The Gift of Real Talk: Is Vitamin C Overrated? "Anec-data" and the Truth About $400 Luxury Serums With Dermatologist Dr. Aegean Chan

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0:08Welcome to Breaking Beauty, the podcast all about the breakthrough people, products, and moments in beauty. We're your hosts, Jill Dunn and Carlene Higgins.

0:21Hello, everyone. Welcome back to Breaking Beauty podcast. I'm one of your co-hosts, Jill Dunn, and I'm here alongside Carlene Higgins. And happy holidays to everyone listening. Hey, Carleen. Hi, happy holidays to everyone and spreading the love to all of you. And we're two longtime beauty editors turned beauty podcasters. I'm proud to say we've been in your feeds every single Wednesday. It's so fun to see the Spotify wrap ups that we've seen. And you know, we are 1 % listeners or 2%. We love that. We are sharing the breakthrough people, products and moments in beauty. And this week is no different.

0:59That's right. And we love Apple Podcasts, too. I don't know why they don't do Apple Podcasts wrapped. Like, they really need to come out with something cool. It's true. Make it fun and shareable. And the thing is, most of our listeners listen on Apple Podcasts. So we love you, too. We're here for you. We wish that the software could catch up. We love our YouTubers, too. We're growing on YouTube, everyone. So follow us on there and hit subscribe and you can watch us. Heck yeah, because there's no weeks off around here and we love sharing content all about beauty. And we even had a few bonus episodes this year.

1:33So there's lots in our archive for y 'all to comb through if you're so inclined, either in your podcast app or YouTube. And this week, we hope that you are enjoying holiday family time. But I've been there. You need to sometimes get out for the hot girl holiday walk or sometimes you just need to go for a drive by yourself and listen to a beauty podcast. We're here for you. That's right. And this week, we're happy to welcome a derm that many of you may follow on social media, and that's Dr. Aegean Chan. So Dr. Chan, she has a really unique skill set. She's a double board certified dermatologist and dermatopathologist.

2:12You heard me right. And as such, Dr. Chan is dedicated to bridging the gap between medical dermatology and everyday skincare. hair. Dr. Chan's clinical expertise spans complex medical dermatology, skin cancer, acne, and cutaneous infectious diseases. She's authored numerous peer-reviewed publications on topics including the skin barrier, congenital skin diseases, and electron microscopy. Yeah, she's a skin nerd of all the skin nerds, I would say. She also serves as the medical director of California Dermatology Group in Santa Barbara, California. And she's an adjunct professor in the Department of Dermatology at the Keck School of Medicine at the University of Southern California.

2:56So she's doing the most at all times. And she's a busy mom of three. She was just back from her maternity leave, from her third baby when we sat down for this conversation. So we really appreciate her time. In this week's episode, we're getting a little nerdy with Dr. Chan. We're going to be chatting about her skin barrier research. She's also going to deliver a truth bomb about why she thinks vitamin C is overrated, which I have personally felt for a long time. I felt so seen. Yes, you did. You guys were bonding. It was pretty much, I was sitting in the middle and I was like, there's going to be a high five here, you know, at a certain point.

3:32So she explains all of that reasoning. Plus we get her input about some trending topics in aesthetics and dermatology, like what she makes of transdermal patches for skincare. I think we're going to be hearing more about that in the year ahead. And we also get her take on if we should be rethinking some of these trending in-office procedures like Morpheus 8 per the FDA guidelines. And stay tuned to the end where we play a fun round of De-Influence Me Dermatologist Edition, where she debunks everything from$400 serums to spicules. In your skincare. That's right. So welcome, Dr. Ajin Chan.

4:16Welcome to Breaking Beauty Podcast, Dr. Ajin Chan. It's wonderful that you're joining us. We have to ask you, first of all, you are a dual board certified dermatologist and dermatopathologist, which is a very unique position to be in and definitely a first for our show. I'm so honored. So first question for you, what exactly is a dermatopathologist? And how does that influence the types of, you know, what exactly do you do? I need to know everything. All right. So have you ever been to a dermatologist where they've biopsied a lump or bump or maybe a rash? Not me personally. Not me. Probably me.

4:57I think so. I think I got a little something sliced off a time. So they're taking that little piece of skin. And they're putting it in a bottle and it goes to the quote unquote lab. So when it gets to the lab, it actually gets embedded in a little piece of wax. So you get a little block of wax and that actually gets sliced almost like a piece of bread. And one of those really thin little slices gets mounted on a slide and it gets stained. And then that slide gets put on my desk and that's where I come in. So I put that slide under the microscope and that's when I can see on a microscopic level what's happening in the skin.

