Dr. Teo Soleymani: How to Improve & Protect Your Skin Health & Appearance
Andrew Huberman:
安德鲁·休伯曼：
Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.
欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.
我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。
My guest today is Dr. Teo Soleymani.
今天我的嘉宾是 Teo Soleymani 博士。
Dr. Teo Soleymani is a double board-certified dermatologist and dermatologic surgeon.
Teo Soleymani 医生是一位获得双重认证的皮肤科医生和皮肤外科医生。
He did his training at Stanford University, and he was a clinical professor of dermatology and dermatologic surgery at UCLA.
他在斯坦福大学接受培训，并担任加州大学洛杉矶分校皮肤病学和皮肤外科临床教授。
That is the University of California, Los Angeles.
那就是加州大学洛杉矶分校。
Today, we discuss all things related to skin appearance, skin health, and skin longevity.
今天，我们讨论与皮肤外观、皮肤健康和皮肤寿命有关的所有事情。
For instance, we discuss sun exposure and the impact it can have on both the appearance and health of one's skin.
例如，我们讨论阳光照射及其对皮肤外观和健康的影响。
In reference to that, we discuss sunscreens, which ones are safe, which ones perhaps elicit a bit more concern or perhaps should be avoided, and we discuss the surprising relationship between sun exposure and skin cancer.
就此而言，我们讨论了防晒霜，哪些是安全的，哪些可能会引起更多关注或者应该避免，并且我们讨论了阳光照射与皮肤癌之间令人惊讶的关系。
We discuss laser treatments for the skin, both for the appearance of skin in order to make it appear more youthful, as well as to prevent certain forms of skin cancer.
我们讨论皮肤激光治疗，既可以改善皮肤外观，使其看起来更年轻，也可以预防某些形式的皮肤癌。
We discuss retinoids, we discuss supplements and nutrition, all in reference, again, to skin health and appearance.
我们讨论类维生素A，我们讨论补充剂和营养，所有这些都再次涉及皮肤健康和外观。
Thanks to Dr. Soleymani's incredible depth of expertise, as well as clarity of communication about the do's and do not's that relate to skincare and appearance and to avoiding and treating skin cancers, by the end of today's episode, you will be armed with an immense amount of knowledge that is the very latest in our understanding of how to improve and protect your skin.
感谢 Soleymani 博士令人难以置信的专业知识深度，以及对与皮肤护理和外观以及避免和治疗皮肤癌相关的注意事项的清晰沟通，在今天的节目结束时，您将掌握大量知识，这些知识是我们对如何改善和保护皮肤的最新了解。
Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.
在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。
It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.
然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。
In keeping with that theme, I'd like to thank the sponsors of today's podcast.
为了与这个主题保持一致，我要感谢今天播客的赞助商。
Our first sponsor is Roka.
我们的第一个赞助商是 Roka。
Roka makes eyeglasses and sunglasses that are the absolute highest quality.
Roka 生产的眼镜和太阳镜绝对是最高品质的。
I've spent a lifetime working on the biology of the visual system, and I can tell you that your visual system has to contend with an enormous number of different challenges in order for you to be able to see clearly from moment to moment.
我花了一生的时间研究视觉系统的生物学，我可以告诉你，你的视觉系统必须应对大量不同的挑战，才能让你时时刻刻都能看得清楚。
Roka understands all of that and has designed all of their eyeglasses and sunglasses with the biology of the visual system in mind.
Roka 了解这一切，并在设计所有眼镜和太阳镜时都考虑到了视觉系统的生物学原理。
Roka eyeglasses and sunglasses were first designed for use in sport, in particular for things like running and cycling, and as a consequence, Roka frames are extremely lightweight, so much so that most of the time you don't even remember that you're wearing them, and they're also designed so that they don't slip off, even if you get sweaty.
Roka 眼镜和太阳镜最初设计用于运动，特别是跑步和骑自行车等运动，因此，Roka 镜架非常轻巧，以至于大多数时候您甚至不记得自己戴着它们，而且它们的设计也使其即使出汗也不会滑落。
Now, even though Roka eyeglasses and sunglasses were initially designed for sport, they now have many different frames and styles, all of which can be used not just for sport, but also for wearing out to dinner, to work, essentially any time and any setting.
现在，尽管 Roka 眼镜和太阳镜最初是为运动而设计的，但现在它们有许多不同的镜框和款式，所有这些不仅可以用于运动，还可以在外出就餐、工作时佩戴，基本上可以在任何时间和任何环境下佩戴。
I wear Roka readers at night or Roka eyeglasses if I'm driving at night, and I wear Roka sunglasses in the middle of the day, any time it's too bright for me to see clearly.
我在晚上戴 Roka 阅读器，如果晚上开车，我会戴 Roka 眼镜；在白天，任何时候光线太亮而看不清楚的时候，我都会戴 Roka 太阳镜。
My eyes are somewhat sensitive, so I need that.
我的眼睛有点敏感，所以我需要它。
I particularly like the Hunter 2.0 frames, which I have as eyeglasses and now as sunglasses, too.
我特别喜欢 Hunter 2.0 镜框，我把它当作眼镜，现在也把它当作太阳镜。
If you'd like to try Roka, you can go to roka.com/huberman to get 20% off your purchase.
如果您想尝试 Roka，可以访问 roka.com/huberman 享受 20% 的购买折扣。
Again, that's roka.com/huberman to get 20% off.
再次强调，roka.com/huberman 可以享受 20% 的折扣。
Today's episode is also brought to us by Joovv.
今天的节目也是Joovv给我们带来的。
Joovv makes medical-grade red light therapy devices.
Joovv 生产医疗级红光治疗设备。
Now, if there's one thing I've consistently emphasized on this podcast, it's the incredible impact that light can have on our biology.
现在，如果我在这个播客中一直强调一件事，那就是光对我们的生物学产生的令人难以置信的影响。
Now, in addition to sunlight, red light and near-infrared light have been shown to have positive effects on improving numerous aspects of cellular and organ health, including faster muscle recovery, improved skin health and wound healing, even improvements in acne, reducing pain and inflammation, improving mitochondrial function, and even improving vision itself.
现在，除了阳光之外，红光和近红外光已被证明对改善细胞和器官健康的许多方面具有积极作用，包括更快的肌肉恢复、改善皮肤健康和伤口愈合，甚至改善痤疮、减轻疼痛和炎症、改善线粒体功能，甚至改善视力本身。
What sets Joovv lights apart, and why they're my preferred red light therapy devices, is that they use clinically proven wavelengths, meaning it uses specific wavelengths of red light and near-infrared light in combination to trigger the optimal cellular adaptations.
Joovv 灯的与众不同之处以及它们成为我首选红光治疗设备的原因在于它们使用经过临床验证的波长，这意味着它结合使用特定波长的红光和近红外光来触发最佳的细胞适应。
Personally, I use the Joovv handheld light both at home and when I travel.
就我个人而言，我在家中和旅行时都会使用 Joovv 手持灯。
It's only about the size of a sandwich, so it's super portable and convenient to use.
它只有三明治大小，因此超级便携且使用方便。
I also have a Joovv whole body panel, and I use that about three or four times per week.
我还有一个 Joovv 全身面板，我每周大约使用三到四次。
If you'd like to try Joovv, you can go to Joovv, spelled J-O-O-V-V, .com/huberman.
如果您想尝试 Joovv，可以访问 Joovv，拼写为 J-O-O-V-V，.com/huberman。
Joovv is offering an exclusive discount to all Huberman Lab listeners with up to $400 off select Joovv products.
Joovv 向所有 Huberman Lab 听众提供独家折扣，精选 Joovv 产品最高可享受 400 美元的折扣。
Again, that's Joovv, J-O-O-V-V, .com/huberman to get $400 off select Joovv products.
同样，Joovv、J-O-O-V-V、.com/huberman 精选 Joovv 产品可享受 400 美元优惠。
Today's episode is also brought to us by Helix Sleep.
今天的节目也是由 Helix Sleep 为我们带来的。
Helix Sleep makes mattresses and pillows that are customized to your unique sleep needs.
Helix Sleep 生产根据您独特的睡眠需求定制的床垫和枕头。
I've spoken many times before on this and other podcasts about the fact that getting a great night's sleep is the foundation of mental health, physical health, and performance.
我之前曾多次在这个播客和其他播客中谈到这样一个事实：睡个好觉是心理健康、身体健康和表现的基础。
Now, the mattress we sleep on makes an enormous difference in terms of the quality of sleep that we get each night.
现在，我们睡觉的床垫对我们每晚的睡眠质量有着巨大的影响。
We need a mattress that is matched to our unique sleep needs, one that is neither too soft nor too hard for you, one that breathes well and that won't be too warm or too cold for you.
我们需要一款符合我们独特睡眠需求的床垫，一张对您来说既不太软也不太硬、透气良好、不会太热或太冷的床垫。
If you go to the Helix website, you can take a brief two-minute quiz, and it asks you questions such as, do you sleep on your back, your side, or your stomach?
如果你访问 Helix 网站，你可以做一个两分钟的简短测验，它会问你一些问题，比如你是仰卧、侧卧还是俯卧？
Do you tend to run hot or cold during the night?
你晚上容易感到热还是冷？
Things of that sort.
诸如此类的事情。
Maybe you know the answers to those questions, maybe you don't.
也许您知道这些问题的答案，也许您不知道。
Either way, Helix will match you to the ideal mattress for you.
无论哪种方式，Helix 都会为您匹配理想的床垫。
For me, that turned out to be the Dusk mattress, D-U-S-K.
对我来说，这就是 Dusk 床垫，D-U-S-K。
I've been sleeping on a Dusk mattress for, gosh, now more than four years, and the sleep that I've been getting is absolutely phenomenal.
我一直睡在 Dusk 床垫上，天哪，现在已经四年多了，而且我睡得绝对是惊人的。
If you'd like to try Helix, you can go to helixsleep.com/huberman, take that brief two-minute sleep quiz, and Helix will match you to a mattress that is customized to your unique sleep needs.
如果您想尝试 Helix，可以访问 helixsleep.com/huberman，进行两分钟的简短睡眠测验，Helix 将为您匹配根据您独特的睡眠需求定制的床垫。
Right now, Helix is giving up to 25% off mattresses and two free pillows.
目前，Helix 提供高达 25% 的床垫折扣和两个免费枕头。
Again, that's helixsleep.com/huberman to get 25% off and two free pillows.
再次强调，helixsleep.com/huberman 提供 25% 折扣和两个免费枕头。
And now for my discussion with Dr. Teo Soleymani.
现在我与 Teo Soleymani 博士进行讨论。
Dr. Teo Soleymani, welcome.
Teo Soleymani 博士，欢迎光临。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Thanks for having me.
谢谢你有我。
It's awesome to be here.
来到这里真是太棒了。
I'm very, very privileged to be here.
我非常非常荣幸来到这里。
Thank you.
谢谢。
Andrew Huberman:
安德鲁·休伯曼：
Oh, well, it's an honor to have you.
哦，好吧，很荣幸有你。
Let's talk about this amazing organ we call skin.
让我们来谈谈这个被我们称为皮肤的神奇器官。
So skin Of course, covers our other organs.
所以皮肤当然覆盖了我们的其他器官。
It's its own living biological entity, and just for sake of educational purposes and to frame the rest of what we're going to talk about, how much turnover is there in our skin?
它是它自己的活生物实体，只是为了教育目的并框架我们将要讨论的其余内容，我们的皮肤有多少周转率？
Meaning the skin that I'm wearing right now, is that going to be 100%, 50% of the skin that I'm going to be wearing a year from now?
意思是我现在穿的皮肤，是不是我一年后穿的皮肤的 100%、50%？
I'm 49 years old, so...
我今年49岁了，所以...
Dr. Teo Soleymani:
Teo Soleymani 博士：
Well, you look great for 49, so whatever you're doing, keep it up.
嗯，49 岁的你看起来很棒，所以无论你在做什么，坚持下去。
So the skin's an amazing organ, just like you said.
所以就像你说的，皮肤是一个神奇的器官。
It's the largest organ and the largest dynamic organ we have in our body.
它是我们体内最大的器官和最大的动态器官。
You have new skin, brand new skin every 28 days.
每 28 天你就会拥有新的皮肤，全新的皮肤。
So the surface of your skin turns over about every month.
所以你的皮肤表面大约每个月都会更新一次。
Now, the stem cells, which are in the lowest portion of our epidermis, remain, and they generate the skin cells, but you have brand new skin the same way you have new gut lining every 28 days.
现在，位于表皮最低部分的干细胞仍然存在，它们会生成皮肤细胞，但您会拥有全新的皮肤，就像每 28 天就会有新的肠道内壁一样。
It's amazing for many reasons, because the skin is one of the few organs that can regenerate because of this.
这令人惊奇的原因有很多，因为皮肤是少数可以因此再生的器官之一。
So you can grow new skin, you can test things on skin.
这样你就可以长出新的皮肤，你可以在皮肤上测试一些东西。
If your skin gets injured, it will regenerate and heal itself, whereas many other organs cannot do that.
如果您的皮肤受伤，它会自我再生和愈合，而许多其他器官则无法做到这一点。
And because of this, it also allows us to use it as a model platform for studying diseases of all kinds.
也正因为如此，也使得我们可以将其作为研究各类疾病的模型平台。
So skin's an amazing organ, and I guess I'm biased, but...
所以皮肤是一个神奇的器官，我想我有偏见，但是......
Andrew Huberman:
安德鲁·休伯曼：
Well, I find a 28-day turnover just to be incredible.
嗯，我发现 28 天的营业额令人难以置信。
The skin, as I understand it, is innervated.
据我了解，皮肤是受神经支配的。
That is, it receives connections from the nervous system.
也就是说，它接收来自神经系统的连接。
So I think for many people, their interest in skin is skin appearance, although we will also talk about skin health.
所以我认为对于很多人来说，他们对皮肤的兴趣是皮肤外观，尽管我们也会谈论皮肤健康。
But in terms of skin appearance, how much does stress, short-term and longer-term stress, impact the appearance of our skin, and how does that work?
但就皮肤外观而言，压力（短期和长期压力）对我们皮肤的外观有多大影响？它是如何发挥作用的？
I could imagine that the neurons release certain things into the skin.
我可以想象神经元将某些东西释放到皮肤中。
Does stress make our skin age faster?
压力会让我们的皮肤老化得更快吗？
Does that mean it turns over more quickly or turns over more slowly?
这是否意味着它翻得更快还是翻得更慢？
Maybe you could link these two aspects of our biology for us.
也许你可以为我们将生物学的这两个方面联系起来。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
That's a great question.
这是一个很好的问题。
So in order to understand that, we have to just look at the structure of the skin.
因此，为了理解这一点，我们必须看看皮肤的结构。
So the skin generally is three layers, the epidermis, the dermis, and the subcutaneous fat.
所以皮肤一般分为三层，表皮、真皮、皮下脂肪。
And the dermis is where most of the biologic activity resides.
真皮是大部分生物活性所在的地方。
That's where our blood vessels are.
那就是我们的血管所在的地方。
That's where the nerves that innervate sensation and movement reside.
那是支配感觉和运动的神经所在的地方。
That's where our hair follicles, oil glands, and sweat glands reside.
那是我们的毛囊、油腺和汗腺所在的地方。
So stress has two components.
所以压力有两个组成部分。
There's what we call acute stress, meaning stress that happens within a short period of time, and then there's long-term stress or chronic stress, and both have different processes in the skin.
有我们所说的急性压力，意思是在短时间内发生的压力，还有长期压力或慢性压力，两者在皮肤中都有不同的过程。
And you see the results of stress both immediately in the skin with release of certain chemical messengers in an autocrine, paracrine, and holocrine fashion, and then you see the long-term deleterious effects of stress in a different mechanism in which there's actually breakdown of the skin.
你会立即看到压力在皮肤上的结果，以自分泌、旁分泌和全分泌的方式释放某些化学信使，然后你会看到压力以不同的机制产生的长期有害影响，其中实际上会导致皮肤破裂。
The easiest way to see this is when people are stressed and they lose their hair, and the hair obviously is an extension of our skin.
最容易看出这一点的方法是，当人们受到压力时，他们会掉头发，而头发显然是我们皮肤的延伸。
It's a biosensor of our well-being, and we see this all the time.
它是我们健康的生物传感器，我们一直都能看到这一点。
I see students during finals time where they're really stressed out, and they're coming with their hair falling out.
我看到学生在期末考试期间压力很大，他们的头发都在脱落。
Or after a large medical illness or a pregnancy, patients will come in and say their hair is falling out.
或者在患了大病或怀孕后，病人会进来说他们的头发正在脱落。
So that acute stress is seen right away, and that's due to several different reasons and release of messengers and hormones and chemical mediators that do this.
因此，急性压力会立即显现出来，这是由于多种不同的原因以及信使、激素和化学介质的释放造成的。
Long-term stress is usually mitigated or caused by cortisol.
长期压力通常是由皮质醇减轻或引起的。
And everybody knows cortisol.
每个人都知道皮质醇。
It's the fundamental stress hormone of our body.
它是我们身体的基本压力激素。
It falls in the same family as drugs that we give, like prednisone.
它与我们给予的药物属于同一家族，例如泼尼松。
It falls in the same family of cholesterol, testosterone, estrogen, but cortisol does something very different.
它与胆固醇、睾酮、雌激素属于同一家族，但皮质醇的作用却截然不同。
It breaks things down to allow our body to utilize it in times of stress, because unfortunately, our body doesn't understand the difference between 21st century stress and old stress.
它会分解事物，让我们的身体在面临压力时利用它，因为不幸的是，我们的身体不了解 21 世纪的压力和旧的压力之间的区别。
So us being chased by a lion, to our body's messaging system, is the same as meeting chronic deadlines at work.
因此，对于我们身体的信息系统来说，我们被狮子追赶，就像在工作中长期满足最后期限一样。
And what happens is cortisol is responsible for the breakdown of things like collagen and elastin, thinning of vessel walls, which allow our skin to look supple and healthy.
皮质醇会导致胶原蛋白和弹性蛋白等物质的分解，使血管壁变薄，从而使我们的皮肤看起来柔软而健康。
So as we have a lot of stress and a lot of cortisol release, we see aging, and there's accelerated aging studies that look at patients and people who are under high periods of stress.
因此，当我们承受很大的压力和大量的皮质醇释放时，我们就会看到衰老，并且有针对处于高压力时期的患者和人们的加速衰老研究。
A great example of studies, we look at presidents in which they appear to have aged much more rapidly than matched controls in a four-year period of time.
这是一个很好的研究例子，我们观察了一些总统，在四年的时间里，他们的衰老速度似乎比对照组要快得多。
So stress plays a really important role.
所以压力起着非常重要的作用。
You see it both immediately and long-term.
你可以立即看到它，也可以长期看到它。
Andrew Huberman:
安德鲁·休伯曼：
I guess people rarely are sympathetic to presidents for aging quickly, because I guess if there were a president who did not age quickly, we would worry they did not work hard enough or something of that sort.
我想人们很少会同情快速衰老的总统，因为我想如果有一位总统没有快速衰老，我们会担心他们工作不够努力或诸如此类。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But the relationship between stress and skin fascinates me because not just of the direct relationship, like when we see people and they're stressed, it seems like the pallor of their skin changes.
但压力和皮肤之间的关系让我着迷，因为不仅仅是直接关系，就像当我们看到人们感到有压力时，他们的皮肤苍白似乎会发生变化。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
The kind of level of-
那种水平——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
gleam in their eyes change.
他们眼中的光芒发生了变化。
Dr. Teo Soleymani:
Teo Soleymani 博士：
For sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
And of course, the eyes are a direct piece of the nervous system, really.
当然，眼睛确实是神经系统的直接组成部分。
They're as close to the brain as one can get-
它们是最接近大脑的地方——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
if you're outside the skull.
如果你在头骨外面。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But it also suggests Because of the dynamic turnover of skin every 28 days, that if people were to become less stressed, that their skin health and appearance might improve.
但它也表明，由于皮肤每 28 天就会动态更新一次，如果人们压力减轻，他们的皮肤健康和外观可能会得到改善。
Is that also the case?
是不是也是这样呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
For sure.
当然。
It's why you see people have a glow after vacation, but you can't quantify that in a test tube or a lab.
这就是为什么你会看到人们在假期后容光焕发，但你无法在试管或实验室中对其进行量化。
So in the immediate phase, there's a big shift in blood flow to the skin.
因此，在立即阶段，流向皮肤的血液发生了很大的变化。
And when you're feeling very stressed out, immediately there's a fight or flight response that constricts the blood vessels in our skin to shuffle them to muscles and places where our body thinks we need to utilize them more.
当你感到压力很大时，立即就会出现一种战斗或逃跑反应，收缩我们皮肤中的血管，将它们转移到肌肉和我们的身体认为需要更多利用它们的地方。
That's why when people are really stressed out, they may look pale or gaunt.
这就是为什么当人们真正感到压力时，他们可能会显得苍白或憔悴。
And we see that right away.
我们马上就看到了这一点。
And then as that builds up over time, the health, the actual quality of our dermis and fat deteriorate from chronic stress changes, mainly due to cortisol and its sibling hormones and messaging systems in our skin.
随着时间的推移，我们的健康状况、真皮和脂肪的实际质量会因慢性压力变化而恶化，这主要是由于皮质醇及其兄弟激素和皮肤中的信息系统造成的。
So for sure.
所以可以肯定的是。
Stress is something that is impossible to quantify in a lab measure, but very easily seen on exam.
压力是无法在实验室测量中量化的东西，但在考试中很容易看出。
Just looking at your skin, I can tell you've had either a rough day.
只要看看你的皮肤，我就知道你今天过得很艰难。
If you didn't sleep well, you can see it in your skin and your eyes.
如果你睡得不好，你可以从你的皮肤和眼睛中看到它。
So absolutely.
绝对如此。
That's why everybody likes to live a stress-free life.
这就是为什么每个人都喜欢无压力的生活。
And we see changes and improvement in skin health when people move away from that stressor, whether it's a physical stressor, emotional stressor, psychosocial stressor.
当人们远离压力源时，无论是身体压力源、情绪压力源还是心理压力源，我们都会看到皮肤健康的变化和改善。
There is actual quantifiable improvements in skin health, and that's pretty fascinating.
皮肤健康确实得到了可量化的改善，这非常令人着迷。
Andrew Huberman:
安德鲁·休伯曼：
It is fascinating.
这是令人着迷的。
It also speaks to the value of having some immediate and long-term stress reduction techniques, just as a sort of first principle of taking care of one's skin.
它还说明了一些即时和长期的减压技巧的价值，就像护理皮肤的首要原则一样。
Dr. Teo Soleymani:
Teo Soleymani 博士：
For sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
There are some other things that cause vasoconstriction, basically the tightening of the vessels and capillaries to the skin, as I understand.
据我了解，还有一些其他因素会导致血管收缩，基本上是皮肤上的血管和毛细血管收紧。
Maybe we could just tick through a few of these and get your sense.
也许我们可以勾选其中一些并了解您的想法。
I consume caffeine every morning, usually yerba mate tea, some coffee a little bit later.
我每天早上都会摄入咖啡因，通常是马黛茶，稍后会喝一些咖啡。
Those will increase vasoconstriction to some extent, although chronic caffeine intake may cause vasodilation.
尽管长期摄入咖啡因可能会导致血管舒张，但这些会在一定程度上增加血管收缩。
So I'd like to know the relationship between caffeine and blood flow to the skin and skin health and appearance.
所以我想知道咖啡因与皮肤血液流动以及皮肤健康和外观之间的关系。
That's the first question.
这是第一个问题。
And then dovetailed with that question is nicotine, which is also thought to be a vasoconstrictor.
与这个问题相吻合的是尼古丁，它也被认为是一种血管收缩剂。
It raises blood pressure because it's a vasoconstrictor.
它会升高血压，因为它是一种血管收缩剂。
What are the effects of caffeine, both acutely and chronically, and nicotine, let's assume that nicotine is consumed either by smoking or oral ingestion, on skin appearance and health?
咖啡因（急性和慢性）和尼古丁（假设尼古丁是通过吸烟或口服摄入摄入的）对皮肤外观和健康有何影响？
Dr. Teo Soleymani:
Teo Soleymani 博士：
That's a good question.
这是个好问题。
So caffeine is a known vasoconstrictor.
所以咖啡因是一种已知的血管收缩剂。
Fortunately, when it's consumed in quantities that we have in coffee, tea, and equivalent beverages, the amount that affects the tiny capillaries and arterioles in our skin is minute and transient.
幸运的是，当我们摄入咖啡、茶和类似饮料中的量时，对我们皮肤中微小毛细血管和小动脉的影响是微小且短暂的。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So you may get a transient vasoconstriction with high caffeine intake, but usually there's a compensatory vasodilation as a result.
因此，摄入大量咖啡因可能会导致短暂的血管收缩，但通常会出现代偿性血管舒张。
So the effects on skin are not as dramatic as people may make it seem.
因此，对皮肤的影响并不像人们想象的那么严重。
Now, one thing that we do see, and it's a little unclear as to why, is that people who have chronic high caffeine intake tend to produce more sebum in their skin, and it may be a result of vasoconstriction, may be a result of something that we don't understand that's compensatory as a result of those changes.
现在，我们确实看到了一件事，但还不清楚为什么，长期摄入大量咖啡因的人往往会在皮肤中产生更多的皮脂，这可能是血管收缩的结果，也可能是我们不明白的结果，而这些变化是补偿性的。
So a lot of people who consume coffee may experience a little bit oilier skin.
因此，很多喝咖啡的人可能会遇到皮肤稍微出油的情况。
That being said, the data's equivocal as to whether or not caffeine has a deleterious, beneficial, or net neutral effect on the skin.
话虽如此，关于咖啡因对皮肤是否有有害、有益或净中性影响的数据尚不明确。
I drink a lot of coffee.
我喝了很多咖啡。
I haven't found that the vasoconstriction is something that's noticeable, but there are people who have different skin types, patients who have rosacea, for example, who are much more sensitive to those changes.
我还没有发现血管收缩是明显的，但是有些人有不同的皮肤类型，例如患有红斑痤疮的患者，他们对这些变化更加敏感。
They may notice that change in the color, in the vasoconstriction more with caffeine consumption.
他们可能会注意到，随着咖啡因的摄入，颜色发生变化，血管收缩更加明显。
What used to be thought was that caffeine itself was a problem for flushing and redness, and now we've realized it's actually not so much the caffeine, because the concentration that reaches the skin is so minuscule.
过去人们认为咖啡因本身会导致潮红和发红，现在我们意识到实际上并不是咖啡因本身，因为到达皮肤的浓度非常小。
It's actually the temperature of the beverages we drink.
它实际上是我们喝的饮料的温度。
So hot beverages can affect the color of your skin, can make you flush more, make the redness more pronounced.
所以热饮料会影响你皮肤的颜色，会让你脸红得更厉害，让红肿更明显。
Cold beverages tend not to have that effect.
冷饮往往没有这种效果。
So it used to be an old adage, and people who had rosacea, for example, we'd say, "Don't drink coffee, don't drink tea." It's actually the temperature of the beverage, not so much the caffeine content.
所以这曾经是一句古老的格言，例如，患有红斑痤疮的人，我们会说，“不要喝咖啡，不要喝茶。”实际上是饮料的温度，而不是咖啡因含量。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
And what about nicotine?
那么尼古丁呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
So nicotine, great question.
尼古丁，很好的问题。
It is a known vasoconstrictor.
它是一种已知的血管收缩剂。
Now, the concentration of nicotine when smoked is higher in the skin because of inhalational effects and the local effect of nicotine on our skin.
现在，由于吸入效应和尼古丁对我们皮肤的局部影响，吸烟时皮肤中的尼古丁浓度较高。
So you do see a measurable vasoconstriction in the skin that becomes a problem, which is why patients who smoke age faster.
所以你确实会看到皮肤出现可测量的血管收缩，这成为一个问题，这就是为什么吸烟的患者衰老得更快的原因。
Patients who had surgery who smoke have a higher risk for poor wound outcomes, for poor healing because of that vasoconstriction.
接受过手术且吸烟的患者因血管收缩而导致伤口结果不良和愈合不良的风险更高。
Usually, people who use or consume nicotine aren't doing it once a week.
通常，使用或消费尼古丁的人不会每周使用一次。
Most people are using it daily or multiple times a day.
大多数人每天或一天多次使用它。
So that chronic vasoconstriction adds up and has a net negative effect on the skin.
因此，慢性血管收缩会累积起来，对皮肤产生净负面影响。
So if you want to keep your skin healthy, if you want to look younger, I would refrain from nicotine use.
所以，如果你想保持皮肤健康，如果你想看起来更年轻，我会避免使用尼古丁。
Andrew Huberman:
安德鲁·休伯曼：
What about vaping nicotine or oral use of nicotine?
电子烟尼古丁或口服尼古丁怎么样？
So nicotine gum, mints, pouches.
所以尼古丁口香糖、薄荷糖、尼古丁袋。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And let's touch on vaping first-
让我们先谈谈电子烟——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
because that's becoming more common.
因为这种情况变得越来越普遍。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So with vaping, we see the same problems in the skin.
因此，通过电子烟，我们会在皮肤上看到同样的问题。
We don't know if it's an inhalational issue or if it's actually the same concentration of nicotine that's reaching local skin causing the effect.
我们不知道这是否是吸入问题，或者是否实际上是相同浓度的尼古丁到达局部皮肤导致了这种效果。
But we see the same vasoconstriction when you match cigarette smoke with vaping if you have the same nicotine content Now, for patches and gum, it's less of a problem.
但是，如果尼古丁含量相同，那么当你将香烟烟雾与电子烟相匹配时，我们会看到相同的血管收缩。现在，对于贴片和口香糖来说，这不是什么问题。
And why that is, is the concentration of nicotine that reaches the skin is much lower.
原因是到达皮肤的尼古丁浓度要低得多。
Usually when you chew it, it has to go through your digestive tract, then enter your bloodstream, then reach the surface of the skin.
通常当你咀嚼它时，它必须穿过你的消化道，然后进入你的血液，然后到达皮肤表面。
When you have a transdermal patch, it still goes through the bloodstream, then ends up in the skin.
当您使用透皮贴剂时，它仍然会通过血液，然后最终进入皮肤。
So because of how much it has to be processed, the concentration that reaches the skin is much lower.
因此，由于需要处理的量，到达皮肤的浓度要低得多。
When we operate, when we do surgery, any surgery of any kind, we try to transition people who smoke or vape to at least gums or patches to mitigate their withdrawal effect, so they don't have the feelings, but it doesn't have the same constrictive effects on their skin.
当我们进行手术时，当我们进行任何类型的手术时，我们都会尝试将吸烟或吸电子烟的人至少转移到牙龈或贴片上，以减轻他们的戒断效应，这样他们就没有这种感觉，但不会对他们的皮肤产生同样的收缩作用。
Andrew Huberman:
安德鲁·休伯曼：
What about alcohol?
那么酒精呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Great question.
很好的问题。
Andrew Huberman:
安德鲁·休伯曼：
I did an episode of this podcast on alcohol, which somewhat to my surprise, was very widely shared.
我制作了一集关于酒精的播客，令我惊讶的是，它得到了广泛的分享。
Only to my surprise because I've never been a big consumer of alcohol, but apparently many out there are.
只是令我惊讶的是，因为我从来都不是酒精的大消费者，但显然有很多人是这样的。
And the data came back, at least to my understanding, that zero alcohol is healthier than any, and that up to two drinks per week is probably okay as long as you're an adult of drinking age and not an alcoholic, you don't have issues with alcohol use disorder, as it's now called.
数据回来了，至少在我看来，零酒精比任何酒精都更健康，而且每周最多喝两杯酒可能是可以的，只要你是一个达到饮酒年龄的成年人而不是酗酒者，你就不会出现现在所谓的酒精使用障碍的问题。
Probably okay, but beyond that, you start running into some health issues that can be offset by better behaviors of other types.
可能没问题，但除此之外，您开始遇到一些健康问题，这些问题可以通过其他类型的更好行为来抵消。
But what about the direct effects of alcohol on skin in the short term?
但短期内酒精对皮肤的直接影响又如何呢？
Does it increase blood flow and therefore improve skin?
它会增加血液流动从而改善皮肤吗？
Are there long-term indirect effects?
是否存在长期的间接影响？
I could imagine that alcohol disrupts the gut microbiome, which then disrupts skin, et cetera.
我可以想象酒精会破坏肠道微生物群，进而破坏皮肤等。
So maybe we could break this down into direct, acute effects, meaning immediate effects that are really direct from consuming alcohol that day, that week, let's say, versus chronic effects through other systems like disruption of sleep and microbiome.
因此，也许我们可以将其分解为直接的、急性的影响，即当天、那一周饮酒所直接产生的即时影响，而不是通过其他系统（如睡眠和微生物群的破坏）产生的慢性影响。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Great question.
