. There are other Hugh Mexicans, but if you just look up the word hume ect in, you'll see that there's many different sorts of Hugh magnets that are out there. So inclusive and humidity are really important. And then dye. It is really important. Used to be thought that sometimes on these shows, people say you drink water on your skin is good, you're gonna cure everything. No, it doesn't work that way. But on the flip side, if you're not drinking enough water, they've done several studies. Now, looking at this, if you don't drink enough water and someone that drinks like maybe say you only drink one cup of water a day or two cups of water day, it's very easy to fall behind on water and take if you're a person that doesn't drink enough water and you start drinking enough water, meaning like you're getting up to 6 to 8 cups. Now, if you have kidney disease or you have other issues where water and take is, you have to be careful again. One size fits all. You can't do that. You have to make sure you have a medical reason to our medical okay to drink water. But if you start drinking enough water, your skin will become more hydrated. They've shown this in multiple studies with biophysical measures that you will get more skin, what we call Turker and will make your skin more plump and more hydrated. And so in those people, drinking enough water isn't important thing. So I talk about that as well.
spk_0: 34:32
Yeah, I love it. So there was a good segue way into How often are people coming into your clinic and asking Dr Silver Mani, How is diet related to my Exuma?
spk_1: 34:42
Everybody 100% actually. Can I say it's 110% cause the people that they bring with them also asked
spk_0: 34:47
to s O. It's seen some kind of relationship, right? But when you look at the research is like not a role, not a role, not a role. But if people are feeling like, how do we address how you balance this?
spk_1: 34:59
Will you balance it by realizing that research has certain benefits and certain limitations? The benefits are, if again, if you're trying to make a global comment and being responsible and putting out responsible public health messages and saying this certain food is gonna flare Exuma, you want to be sure you get that right with some level of validity, And so to make public health message is out there for the whole general public. This is something that I think people don't realize in the general public. Is that when you're gonna put out a public health message, you want to be sure you have a lot of evidence behind it? Because, like I'm saying, you also have to realize there's a lot of personal differences between people, so you don't put something out there that's only true for maybe 10%. Make it seem like it's true for everyone because that I don't think is responsible. That's irresponsible. So when we put public health message is out there, it's got to be done well, it's gotta have a lot of study, and that's where the whole challenge was saying, Oh, this hasn't been proven yet. That's why it comes to light because you're trying to find something with enough validity for enough people that when you put it out there to relevant to a good lot of the people again, it won't be relevant to every single person. But you wanna have some responsibility with how you do that, and so that's why that's important. But the same time, I know that a lot of folks come in and say You listen, I ate strawberries is an example and it flared. My eczema or other people will say some other food item that flared my exam. A. Some people say cow's milk, and the problem that occurs is when someone says, Oh, cowsmilk played it for me. Therefore, it flares it for everybody. That's not true, you know, it depends from person to person. And so that's why if a cosmic flared for you and maybe your friend and another friend great, that's three people, But we can't go out there, make a public health message around that. On the flip side, you can't say, you know, if I ate eggs and I flared again, you can't put a public health message about that if it's only a small subset of people cause that's not fair, because you might end up messing up their nutrition overall. And that's not the right approach either. So we have to balance these approaches. But there's no question when people come in, they've tried all kinds of food challenges for themselves, and they've seen different sorts of things that have flared them and not flared them. And I think those are valid to cause that's their experience. That's their skin. And so if they're having that experience, I can't fall back and say, Well, there's no public health message about this. Therefore, it's not true to me that silly, because the public health messages weren't even geared to be able to do that. And so you have to do it in the room and say, OK, that's not working for you or let's work together and develop a food diary that we can see when things flare. I think that's actually more responsible medicine for