5:33So if it's a mole, whether those cells look happy and benign, or if it's cancerous, make a diagnosis, write it in a report, and that would go to the dermatologist. And that would help inform, you know, next steps for treatment. What's really interesting about it is that it is kind of like an art. So especially when we're dealing with rashes. So we're looking at the types of cells there are, what level of the skin they're at, and that can help us put the picture together for your dermatologist. Okay. Well, since you have this very unique dual perspective, what do you think is one of the sneakiest things on a cellular level that accelerates our skin aging?

6:15I feel like that's kind of a tricky question for me to answer because, I mean, I am a bread and butter dermatologist. And I feel like with all the social media and I think dermatology gets misrepresented. There's no big secret. We're not gatekeeping. Right. There's no big secret. Most of it is really knowledge that we know and common sense. So, I mean, I would say UV damage. Right. is still, in my mind, the number one driver of skin aging, particularly of aesthetic concerns. But I will say coming from the dermatopathology lens, I know what sun damaged skin looks like. So under the microscope, you have the top layer of the skin, the epidermis.

7:01We're going into a little science lesson now. And then the deeper layers, the dermis. So that's where the blood vessels are. That's where all the collagen, elastic fibers, all of the hyaluronic acid that our body produces. It lives there. Over time, chronic sun exposure actually makes that collagen and those elastic fibers degrade. So you get this change that we call solar elastosis. That's sort of, I call it mushy collagen and it's just this amorphous purple stuff. And so when you're thinking about products and thinking about claims, I always have that image in my mind. I'm like, could this cream actually alter this chronic change from UV damage over 50 years?

7:45Yeah. And so that's sort of my, yeah. And the answer is probably not. A little too good to be true. Maybe. Maybe. You can pass a point of no return, I suppose. Well, I think you can always like not reverse sun damage, but you can prevent future, right? Well, prevention is much more effective. Yeah. Reverse. Definitely. Definitely. Let's talk about barrier repair and skin barrier. These have become buzzwords at this point in the beauty industry, but you've actually published research on the skin barrier. So what's the nerdiest or coolest thing that you've learned about the skin barrier that perhaps only someone looking at it through a microscope might know?

8:26the skin barrier is amazing. It is this really dynamic organ. And I actually, in my research, did electron microscopy. So really getting to this actual, the cellular level of looking at the skin and the epidermis. And I think that before skin barrier health became a trend, which I love, especially in like the 2000s, it was like, you got to scrub your skin to get it to look nice. You know, you do the proactive, you do the St. Ives. And it's sort of based on this idea that the top layer of your skin is inert. It's like a kitchen counter. You just got to scrub it clean and you'll have clear skin.

9:06But I think what people still probably don't understand is really how complex on a microscopic level the skin barrier is. So when we talk about the skin barrier, usually we're talking about the outermost layer, the stratum corneum. So that is made up of stacked up dead skin cells, so dead keratinocytes. But between those keratinocytes is what we call the lipid bilayer. So that's where, you know, your ceramides, your cholesterols come in. And then within that, there's all these little proteins like filaggrin and they signal to each other and they're really good at repairing themselves. You know, I feel like the discourse around beauty is that you have to do these things to get your skin to look a certain way.

9:46And I always like to say, give your skin credit. It's evolved over millennia to really function pretty well on its own. And so I just, I think that the dynamic nature of the skin barrier I think is underappreciated. It's, yeah, it's very cool. Yeah. I love how a lot of people think about their skin barrier only from the neck up and they're just like, and then like never moisturize their body. Guilty as charged. Let's see those elbows. Yeah, it's an organ, guys. Make sure it's all hydrated. Yeah. And as consumers, like, I feel like there's just so many products out there and we often are looking for products that target a specific perceived problem, acne, wrinkles, dark spots.

10:30So why is maintaining a healthy skin barrier as important to target from your perspective? Like if you're out there shopping and you're like, I only care about acne, why should you also care about skin barrier? So the skin barrier, that's like the foundation of your house. You want that to be healthy and sturdy and robust because all the treatments for these particular concerns, acne, hyperpigmentation, et cetera, they typically can be irritating to the skin. So if you can't tolerate those treatments, often you're affecting your skin barrier when you're putting those treatments on. So if you want to be able to maximize how much medication you can get on your skin, you want to have that healthy skin barrier first.

11:13And so particularly with acne, people are disrupting their skin barrier left and right. And I tell my patients that come in, they're doing 10 things, you know, they're scrubbing their skin. And I say, just stop all of that. Don't worry about your acne. Just do a week of essentially a detox. Just do gentle skincare, give it some TLC, do a hydrating cleanser, moisturize. And a lot of times they'll come back and say, that actually got rid of a lot of my acne. Because you can get reactive acne if you're drying your skin out too much, you get that excess oil production that can lead to more acne breakouts.