很好的问题。
Alcohol and skin connections, complicated, convoluted, but generally thought to be a net negative, both short term and long term.
酒精和皮肤之间的联系虽然复杂、令人费解，但通常被认为是短期和长期的净负面影响。
So first, alcohol tends to be a mild diuretic, so it makes our body dispose of water a little bit more frequently.
首先，酒精是一种温和的利尿剂，因此它会让我们的身体更频繁地排出水分。
What happens short term is that, one, you get almost a mild diuretic effect from alcohol consumption, which is why you tend to be thirsty in the middle of the night and wake up in the morning tend to be parched.
短期内发生的情况是，第一，饮酒会产生轻微的利尿作用，这就是为什么你会在半夜感到口渴，早上醒来会感到口渴。
As a result, you see that diuretic effect on our skin.
结果，您会看到对我们皮肤的利尿作用。
You see a little bit of hollowing in areas that you'd have normal volume and suppleness, which is why people tend to see bags under their eyes, or they look like they had a hangover is from that mild diuretic effect.
你会看到原本有正常体积和柔软度的区域有一点凹陷，这就是为什么人们往往会看到眼袋，或者他们看起来像是宿醉了，这是因为温和的利尿作用。
Also, as a compensatory mechanism, the skin produces a bit more sebum to compensate for that drying out effect.
此外，作为一种补偿机制，皮肤会产生更多的皮脂来补偿干燥效应。
So in the acute phase, your skin dries out, you look a little bit worse because of that diuretic effect.
因此，在急性期，您的皮肤会变得干燥，由于利尿作用，您看起来会变得更糟。
In patients who cannot, or people who cannot tolerate alcohol, and there are genetics in Asian populations, in Southeast Asians that have a difficulty in breaking down acetaldehyde, that is a toxin that shows up in the skin and makes the skin vasodilate as a result.
对于不能耐受酒精的患者或不能耐受酒精的人，以及亚洲人群和东南亚人的遗传因素，他们难以分解乙醛，乙醛是一种出现在皮肤中的毒素，导致皮肤血管舒张。
So that common college term that we used to hear, the flush or the glow or incorrectly called the Asian glow is as a result of the inability to break down alcohol, and that usually you see immediately.
因此，我们过去常听到的大学术语“红晕”、“红晕”或错误地称为“亚洲红晕”是由于无法分解酒精造成的，通常您会立即看到。
People get a very bright red flush in their skin because of the acetaldehyde buildup in the skin.
由于乙醛在皮肤中积聚，人们的皮肤会出现非常明亮的红色。
Long term, one, the diuretic effect becomes a problem, so over time, your skin's producing constantly more sebum to keep the skin supple.
从长远来看，第一，利尿作用会成为一个问题，因此随着时间的推移，您的皮肤会不断产生更多的皮脂以保持皮肤柔软。
Your skin is drying out, and as a result, you run into things like breakouts and congested skin, blackheads, whiteheads, things like that.
你的皮肤正在干燥，结果就会出现痘痘、皮肤充血、黑头、白头等问题。
But long-term alcohol use is also associated with lifestyle choices that may make your skin health worse.
但长期饮酒也与生活方式的选择有关，这可能会使您的皮肤健康状况恶化。
Generally speaking, when people are out binge drinking, they tend not to come home and do things that'll maintain their skin.
一般来说，当人们在外面酗酒时，他们往往不会回家做一些可以保养皮肤的事情。
Now, that's not a fixed rule, but most of the time when you're out having a few beers or cocktails at the bar, you tend to come home and not do your diligent skincare routine, or you may not be up with your hydration status or your dietary habits.
现在，这不是一个固定的规则，但大多数时候，当您出去在酒吧喝几杯啤酒或鸡尾酒时，您往往回家后并没有进行认真的护肤程序，或者您可能不适合自己的水分状况或饮食习惯。
So that's something we can't quantify easily but contributes significantly to faster aging, poor skin health.
因此，这是我们无法轻易量化的东西，但却会显着加速衰老和皮肤健康状况不佳。
Then the gut microbiome question.
然后是肠道微生物组问题。
This is a great question because the data is widely variable for alcohol consumption and the effects or changes, permanent or transient, in the gut microbiome.
这是一个很好的问题，因为饮酒数据以及肠道微生物组的永久或暂时的影响或变化的数据变化很大。
There are some alcohol products like kombucha that has a higher alcohol concentration that's healthy for your gut.
有些酒精产品（例如康普茶）的酒精浓度较高，对肠道健康有益。
Then there's hard alcohols with a higher concentration that act as anesthetics and act as gut paralytics.
然后是浓度较高的烈酒，可以起到麻醉剂和肠道麻痹剂的作用。
So one of the things we see in people who consume a lot of high-percentage alcohols is actually gut immobility and gut paralysis, partly because of the anesthetic effect, partly because of the analgesic effect of alcohol, and also because it affects gut motility as a toxin.
因此，我们在摄入大量高浓度酒精的人身上看到的情况之一实际上是肠道不动和肠道麻痹，部分原因是麻醉作用，部分原因是酒精的镇痛作用，还因为它作为毒素影响肠道蠕动。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So generally speaking, the gut health, depending on your consumption patterns, use, and concentration, can be very deleterious.
因此，一般来说，肠道健康可能非常有害，具体取决于您的消费模式、使用情况和浓度。
Some people are very sensitive, and they have changes that reflect in the skin as a result of drinking a lot.
有些人非常敏感，大量饮酒会导致皮肤发生变化。
And then there are some people who tolerate it more or may be consuming things that are healthier for the gut microbiome, things like fermented alcohols like kombucha and things like that.
还有一些人对它的耐受性更强，或者可能正在食用对肠道微生物组更健康的东西，比如康普茶等发酵酒精之类的东西。
So generally speaking, the higher the concentration, the greater the problems.
所以一般来说，浓度越高，问题就越大。
The higher the percentage of alcohol, the greater the problems.
酒精含量越高，问题就越大。
That includes the diuretic effect, that includes effect on the gut microbiome, that includes lifestyle habits.
这包括利尿作用，包括对肠道微生物组的影响，包括生活习惯。
If you're drinking a lot of higher percentage alcohols, you tend To feel the effects, not just in the skin, cognitively, behavior-wise, that can affect you.
如果你喝了很多高浓度的酒精，你往往会感受到这些影响，不仅仅是在皮肤上，在认知上、行为上也会影响你。
Whereas sometimes lower concentration alcohols, depending on the setting and lifestyle, may be net neutral, may be positive, unclear on that part.
而有时较低浓度的酒精，根据环境和生活方式，可能是净中性的，可能是积极的，这部分不清楚。
Andrew Huberman:
安德鲁·休伯曼：
But I'm not hearing any positive effects of alcohol on skin health or appearance.
但我没有听说酒精对皮肤健康或外观有任何积极影响。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Generally not.
一般不会。
Same as what we've seen with other organ systems, the brain, the liver, the skin reflects the same thing.
与我们在其他器官系统中看到的一样，大脑、肝脏、皮肤也反映了同样的事情。
If anything, it may be a net neutral.
如果有的话，它可能是一个网络中立的。
Most of the time it's a net negative.
大多数时候它是净负值。
Andrew Huberman:
安德鲁·休伯曼：
And what I'm pulling from all of the discussion we've had up until now is that improved blood flow and strong hydration status are both important.
我从迄今为止我们进行的所有讨论中得出的结论是，改善血流量和强水合作用状态都很重要。
Do you recommend patients drink a certain amount of fluid each day, or maintain adequate hydration as a means to build or maintain skin health and appearance?
您是否建议患者每天喝一定量的液体，或保持足够的水分，以建立或维持皮肤健康和外观？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Great question.
很好的问题。
So that's another common misconception that I see in that thinking drinking a lot of water will, or drinking a lot of fluids will directly affect the hydration status of their skin.
这是我看到的另一个常见的误解，认为喝大量的水会直接影响皮肤的水合状态。
And while there's a certain degree of truth to that, if you're dehydrated, in that you need replenishment of fluid systemically, every study that's looked at transepidermal water loss has not shown a great connection with regular fluid intake and water intake, and skin hydration status.
虽然这在一定程度上是正确的，但如果你脱水了，你需要系统性地补充液体，但每一项关于经表皮失水的研究都没有显示出与定期液体摄入量和水摄入量以及皮肤水合状态有很大的联系。
We find that that tends to be genetically defined and genetically encoded.
我们发现这往往是由基因定义和基因编码的。
Some people have drier skin.
有些人的皮肤比较干燥。
They need more methods to moisturize their skin.
他们需要更多的方法来滋润皮肤。
Some people have oilier skin, and their sebum provides that moisturization.
有些人的皮肤较油，他们的皮脂可以提供保湿作用。
Now, if you're doing things, if you're active, if you're an athlete, if you're doing things in which you are dehydrated, then totally different story.
现在，如果你正在做一些事情，如果你很活跃，如果你是一名运动员，如果你正在做脱水的事情，那么情况就完全不同了。
But if you're living a more or less balanced life or a sedentary life, and you're doing all the regular things, drinking a lot of water or fluids has not been shown to improve skin health.
但是，如果您过着或多或少平衡的生活或久坐的生活，并且您做所有常规的事情，那么喝大量的水或液体并没有被证明可以改善皮肤健康。
So that's why, generally speaking, most dermatologists will recommend some sort of moisturizer to replenish that.
因此，一般来说，大多数皮肤科医生会推荐某种保湿霜来补充水分。
But you got to know your skin.
但你必须了解自己的皮肤。
For example, my skin, I tend to be oilier.
例如，我的皮肤比较油。
I don't usually need a moisturizer as much, whereas somebody who is drier will need some sort of barrier protection to minimize that transepidermal water loss.
我通常不需要那么多保湿霜，而干燥的人则需要某种屏障保护，以尽量减少经皮水分流失。
Andrew Huberman:
安德鲁·休伯曼：
What are some of the parameters for selecting a moisturizer?
选择保湿霜的一些参数是什么？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
People are immediately going to say, "Well, what constitutes a good moisturizer?"
人们立刻就会说：“那么，什么才是好的保湿霜呢？”
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What should it have in it?
里面应该有什么？
What are some things to avoid?
有哪些事情需要避免？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
It's a crazy market.
这是一个疯狂的市场。
There's a lot of things out there.
那里有很多东西。
You can Google "skin snail moisturizer," and you'll find people putting snail mucin on their skin as a moisturizer.
你可以在谷歌上搜索“皮肤蜗牛保湿剂”，你会发现人们把蜗牛粘蛋白涂在皮肤上作为保湿剂。
Andrew Huberman:
安德鲁·休伯曼：
And you were telling me before this-
而你在此之前告诉过我——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
recording started, there are people who, and forgive me for those that cringe when I say this, that put placental extract.
录音开始后，有人放了胎盘提取物，请原谅我说这些时那些感到畏缩的人。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Human placenta as a means of rejuvenating their skin health.
人类胎盘作为恢复皮肤健康的一种手段。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
I don't advocate it or don't say anything against it, but I probably wouldn't recommend it.
我不提倡它，也不反对它，但我可能不会推荐它。
There's better, safer, more cost-effective ways of doing this.
有更好、更安全、更具成本效益的方法来做到这一点。
Simple things you want to look for.
您想要寻找的简单事物。
One, is it non-comedogenic?
一，它不会引起粉刺吗？
That's a word you want to look for, for any moisturizer that's been tested not to clog your pores.
对于任何经过测试不会堵塞毛孔的保湿霜，您都需要寻找这个词。
That's a basic thing to look for where you won't cause another problem in trying to fix one problem.
这是一个基本的事情，要注意在尝试解决一个问题时不会导致另一个问题。
Number two, how oily or dry are you?
第二，你是油性还是干性？
Generally speaking, there are three flavors of moisturizers.
一般来说，保湿霜分为三种口味。
There's ointments, there's creams, and there's lotions.
有药膏，有霜，还有乳液。
Ointments are greasy.
药膏很油腻。
They're like petrolatum jelly or Vaseline-based.
它们就像凡士林果冻或凡士林基的。
Those are the best for moisturizing your skin, but they're greasy.
这些是滋润皮肤的最佳选择，但它们很油腻。
Then there's creams, which are water emulsions with oil suspended in it.
然后是面霜，它是悬浮有油的水乳液。
And then there's lotions, which are generally powders that are resuspended with water.
然后是乳液，通常是用水重新悬浮的粉末。
We, as dermatologists, tend to like the greasier, the better.
作为皮肤科医生，我们往往喜欢越油腻越好。
It provides the best barrier protection, but you have to know your skin.
它提供了最好的屏障保护，但你必须了解你的皮肤。
If you're somebody that is eczema-prone, you will need something that is an ointment that does better to protect the skin from drying out.
如果您是湿疹高发人群，您将需要一种能更好地防止皮肤干燥的药膏。
If you're somebody that is acne-prone, you won't tolerate greasy things.
如果你是一个容易长粉刺的人，你就不会容忍油腻的东西。
You'll break out more.
你会爆发更多。
So you want to look for a lighter moisturizer that's non-comedogenic.
因此，您需要寻找一种不会引起粉刺、质地轻盈的保湿霜。
So in a long story short, it's very person-to-person specific.
所以总而言之，这是因人而异的。
You got to know your skin, but the fundamental things you want to look for is has this been tested to not clog pores, and is it in a pump bottle or is it in a jar?
你必须了解你的皮肤，但你想要寻找的基本东西是它是否经过测试不会堵塞毛孔，它是在泵瓶中还是在罐子中？
Jars tend to be more occlusive.
罐子往往更封闭。
They tend to provide more moisturization, but they can lead to problems like acne and breakouts.
它们往往能提供更多的保湿作用，但也会导致痤疮和痘痘等问题。
Whereas things in a pump bottle, because they're powders in suspension and they have to put alcohol in the product to allow it to come out of the pump mechanism, they tend to be lighter and not provide as much moisturization.
而泵瓶中的东西，因为它们是悬浮的粉末，并且必须在产品中加入酒精以使其从泵机构中出来，所以它们往往更轻并且不能提供那么多的保湿作用。
Andrew Huberman:
安德鲁·休伯曼：
I see.
我明白了。
So when I think about something in a jar, I think of something like Aquaphor-
所以当我想到罐子里的东西时，我会想到类似 Aquaphor 的东西——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
or something, which is pretty thick-
或者什么东西，相当厚-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Greasy
油腻
Andrew Huberman:
安德鲁·休伯曼：
...
...
thick stuff.
厚厚的东西。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
It's great.
这很棒。
Andrew Huberman:
安德鲁·休伯曼：
So that would be fine for someone with eczema, not okay for somebody with acne.
因此，这对于患有湿疹的人来说没问题，但对于患有痤疮的人来说则不好。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Exactly.
确切地。
The greasier, the more occlusion it provides.
越油腻，它提供的遮挡就越多。
But in doing so, it clogs everything.
但这样做却会堵塞一切。
Now, if you're one that has some sort of skin issue in which you need that, it's the best thing.
现在，如果您有某种皮肤问题而需要它，那么这是最好的事情。
If you're one that is breaking out all the time, you want something lighter.
如果你是一个经常爆发的人，你会想要一些更轻松的东西。
Andrew Huberman:
安德鲁·休伯曼：
I'd like to take a quick break and acknowledge our sponsor, AG1.
我想稍微休息一下并感谢我们的赞助商 AG1。
By now, many of you have heard me say that if I could take just one supplement, that supplement would be AG1.
到目前为止，你们很多人都听我说过，如果我只能服用一种补充剂，那么该补充剂就是 AG1。
The reason for that is AG1 is the highest quality and most complete of the foundational nutritional supplements available.
原因是 AG1 是现有的基础营养补充剂中质量最高、最全面的。
What that means is that it contains not just vitamins and minerals, but also probiotics, prebiotics, and adaptogens to cover any gaps you may have in your diet and provide support for a demanding life.
这意味着它不仅含有维生素和矿物质，还含有益生菌、益生元和适应原，可以弥补您饮食中可能存在的任何空白，并为高要求的生活提供支持。
For me, even if I eat mostly whole foods and minimally processed foods, which I do for most of my food intake, it's very difficult for me to get enough fruits and vegetables, vitamins and minerals, micronutrients, and adaptogens from food alone.
对我来说，即使我主要吃天然食品和最低限度加工的食品（这是我摄入的大部分食物的一部分），我也很难仅从食物中获取足够的水果和蔬菜、维生素和矿物质、微量营养素和适应原。
For that reason, I've been taking AG1 daily since 2012, and often twice a day, once in the morning or mid-morning, and again in the afternoon or evening.
因此，自 2012 年以来，我每天服用 AG1，通常每天两次，一次在早上或上午，一次在下午或晚上。
When I do that, it clearly bolsters my energy, my immune system, and my gut microbiome.
当我这样做时，它明显增强了我的能量、我的免疫系统和我的肠道微生物组。
These are all critical to brain function, mood, physical performance, and much more.
这些对于大脑功能、情绪、身体表现等都至关重要。
If you'd like to try AG1, you can go to drinkag1.com/huberman to claim their special offer.
如果您想尝试 AG1，可以访问 Drinkag1.com/huberman 以获得特别优惠。
Right now, they're giving away five free travel packs plus a year's supply of vitamin D3K2.
目前，他们赠送五个免费旅行包以及一年的维生素 D3K2。
Again, that's drinkag1.com/huberman to claim that special offer.
再次强调，您可以通过 Drinkag1.com/huberman 领取特别优惠。
Why do people wake up with bags under their eyes if they just slept for six or eight hours?
为什么人只睡了六、八个小时，醒来时就会出现眼袋？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, well, maybe you need a little bit more sleep, or maybe you had a wild night.
是的，好吧，也许你需要多睡一会儿，或者也许你度过了一个疯狂的夜晚。
I can't tell.
我不知道。
But generally, the bags are caused by two things.
但一般来说，袋子是由两个原因造成的。
One, fluid retention.
一、液体潴留。
So there's some lymphatic change that occurs under the eyes that's most noticeable because the skin under our eyes and on the surface of our eyelids is the thinnest, so fluid changes are seen the quickest there.
因此，眼睛下方发生的一些淋巴变化最为明显，因为我们眼睛下方和眼睑表面的皮肤最薄，因此那里的液体变化最快。
And as we're in a supine or prone position, fluid moves from our extremities back to our central venous system, and it's easier to collect in the face, so we see it around the face.
当我们处于仰卧或俯卧位时，液体会从我们的四肢流回我们的中央静脉系统，并且更容易聚集在面部，因此我们会在面部周围看到它。
The other thing that we do notice with bags is just age-related fat herniation that shows up more as we wake up because of positional changes.
我们注意到的关于包的另一件事是与年龄相关的脂肪突出，当我们醒来时，由于位置的变化，这种脂肪突出会更加明显。
So if you've had a heavy meal the night before, something that has high salt content, you're going to retain a little bit more water because of that solute shift.
因此，如果您前一天晚上吃了一顿大餐，即含盐量高的食物，那么由于溶质的转移，您会保留更多的水分。
You may notice your eyes are puffier in the morning.
您可能会注意到早上您的眼睛更加浮肿。
If you have allergies, seasonal allergies, asthma, eczema, they run in a family, that tends to make your skin retain a little bit more water as a result of that allergy response.
如果您有过敏症、季节性过敏、哮喘、湿疹，它们是家族遗传的，由于过敏反应，往往会使您的皮肤保留更多的水分。
So people will notice springtime or fall time, their eyes are swollen or their eyes are puffy, especially when their allergies are flaring.
因此，人们会注意到春天或秋天的时候，他们的眼睛会肿胀或浮肿，尤其是当他们的过敏症状加剧时。
It's a product of water retention from all the histamine release and changes that occur in the skin.
它是所有组胺释放和皮肤发生变化导致的水分滞留的产物。
Andrew Huberman:
安德鲁·休伯曼：
Skin cleansing is a topic that gets a lot of coverage.
皮肤清洁是一个被广泛报道的话题。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And I sometimes get chuckles or even attacks for saying I've always just used unscented Dove soap, the bar, not the liquid soap.
有时我会因为说我一直只使用无味的多芬肥皂而不是液体肥皂而遭到嘲笑甚至攻击。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Or like a Cetaphil soap.
或者像丝塔芙肥皂。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And this is because when I was younger, much younger, I had very sensitive skin when I was a kid, seven, eight, nine years old.
这是因为当我年轻得多的时候，我七岁、八岁、九岁的时候皮肤非常敏感。
I think I just started using unscented Dove soap at some point and things like it, gentle soaps without fragrances.
我想我只是在某个时候开始使用无味的多芬肥皂之类的东西，不含香料的温和肥皂。
What are your thoughts on those?
您对此有何看法？
And I ask not for my own purposes, I'm going to stick with it because it works for me unless you tell me I shouldn't.
我的要求不是为了我自己的目的，我会坚持下去，因为它对我有用，除非你告诉我不应该。
But I see this enormous market for skin cleansers that includes a range of costs from relatively low to near astronomical.
但我看到了皮肤清洁剂的巨大市场，其成本从相对较低到接近天文数字不等。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And if you tell me that this unscented Dove soap or Cetaphil soap is the way to go, and by the way, I'm not sponsored by either of those.
如果你告诉我这款无味的多芬肥皂或丝塔芙肥皂是不错的选择，顺便说一句，我没有得到这两者的赞助。
I don't even know who they're manufactured by, so there's no commercial angle here.
我什至不知道它们是由谁制造的，所以这里没有商业角度。
But I'll be relieved because they tend to fall on the lower end of the cost bracket relative to some of these astronomically priced cleansers.
但我会松一口气，因为相对于一些天价清洁剂而言，它们的成本往往处于较低水平。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Skincare is an incredible multi-billion dollar market.
护肤品是一个令人难以置信的数十亿美元市场。
That being said, there is not a shred of evidence that anything more expensive works better than anything cost-effective, so that's first and foremost.
话虽如此，没有任何证据表明任何更昂贵的东西都比任何具有成本效益的东西效果更好，所以这是首要的。
Number two, Dove white bar soap is amazing.
第二，多芬白皂棒棒极了。
It's what we recommend for newborns and kids with sensitive skin.
这是我们为新生儿和皮肤敏感的儿童推荐的产品。
Generally, when we say sensitive skin, especially in kids, toddlers, and adolescents, there's a component of some sort of eczema or atopic dermatitis that is not bad enough to have a diagnosis, but enough to say, "I had sensitive skin." So Dove white bar soap is what I use for my kids, and I'm not sponsored by anybody either, but I think it's an amazing product because it's safe, it's effective, it has the least amount of ingredients, no fragrances.
一般来说，当我们说敏感皮肤时，尤其是儿童、幼儿和青少年，其中存在某种湿疹或特应性皮炎的成分，这些成分还没有严重到需要诊断，但足以说“我有敏感皮肤”。所以我给我的孩子用的是多芬白色肥皂，我也没有得到任何人的赞助，但我认为这是一个很棒的产品，因为它安全、有效、成分最少、不含香料。
These are all things that can irritate or cause an allergic response to skin that is sensitive, meaning your skin mounts an immune response to some sort of environmental allergen or trigger.
这些都会刺激敏感皮肤或引起过敏反应，这意味着您的皮肤会对某种环境过敏原或触发因素产生免疫反应。
That's what we generally mean when we talk about sensitive skin.
这就是我们通常所说的敏感皮肤。
I personally use Cetaphil.
我个人使用丝塔芙。
That's my face wash.
这就是我的洗脸方法
I have oily skin, and I use the one that takes off more of the oil.
我是油性皮肤，所以我用的是比较能去除油脂的一款。
So what you're looking for is defined by what bothers you or what your skin predicament is.
因此，您要寻找的产品取决于困扰您的问题或您的皮肤困境。
What I do see as a problem nowadays is, particularly in the United States, we're a hyper-hygienic society, so what people tend to do is over-cleanse, and they over-cleanse for several reasons.
我认为现在的一个问题是，特别是在美国，我们是一个高度卫生的社会，所以人们往往会过度清洁，而他们过度清洁的原因有几个。
One, because they are told that cleansing will fix their skin issue, or number two, they're told that some sort of organism is on their skin or some sort of bacteria that needs to be cleansed off to keep their skin healthy.
第一，因为他们被告知清洁可以解决他们的皮肤问题，或者第二，他们被告知皮肤上有某种生物体或某种细菌，需要清除以保持皮肤健康。
Neither are true.
两者都不是真的。
The first thing you want in terms of a cleanser is something that's mild, fragrance-free, and has been tested to be hypoallergenic or non-comedogenic.
对于清洁剂，您首先需要的是温和、无香料，并且经过测试低过敏性或不会引起粉刺的清洁剂。
And that's first.
这是第一。
Cetaphil, Dove, CeraVe, great stuff No association with any of them.
Cetaphil、Dove、CeraVe，很棒的东西，与它们中的任何一个都没有关联。
Andrew Huberman:
安德鲁·休伯曼：
The unscented, non-fragranced versions of them.
它们的无香、无香版本。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Exactly.
正是如此。
That's first.
这是第一。
Fragrances tend to be a problem for sensitive skin in patients who have atopic dermatitis or eczema.
对于患有特应性皮炎或湿疹的患者来说，香水往往是敏感皮肤的一个问题。
They tend to trigger allergic responses or exacerbations of their eczema flare, so we try to avoid fragrances by all means.
它们往往会引发过敏反应或加剧湿疹，因此我们尽量避免使用香水。
Then things that are gels or liquids tend to have preservatives in them to increase shelf stability, whereas bars tend not to.
然后，凝胶或液体的东西往往含有防腐剂以提高货架稳定性，而棒状的东西往往不含防腐剂。
So if you are going to pick something that is a gel, a liquid, look for one that's been tested by a dermatology group or verified by the American Academy of Dermatology as one that is not allergenic or has multiple preservatives, because that's another well-known but unidentified source of problems.
因此，如果您要选择凝胶或液体的产品，请寻找经过皮肤病学小组测试或经美国皮肤病学会验证为不会过敏或含有多种防腐剂的产品，因为这是另一个众所周知但尚未确定的问题根源。
Well known to the dermatology world, not known to the average person, that the preservatives in our cleansers are a problem.
皮肤病界众所周知，但普通人却不知道，我们的清洁剂中的防腐剂是一个问题。
Over-cleansing becomes really problematic in eradicating the skin microbiome.
过度清洁对于根除皮肤微生物组来说确实是一个问题。
So what we see a lot of times are cleansers that are either bactericidal, bacteriostatics, things like benzoyl peroxide, things like salicylic acid, things like certain astringent toners that are alcohol-based.
所以我们经常看到的清洁剂要么是杀菌的，要么是抑菌的，比如过氧化苯甲酰、水杨酸、某些含酒精的收敛爽肤水。
And what they do is not only do they strip the normal oils from our skin that keep our skin supple and healthy, but they eradicate the normal host skin microbiome.
它们所做的不仅是从我们的皮肤上去除保持皮肤柔软和健康的正常油脂，而且还根除正常的宿主皮肤微生物组。
Those are all the microorganisms that live on our skin, and we have trillions of them actively surveying our skin, living in normal symbiotic homeostasis, meaning they're our friends.
这些都是生活在我们皮肤上的微生物，我们有数万亿的微生物积极地调查我们的皮肤，生活在正常的共生稳态中，这意味着它们是我们的朋友。
They're living there for a reason.
他们住在那里是有原因的。
They don't cause any problems.
它们不会造成任何问题。
But when you cleanse them off, you open up an area for pathogens to take effect, and that's when we see a lot of problems, more so in industrialized countries.
但是当你清理掉它们时，你就为病原体的发挥作用开辟了一个区域，这就是我们看到很多问题的时候，在工业化国家更是如此。
The United States is a notorious place for washing, especially after COVID.
美国是一个臭名昭著的洗涤之地，尤其是在新冠疫情之后。
Wash, wash, wash, wash more, use a toner, wash some more.
洗，洗，洗，多洗，用爽肤水，多洗一些。
And that becomes really problematic because it sets up for organisms to take seed when they shouldn't be there.
这确实是一个问题，因为它让有机体在不应该存在的时候获取种子。
So overall, cleansing is great, and the amount that you need to cleanse is based on how oily or sebaceous your skin is.
所以总的来说，清洁效果很好，你需要清洁的量取决于你的皮肤的油性或皮脂分泌程度。
The older you get, you may not need to cleanse as much.
随着年龄的增长，您可能不需要那么多清洁。
Older patients don't need to cleanse their skin at all every day because they don't produce as much sebum or oil as younger patients.
老年患者根本不需要每天清洁皮肤，因为他们不像年轻患者那样产生那么多的皮脂或油脂。
But everything should be defined by your skin's characteristics.
但一切都应该根据您的皮肤特征来定义。
So if you are one in which you notice by the end of the day, "I'm oily.
因此，如果你是一个在一天结束时注意到的人，“我很油腻。
I'm breaking out," cleansing may be something that's beneficial for you to take off that excess sebum.
我要爆发了，”清洁可能有助于去除多余的皮脂。
If you're one that has dry skin, if you're one that had sensitive skin as a child, then over-cleansing is going to be a problem.
如果你是干性皮肤，如果你小时候皮肤敏感，那么过度清洁就会成为一个问题。
You're going to want to minimize that and keep that moisturization or that barrier protection going.
您需要尽量减少这种情况，并保持保湿或屏障保护。
Andrew Huberman:
安德鲁·休伯曼：
So does that mean that people should bathe probably once or twice a day, but the people that are bathing three times a day, it's probably excessive?
那么，这是否意味着人们应该每天洗澡一到两次，但是对于每天洗澡三次的人来说，这可能是过量的吗？
Are we saying that you can't get into water?
我们是说不能下水吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
When you say cleansing, you're talking about face cleansing.
当你说清洁时，你指的是面部清洁。
I realize this is going to be highly individual, but-
我意识到这将是非常个人化的，但是-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
some people are just out of habit, shower and use cleanser twice a day-
有些人只是出于习惯，每天洗澡、用洗面奶两次——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
or once a day.
或每天一次。
I think for me, it's in the morning or in the evening, sometimes both.
我想对我来说，是在早上或晚上，有时两者都有。
If I do a workout, I try and shower-
如果我锻炼身体，我会尝试洗澡-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
as close as possible after the workout.
锻炼后尽可能接近。
As soon as possible after the workout, rather, because otherwise I will break out.
锻炼后尽快，因为否则我会爆发。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So it sounds like one has to kind of learn what their cadence is, and that's going to vary by age.
因此，听起来人们必须了解自己的节奏是什么，而且这会因年龄而异。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
There's a lot of factors to this.
这有很多因素。
I think Ashton Kutcher and Mila Kunis famously said they shower, I think once a week or something like that, and it stirred up a lot of conversation when that came out.
我认为阿什顿·库彻和米拉·库尼斯曾说过，他们每周洗一次澡或者类似的说法，这句话一出，就引起了很多讨论。
Truth be told, you don't have to cleanse every day if your skin is otherwise fine and healthy and you're not bothered by anything, you live a lifestyle in which you're not sweating excessively or producing a lot of sebum.
说实话，如果您的皮肤状况良好且健康，并且没有任何事情困扰，您的生活方式不会过度出汗或产生大量皮脂，那么您就不必每天进行清洁。
I myself, same thing.
我自己，也是这样。
I work out, so I shower after working out, and I usually shower before I get into bed because after a long day of work, I tend to have things on my skin that shouldn't be there.
我锻炼身体，所以锻炼后我会洗澡，而且我通常在上床睡觉前洗澡，因为经过一整天的工作后，我的皮肤上往往会有不应该存在的东西。
That's only fitting for me because if I don't, I tend to have problems.
这只适合我，因为如果我不这样做，我往往会遇到问题。
I tend to break out.
我倾向于爆发。
I tend to have things that shouldn't happen because of my hygiene habits.
由于我的卫生习惯，我经常会发生一些不应该发生的事情。
That said, there is no indication or no medical necessity to have to cleanse your skin even once a day.
也就是说，没有迹象表明或没有医学必要性必须每天清洁一次皮肤。
Oftentimes, older patients cleanse or shower once a week, and they're totally fine.
通常，老年患者每周清洁或淋浴一次，就完全没问题了。
But it'll have to be defined by your skin and what problems or ailments are specific to you.
但它必须根据您的皮肤以及您特有的问题或疾病来定义。
Generally, if you work out, if you let sweat dry on your skin, it causes several problems.
一般来说，如果你锻炼时，如果让皮肤上的汗水变干，就会导致一些问题。
Number one is irritation itself from the salts that crystallize from the sweat drying off.
第一个是汗水干燥时结晶的盐本身的刺激。
Number two, the sweat itself is a source of food for certain yeast that are normal symbiotic yeast that live on our skin, so it contributes to things like dandruff, what we call tinea versicolor, which is a type of yeast that grows on our skin.
