046: How Light Therapy Can Be Useful To Stop Skin Rashes w/ Dr. Jared Jagdeo

Many of us with chronic skin rashes are unable to find relief with conventional treatment and steroid creams. UV Light Therapy might be a welcome alternative, potentially able to reduce the immuno-inflammatory response in the skin.

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My guest today, Dr. Jared Jagdeo, is a board certified dermatologist in New York City who specializes in helping patients achieve their best skin.

Dr. Jagdeo focuses on skin health and wellness, using a combination of procedures, lasers and topical agents to help patients achieve their skin wellness goals. He is also an expert on sensitive skin care concerns and male aesthetics.

Dr. Jagdeo is a physician-scientist who sees patients and conducts skin-related laboratory and clinical trials research. He is the founding director of the Laser, Aesthetics and Body Institute at SUNY Downstate Medical Center in Brooklyn, NY and the founding director of the Center for Photomedicine, also at SUNY Downstate Medical Center.

Join us as we talk about how UV light therapy may be helpful for those with chronic skin rashes.

Have you ever tried UV light therapy for your skin condition? Tell me about it in the comments!

In this episode:

• What is UV light therapy and why might it be useful for people with chronic skin rashes?
• Should you go out in the sun more?
• Does UV light therapy affect the skin microbiome?
• What is red light therapy?
• What's the difference between going to a tanning bed at a salon and getting UV light treatment at a dermatologist's office?
• Can this therapy be used for scarring?
• Is there a risk of skin cancer with UV light therapy?

Quotes

“By using UV light, you're able to actually reduce the number of inflammatory cells that are in the skin that caused these conditions [e.g. eczema, psoriasis, and vitiligo] and result in better younger, healthier skin.” [3:05]

“One of the things we've found is that that you can actually change skin cell function and also different skin conditions by using visible and infrared light to enhance skin health and wellness. And also limit some of the harmful known side effects that are associated with ultraviolet radiation. So choosing the specific wavelength of light may have a tremendous amount of benefit and tremendous potential for skin health and wellness. ” [5:49]

“Tanning beds that are in tanning salons are very, very different and distinct and harmful compared to the phototherapy units that are in a physician's office, such as a board-certified dermatologist office or an academic medical center.” [12:13]

Links

Follow Dr. Jared on Instagram

Cosmeceuticals and Active Cosmetics book

SUNY Downstate Medical Center in Brooklyn, NY

046: How Light Therapy Can Be Useful To Stop Skin Rashes w/ Dr. Jared Jagdeo FULL TRANSCRIPT

Jennifer: Hi everyone. Welcome back. Today I've got a really interesting guest. He is a dermatologist that has a lot of experience in the whole world of sensitive skin care and I wanted to talk so much about this topic of UV light treatments and how that can be incorporated in and you know, if there's any concerns because people have had questions about concerns in using that in their journey. And so I thought why not bring someone on was experienced with that and can speak very straightforward to you about the pros and cons of that. My guest today is Doctor Jared Jagdeo and he is a board certified dermatologist in New York City specializing in helping patients achieve their best skin. He's an expert on sensitive skin care concerns and male aesthetics. As a physician scientist who sees patients and conducts skin-related laboratory and clinical trials research, Dr Jagdeo is the founding director of The MLaser Aesthetics and Body Institute and the Center for Photo Medicine, which are both located at the SUNY Downtown Medical Center in Brooklyn, New York. Thank you so much for joining us, Doctor Jared.

Dr. Jared: Thank you very much for having me on your podcast. I appreciate it.

Jennifer: Well I'm excited to bring this information forward cause I think a lot of people don't oftentimes get full complete answers from their doctors. They just kind of get these, well I think we should do this and that's it. And they really don't know whether they will feel comfortable doing that or not. So can you talk to us a little bit about what is UV light therapy and why it might be helpful for somebody who's had chronic rashes that they can't seem to get rid of or manage just with like topical steroids?

Dr. Jared: That's a very great question Jennifer. A lot of patients who have chronic rashes that they can't manage just with steroids, UV phototherapy may be a great option for them. The reason why UV phototherapy may be a great option is is that there are different types of UV phototherapy either delivered by fluorescent bulbs and what looks like an upright tanning booth sort of set up or via laser. And this can be done to help patients via suppression of their immune inflammatory response to whatever their skin condition is. And this helps create a much less red, less irritated skin to help patients achieve a lot more improvement in their skin condition and their symptoms. Some of the conditions that are treated that have inflammation as a key component of the condition includes vitiligo, Eczema and psoriasis. Those are three different types of inflammatory conditions that are very common in the population.

Dr. Jared: And by using UV light, you're able to actually reduce the number of inflammatory cells that are in the skin that caused these conditions and result in better younger, healthier skin. One of the wonderful things about UV phototherapy is that it's been studied and refined over the years. This, you know, sort of photo therapy really dates back to ancient times when Egyptians used to expose their skin when they had different skin conditions to the sun. And notice that, you know, in approximately 200 BC, which is, you know, over 2000 years ago, that by exposing their skin to sun, that the sun's ultraviolet rays would result in an improvement in their skin rashes and other conditions such as symptoms such as itching and burning and just irritation.