11:51So I find that if you think about your barrier first, get it healthy, you feel like your skin is supple, not feeling too tight, not too dry, then you can start slowly introducing those active ingredients in. PH, let's talk about that because I think that is often what happens as well during skin barrier upheaval. So like what in your research, what does, does pH count for that much? Like, are we being misled or what? So I, yes, pH is a factor in that skin barrier balance. I do think it's become something that people become overly concerned about. Okay. So I think, yes, I think biologically it is relevant, but in terms of it being clinically relevant, I don't necessarily think that the everyday consumer necessarily needs to, you know, do a weekend course on skin pH and how to manage it.

12:47I do think that, you know, well-formulated products, they do take into account the pH and aren't disrupting the skin barrier with that. Okay. Except for vitamin C. Except for vitamin C. Honestly, I cannot. And I think it's like from my understanding, it's allosorbic acid specifically, that one. but that one I feel like just throws my pH so far out of whack and my skin is like irritated for a week after. So yeah. So I don't use it. And every germ will say vitamin C essential in your routine. Do you want my thoughts on that? Yes, I do. I do. You're the woman. And I think, you know, what you said was really great because I think, you know, you're thinking about pH, but it's really just about how your skin feels.

13:32And so that's, you of where I sort of focus my education on is really helping people feel confident in assessing your own skin. You don't need someone to tell you what's good for your skin. Because if you actually just stop and sort of ignore what's being fed to you in your feeds, you have a pretty good sense, an intuitive sense of what works for your skin, what doesn't, what makes your skin feel good and look its best. You know, it's so individual. And so I think it can get really stressful and confusing for people if they're trying to incorporate too much. And then, you know, in terms of vitamin C, I honestly think it's overrated.

14:10For me as a dermatologist and as a regular person and a mom, we're all busy. We all have so much going on in our days. So for me, vitamin C is sort of a second tier. Okay. You heard it here. My jaw is on the floor. I think, you know, and I think a lot of people are scared. I think a lot of dermatologists are sort of scared to say that, but focus on your skin barrier. So make sure you have a really good, consistent routine with your cleanser, your moisturizer, your sunscreen. If you have got that, you're like, okay, I can do this with my eyes closed or hung over, you know, great. and then add on your retinoid.

14:56And if you have that and you don't have to think about it and it's really rote and your skin is tolerating well, great. I always tell people, I love AHAs. I feel like that gives you the best bang for your buck. I think it really addresses a lot of aesthetic concerns, you know, acne, hyperpigmentation, texture. So there's something like lactic acid or glycolic. You know, get that in your routine. And then if you have that dialed in and you're feeling good and you're feeling confident, then you maybe add in a vitamin C. But I think a lot of people, because of all the hype around vitamin C, they're like, that's the one thing that I should be using.

15:32When I think the other sort of more tried and true old school, not as glamorous ingredients don't get incorporated into people's routines. And I think that's a missed opportunity. Yeah. I do feel as though we're hearing about it less than we were like three years ago. Well, it popped off, I think. And then it sort of tapered off. Yeah, for sure. But dermatologists will still say, aside from you, maybe, that, you know, it's about sunscreen, retinoid and vitamin C and a moisturizer, obviously, but like, period, that's, that's it. I mean, I don't, I'm currently not using a vitamin C. Yeah, me neither.

16:09It's just one of those things that falls off because I don't see that immediate benefit. Yes, I think there's a lot of great research. I think it is a great antioxidant. So if you're maybe living in an urban place where there's a lot of pollution, you're in the sun a lot, I think over time it probably has some cumulative benefits. But I think we're all people that want to put our efforts into things where you can see visible results. And so often I tell people, great, if you want to try this XYZ product, try one bottle. You know, and if by the end of it you notice no difference in your skin. Yeah.

16:45and you feel like you want to put your efforts towards other things, then, you know, I think that's information. I think that's okay. Yeah.

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19:15Now back to the show. Have you ever looked in the mirror and not recognized yourself? Me too. Hi, I'm Caroline Baudino from Instagram Shop with Caroline and host of Coming In Hot. This tough New Yorker who swore she would never depend on a man lives to wear all her jewels and look fabulous, let everyone else's expectations of being a mom, a wife, a daughter to Cuban parents take priority. I finally put my oxygen mask on first and took the biggest bet of my life. Join me every Monday on Coming In Hot to deep dive on finding your own happy tools and living your best life too. Yes, we can.