第二，汗液本身是某些酵母菌的食物来源，这些酵母菌是生活在我们皮肤上的正常共生酵母菌，因此它会导致头皮屑（我们称之为花斑癣）等问题，这是一种生长在我们皮肤上的酵母菌。
So generally, if you work out, try to wash those things off.
所以一般来说，如果你锻炼了，试着把这些东西洗掉。
Also, if you are one of acne-prone skin, if you're an adolescent, if you're a teenager, if you're an adult dealing with acne, the sebum that your body's producing is food for the bacteria that cause this, so you tend to want to clean some of that excess sebum off.
另外，如果你是一个容易长粉刺的皮肤，如果你是一个青少年，如果你是一个正在处理粉刺的成年人，你身体产生的皮脂是引起粉刺的细菌的食物，所以你往往想要清除一些多余的皮脂。
Those are simple indications to cleanse both your face and your body.
这些都是清洁面部和身体的简单指示。
But if you're not having any problems, you actually don't need to do any of that.
但如果您没有遇到任何问题，则实际上不需要执行任何操作。
In Europe, they shower and cleanse at a fraction of the frequency that we do in the United States, and when you look at incidences of the most common skin conditions, they're the same.
在欧洲，他们淋浴和清洁的频率只是我们在美国的一小部分，而且当你观察最常见皮肤状况的发生率时，你会发现它们是相同的。
Andrew Huberman:
安德鲁·休伯曼：
Including things like acne, psoriasis.
包括痤疮、牛皮癣等。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Most people think about shampooing for sake of hair.
大多数人认为洗头是为了头发。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But there's the scalp component.
但还有头皮成分。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And since you're an expert in skin, we should probably spend a bit of time on this.
既然您是皮肤专家，我们可能应该在这方面花一些时间。
For people that tend to have a dry or flaky scalp, what should they do about that?
对于头皮容易干燥或脱皮的人来说，应该怎么办呢？
My understanding is that some of the more typical commercial anti-dandruff shampoos can contain things that might cause issues for hair itself.
我的理解是，一些更典型的商业去屑洗发水可能含有可能导致头发本身问题的物质。
So they might help with the flaking and drying of the scalp, but damage other aspects of either appearance or health of hair.
因此，它们可能有助于缓解头皮剥落和干燥，但会损害头发外观或健康的其他方面。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What are some really good options for people that have dry scalp?
对于头皮干燥的人来说，有哪些真正好的选择？
What are some great options for people that have oily scalp?
对于油性头皮的人来说，有哪些不错的选择？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And let's leave aside the frequency of use and just perhaps just put it on the shelf as much as you need it, but not more.
让我们先把使用频率放在一边，也许只是把它放在架子上，需要多少就放多少，但不要更多。
So that could be once a week, it could be daily.
所以可以是每周一次，也可以是每天一次。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It could be twice a day if in extreme cases, it sounds like.
如果在极端情况下，听起来可能是一天两次。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So when we think about the scalp, when we think about dry or flaky scalp, we think about two main conditions, either seborrheic dermatitis, which is medical-grade dandruff, or the medical name for dandruff, or psoriasis.
因此，当我们想到头皮时，当我们想到干燥或片状头皮时，我们会想到两种主要情况，要么是脂溢性皮炎，即医学级头皮屑，要么是头皮屑的医学名称，即牛皮癣。
They're two different entities, but they generally contribute to the same problem, which is redness, flaking, and dryness of the scalp.
它们是两个不同的实体，但它们通常会导致相同的问题，即头皮发红、剥落和干燥。
Now, it's important to note that the hair on your head is dead.
现在，重要的是要注意你头上的头发已经死了。
It's not alive.
它没有活着。
The only area that's alive is two and a half millimeters in the skin.
唯一有活力的区域是皮肤内两毫米半的地方。
So the hair that we see on our scalp is not a living entity.
所以我们在头皮上看到的头发并不是一个生命体。
So there's a common misconception that you can affect the health or quality of your hair by putting things on the hair, and I'll go into that in just a minute.
因此，有一种常见的误解，认为在头发上涂抹东西会影响头发的健康或质量，我稍后会对此进行讨论。
But the hair itself that you see is not living.
但你看到的头发本身并没有生命。
The only area that's living are the stem cells in the papilla of the hair and in the bulge region of the hair, which reside in the skin.
唯一活着的区域是位于皮肤中的毛发乳头和毛发隆起区域的干细胞。
So nothing that you put on your scalp will make you lose your hair, will make you grow new hair for the most part.
因此，涂抹在头皮上的任何东西都不会导致脱发，而且大部分情况下不会让您长出新头发。
Why that's important, when we treat dry or flaky scalp, we treat it with several things.
为什么这很重要，当我们治疗干燥或片状头皮时，我们会用几种方法来治疗。
The most common cause is an overgrowth of yeast from the sweat and oil that is produced from our scalp, and that's seborrheic dermatitis.
最常见的原因是我们头皮产生的汗液和油脂导致酵母菌过度生长，这就是脂溢性皮炎。
That's the medical name for dandruff.
这是头皮屑的医学名称。
And so we treat it by, one, lowering the amount of that yeast that's living, and that's usually with shampoos that are prescription or over-the-counter.
因此，我们的治疗方法是，第一，降低活酵母的数量，这通常是使用处方或非处方洗发水。
Things like zinc or ketoconazole shampoos are very common things.
像锌或酮康唑洗发水这样的东西是很常见的。
And then the other thing that we do is to dampen the immune response to this overgrowth of yeast.
然后我们做的另一件事是抑制对酵母过度生长的免疫反应。
So the reason our skin flakes and gets red and proliferates is our immune system's responding to something.
因此，我们的皮肤剥落、变红和增殖的原因是我们的免疫系统对某些东西做出了反应。
It's either responding to the yeast or it's responding to itself, which is what psoriasis is.
它要么对酵母做出反应，要么对自身做出反应，这就是牛皮癣。
It's an immune-mediated overproliferation of skin cells because the immune system is overactive in the skin.
这是一种免疫介导的皮肤细胞过度增殖，因为皮肤中的免疫系统过度活跃。
And the way we treat that is just topicals or certain medications that suppress the skin's immune system or immune activity.
我们治疗的方法只是局部用药或某些抑制皮肤免疫系统或免疫活动的药物。
None of that affect the actual hair itself.
这些都不会影响实际的头发本身。
What does happen is shampoos tend to have things that strip oils as a mechanism of cleaning.
实际情况是，洗发水往往含有去油成分，作为一种清洁机制。
So when you take a cross-section of the hair, there's seven layers, and the layer that provides that color, sheen, and structure is called the cuticle.
因此，当你观察头发的横截面时，你会发现头发有七层，提供颜色、光泽和结构的层称为角质层。
As we age, we lose the cuticle, and that's a common problem what we see in male and female pattern hair loss or androgenetic alopecia, is we lose that cuticle, which makes us lose the shine and the structure and the strength of our hair.
随着年龄的增长，我们会失去角质层，这是我们在男性和女性型脱发或雄激素性脱发中看到的一个常见问题，就是我们失去了角质层，这使我们失去了头发的光泽、结构和强度。
Our body tries to replenish that with the oils.
我们的身体试图用油来补充它。
So when people wash their hair, sometimes they feel like the hair becomes more limp or dull or lifeless.
因此，当人们洗头时，有时会感觉头发变得更加柔软、暗淡或毫无生气。
It's because we've taken that artificial oil coating that replaced the cuticle and washed it off.
这是因为我们已经用人造油涂层代替了角质层并将其洗掉。
So good news is you're not going to do any harm putting any of the topicals on your scalp.
好消息是，将任何外用药物涂抹在头皮上不会造成任何伤害。
Bad news is you probably won't bring a lot of it back to life either.
坏消息是你可能也无法让很多东西复活。
But when we treat flakiness, redness, things like that, we're treating two entities, usually with topicals, and because we're either trying to treat overproliferation of something or trying to calm down the skin's immune system.
但当我们治疗片状、发红等类似问题时，我们通常是用外用药物来治疗两个实体，因为我们要么试图治疗某些物质的过度增殖，要么试图平静皮肤的免疫系统。
Andrew Huberman:
安德鲁·休伯曼：
Got it.
明白了。
So it sounds like the best options for cleansing skin, for shampooing, really stem from knowing whether or not your skin tends to err oily or dry.
因此，这听起来像是清洁皮肤、洗发的最佳选择，实际上源于了解您的皮肤是否倾向于油性或干性。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Figuring out how often to cleanse, and then as you pointed out before, even though there's an enormous range of cost for these things, none of the solutions that you're describing sound like they fall on the high end of cost or even in the middle end of cost, which is a bit surprising to me.
弄清楚多久清洁一次，然后正如您之前指出的，尽管这些东西的成本范围很大，但您所描述的解决方案听起来都不像成本的高端，甚至是成本的中端，这让我有点惊讶。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
This might be one of the few areas where if I had a magic wand, I would make for all organic, non-processed and minimally processed foods to be very inexpensive.
这可能是少数几个领域之一，如果我有一根魔杖，我会让所有有机、非加工和最低限度加工的食品变得非常便宜。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But it turns out those things tend to be more expensive.
但事实证明这些东西往往更贵。
You can go to farmers markets and cut back on the cost, et cetera, but there seems to be an unfortunate trade-off between availability and cost and benefit.
您可以去农贸市场并削减成本等等，但在可用性与成本和收益之间似乎存在不幸的权衡。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Or at least risk.
或者至少是风险。
But it doesn't sound like that's the case with skincare or scalp care, that one can exercise really excellent skin and scalp care without having to go into a range of spending an outrageous amount of money.
但听起来皮肤护理或头皮护理的情况并非如此，人们可以进行真正出色的皮肤和头皮护理，而不必花费大量金钱。
Dr. Teo Soleymani:
Teo Soleymani 博士：
No, I think, one, you're absolutely right.
不，我认为，一，你是绝对正确的。
The more expensive does not mean better.
越贵并不意味着越好。
In fact, they sometimes become more problematic because there's more ingredients in the more expensive products, including elegant fragrances and stuff like that, which can be problematic.
事实上，它们有时会变得更成问题，因为更昂贵的产品中含有更多成分，包括优雅的香水和类似的东西，这可能会产生问题。
That's number one.
这是第一。
The second thing to know is that generally speaking, there is some connection between skin health, skincare, and this realm of beauty, which people overlap a lot in.
第二件事要知道的是，一般来说，皮肤健康、护肤和这个美丽境界之间存在着某种联系，人们在这方面有很多重叠。
When we trend into this realm of beauty, glamour, et cetera Price and objectivity are taken out, and that's why you see a lot of skincare products that are so expensive because they draw towards another level of desire that's not just medical, it's aesthetic.
当我们进入美丽、魅力等领域时，价格和客观性就被排除在外，这就是为什么你会看到很多护肤品如此昂贵，因为它们吸引了另一个层次的欲望，不仅仅是医疗，而是审美。
And that's where you'll find creams that are $200, $300 for a little amount of cream that does the same thing that your jar of petrolatum or Vaseline or Aquaphor does.
在那里你会发现一些售价 200 美元、300 美元的面霜，其作用与你那罐凡士林或凡士林或 Aquaphor 的作用相同。
That part is really hard to mitigate.
这部分确实很难缓解。
But in general, almost everything that we as dermatologists and skin cancer surgeons and experts in the field recommend are really cheap, cost-effective, and they have the least amount of ingredients in them.
但总的来说，我们作为皮肤科医生和皮肤癌外科医生以及该领域的专家推荐的几乎所有东西都非常便宜，具有成本效益，而且它们的成分含量最少。
And that's what I would recommend.
这就是我所推荐的。
That's what I recommend for my family and for my patients.
这就是我向我的家人和患者的建议。
You don't have to spend a lot to have excellent skincare, and you don't need to have it be a multi-step routine.
您无需花费大量资金即可获得出色的护肤效果，也无需进行多步骤的日常护理。
Oftentimes, people overdo it.
很多时候，人们做得太过分了。
The more steps there are, there's more chances that something your skin will respond to negatively, the more chances you are to have a bad outcome to an ingredient of a product you're putting on your skin.
步骤越多，皮肤产生负面反应的可能性就越大，涂抹在皮肤上的产品成分产生不良结果的可能性就越大。
So keep it simple, keep it cheap, and you'll do great.
因此，保持简单、便宜，你就会做得很好。
Andrew Huberman:
安德鲁·休伯曼：
It's going to be very reassuring to many people.
这会让很多人感到非常放心。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It's also going to be somewhat destabilizing to people-
这也会给人们带来一些不稳定——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
who are really attached to the idea that the more expensive products are really doing something that much more beneficial for them.
他们真正相信更昂贵的产品确实对他们更有利。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Not much at all.
一点也不多。
Not anything.
没什么。
And another important thing to consider when looking at skincare, skin health, and then trending into that area of aesthetics and beauty is that most active ingredients, if they're really active, tend to be controlled by the FDA.
在考虑护肤、皮肤健康以及美学和美容领域时要考虑的另一件重要事情是，大多数活性成分（如果它们确实有效）往往会受到 FDA 的控制。
So most things that are sold over the counter have actives that are not at a concentration high enough to be considered therapeutic, because that's when you get into the definition of a drug.
因此，大多数在柜台上出售的药物都含有活性成分，其浓度不足以被视为具有治疗作用，因为这是您进入药物定义的时候。
So looking at things like anti-dandruff shampoos, anti-aging creams, acne medications, they work a little bit.
因此，看看去屑洗发水、抗衰老霜、痤疮药物等产品，它们都有一定的作用。
If they work perfectly, then most medical dermatologists would be out of a lot of patients, and we see a lot of skin disease that still continues because the active ingredients aren't at a concentration high enough to provide therapeutic benefit.
如果它们工作完美，那么大多数医学皮肤科医生将不再需要大量患者，而且我们看到许多皮肤病仍然存在，因为活性成分的浓度不足以提供治疗效果。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So save your money.
所以省点钱吧。
If you really need something to change some part of your skin, see a good dermatologist, see an expert, and see what they can come up with.
如果您确实需要一些东西来改变皮肤的某些部分，请去看一位优秀的皮肤科医生，看看专家，看看他们能想出什么办法。
Andrew Huberman:
安德鲁·休伯曼：
So this seems like an appropriate time to ask about sun exposure, and then we'll also talk about sunscreen, sunblocks, skin cancer.
因此，现在似乎是询问有关阳光照射的合适时机，然后我们还将讨论防晒霜、防晒霜和皮肤癌。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
But what is the relationship between sun exposure and skin health, specifically?
但阳光照射和皮肤健康之间具体有什么关系呢？
Meaning how much sun exposure is healthy for our skin?
这意味着多少阳光照射对我们的皮肤是健康的？
I'm a big believer in getting sun exposure to the eyes early in the day, blinking as needed to protect the eyes, of course.
我坚信在一天的早些时候让眼睛接触阳光，当然，根据需要眨眼以保护眼睛。
But in order to set one's circadian rhythm for elevated daytime mood, focus, and alertness, and improved nighttime sleep, there's just so much data to support setting one's circadian rhythm properly for sake of health, and there's so much data to support the fact that sunlight viewing, in particular, is the best way to do that, and sunlight viewing in the early part of the day, in particular, is the best way to do that.
但是，为了设置一个人的昼夜节律以提高白天的情绪、注意力和警觉性，并改善夜间睡眠，有很多数据支持为了健康而正确设置一个人的昼夜节律，并且有很多数据支持这样一个事实，即观看阳光尤其是做到这一点的最佳方法，特别是在一天的早些时候观看阳光是做到这一点的最佳方法。
But beyond that, how much sun exposure to the skin is good for us?
但除此之外，皮肤接触多少阳光对我们有益呢？
Is it zero?
是零吗？
Is it five minutes?
是五分钟吗？
Does it depend?
这取决于吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Great controversial question, and it depends on which school of thought or camp you belong in.
这是一个很有争议的问题，这取决于你属于哪个思想流派或阵营。
As a skin cancer surgeon and somebody who's developed a reputation for seeing some of the worst, most complicated, and life-threatening skin cancers in Los Angeles, obviously, I see some of the consequences of long-term sun exposure and chronic photoaging.
作为一名皮肤癌外科医生，以及因在洛杉矶见过一些最严重、最复杂、危及生命的皮肤癌而闻名的人，显然，我看到了长期阳光照射和慢性光老化的一些后果。
That being said, I absolutely think that getting sun is healthy for us.
话虽这么说，我绝对认为晒太阳对我们来说是健康的。
Now, why?
现在，为什么？
The studies that talk about vitamin D, and we'll touch on vitamin D as its own entity, and then overall health as another entity, but most of the studies that look at vitamin D synthesis from UV exposure on the skin suggest that you only need about 15 minutes, and that you don't need a broad surface area of exposure.
讨论维生素 D 的研究，我们将讨论维生素 D 作为其自身的实体，然后将整体健康作为另一个实体，但大多数研究通过皮肤紫外线照射合成维生素 D 的研究表明，您只需要大约 15 分钟，并且不需要大面积的暴露。
You can get enough vitamin D formation with just about 15 to 20 minutes of sun on your forearms.
只需在前臂上晒 15 至 20 分钟的阳光，即可形成足够的维生素 D。
So there's a whole school of thought by a lot of experts who think there's no amount of UV exposure that's healthy for the skin, and I tend to be on the other camp for several reasons.
因此，许多专家有一个完整的思想流派，他们认为没有多少紫外线照射对皮肤是健康的，而我倾向于站在另一个阵营，原因有几个。
One, there's a component of feel-goodness, if that's a word, from being in the sun that affects overall skin and physical biology.
第一，阳光下的感觉良好（如果可以用这个词来形容的话）会影响整体皮肤和身体生物学。
When you're out on a sunny day, you tend to be less stressed, you tend to be a little happier.
当你在阳光明媚的日子外出时，你的压力往往会减轻，你往往会更快乐一些。
Now, it's a generalization, but most of the time when you get outdoors, you get outside, and it's a nice sunny day, you feel better.
现在，这是一个概括，但大多数时候，当你到户外时，你到了户外，而且天气晴朗，你会感觉更好。
And although you can't quantify that feeling better, there are some parameters that can be measured.
虽然你无法更好地量化这种感觉，但有一些参数是可以测量的。
Decreases in cortisol response, improvements in skin appearance and texture.
减少皮质醇反应，改善皮肤外观和质地。
The other important thing about being out in the sun is finding out your own tolerance, right?
晒太阳的另一个重要的事情是找到你自己的耐受力，对吧？
So I have a little bit more olive skin, and I can tolerate the sun a little bit longer than somebody who is fairer and lighter eyes.
所以我的皮肤是橄榄色的，而且我比那些眼睛更白、颜色更浅的人能忍受阳光的时间更长一些。
In my opinion, I don't think, and in most of the evidence, there isn't a finite amount of time because that time is dictated by your skin's ability to tolerate the UV.
在我看来，我认为，并且在大多数证据中，没有有限的时间，因为该时间是由皮肤耐受紫外线的能力决定的。
But I absolutely do not think that sun avoidance is a healthy thing, and this is coming from somebody who operates on head and neck skin cancers literally every day.
但我绝对不认为避免日晒是一件健康的事情，而且这是来自每天都在进行头颈皮肤癌手术的人。
I think there is a component of sun exposure that's not just for vitamin D synthesis, but something that improves your overall wellness that is visible and maybe not laboratory measurable, but you definitely are healthier when you're feeling better and you're happier.
我认为阳光照射的一个组成部分不仅有助于维生素 D 的合成，而且还能改善您的整体健康状况，这种健康状况是可见的，也许无法通过实验室测量，但当您感觉更好、更快乐时，您肯定会更健康。
I lived on the East Coast in places that had lower days of sun, and I had seasonal affective disorder.
我住在东海岸，阳光照射时间较少的地方，我患有季节性情感障碍。
It bothered me.
这让我很烦恼。
My mood was lower.
我的心情比较低落。
I felt not as healthy.
我感觉不太健康。
I'd come home, my family would say, "Hey, you look sick." And I wasn't sick.
我回到家，我的家人会说：“嘿，你看起来病了。”而且我没有生病。
I hadn't had any sun, and I was lighter than I was, and my family interpreted that as not being healthy.
我没有晒过太阳，体重也比实际体重轻，我的家人认为这不健康。
My wife, on the other hand, didn't.
另一方面，我的妻子则没有。
She didn't mind the grayness.
她并不介意灰色。
So there's a timeline for biologic processes like vitamin D formation that's helpful.
因此，维生素 D 形成等生物过程的时间表很有帮助。
People can argue that you can get it through supplementation in food, and that's correct.
人们可能会说你可以通过食物补充剂来获取它，这是正确的。
But there is a component of sun exposure that makes you feel better overall and provides some sort of wellness that you may not be able to quantify, but you see in appearance and in discussion in longevity.
但是，阳光照射的一部分可以让你整体感觉更好，并提供某种你可能无法量化的健康，但你可以从外表和关于长寿的讨论中看到。
So absolutely, I think you should be out in the sun.
所以绝对，我认为你应该出去晒太阳。
I don't think you should burn, and I don't think you should be out long enough where your skin starts to turn red.
我认为你不应该被烧伤，也不应该在皮肤开始变红的地方待太久。
That's the first sign that you're reaching critical mass in terms of UV exposure.
这是您的紫外线暴露量达到临界值的第一个迹象。
But I absolutely think the sun is a good thing for us.
但我绝对认为阳光对我们来说是一件好事。
Andrew Huberman:
安德鲁·休伯曼：
So even midday sun, maybe if there's some cloud cover or if we have some sunscreen on or a physical barrier like hat and long sleeves, then getting some sun exposure in your mind is good for our overall wellbeing, mood, et cetera.
因此，即使是正午的阳光，也许如果有一些云层，或者如果我们涂了一些防晒霜，或者有帽子和长袖之类的物理屏障，那么在你的脑海中接触一些阳光对我们的整体健康、情绪等都有好处。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Midday sun has a higher UV index, so you're more likely to burn and have a problem with prolonged exposure.
正午的阳光具有较高的紫外线指数，因此您更容易被晒伤，并且长时间暴露在阳光下会出现问题。
But yeah, absolutely.
但是，是的，绝对是。
There's been numerous studies that have looked at people who go out for a walk in busy urban cities, in work environments.
有大量研究调查了在繁忙的城市和工作环境中外出散步的人。
If they go out for a walk in the sun, they feel better.
如果他们出去在阳光下散步，他们会感觉更好。
Their stress responses are lower.
他们的压力反应较低。
Their questionnaires in responding to life stressors and day-to-day stressors are decreased.
他们对生活压力和日常压力的问卷调查有所减少。
There's a lot of studies that look at being outside as a measure of wellbeing, mental health wellbeing is improved with outdoor sun exposure, so there's a lot of that.
有很多研究将户外活动视为幸福感的衡量标准，户外阳光照射可以改善心理健康，所以这样的研究有很多。
Now, can I quantify it in the skin?
现在，我可以量化皮肤中的它吗？
Hard to say.
很难说。
One thing we do know is that obviously too much sun exposure, like anything, too much of a good thing can be a bad thing.
我们确实知道的一件事是，显然，太多的阳光照射，就像任何事情一样，太多的好事可能是坏事。
But I really do think that being out in the sun for the amount that your skin can tolerate is a good thing.
但我确实认为，在皮肤可以承受的范围内晒太阳是一件好事。
Andrew Huberman:
安德鲁·休伯曼：
I'd like to take a brief break to thank one of our sponsors, LMNT.
我想短暂休息一下，以感谢我们的赞助商之一 LMNT。
LMNT is an electrolyte drink that has everything you need and nothing you don't.
LMNT 是一种电解质饮料，拥有您需要的一切，没有您不需要的东西。
That means the electrolytes, sodium, magnesium, and potassium, in the correct ratios, but no sugar.
这意味着电解质、钠、镁和钾的比例正确，但不含糖。
Now, I and others on the podcast have talked a lot about the critical importance of hydration for proper brain and bodily function.
现在，我和播客上的其他人已经谈论了很多关于水合作用对于大脑和身体正常功能的至关重要性。
Research shows that even a slight degree of dehydration can really diminish cognitive and physical performance.
研究表明，即使是轻微程度的脱水也会确实降低认知和身体表现。
It's also important that you get adequate electrolytes in order for your body and brain to function at their best.
获得足够的电解质也很重要，这样您的身体和大脑才能发挥最佳功能。
The electrolytes, sodium, magnesium, and potassium, are critical for the functioning of all the cells in your body, especially your neurons or nerve cells.
电解质（钠、镁和钾）对于体内所有细胞（尤其是神经元或神经细胞）的功能至关重要。
To make sure that I'm getting proper amounts of hydration and electrolytes, I dissolve one packet of LMNT in about 16 to 32 ounces of water when I wake up in the morning, and I drink that basically first thing in the morning.
为了确保我获得适量的水合作用和电解质，当我早上醒来时，我将一包 LMNT 溶解在大约 16 至 32 盎司的水中，并且我基本上早上第一件事就是喝它。
I also drink LMNT dissolved in water during any kind of physical exercise I'm doing, especially on hot days if I'm sweating a lot and losing water and electrolytes.
我还会在进行任何体育锻炼时饮用溶解在水中的 LMNT，尤其是在炎热的天气里，如果我大量出汗并失去水分和电解质。
If you'd like to try LMNT, you can go to drinklmnt.com/huberman, spelled drink L-M-N-T.com/huberman to claim a free LMNT sample pack with the purchase of any LMNT drink mix.
如果您想尝试 LMNT，可以访问 Drinklmnt.com/huberman（拼写为 Drink L-M-N-T.com/huberman），购买任何 LMNT 混合饮料即可领取免费 LMNT 样品包。
Again, that's drinklmnt.com/huberman to claim a free sample pack.
再次强调，请访问 Drinklmnt.com/huberman 索取免费样品包。
What about sunscreens and sunblocks?
防晒霜和防晒霜怎么样？
And I think we should distinguish between those two labels.
我认为我们应该区分这两个标签。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
In the old days, as I understand, sunscreen was the word used to describe stuff that you put on your skin that absorbs UV, and then sunblock is the stuff that you put on your skin to reflect UV.
在过去，据我了解，防晒霜这个词用来形容涂在皮肤上吸收紫外线的东西，然后防晒霜就是涂在皮肤上反射紫外线的东西。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Typically, nowadays, people say sunscreen more than they say sunblock, or they use them interchangeably without any knowledge of the underlying mechanism.
通常，现在人们说防晒霜的次数多于他们说防晒霜的次数，或者他们在不了解其潜在机制的情况下互换使用它们。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So first of all, let's clarify sunscreen versus sunblock.
首先，让我们澄清一下防晒霜和防晒霜。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So a lot of the nomenclature, data, understanding chemicals, things that were considered okay to be used came from an original FDA 1999 manuscript, and that data hadn't changed for almost 20-something years.
因此，许多术语、数据、化学物质理解以及被认为可以使用的东西都来自 FDA 1999 年的原始手稿，并且这些数据几乎 20 多年来没有改变。
And more recently, in 2021, the FDA released a proposed final order for the term sunscreens as a whole.
最近，即 2021 年，FDA 发布了针对整个防晒霜一词的拟议最终命令。
Now, when we talk about sunscreens, sunscreens are considered an over-the-counter, non-prescription drug, so they're regulated tightly by the FDA.
现在，当我们谈论防晒霜时，防晒霜被认为是一种非处方药，因此受到 FDA 的严格监管。
They're in the same category as any over-the-counter drug.
它们与任何非处方药属于同一类别。
So before this decision ruling, there was a lot of nomenclature, wording confusion.
所以在这个决定裁决之前，存在着很多术语、措辞的混乱。
Sunblock seemed better than sunscreen, suntan, suntan oil.
防晒霜似乎比防晒霜、防晒霜、防晒油更好。
All of that's been changed recently, or has been proposed to get rid of to unify the field and make it very clear what the goal is.
所有这些最近都被改变了，或者已经被提议摆脱以统一该领域并明确目标是什么。
So no longer do we use the term sunblock, although in the past, that had been used for things like zinc or zinc and titanium-based creams, like the old 1980s or 1990s white lifeguard noses, if you remember.
因此，我们不再使用防晒霜这个术语，尽管在过去，防晒霜曾被用于锌或锌和钛基面霜之类的东西，比如 20 世纪 80 年代或 90 年代的白色救生员鼻子，如果你还记得的话。
That used to be thought of sunblock, whereas less protective chemicals were used as sunscreen.
这曾经被认为是防晒霜，而防护性较低的化学物质则被用作防晒霜。
Now that's changing, and the FDA 2021 proposed order says we need to unify everything and call it a sunscreen.
现在这种情况正在改变，FDA 2021 年拟议命令称我们需要统一所有内容并将其称为防晒霜。
Now, sunscreens being regulated drugs take a lot of scrutiny for many reasons.
现在，由于多种原因，防晒霜成为受管制药物，受到严格审查。
They take scrutiny from the FDA in terms of proving efficacy and safety.
他们在证明有效性和安全性方面接受 FDA 的审查。
They take a lot of scrutiny in society for being dangerous or not dangerous, effective or not effective, causing downstream effects or not causing downstream effects.
它们因危险或不危险、有效或无效、造成下游影响或不造成下游影响而受到社会的大量审查。
So that's been a big point of contention in terms of the population, the American Academy's stance, dermatologists' stance, and then the skin cancer patients' beliefs, the beauty experts' beliefs, and average persons' opinions.
因此，就人口、美国科学院的立场、皮肤科医生的立场，以及皮肤癌患者的信念、美容专家的信念和普通人的观点而言，这一直是一个争论的焦点。
Sunscreens generally fall into creams, lotions, topical products that protect the skin against sunburn.
防晒霜通常分为霜剂、乳液、保护皮肤免遭晒伤的外用产品。
We used to be able to suggest that they reduce the risk of skin cancer, prevented premature aging, but that can be a little convoluted, and the FDA is rewording that into not being able to say that anymore in their proposed order.
我们曾经能够建议它们降低皮肤癌的风险，防止过早衰老，但这可能有点复杂，FDA 正在将其改写为不能在他们提议的命令中再这么说。
But what sunscreen's intention is, is to protect the skin against excess UV exposure, and they come in two flavors.
但防晒霜的目的是保护皮肤免受过度紫外线照射，它们有两种口味。
They come in mineral-based sunscreens, which tend to be in the category of zinc and titanium minerals, and they tend to be chemical sunscreens, which are a bunch of different chemicals.
它们属于矿物防晒霜，通常属于锌和钛矿物类别，它们往往是化学防晒霜，是一堆不同的化学物质。
Andrew Huberman:
安德鲁·休伯曼：
Mineral-based sunscreens are sometimes called inorganic.
矿物防晒霜有时被称为无机防晒霜。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Correct?
对吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Inorganic or physical sunscreens, whereas the chemicals are considered organic or chemical sunscreens.
无机或物理防晒霜，而化学物质则被视为有机或化学防晒霜。
Totally right.
完全正确。
Andrew Huberman:
安德鲁·休伯曼：
Is the mechanism for these two the same?
这两者的作用机制是一样的吗？
Because I was under the impression that the mineral-based inorganic sunscreens reflected back UV rays, whereas the chemical-based sunscreens absorbed UV rays.
因为我的印象是矿物基无机防晒霜会反射紫外线，而化学防晒霜会吸收紫外线。
But there's a bit of a online-
不过网上有一点——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
debate about this, claiming that they all absorb UV rays.
对此有争论，声称它们都吸收紫外线。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So historically, it had been thought that mineral or physical sunscreens, zinc, zinc and titanium sunscreens, worked by basically acting as a metal-reflecting shield.
从历史上看，人们一直认为矿物或物理防晒霜、锌、锌和钛防晒霜的作用基本上是充当金属反射罩。
And for the most part, that thinking is not incorrect.
在大多数情况下，这种想法并没有错。
There was a new study that showed that they work by actually absorbing them, but not having any sort of chemical change.
一项新的研究表明，它们实际上是通过吸收它们来起作用的，但没有发生任何化学变化。
So the way chemical organic sunscreens work is they absorb the ultraviolet radiation, they undergo a chemical reaction to reduce its energy and dissipate that energy as heat.
因此，化学有机防晒霜的工作方式是吸收紫外线辐射，进行化学反应以减少其能量并将该能量以热量的形式耗散。
So chemical sunscreens work by actually absorbing it and undergoing a change, whereas mineral or physical sunscreens don't do that.
因此，化学防晒霜的工作原理是实际吸收它并发生变化，而矿物或物理防晒霜则不会这样做。
I still think of them simply as minerals basically shield the skin like armor, whereas chemicals act as a sink and undergo a change to reduce that energy.
我仍然认为它们只是矿物质，基本上像盔甲一样保护皮肤，而化学物质则充当水槽并经历变化以减少能量。
So that's kind of the simplistic way that topical sunscreens work.
这就是外用防晒霜的简单作用方式。
Andrew Huberman:
安德鲁·休伯曼：
So what is your recommendation about protecting oneself from the sun?
