Skin is Health’s Magic Mirror: Meet Dr. Trevor Cates | Big Bold Health Podcast Ep 17

Hello and welcome back to the Big Bold Health podcast. We are making health personal. In this series, we are talking to female physicians, female health leaders, who are charting our journey from a disease based system to a health based system and all that entails. Super excited to have here Dr. Trevor Cates here with us. She is not only a naturopathic doctor, but a leader in the space of skin health. And, you know, it's interesting, Jeff and I were looking through all the answers that people put on Big Bold Health is what does health mean to them? And we've got quite a few that were talking about skin. And so I know that this is a really important thing to a lot of people. So one of the things I wanted to ask you, I think it's become more and more clear for anyone in our field, and probably further afield, that skin health is a function of overall health. And I would love just to dive in from your perspective as to how that works and what is the range of things that you're working with when.

You'Re working with people in these areas.

Yeah, I like to call skin our magic mirror that gives us great clues about our overall health. And it's our largest organ. It's right on the surface of our body. So it's this amazing tool that we have that gives us information about our health. But. But so often it's ignored or covered up. The typical approach to skin is often to use a more suppressive approach. Conventional dermatology, suppress the symptom, cover it up, or for women, wear makeup. What are the tricks of wearing makeup? To cover up the different blemishes. But actually, skin is giving us information about what's behind it, the root causes behind it. And when we ignore it, we miss an opportunity. And we also sometimes don't delay health issues, I mean, or actually prolong health issues rather than fix them right in the beginning.

Yeah.

So give us a couple of examples of like, you know, you're probably diagnosing everyone when you walk through an airport, but, like, what are some things that maybe most people wouldn't know that you would see and say, hey, you might want to think of this just based on your experience of pattern recognition and.

Treating these kind of issues for what, decade or more?

Yeah. And so let me back up for a second and kind of explain why I really wanted to focus on this because I have my own personal journey with it, and I really experienced as a child how much skin can play a role in our lives. I struggled with health challenges and skin issues as a child. I Had allergies that showed a lot up a lot as eczema and hives and little bumps that would appear on my skin. And I remember really well how much was not only tough physically, the itching and the sensations that I would feel, but also how embarrassing it was as a child to have, especially when it's on your face. So over the years, when I talk to patients and they tell me about their skin, I think people that don't have skin issues oftentimes think, oh, it's just skin. It's really not that big of a deal. But anybody that has a chronic skin issue knows how debilitating it can be and how it can impact you on so many different levels. And so I think it's really important. And I know that when I was working in spas and I was doing a two week weight loss program in the Waldorf Astoria, and people would do the two week weight loss program, at the end of it, they would say, Dr. K, it's amazing. I've lost all this weight. But what surprises me is my skin. I didn't know it could look this good. And what I realized is that so many people weren't thinking of skin in this way, of it being an outer image of health, and that it's also an opportunity. When you look at it, it can give you really great information about what's going on underneath it. And that's why I wrote. Ended up writing my book, Clean Skin from Within. Because of my experience, why I even got into this field of medicine. What led me here was my skin. And I knew early on, and I realized it's a message that needs to get out to more people.

Yeah, absolutely.

Jeff, I know this is not something that's banging our wheelhouse, but probably I know you're super passionate about finding easy ways to understand the body more clearly, and so this must right up there.

No, I. When I first met Dr. Cates here a couple of years ago and, you know, immediately was inspired to her message. Obviously, first of all, she's a great example of what she's teaching, but secondly, she really communicates this model so elegantly. And I said, you know, this is an individual who really can help teach people about something that's actually quite complex. If you really study skin and subdermal physiology, it gets pretty weighty and there's all sorts of things going on. Matrix, metalloproteinases, and all these things that cause inflammation. Inflammation and things that we who love the biochemical piece parts really get into. But for the person who Suffers from a skin problem. It's just so simple. As Dr. Cates was saying, I can see it every day. I can't hide it easily. And it's not like something I can just put my clothes on. If it's on my face or hands or arms, it may mean something that's going to travel with me. Which in some ways is a reminder, isn't it? It's a warning sign, which is what you've used so effectively to. It's like a behavior modification tool, because that person can see how effective their program is in doing something that's beneficial. So I think you've harnessed it so beautifully.

