The Science of Skin

Is there finally a fast-acting oral treatment for chronic hives? In this episode of the Science of Skin Podcast, board-certified dermatologist Dr. Ted Lain is joined by Dr. Naiem Issa, a dermatologist in Northern Virginia and assistant professor of dermatology at the University of Miami and George Washington University, to break down the phase 3 clinical trial results for Rhapsido (remibrutinib), the first oral BTK inhibitor for chronic spontaneous urticaria (CSU).

Dr. Issa explains how Bruton's tyrosine kinase (BTK) inhibition works inside the mast cell to block the signals that lead to degranulation and histamine release, and why remibrutinib's covalent, highly selective binding helps explain its rapid onset and durable results. The doctors then walk through the pivotal trial data, including reductions in the Hives Severity Score (HSS7), Itch Severity Score (ISS7), and Urticaria Activity Score (UAS7). Patients saw about a 40% reduction in hives as early as week one, around 70% by week 12, and continued improvement through 52 weeks. Nearly 28% of patients reached UAS7 = 0, meaning complete absence of hives and itch, at week 12 compared with 6.5% on placebo, rising to almost 46% at one year.

They also discuss the challenging trial population, which included patients with severe disease uncontrolled on up to four times the standard dose of second-generation antihistamines, many with angioedema, and about a third with prior anti-IgE biologic therapy such as omalizumab. Dr. Lain and Dr. Issa cover angioedema-free weeks, what complete control means for quality of life, how this data may change CSU treatment for dermatologists and allergists, and what new data on even faster onset may be coming soon.

This episode is sponsored by Novartis with content independently created by the Science of Skin podcast.

⚠️ This content is for educational and informational purposes only and reflects the personal research findings and opinions of the speakers. It is not medical advice. The discussion involves animal studies and experimental research; consult a licensed healthcare provider for questions about your own health.

If you enjoyed this episode, please leave a 5-star rating and share with a colleague — word of mouth helps our podcast grow!

Can a topical serum work like a neurotoxin? Recorded live in Paris, Dr. Ted Lain sits down with Dr. Peter Bjerring to find out. Dr. Bjerring is a professor of dermatology at Aalborg University Hospital in Denmark, a laser pioneer who helped develop IPL technology, and a Knight of the Order of the Dannebrog.

Together they break down SkinCeuticals P-TIOX, a serum built around two viper-venom-derived neuropeptides. One acts presynaptically, like botulinum toxin. The other blocks acetylcholine receptors on the muscle side. Both are small enough to penetrate the skin, which injectable toxins can't do.

Dr. Bjerring walks through two of his clinical studies. In a split-forehead sweat study using the Minor iodine-starch test, the treated side showed little to no sweating after just three applications. That suggests the peptides really do reach their targets in the skin. In an 8-week, all-male study of 36 participants across multiple ethnicities, twice-daily use reduced forehead and glabellar lines by about 15%. Crow's feet, nasolabial folds, and even marionette lines also improved, and results kept getting better between weeks 4 and 8.

The conversation also covers the supporting ingredients: 5% polyhydroxy acid for gentle exfoliation, niacinamide for barrier support, tone, and redness, and Laminaria digitata for antioxidant and collagen support. They discuss why so many self-reported sensitive-skin participants had no irritation, and how P-TIOX may pair with injectable neurotoxins to target the fine, superficial texture lines that injections miss.

If you enjoyed this episode, please leave a 5-star rating and share it with a colleague. Word of mouth helps our podcast grow! Have questions or ideas for future episodes? Email us at [email protected].

Disclaimer: This clip is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.

In this episode of the Science of Skin Podcast, Dr. Ted Lain talks with Dr. Rich Miller, professor of pathology at the University of Michigan and director of the Paul F. Glenn Center for Aging Research, about the science of slowing biological aging.

Dr. Miller explains why lifespan and health span move together, not in opposition, and walks through decades of research using genetic mutants, calorie-restricted diets, and drugs like rapamycin, acarbose, canagliflozin, and 17 alpha-estradiol to extend lifespan in mice. The conversation covers how these interventions work through pathways like mTOR and glucose regulation, why some drugs affect males and females differently, and the surprising finding that many of these anti-aging effects hold up even when treatment starts in middle age rather than early in life.

The two also discuss the challenge of translating mouse research to humans, Dr. Miller's work developing "aging rate indicators" that could make human drug trials for aging far more practical, and his call for more dermatology involvement in aging research — including his hope to see skin aging studied alongside the organs his lab has already examined. The episode closes with a candid take on supplement industry claims and what the current evidence actually supports for slowing aging today.

⚠️ This content is for educational and informational purposes only and reflects the personal research findings and opinions of the speakers. It is not medical advice. The discussion involves animal studies and experimental research; consult a licensed healthcare provider for questions about your own health.

If you enjoyed this episode, please leave a 5-star rating and share with a colleague — word of mouth helps our podcast grow!

In this episode of the Science of Skin Podcast, Dr. Ted Lain sits down with Dr. Sarina Elmariah, MD, PhD, professor of dermatology at UC San Francisco and director of the UCSF Center for Itch and Neurosensory Disorders, for a deep dive into chronic spontaneous urticaria (CSU).

