Skincare might seem mundane or easy to overlook, but it plays a crucial role in our training routines. In fact, a recent study found that over 80% of cyclists understood the importance of sunscreen, but only 39% used it even some of the time. It’s time we change that statistic and prioritize our skin health.
Training plans can be unfulfilled by a saddle sore that keeps you from riding, or a blister that can make simply walking a painful experience. An even scarier conseuqence is that unprotected skin in the sun can lead to cancer if we don’t take proper precautions. This is why every pro cyclist, runner, and triathlete should have a detailed plan for how to keep their skin healthy.
In today’s episode, we talk with dermatologist Dr. Lela Lankerani. She helps us understand how to protect yourself from the sun while still receiving the benefits we need from sun exposure. We also dive into some specific skin issues like how to avoid and treat saddle sores, blisters, and road rash.
Joining Dr. Lankerani, we also hear the strategies employed by caoch Ryan Bolton, and previous national champion cyclist Stephen Hyde. Dr Andy Pruitt also shares some of his thoughts on the most common skin issues in endurance athletes.
So, put on your sunscreen, and let’s make you fast!
Quotes from the Show
Dr. Lela Lankerani
“I just would like everyone to remember that daily sun protection is paramount, especially if you’re training in it. And it’s really easy to find the sunscreens these days. They’re a lot more user friendly. They’re are a lot more elegant to apply on the skin so there really should be no excuse as to why someone should not use it. I definitely think people should aim for looking for a sunscreen that’s mineral based, that covers both the UVA and UVB spectrum, I think they need to at least think about between an SPF of 30 and 50. Because anything below is just not going to cut it. And anything above is unnecessary. And I really can’t stress the importance of re application every two hours. I mean, that’s where people run into the most problems. And by whatever means necessary, if that means just spraying it on after that original application with the cream, fine. “
“If you are exposed [to the sun], if you have a history, if you are fair skinned or, you know, just an accumulation of exposure, I think having a dermatologist do your yearly skin checks will be one less thing that you need to stress that about, let us stress out about your skin so that you don’t have to. Making those yearly skin checks would be another important thing for those athletes that are exposed for years and years and years. “
“Our risk of skin cancer, or long term bad effects from the sun have been occurring and accumulating our whole life. Everything starts when you’re a kid. And I know unfortunately, I suffered a very severe sunburn when I was a child. And you hope and you wish that was back in the past; It’s not going to affect me today. But we need to understand that it does. And we need to use that to make better decisions as we move forward. And we can’t necessarily change our past. But we can begin affecting our future by beginning appropriate skincare and sun routines now, but also, as you said, get checked out by someone. I have yearly skin checks with my dermatologist. But I remember I put it off for a couple of years. I know I really should do this but there was maybe a little bit of a self conscious nature. And I think that a lot of people get into that mindset. But it’s better to begin this before there’s a problem than to begin this after there’s a problem. And I think oftentimes when we talk about maybe melanoma and skin cancers, catching that stuff early is life changing for the better, so get out there do it this year, it’s the middle of summer you can go get a skincare check now and get one next year and get one the year after that. But it’s important for your overall health.“
“We have talked in the past on the show about how I’ll have athletes tell me they that they want to get really serious, and they’re gonna bump their training volume up to 18 or 20 hours a week. And my response is always I get you have the time to do that. But do you have the tools? Do you have the processes in place to be able to handle that? And often the answer that is no. So I think maybe some of our listeners have have listened to this episode and gotten skin care that’s kind of mundane. But I can tell you if there’s one thing that I’ve seen stop people from getting serious about their training, it’s because of that skincare, I have seen more than a few cyclists bump up to 20 hours a week. They get two weeks in of that sort of volume. And by the third week, they are a mess of saddle sores and blisters and abrasions. And their next week is five hours because they can’t even get on the bike anymore. […] I could tell you all the experience riders at the center had very detailed from experience practices to take care of the skin so that they could keep sitting on that saddle.”
Rob Pickels 0:04
Hello, and welcome to Fast Talk your source for the science of endurance performance. I’m your host Rob Pickels here with Coach Connor skincare. It doesn’t sound like a performance topic, but a healthy athlete is a fast athlete, and that goes through your skin to how many of you have lost training time due to saddle sores, Road Rash, or blisters? Even more important? How many of you have annual skin care checks to look for the cancerous growths that plague those who spend countless hours in the sun? Every endurance sports athlete has to endure the miles on our bodies, and our skin has to endure those miles to in today’s episode, we talk with dermatologist Dr. Lela Lankerani about how to best protect ourselves from the sun while also getting the benefits we need from sun exposure. But we also dive deep with her into some of the touchy or skin issues like saddle sores, blisters and road rash. Joining Dr. Lela Lankerani Dr. Andy Pruitt will also share some of his thoughts on the most common skin issues in endurance athletes. We’ll also hear the strategies employed by Coach Ryan Bolton and national champion cyclist Steven Hyde. So take care of your body’s biggest Oregon and let’s make you fast.