那么对于保护自己免受阳光照射，您有什么建议呢？
And maybe for the moment, let's just set aside sunscreens and acknowledge that a physical barrier like hat, long sleeves, long pants, provides a pretty good barrier to the sun, correct?
也许现在，我们先把防晒霜放在一边，承认帽子、长袖、长裤等物理屏障可以很好地阻挡阳光，对吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
In fact, physical barriers like shade, clothing, hats have been shown to be more effective than topical sunscreens for several reasons.
事实上，由于多种原因，遮荫、衣服、帽子等物理屏障已被证明比局部防晒霜更有效。
But there are many ways to protect your skin, and you have to ask why you're protecting your skin.
但保护皮肤的方法有很多，您必须问为什么要保护皮肤。
So is it because you're worried about premature aging, photo damage, and things of that nature?
那么是因为您担心过早衰老、光损伤之类的事情吗？
Are you worried about your risk for skin cancer?
您担心自己患皮肤癌的风险吗？
Do you have a sun-sensitive skin condition like lupus or PMLE that is sensitive to UV exposure?
您是否患有红斑狼疮或 PMLE 等对阳光敏感的皮肤病，对紫外线照射敏感？
So the first question is, why are you worried, or why are you taking protection?
所以第一个问题是，你为什么担心，或者为什么要采取保护措施？
And then you customize your approach to that.
然后你定制你的方法。
Now, sunscreen, topical sunscreens, are not the only form.
现在，防晒霜、外用防晒霜并不是唯一的形式。
By and large, there are many other forms, both physical blockers and certain things in the supplement world that can protect your skin.
总的来说，还有许多其他形式可以保护您的皮肤，包括物理阻滞剂和补充剂领域的某些物质。
For example, I myself take a product called Sun Powder that provides an internal sun shield and allows me to be in the sun longer, without the need to reapply or if I can't reapply.
例如，我自己服用一种名为“Sun Powder”的产品，它提供内部遮阳罩，让我可以在阳光下停留更长时间，而无需重新涂抹或无法重新涂抹。
But by and large, the best way to protect your skin is some sort of shield, whether it's clothing, hat, or some sort of cream that you put on.
但总的来说，保护皮肤的最佳方法是某种防护罩，无论是衣服、帽子还是涂抹的某种霜。
Now, for patients who are worried or for people who are worried about premature aging, they don't have a strong family history of skin cancer.
现在，对于担心的患者或担心过早衰老的人来说，他们没有明显的皮肤癌家族史。
They've never had one before themselves.
他们之前从未有过这样的经历。
Then the approach to that is a little bit different than people who are worried about skin cancer development, strong family history of skin cancer.
那么，这种方法与那些担心皮肤癌发展、强烈的皮肤癌家族史的人有点不同。
They're worried about losing a part of their ear or a part of their nose to skin cancer development.
他们担心因皮肤癌而失去一部分耳朵或一部分鼻子。
And that's very different from medical conditions that are very sun sensitive.
这与对阳光非常敏感的医疗状况有很大不同。
By and large, the patients who have medical conditions that are sun sensitive, the large one being lupus, for example, need the most sun protection because they are so inherently sensitive to UV exposure.
总的来说，患有对阳光敏感的疾病（例如狼疮）的患者最需要防晒，因为他们天生对紫外线照射非常敏感。
Something that's very interesting, we know without a doubt that every common skin cancer, there's many skin cancer types, but the three most common are basal cell carcinoma, squamous cell carcinoma, and melanoma.
非常有趣的是，我们毫无疑问地知道，每种常见的皮肤癌都有很多种皮肤癌类型，但最常见的三种是基底细胞癌、鳞状细胞癌和黑色素瘤。
Those are the three most common ones we see.
这是我们最常见的三种。
They have all been shown to have UV mutation signatures when we sequence the tumors.
当我们对肿瘤进行测序时，它们都被证明具有紫外线突变特征。
However, in every single clinical trial, in every single randomized trial that looked at topical sunscreens as a means of reducing risk, there has not been a single study that showed any sort of risk reduction in the development of the most common skin cancer, which is basal cell carcinoma.
然而，在每一项临床试验中，在每一项将外用防晒霜作为降低风险手段的随机试验中，都没有一项研究表明，最常见的皮肤癌（即基底细胞癌）的发展风险有任何形式的降低。
One in four Americans will develop this.
四分之一的美国人会发展这个。
Also, there hasn't been a single study to date that showed that diligent sunscreen use, topical sunscreens, will reduce disease-specific death or dying from skin cancer.
此外，迄今为止还没有一项研究表明勤奋使用防晒霜（局部防晒霜）可以减少特定疾病的死亡或死于皮肤癌的风险。
So if you think every skin cancer is sun-driven, there are UV mutation profiles in these tumors, then by using sunscreen should reduce that.
因此，如果您认为每种皮肤癌都是由阳光引起的，那么这些肿瘤中存在紫外线突变特征，那么使用防晒霜应该可以减少这种情况。
And it's not that clear.
这还不是那么清楚。
We don't understand fully the drivers of this.
我们并不完全了解其驱动因素。
So why I bring this up and why we talk about sunscreens and barriers to blockade first, topical sunscreens are not the only form.
那么为什么我要提出这个问题，为什么我们首先要谈论防晒霜和封锁障碍，外用防晒霜并不是唯一的形式。
In fact, clothing and shields, shade and hat are, in my opinion, better, and a lot of studies suggest that they're better.
事实上，在我看来，衣服和盾牌、遮阳罩和帽子更好，而且很多研究表明它们更好。
There are oral supplements that can also protect your skin from burning and reduce your skin cancer risk.
有些口服补充剂还可以保护您的皮肤免遭灼伤并降低患皮肤癌的风险。
And number three, not everything is sun-driven.
第三，并非所有事物都是由太阳驱动的。
We do know that diligent sunscreen use decreases the incidence or the amount of melanoma formation and squamous cell formation, but we still don't know whether that reduction has changed the number of patients dying from that.
我们确实知道，勤奋使用防晒霜可以降低黑色素瘤和鳞状细胞形成的发生率或数量，但我们仍然不知道这种减少是否改变了因此死亡的患者数量。
We also know that it has no bearing in the development of the most common skin cancer, which is basal cell.
我们还知道，它与最常见的皮肤癌（基底细胞癌）的发展无关。
So we go back to the drawing board and scratch our heads saying, "Hey, what is the trigger?" The genetics loads the gun, for example, and maybe even pulls the hammer, but what in the environment is the trigger?
所以我们回到绘图板并挠头说：“嘿，触发点是什么？”例如，基因给枪上膛，甚至可能拉动击锤，但扳机在环境中是什么？
Is it strictly UV?
严格来说是紫外线吗？
Is it some other culprit?
难道还有其他罪魁祸首吗？
So sunscreens are a really hotly debated topic.
因此，防晒霜是一个非常热门的话题。
So many things to talk about in terms of sunscreen.
关于防晒，有很多话要说。
Andrew Huberman:
安德鲁·休伯曼：
So if I understand correctly, you're saying that the use of sunscreen can protect against premature aging.
如果我理解正确的话，你是说使用防晒霜可以防止过早衰老。
Let's say sunblock, because I think we're going to arrive at mineral-based sunscreens probably being the better option.
让我们说防晒霜，因为我认为我们将推出矿物防晒霜，这可能是更好的选择。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
But we can make sure that we double-click on that, so to speak.
但可以这么说，我们可以确保双击它。
But that sun exposure itself perhaps is not linked to the most deadly of skin cancers.
但阳光照射本身可能与最致命的皮肤癌无关。
That tells me two things.
这告诉我两件事。
It doesn't tell me that I can just spend as much time as I want in the sun, but it does tell me that I should probably look into the things that cause the most deadly skin cancers.
它并没有告诉我我可以在阳光下度过尽可能多的时间，但它确实告诉我我应该研究导致最致命的皮肤癌的因素。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
But I'm also hearing that regular application of sunblock and/or physical barrier will protect my skin against some forms of premature aging caused by sun exposure, but will not necessarily protect me against the most common forms of skin cancer.
但我也听说，定期使用防晒霜和/或物理屏障可以保护我的皮肤免受阳光照射引起的某些形式的过早衰老，但不一定能保护我免受最常见形式的皮肤癌的影响。
That is peculiar in the sense that, or even baffling to the non-dermatologist, me, because we already know that sun exposure causes UV mutations.
从某种意义上说，这很奇怪，甚至让我这个非皮肤科医生感到困惑，因为我们已经知道阳光照射会导致紫外线突变。
Mutations in the DNA of cells is one of the core components of cancer.
细胞DNA突变是癌症的核心组成部分之一。
So how do we square all of this?
那么我们如何解决所有这些问题呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Great question, and the more we dive into this, and the more experts we look at, and the more data we collect, the more we're scratching our head as to we don't know and why this occurs.
这是一个很好的问题，我们越深入研究这个问题，我们研究的专家越多，我们收集的数据越多，我们就越摸不着头脑，不知道为什么会发生这种情况。
Now, I'm not saying don't use sunscreen.
现在，我并不是说不要使用防晒霜。
Let's just let that be known.
让我们让大家知道这一点。
I think sunscreens are excellent forms to protect against premature photoaging and signs of sun damage.
我认为防晒霜是防止过早光老化和阳光损伤迹象的极好形式。
I think sunscreens help reduce the incidence of common garden variety skin cancers, but they are not the only form of protection, and they seem to not be as important or have as much effect in reducing the incidence of our most common skin cancer, which is basal cell carcinoma.
我认为防晒霜有助于降低常见皮肤癌的发病率，但它们并不是唯一的保护形式，而且它们在降低我们最常见的皮肤癌（即基底细胞癌）的发病率方面似乎并不那么重要或有那么大的作用。
Moreover, I would say, and the data unfortunately shows, that the majority of skin cancers that we see that end up hurting people or killing patients don't arise in chronic sun-exposed areas to begin with.
此外，我想说，不幸的是，数据显示，我们看到的大多数最终伤害人类或杀死患者的皮肤癌并不是出现在长期暴露在阳光下的区域。
I have a 27-year-old patient right now dying of metastatic melanoma that arose in completely sun-protected skin.
我有一位 27 岁的患者，现在死于完全防晒的皮肤中出现的转移性黑色素瘤。
I have a 56-year-old mechanic right now who's dying of a squamous cell carcinoma that arose from the back of his ear.
我现在有一位 56 岁的机械师，他死于耳后的鳞状细胞癌。
And most experts who have this type of experience dealing with these patients have the same observation.
大多数拥有此类患者治疗经验的专家也有相同的观察结果。
So the question is, what's pulling the trigger?
那么问题来了，是什么触发了这一事件？
For the most part, UV plays a big role.
在大多数情况下，紫外线发挥着重要作用。
The mechanism in which cancer forms, if we believe the basic high school biology, is hyperplasia, metaplasia, dysplasia, carcinoma.
如果我们相信基础高中生物学的话，癌症形成的机制是增生、化生、不典型增生、癌。
So there's a trajectory of changes that are occurring as a result of cumulative mutations in the skin.
因此，由于皮肤突变的累积，正在发生一系列变化。
If we believe that trajectory, then every skin cancer should see that change, and we just don't see that.
如果我们相信这个轨迹，那么每种皮肤癌都应该看到这种变化，但我们只是没有看到。
Also, we know that skin cancers that arise in sun-damaged skin behave differently than the ones that are very lethal.
此外，我们知道，因阳光受损的皮肤而产生的皮肤癌与致命性皮肤癌的表现不同。
So why I bring this up, I think sunscreen is very helpful, but we have this unfortunate trend in medicine, particularly in dermatology, to guilt people into thinking that they caused this to themselves, and I don't think that's right nor okay, and I don't like that.
所以为什么我提出这个问题，我认为防晒霜非常有帮助，但我们在医学上有这种不幸的趋势，特别是在皮肤科，让人们感到内疚，认为这是他们自己造成的，我认为这是不对的，也不好，我不喜欢这样。
Because they make it seem that, "Oh, the sun you got in 1987, that one sunburn in Hawaii did it to you," and that's absolutely not the case.
因为他们让人觉得，“哦，1987 年的阳光，夏威夷的一次晒伤让你受伤了”，但事实绝对不是这样。
There are many things at play, fundamentally your genetics and immune system, that play a huge role in skin cancer development that sunscreen cannot address and will not address.
有很多因素在起作用，从根本上讲是您的遗传和免疫系统，它们在皮肤癌的发展中发挥着巨大作用，而防晒霜无法解决也不会解决这些问题。
Now, the wild card is, okay, what are my genetics?
现在，变数是，好吧，我的基因是什么？
And that's the part we don't know, which is why dermatologists say, "Okay, let's at least control the thing that we can," which is UV exposure.
这就是我们不知道的部分，这就是为什么皮肤科医生说，“好吧，让我们至少控制我们能控制的事情”，那就是紫外线照射。
But I bring this up because don't feel bad about getting some sun, and don't feel guilted into something that if something bad occurs, it's not your fault.
但我提出这个问题是因为不要因为晒太阳而感到难过，也不要因为如果发生不好的事情而感到内疚，这不是你的错。
Some of it is out of your control, and that's really important because I see a lot of very bad skin cancers in my practice, and I hate this feeling of patients feeling like they did it to themselves.
其中一些是你无法控制的，这非常重要，因为我在实践中看到了很多非常严重的皮肤癌，我讨厌患者感觉像是他们自己做的事情。
Andrew Huberman:
安德鲁·休伯曼：
I think most people would prefer not to have the premature aging caused by sun exposure.
我想大多数人都不愿意因为阳光照射而过早衰老。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So what should those people do?
那么那些人应该做什么呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I've taken on a practice of Putting a mineral-based inorganic sunscreen on my face, my arms if they're going to be exposed, back of my neck, tops of my ears, if I'm going to be out in midday or late day sun that feels intense, and I'll do that every single time I go out now.
我已经采取了一种做法，在我的脸上、我的手臂（如果它们要暴露在外）、我的脖子后面、我的耳朵顶部（如果我要在正午或傍晚的阳光下感觉很强烈）外出，我会在我每次出门时都这样做。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
On overcast days, not so much.
阴天的话，就不那么严重了。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Okay.
好的。
Andrew Huberman:
安德鲁·休伯曼：
For viewing morning sunlight, I don't do that.
为了观看早晨的阳光，我不会这样做。
In fact, when the sun is low in the sky, I don't tend to wear sunblock.
事实上，当太阳在天空中很低时，我不太倾向于涂防晒霜。
That's me.
这就是我。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
That's been my choice.
这是我的选择。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
There were a few years there where I didn't put on sunscreen, or if I did, it was on a camping trip or skiing or something where the sun felt very intense, and in that case, I would just reach for whatever sunscreen or sunblock was available because I wasn't aware that some of the ingredients in certain chemical-based sunscreens may be problematic.
有几年我没有涂防晒霜，或者即使涂了，也是在野营旅行或滑雪或阳光非常强烈的地方，在这种情况下，我只会使用任何可用的防晒霜或防晒霜，因为我不知道某些化学防晒霜中的某些成分可能有问题。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So, I think I fall into the typical category of a lot of people.
所以，我想我属于很多人的典型类别。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But of course, there's the category of people that are like, nope, sunscreen sunblock is terrible all the time, or they're just too lazy or uninterested in applying it.
但当然，有一类人会说，不，防晒霜一直很糟糕，或者他们只是太懒了或对使用它不感兴趣。
But then there's this whole category of people that are putting it on every single time they go outside-
但有一类人每次出门都会戴上它——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
in hopes that that's going to keep their skin appearing much younger.
希望这能让他们的皮肤看起来更年轻。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And just generally are kind of afraid of the sun.
而且一般来说都有点害怕阳光。
Dr. Teo Soleymani:
Teo Soleymani 博士：
A lot of good points.
有很多优点。
So there's that famous New England Journal of Medicine picture of the truck driver that got chronic sun exposure on the left side of his face, and you see all this wrinkling and modeling of the skin on the left side and nothing on the right side.
因此，有一张著名的《新英格兰医学杂志》照片，卡车司机的左脸长期暴露在阳光下，你会看到左侧皮肤出现皱纹和造型，而右侧却什么也没有。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So by absolute measure, sun protection or UV protection will reduce premature aging.
因此，从绝对意义上讲，防晒或防紫外线将减少过早衰老。
Now, interestingly, that guy did not develop anything in that area, so again, it goes back to, well, what's pulling the-
现在，有趣的是，那个人没有在该领域开发任何东西，所以再次，它又回到了，好吧，是什么在拉-
Andrew Huberman:
安德鲁·休伯曼：
No skin cancers
无皮肤癌
Dr. Teo Soleymani:
Teo Soleymani 博士：
...
...
nerve?
神经？
So the question is, what's pulling the trigger?
那么问题来了，是什么触发了这一事件？
Is it truly UV, or is there something else we're missing?
它真的是紫外线吗？还是我们还遗漏了其他东西？
Andrew Huberman:
安德鲁·休伯曼：
If you tell me that he got skin cancer on the opposite side, then I'm really going to gasp.
如果你告诉我他的另一侧得了皮肤癌，那我真的要倒吸一口凉气了。
But yeah.
但是是的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
I don't know if he's had any on the opposite side, but in that photo, it's purely premature aging.
我不知道他的对面有没有，但在那张照片里，纯粹是未老先衰。
So things that you want to do, obviously, don't let your skin turn red.
所以，显然，你想做的事情就是不要让你的皮肤变红。
Take some form of barrier protection, whether it's a sunscreen, a supplement like polypodium, something that protects your skin from the inside out.
采取某种形式的屏障保护，无论是防晒霜、Polypodium 之类的补充剂，还是从内到外保护您的皮肤的东西。
And skin changes are cumulative.
而且皮肤的变化是累积的。
So what we can tolerate in our teens and 20s is very different than what we can tolerate in our 40s, 50s, and 60s because there's a cumulative mutation profile burden that we see.
因此，我们在十几岁和 20 多岁的时候所能忍受的与我们在 40 多岁、50 多岁和 60 多岁的时候所能忍受的有很大不同，因为我们看到了累积的突变谱负担。
Interestingly, there was an eyelid study that was published recently that looked at eyelid skin that was removed during cosmetic surgery, upper eyelid lifts that were otherwise discarded.
有趣的是，最近发表了一项眼睑研究，研究的是整容手术中去除的眼睑皮肤，以及原本被丢弃的上眼睑提拉术。
And when they ran genetic sequencing on normal eyelid skin, they saw the same mutations that they would see in matched skin cancers.
当他们对正常眼睑皮肤进行基因测序时，他们发现了与匹配的皮肤癌中相同的突变。
Andrew Huberman:
安德鲁·休伯曼：
Mm.
嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
But the eyelids didn't have any skin cancer.
但眼睑没有任何皮肤癌。
So we know UV triggers these mutations, and we know UV degrades collagen and elastin.
所以我们知道紫外线会引发这些突变，并且我们知道紫外线会降解胶原蛋白和弹性蛋白。
It thins blood vessel walls as a mechanism of its effects on the dermis.
它使血管壁变薄，这是其对真皮产生影响的机制。
The data is equivocal as to how those mutations trigger skin cancer formation, but in terms of premature aging, absolutely.
关于这些突变如何引发皮肤癌形成的数据尚不明确，但就过早衰老而言，绝对是这样。
So you want to take some form of protection.
所以你想采取某种形式的保护。
Now, what type of protection do you take?
现在，您采取什么类型的保护？
Depends on your genetics, how much you can tolerate, and what your family lineage looks like.
取决于你的基因、你能忍受的程度以及你的家族血统。
Some people have the genetics of early aging.
有些人有早衰的基因。
It's part of their skin biology, and you can't change that, but you can mitigate that risk with more strict UV avoidance.
这是他们皮肤生物学的一部分，你无法改变这一点，但你可以通过更严格的避免紫外线来降低这种风险。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Some people, they look young longer.
有些人，看起来年轻的时间更长。
Some family lineages just have great genetics in their skin.
有些家族血统的皮肤上有很好的遗传基因。
They can tolerate a little bit more sun.
他们可以忍受多一点的阳光。
In terms of physical sunscreens versus chemical sunscreens, that's a hotly debated topic.
就物理防晒霜与化学防晒霜而言，这是一个备受争议的话题。
In my personal practice and for my family, I tend to only recommend mineral zinc or zinc and titanium sunscreens for several reasons.
在我的个人实践和我的家人中，出于多种原因，我倾向于只推荐矿物锌或锌和钛防晒霜。
In the original set of sunscreens that were approved by the FDA that came out in 1999, there wasn't enough data to look at biologic effects, efficacy, internal organ involvement, et cetera.
在 1999 年 FDA 批准的第一批防晒霜中，没有足够的数据来研究生物效应、功效、内脏器官参与等。
Fast-forward 20 years, and we've gathered a lot more information about these chemical organic compounds.
快进 20 年，我们收集了更多有关这些化学有机化合物的信息。
There is an amazing 2020 study that looked at absorption of chemical sunscreens when they're applied onto the skin.
2020 年有一项令人惊叹的研究，研究了化学防晒霜涂在皮肤上后的吸收情况。
They looked at absorption with single application, and they looked at absorption over four days of application.
他们观察了单次涂抹的吸收情况，并观察了四天涂抹后的吸收情况。
Now, in the study, they applied a little bit more than real-world experience would, but even with single application, they saw blood plasma absorption of these chemicals that were 100 to 500 times greater than the upper threshold defined by the FDA.
现在，在这项研究中，他们的应用比现实世界的经验多了一点，但即使是单次应用，他们也发现这些化学物质的血浆吸收量比 FDA 定义的上限高 100 到 500 倍。
Now, the question exists, okay, what does that mean?
现在，问题存在了，好吧，这意味着什么？
Is this healthy?
这健康吗？
Is this not healthy?
这不健康吗？
Is it neither?
两者都不是吗？
That's still up for debate, but in looking at the more recent literature and looking at the chemical structure of these compounds, a lot of these are phenolic compounds, meaning they have one or two, usually two benzene rings attached together, and they look very similar to one another.
这仍然有争议，但在查看最近的文献和这些化合物的化学结构时，很多都是酚类化合物，这意味着它们有一个或两个，通常是两个苯环连接在一起，而且它们看起来彼此非常相似。
There's been a lot of basic science, animal study, and retrospective human studies in the last two or three years that suggest that some of these chemical compounds, particularly oxybenzone, particularly octocrylene, particularly octinoxate, that can have endocrine disruption or affect the nervous system because they mimic a lot of biologic phenolic compounds and a lot of biologic hormones.
在过去的两三年里，大量的基础科学、动物研究和回顾性人类研究表明，其中一些化合物，特别是氧苯酮，特别是奥克立林，特别是辛诺酯，可能会扰乱内分泌或影响神经系统，因为它们模仿了许多生物酚类化合物和生物激素。
If you actually look at the structure of oxybenzone, it looks very similar to the structure of bisphenol A, which has been now banned in a lot of the lining of plastic bottles.
如果你仔细观察氧苯酮的结构，它看起来与双酚A的结构非常相似，双酚A现在已被禁止用于许多塑料瓶的内衬中。
Why?
为什么？
Because of the same concept.
因为同样的理念。
Now, the data's not 100% one way or another, but there's enough smoldering evidence that makes me think, "Hmm, we should reinvestigate this." And in fact, the FDA's proposed final order in 2021 changed these chemicals from GRASE, generally recognized as safe and effective, to not GRASE because of these concerns.
现在，无论怎样，数据并不是 100%，但有足够多的证据让我想，“嗯，我们应该重新调查这一点。”事实上，出于这些担忧，FDA 提议的 2021 年最终命令将这些化学品从普遍认为安全有效的 GRASE 改为不 GRASE。
There's data that suggests that the chemicals are found in breast milk, amniotic fluid, blood plasma, urine.
有数据表明，这些化学物质存在于母乳、羊水、血浆、尿液中。
So there's a lot of things that we don't know, and I always say this in science, we take two steps forward and then maybe one step diagonally or sideways because we ran into unexpected things.
所以有很多事情我们不知道，我总是在科学上这么说，我们向前迈两步，然后可能对角或向侧面迈一步，因为我们遇到了意想不到的事情。
I tend to recommend mineral sunscreens because they don't have any of that data.
我倾向于推荐矿物防晒霜，因为他们没有任何这些数据。
They haven't for the last 30, 40 years.
过去 30、40 年来他们一直没有这样做。
They're considered safe.
他们被认为是安全的。
And in fact, for young kids, particularly those six months and under, the American Academy of Dermatology and the American Academy of Pediatrics generally recommends avoiding chemical sunscreens.
事实上，对于年幼的孩子，尤其是六个月及以下的孩子，美国皮肤病学会和美国儿科学会普遍建议避免使用化学防晒霜。
Why?
为什么？
Children's skin, particularly infants and toddlers, behaves more like mucous membranes than adult skin.
儿童皮肤，尤其是婴儿和幼儿的皮肤，比成人皮肤更像粘膜。
Their barrier is not as tightly woven, so they absorb these things at a much higher concentration.
它们的屏障编织得不那么紧密，因此它们吸收这些物质的浓度要高得多。
So if you are to apply something on kids, especially young kids six months or under, we recommend minerals to begin with.
因此，如果您要为儿童（尤其是六个月或以下的幼儿）涂抹某些东西，我们建议首先使用矿物质。
So I say, if you have a pool of compounds that has maybe even smoldering evidence on the basic science level that something's off versus a group of compounds that have really no data, which one would you pick?
所以我说，如果你有一组化合物，在基础科学层面上甚至有闷烧的证据表明有些东西不对劲，而一组化合物实际上没有数据，你会选择哪一个？
And they do the same thing.
他们做同样的事情。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
I'd naturally gravitate towards that.
我自然会倾向于这一点。
Andrew Huberman:
安德鲁·休伯曼：
So the takeaway for me is physical barrier, no issues.
所以对我来说，物理障碍是没有问题的。
Mineral-based sunscreen, safest.
矿物防晒霜，最安全。
So that's zinc oxide, titanium dioxide.
这就是氧化锌、二氧化钛。
Dr. Teo Soleymani:
Teo Soleymani 博士：
And that's mineral, not powder, not mineral powder, but mineral topicals, because mineral powders are a whole other issue we'll talk about.
那是矿物质，不是粉末，不是矿物质粉末，而是矿物质外用，因为矿物质粉末是我们要讨论的另一个问题。
Andrew Huberman:
安德鲁·休伯曼：
Okay.
好的。
And then chemical-based sunscreens, probably best avoided.
然后是化学防晒霜，最好避免使用。
And then you mentioned polypodium.
然后你提到了息肉池。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So this is a pill, it's a supplement basically that one can take.
所以这是一种药丸，基本上是一种可以服用的补充剂。
I only call it a supplement because-
我只称其为补充，因为-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
it's not a prescription drug, correct?
这不是处方药，对吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
That protects your skin from UV damage from the inside.
这可以保护您的皮肤免受内部紫外线的伤害。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So exactly right.
完全正确。
Mineral-based creams and lotions I tend to prefer and recommend in my practice, and most people will if you're worried about any risk, any consequence.
在我的实践中，我倾向于选择并推荐矿物基面霜和乳液，如果您担心任何风险、任何后果，大多数人都会这样做。
Chemicals I tend to personally avoid.
我个人倾向于避免使用化学品。
Now, this may not be in line with all my dermatology colleagues, but I tend to avoid them, and I do not recommend them for kids.
现在，这可能与我所有皮肤科同事的观点不一致，但我倾向于避免使用它们，而且我不推荐给孩子使用它们。
In terms of things that you can do in addition to provide sun protection, polypodium's a fern from the Amazon rainforest that was discovered when they studied an indigenous population that would eat this fern before they would go on their fishing expeditions on the Amazon, and they'd be gone for three days.
除了提供防晒之外，水龙骨是一种来自亚马逊雨林的蕨类植物，他们在研究土著居民时发现了这种蕨类植物，这些土著居民在去亚马逊钓鱼之前会吃这种蕨类植物，并且他们会离开三天。
They'd eat this fern and come back not burned.
他们会吃掉这种蕨类植物，回来时不会被烧伤。
So a lot of studies were done on this fern in the last five, 10 years that showed it increases your skin's minimal erythema dose, the amount of redness your skin gets from UV exposure, that's our general barometer for effectiveness, without any topicals.
因此，过去五、十年对这种蕨类植物进行的大量研究表明，它会增加皮肤的最小红斑剂量，即皮肤因紫外线照射而发红的程度，这是我们衡量有效性的一般晴雨表，无需任何外用药物。
It's taken or ingested orally.
它是口服或摄入的。
I personally use a form called Sun Powder that also has nicotinamide in it, and we can talk about nicotinamide later.
我个人使用一种叫做防晒粉的形式，里面也含有烟酰胺，烟酰胺我们稍后再谈。
But if in and of itself it works great, in conjunction with topicals, you get the best of both worlds.
但如果它本身效果很好，那么与主题结合起来，你就能两全其美。
You get internal shielding and external shielding.
您可以获得内部屏蔽和外部屏蔽。
Now it is a supplement, so it's not a controlled drug the way the FDA regulates sunscreen.
现在它是一种补充剂，因此它不是 FDA 监管防晒霜的受控药物。
So it isn't really a sunscreen, but it's a way to prevent sunburns, increase the amount of time you can be outside, and increase the efficacy of your topical.
因此，它并不是真正的防晒霜，而是一种防止晒伤、增加户外活动时间并提高外用防晒霜功效的方法。
So if you're somebody who's very fair-skinned, who burns all the time, or if you're somebody who has what we call sun hives or prickly sun rash, PMLE, this is an added thing that you can use that will boost your sun protective factors.
因此，如果您的皮肤非常白皙，经常被晒伤，或者您患有我们所说的太阳荨麻疹或带刺的太阳皮疹（PMLE），那么您可以使用此附加产品来增强您的防晒系数。
It's awesome.
太棒了。
And if you're somebody who's active, like you're in the water or you're exercising or you're playing a sport and you can't reapply, I love polypodium for that added benefit.
如果你是一个活跃的人，比如你在水中，或者你正在锻炼，或者你正在参加一项运动，但你无法重新申请，我喜欢 Polypodium，因为它具有额外的好处。
Andrew Huberman:
安德鲁·休伯曼：
What are the dosages of polypodium that are useful, and are there any side effects?
水龙骨的有用剂量是多少，有副作用吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, great question.
是的，很好的问题。
So there's been a wide variety of doses investigated, anywhere from 50, 100, 240, 480.
因此，研究人员对各种剂量进行了研究，从 50、100、240、480 不等。
Generally, some-
一般来说，一些——
Andrew Huberman:
安德鲁·休伯曼：
You said 1,500.
你说的是1500。
Dr. Teo Soleymani:
Teo Soleymani 博士：
No. Sorry, 50 milligrams-
不，抱歉，50 毫克-
Andrew Huberman:
安德鲁·休伯曼：
50
50
Dr. Teo Soleymani:
Teo Soleymani 博士：
...
...
100 milligrams-
100毫克-
Andrew Huberman:
安德鲁·休伯曼：
Okay
好的
Dr. Teo Soleymani:
Teo Soleymani 博士：
...
...
240, 480.
240、480。
Andrew Huberman:
安德鲁·休伯曼：
Got it.
明白了。
Uh-huh.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Somewhere between 50 and 480 milligrams is what's commonly used.
常用的剂量在 50 至 480 毫克之间。
The most common side effect can be a little upset stomach if you can't tolerate the plant for whatever reason.
如果您出于某种原因无法忍受这种植物，最常见的副作用可能是胃部不适。
Andrew Huberman:
安德鲁·休伯曼：
It's taken daily?
是每天拍的吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
You can either take it daily as a method of preventing premature photoaging and pigmentary change, or you can take it as an as needed an hour before you get sun, to shield you from the sun.
您可以每天服用，作为预防过早光老化和色素变化的方法，也可以在晒太阳前一小时根据需要服用，以保护您免受阳光照射。
The other thing that it helps prevent that some sunscreens cannot, particularly the chemical sunscreens cannot, is the effects of visible light.
它有助于防止某些防晒霜（尤其是化学防晒霜）无法防止的另一件事是可见光的影响。
So there are certain skin conditions, the most common is melasma, which a lot of women have.
所以有一定的皮肤状况，最常见的是黄褐斑，很多女性都有这种情况。
It's, I think, the bane of their existence.
我认为这是他们存在的祸根。
It used to be called the mask of pregnancy.
它曾经被称为怀孕面膜。
And melasma is something that is very sensitive to both UV and visible light.
黄褐斑对紫外线和可见光都非常敏感。
Chemical sunscreens don't do a good job blocking visible light.
化学防晒霜不能很好地阻挡可见光。
Polypodium's been shown to help block the effects of visible light as well, which makes melasma worse.
水龙骨也被证明有助于阻止可见光的影响，可见光会使黄褐斑变得更严重。
It's this discoloration that we see mostly in women, usually after pregnancy or women who are on birth control.