Jennifer: That's really interesting. So what about somebody who has these conditions and they're afraid to go out in the sun. I mean, I'm not saying that they're necessarily comparable, but do you ever recommend that patients, say somebody has really bad eczema or something like that? Would you, do you ask them like, hey, how much time do you spend out in the sun?

Dr. Jared: It's a little bit of a catch 22 because as a dermatologist, I oftentimes share with patients that they may want to limit their sun exposure. And definitely choose how to get that sun exposure because we're always worried about the concerns of the UV light and other forms of light that are part of solar radiation causing skin cancer and aging. And so, you know, the sun puts out several different types of radiation: UV radiation or UV light is about 10% of the light that gets put out from the sun. And then visible light such as, you know, the whole spectrum ROYGBIV (red, orange, yellow, green, blue, indigo, violet), that comprises about 45% of the light that comes from the sun. And then infrared light actually comprises the other 45% of sun emissions. So, you know, one of the things that's really kind of taken off recently, and you know, I'm very fortunate that our laboratory is a pioneer and at the forefront of this is studying the benefits of other sorts of light, such as visible light and infrared light for skin health and wellness. And one of the things that we've really found is that that you can actually change skin cell function and also different skin conditions by using visible and infrared light to enhance skin health and wellness. And also limit some of the harmful known side effects that are associated with ultraviolet radiation. So choosing the specific wavelength of light may have a tremendous amount of benefit and tremendous potential for skin health and wellness.

Jennifer: That's really cool. So you're actually, it's like you're kind of able to cherry pick what part of the spectrum may work best for a condition as opposed to saying, hey, go out in the sun, be exposed to everything. I mean, it's kind of like a mixed bag, right? You don't know what you're going to end up with. So we use this light therapy. It's helping to reduce this immuno inflammatory response. Does it also affect the microbiome of the skin at all?

Dr. Jared: So there haven't been a lot of studies with regards to how light changes the microbiome. The microbiome is such a hot topic. Basically the microbiome is the interplay of different organisms that are on and in our body and how those affect health and wellbeing, including skin health and wellbeing. And this is such a fascinating topic because so many different things actually do change the permutations of our microbiome. And the microbiome has been found to actually lead to improvements in skin health and wellness. Especially one of the things that's been really well studied and investigated over the years is how the skin microbiome is involved in different skin conditions such as acne and also atopic dermatitis, otherwise known as eczema. So it's really important to have this microbiome studied as we have been doing and continue to study how light actually changes the microbiome. That is such an important topic yet more research dollars and time need to be spent on it.

Jennifer: Yes, I agree with you. I have a question too. You mentioned the different spectrum or that the spectrum and there's these different types of light. Have you heard of something called red light therapy? I've started to see some products on the market and I've seen some people say, oh well I'm using the red light therapy to help with my skin. And I'm always a little bit skeptical. I'm kind of wondering, do you know anything about that? Is that sort of like a fad or is there maybe something to it?

Dr. Jared: Well, I am so happy that you asked me about that because that's actually one of my areas of scientific interest. I've studied in the laboratory and, and in clinical trials, red light phototherapy for more than the past decade. This is such an important area of research and red light actually has the potential to really improve patient health and wellness. I'll share with you that we've been looking into it for improvement in hair growth. We've also looked at it in terms of how red light can help even out the skin's tone and texture by minimization of scarring and normalization of the main cells in the dermis, known as the fibroblasts.

Jennifer: Wow. You and I both know there's a lot of people that like to kind of do things on their own, but we also know that there can be a big difference between what happens and goes on in a doctor's office, for example, or a medical center versus what you can buy on the Internet. So my question then is for everybody going, oh my gosh, maybe I should go buy a red light therapy unit that I can find online. Do you know if there's any difference between what might be available at say, like your practice or at your center versus something that you can buy commercially online?

Dr. Jared: I think that that's a really important aspect that you bring up. You know what patients are able to do at home versus what they can do in the physician's office. What I like to tell patients is that it's so important to use products that have been backed by science and backed by clinical studies that really support their use. A lot of these red light products are not comparable. It's very important to know that because we're only able to see the light output but the red light is just visible as a red light output. But there are so many different things that are kind of unable for us to see such as the power density, the specific wavelength of the light. And it's really important to look at some of those other parameters. So that's why I do like to recommend that patients use products that have only been clinically tested and published on or presented on at meetings that have shown benefit because otherwise as you said, there are a lot of differences in some of these products. And you know, a red light is not just any old red light. You have to have a clinical grade product.