Dr. Elmariah breaks down the role of Bruton's tyrosine kinase (BTK) in mast cell degranulation and explains how it sits at the center of the histamine release cascade. The conversation covers the difference between Type I (auto-allergic) and Type IIb (autoimmune) CSU pathways, available diagnostic tools like autologous serum skin testing and basophil activation testing, and why BTK appears to be a common thread across nearly all CSU mechanisms — including many inducible urticarias.

The two also discuss remibrutinib (brand name Rhapsido), a BTK inhibitor newly FDA-approved for CSU, and what makes its binding mechanism distinct from earlier BTK inhibitors. They close with a look beyond histamine at the other inflammatory mediators — proteases, leukotrienes, prostaglandins, and cytokines — that help explain why so many CSU patients don't respond to antihistamines alone, and why angioedema tends to linger longer than a typical urticarial wheel.

This episode is sponsored by Novartis with content independently created by the Science of Skin podcast.

⚠️ This content is for educational and informational purposes only and reflects the personal research findings and opinions of the speakers. It is not medical advice. The discussion involves animal studies and experimental research; consult a licensed healthcare provider for questions about your own health.

If you enjoyed this episode, please leave a 5-star rating and share with a colleague — word of mouth helps our podcast grow!

Korean skincare is everywhere on social media — but how much of it is backed by real dermatologic science? In this episode of The Science of Skin Podcast, Dr. Patti Farris sits down with Dr. Jane Yoo, board-certified dermatologist, fellowship-trained Mohs surgeon, and "The K-Beauty Dermatologist," to separate fact from TikTok fiction.

They trace K-beauty's roots from the Goryeo and Joseon dynasties through the Hallyu wave, then dig into the science: ceramide-dominant, barrier-centric formulations, low-pH cleansers, and why "glass skin" is more about consistent barrier care (and good lighting) than any single product. Dr. Yoo also breaks down the real evidence behind snail mucin, PDRN and PN, exosomes, and silica spicules — including where the hype outpaces the data — plus whether double cleansing is really necessary and why Korean sunscreen filters like bemotrizinol (Tinosorb S) may be the biggest public health advance in photoprotection in 25 years.

In this episode:

The real history of K-beauty, from royal court rituals to global export

What actually causes "glass skin" (and what doesn't)

The truth about snail mucin, PDRN/PN, exosomes, and spicules

Do you really need to double cleanse?

Why newly approved filters like bemotrizinol could change US sunscreens

Tinted, visible-light-blocking sunscreens for skin of color

Have a question or an idea for a future episode?

Email [email protected].

Join us at the Science of Skin Summit, September 17-20 in Austin, TX, or the new Science of Skin Longevity Conference in Scottsdale, February 2027.

Learn more at scienceofskinsummit.com

If you enjoyed this episode, please leave a 5-star rating and share with a colleague — word of mouth helps our podcast grow!

⚠️ This content is for educational and informational purposes only and reflects the personal clinical opinions and experiences of the speakers. It is not medical advice. Consult a licensed healthcare provider for questions about diagnosis or treatment.

In this episode of the Science of Skin Podcast, Dr. Patti Farris sits down with Dr. Dustin Portela and Mimi Banks (Principal, Mimi Banks Social) to talk all things DermFluencer University — the influencer education track heading into its third year at the Science of Skin Summit in Austin, TX (September 17–20).

Dustin and Mimi trace the program's origin from a single standing-room-only session to a full two-day experience combining a hands-on masterclass with practical, camera-ready workshops. They dig into why physicians need to show up in the spaces where health misinformation spreads — especially around topics like sunscreen and skin cancer — and share the systems, batching techniques, and content frameworks that make creating sustainable for busy clinicians.

The conversation also covers Med Creator 101, the podcast-turned-course born out of Dustin and Mimi's countless one-on-one conversations with physicians at AAD 2024, now distilled into an eight-module course covering everything from content hooks to HIPAA-conscious posting.

Whether you're a dermatologist, NP, PA, or aesthetician curious about content creation, this episode offers a behind-the-scenes look at how to build an authentic, science-backed presence online — imperfections and all.

Topics covered: DermFluencer University · Med Creator 101 · content batching & systems · combating skincare misinformation · camera presence & branding workshops · Science of Skin Summit 2026

In this special bonus episode of the Science of Skin Podcast, Dr. Patti Farris sits down with Dr. Sandra (Sandy) Johnson — private practice dermatologist in Fort Smith, Arkansas, and member of the American Academy of Dermatology's Board of Directors — for an urgent conversation on the CMS reimbursement cuts threatening the future of dermatology.

Dr. Johnson breaks down the three major proposals from CMS that could devastate dermatology practices nationwide: a proposed cut to the 25-modifier that would penalize combined evaluation-and-procedure visits, a potential overhaul of indirect practice expense calculations that could hit dermatology harder than most specialties, and an effort to remove the AMA's RUC representation — stripping physicians of their voice in how reimbursement values are set.