这种变色最常见于女性，通常是怀孕后或正在采取节育措施的女性。
It is really challenging to treat, and sun protection is the first line, like ...
治疗起来确实很有挑战性，防晒是第一线，比如……
diligent sun protection, but we found that supplementing with polypodium enhances this and makes patients' treatments more effective.
勤奋防晒，但我们发现补充水螅可以增强防晒效果，并使患者的治疗更有效。
Andrew Huberman:
安德鲁·休伯曼：
Interesting, and you mentioned Sun Powder as a potential-
有趣的是，你提到防晒粉是一种潜在的-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
that's a brand name?
这是一个品牌名称吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
So yes.
所以是的。
Sun Powder is a brand.
防晒粉是一个品牌。
It's a product that I helped formulate with one of my colleagues over at Harvard who's a laser and aesthetic dermatologist, Harvard-trained, and this is something that we came up with when I was up at Stanford, and it's a supplement dedicated to skin health, and it does two things.
这是我和哈佛的一位同事帮助制定的产品，他是一名激光和美容皮肤科医生，受过哈佛培训，这是我在斯坦福大学时想出的东西，它是一种致力于皮肤健康的补充剂，它有两个作用。
I take it daily myself as a single scoop.
我自己每天都会把它当作一勺。
It helps reduce your skin cancer risk, your non-melanoma skin cancer risk by up to 30%, and the data was published in the New England Journal of Medicine in a phase 3 randomized trial for one of the ingredients.
它有助于降低皮肤癌风险，将非黑色素瘤皮肤癌风险降低高达 30%，该数据发表在《新英格兰医学杂志》上针对其中一种成分进行的 3 期随机试验中。
The other ingredient, obviously, is polypodium, and I take that one to prevent sun-related changes, but also help reduce my risk of burning.
显然，另一种成分是水龙骨，我服用这种成分是为了防止与阳光相关的变化，同时也有助于降低晒伤的风险。
Often, when I personally find the need for sunscreen, it's when I can't apply.
通常，当我个人发现需要防晒霜时，就是在我无法涂抹的时候。
I'm always at the water, I'm swimming.
我总是在水边，我在游泳。
My son, he's seven.
我儿子七岁了。
He races on a swim team.
他参加游泳队比赛。
I cannot get this kid to reapply sunscreen.
我无法让这孩子重新涂抹防晒霜。
So this is a supplement that I give him, and it took us several years of formulation and testing, including MED testing, which is minimal erythema dose testing to come up with.
这是我给他的补充剂，我们花了几年的时间进行配制和测试，包括 MED 测试，这是最小红斑剂量测试的结果。
It's easy over the counter, and it's one of many supplements that contain polypodium.
它很容易在柜台上买到，而且它是含有水螅的众多补充剂之一。
I just like it because it's a single scoop, and I mix it into my morning drink, and I'm done.
我只是喜欢它，因为它只是一勺，我将它混合到我早上的饮料中，然后就完成了。
Andrew Huberman:
安德鲁·休伯曼：
Terrific.
太棒了。
I think we both agree that the mineral-based sunscreens are going to be the best option of the ones out there, if one is at all concerned about some of these chemical components in chemical sunscreens.
我想我们都同意，如果有人担心化学防晒霜中的某些化学成分，那么矿物防晒霜将是最好的选择。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Fair enough?
够公平吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Absolutely agree.
绝对同意。
Andrew Huberman:
安德鲁·休伯曼：
Yeah, so within that category, are there particular things to look for?
是的，那么在这个类别中，有什么特别需要寻找的东西吗？
I'm not necessarily trying to aim for particular brands here-
我不一定要针对特定品牌-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
but given that I have no relationship to any skincare products, I would just like to know which ones-
但鉴于我与任何护肤品都没有关系，我只想知道哪些 -
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
to look for, or will any zinc oxide and/or titanium dioxide-containing sunscreen, provided there are no chemical components in there-
寻找或寻找任何含有氧化锌和/或二氧化钛的防晒霜，前提是其中不含化学成分 -
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
besides the inactive ingredients, of course.
当然，除了非活性成分。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Will any suffice?
有就够了吗？
Because in that case, people can just shop for cost or availability.
因为在这种情况下，人们可以只考虑成本或可用性。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So I tend to take a pragmatic approach in this.
所以我在这方面倾向于采取务实的态度。
My recommendation is a brand that you will use, because if I recommend a brand, and you don't like it, it doesn't feel good or smell good, you're never going to use it, and it's a waste of your money and time.
我推荐的是一个你会使用的品牌，因为如果我推荐一个品牌，而你不喜欢它，它感觉不好或气味不好，你永远不会使用它，这是浪费你的金钱和时间。
So number one, any brand that is mineral-based is fine.
所以第一，任何基于矿物质的品牌都可以。
What you're looking for is broad-spectrum coverage, which almost all mineral-based sunscreens provide.
您需要的是广谱防晒霜，几乎所有矿物防晒霜都具备这种功能。
Broad-spectrum, meaning UVA and UVB, and we know these two UV forms do different things in the skin.
广谱，即 UVA 和 UVB，我们知道这两种紫外线形式对皮肤有不同的作用。
We know that UVB is more implicated in redness and some early skin cancer changes.
我们知道 UVB 更容易导致发红和一些早期皮肤癌的变化。
We know UVA is linked to premature photoaging and certain melanomas.
我们知道 UVA 与过早光老化和某些黑色素瘤有关。
So you want something that provides broad-spectrum coverage.
因此，您需要能够提供广谱覆盖的产品。
You're looking for a number, the SPF we talk about.
您正在寻找一个数字，即我们所说的 SPF。
You're looking for a number above 30.
您正在寻找 30 以上的数字。
Why 30?
为什么是30？
Because every study that looked at defining the SPF required you to put a certain amount on the skin.
因为每项定义 SPF 值的研究都要求您在皮肤上涂抹一定量的防晒霜。
Generally, it's an entire shot glass worth of the product on sun-exposed skin.
一般来说，在暴露于阳光下的皮肤上，该产品相当于一整杯产品。
Most of the time in real-world practice, people don't put on that much.
在现实世界的实践中，大多数时候人们不会穿那么多。
They put on maybe half that.
他们可能只穿了一半。
So what you're really getting when you buy something that's SPF 15 is like an SPF of eight.
因此，当您购买 SPF 15 的产品时，您真正得到的效果就像 SPF 为 8 一样。
So if you're looking for something that provides protection, SPF 30 or greater is higher.
因此，如果您正在寻找能够提供保护的产品，SPF 30 或更高的产品会更好。
The higher the zinc concentration, the better it protects against UV invisible light, the chalkier it may go on.
锌浓度越高，它对紫外线不可见光的防护效果越好，它可能会变得越白。
So that's where you find that balance.
所以这就是你找到平衡的地方。
That's actually where the chemical sunscreens came about, is the cosmeceutical industry finding things that felt nicer on the skin so that people could put makeup on without that grainy chalkiness.
这实际上就是化学防晒霜的由来，药妆行业寻找对皮肤感觉更好的东西，这样人们在化妆时就不会出现颗粒状的白垩感。
But in doing so, we ran into some issues.
但在这样做的过程中，我们遇到了一些问题。
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What are some, if any, of the concerns that some of the components in chemical-based sunscreens can cross the blood-brain barrier?
对于化学防晒霜中的某些成分可能穿过血脑屏障的担忧（如果有的话），有哪些担忧？
Dr. Teo Soleymani:
Teo Soleymani 博士：
It's not unjustified to think that.
这样想并非没有道理。
They are organic phenolic compounds.
它们是有机酚类化合物。
They are hydrophobic.
它们是疏水性的。
They're lipophilic, meaning they can cross membranes very easily, which is why they run into this endocrine disruption and some nervous system dysregulation.
它们是亲脂性的，这意味着它们可以很容易地跨膜，这就是为什么它们会遇到内分泌干扰和一些神经系统失调的问题。
Whether that's been validated to be problematic in humans has yet to be seen, but at least in vitro studies in certain animal models, we see this.
这是否被证实对人类有问题还有待观察，但至少在某些动物模型的体外研究中，我们看到了这一点。
So when you apply a certain concentration, and with that 2020 study that showed that we're seeing it in the blood at levels that are 200 to 500 times the upper limit of normal, as defined by sunscreen criteria, now we have to scratch our head.
因此，当你使用某种浓度时，2020 年的研究表明，我们在血液中看到的浓度是防晒霜标准定义的正常上限的 200 到 500 倍，现在我们必须挠头了。
Well, where is this circulating?
那么，这个消息在哪里流传呢？
Where is this going?
这是要去哪里？
Are we collecting it in our adipose tissue?
我们是否将其收集在脂肪组织中？
If we're collecting it there, we may be collecting it up here.
如果我们在那里收集它，我们可能会在这里收集它。
We may be collecting it in the nerves.
我们可能正在将它收集在神经中。
So it's a really fascinating world to see where we're going with these.
所以，看看我们将如何处理这些，这是一个非常迷人的世界。
And in fact, the 16 most common chemicals that in '99 were everywhere from spray sunscreens and bottles and things like that are now being defined as hmm, question mark, maybe not safe by the FDA, the very company that regulates it.
事实上，16 种最常见的化学物质在 99 年随处可见，包括喷雾防晒霜和瓶子之类的东西，现在被监管该物质的公司 FDA 定义为嗯，问号，可能不安全。
Andrew Huberman:
安德鲁·休伯曼：
Another call for the mineral-based sunscreens-
另一个对矿物防晒霜的呼吁——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
just as a why take the risk?
就像为什么要冒险？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Or even shade hat clothing.
甚至遮阳帽服装。
If you're really worried about putting something on and absorption, you get excellent protection by actual barriers.
如果您真的担心穿上和吸收某些东西，您可以通过实际屏障获得出色的保护。
Andrew Huberman:
安德鲁·休伯曼：
This seems like a good time to shift a little bit of our attention to nutrition and the gut microbiome.
这似乎是将我们的注意力转移到营养和肠道微生物组上的好时机。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Now, this is an infinitely large topic.
现在，这是一个无限大的话题。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
We could spend several episodes discussing this.
我们可以花几集来讨论这个问题。
But if you were to provide us some of the major takeaways as it relates to nutrition and skin health nutrition and skin appearance, gut and skin health and appearance, what would those be?
但是，如果您要向我们提供一些与营养和皮肤健康、营养和皮肤外观、肠道和皮肤健康和外观相关的主要要点，这些要点会是什么？
Dr. Teo Soleymani:
Teo Soleymani 博士：
So there is an incredible connection between the gut microbiome and skin health and the skin microbiome, of which we're only now just understanding the gravity, the extent, and the connection.
因此，肠道微生物群与皮肤健康和皮肤微生物群之间存在着令人难以置信的联系，我们现在才刚刚了解其重要性、程度和联系。
We know from many studies, many elegant studies, a lot of studies done out of my colleagues' labs up at Stanford, that modulating the gut microbiome affects inflammatory conditions of the skin.
我们从许多研究中了解到，许多优雅的研究，以及我在斯坦福大学同事实验室进行的大量研究，调节肠道微生物组会影响皮肤的炎症状况。
Meaning if you control the dysregulation of the gut microbiome, if you have an anti-inflammatory dietary habit, actual skin disease decreases in intensity and severity.
这意味着，如果您控制肠道微生物组的失调，如果您有抗炎饮食习惯，实际皮肤病的强度和严重程度就会降低。
Psoriasis, eczema, acne.
牛皮癣、湿疹、痤疮。
And this is not just subjectively, it's measurable and quantifiable and reproducible.
这不仅仅是主观的，它是可测量、可量化和可重复的。
So the connection is fascinating.
所以这种联系很有趣。
Now, how we modulate it, that's the unknown.
现在，我们如何调节它，这是未知的。
We know in many different studies that some patients' gut microbiomes are wildly fluctuant to what they do from their environment in terms of dietary habits, antibiotics, things like that.
我们在许多不同的研究中知道，一些患者的肠道微生物组会因饮食习惯、抗生素等环境因素而发生巨大波动。
Some people's gut microbiomes are rock solid.
有些人的肠道微生物群坚如磐石。
Nothing changes them.
没有什么能改变他们。
And deciphering whose will benefit from what is the hardest part.
并解读谁将从中受益，这是最困难的部分。
In terms of nutrition overall, obviously everybody has told you this since the dawn of modern medicine is a well-balanced diet is good for everything.
就整体营养而言，显然自现代医学诞生以来每个人都告诉过你，均衡的饮食对一切都有好处。
Unfortunately, in the 21st century, there are a lot of diets.
不幸的是，在21世纪，饮食有很多。
There are a lot of fad diets, there are a lot of restrictive diets, and that's where we see nutrition play an important role in both appearance and actual skin disease health.
有很多时尚饮食，有很多限制性饮食，这就是我们看到营养在外观和实际皮肤疾病健康方面发挥重要作用的地方。
And there's so many different avenues to discuss this.
有很多不同的途径可以讨论这个问题。
Things like dietary habits and changes for acne, things like dietary habits and changes for anti-aging, things like dietary habits for rash disorders like psoriasis and eczema.
比如饮食习惯和痤疮的改变，比如饮食习惯和抗衰老的改变，比如牛皮癣和湿疹等皮疹疾病的饮食习惯。
It's so much to explore.
有太多值得探索的地方。
Andrew Huberman:
安德鲁·休伯曼：
So my understanding, and we'll get into this more as it relates to acne, is that patterns of eating, either content, food volume, that is caloric load, et cetera, that increase insulin and things like mTOR are sort of pro-acne.
所以我的理解是，我们将进一步讨论与痤疮相关的问题，那就是饮食模式，无论是内容、食物量、热量负荷等等，都会增加胰岛素和 mTOR 之类的东西，从而促进痤疮。
They're going to aggravate or increase acne.
它们会加重或增加痤疮。
Whereas the things that tend to lower circulating blood glucose, insulin, and reduce inflammation tend to be kind of anti-acne or sorry, pull in the other direction towards reducing acne load.
虽然那些能够降低循环血糖、胰岛素和减少炎症的药物往往具有抗痤疮作用，但遗憾的是，相反，它们却可以减少痤疮负荷。
But if we were to just step back and say, okay, the typical person who wants to have the healthiest, best appearing skin, who's not dealing with any specific issue, because we will get into those specific issues, can we say they should eat a vegan diet, a vegetarian diet?
但如果我们退一步说，好吧，那些想要拥有最健康、最好看的皮肤的典型人，他们不处理任何具体问题，因为我们将讨论这些具体问题，我们可以说他们应该吃纯素饮食吗？
Is it okay to be an omnivore?
做一个杂食动物好吗？
Some people are on the extreme of this kind of carnivore type diet.
有些人处于这种食肉动物饮食的极端状态。
Some of those people actually report elimination of certain skin conditions.
其中一些人实际上报告消除了某些皮肤状况。
I don't know, I've never tried one of those-
我不知道，我从未尝试过其中之一-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
extreme diets, but you hear this, but again, you hear a lot of things.
极端节食，但你听到这个，但你又听到很多事情。
So it seems to me that the relationship between keeping the gut microbiome healthy and ingesting sufficient amounts of fiber is pretty clear.
因此，在我看来，保持肠道微生物群健康和摄入足够纤维之间的关系是非常清楚的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
The relationship between keeping the gut microbiome healthy and overall, that is systemic inflammation-
保持肠道微生物组健康和整体健康之间的关系，即全身炎症-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
low is pretty clear, and that eating foods that are mostly unprocessed or minimally processed keeps inflammation on the lower side as opposed to eating more processed foods.
低是很明显的，与吃更多加工食品相比，吃大部分未加工或最低限度加工的食物可以使炎症降低。
But assuming you...
但假设你...
Would you agree or disagree with any of that?
您同意还是不同意其中任何一个？
Dr. Teo Soleymani:
Teo Soleymani 博士：
100%.
100%。
Andrew Huberman:
安德鲁·休伯曼：
Feel free to disagree, please.
如有不同意见，请随意。
Dr. Teo Soleymani:
Teo Soleymani 博士：
No, no.
不，不。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
So assuming that that's all true, is there any evidence that the ingestion of specific foods can make skin healthier?
那么假设这一切都是真的，是否有任何证据表明摄入特定食物可以使皮肤更健康？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Like, you'll see this stuff like-
就像，你会看到这样的东西——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
if you have two cups of blueberries a day, your skin is going to be healthier.
如果你每天喝两杯蓝莓，你的皮肤会更健康。
Or is all of that indirect by virtue of specific micronutrients that are in those foods?
或者所有这些都是通过这些食物中特定的微量营养素间接实现的？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So there's a lot of layers to unravel on this.
因此，这方面有很多层面需要解开。
So if you're going to pick one simple diet for optimal skin health, it's a high protein, anti-inflammatory diet.
因此，如果您要选择一种简单的饮食来获得最佳的皮肤健康，那就是高蛋白、抗炎饮食。
So high protein, animal source proteins, fruits and vegetables based on your ability to tolerate the fibers in the fruits and vegetables.
如此高的蛋白质、动物源蛋白质、水果和蔬菜取决于您对水果和蔬菜中纤维的耐受能力。
Things that are inflammatory are inflammatory for two reasons.
具有炎症性的事物具有炎症性有两个原因。
One, the glucose insulin pathway, but number two, the bacteria in our gut process and release byproducts of metabolism of certain things, and those byproducts, basically they're digestive products, can be very pro-inflammatory.
第一，葡萄糖胰岛素途径，第二，我们肠道中的细菌处理并释放某些物质代谢的副产品，而这些副产品基本上是消化产物，可能非常促炎。
So often you hear these anecdotal stories of, "I eliminated tomatoes, and my psoriasis got better." That person may have had an inability to tolerate tomatoes because of their gut microbiome's ability to digest the lycopene or whatever it is.
你经常会听到这样的轶事故事：“我去掉了西红柿，我的牛皮癣好多了。”这个人可能无法忍受西红柿，因为他们的肠道微生物群具有消化番茄红素或其他物质的能力。
We do know for certain that anti-inflammatory diets do improve skin health that are measurable and seen in clinic.
我们确实知道，抗炎饮食确实可以改善皮肤健康，这是可以测量和在临床上看到的。
So absolutely high protein, a complete protein.
所以绝对是高蛋白，完整的蛋白质。
When I say complete protein tends to be animal-based products, eggs, meat, chicken, fish, less so plant proteins just because of bioavailability and complete amino acid profiles.
当我说完全蛋白质往往是动物性产品、鸡蛋、肉、鸡肉、鱼时，植物蛋白就较少，因为生物利用度和完整的氨基酸谱。
You want a high protein, anti-inflammatory diet.
您需要高蛋白、抗炎饮食。
That's number one.
这是第一。
In terms of what you can introduce to your skin to improve one or two parameters, I don't think that's real.
就可以向皮肤引入什么来改善一两个参数而言，我认为这是不真实的。
Why I bring this up, we see a lot of talk and you've had a lot of people discuss collagen, for example, and this is an incredibly popular product in the skin world because its claim to fame is it does everything.
为什么我提出这个问题，我们看到了很多讨论，例如，很多人都在讨论胶原蛋白，这是皮肤界非常受欢迎的产品，因为它的名声在于它无所不能。
Keeps you looking young, keeps your skin healthy, et cetera.
让您看起来年轻，保持皮肤健康等等。
Well, we know collagen is essential to our skin health.
嗯，我们知道胶原蛋白对我们的皮肤健康至关重要。
Literally, it's what our dermis is made of that give us our suppleness, our youth, no wrinkles, things like that.
从字面上看，我们的真皮是由它构成的，它赋予我们柔软、年轻、没有皱纹等类似的东西。
Collagen is made of three amino acids, glycine, proline, and usually hydroxyproline or hydroxyl lysine.
胶原蛋白由三种氨基酸组成：甘氨酸、脯氨酸，通常还有羟脯氨酸或羟赖氨酸。
Okay?
好的？
Those three amino acids are non-essential amino acids, meaning your body has the ability to synthesize these from sugars and fats that it eats.
这三种氨基酸是非必需氨基酸，这意味着您的身体有能力从所吃的糖和脂肪中合成这些氨基酸。
So collagen supplementation is not an essential protein, unlike animal proteins, which provide all 20 amino acids, including the essential ones your body cannot synthesize.
因此，胶原蛋白补充剂不是必需蛋白质，与动物蛋白不同，动物蛋白提供全部 20 种氨基酸，包括身体无法合成的必需氨基酸。
Now, you may ask, okay, well, I see all these studies that suggest collagen supplementation improves skin health, skin appearance.
现在，您可能会问，好吧，我看到所有这些研究都表明补充胶原蛋白可以改善皮肤健康和皮肤外观。
There's several reasons for that.
这有几个原因。
I don't think it doesn't.
我不认为没有。
I think there is some benefit.
我认为有一些好处。
The question is, what are the confounding variables to this?
问题是，其中的混杂变量是什么？
Were the people in the studies on restrictive diets because they were thinking about beauty and aesthetic?
研究中的人们限制饮食是因为他们考虑的是美丽和审美吗？
Were they restricting patterns of food, dietary food, things like that, in which they weren't getting a sufficient amount of protein source to begin with, so when they supplemented, we saw improvements in their skin?
他们是否限制了食物模式、膳食食品等，导致他们一开始就没有获得足够量的蛋白质来源，所以当他们补充时，我们看到他们的皮肤有所改善？
And a lot of these studies are patient recall or patient questionnaire studies in which there is inherent subjectivity and confounding variables in this.
这些研究很多都是患者回忆或患者问卷调查研究，其中存在固有的主观性和混杂变量。
When people take an intervention that says, "Hey, you may look better," or, "This may improve the appearance of your skin," not only do you have a placebo effect in saying, "Yeah, I do look better," you may also do other things during your day, change your behaviors and lifestyle to fit the goal that you subconsciously want.
当人们采取干预措施时，“嘿，你可能看起来更好”，或者“这可能会改善你的皮肤外观”，你不仅会因为说“是的，我看起来更好”而产生安慰剂效应，你还可能在一天中做其他事情，改变你的行为和生活方式，以适应你潜意识想要的目标。
So that's one.
这就是其中之一。
Number two, there is a component in, for example, collagen supplementation that is forgotten about quite a bit, and that's the increase in blood osmolality, and I learned this in the fitness world.
第二，例如，胶原蛋白补充剂中有一个成分被人们遗忘了很多，那就是血液渗透压的增加，我在健身界学到了这一点。
I was really big into fitness in college, and it was my escape from life stressors.
我在大学时非常喜欢健身，这是我逃避生活压力的方法。
And we found that people who supplemented with any powdered protein source, doesn't matter, collagen, albumin, whey, and more so with people who supplement with creatine, that there is an increase in blood os- or plasma osmolality.
我们发现，补充任何粉状蛋白质来源的人，无论是胶原蛋白、白蛋白、乳清，还是补充肌酸的人，都没有关系，血液渗透压或血浆渗透压都会增加。
So the solute concentration increase in the blood, which draws water in.
因此，血液中的溶质浓度增加，从而吸收水分。
That's predominantly how things like creatine make you look bigger, and I know we're going a little bit on a tangent, but one of the reasons the way collagen works is your blood osmolality increases.
这主要是肌酸等物质让你看起来更大的原因，我知道我们有点偏离主题，但胶原蛋白发挥作用的原因之一是你的血液渗透压增加。
You draw a little bit more water into the vessels, which plumps up the appearance of the skin.
您将更多的水吸入血管中，从而使皮肤的外观变得饱满。
So there is a hydration component from the water draw, and this is measurable.
因此，抽取的水会产生水合成分，这是可以测量的。
You can draw a patient's blood after consuming collagen protein, whey protein, and see this spike in plasma protein.
您可以在摄入胶原蛋白、乳清蛋白后抽取患者的血液，并观察血浆蛋白的峰值。
So there's that component as well, which is not truly a benefit, but it's an aesthetic benefit.
所以还有这个成分，这并不是真正的好处，但它是一种美学上的好处。
Why that tends to be a problem is sometimes people who supplement with collagen end up actually having high blood pressure, and they're otherwise healthy.
为什么这往往是一个问题，因为有时补充胶原蛋白的人最终实际上患有高血压，而他们在其他方面都很健康。
And this was something that we saw in the fitness world a lot is that young college athletes, high school athletes that would come in, they would otherwise be completely healthy and would be running high blood pressures.
我们在健身界经常看到年轻的大学运动员、高中运动员加入，否则他们会完全健康，但会患有高血压。
If you took away their protein and creatine supplementation, their blood pressures dropped.
如果你取消他们的蛋白质和肌酸补充剂，他们的血压就会下降。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Teo Soleymani:
Teo Soleymani 博士：
And it's really fascinating stuff, and I used to work out at UCLA with one of the professors of FISAI who was a really big dude, and we worked out together, and we did all these studies and looked at young, otherwise healthy people.
这真的很有趣，我曾经在加州大学洛杉矶分校和 FISAI 的一位教授一起锻炼，他是一个非常大的家伙，我们一起锻炼，我们做了所有这些研究，观察了年轻的、其他方面健康的人。
So that's one component.
这就是其中一个组成部分。
The other question is, do any of these food changes actually quantifiably increase skin collagen density, skin elastin density?
另一个问题是，这些食物变化是否真的可以量化地增加皮肤胶原蛋白密度、皮肤弹性蛋白密度？
There's no evidence that taking these things will traffic or meaning will go to where you want them to.
没有证据表明拿走这些东西会带来流量或意义会到达你想要它们去的地方。
It's kind of silly to think if I drink this, it's going to go into my stomach, go into my intestine, be absorbed, and then know to go exactly to my cheek.
认为如果我喝了这个，它就会进入我的胃，进入我的肠道，被吸收，然后知道准确地到达我的脸颊，这有点愚蠢。
Usually doesn't occur that way.
通常不会出现这种情况。
And when we've looked at histologic comparison studies, the data is equivocal.
当我们查看组织学比较研究时，数据是模棱两可的。
Some studies have showed a slight increase in collagen density, and you wonder, are those patients, one, that are on restrictive diets to begin with?
一些研究表明胶原蛋白密度略有增加，您想知道这些患者是否一开始就限制饮食？
And then there are some studies that have shown there's really no density change in collagen and elastin, so the supplements really don't actually make a physical difference.
还有一些研究表明，胶原蛋白和弹性蛋白的密度实际上没有变化，因此补充剂实际上不会对身体产生影响。
Now, the other question is, is that study too short of term?
现在，另一个问题是，这项研究的期限是否太短？
How long do you stay on these?
你在这些上停留多久？
Data's wild, and there's a lot to understand, but we do know high protein, complete proteins, anti-inflammatory diets, absolutely critical for skin health.
数据很丰富，有很多东西需要理解，但我们确实知道高蛋白、完整蛋白、抗炎饮食对皮肤健康绝对至关重要。
Andrew Huberman:
安德鲁·休伯曼：
I guess the most direct question is, do you yourself consume collagen proteins in a supplement form or make it a point to eat things like bone broth, which contain high percentages of collagen?
我想最直接的问题是，您自己是否以补充剂的形式食用胶原蛋白，或者是否重视吃骨头汤等含有高比例胶原蛋白的东西？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Great question.
很好的问题。
I do supplement only in sun powder, which is my daily supplement.
我只补充防晒粉，这是我的日常补充。
It contains bioactive collagen peptides.
它含有生物活性胶原蛋白肽。
Aside from that, I think natural sources are better.
除此之外，我认为天然来源更好。
So my wife cooks a lot at home, bone broth, beef bone broth, chicken bone broth, a lot of animal meats.
所以我老婆在家做饭很多，骨头汤，牛骨汤，鸡骨汤，很多动物肉。
My diet tends to be more in the, I guess, old school, you'd call it Atkins or keto diet, where I eat a lot of proteins and mostly fruits and vegetables.
我想，我的饮食更倾向于老派，你可以称之为阿特金斯或酮饮食，我吃大量的蛋白质，主要是水果和蔬菜。
I'm not very restrictive, but I know that's what's made the biggest difference.
我并没有太多的限制，但我知道这就是最大的不同。
I know that if I go on a sugar binge, in a few days, I'm breaking out.
我知道如果我继续吃糖，几天后我就会爆发。
It's like clockwork for me.
这对我来说就像发条一样。
Some people are not as sensitive.
有些人则没有那么敏感。
My body is, and that's where the personalized medicine comes in.
我的身体是这样的，这就是个性化医疗的用武之地。
Andrew Huberman:
安德鲁·休伯曼：
Is there a role for omega-3 fatty acids like fish oils and things of that sort for skin health specifically?
鱼油等 omega-3 脂肪酸对皮肤健康有作用吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yes and no. Yes, there is some evidence that omega-3 supplementation, and tends to be better in fish form than- Non-fish formats, but omega-3s tend to be anti-inflammatory, so there's an improvement in skin health because of that.
是和不是。是的，有一些证据表明，补充 omega-3 鱼制品往往比非鱼制品更好，但 omega-3 往往具有抗炎作用，因此可以改善皮肤健康。
One thing we do see is they thin the blood, so people tend to bruise a little bit more.
我们确实看到的一件事是它们会稀释血液，因此人们往往会出现更多的瘀伤。
So actually, in my practice, I have people stop omega-3s before any sort of surgery because they bleed more.
所以实际上，在我的实践中，我让人们在任何类型的手术之前停止使用 omega-3，因为他们流血更多。
Andrew Huberman:
安德鲁·休伯曼：
What about some treatments that are known to be beneficial for the appearance and health of skin that-
一些已知对皮肤外观和健康有益的治疗方法怎么样？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
people are not as aware of?
人们不知道吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Because I think people who are concerned with their skin health and appearance, they think about sunscreen-
因为我认为关心皮肤健康和外观的人会考虑防晒霜——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and we've learned a lot about that from you.
我们从你那里学到了很多这方面的知识。
But what are some things that really work to improve skin health and appearance that-
但是，有哪些真正可以改善皮肤健康和外观的东西——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
perhaps require a visit to the dermatologist, but that you don't hear enough about?
也许需要去看皮肤科医生，但您对此了解得还不够多？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So two big categories.
所以分为两大类。
So we know the skin turns over, right?
所以我们知道皮肤会翻转，对吗？
It turns over every 28 days.
每 28 天翻转一次。
So in theory, if you keep turning the skin over, you can get rid of those mutations that occur in the skin that's stacking up and hope to bring out more vital, youthful skin that's not just appearing vital, but actually biologically healthier.
因此，从理论上讲，如果你不断翻转皮肤，你就可以消除皮肤中发生的那些堆积的突变，并有望带来更有活力、更年轻的皮肤，不仅看起来有活力，而且实际上在生物学上更健康。
And there's two categories of things you can do.
您可以做两类事情。
The first is the family of retinoids.
第一个是类维生素A家族。
Amazing medications, amazing drugs, been around for 50 years.
神奇的药物，神奇的药物，已经存在了 50 年。
They come in oral form and topical form.
它们有口服形式和局部形式。
And these increase the time, or they shorten the time, they increase the skin turnover from 28 days to somewhere between seven to nine days.
这些会增加时间，或者缩短时间，将皮肤周转时间从 28 天增加到 7 到 9 天。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
And in doing so, they've been shown to decrease skin cancer and pre-cancer formation.
事实证明，它们可以减少皮肤癌和癌前病变的形成。
They've been actually shown to grow new collagen.
事实上，它们已被证明可以生长新的胶原蛋白。
They've been shown to increase elastin in appearance, and this has been histologically verified in study after study, meaning we take a biopsy of the skin, have them start a prescription retinoid, re-biopsy the skin, and stain it for collagen or elastin, and you see a marked improvement.
它们已被证明可以增加弹性蛋白的外观，并且这已经在一项又一项的研究中得到组织学证实，这意味着我们对皮肤进行活检，让他们开始服用处方类维生素A，重新对皮肤进行活检，并对胶原蛋白或弹性蛋白进行染色，你会看到明显的改善。
It's every dermatologist's well-known tool, and for some reason, it's still not well-known in the population.
它是每个皮肤科医生众所周知的工具，但由于某种原因，它在人群中仍然不为人所知。
Its original indication was for acne, and still is first line for acne, because what it does is it dries out the oil glands.
它最初的适应症是治疗痤疮，现在仍然是治疗痤疮的一线药物，因为它的作用是使皮脂腺干燥。
But in doing so, it also helps repair skin.
但这样做也有助于修复皮肤。
So I recommend every single person to be on a prescription strength retinoid, which is different than over-the-counter retinol, and there's a lot of confusion, and I think the confusion is intentional in the cosmeceutical world as to why this is, but everybody should be on a prescription strength retinoid.
因此，我建议每个人都服用处方强度的视黄醇，这与非处方视黄醇不同，并且存在很多混乱，我认为药妆界对于为什么会出现这种混乱是故意的，但每个人都应该服用处方强度的视黄醇。
Usually topicals is all you need.
通常主题就足够了。
The most common are things like tretinoin, adapalene, or tazarotene.