Thank you. And it really is oftentimes the first sign that something's out of balance. Like, for example, hypothyroidism. It's oftentimes one of the first signs of hypothyroidism, low thyroid function is dry skin. And so people will sometimes be putting on more moisturizer and trying to do things topically rather than, why is my skin dry? When you combine those with, of course, the other symptoms related to that, then you can see what that is. And I think that oftentimes people will have a skin issue, cover it up, just kind of ignore it, and then realize they've got some other big health issue going on.

Yeah, it's interesting because it's actually a similar process to things inside the body.

Right.

The suppressive strategies. But ultimately, I think with skin, there's just. Is there a different incentive to deal with it? Because it's so face forward. It's kind of like a function. Your personality is very tied up into it. What are the incentives to fix your skin problems that don't exist in internal medicine?

Right. Well, I mean, certainly it's the first thing that people see when they meet you. Or a lot of times with doctors, especially more functional medicine or natural doctors. We're going to look at the skin is one of the first things that we see as soon as you walk in. And so certainly it does motivate a lot of people. I think that's one of the reasons why I wanted to focus on that, because it was a way to kind of open the door for people. They come in and say, Dr. Case, what product should I use for my skin? I'm at the spa. What should I use? And I'm like, no, we need to get to the root cause first. And then we could talk about what skincare products you should be using.

So let me jump in here because I think there's a. I Know that you probably use this in languaging to some of your patients. The two major companies that are selling the fastest growing medications right now, which are the immune suppressive drugs, Humira and Enbrel. These are what are called TNF alpha blocking drugs. They block inflammation at a core level and then they create other problems because they so suppress the immune system that you get up against the infections. At first, these started off as drugs that were approved by the Food and Drug Administration to treat arthritis or forms of. More recently, however, the drug companies being smarter said, well, what other conditions are associated with the same kind of inflammation we have in my. So we could get other kinds of indications and sell it to other people through other specialties like dermatology. So now we see these drugs, Humira and enroll being repositioned with clinical trials for eczema and psoriasis. Right. So now we say, well, hold on, I thought that was an arthritis drug. And now you're saying it's a skin drug. So it's a beautiful example of what you're talking about, that it really starts inside.

Yeah. And so oftentimes what I was seeing in my practice was I would get these patients later in their lives, but they would give me this history of when I was a baby, when I was a child, I had eczema, I was given topical steroids, I was given these things to suppress it. Right. Suppressing it, then that wasn't as much of an issue. And then I got older and I got asthma, and then I started using an inhaler. And so then I got through that period of my life and now I have an autoimmune disease because they never addressed the issues with the immune system at an early age. And the inflammation that was going on internally. And if people can get that early on, when the skin is oftentimes that early sign of that, they can prevent a much tougher health conditions.

So that I think you just stated so elegantly why we call this the big bold health podcast. What we want people to understand is that we don't need to be apologists about asking questions about health. There's a lot of us that feel when we go to the doctor, we only want to ask questions about disease because that doctor is skilled in the art of disease. They may not be so skilled in the art of health. The things that you're talking about are preemptive of disease that really are the root causes for dysfunction that we call ill health. So what you are really doing, I think, is championing why we think big and Bold about our health is so important. We want people to be more assertive. We want them to not be apologists about saying, okay, I know you can cover it over, but where did it come from and what can I do about it? And I'm prepared to take those steps, but I need the tools and I need the explanation. And that's what you've done so beautifully, not just with your patients, with your writing and your podcast and so forth. So you feel this is spreading? Is the message getting across? Are you seeing receptivity?