stepping away from responsible public health messages. I think responsible medicine is listening to what the patients trying to tell you as well. Andrea lies ing that sometimes the research isn't there because we haven't done this study. And if the patient's telling you that this causes them to flare, I'm not gonna tell them that it's not gonna flare. Except in one specific case. Krista is when. If they're starting to take everything away and their child is starting to become malnutrition, or you can see there's a deficiency in nutrition, I think there is a responsibility step in and say, OK, listen, we need to do this in a responsible way because you can't have your child just on rice water. It's not gonna work because that will cause other issues, too. So it's just taking a balanced approach,
spk_0: 37:55
right? I see that whole spectrum. Obviously, these are the people you
spk_1: 37:59
writing. Being in the diet space. You're going to see all kinds of stuff
spk_0: 38:03
right, and sometimes dietary changes do help resolve it. I mean, I use this example all the time that what you are consuming all the time is what's going through your digestive tract and influencing your immune system, so it's going to make some kind of impact will be curious kind of what your thoughts are. I mean, like you just said, You don't say to people. Oh, that's ridiculous. Like, of course, diet is not related to your exam. It when someone clearly sees a difference. Is it a chicken or an egg situation, right? Like which came first, I think is part of the concern. And then I look at why would you have a flare from this? Right? So there's patterns of foods that go together, and it doesn't mean that it's a long term restriction. It might mean that, Hey, I need to help you digest these particular types of things or these types of neurotransmitters or whatever. That Aaron, these foods that are significantly higher in these foods. We need to be able to process that better so your body can break that down and move it out because right now it's backed up and not moving. Oh, so when people come in, you empathize with them, you say? Sure, we try to be responsible about it. But if people ask you, is that related? Or if you say you know, is it a causative factor, or is it like a result of Exuma. What's your opinion there?
spk_1: 39:01
My opinion is to ask them, Do you think it's related to you because you've been eating for so many years now? Like what have you found? I mean, I like to reflect it back to them. I do say that we are now learning that diet has a role in skin. There's no question about it. And then I'd like to learn about how you think it's affecting you. Yeah, I and I think by doing that you empower the patient to unto ways When I get to learn a bit more about what's been bothering them and what's then the patterns, they've noticed what allows them to talk about it. And I think that's really important because I think people want to also mention and it doesn't take that long. It's not like people worry that it's gonna become like an hour long conversation. No, it's like a minute, you know, they just tell you really quickly, like what it's been flaring them, and sometimes they'll have different sorts of tangents that they'll go on because it's really important to them and you just try toe, you know, gather all that information and put it together in a consolidated pattern. And if they're not really sure, we just tell them. Start doing a food diary. Uh, just giving them some tools and saying, Hey, when you have a flair, just write down What did you eat today and then make a note? Did I flare today? And I tell them, Remember what you eat today might cause a flare tomorrow or the day after. So let's not make any assumptions. Just write down faithfully what you're eating and then when you have your flares and let's look at it and see what we find,
spk_0: 40:08
Yeah, I appreciate you saying like that because we do learn the most from our clients, right? I mean, one of the things that I'm sure you do, too, is I listen very closely toe how this skin issue is behaving because a friend that they all behave a little bit differently. But there's a lot of correlation between how things were behaving a one kiddo versus another, and sometimes we can use those experiences from one to help the other one right. So I appreciate that you're asking them to be the detective because that's really all you can. D'oh! I mean, there's a way more that you can do. But at the end of the day, if someone isn't very personally aware, it's not really going to matter. Because if they're not personally wearing, can't personally see it and can't personally track it, then there's no amount that someone else can do to help them without that information.
spk_1: 40:47
Yeah, that's right. I agree.
spk_0: 40:49
So out wrap up here. But I work with the kids in exam, and it's such a more prevalent right than adults. What do you think that exam is so prevalent in Children?