Beyond the policy breakdown, Dr. Johnson shares what the AAD is doing to fight back and exactly what members can do right now: submitting the 30-second advocacy letter through Voter Voice, rallying staff and patients to do the same, donating to SkinPAC, and attending this year's Legislative Conference in Washington, DC before the mid-September deadline.

This is a call to action for the entire dermatology community — because a united voice is the specialty's best defense.

Topics covered:

• The proposed 9–25% CMS reimbursement cuts
• The 25-modifier and what it means for combined visits
• Indirect practice expenses and why dermatology may be hit hardest
• Efforts to remove the AMA from the RUC
• How to take action: Voter Voice, SkinPAC, and the AAD Legislative Conference

Millions of people live with chronic spontaneous urticaria (CSU) — unpredictable hives and angioedema lasting six weeks or longer with no identifiable trigger. In this episode of the Science of Skin podcast, board-certified dermatologists Dr. Ted Lain and Dr. Michelle Tarbox (Chair, Department of Dermatology, Texas Tech University Health Sciences Center, and host of the Dermosphere podcast) break down what CSU actually is, why it's often misdiagnosed as an allergy, and how it's treated — from first-line antihistamines to omalizumab (Xolair) to the newest option: Rhapsido (remibrutinib), the first oral BTK inhibitor approved for CSU.

In this episode, you'll learn:

• How CSU is diagnosed and why it's classified as a skin disease, not a true allergy
• The autoimmune vs. autoallergic subtypes driving chronic hives and angioedema
• Why antihistamine updosing often falls short — and its impact on quality of life
• How BTK inhibitors like remibrutinib (Rhapsido) work differently than biologics like omalizumab
• Real patient stories on the toll of chronic hives, misdiagnosis, and finding relief

This episode is sponsored by Novartis with content independently created by the Science of Skin podcast.

⚠️ This content is for educational and informational purposes only and reflects the personal research findings and opinions of the speakers. It is not medical advice. The discussion involves animal studies and experimental research; consult a licensed healthcare provider for questions about your own health.

If you enjoyed this episode, please leave a 5-star rating and share with a colleague — word of mouth helps our podcast grow!

Have a question or an idea for a future episode? Email us at [email protected].

Epiduo is now available over the counter — and in this full episode of the Science of Skin Podcast, board-certified dermatologists Dr. Ted Lain and Dr. Patti Farris break down everything you need to know about this fixed-dose combination acne treatment.

From the landmark phase 3 clinical trial data to real-world tolerability, scarring reduction, and the risks of compounded alternatives, this is the definitive deep dive on adapalene 0.1% and benzoyl peroxide 2.5%.

In this episode:
✅ Why Epiduo's move to OTC is a game-changer for acne patients facing prescription barriers
✅ Full breakdown of the 2009 phase 3 trial: 1,600+ patients, 60 study centers, 4 treatment cohorts
✅ 67% reduction in inflammatory lesions and 60% reduction in total lesion count by week 12
✅ IGA success rates — 35% achieved clear/almost clear skin vs. 22-24% with monotherapy alone
✅ Phase 3B international trial data across diverse Fitzpatrick skin types
✅ Excellent tolerability data — erythema, dryness, and irritation all rated below "mild"
✅ How Epiduo addresses the full acne lesion life cycle, including scarring and PIH
✅ Why formulation science and FDA-approved testing matter vs. compounded alternatives
✅ The CeraVe/Cetaphil CAMP regimen (cleanse, moisturize, protect) for acne patients
✅ Real-world pricing, dosing, and application tips for OTC Epiduo

This episode of the Science of Skin Podcast is sponsored by Galderma.

Have a question or an idea for a future episode? Email [email protected].

Join us at the Science of Skin Summit, September 17-20 in Austin, TX, or the new Science of Skin Longevity Conference in Scottsdale, February 2027. Learn more at scienceofskinsummit.com.

If you enjoyed this episode, please leave a 5-star rating and share with a colleague — word of mouth helps our podcast grow!

⚠️ This content is for educational and informational purposes only and reflects the personal clinical opinions and experiences of the speakers. It is not medical advice. Consult a licensed healthcare provider for questions about diagnosis or treatment.

Dr. Ted Lain welcomes Dr. Mona Shariari — Associate Clinical Professor of Dermatology at Yale School of Medicine, Associate Director of Clinical Trials at Central Connecticut Dermatology, and host of the Medical Sisterhood Podcast — for a deep dive into one of dermatology's most persistent challenges: polypharmacy and topical confusion.

Ted and Mona look back at the old-school regimens dermatologists used to write out — one topical for the face, another for the body, different products for weekdays versus weekends — and how that complexity set patients up for poor adherence and side effects like skin thinning and hypopigmentation from steroid overuse. They discuss why once-daily, non-steroidal options like roflumilast cream and foam have changed the equation, allowing head-to-toe use without the body surface area and duration limits that come with topical steroids.

Got a question or an idea for a future episode? Email [email protected]

Join us at the Science of Skin Summit in Austin, TX this September, and the Science of Skin Longevity Summit in Scottsdale, AZ in February 2027. Details at scienceofskinsummit.com

If you enjoyed this episode, please subscribe and leave a 5-star rating — word of mouth is how this podcast grows!

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