I am seeing changes in dermatology, in the dermatology world. And I think part of what's happening is there is information coming out, some research coming out about the skin microbiome that's really showing a lot of what we've been doing has not been really working. And all these antibiotics that have been used for many, many years, both topically and internally for dermatologic conditions, have created dysbiosis issues, not only in the gut, but. But also for the skin. The skin microbiome. You probably talk a lot about the gut microbiome, and people know about the diversity that we want in the gut, but the skin has its own group of bacteria, viruses and fungi, all kinds of things that live on it. And it has this balance that it needs to be healthy. And so what we've been doing with all the antibiotic use has disrupted that. And now we've created something a lot of people are experiencing leaky skin, kind of like leaky gut that people have talked about. And so, so many of these, eczema, especially atopic dermatitis, these inflammatory skin issues, we've damaged the barrier function that the skin has. So our skin works like this barrier to the outside world. That's one of the biggest functions that it has. But with all we've been doing to it, it has actually broken down that barrier. So. So now it can't function the same way. And it's totally, completely inflamed. It doesn't have the right balance of microorganisms. And I've heard at some of these more integrative dermatology types of conferences, I've heard this. People talking about this. This conversation is starting to happen. Okay, we've kind of done things maybe not the best way. What else can we do to support the body and support skin?

Fantastic.

Yeah.

So I know there is a controversial area that many people are now grappling with as it relates to skin health, and that's sun protection and sun damage, that kind of balance and People are now hearing that these SPF containing sun creams get absorbed and that maybe that's not so safe either. So how do you counsel people in.

The light of kills coral reefs too? Right? You read that, you're like, well, if it's killing coral reefs, do I really.

Want to have it on me?

So what's the balance there?

Yeah. And it is. Here we are trying to do a good thing. And usually medicine is, and developments and technology and products. We're usually starting with a concept of wanting to do a good thing. We're trying to protect the skin from sun damage, from premature aging, from skin cancer. But with all of the chemical sunscreens, the problem is that. Well, for one of the. There are actually a number of reasons why sunscreens could be a problem, but one of the big ones is that they have endocrine disrupting chemicals. And many of the ingredients, like oxybenzone is one that's in a lot of chemical sunscreens. And so we exposed to so many of these endocrine disrupting chemicals, these hormone disrupting chemicals in the environment and our air and our water and our food. And now, you know, also in our personal care products, including sunscreen. So here we are trying to do a good thing in exposing ourselves to these hormone destruction chemicals that will actually bind to hormone receptors, mimic them or change the way that they function. So that can lead to. We're seeing the changes, and I'm sure you all talk about the changes that we're seeing in certain diseases and these hormone related diseases. We're seeing more of these thyroid disease, certain types of breast and prostate cancer and infertility, these kinds of things. So we look at sunscreen, the last thing you want to do is try and you're doing a good thing you're doing is add more hormone disrupting chemicals into the mix of it all. So I think there's that. And then what else, what else are we. Because the products don't just sit on the skin, they get absorbed. We don't absorb them like we do if we ingest them. But we do absorb a lot of the ingredients that we put on our skin. So what else, what else are we doing? And all of the ingredients, if you look at the label of your sunscreen, what is in there? Do you want that in your body? And so what I usually tell people is to, when we look at sun protection, I think it is still important to protect our skin from the sun to a certain extent. Of course, we've got benefits from vitamin D from sun exposure, we need that for a healthy immune system. We also know that getting outdoors in the sunshine feels good and increases endorphins. There are a lot of health benefits to it. So of course I'm not going to tell people, stay out of the sun. Hey, I live in Park City, Utah. I bike and I ski and I run. I enjoy the outdoors. I'm not going to stay out of the sun entirely. But there are things that we can do. Trying to stay in the shade as much as possible, especially during the middle of the day when the sun rays are the strongest. Wearing hats and protective clothing I think could be some of the best things. And then when you're looking at using sunblocks, look for one that is a zinc oxide based sunblock with a tint because the tint also adds some extra protection. So zinc oxide seems to be the safest of all of the different options that I've seen. And also I think we need to try and stay away from the sprays and powders because I'm concerned about when we inhale these substances, especially if they're nano sized, that means they're really, really tiny particles. I'm concerned about when we breathe those in, getting attracted in the lungs.