spk_1: 40:57
Yeah, and Children. I think that there's a couple things that are involved in their Their immune systems are just starting to learn and come into their own. So the immune system is geared to be a bit reactive to things, and so that, unfortunately, is one of the things. Whereas your child, your immune system's probably just a little bit more in overdrive status, but the other factor is that you don't have the natural oils that are being produced on the skin. This a basis clan's heir relatively quiet Essen, and they're quieter. And then, as you get towards puberty, the hormones start to shift, and the homeland's probably trigger some of the natural oil glands. And who knows whatever else happens with hormonal shifts. But I think that as you hit towards puberty, you have different changes in the body, and I think that also shifts the way your skin barrier is functioning. And so I think that's why you have some differences and some people is they get to adulthood. It just presents its. You know, whatever was there before doesn't go away completely. It stays mild, and some people just stays severe. And that is an area that needs more research to understand wide, some Children get better. And why don't some people have their asthma go away as they get older? I think again goes to show with the diagnosis of a topic dermatitis. It's not just a one size fits all. We are like little different nuances to how the disease progresses on how the disease improves.
spk_0: 42:09
Since you also suffered with examine it, Did you have a family history of skin things or something related?
spk_1: 42:14
When it comes to things like no, Miller dermatitis are atopic dermatitis. Family history does play a role. I think that if your parents are your siblings have add eggs. MMA. I have a sibling who has, Ah, exam as well. If you have that in the background, you do have a higher risk of developing yourself. There's no question, and it just speaks to the fact that there's a genetic component. Obviously, it's not the only thing, but it's definitely there. And so it's an important part of the piece of any history that you're taking, what the patient is to understand if this is something that's prevalent in the family generally.
spk_0: 42:43
Okay, before we get into talking about Jeeva Factory, you know, as an integrative dermatologist, there's other practitioners that you work with a specific skin institute. What do you think kind of sets apart what you guys were doing versus maybe someone else's dermatology office? How are you looking at things a little bit differently in using like doing protocols and advising your clients differently?
spk_1: 43:03
Well, you know, I respect a lot of my colleagues in dermatology. They do some really tough work because people don't have good access in general. And so if you can get in to see a dermatologist for any skin issue, and let me just add hair and nails. Dermatologists are the expert at that, too. And so, if you have any hair issues or nail issues or skin issues, really should try to get to see a dermatologist if things aren't working out, regardless of whether they're integrative or not. I think the integrative approach, what that allows us to do is one thing it allows us to. And I can only speak from my experience. It's always hard for me to compare, because I don't know what other folks are doing now. I'm seeing that lot of people are starting to build in nutrition into their conversation. And I just have this internal. Yea, because you know, everybody is starting to talk about this. I think we do well is that we really listen to the patients and we start bringing in the psychological aspect and, well, sometimes delve into things that might not seem like dermatology. At first blush, like I was saying, like What's your home environment or what are the stresses in your life and just have a quick conversation around that, too, because we think it's really important for people there see that their visit for the skin isn't just gonna be about their skin and that there's more involved. And I think that in and of itself is a slight bit of a different approach than what I was taught in residency in residency. We really focused in on learning the skin stuff really well, and I can understand why, because you want to make sure you get diagnoses correct. You want to make sure you understand what the treatment protocols are, but we realize there's much more to a person that can affect their skin beyond just their skin or what they're putting on it. And so conversation around what supplements They're using conversations around what their diet is, conversations around what other general stress is. I think that is a little extra level of interest in them as a person. And so I think people see that when they come through and work with us.