最常见的是维甲酸、阿达帕林或他扎罗汀。
And there's oral forms.
还有口头形式。
The most common is Accutane or isotretinoin, and a lesser-known drug called acitretin or Soriatane, and I usually reserve that for my high sun damage skin cancer patients.
最常见的是维甲酸或异维A酸，还有一种不太为人所知的药物，称为阿维A或索里亚坦，我通常将其保留给我的高阳光伤害皮肤癌患者。
It really makes a difference.
这真的很重要。
But I'm going to touch back about retinol versus retinoids.
但我要回过头来谈谈视黄醇和类视黄醇。
So many, many years we studied retinoids.
我们研究类维生素A很多很多年了。
The way retinoids work is they activate transcription factors.
类维生素A的作用方式是激活转录因子。
They're nuclear messaging hormones.
它们是核信息激素。
So these compounds bind retinoic acid receptors, and they activate the transcription of certain genes.
因此，这些化合物与视黄酸受体结合，并激活某些基因的转录。
One of the genes we know that it can affect is the sonic hedgehog pathway and some of the embryologic genes.
我们知道它可以影响的基因之一是声波刺猬通路和一些胚胎基因。
Why that's important is when we first studied retinoids in oral or cream version, we noticed that these can affect the development of a fetus, and they can be passed through breast milk and through sperm or semen.
为什么这很重要，因为当我们第一次研究口服或霜剂形式的类维生素A时，我们注意到它们会影响胎儿的发育，并且它们可以通过母乳、精子或精液传播。
So because of this issue, the FDA regulated it very tightly, and it's pretty regulated worldwide because the effects are devastating, missing arms, missing legs type of birth defects.
因此，由于这个问题，美国食品和药物管理局对其进行了非常严格的监管，并且在全世界范围内都受到了相当严格的监管，因为其影响是毁灭性的，缺胳膊、缺腿类型的先天缺陷。
Because the medication was so effective and we saw an improvement in both quality and appearance of skin, the cosmeceutical beauty world said, "Oh, okay, this is awesome.
因为药物非常有效，而且我们看到皮肤质量和外观都有所改善，药妆美容界说：“哦，好吧，这太棒了。
We need to figure out a way to get this on the shelf but not be a prescription." Out came retinols with an O-L, which is the inactive version of retinoic acid, which is retinoids.
我们需要找到一种方法将其上架，但不能成为处方。”结果是带有 O-L 的视黄醇，它是视黄酸（视黄酸）的非活性版本，是类视黄醇。
And what has to happen is retinol needs to be converted in a two-step process to become active retinoic acid.
必须发生的是，视黄醇需要通过两步过程转化为活性视黄酸。
Otherwise, it's a completely inactive prodrug, which is sold over the counter at concentrations that are not biologically active.
否则，它是一种完全无活性的前药，在柜台上以不具有生物活性的浓度出售。
That's how cosmeceutical companies can get away with prescribing this for people of childbearing age.
这就是药妆公司为育龄人群开这种药的原因。
In my opinion, if you want a retinoid, get a prescription for it.
在我看来，如果您想要类维生素A，请开处方。
The over-the-counter stuff is not very effective, if at all.
非处方药即使有效果，也不是很有效。
The shelf stability, many studies have shown that almost all retinoids over the counter, retinols over the counter are basically unstabilized by one year, so you don't even know what you're paying for.
保质期稳定性，很多研究表明，几乎所有非处方类视黄醇、非处方视黄醇基本都不稳定，所以你根本不知道自己买的是什么。
The prescription is easy to get.
处方很容易获得。
You can see pretty much any dermatologist, and it's the only version that's truly effective.
您几乎可以去看任何皮肤科医生，而且这是唯一真正有效的版本。
So everybody should be on it.
所以每个人都应该参与其中。
Protects your skin, keeps you looking young, reduces skin cancer risk, grows new collagen.
保护您的皮肤，让您看起来年轻，降低皮肤癌风险，生长新的胶原蛋白。
Literally the only consequence is that when you first start, your skin may be a little bit red or peely as the skin acclimates or turns over.
从字面上看，唯一的后果是，当您第一次开始时，随着皮肤适应或翻转，您的皮肤可能会有点发红或脱皮。
Other than that, nothing.
除此之外，什么也没有。
Andrew Huberman:
安德鲁·休伯曼：
Why do you think, given the immense interest in skin appearance and health, that we don't hear more about this?
鉴于人们对皮肤外观和健康的巨大兴趣，您认为为什么我们没有听到更多有关此的信息？
Dr. Teo Soleymani:
Teo Soleymani 博士：
That's a great question.
这是一个很好的问题。
So we hear so much about retinol.
所以我们听说了很多关于视黄醇的事情。
Every magazine you open that has anything, you'll see intensive night cream, intensive eye serum, Regenerist eye repair, and all of them have retinol.
每打开一本杂志，你都会看到强效晚霜、强效眼部精华液、新生眼部修复精华，所有这些都含有视黄醇。
None of them have retinoid or tretinoin for many reasons.
由于多种原因，他们都没有类维生素A或维A酸。
Originally, it was made for acne And the patients that came in to get them for acne were not necessarily in the same line of thought of premature aging and longevity.
本来就是为了祛痘而生的，而来拿它来祛痘的患者，也不一定都是早衰长寿的同一思路。
Andrew Huberman:
安德鲁·休伯曼：
This would be things like RetinA.
这就是像 RetinA 这样的东西。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, RetinA, exactly, or Accutane, or Differin.
是的，确切地说是RetinA，或者Accutane，或者达芙文。
These are the brand names for these products.
这些是这些产品的品牌名称。
So there was a disconnect between the people seeking the anti-aging effects and the people getting it as a prescription.
因此，寻求抗衰老功效的人和将其作为处方的人之间存在脱节。
That's one.
这是一个。
And number two, as soon as cosmeceutical companies figured out a way to market over-the-counter inactive versions, that went haywire.
第二，药妆公司一旦找到一种方法来销售非活性版本的非处方药，就会陷入混乱。
So you can Google retinol and there's million things.
所以你可以谷歌视黄醇，有数百万种东西。
When you google tretinoin, you only hear about acne.
当你谷歌维甲酸时，你只会听到痤疮。
So there's a little bit of a disconnect, much like all in medicine, between what docs know and think the population knows and what the population actually knows.
因此，就像医学界一样，医生所知道的和认为人们知道的东西与人们实际知道的东西之间存在着一点脱节。
But that's the one thing I think we've been doing a great job on in modern-day social media is advocating for these medicines.
但我认为我们在现代社交媒体上一直做得很好的一件事就是倡导这些药物。
Now, that's one realm of things that you can do to absolutely improve the quality of your skin, long-term health, appearance, actually revitalize the skin.
现在，这是你可以做的事情之一，可以绝对改善你的皮肤质量、长期健康、外观，实际上使皮肤焕发活力。
Then there's a whole set of procedures that can be done that have been shown to improve not only the appearance, but actual biologic health.
然后有一整套可以完成的程序，这些程序已被证明不仅可以改善外观，而且可以改善实际的生物健康。
So that's where we fall into the laser world, and somebody who's been in photobiology, albeit a slightly different realm, you know the effects of light and the incredible changes that it can have in biology.
这就是我们陷入激光世界的地方，而从事光生物学的人，尽管领域略有不同，你知道光的影响以及它可以在生物学中产生的令人难以置信的变化。
Most of what we understand for lasers in medicine came out of dermatology studies.
我们对激光在医学上的了解大部分来自皮肤病学研究。
A lot of the understanding of laser biology came out of the Wellman Institute over at Harvard, where many of my colleagues are.
对激光生物学的很多理解都来自哈佛大学韦尔曼研究所，我的许多同事都在那里。
And we now know that certain laser devices, certain resurfacing devices not only improve the appearance of your skin, clinically, they reduce your risk of skin cancer by 20%, maybe greater.
我们现在知道，某些激光设备、某些换肤设备不仅可以改善皮肤外观，在临床上，它们还可以将您患皮肤癌的风险降低 20%，甚至更高。
And even more amazingly is when you do microarray gene studies, they actually activate the genes of more youthful, healthy skin cells that were quiescent as we age.
更令人惊奇的是，当你进行微阵列基因研究时，它们实际上激活了更年轻、更健康的皮肤细胞的基因，这些细胞随着年龄的增长而处于静止状态。
So there's genetic verification, clinical verification, and aesthetic verification.
所以有基因验证、临床验证和美学验证。
These things are awesome.
这些东西太棒了。
Now, laser is a big umbrella term.
现在，激光是一个大术语。
Some of the devices we use are not lasers.
我们使用的一些设备不是激光器。
They're actually light, broadband light, or intense pulsed light.
它们实际上是光、宽带光或强脉冲光。
Some of them are lasers.
其中一些是激光。
Some of them are ablative, some of them are non-ablative, and we get into the nuances of these things.
其中一些是烧蚀的，一些是非烧蚀的，我们深入了解这些事情的细微差别。
But there are a few lasers that have been shown to make these dramatic differences.
但有一些激光已被证明可以产生这些巨大的差异。
So if you're interested, see an expert.
因此，如果您有兴趣，请咨询专家。
Andrew Huberman:
安德鲁·休伯曼：
So this would be go to your dermatologist, ask for some, is it laser resurfacing?
所以这应该去找你的皮肤科医生，询问一些，这是激光换肤吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So laser resurfacing it tends to be, and what's really popular, there's two forms of laser resurfacing.
因此，激光换肤往往是这样，真正流行的是，激光换肤有两种形式。
There's what we call non-ablative, meaning it doesn't burn or vaporize the top layer of skin, and then there's ablative resurfacing, which vaporizes the top layer of skin.
有我们所说的非剥脱性，这意味着它不会燃烧或蒸发皮肤表层，然后是剥脱性换肤，它会蒸发皮肤表层。
Obviously, ablative ones are much more aggressive, much more effective, a lot more downtime, and a lot riskier because you're literally peeling the face off or any part of the body, and it regrows without any scarring.
显然，烧蚀性方法更具侵略性，更有效，恢复时间更长，风险也更大，因为你实际上是将脸部或身体的任何部分剥落，并且它会重新生长而不会留下任何疤痕。
That's also another beauty of the skin is you can literally peel it off entirely and have it regrow as if nothing ever happened.
这也是皮肤的另一个美妙之处，那就是你可以将它完全剥离并让它重新生长，就像什么都没发生过一样。
Andrew Huberman:
安德鲁·休伯曼：
So people have this done once a year or so?
那么人们每年左右都会进行一次这样的操作吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
For ablative resurfacing, it's like once every five years or so on.
对于烧蚀性表面重修，大约每五年一次左右。
It's pretty dramatic.
这非常具有戏剧性。
Andrew Huberman:
安德鲁·休伯曼：
And how long is the downtime?
停机时间是多长？
Dr. Teo Soleymani:
Teo Soleymani 博士：
For ablative resurfacing, two weeks.
对于烧蚀性表面重修，需要两周。
Usually two weeks you're pretty raw and sore.
通常两周后你就会感到浑身酸痛。
It's fallen out of favor in most big cities because of the downtime and the inherent risks, but it's still used in the right patient.
由于停机时间和固有风险，它在大多数大城市已经失宠，但它仍然用于合适的患者。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Non-ablative resurfacing, meaning it doesn't vaporize the top layer but drills holes into the dermis and targets certain parts of the epidermis without causing burn injury, that's become much more popular because the downtime is markedly less.
非剥脱性换肤，意味着它不会蒸发顶层，而是在真皮中钻孔并针对表皮的某些部分，而不会造成烧伤，这种方式变得更加流行，因为停机时间明显减少。
People can go back to work and enjoy their activities while having pretty much the same benefits, albeit a little bit less than ablative lasers.
人们可以回去工作并享受他们的活动，同时获得几乎相同的好处，尽管比烧蚀激光略少一些。
These we generally recommend annually or biannually, depending on what you're trying to target.
我们通常每年或每半年推荐一次，具体取决于您的目标。
A large Harvard study just came out that showed that non-ablative fractionated laser resurfacing, particularly with a device called Fraxel, actually cuts your skin cancer risk by 20% because it eliminates those mutations and gets rid of those cells that had been collecting the stuff.
哈佛大学刚刚发表的一项大型研究表明，非剥脱性点阵激光换肤，尤其是使用一种名为 Fraxel 的设备，实际上可以降低 20% 的皮肤癌风险，因为它消除了这些突变并清除了那些一直在收集这些物质的细胞。
It's amazing.
太棒了。
Andrew Huberman:
安德鲁·休伯曼：
How is this different than exfoliating skin?
这与去角质皮肤有何不同？
Like if one were to just try and scrape away some of the-
就像如果有人试图刮掉一些-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
dead skin-
死皮-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
through some semi-vigorous buffing of the skin-
通过对皮肤进行一些半强力的抛光-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
with a sponge.
用海绵。
I've never done either of these procedures.
我从来没有做过这些程序。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Like I said, my skincare routine is very basic.
就像我说的，我的护肤程序非常基本。
It's the unscented Dove soap, the shower once or twice a day, and-
这是无味的多芬肥皂，每天淋浴一两次，还有——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Your skin looks great, so keep doing what you're doing.
你的皮肤看起来很棒，所以继续做你正在做的事情。
Andrew Huberman:
安德鲁·休伯曼：
I mean, I feel pretty good.
我的意思是，我感觉很好。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I think sleep seems to play a significant role for me.
我认为睡眠对我来说似乎起着重要作用。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I do get probably a bit more sun exposure than most people.
我确实比大多数人暴露在阳光下的时间要多一些。
I'm conscious of checking for skin cancers, and we'll talk about that-
我有意识地检查皮肤癌，我们会讨论这个-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
because those do run in my family.
因为这些确实是我家族的传统。
And I try and eat right and exercise right.
我尝试正确饮食和正确锻炼。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Haven't consumed much alcohol in my lifetime, so.
我这辈子没喝多少酒，所以。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Look, your skin will tell you if something's wrong.
看，如果有什么问题，你的皮肤会告诉你。
So that's the first line.
这是第一行。
Now, you talk about dermabrasion or microdermabrasion, the good old St. Ives Apricot Scrub that every dermatologist frowns upon, but ironically, I use myself after a heavy workout at the beach and I'm all greasy, but don't get mad at me for using that stuff.
现在，你谈论的是磨皮术或微晶磨皮术，这是每个皮肤科医生都皱眉的古老圣艾夫斯杏子磨砂膏，但讽刺的是，我在海滩剧烈运动后使用自己，我全身都很油腻，但不要因为我使用这些东西而生我的气。
The depth is key.
深度是关键。
So when we do microdermabrasion or some sort of dermabrasion, the only thing we're really scraping off is really the stratum corneum, which is the highest layer of skin cells that don't even have a nucleus.
因此，当我们进行微晶磨皮术或某种磨皮术时，我们真正刮掉的唯一东西实际上是角质层，它是皮肤细胞的最高层，甚至没有细胞核。
They're dead skin cells.
它们是死皮细胞。
That's all you're scraping off.
这就是你要刮掉的一切。
Whereas lasers Target through the epidermis and into the dermis, and you control for that depth.
而激光则穿过表皮进入真皮，您可以控制该深度。
And what you control for is the amount of heat energy delivered to that depth to target a certain thing.
您控制的是传递到该深度以瞄准特定物体的热能的量。
Andrew Huberman:
安德鲁·休伯曼：
Mm-hmm.
嗯嗯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So in theory, what you describe in terms of dermabrasion is the same premise the old school ablative lasers do.
因此，从理论上讲，您所描述的磨皮术与老式烧蚀激光的前提相同。
They just fry everything off and you grow new skin.
他们只是把所有东西都炸掉，然后你就会长出新的皮肤。
And in frying everything off, it fries off sun damage, wrinkles, pre-cancers, and skin cancers.
在消除一切的同时，它还能消除阳光损伤、皱纹、癌前病变和皮肤癌。
But in doing that, you're a bloody mess for a few weeks.
但这样做的话，你会在几周内陷入一团糟。
Not popular for many reasons, but very effective.
由于多种原因不受欢迎，但非常有效。
We did a ton of this at Stanford, and we did a ton of the other one at Stanford.
我们在斯坦福大学做了很多这样的事情，我们在斯坦福大学也做了很多其他的事情。
In my practice, I do a lot of laser work as well.
在我的实践中，我也做了很多激光工作。
The non-ablative stuff picks and chooses.
非烧蚀的东西是挑选的。
That was the beauty of learning about laser and photobiology, is how we target a certain structure and avoid damaging all the other ones.
这就是学习激光和光生物学的美妙之处，就是我们如何瞄准特定结构并避免损坏所有其他结构。
The theory of selective photothermolysis that came out of Rox Anderson's lab at Harvard, that was the game changer.
哈佛大学 Rox Anderson 实验室提出的选择性光热解理论改变了游戏规则。
We can now pick any appendage in the skin and find a way to target it and leave the rest undisturbed.
现在，我们可以挑选皮肤中的任何附属物，并找到一种方法来瞄准它，而让其余部分不受干扰。
So if you have broken blood vessels, you decide to use BPC 157 and it worked great, and the blood vessels started to grow and you're like, "I don't like the look of them," there is a laser that targets solely blood vessels.
因此，如果您的血管破裂，您决定使用 BPC 157，它效果很好，血管开始生长，您会说，“我不喜欢它们的外观”，有一种激光仅针对血管。
Andrew Huberman:
安德鲁·休伯曼：
Is that the IPL laser?
那是IPL激光吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
IPL is okay.
IPL还可以。
IPL stands for intense pulsed light.
IPL 代表强脉冲光。
It's somewhat effective, but not very effective.
有一定效果，但效果不是很好。
The gold standard is what we call the pulse dye laser or the Vbeam laser, and that is a 595 nanometer laser that targets oxyhemoglobin.
黄金标准是我们所说的脉冲染料激光或 Vbeam 激光，这是一种针对氧合血红蛋白的 595 纳米激光。
Andrew Huberman:
安德鲁·休伯曼：
I've had that actually because I had an angioma.
我之所以这样，实际上是因为我患有血管瘤。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Had it three times, and the third time they hit this thing, it went away, but not without a very significant bruise-
已经有三次了，第三次他们击中这个东西时，它就消失了，但并非没有非常严重的瘀伤——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
lasting almost a month.
持续了将近一个月。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Ah.
啊。
Andrew Huberman:
安德鲁·休伯曼：
I mean, it was pretty dramatic.
我的意思是，这非常戏剧化。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Overdone it.
太过分了。
Andrew Huberman:
安德鲁·休伯曼：
Right.
对。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But it did eliminate the vessel.
但它确实消除了这艘船。
That was very-
那是非常-
Dr. Teo Soleymani:
Teo Soleymani 博士：
By any means necessary, right?
无论如何必要，对吧？
To just nuke-
只是用核武器-
Andrew Huberman:
安德鲁·休伯曼：
Yeah
是啊
Dr. Teo Soleymani:
Teo Soleymani 博士：
...
...
the skin.
皮肤。
Andrew Huberman:
安德鲁·休伯曼：
So as long as we're on the topic of photobiomodulation-
所以只要我们谈论光生物调节的话题-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
what about red light, near-infrared light?
红光、近红外光呢？
Is there any evidence that it can benefit skin health and appearance?
是否有任何证据表明它有益于皮肤健康和外观？
Nowadays you can find masks that will emit red light.
现在你可以找到会发出红光的面具。
Some people will purchase red lights they stand in front of.
有些人会购买他们面前的红灯。
Dr. Teo Soleymani:
Teo Soleymani 博士：
I think they're very effective.
我认为它们非常有效。
I think they work great.
我认为他们工作得很好。
The question is to what extent is that improvement objective and measurable, and what extent is subjective?
问题是这种改进在多大程度上是客观且可衡量的，在多大程度上是主观的？
That being said, there's a lot of evidence that shows that red light therapy improves vascular flow in the skin.
话虽如此，有大量证据表明红光疗法可以改善皮肤的血管流动。
We use it for things like hair restoration, post-procedure recovery, improvement in skin health after UV damage.
我们用它来修复头发、术后恢复、改善紫外线损伤后的皮肤健康。
We actually found a recent study that looked at red light therapy and irradiating mice, and if you pre-treat the mice with the red light therapy before they get UV exposure compared to controls, the pre-treated group had much less of the changes with UV exposure.
事实上，我们最近发现了一项研究，该研究着眼于红光疗法和照射小鼠，如果在小鼠接受紫外线照射之前对它们进行预处理，与对照组相比，经过预处理的组在紫外线照射下的变化要小得多。
So very fascinating stuff.
非常令人着迷的东西。
How it works, uncertain.
它如何运作，不确定。
We think a lot of it has to do with increased vascular flow, which is why a lot of times we recommend it for post-procedure, we recommend it for hair regrowth.
我们认为这很大程度上与血管流量增加有关，这就是为什么我们很多时候推荐它用于术后，我们推荐它用于头发再生。
There's some evidence that if you increase blood flow to the dermal papilla of the hair, it grows new hair.
有证据表明，如果增加头发真皮乳头的血流量，就会长出新头发。
That's how Minoxidil or Rogaine works.
这就是米诺地尔或落健的作用原理。
But I like it.
但我喜欢它。
I think it's a great group of products or devices.
我认为这是一组很棒的产品或设备。
As a standalone, uncertain as to how effective they are.
作为一个独立的个体，不确定它们的效果如何。
And one of the reasons of the heterogeneity in the data, or so much difference, is there's no regulation in terms of the energy, the density of light, the type of light, the duration of treatment.
数据不均匀或差异如此之大的原因之一是在能量、光密度、光类型、治疗持续时间方面没有规定。
So some devices have high wattage, high energy output, high density of lights.
所以有些设备具有高瓦数、高能量输出、高光密度。
They may be more effective than its equivalent counterpart.
它们可能比同等的对应物更有效。
And until that gets defined more uniform in accessibility, I don't know which device to recommend.
在可访问性得到更统一的定义之前，我不知道该推荐哪种设备。
I obviously have preferences one way or another, but there's so much on the market that's marketed as red light that is not effective, and some stuff that's really good.
显然，我有这样或那样的偏好，但市场上有很多东西以红灯的形式销售，但效果不佳，而有些东西确实很好。
Andrew Huberman:
安德鲁·休伯曼：
So probably looking for something that's at least endorsed by dermatologists-
所以可能正在寻找至少得到皮肤科医生认可的东西-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
makes sense.
有道理。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, absolutely.
是的，绝对是。
Andrew Huberman:
安德鲁·休伯曼：
And I should say here, I have no angle into this.
我应该在这里说，我对此没有任何看法。
These masks that emit red light are-
这些发出红光的面具是——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
I don't have any business relationship to them, so that's not why I bring it up.
我和他们没有任何业务关系，所以这不是我提出这个问题的原因。
I was just very curious.
我只是很好奇。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I see them in my Instagram feed-
我在我的 Instagram 动态中看到它们 -
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
probably by virtue of doing public-facing health and science information.
可能是通过提供面向公众的健康和科学信息。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And my interest in light.
还有我对光的兴趣。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What about-- Oh, yes.
怎么样——哦，是的。
Excuse me.
打扰一下。
Dr. Teo Soleymani:
Teo Soleymani 博士：
I was going to say, the panels tend to be much higher in energy, much more effective, and most of the studies have looked at the big wall panels.
我想说的是，面板的能量往往更高，更有效，而且大多数研究都着眼于大型墙板。
The battery-powered face masks just aren't powered enough to have much improvement.
电池供电的面罩供电不足，无法有太大改善。
We do see some improvement when red and blue is used together, mostly for acne-prone skin, because blue light alone has some antimicrobial properties.
当红色和蓝色一起使用时，我们确实看到了一些改善，主要是针对容易长粉刺的皮肤，因为单独的蓝光具有一些抗菌特性。
So when used in conjunction, you can get some improvement in actual skin illnesses.
所以配合使用的话，可以对实际的皮肤疾病得到一定的改善。
But the masks alone with just red light, most of them are not powered enough.
但光是红灯的面罩，大多供电不足。
They don't have enough energy, but there are some that are good.
他们没有足够的能量，但也有一些是好的。
The wall panels tend to be better.
墙板往往更好。
Andrew Huberman:
安德鲁·休伯曼：
Thank you for that, and full disclosure, I was accurate in saying that I don't have any relationship to any red light mask companies or products.
谢谢您的充分披露，我准确地说我与任何红光面罩公司或产品没有任何关系。
But this podcast is sponsored by Joovv, which makes medical grade panels for-
但这个播客是由 Joovv 赞助的，该公司生产医疗级面板：
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
red light and near-infrared light.
红光和近红外光。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And I do own one of those, and I have a small portable one I use, and then I have a panel I stand in front of.
我确实拥有其中一个，并且我使用了一个小型便携式设备，然后我站在前面有一个面板。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So that includes my face.
所以这包括我的脸。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And then I'll turn around, and so do a whole body-
然后我会转过身来，整个身体也会转过身来——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
a couple times a week.
每周几次。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Panels are good.
面板很好。
Joovv is a good company.
Joovv是一家好公司。
It's been around for a while, and most of the experts in laser and photobiology agree that panels are the way to go if you want red light.
它已经存在了一段时间，大多数激光和光生物学专家都同意，如果你想要红光，面板是最好的选择。
Andrew Huberman:
安德鲁·休伯曼：
It's interesting when people see and hear about red light and near-infrared light therapies.
当人们看到和听到红光和近红外光疗法时，这很有趣。
I think a lot of people think, "Oh, this is kind of like next stage biohacking." But There was a Nobel Prize given for photobiomodulation for the treatment of lupus-
我想很多人都会想，“哦，这有点像下一阶段的生物黑客。”但是诺贝尔奖因光生物调节治疗狼疮而获得——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
in the early 1900s.
1900年代初期。
So this is a long-standing thing, the use of light, of particular wavelengths or combinations of wavelengths, of which red light and blue light are, of course, in order to target different layers within the skin to get some desired effect.
所以这是一个长期存在的事情，使用特定波长或波长组合的光，其中红光和蓝光，当然是为了针对皮肤内的不同层以获得一些所需的效果。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Light has been around for a long time.
光已经存在很长时间了。
I have a phototherapy unit in my practice in which we use narrow-band ultraviolet B light to treat conditions like psoriasis, to treat conditions like vitiligo.
我的诊所有一个光疗设备，我们使用窄带紫外线 B 光来治疗牛皮癣等疾病，治疗白癜风等疾病。
There's a very strong immunomodulatory effect of light on the skin.
光对皮肤有很强的免疫调节作用。
It actually suppresses overactive immune activity.
它实际上抑制过度活跃的免疫活动。
It can help increase vascularity in the skin.
它可以帮助增加皮肤的血管供应。
It can improve blood flow, so depending on the wavelength you pick and where it overlies on the absorption curves, makes a big difference.
它可以改善血液流动，因此根据您选择的波长以及它在吸收曲线上的位置，会产生很大的差异。
It's interesting that we talk about light, and as a skin cancer surgeon, this has always been interesting to me in that we use UV light to treat certain conditions, and we assume UV light is purely pathogenic, and I don't think that's the case.
有趣的是，我们谈论光，作为一名皮肤癌外科医生，这对我来说一直很有趣，因为我们使用紫外线来治疗某些病症，我们假设紫外线纯粹是致病的，但我认为情况并非如此。
And why I bring this up is one of the most common things we use light therapy for is patients with vitiligo, which is this autoimmune condition in which your immune system attacks the cells that produce our skin color.
我之所以提出这个问题，是因为我们使用光疗法最常见的疾病之一是白癜风患者，这是一种自身免疫性疾病，您的免疫系统会攻击产生我们肤色的细胞。
And the standard treatment is certain creams that suppress the immune system in the skin, phototherapy, excimer laser, which is a UV laser, and then now the new world of immunotherapies by pill form.
标准治疗方法是使用某些抑制皮肤免疫系统的乳膏、光疗、准分子激光（一种紫外线激光），以及现在采用药丸形式的免疫疗法的新世界。
The JAK inhibitors have made a huge difference.
JAK 抑制剂产生了巨大的变化。
But if we thought, and I go back on this tangent because the more we think about it, the less we know.
但如果我们思考的话，我就会回到这个切线，因为我们思考得越多，我们知道的就越少。
If we think UV is truly deleterious, then patients with vitiligo should have an higher incidence of skin cancer.
如果我们认为紫外线确实有害，那么白癜风患者患皮肤癌的发病率应该更高。
And in fact, the opposite is true.
事实上，事实恰恰相反。
They have a lower incidence of skin cancer even when you match them for amount of UV exposure over time.
即使您将一段时间内的紫外线暴露量与它们相匹配，它们的皮肤癌发病率也较低。
So it goes to tell us that there's so much about light and skin we don't understand, so much about sun and UV and skin we don't understand, and an incredible component about our skin's immune system that we're only now figuring out that play an important role.
所以它告诉我们，关于光和皮肤，有太多我们不了解的地方，有太多关于阳光、紫外线和皮肤我们不了解的地方，还有我们皮肤免疫系统中一个令人难以置信的组成部分，我们现在才发现它发挥着重要作用。
Patients who have transplants, for example.
例如，接受移植的患者。
Transplant patients in the early '90s, the number one cause of death for transplant patients that was not related to their transplant was metastatic skin cancer.
90年代初的移植患者中，与移植无关的移植患者的第一大死因是转移性皮肤癌。
And this was in patients who were strictly sun protected.
这是在严格防晒的患者身上发生的。
So we talk about biology, photobiology, LED, UV, and skin health, and there's so much we don't know as we gather more data and look at populations and cohorts.
所以我们谈论生物学、光生物学、LED、紫外线和皮肤健康，当我们收集更多数据并观察人群和群体时，我们不知道的东西太多了。
So I don't know why I brought that up as a tangent, but-
所以我不知道为什么我把它作为切线提出来，但是-
Andrew Huberman:
安德鲁·休伯曼：
No, I think it's a very relevant tangent because the relationship between immune system function and skin is very clear.
不，我认为这是一个非常相关的切线，因为免疫系统功能和皮肤之间的关系非常清楚。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
And these conditions that you're referring to, vitiligo, acne, psoriasis, eczema, et cetera, have interesting relationships to the immune system.
你提到的白癜风、痤疮、牛皮癣、湿疹等疾病与免疫系统有着有趣的关系。
So that's actually a perfect segue for what I'd like to talk about next.
所以这实际上是我接下来要讨论的内容的完美延续。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Sure.
当然。
Andrew Huberman:
安德鲁·休伯曼：
So let's start with psoriasis.
那么让我们从牛皮癣开始吧。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What is the story with psoriasis?
牛皮癣有什么故事？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What is it?
它是什么？
What can make it worse?
什么会使情况变得更糟？
What can make it better?
什么可以让它变得更好？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Psoriasis is like the quintessential skin condition.
牛皮癣就像典型的皮肤病。
I have it myself on my elbows and knees, and for about 100 years, it was thought to be a problem, a rash, that is caused by too much skin turnover or excess skin proliferation.
我自己的肘部和膝盖上也有这种情况，大约 100 年来，人们一直认为这是一个问题，是一种皮疹，是由皮肤更新过多或皮肤过度增生引起的。
And for 100 years, we treated it the same way.
一百年来，我们一直以同样的方式对待它。
We gave medicines that basically took the skin off, what we call keratolytics.
我们提供的药物基本上可以去除皮肤，即我们所说的角质层分离剂。
We found that that wasn't very effective, and some people can be hospitalized, and it can be life-threatening if psoriasis involves the entire body.
我们发现这不是很有效，有些人可能会住院，如果牛皮癣累及整个身体，可能会危及生命。
It usually looks like red patches or plaques with kind of a silvery scale on the surface and starts usually elbows and knees or the scalp, but can involve pretty much the entirety of the body.
它通常看起来像表面有银色鳞片的红色斑块或斑块，通常从肘部、膝盖或头皮开始，但几乎可以累及整个身体。
And what we found in the last 30 years with a lot of elegant studies and a lot of very, very nice basic science research is that it's actually due to overactivity of our skin's immune system.
在过去的 30 年里，我们通过大量优雅的研究和大量非常非常好的基础科学研究发现，这实际上是由于我们皮肤免疫系统的过度活跃造成的。
So there's overactivity of certain interleukins, which are these messengers that our immune cells produce, that makes the skin turn over faster than it should.
因此，某些白细胞介素（我们的免疫细胞产生的信使）过度活跃，使皮肤的更新速度超过应有的速度。
And this epiphany was remarkable because we found that instead of targeting the skin, we can target the immune system, and we can eradicate or treat psoriasis entirely.
这一顿悟是非凡的，因为我们发现我们可以瞄准免疫系统，而不是针对皮肤，并且可以完全根除或治疗牛皮癣。
And in the '90s and early 2000s, that targeting was very crude.
在 20 世纪 90 年代和 2000 年代初，这种定位非常粗略。
It was a very umbrella approach.