Jennifer: Right. And what you get on Amazon, I don't know how much they cost, but you know, it might something you buy for like $25 or even $100 might not be comparable and you're like, I'm doing all this red light therapy and in reality, you're not really using the appropriate type of device. So some people have also asked me about tanning beds and I know you mentioned in the beginning you said it's like a standup booth that kind of looks like a tanning bed. And I thought, you know what, I really should probably ask about this because I have heard horror stories that some people thought that they could go to a tanning salons and use that because their skin would improve after getting in a tanning bed. But you and I both are very well aware that there are some really serious risks involved with the tanning beds. So what's the difference between going to a tanning bed at some salon around your local area versus the type of UV light treatment that they would get through a dermatologist's office?

Dr. Jared: Tanning beds that are in tanning salons are very, very different and distinct and harmful compared to the phototherapy units that are in a physician's office such as a board certified dermatologist office or an academic medical center. I would like to just share with you some of the key differences. Some of the differences involve design of the phototherapy unit and also some of the safety associated with it. With regards to most dermatologist's offices, the lights that we use in our systems are actually narrow band ultraviolet B light. And this light does not penetrate very deeply into the skin and it's really very fine tuned to give the best benefit in terms of antiinflammatory yet yield the least amount of side effects to patients. Oftentimes the tanning beds that are in these tanning salons are ultraviolet A light, which may not be the right sort of therapy for you depending on what your skin condition is.

Dr. Jared: Ultraviolet A light really leads to more immediate tanning, so people come out immediately tan and brown, which may sound attractive to patients. However, that often does a lot more damage to the skin. We dermatologists sometimes do use specific wavelengths of ultraviolet A light, called UVA One and that's oftentimes for much more deeper in the skin problems such as scleroderma which is like a scarring and hardening of the skin, which is not really anything similar to atopic dermatitis (which is also known as Eczema) or psoriasis. So for psoriasis and Eczema, you really want to go to a dermatologist, a board-certified dermatologist, be evaluated fully and consider using a phototherapy unit that gives out narrow band ultraviolet light. And that wavelength is usually around 311 to 313 nanometers of wavelength.

Jennifer: So the point here, the message is the tanning bed is not the way to go. It's not safe and that's not really how you're gonna get the most benefit for your skin if you've been dealing with these issues. And I know that we weren't really focused on scarring, but I do get questions on scarring and so UV light therapy can actually be beneficial. Like say somebody has scars from Eczema or psoriasis or acne when they were younger. You can also use that as treatment?

Dr. Jared: UV phototherapy would not be my modality for treating acne scars or scars from any other condition. I would really recommend that again, a patient goes and sees a board certified dermatologist because we are the experts in treatment of scars, especially the ones who specialize in using laser treatment modalities. A fractionated carbon dioxide laser or a CO2 laser is really the accepted gold standard for treatment of scarring and that can really lead to great results. There are other modalities that are on the market that can also give great outcomes for patients who have scarring, such as microneedling with or without radio frequency and some non-ablative treatments as well. There are some other injectable approaches for the treatment of scarring as well, such as an anti-inflammatory Kenalog or steroid shot that can sometimes give benefit as well.

Jennifer: Interesting. Well I'm glad that we kind of cleared that up but that's great that there are also those options too because a lot of times you can end up with scars that are pretty unsightly and even though the issue may have resolved itself, people are kind of still walking around almost like marked or branded from this long period of time where their skin was really unhappy. One last question for you if you don't mind. Cause I think this is a question like it would be a question that I would have if I was a patient considering us. Is there a risk of cancer with this more narrow band, UV light or is that something that you have kind of controlled for because you're being more careful in the type of light that you're using and this type of treatment?

Dr. Jared: So very fortunately, the theoretical risk of cancer is very, very small using narrow band, either phototherapy or an excimer laser, which is a 308 nanometer wavelength laser, which is specific for UVB light for these inflammatory conditions such as vitiligo, atopic dermatitis or psoriasis. Really, I haven't seen any patients who have ever developed any skin cancers due to this type of photo therapy. And that's really the wonder of being able to fine-tune these lights to be able to give patients the best outcomes possible.

Jennifer: Wow. That's really, that's actually really great to know that because you know, I think sometimes people are nervous to ask those questions, but it's important to ask questions and to be, to walk into something like this with the full deck in front of you and you're like, all right, I feel comfortable with this. I just want to say thank you so much for answering these questions and being so candid about them too, because a lot of times there's confusion about how to best take care of your skin. And I know that my listeners are really motivated to be their best advocates. They've struggled and suffered for a long time and I know that they are really going to appreciate this and so how can we find you? You're located in Brooklyn, do you work in clinical practice?

Dr. Jared: Absolutely. I'm here at the State University of New York, SUNY Downstate Medical Center and I'm the director of the Laser Aesthetic and Body Institute here. I'm able to see patients for any student condition that they would like. And I'm also available via Instagram at Dr Jared Jagdeo. So please reach out, come in and I look forward to seeing you.

Jennifer: And we'll definitely put all of your links of how everyone can find you in the show notes. And I know that you also have a publication as well. We'll include that too, because it's nice to be able, I know that some of the listeners are practitioners and they're very interested in getting their hands on more information, so it'll be nice to be able to share that with them. Thank you so much for joining us.

Dr. Jared: Thank you so much. Appreciate it.