20:04I also wanted to ask you while we're on the skin barrier topic about just the microbiome and like how that played into your research, if it did at all on the skin barrier. Yes, I did look at that. I think the microbiome, again, I think there's still so much we don't know. It's really complex. And I think it's still hard to say, you know, how alterations in the skin microbiome can necessarily lead to actionable treatment. So we know it's there. We know it plays a big role in skin health. But I think when it's being marketed, when things are being marketed towards improving your skin microbiome, I think it's hard to say whether or not those things necessarily are musts.

20:49Yeah. So again, I always say, go back to basics, like get your routine down, get those tried and true ingredients down. And then maybe you add in some things and maybe that's the thing for you that helps you with your breakouts. You know, again, I'm not against anecdata. Sure. But I think... What's anecdata? Anecdata. What's that? It's really when people use anecdotes as data. Okay. Got it. So it's that, oh, my friend used this and she said it was amazing, which I think is like all of TikTok. Right. Of course. And so I call that anecdata. And I think, you know, it's not what I would use. Like I wouldn't use that in a patient setting to be like, I recommend this, this, and this for you.

21:30But you know, if your friend said, oh, this is a great product. I really loved it. That's great. Try it for yourself. And I would say like a lot of the time people say, oh, it did nothing for me. You know, because everybody's, it's so different. And I don't think it's just statistically significant enough for me. That's why I don't really talk about products on my platform. Yes. Because I just sort of want to keep it more open-ended. Yeah. Yeah. And you can make your own decision. I do think that whole microbiome conversation is really just a spinoff because of the wellness trend of talking about gut health and gut microbiome.

22:04And that is, we know is so powerful to our overall health. And I think you're exactly right. We know that the microbiome is powerful on our skin, but we just don't know enough yet. And it's sort of like treating it. You said supplement. Yeah. Discussion. Right. Like we don't necessarily have enough data to say that these are things that are for sure beneficial for you. Okay. Well, this is really, I think, what gets at the heart of so many, so many skincare products is there's this idea that what's good for us internally. If we apply it topically, it must be good too. And we've seen that take off in so many different types of products, whether it's turmeric or honey, like there's a gazillion products that have come out like that.

22:51But it really comes down to, and I think you're the perfect person to talk to about this, is how much it's penetrating the skin barrier and actually doing anything. And I think this is also partially what's confounding about the skincare industry in general is that you'll hear experts, some experts who will say, well, molecules in general are too large to penetrate the skin. So for example, it won't enter the bloodstream. But then we heard that for years, but then there was sunscreen information that came out that said, well, actually it does, like nanoparticles do enter the bloodstream, but they don't, we don't know that it causes it.

23:36There's no data that says it causes harm. And you can correct me if I'm wrong. So I find that confusing is that sometimes the story is that it's these tiny molecules are penetrating and doing something. And sometimes they're not, don't worry about it. It's only working on the surface level of your skin. So it's really dependent on the molecule itself. And so, you know, again, going back to the microscopic molecular level, the skin, it really is like I like to use the analogy of a brick wall. When the skin barrier is intact, its primary function is to keep things out of the body and to keep things inside the body inside that, you know, all your water content does not evaporate out.

24:18And it generally does that. So, you know, when you see those things where they sort of compare skin to mesh, you know, where whatever you put on the skin automatically goes into your bloodstream, That is not the case. But again, depending on the size, there is that selective permeation. And that's where those organic filters have been found in the bloodstream is just through that process. Things can either go around the skin cells or pass through the skin cells. And it really depends on its chemical properties and its size as well. And so it's really hard to say, And I really like to look to data.

25:00Yeah. Is there any particular ingredient you wouldn't use because it does enter the bloodstream? I don't because I do think that there's a lot of public health data. There's a lot of, you know, there aren't any signals. We've had these filters, the organic filters for decades, and there are no human safety signals that have come up. I think she means are there any ingredients that you would avoid on a label, period, because you'd be concerned that it might enter the bloodstream? No, but this does come up and you've probably seen since I've become a mother. I think the question of using things during pregnancy and breastfeeding, that's a pretty fraught time.

25:40I think, you know, obviously you want to prioritize the safety of your fetus or your infant. But I do think there's a lot of incorrect information out there that actually deprives women of things that could potentially help boost their mood and help themselves feel better. So I've done a lot of sort of myth busting around the idea of using retinoids during breastfeeding. So I think that there are a lot of articles that sort of just take the recommendations from pregnancy and put that into breastfeeding. But as we know, they're two different, totally different biologic states, right? So retinoids can, they do get absorbed into the system, albeit in really small amounts, especially if you're just putting it on your face.