spk_0: 44:40
So I mean, while you're not sleeping in a full night of sleep and you're very excited and you're trying to change the world, you've got a new project going on or it's gonna be kind of the umbrella for the other projects is called Jeeva factor. Usually tell us what that is and where people can find you. Yeah, Gina, factors
spk_1: 44:54
really born out of this idea that Jeeva means vitality when you look at it in Sanskrit and Jeeva factories. Just this idea that we can all reach our vitality if we think about it and working on it. And we all want to. We all want to be vital. And vitality means different things for different people. And for some people, it could be as simple as reading something inspiring and just thinking about Oh, how my living my life for how my organizing things or for other folks it can be What is my skin regimen that's working and focusing in on the ingredients and for other folks that might be What am I eating? So Jeeva factor really is this umbrella approach that we're taking that's gonna bridge together what we find in the research world with our studies, what we find in the clinic and what we learned from our patients and then building out a podcast. We're going to be creating a podcast called the Holistic Health Podcast, and it really is emerging of different folks We're bringing together people from naturopathic medicine, my background and ironic medicine and western medicine and folks that are really into the ingredients aestheticians. We're putting everybody together to bring together this platform so that you can come in learn, and the idea is eventually start thinking about, Hey, what is my skin type? And how can my skin type drive me towards better products for myself and better solutions, not just things that you buy, but how do you eat? How do you live? How do you exercise? Are there different kinds of yoga That's better for you? And eventually what would love to do is building out a situation where we have wellness retreats and we start thinking about not just skin but skin body mind. And we're putting all of that together because we know it all runs together. So why not try to create a coordinated platform that's gonna work on that? And so that'll be releasing in the next month. Jeeva factory dot com. That's J. I. Ve a factory dot com.
spk_0: 46:30
I love it and actually wanna plug your skin type quiz because it's fabulous. I don't know if it's gonna move over to Jeeva factor if it's in Jeeva factory is live, and we will be live by the time this episode publishes regardless. But the skin tight quiz, I believe, is on your practice website, which is, I think it's P S I derm dot com Is that without us?
spk_1: 46:48
That's right. We also developed the tool itself, and we wanted the tool to be agnostic from everything. We just wanted to be about the tulips. So it's called Germany the D E R M v E D H. Basically it's like dermatology, invaders, knowledge. So just knowledge of the skin. It's meant to just talk about skin types going there. You take a short quiz about and that gives you some ideas around the skin, body mind and then a lot about ingredients and what we're gonna do on there It's really cool is we're gonna have ah, product profiler so you can put a product in there and it can look at the ingredients and it can tell you Hey, this is a good fit with their skin type or not, and eventual. What we'd like to do is expand that to the nutritional space and say, Hey, is this nutritional product a good fit for what you want. Like if you're trying to help with getting enhanced sleep or if you're dealing with anxieties, what's the evidence say around this? And so we're building that platform that separate just so that we can offer it as a tool that could be helpful for you to learn more about yourself.
spk_0: 47:39
All right, love it. Thank you so much for being such a pioneer in this area. That's kind of frustrating area because it's, you know, affects our emotions and our vanity so much, and we want it to be gone immediately, and there has to be a learning curve. And you bring so much enthusiastic excitement to it that you make me really excited about the future and kind of changing the paradigm, so to speak, of how we're addressing skin and how we can address it more appropriately in individually. So I appreciate all the work you're doing, looking forward to following you and the new podcast Very excited. So jeeva factory dot com Anything else you wanna leave listeners with? Has it got reaction on something they can do today toe improve their overall health status or their skin.
spk_1: 48:15
Yeah, I love that pun intended, right? The gut reaction. Yeah. So But I was just going to say thank you so much. No, I think it's just realized that anyone organ isn't driven by just that organ is driven by us as holistic people and our thoughts and what we do also play into it. So, yeah, we're looking forward to seeing how we can change the conversation around health by taking a holistic approach.
spk_0: 48:36
I love it. All right. Thanks so much. Thank you. One of the best gift you could give us at the less stress life is your feedback. We are paid in podcast reviews. If you enjoy this or any other episode, please leave us a review in the iTunes store or from your podcast app. Just search for less dressed life as if you're not already subscribed. Click on the banana face image scroll to the bottom where it shows the text of other reviews and write a review while you're there. Hey, make sure you hit. Subscribe for android or stitcher users. You gotta go to the desktop site and search for less dress life and then scroll down to leave a review. Stitcher doesn't load Apple reviews on their site. So if you want, you can leave a review in both places. Your feedback means a lot to the success of the show. Thanks so much for taking the time to do that, you rock.