Well, this is what big bold health is all about. They're giving us big, bold ideas to protect ourselves. And I think that, you know, life is all about balance, isn't it? I think that's what we're learning and so asking the right questions so we can find the right balance as we're moving forward on our own trajectory. Each person has their own aspiration of health. That's what we're trying to validate in big bold health is you want to be healthy. What is your definition of health? And then let's give you the tools that you can achieve it. Let's not give somebody else's recipe, let's give you the tools that you need. So I think you've really shared some extraordinary insight for us. And I know, James, as you're raising your daughter now, you're going to be confronted in the Sacramento Valley with a lot of sun and what you're going to be doing.

A lot of sun.

Yeah.

No, I mean, it's already. I can see, you know, what she learns from mom and you know, what we're helping there. But I'm super glad all the way through this journey, being a parent, being in this industry for the last 15 years, having access to the brightest minds. What's really interesting is a lot of the stuff that when I First moved to America in 2005 was like things that were only talked about in like a very small number of people at these like small medical conventions. Like, oh, you know, there might be a downside to wearing sunscreen. Like it was just something that I wouldn't talk about to other people. I didn't know because it was just so out there. Everyone's talking about it now and there's been such a, you know, a shift in the last 15 years for people to really think, what am I putting on my skin? Where is it going? What is the like effect on the ecosystem? All these things, what are these ingredients that I don't know what they. So I think they're just the level of consciousness about these kind of things is only going in under.

Pretty exciting. Yeah. I think Dr. Cates, you've done a really great job of helping us to understand how we fit into the system. Right. Human beings are part, as you say, the sun. It's part of a good part of our life. But it's finding the right balance and the right things to do to manage your own individual. Like some people are much more fair skinned and much more susceptible. They don't pan as quickly. Their melanin doesn't provide the protection. So they have to personalize their own approach. You can't use a formulaic approach. And, and I think you've really helped open up the skin as a boundary as to how we might start taking charge of our own health. So thanks so much.

Absolutely. And I know you mentioned with your daughter, she's going to start be interested in personal care products and skin care products. If you think about how many skincare products we all use, especially girls and women, we use so many different ones. And according to the environmental working group, we use an average of 12 personal care products across men and women. That's an average. Women typically use more than that. And that exposes us to 126 unique ingredients. And the problem is, is that there's not a lot of regulation, especially in the United States around the personal care product ingredients. In Europe they've banned over a thousand ingredients. In the US I think it's like 12 ingredients that have been banned now by the FDA. So it's really up to the consumer to become educated and to be aware of what's going into these personal care products. Really think about it. It's for girls, makeup, makeup also. But there's deodorant, shampoo, conditioner. They've got all the different personal care products you use. And we're getting exposed to these endocrine disrupting chemicals in this form, partly from the skin and partly we're breathing it in things that we spray in the air, powders and different things that we're using.

And we're dealing with what, three generations at least, transgenerational epigenetics. Right. Of like grandma's special spray that she.

Used to keep the mosquitoes off.

It was like unbelievably.

Oh, yes. And then methyl diethyl toluamide. Yes. Really bad stuff. And maybe some ddt.

And people look at ingredient labels and they don't know what it is because it's, you know, dmdm, hydantoin. Did you know that that's a formaldehyde releaser? Most people don't know that. And it's in most lotions. So when you put something with these formaldehyde releasers onto your skin, it releases formaldehyde into the air. And we know that how toxic formaldehyde is, it's a carcinogenic ingredient. And so these ingredients are releasing formaldehyde, but they don't have to put formaldehyde on the label because it's not actually formaldehyde. It just releases formaldehyde when you rub it in. So it's so hard for the public to really know, but luckily there are tools and resources to be empowered.

Well, I know your writing really helps to do a great job of bringing that more to the attention of the consumer. So we are fully behind Dr. Trevor Cates and the big bowl health skin approach. So thank you. Absolutely.

Well, look, it's been a great episode. I hope that if skin is important to you that you've learned something here. Definitely. Follow Dr. Cates. Check out her book, Clean Skin from Within. Trevor, thanks so much for being here and being part of this big bold health journey. And if you're watching this at home, please, please go to Big Bold Health. Tell us what health means to you. We are creating these episodes on the back of all the things that you're telling us health means to you. And this personal view of health is moving forward very quickly. So I've been here with my co host, Dr. Jeffrey Bland, Dr. Trevor Cates. This has been the Big Bold Health podcast. See you next time.