这是一种非常笼统的方法。
We suppressed the entire immune system and ran into the consequences of that.
我们抑制了整个免疫系统并遇到了由此产生的后果。
So medications that we gave for that increased risk for infections and skin cancers, et cetera.
因此，我们服用的药物会增加感染和皮肤癌等的风险。
Now we have amazing drugs that target one or two molecules, messenger molecules of our immune system, and clear up people's psoriasis.
现在我们有了神奇的药物，可以针对一两个分子，即我们免疫系统的信使分子，并清除人们的牛皮癣。
We have drugs now you take three times a year, and you could have head-to-toe psoriasis and be completely clear.
我们现在有药物，您每年服用三次，您可能患有从头到脚的牛皮癣并且完全康复。
It tends to run in families.
它往往在家庭中流行。
There is a very strong hereditary or genetic component to it, and it tends to be associated with arthritis, psoriatic arthritis.
它有很强的遗传或基因成分，它往往与关节炎、银屑病关节炎有关。
So psoriasis is like the quintessential skin condition that people see dermatologists and even rheumatologists for.
因此，牛皮癣就像人们去看皮肤科医生甚至风湿病医生的典型皮肤病。
Andrew Huberman:
安德鲁·休伯曼：
So these drugs that target these specific interleukins seem like the most direct way to treat psoriasis.
因此，这些针对这些特定白细胞介素的药物似乎是治疗牛皮癣的最直接方法。
Some people, for whatever reason, have an aversion to-
有些人，无论出于何种原因，都厌恶——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
prescription drugs.
处方药。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I'm not necessarily one of those people, but I, like everybody else, would like to know what we can do to Reduce symptoms of things like psoriasis-
我不一定是这些人中的一员，但我和其他人一样，想知道我们可以做些什么来减少牛皮癣等症状 -
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
without having to, quote-unquote, "take anything."
不必“拿走任何东西”。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, I should probably backtrack.
是的，我也许应该回头。
So psoriasis obviously comes in severity.
所以牛皮癣显然很严重。
There's mild disease, which majority of people have, there's moderate, and severe.
大多数人都患有轻度疾病，有中度疾病和重度疾病。
And generally speaking, the most common things that we treat mild psoriasis with is creams and lotions, moisturizers, sometimes low-potency topical steroids or high-potency topical steroids, and then things like keratolytics, like salicylic acid, that take that excess scale off.
一般来说，我们治疗轻度牛皮癣最常用的药物是乳霜和乳液、保湿剂，有时是低效外用类固醇或高效外用类固醇，然后是角质层分离剂（如水杨酸），可以去除多余的鳞屑。
We also know that because it's an immune inflammatory condition, that diet plays a big role in improving mild or moderate cases.
我们还知道，由于这是一种免疫炎症性疾病，因此饮食在改善轻度或中度病例方面发挥着重要作用。
And we also know that weight loss plays a very big role in improving the appearance of psoriasis.
而且我们也知道，减肥对于改善牛皮癣的出现有着非常大的作用。
So as we lose weight, as there's improvement in insulin resistance, and as we transition diets and lifestyles from inflammatory to anti-inflammatory, psoriasis tends to clear without any intervention needed, without any medical intervention needed.
因此，当我们减肥时，随着胰岛素抵抗的改善，当我们将饮食和生活方式从炎症转变为抗炎时，牛皮癣往往会在不需要任何干预的情况下消失，不需要任何医疗干预。
If there's still continued rashes and skin activity, then you'd look at topicals, like cortisones, emollients like Aquaphor and Vaseline, things with some sort of acid or a retinoid to get rid of that excess scale.
如果皮疹和皮肤活动仍然持续存在，那么你可以考虑使用外用药物，如可的松、Aquaphor 和凡士林等润肤剂、含有某种酸或类维生素A的物质来去除多余的水垢。
That's the fundamental cornerstone of treating psoriasis.
这是治疗牛皮癣的基本基石。
And then when it gets bad, we talk about additional pharmacologic interventions.
然后当情况恶化时，我们会讨论额外的药物干预措施。
Also, interestingly, one of the earliest conditions in which phototherapy was used is psoriasis.
此外，有趣的是，最早使用光疗的疾病之一是牛皮癣。
We know that when we shine UV light on the skin, that it suppresses the skin's immune system and clears psoriasis, and that's an excellent way to treat it without pharmacologic intervention, without any creams, pills, injections, or otherwise medication.
我们知道，当我们用紫外线照射皮肤时，它会抑制皮肤的免疫系统并清除牛皮癣，这是治疗牛皮癣的绝佳方法，无需药物干预，无需任何乳膏、药丸、注射剂或其他药物。
It used to be used in the Dead Sea.
它曾经用于死海。
People would go lather in the mud in the Dead Sea and sit out in the sun, and that was the first crude way to use phototherapy to treat psoriasis.
人们会在死海的泥浆中起泡沫，然后坐在阳光下，这是使用光疗法治疗牛皮癣的第一个原始方法。
Andrew Huberman:
安德鲁·休伯曼：
That was my question.
这就是我的问题。
Since the sun emits UV, why not just get some additional sunlight exposure for psoriasis?
既然太阳会发射紫外线，为什么不多接受一些阳光照射来治疗牛皮癣呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
So you can.
所以你可以。
Most dermatologists wouldn't recommend it.
大多数皮肤科医生不会推荐它。
I think it's actually not a bad thing.
我认为这其实并不是一件坏事。
My psoriasis clears in the summertime and flares in the wintertime.
我的牛皮癣在夏天消失，在冬天发作。
The problem with pure sunlight is that it's a mix of rays, right?
纯阳光的问题在于它是光线的混合，对吗？
There's X-rays, gamma rays, which generally don't penetrate the atmosphere.
X射线、伽马射线通常不会穿透大气层。
There's UVC, UVB, UVA, visible light, infrared light.
有UVC、UVB、UVA、可见光、红外光。
So that heterogeneous light, some have no improvement in psoriasis, and some have great improvement.
所以说异质光，有的牛皮癣没有改善，有的有很大改善。
So we were able to figure out which wavelengths make a big difference, and it's around the 311, 312 nanometer range.
所以我们能够找出哪些波长会产生很大的差异，它大约在 311、312 纳米范围内。
But sunlight does clear people's psoriasis up.
但阳光确实可以清除人们的牛皮癣。
That's why we see in northern latitudes where there's less sun intensity, the incidence of psoriasis is markedly higher than equatorial latitudes.
这就是为什么我们看到在阳光强度较低的北纬地区，牛皮癣的发病率明显高于赤道纬度地区。
And patients will say their psoriasis gets better when they're on a beach vacation.
患者会说，当他们去海滩度假时，他们的牛皮癣会好转。
When they go back home, their psoriasis flares.
当他们回到家时，他们的牛皮癣就会发作。
There's also some component with vitamin D as well, but I think that's just secondary to the lack of UV exposure.
还有一些含有维生素 D 的成分，但我认为这只是缺乏紫外线照射的次要因素。
Andrew Huberman:
安德鲁·休伯曼：
What about vitiligo?
白癜风怎么办？
This is something I did not cover in the solo episode about skin health, but I got a lot of questions about vitiligo, of course, being this typically patchy, non-pigmented regions of skin that you said is at least some cases are related to the immune system.
这是我在关于皮肤健康的独奏中没有提到的内容，但我有很多关于白癜风的问题，当然，这是典型的斑片状、非色素沉着的皮肤区域，你说至少有些病例与免疫系统有关。
These people get skin cancers less often.
这些人患皮肤癌的频率较低。
Is that right?
是这样吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So vitiligo is autoimmune, meaning your immune system is attacking itself.
因此，白癜风是自身免疫性疾病，这意味着您的免疫系统正在攻击自身。
Depigmentary skin disorder, meaning it's a condition in which your immune system attacks and kills the melanocytes, which are the cells that produce our skin's color.
色素脱失性皮肤病，这意味着您的免疫系统会攻击并杀死黑色素细胞，而黑色素细胞是产生皮肤颜色的细胞。
And we've found that it's an autoimmune condition from many basic science and elegant studies.
我们从许多基础科学和优雅的研究中发现这是一种自身免疫性疾病。
It's also very closely associated with other autoimmune conditions.
它也与其他自身免疫性疾病密切相关。
So patients tend to also have atopic dermatitis, autoimmune thyroid disease, autoimmune anemia.
因此患者往往还患有特应性皮炎、自身免疫性甲状腺疾病、自身免疫性贫血。
There's some sort of immune dyscrasia that involves vitiligo patients.
白癜风患者存在某种免疫失调。
And what happens is the immune system at first paralyzes these cells with immune activity attacking them, and over time, these cells no longer survive and die off.
所发生的情况是，免疫系统首先通过攻击它们的免疫活动来麻痹这些细胞，随着时间的推移，这些细胞不再存活并死亡。
The cornerstone in treatment has always been some way to suppress the skin's immune response.
治疗的基石始终是抑制皮肤免疫反应的某种方法。
Most of the time, vitiligo tends to be focal, single areas, or segmental.
大多数时候，白癜风往往是局灶性、单一区域或节段性的。
Unfortunately, in certain cases, it can be whole body or completely depigmenting.
不幸的是，在某些情况下，它可能是全身或完全脱色。
Very uncommon, but we see this.
非常罕见，但我们看到了这一点。
We treat it by doing things that'll help quiet the immune response in the skin.
我们通过采取有助于平息皮肤免疫反应的措施来治疗它。
So topical creams, topical steroids, et cetera, topical calcineurin inhibitors, which are non-steroidal anti-inflammatory medications.
因此，外用乳膏、外用类固醇等、外用钙调神经磷酸酶抑制剂都是非类固醇抗炎药物。
We also use certain wavelengths of UV light to treat this, excimer laser at 308 nanometers, UVB, UVA.
我们还使用某些波长的紫外线来治疗这种情况，即 308 纳米准分子激光、UVB、UVA。
And then the renaissance in vitiligo has happened in the last three or four years with the identification of JAK inhibitors, which are these drugs that block the Janus kinase pathway.
随着 JAK 抑制剂（阻断 Janus 激酶通路的药物）的发现，白癜风在过去的三四年里得到了复兴。
And we found that the JAK stat pathway plays a really important role in autoimmune mediation of melanocyte death.
我们发现 JAK stat 通路在黑色素细胞死亡的自身免疫介导中发挥着非常重要的作用。
So new creams and actually oral medications have come out for patients who have very refractory vitiligo.
因此，针对难治性白癜风患者的新药膏和口服药物已经问世。
The immune component is very fascinating because understanding immune biology and the immune system's effects on skin health comes from studying these patients.
免疫成分非常令人着迷，因为了解免疫生物学和免疫系统对皮肤健康的影响来自于对这些患者的研究。
When patients have vitiligo, they lose all of their color, so you would assume that they're much more susceptible to sunburns, which they are.
当患者患有白癜风时，他们会失去所有颜色，因此您会认为他们更容易被晒伤，事实也确实如此。
But when you look at incidence of skin cancers, they have a significantly lower incidence of skin cancer, and this is because of the immune phenomenon in immune surveillance of cancer, and that occurs throughout the body, but the skin is a model platform for this.
但当你观察皮肤癌的发病率时，他们的皮肤癌发病率明显较低，这是因为癌症免疫监视中的免疫现象，并且发生在全身各处，而皮肤是这种现象的模型平台。
What happens is your immune system surveys for mutant changes that occur, whether it's UV related, et cetera, infection, toxin, whatever.
发生的事情是你的免疫系统调查发生的突变变化，无论它是否与紫外线相关，感染，毒素，等等。
And patients who have vitiligo have overactivity of these immune cells and over-surveillance.
白癜风患者的这些免疫细胞过度活跃，并且过度监视。
So they are able to clear a lot of these precancerous changes before they form into something.
因此，他们能够在这些癌前变化形成之前清除它们。
So that played a big role in not only understanding how to treat vitiligo, but some of our new medicines.
因此，这不仅对了解如何治疗白癜风，而且对我们的一些新药也发挥了重要作用。
Actually, the medicines that won the Nobel Prize in 2018 for treating melanoma came from understanding immune activity and cancer pathogenesis.
事实上，2018年获得诺贝尔奖的治疗黑色素瘤的药物就来自于对免疫活性和癌症发病机制的了解。
Andrew Huberman:
安德鲁·休伯曼：
It's fascinating.
这很有趣。
Again, speaking to the fact that skin is far more than just this-
再说一遍，皮肤远不止于此——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
protective outer sheath.
保护外护套。
It's a reflection of so much that's going on internally.
这反映了内部发生的很多事情。
And we know that intuitively.
我们凭直觉就知道这一点。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Also by observing others.
也是通过观察别人。
I think this is one of several ways that parents can communicate well with their children, or their children with their parents, rather, in terms of how they're feeling prior to language.
我认为这是父母与孩子或孩子与父母进行良好沟通的几种方式之一，更确切地说，是在语言之前就他们的感受进行沟通。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
They'll look at their skin.
他们会观察自己的皮肤。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Their stool.
他们的凳子。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Yeah, yeah.
是啊是啊。
Andrew Huberman:
安德鲁·休伯曼：
Obviously fussiness and mood and those things too, but we seem to have developed an intuitive understanding that a shift in the tone of the skin or some other features of the skin signal to us wellness or lack of wellness.
显然，烦躁和情绪以及这些事情也是如此，但我们似乎已经形成了一种直观的理解，即肤色的变化或皮肤的其他一些特征向我们发出健康或缺乏健康的信号。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
The skin's a biosensor.
皮肤是一个生物传感器。
The entire skin, hair, nails is a biosensor.
整个皮肤、头发、指甲都是一个生物传感器。
So you can utilize the skin as the first barometer of illness.
因此，您可以利用皮肤作为疾病的第一晴雨表。
From acute illness to chronic illness.
从急性病到慢性病。
Acutely, you can see changes in just looking pal, with pallor, looking ghastly, things like that, but chronic illness as well.
急剧地，你可以看到只是看起来朋友的变化，脸色苍白，看起来可怕，诸如此类，但慢性疾病也是如此。
When you used to go to the pediatrician, and they would do this to look at your eyes, what they were looking for was the color of the conjunctiva.
当你过去去看儿科医生时，他们会这样做来检查你的眼睛，他们要寻找的是结膜的颜色。
If it was white or pale, they knew you had iron deficiency.
如果它是白色或苍白的，他们就知道你缺铁了。
When kids get hand, foot, and mouth syndrome and they have a high fever, they lose their fingernails.
当孩子患上手足口综合症并发高烧时，他们的指甲就会脱落。
When college students are stressed out, they lose their hair.
当大学生压力过大时，他们就会掉头发。
The body's amazing ability to tell you it's under stress is shown in the skin, hair, and nails.
身体有惊人的能力告诉你它正处于压力之下，这一能力体现在皮肤、头发和指甲上。
What it does is it says, "Why am I wasting energy producing something that is not necessary because I'm fighting something else?
它的作用是说：“为什么我要浪费精力生产一些不必要的东西，因为我正在与其他东西作斗争？
Let's just shed this." And you can tell right away.
让我们摆脱这个吧。”你马上就能知道。
We used to, in clinic when I'd see medical students or college students come in, I knew it was finals week, they'd come with clumps of hair.
我们过去常常在诊所里看到医学院的学生或大学生进来，我知道这是期末考试周，他们会带着一簇头发来。
And as soon as finals week passed, it usually took a few months, their hair grew back.
一旦期末考试周过去，通常需要几个月的时间，他们的头发又长回来了。
It's awesome.
太棒了。
The skin's a really cool biosensor, and you can tell a lot.
皮肤是一个非常酷的生物传感器，你可以知道很多东西。
Andrew Huberman:
安德鲁·休伯曼：
It is so cool.
太酷了。
What about acne?
痤疮怎么办？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Acne seems very common as we progress through puberty, there seems to be more acne.
随着青春期的进展，痤疮似乎很常见，并且痤疮似乎越来越多。
Sometimes it's transient, sometimes it's not.
有时它是短暂的，有时则不是。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
What are some things that people can do to prevent or reduce acne?
人们可以采取哪些措施来预防或减少痤疮？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Another quintessential derm problem that affects so many people.
另一个影响很多人的典型皮肤问题。
Acne tends to be a condition that is bimodal, meaning we tend to see it in adolescents, we tend to see it in 25 to 35-year-olds, and for the unfortunate group of people that bridge that gap, we see it anywhere from 12 to 35.
痤疮往往是一种双峰病症，这意味着我们往往会在青少年中看到它，我们往往会在 25 至 35 岁的人群中看到它，而对于弥补这一差距的不幸人群，我们会在 12 至 35 岁之间的任何地方看到它。
Acne is a condition that's usually seen by pimples.
痤疮是一种通常表现为粉刺的病症。
What we call blackheads or whiteheads, zits or boils, and it's thought to be caused by three important things.
我们所说的黑头或白头、青春痘或疖子，它被认为是由三个重要因素引起的。
It's an overproduction of sebum, which is the oily stuff that comes out of your skin, and that's dictated by your hormones.
这是皮脂分泌过多，皮脂是从皮肤中排出的油性物质，这是由荷尔蒙决定的。
Your hormones will increase the output of sebum, and that usually occurs in puberty, but can also occur if you're taking medications like prednisone, cortisol, testosterone, anything that is a hormone driver.
你的荷尔蒙会增加皮脂的分泌，这通常发生在青春期，但如果你服用强的松、皮质醇、睾酮等激素驱动药物，也会发生这种情况。
So sebum is the first cause.
所以皮脂是第一个原因。
Sebum is the food for the bacteria that cause acne.
皮脂是引起痤疮的细菌的食物。
So as there's more food, the bacteria proliferate.
因此，随着食物的增多，细菌就会繁殖。
And in proliferation, it recruits an immune response.
在增殖过程中，它会招募免疫反应。
Your immune system says, "Hey, there's a little bit too much of these organisms.
你的免疫系统会说：“嘿，这些生物体有点太多了。
Let's go and take care of them." That's where you get that red zit.
我们去照顾他们吧。”这就是你长红色痘痘的地方。
So in treating acne, you got to treat all three components to get really effectively clear skin.
因此，在治疗痤疮时，您必须治疗所有三个成分，才能真正有效地清洁皮肤。
Somehow reduce the sebum, get rid of the bacteria, and calm the immune system down.
以某种方式减少皮脂，清除细菌，并平静免疫系统。
That's done with creams, oral medications, a combination of both.
这是通过药膏、口服药物或两者的组合来完成的。
Sometimes certain lasers can help eradicate the oil glands that feed the bacteria.
有时某些激光可以帮助消灭滋养细菌的油腺。
But acne's a fascinating condition.
但痤疮是一种令人着迷的病症。
Almost everybody will have it at some point in their life.
几乎每个人在一生中的某个时刻都会拥有它。
Andrew Huberman:
安德鲁·休伯曼：
Is it true that eating a diet that is of slight excess in calories because it will tend to push the insulin glucose regulation system more into the positive as opposed to, let's just say, higher levels of insulin in circulating blood glucose than one would observe at, say, maintenance calories or sub-maintenance calories that overeating a little bit could cause acne, that any foods that promote increases in glucose and insulin, so sugary foods-
是否真的吃卡路里稍微过量的饮食，因为它往往会将胰岛素葡萄糖调节系统推向积极的状态，而不是循环血糖中的胰岛素水平高于人们在维持卡路里或次维持卡路里中观察到的水平，吃一点点过量可能会导致痤疮，任何促进葡萄糖和胰岛素增加的食物，所以含糖食物-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
high glycemic foods-
高血糖食物——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
these sorts of things.
诸如此类的事情。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Can that actually increase acne?
真的可以增加痘痘吗？
Fried foods.
油炸食品。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So it's not the caloric deficit or the caloric surplus.
所以这不是热量赤字或热量盈余。
It's the glycemic index or the amount of insulin response.
它是血糖指数或胰岛素反应量。
So we know that high glycemic index foods will make acne worse.
所以我们知道高血糖指数食物会让痤疮变得更严重。
In almost every study that we've looked at, in sugary processed foods will flare your acne.
在我们看过的几乎每一项研究中，含糖加工食品都会加剧痤疮。
There's some component of that inflammatory response that not only drives sebum production and bacterial growth, but actually worsens the skin's immune response.
炎症反应的某些成分不仅会促进皮脂产生和细菌生长，而且实际上会恶化皮肤的免疫反应。
The skin's immune response is a little feisty when you're eating pro-inflammatory things.
当你吃促炎的东西时，皮肤的免疫反应会有点活跃。
The other thing that I do hear a lot about is dairy.
我经常听到的另一件事是乳制品。
And there's this misconception that dairy causes acne.
还有一种误解，认为乳制品会导致痤疮。
What we really see when we looked at a really cool study that was done out of Penn State is that it's not so much whole fat dairy products, but skim and non-fat dairy products that can make your acne flare.
当我们看到宾夕法尼亚州立大学进行的一项非常酷的研究时，我们真正看到的是，并不是全脂乳制品，而是脱脂乳制品和脱脂乳制品会让你的痤疮爆发。
And the reason for that is that usually in the United States, there's an emulsifier that's put in non-fat or skim products to give the same mouth feel as full fat, so people feel like they're getting the same without the calories, and that has a glycemic response.
原因是，通常在美国，脱脂或脱脂产品中会添加乳化剂，以提供与全脂产品相同的口感，因此人们会觉得自己在没有卡路里的情况下获得了相同的效果，并且会产生血糖反应。
So it's usually sugary foods, non-fat skim dairy products that will make your acne flare.
因此，通常是含糖食物、脱脂脱脂乳制品会让你的痤疮爆发。
Andrew Huberman:
安德鲁·休伯曼：
What about rosacea?
红斑痤疮怎么办？
I hear so much about this, and I'm going to assume that we can mark off at least one thing as clear, which is that alcohol can exacerbate rosacea, maybe directly, but certainly indirectly by-
我听说过很多这样的事情，我假设我们至少可以明确一件事，那就是酒精可能会加剧红斑痤疮，也许是直接的，但肯定是间接的——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
impeding some aspects of the microbiome, disrupting sleep.
阻碍微生物组的某些方面，扰乱睡眠。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Rosacea gets worse.
酒渣鼻变得更糟。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
But what are things that people can do, dos and don'ts, that is, for rosacea, if it's mild rosacea-
但是，对于红斑痤疮，人们可以做什么，该做和不该做的事情是什么，如果是轻度红斑痤疮-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
like excessively ruddy cheeks or-
比如脸颊过于红润或者——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
superficial riding capillaries that-
浅层毛细血管——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
seem to bother a lot of people.
似乎困扰了很多人。
I know that it bothers a lot of people because they asked about this quite a lot in the-
我知道这让很多人感到困扰，因为他们在 –
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
questions when I solicited for questions.
当我征求问题时提出问题。
Dr. Teo Soleymani:
Teo Soleymani 博士：
So rosacea, commonly known as adult acne, tends to come in four flavors.
因此，红斑痤疮，俗称成人痤疮，往往有四种类型。
The first form is the redness form, what we call erythematotelangiectatic form, or the ruddiness, broken blood vessels, redness of the cheeks and flushing.
第一种形式是发红形式，即我们所说的红斑毛细血管扩张形式，或者是面色红润、血管破裂、脸颊发红和潮红。
That's by and far the most common form.
这是迄今为止最常见的形式。
There's also the papulopustular form, which is the pimple form, which is what we think about in adult acne.
还有丘疹脓疱形式，即丘疹形式，这就是我们对成人痤疮的看法。
There's also the phymatous form, which is the enlargement of the nose that kind of looks like toad skin.
还有一种实体形式，即鼻子增大，看起来像蟾蜍皮。
We used to think it was a sign of alcoholism or sailors or construction workers that would have these enlarged nose.
我们曾经认为这是酗酒的迹象，或者水手或建筑工人的鼻子会变大。
We thought it was a product of their environment.
我们认为这是他们环境的产物。
That's actually a form of rosacea.
这实际上是红斑痤疮的一种形式。
And then there's ocular rosacea, which affects the eyes.
还有眼部红斑痤疮，它会影响眼睛。
By and far, the two most common that we see people in practice for is the redness form, redness and flushing, or the pimple form.
到目前为止，我们在实践中看到人们最常见的两种是发红形式、发红和潮红，或丘疹形式。
You're absolutely right in that alcohol can contribute to it and worsen it for two reasons.
你是完全正确的，酒精会导致这种情况并使其恶化，原因有两个。
One, alcohol itself is a vasodilator, and acetaldehyde is a much more potent vasodilator, so when you drink, you flush.
第一，酒精本身就是一种血管扩张剂，而乙醛是一种更有效的血管扩张剂，所以当你喝酒时，你会脸红。
Also, chronic impairment of the gut microbiome and lifestyle changes that make you drink more probably will exacerbate your rosacea.
此外，肠道微生物群的慢性损伤和生活方式的改变可能会导致你喝酒更多，从而加剧红斑痤疮。
But things that trigger the redness include UV light because of vasodilation, spicy foods, hot beverages, emotions, life stressors, all the things that make you flush.
但引发发红的因素包括血管舒张引起的紫外线、辛辣食物、热饮料、情绪、生活压力以及所有让你脸红的因素。
What triggers the breakouts is a little bit different, and why that's important is how we treat them.
引发痘痘的原因有些不同，而这很重要的是我们如何对待它们。
So what triggers breakouts is thought to be both organisms that live on our skin, including bacteria and certain mites, but also immune dysregulation in our skin.
因此，引发痘痘的因素被认为是生活在我们皮肤上的生物体，包括细菌和某些螨虫，还有我们皮肤中的免疫失调。
That we don't really understand.
以至于我们真的不明白。
We're just now elucidating how the immune system in the skin becomes dysfunctional to show those breakouts.
我们现在刚刚阐明皮肤中的免疫系统如何变得功能失调以显示这些痘痘。
In terms of treating redness, we have some creams that are okay at temporarily blanching those vessels out, but they're not great, and they're temporary.
在治疗发红方面，我们有一些面霜可以暂时漂白这些血管，但效果不是很好，而且是暂时的。
We don't have great treatments for them, but we have great lasers for redness.
我们没有很好的治疗方法，但我们有很好的激光治疗红肿。
So when patients come to see me for redness or any dermatologist for redness, generally there's a discussion about laser destruction of those blood vessels.
因此，当患者因发红而找我或因发红而找皮肤科医生时，通常都会讨论激光破坏这些血管。
When we talk about breakouts or pimple form of rosacea, we have excellent medications in terms of both creams and oral medications that suppress both the bacterial and mite growth, as well as the immune response in the skin.
当我们谈论红斑痤疮或丘疹形式时，我们有很好的药物，包括乳膏和口服药物，可以抑制细菌和螨虫的生长，以及皮肤的免疫反应。
So you kind of have to take a look at what form you have and what will be the best treatment.
所以你必须看看你有什么形式以及什么是最好的治疗方法。
Andrew Huberman:
安德鲁·休伯曼：
Eczema.
湿疹。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Umbrella term for what we generally consider as atopic dermatitis or what used to be colloquially termed as sensitive skin in childhood.
我们通常认为的特应性皮炎或儿童时期通俗地称为敏感皮肤的总称。
And that's a very prominent skin condition also dictated by the immune system, but in two forms.
这是一种非常突出的皮肤状况，也是由免疫系统决定的，但有两种形式。
Eczema tends to be caused by three major prongs.
湿疹往往是由三个主要因素引起的。
The first prong is a genetic barrier defect in the skin.
第一个方面是皮肤的遗传屏障缺陷。
So patients with eczema tend to have a microscopic weave of their skin that's not as tight as somebody without eczema, and that's usually defined by a gene called filaggrin.
因此，湿疹患者的皮肤组织往往不像没有湿疹的人那么紧，这通常是由一种叫做聚丝蛋白的基因决定的。
That's the first reason to develop eczema.
这是发生湿疹的第一个原因。
The second reason is an environmental allergen or trigger that's able to get through these weaves easier because of this genetic change.
第二个原因是环境过敏原或触发因素，由于这种基因变化，它们能够更容易地穿过这些编织物。
The third thing is an aberrant immune response to these triggers.
第三件事是对这些触发因素的异常免疫反应。
So patients with eczema tend to have an immune system that responds a little bit more vigorously or overactively to the same environmental trigger, probably because there's more trigger getting in through the barrier defect than somebody who doesn't.
因此，湿疹患者的免疫系统往往对相同的环境触发因素反应更强烈或过度活跃，这可能是因为与没有湿疹的人相比，通过屏障缺陷进入的触发因素更多。
So the cornerstone in treating eczema is treating these three things.
所以治疗湿疹的基石是治疗这三件事。
Why dermatologists make a big stink about moisturize, moisturize, moisturize for eczema is to seal that barrier with a moisturizer because we're basically putting the mortar back in between the bricks, which are the skin cells, to seal the skin off to not allow the environmental allergen to get in.
为什么皮肤科医生对湿疹的保湿、保湿、保湿大喊大叫，就是用保湿霜密封这个屏障，因为我们基本上是将砂浆放回砖块之间，即皮肤细胞，以密封皮肤，不让环境过敏原进入。
That's the first.
这是第一个。
The second is to avoid environmental triggers.
二是避免环境诱因。
So fragrances, preservatives, seasonal allergies, pollens, things that trigger that immune response, we try to mitigate.
因此，我们试图减轻香水、防腐剂、季节性过敏、花粉等引发免疫反应的物质。
Now, obviously, trying to control environmental pollens is hard.
显然，现在控制环境花粉是很困难的。
But using things like we talked about earlier, fragrance-free cleansers, fragrance-free detergents, fragrance-free Skincare products, non-preservative-based skincare products will mitigate the environmental triggers.
但使用我们之前谈到的无香料清洁剂、无香料洗涤剂、无香料护肤品、不含防腐剂的护肤品将减轻环境触发因素。
And then the third thing is just calming the immune system down, and that can be done in a variety of ways.
第三件事就是让免疫系统平静下来，这可以通过多种方式来完成。
Most commonly, it's topical medications, like topical steroids, that dampen the immune system in the skin.
最常见的是外用药物，如外用类固醇，会抑制皮肤的免疫系统。
And when eczema is really, really bad, there are biologic medications that control certain interleukins, and they've made an incredible advancement in eczema control.
当湿疹非常非常严重时，有一些生物药物可以控制某些白细胞介素，它们在湿疹控制方面取得了令人难以置信的进步。
We can control patients for life with some of these injectable medicines.
我们可以使用其中一些注射药物来终生控制患者。
Andrew Huberman:
安德鲁·休伯曼：
A couple things that you taught me that I just want to pass along in short form, and please correct me if I have this wrong.
您教给我的一些事情我只想以简短的形式传递给您，如果我有错误，请纠正我。
One, if you can avoid popping pimples-
一，如果你能避免挤痘痘——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
definitely avoid it-
绝对要避免——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, don't do that
是的，不要这样做
Andrew Huberman:
安德鲁·休伯曼：
...
...
because it can cause damage-
因为它可能会造成损害——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
recruitment of-
招募-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
these matrix metalloproteases-
这些基质金属蛋白酶-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
which essentially digests some of the deeper layers of the skin-
它本质上消化了皮肤的一些深层-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
leave scars.
留下疤痕。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Yeah, totally.
是的，完全可以。
So it's very gratifying, and you want to do it.
所以这是非常令人欣慰的，你也想这么做。
There's some subconscious desire to pop a pimple.
潜意识里有一种想要挤掉痘痘的欲望。
I have it myself.
我自己就有。
Anytime I see a pimple, I'm like, "Man, I want to get at this thing."
每当我看到痘痘时，我都会想，“伙计，我想解决这个问题。”
Andrew Huberman:
安德鲁·休伯曼：
I think it's to eradicate the-
我认为这是为了根除——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, exactly
是的，正是如此
Andrew Huberman:
安德鲁·休伯曼：
...
...
infection type of thing.
感染类型的事情。
Even if it's not an infection, I think that's it.
即使不是感染，我想就是这样。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Possibly.
可能吧。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Like a evolutionary reason.
就像进化的原因一样。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, very possible.
是的，很有可能。
The reason we don't want to do that, and the reason why we always say, "Don't pick at your skin," is when there's an immune response in the skin, the immune system's trying to fix something and fight something, and in doing so, it recruits different enzymes.
我们不想这样做的原因，以及我们总是说“不要抓你的皮肤”的原因是，当皮肤出现免疫反应时，免疫系统会试图修复某些东西并对抗某些东西，在此过程中，它会招募不同的酶。
The most common enzyme is what you exactly described, matrix metalloproteinases, which are these enzymes that eat apart collagen and elastin to allow it to remodel.
最常见的酶就是您所描述的基质金属蛋白酶，这些酶会分解胶原蛋白和弹性蛋白以使其重塑。
When you cause physical trauma in the skin, you recruit a much larger immune response than what was warranted for that insult.
当你对皮肤造成物理创伤时，你会引发比这种侮辱所需要的更大的免疫反应。
So these MMPs, these matrix metalloproteinases, enter at a much higher amount, and they eat away at the collagen and elastin.
因此，这些 MMP、这些基质金属蛋白酶以更高的量进入，它们会吞噬胶原蛋白和弹性蛋白。
That's what leaves an acne scar.
这就是留下痤疮疤痕的原因。
Now, people are going to pop their pimples, whether we want to or not.
现在，无论我们愿意与否，人们都会挤粉刺。
So if you're going to do it, I don't recommend it, but if you're going to do it, generally what we recommend is if there is no tip, don't even think about it.
所以如果你要做的话，我不推荐，但是如果你要做的话，一般我们建议的是如果没有小费的话，想都别想。
If there is a small white tip and not much pain or induration, you can use a warm compress to see if you can soften that and see if it'll expel itself.
如果有一个白色的小尖端，并且没有太大的疼痛或硬结，您可以使用热敷来看看是否可以软化它，看看它是否会自行排出。
Pushing, we don't recommend.
推，我们不推荐。
Stretching can sometimes unroof a pimple, tends to cause less trauma, but again, if you listen to one thing, don't do it.
伸展运动有时可以去除粉刺，往往会减少创伤，但同样，如果你听了一件事，就不要这样做。
Andrew Huberman:
安德鲁·休伯曼：
And if they pop on their own, can't believe we're having this conversation-
如果他们自己突然出现，我简直不敢相信我们正在进行这样的对话——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
but that's a skin health and appearance episode after all.
但这毕竟是皮肤健康和外观的事件。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
If they pop on their own, then cleaning it with a gentle cleanser is probably the best way to go.
如果它们自行弹出，那么用温和的清洁剂清洁可能是最好的方法。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
No topical antibiotics, is that right?
没有外用抗生素，对吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
No. Don't use any hydrogen peroxide.
不，不要使用任何过氧化氢。
It's a common misconception, thinking it fights things.
这是一种常见的误解，认为它会与事物作斗争。
Peroxide doesn't let wounds heal.
过氧化物不会让伤口愈合。
It just kills anything living.
它只会杀死任何活着的东西。
So no peroxide and no topical antibiotics that are over the counter.
因此，没有过氧化物，也没有非处方外用抗生素。
Most of these don't have any antibiotic properties anyway because most organisms are resistant to them because of the widespread availability and use.
其中大多数无论如何都不具有任何抗生素特性，因为大多数生物体由于其广泛的可用性和使用而对其具有抗药性。
And two, they cause a lot of allergic contact dermatitis and rashes in people who are susceptible to them.
第二，它们会导致易感人群出现大量过敏性接触性皮炎和皮疹。
So we just say, if it pops on its own, leave it alone.
所以我们只是说，如果它自己弹出，就不要管它。
May want to put a little ointment on there if you have a sore, but otherwise, ignore it.
如果您有疼痛，可能需要在上面涂一点药膏，但除此之外，请忽略它。
Andrew Huberman:
安德鲁·休伯曼：
And what about the use of corticosteroid cream, like if somebody has a red bump and they're-
那么使用皮质类固醇霜怎么样，比如如果有人长了红肿，而且他们——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
headed to an event or something-
前往某个活动或某事-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and they want to-
他们想要——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
eliminate some of the redness and bumpiness?
消除一些发红和凹凸不平？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So a common thing we see a lot of people for, it's like a day before their wedding or a day before a big social event, and they have a zit on their forehead, and they say, "What can you do for me?
所以我们看到很多人都会遇到这样一个常见的事情，就像在婚礼前一天或大型社交活动前一天，他们额头上长了一颗痘痘，他们说：“你能为我做什么？
I need this gone." So exactly like we talked about, topical corticosteroids and, to a greater extent, injectable intralesional corticosteroids suppress the immune response temporarily.
我需要这个消失。”正如我们所讨论的，外用皮质类固醇以及在更大程度上注射病灶内皮质类固醇可以暂时抑制免疫反应。
So you can use them cautiously if you have an event within the next day or two.
因此，如果您在接下来的一两天内有活动，您可以谨慎使用它们。
Long-term use, it causes multiple problems.
长期使用，会引发多种问题。
It causes thinning of the skin and can increase the risk of the acne scar forming, and you can have rebound acne from topical steroids used all over the face.
它会导致皮肤变薄，并会增加痤疮疤痕形成的风险，而且全脸使用外用类固醇可能会导致痤疮反弹。
Oftentimes, we see a lot of people who are in the public eye asking for steroid injections of their acne.
通常，我们会看到很多在公众视野中的人要求注射类固醇来治疗痤疮。
I, as a surgeon, usually see a lot of the consequences of that, so I tend not to utilize steroid injections for acne.
作为一名外科医生，我通常会看到很多由此产生的后果，所以我倾向于不使用类固醇注射来治疗痤疮。
The reason for that is if you place just a little too much, and we're talking less than 0.1 milliliter difference, you can have a permanent atrophic divot in the skin that is only fixed by surgery.
原因是，如果您放置得太多，我们说的是小于 0.1 毫升的差异，您的皮肤上可能会出现永久性的萎缩性凹痕，只有通过手术才能修复。
So I see a lot of young patients that come in who had an acne spot injected here, and now that divot is left, and that's permanent.
所以我看到很多年轻患者进来，他们在这里注射了痤疮斑点，现在留下了那块草皮，这是永久性的。
If it's going to be done, it should be done by a dermatologist who knows what they're doing.
如果要做的话，应该由知道自己在做什么的皮肤科医生来完成。
Low concentrations, usually bottom half of the face, can be effective in getting rid of a really bad pimple that needs to be gone immediately.
低浓度（通常是脸的下半部分）可以有效消除需要立即消除的严重粉刺。
You just got to know the risks.
您只需了解风险即可。
Andrew Huberman:
安德鲁·休伯曼：
Assuming sterile technique and other safety measures in place, are tattoos inherently bad for skin?
假设无菌技术和其他安全措施到位，纹身本质上对皮肤有害吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
No, I don't think so.
不，我不这么认为。
I think tattoos are an awesome form of art, and I think it used to be linked to stereotypes that are no longer true.
我认为纹身是一种很棒的艺术形式，我认为它曾经与不再真实的刻板印象联系在一起。
I think the challenge with tattoos is two things, making sure that what is being placed underneath the skin is not an allergen.
我认为纹身的挑战有两点，确保放置在皮肤下面的东西不是过敏原。
We see this mostly with reds that use cinnamates.
我们主要在使用肉桂酸盐的红葡萄酒中看到这种情况。
They produce a lot of granulomatous reactions or foreign body reactions.
它们产生大量肉芽肿反应或异物反应。
One, making sure, obviously, they're using clean, safe equipment that's sterile.
第一，显然，确保他们使用干净、安全且无菌的设备。
You don't want the bloodborne pathogens.
你不需要血源性病原体。
The real challenge is surveying for growths.
真正的挑战是调查增长情况。
In patients who have a lot of tattoos, it's hard to see small skin cancers form or changes in moles because usually the tattoos are of dark color.
在有大量纹身的患者中，很难看到小皮肤癌的形成或痣的变化，因为纹身通常是深色的。
So The surveillance part becomes a little bit more challenging.
因此，监视部分变得更具挑战性。
So if you have a lot of tattoos, just make sure to see your dermatologist and somebody who feels comfortable and confident in screening.
因此，如果您有很多纹身，请务必去看皮肤科医生和对筛查感到舒适和自信的人。
But other than that, no. They've been around for hundreds and hundreds of years, and I think they're fine if done correctly.
但除此之外，没有。它们已经存在了数百年，我认为如果做得正确，它们就很好。
Andrew Huberman:
安德鲁·休伯曼：
That's a good segue into surveying for skin cancers.
这是皮肤癌调查的一个很好的延续。
Earlier, you talked about some of the more common forms of skin cancer.
早些时候，您谈到了一些更常见的皮肤癌形式。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Squamous cell carcinoma-
鳞状细胞癌-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
basal cell carcinoma.
基底细胞癌。
But then there's the one that no one truly wants, which is melanoma.
但还有一种没有人真正想要的，那就是黑色素瘤。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Melanoma, yeah.
黑色素瘤，是的。
Andrew Huberman:
安德鲁·休伯曼：
So I was taught to keep an eye on my moles.
所以我被教导要留意我的痣。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
If they change, change in border, change in size, et cetera, to notify a dermatologist.
如果它们发生变化，边界发生变化，尺寸发生变化等，请通知皮肤科医生。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
I get my moles checked about, I don't know, I just had it done less than a year ago.
我检查了我的痣，我不知道，我不到一年前才做过。
But what about getting all skin checked?
但如果要检查所有皮肤呢？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
This is your area of expertise.
这是您的专业领域。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
So if you had a magic wand-
所以如果你有一根魔杖——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
to help prevent skin cancers-
帮助预防皮肤癌-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
what would you have people do?
你会让人们做什么？
Dr. Teo Soleymani:
Teo Soleymani 博士：
That's a great question.
这是一个很好的问题。
So obviously there are many forms of skin cancer, but the three most common, like we talked about, basal cell carcinoma, squamous cell carcinoma, and melanoma.
显然，皮肤癌有多种形式，但最常见的三种，就像我们谈到的，基底细胞癌、鳞状细胞癌和黑色素瘤。
There are other types like Merkel cell and et cetera, but they're far less common.
还有其他类型，如默克尔细胞等，但它们不太常见。
Now, historically, melanoma's been our number one killer for skin cancer until about a few years ago, around 2018, when the Nobel Prize was won for the new drugs that treated melanoma.
现在，从历史上看，黑色素瘤一直是我们皮肤癌的头号杀手，直到大约几年前，即 2018 年左右，治疗黑色素瘤的新药获得了诺贝尔奖。
This year, we expect three times as many deaths in the United States from squamous cell carcinoma than we do melanoma, but nobody talks about that.
今年，我们预计美国死于鳞状细胞癌的人数是黑色素瘤的三倍，但没有人谈论这一点。
We lose a patient every about 62 minutes to melanoma, but one every 37 minutes to squamous cell carcinoma.
我们每 62 分钟就有一名黑色素瘤患者死亡，但每 37 分钟就有一名鳞状细胞癌患者死亡。
First and foremost, the thing that you want to look for in terms of skin cancer risk and predisposition is look at family history.
首先也是最重要的，您想要寻找皮肤癌风险和易感性的事情是查看家族史。
Your family history and your genetics plays the largest role in predisposition for skin cancer development.
您的家族史和遗传学在皮肤癌发生的易感性中起着最大的作用。
If you can gather a family history, you can understand your risk in developing it, and it can help dictate your screening.
如果您可以收集家族史，您就可以了解患上该病的风险，并且可以帮助决定您的筛查。
Now, if you can't get a family history or you don't know your family history, not a problem.
现在，如果您无法获得家族史或者您不知道自己的家族史，那也不是问题。
Generally, we recommend an annual skin exam by a good, reputable, board-certified dermatologist, and that includes every square inch of your skin, including your hair, between your toes, in the genital area.
一般来说，我们建议每年由一位信誉良好、经过委员会认证的皮肤科医生进行一次皮肤检查，检查范围包括您的每一平方英寸皮肤，包括您的头发、脚趾间和生殖器区域。
We can develop a skin cancer anywhere.
我们在任何地方都可能患上皮肤癌。
Bob Marley died of a melanoma on his toenail that was thought to be a soccer injury.
鲍勃·马利 (Bob Marley) 死于脚趾甲黑色素瘤，被认为是足球损伤。
Jimmy Buffett died of a Merkel cell carcinoma, one of these rarer types that occur in sun-exposed areas.
吉米·巴菲特死于默克尔细胞癌，这是发生在阳光照射区域的罕见类型之一。
Anybody can get them.
任何人都可以得到它们。
Obviously, there's predispositions in higher risk populations, but it's such an easy non-invasive exam to do that everybody should get one at least once a year.
显然，高风险人群存在易感性，但这是一项非常简单的非侵入性检查，每个人都应该每年至少接受一次。
The other reason why I bring this up is skin cancers can develop in sun-protected areas.
我提出这个问题的另一个原因是皮肤癌可能在受阳光保护的区域发生。
One of the areas that I see a rapid increase in skin cancer development is in genital areas and in the mouth due to HPV, and we see this a lot in younger and younger patients.
我发现，由于 HPV，皮肤癌发展迅速增加的区域之一是生殖器区域和口腔，而且我们在越来越年轻的患者中经常看到这种情况。
Probably in the last month I've operated on six or seven young patients under the age of 40 with squamous cell carcinomas caused by HPV in the genital region.
大概在上个月，我为六七名 40 岁以下的年轻患者进行了手术，这些患者患有由 HPV 引起的生殖器区域的鳞状细胞癌。
This is obviously not sun driven.
这显然不是太阳驱动的。
It's not something you can put sunscreen or take a product to protect you from, but it's something that's easily monitored or surveyed.
这不是你可以涂抹防晒霜或使用产品来保护自己的东西，但它是很容易监控或调查的东西。
So I would say at the very minimum, get a family history or a personal history, get an annual surveillance exam.
所以我想说，至少要了解家族史或个人史，每年进行一次监测检查。
If you have a lot of moles, I used to direct the Pigmented Lesions and Melanoma Clinic, this is something that was really hard for a lot of dermatologists and patients to follow when they're covered with moles, see which one is changing.
如果你有很多痣，我曾经指导色素病变和黑色素瘤诊所，这对于很多皮肤科医生和患者来说，当他们长满痣时，很难跟踪，看看哪一颗正在发生变化。
There are tools that can be utilized, including whole body photography, mole mapping, and some new AI-based softwares that basically track the moles and look for changes as you feed the software more and more pictures from the patients.
有一些工具可以使用，包括全身摄影、痣测绘和一些新的基于人工智能的软件，这些软件基本上可以跟踪痣并在您向软件提供越来越多的患者照片时寻找变化。
It's fascinating.
这很有趣。
A lot of the stuff is developing from our, well I should say my alma mater, but up at Stanford is these AI-based software apps that allow us to survey some of the most challenging patients.
很多东西都是从我们的母校开发的，但在斯坦福大学，这些基于人工智能的软件应用程序使我们能够调查一些最具挑战性的患者。
So if you have a lot of moles, your screening may be more than once a year.
因此，如果您有很多痣，您的筛查可能每年不止一次。
If you have a lot of moles, you inherently have a slightly increased risk for melanoma.
如果你有很多痣，那么你患黑色素瘤的风险自然会略有增加。
Now, we always use these terms interchangeably, melanoma, skin cancer, basal, squamous, et cetera.
现在，我们总是互换使用这些术语，黑色素瘤、皮肤癌、基底癌、鳞状细胞癌等等。
Importantly to know, for every one melanoma, there's 10 non-melanoma skin cancers, that's namely basal cell and squamous cell.
重要的是要知道，每有一种黑色素瘤，就有 10 种非黑色素瘤皮肤癌，即基底细胞癌和鳞状细胞癌。
About five million Americans will be diagnosed with one of the non-melanomas this year alone.
仅今年就有约五百万美国人被诊断出患有一种非黑色素瘤。
Andrew Huberman:
安德鲁·休伯曼：
Five million.
五百万。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Five million.
五百万。
Andrew Huberman:
安德鲁·休伯曼：
It's a big number.
这是一个很大的数字。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, it's about one in four Americans at some point in their lifetime will develop a skin cancer, encroaching one in three Americans by the end of 2030.
是的，大约四分之一的美国人在一生中的某个时刻会患上皮肤癌，到 2030 年底，这一比例将达到三分之一的美国人。
So it's a lot.
所以数量很多。
Majority of these are not life-threatening, but they're functionally and cosmetically disfiguring.
其中大多数不会危及生命，但会造成功能和外观毁坏。
They arise on sun-exposed areas, so surveillance is really important.
它们出现在暴露在阳光下的区域，因此监视非常重要。
Andrew Huberman:
安德鲁·休伯曼：
For the HPV that eventually becomes squamous cell carcinoma-
对于最终变成鳞状细胞癌的HPV——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
is the HPV vaccine effective even at older ages?
HPV 疫苗即使在老年也有效吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, great question.
是的，很好的问题。
So we are seeing HPV become a real problem in many cancers in the body, not just the original cervical cancer, which was the number one killer in young women for cancer until the vaccine came out.
因此，我们看到 HPV 成为体内许多癌症的一个真正问题，而不仅仅是最初的宫颈癌，在疫苗问世之前，宫颈癌是年轻女性癌症的头号杀手。
But we're seeing it now as the number one cause of throat cancer in young adults and sexually active adults, significantly increased risk of squamous cell carcinomas in sun-protected areas, immunosuppressed patients.
但我们现在将其视为年轻人和性活跃成年人患喉癌的第一大原因，在阳光保护区和免疫抑制患者中，鳞状细胞癌的风险显着增加。
The vaccine, the Gardasil vaccine, which Treats or builds immunity to HPV covers the strains that cause cancer 16, 18, 31, 33, and so on.
加德西 (Gardasil) 疫苗可治疗 HPV 或增强其免疫力，涵盖导致癌症的毒株 16、18、31、33 等。
I recommend anybody who is either sexually active or anybody who, in population, literally anyone, should get vaccinated.
我建议任何性活跃的人或人口中的任何人（实际上是任何人）都应该接种疫苗。
The new guidelines have extended the age up until, I think, late 40s for both men and women.
我认为，新的指导方针将男性和女性的年龄延长至 40 岁末。
It used to be only for young women, because the cervical cancer risk, but now we've found that so many things are implicated with HPV, that the on-label use is up to the late 40s.
过去它只适用于年轻女性，因为存在宫颈癌风险，但现在我们发现很多事情都与 HPV 相关，标签上的使用范围一直持续到 40 多岁。
So if you have any concern, I highly recommend getting the vaccine.
因此，如果您有任何疑虑，我强烈建议您接种疫苗。
Andrew Huberman:
安德鲁·休伯曼：
As I recall, plantar warts-
我记得，跖疣——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
which are these warts that burrow a kind of root-
这些疣是在根部挖洞的——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
into the bottom of the foot, they're very painful.
进入脚底，非常疼痛。
That actually can be caused by HPV.
这实际上可能是由 HPV 引起的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
It's a form of HPV.
它是 HPV 的一种形式。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So yeah.
所以是的。
Andrew Huberman:
安德鲁·休伯曼：
And it's not sexually transmitted, it's-
而且它不是性传播的，而是——
Dr. Teo Soleymani:
Teo Soleymani 博士：
No
否
Andrew Huberman:
安德鲁·休伯曼：
...
...
locker room transmitted.
更衣室传送。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
So HPV comes in about 200 strains, or like 190 strains.
因此，HPV 大约有 200 种病毒株，或者大约 190 种病毒株。
Strains one, two, and four, for example, cause warts on the hands and feet.
例如，菌株一、二和四会导致手和脚上出现疣。
What you see like gym-goers and kids, they get warts.
你所看到的健身爱好者和孩子，他们都会长疣。
HPV 6 and 11, for example, cause genital warts.
例如，HPV 6 和 11 会导致尖锐湿疣。
HPV strains 16, 18, 31, and 33 cause cancer.
HPV 16、18、31 和 33 株可导致癌症。
The question is, when you get something, does it come with its brothers or its siblings?
问题是，当你得到某样东西时，它是与它的兄弟还是兄弟姐妹一起出现的？
And that's the question we don't know.
这就是我们不知道的问题。
The vaccine was made to treat high-risk strains, but because of cross-antigenicity, we see that patients who get vaccinated, their warts go away.
该疫苗是为了治疗高危菌株而制造的，但由于交叉抗原性，我们看到接种疫苗的患者的疣消失了。
And we saw this in the hospital in transplant patients who were covered with warts because of their immunosuppressed effect.
我们在医院的移植患者身上看到了这种情况，他们由于免疫抑制作用而浑身长满疣。
When we would vaccinate them, their warts would get better.
当我们给他们接种疫苗时，他们的疣就会好起来。
Andrew Huberman:
安德鲁·休伯曼：
So warts on their fingers, plantar warts on their feet.
所以手指上有疣，脚上有跖疣。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Interesting.
有趣。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Transplant patients and anybody who is immunosuppressed, they have a tough time fighting plantar warts, finger warts, any sort of viral-based condition because their immune system is suppressed from medications or otherwise.
对于移植患者和任何免疫抑制的人来说，他们很难对抗跖疣、手指疣和任何一种基于病毒的疾病，因为他们的免疫系统受到药物或其他方式的抑制。
So they usually have a tough time fighting these things.
所以他们通常很难与这些事情作斗争。
They have a higher incidence of a lot of things, but the vaccine was cool in eradicating it.
他们有很多事情的发生率较高，但疫苗在根除它方面很酷。
Now, I'm not saying go get a vaccine because you have a plantar wart.
现在，我并不是说因为你患有足底疣就去接种疫苗。
That's silly and overkill.
这是愚蠢和过分的。
Usually, warts we treat with freezing, in-office procedures, easy things.
通常，我们用冷冻、办公室内程序、简单的方法来治疗疣。
But-
但是——
Andrew Huberman:
安德鲁·休伯曼：
Plantar warts can be burnt out.
跖疣可以被烧掉。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
Yeah.
是的。
Dr. Teo Soleymani:
Teo Soleymani 博士：
We burn them or freeze them or scrape them, use a little medication.
我们烧毁它们、冷冻它们或刮掉它们，使用一些药物。
But the vaccine does improve some of the burden of disease, even though it doesn't target that strain.
但该疫苗确实减轻了一些疾病负担，尽管它并不针对该菌株。
Andrew Huberman:
安德鲁·休伯曼：
Do you think soon we will be in the landscape of vaccines for all forms of skin cancer?
您认为很快我们就会进入针对所有形式皮肤癌的疫苗领域吗？
Dr. Teo Soleymani:
Teo Soleymani 博士：
I think we're on the forefront, and the term vaccine is a really big umbrella term.
我认为我们处于最前沿，疫苗一词是一个非常大的总括术语。
Andrew Huberman:
安德鲁·休伯曼：
Loaded term, too.
负载术语也是如此。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, I know.
是的，我知道。
It's going to garner a lot of questions.
这将会引起很多问题。
I think, yes, absolutely.
我想，是的，绝对是的。
There was a new study that showed that an mRNA vaccine, and that is already pretty controversial, was shown to improve melanoma survival after surgery and chemotherapy.
一项新的研究表明，已经颇具争议的 mRNA 疫苗可以提高手术和化疗后黑色素瘤的存活率。
So the goal of all these things is to prime your immune system and have the immune system know what to target.
因此，所有这些事情的目标是让您的免疫系统做好准备，并让免疫系统知道要瞄准什么。
It's to teach the immune system, "Hey, this is bad.
这是为了教导免疫系统，“嘿，这很糟糕。
Next time you see this, go attack it." It's like showing a bloodhound a steak and then going on the hunt.
下次你看到这个的时候，就去攻击它吧。”这就像向猎犬展示一块牛排，然后继续狩猎。
The bloodhound now knows what to scent for and what is normal and what isn't.
猎犬现在知道要闻什么，什么是正常的，什么是不正常的。
So the vaccines have a lot of controversial things.
所以疫苗有很多有争议的事情。
I think for medicine and cancer biology, it's going to be revolutionary.
我认为对于医学和癌症生物学来说，这将是革命性的。
We see it for brain tumors, we see it for glioblastoma.
我们看到它用于脑肿瘤，我们看到它用于胶质母细胞瘤。
Incredible changes with dendritic cell vaccines.
树突状细胞疫苗带来了令人难以置信的变化。
We see it for melanoma now.
我们现在看到它用于黑色素瘤。
And in the future, it may be used for all skin cancers with an asterisk, depending on how much we can activate the immune system to target it.
未来，它可能用于治疗所有带星号的皮肤癌，具体取决于我们可以激活多少免疫系统来瞄准它。
Andrew Huberman:
安德鲁·休伯曼：
Fascinating, and a good place for us to probably pause until the next time we have you back to talk about where that technology evolves.
这是一个令人着迷的好地方，我们可能会停下来，直到下次我们请您回来谈论该技术的发展方向。
Because today you've taught us so much about skin, what it is, its anatomy, its physiology, what it reflects in terms of our internal workings, health, or in some cases, challenges with health.
因为今天你教了我们很多关于皮肤的知识，它是什么，它的解剖学，它的生理学，它反映了我们的内部运作，健康，或者在某些情况下，健康挑战。
We talked about various conditions such as psoriasis, acne, eczema, dandruff-
我们讨论了各种病症，例如牛皮癣、痤疮、湿疹、头皮屑-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
as it's sometimes called.
有时这样称呼。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Everything, yeah.
一切，是的。
Andrew Huberman:
安德鲁·休伯曼：
And what we can do.
以及我们能做什么。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Andrew Huberman:
安德鲁·休伯曼：
The role of nutrition, avoiding certain things like excess alcohol, nicotine, et cetera, but also some of the newer and more exciting treatments that exist for all these conditions.
营养的作用，避免某些东西，如过量的酒精、尼古丁等，以及针对所有这些病症的一些更新、更令人兴奋的治疗方法。
Some merely cosmetic and-
有些只是装饰性的并且-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
uncomfortable, some truly life-threatening-
不舒服，有些确实危及生命——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
and dangerous, like melanoma.
而且很危险，比如黑色素瘤。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah, yeah.
是啊，是啊。
Andrew Huberman:
安德鲁·休伯曼：
So for all those reasons, and also for taking time out of your very busy clinical schedule to come talk to us-
因此，出于所有这些原因，也为了从您非常繁忙的临床日程中抽出时间来与我们交谈-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Appreciate it
欣赏它
Andrew Huberman:
安德鲁·休伯曼：
...
...
I really appreciate it, and I want to voice my appreciation both for myself and for those listening and viewing.
我真的很感激，我想向我自己以及那些聆听和观看的人表达我的感激之情。
I know people will have many, many questions-
我知道人们会有很多很多问题——
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah
是啊
Andrew Huberman:
安德鲁·休伯曼：
...
...
so we will refer them to your social media accounts and-
所以我们会将他们推荐给您的社交媒体帐户并且-
Dr. Teo Soleymani:
Teo Soleymani 博士：
Happy to answer however I can
尽我所能很高兴回答
Andrew Huberman:
安德鲁·休伯曼：
...
...
and links to your clinic and so forth, so that they can have those questions addressed and who knows, maybe even get the chance to work with you.
以及您的诊所的链接等，以便他们可以解决这些问题，谁知道呢，甚至可能有机会与您合作。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Appreciate it.
欣赏它。
Andrew Huberman:
安德鲁·休伯曼：
In the meantime, I just want to say thank you for this public education gift that you've given us.
与此同时，我只想对您送给我们的这份公共教育礼物表示感谢。
I'm thinking about skin very differently now, and I plan to do and not do certain things in light of today's conversation, no pun intended, so.
我现在对皮肤的看法非常不同，我计划根据今天的谈话做或不做某些事情，没有双关语的意思，所以。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Yeah.
是的。
Thank you for the opportunity.
谢谢你给我这个机会。
I'm incredibly grateful to be here.
我非常感激来到这里。
I think teaching is really important.
我觉得教学真的很重要。
Having evidence-based discussions is really important.
进行基于证据的讨论非常重要。
Challenging dogma is also important, done in the right way, in the evidence-based way.
挑战教条也很重要，但要以正确的方式、基于证据的方式进行。
I love what I do.
我热爱我所做的事情。
I love everything about the skin.
我喜欢与皮肤有关的一切。
I love seeing patients and also challenging the status quo on certain things.
我喜欢看望病人，也喜欢在某些事情上挑战现状。
So thank you for the opportunity.
所以谢谢你给我这个机会。
It's been a lot of fun.
这很有趣。
There's a lot to talk about in skin.
关于皮肤有很多话要说。
We can probably talk for a decade if you let me, but I appreciate it.
如果你允许的话，我们可能可以聊十年，但我很感激。
Thank you.
谢谢。
Andrew Huberman:
安德鲁·休伯曼：
Well, we will certainly bring you back to further the discussion.
好吧，我们一定会把你带回来进一步讨论。
Meanwhile, thank you ever so much, Dr. Soleymani.
同时，非常感谢您，Soleymani 博士。
Dr. Teo Soleymani:
Teo Soleymani 博士：
Appreciate it.
欣赏它。
Thank you.
谢谢。
Andrew Huberman:
安德鲁·休伯曼：
Thank you for joining me for today's discussion about how to improve and protect your skin with Dr. Teo Soleymani.
感谢您今天与 Teo Soleymani 博士一起讨论如何改善和保护您的皮肤。
To learn more about his work and find links to his clinic, please see the show note captions.
要了解有关他的工作的更多信息并找到他的诊所的链接，请参阅节目注释标题。
If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel.
如果您正在学习和/或喜欢此播客，请订阅我们的 YouTube 频道。
That's a terrific zero-cost way to support us.
这是支持我们的绝佳零成本方式。
In addition, please subscribe to the podcast on both Spotify and on Apple.
此外，请在 Spotify 和 Apple 上订阅该播客。
And on both Spotify and Apple, you can leave us up to a five-star review.
在 Spotify 和 Apple 上，您都可以给我们五星级的评价。
Please check out the sponsors mentioned at the beginning and throughout today's episode.
请查看今天节目开头和整个节目中提到的赞助商。
That's the best way to support this podcast.
这是支持这个播客的最佳方式。
If you have questions for me or comments about the podcast or topics or guests you'd like me to consider for the Huberman Lab podcast, please put those in the comments on YouTube.
如果您对我有疑问或对播客有意见，或者希望我为 Huberman Lab 播客考虑主题或嘉宾，请在 YouTube 上发表评论。
I do read all the comments.
我确实阅读了所有评论。
For those of you that haven't heard, I have a new book coming out.
对于那些还没有听说过的人，我即将出版一本新书。
It's my very first book.
这是我的第一本书。
It's entitled "Protocols: An Operating Manual for the Human Body." This is a book that I've been working on for more than five years, and that's based on more than 30 years of research and experience.
它的标题是“协议：人体操作手册”。这本书是我花了五年多时间编写的，它基于 30 多年的研究和经验。
And it covers protocols for everything from sleep to exercise to stress control, protocols related to focus and motivation, and of course, I provide the scientific substantiation for the protocols that are included.
它涵盖了从睡眠到运动再到压力控制的所有协议，以及与注意力和动机相关的协议，当然，我为所包含的协议提供了科学依据。
The book is now available by presale at protocolsbook.com.
该书现已在protocolbook.com 上预售。
There you can find links to various vendors.
在那里您可以找到各个供应商的链接。
You can pick the one that you like best.
您可以选择您最喜欢的一个。
Again, the book is called "Protocols: An Operating Manual for the Human Body." If you're not already following me on social media, I am Huberman Lab on all social media platforms.
同样，这本书的名字是“协议：人体操作手册”。如果您还没有在社交媒体上关注我，我是所有社交媒体平台上的 Huberman Lab。
So that's Instagram, Twitter, now known as X, Threads, Facebook, and LinkedIn.
这就是 Instagram、Twitter（现在称为 X）、Threads、Facebook 和 LinkedIn。
And on all those platforms, I cover science and science-related tools, some of which overlaps with the content of the Huberman Lab podcast, but much of which is distinct from the content on the Huberman Lab podcast.
在所有这些平台上，我介绍了科学和科学相关的工具，其中一些与胡伯曼实验室播客的内容重叠，但其中大部分与胡伯曼实验室播客的内容不同。
Again, that's Huberman Lab on all social media channels.
同样，这是所有社交媒体渠道上的 Huberman Lab。
And if you haven't already subscribed to our Neural Network Newsletter, our Neural Network Newsletter is a zero-cost monthly newsletter that includes protocols which are brief one to three-page PDFs which summarize various things that you can do in order to, for instance, optimize neuroplasticity and learning or optimize your sleep or improve dopamine regulation.
如果您还没有订阅我们的神经网络时事通讯，我们的神经网络时事通讯是一份零成本的月度时事通讯，其中包括简短的一到三页 PDF 协议，其中总结了您可以做的各种事情，例如，优化神经可塑性和学习或优化您的睡眠或改善多巴胺调节。
Again, all available at completely zero cost.
同样，所有这些都可以完全零成本获得。
You simply go to hubermanlab.com, go to the Menu tab in the top right corner, scroll down to Newsletter, and provide us your email to obtain the newsletter.
您只需访问 hubermanlab.com，转到右上角的“菜单”选项卡，向下滚动到新闻通讯，并向我们提供您的电子邮件即可获取新闻通讯。
And I'd like to point out that we do not share your email with anybody.
我想指出的是，我们不会与任何人分享您的电子邮件。
Once again, thank you for joining me for today's discussion about skin health and appearance with Dr. Teo Soleymani.
再次感谢您今天与 Teo Soleymani 博士一起讨论皮肤健康和外观。
And last but certainly not least, thank you for your interest in science.
最后但并非最不重要的一点是，感谢您对科学的兴趣。