Rob Pickels 1:16
Hey, Fast Talk listeners. This is Rob Hybels. Wouldn’t it be cool to decide what Trevor and I are going to talk about on an upcoming show? Or how about we answer a question on polarized training you’ve been dying to know what about a 30 minute zoom call with me or Trevor on your favorite sports endurance topic. This is all possible when you become a fast talk Patreon member. We have four monthly memberships to fit your level of support. If you enjoy fast talk, help us stay independent and dishing out your favorite sports science topics by becoming a fast talk Patreon member today at patreon.com/fast off podcast.
Trevor Connor 1:54
Well, welcome to fast talk everybody. Leila. Great to have you join us. We’re really excited to talk with you about this particular topic.
Dr. Lela Lankerani 2:02
Thank you for having me.
Rob Pickels 2:03
Yeah, Trevor, this is a different one for us today, you know, usually where we’re what we’re diving into the science of endurance performance. And today we’re talking about skincare. Yeah. And in some regard, that might not be a performance topic, we’re not talking about how to make your skin more aerodynamic today, unless you have tips for that. No. But we oftentimes we talk about health and in my opinion, skincare, and skin health is really, really important to endurance athletes, because we spend so much time in the sun, we spend so much time in the water, we spend so much time crashing our bikes, that I think it’s really important that we do a great job taking care of ourselves in the long run. Because ultimately, if we can reduce some problems, maybe that means we train more and that helps our endurance performance.
Trevor Connor 2:50
So I’m going to start this one out, I’m going to share a story just to give our audience an idea of how important this is. Because as you know, I’m a pretty healthy guy, I try to eat right, I try to exercise. So I recently had my 50th birthday, which meant getting all my tests done and the doctor sent me to a dermatologist and I’m thinking, I’m gonna be great. They’re gonna tell me my skin is fantastic. So first thing they did is they looked at this mole on my shoulder and went, well you got a melanoma now we got to cut a big chunk out of your shoulder, which was no fun. And then they pointed out all these wrinkles in my arm and went start using sunscreen dummy.
Dr. Lela Lankerani 3:30
Yeah, we’re good at being honest.
Trevor Connor 3:33
So it was a kind of an eye opener of Yeah, I take care of all these other things, but I haven’t been taken care of this. And look what happens. So Lila, we’re gonna have talked about all sorts of sides of skincare. But is there anywhere you’d like to start? This is just kind of general advice to athletes who are out in the sun a lot.
Dr. Lela Lankerani 3:50
Well, touching base on what you just said, like, the importance of yearly skin checks, especially for those that are exposed to the sun almost 24/7 When they’re training or depending on where they live is of utmost importance is having a trained eye to look you over and have a complete skin exam to catch things early, so that they aren’t a problem down the line for your health and so 50 That’s a great age to start making a skin exam party or yearly preventative screening. But I do encourage people who are in their 20s and 30s, to start doing it as a baseline, and especially if they’re in it. I mean, the skin is the largest organ and is the most abused organ. If you think about it, you know, we don’t always wear the sunscreen like we should because we think oh, we’re only outside for 2030 minutes, no big deal, but it’s an accumulation of all that sun that finally catches up with people after a certain age.
Rob Pickels 4:47
Yeah, I know for me, I’m in my early 40s 41 I’ve been getting skincare checks regularly for a few years now because I’m pretty much the whitest Portuguese person in the world. And so I Don’t go tanning I go reddening pretty much my life. So it’s always been an important topic to me. Because it’s not something you know that it’s not a direction that I want to go down at least in terms of Sun related skincare issues. Yeah, I have some some questions related to kind of endurance athletes and exercise and how exercise maybe changes skin physiology. I know from my thermal physiology side of things that the body diverts more blood flow to the skin to help with cooling purposes, without blood flow change or anything else with exercise? How does the physiology and the skin change between an athlete and a non athlete as being an athlete healthy for you? Does it not make a difference?
Dr. Lela Lankerani 5:43
Absolutely. No, it makes a huge difference. You know, like what like we tell our children like eat well sleep, well exercise, all of that will contribute to your overall health, right? When you have increased blood flow, you are bringing oxygen to those skin cells, and you are bringing nutrients to those skin cells. And so and then, you know, on the flip side, that blood flow then carries away the waste products, including free radicals. And now you’ve got this post workout glow, if you will, and you know, you’re just skin overall is healthy. And then not only that, you now have, you know, a stress release, right? And stress causes a lot of problems in our skin, it can cause an exacerbation of acne, psoriasis, eczema, and when you work out, you reduce your stress levels, which overall contributes to that inflammatory process that some people have.
Trevor Connor 6:34
The other thing I think would be worth pointing out. And you can certainly talk more to this is they’ve shown that sun exposure on the skin is an oxidative stress and having some sort of oxidative defense is going to help and exercise particularly endurance exercise does up regulate nitric oxide, it helps produce some of those antioxidants that are going to protect your skin a little more.
Dr. Lela Lankerani 6:57
Absolutely, but and then too much of a good thing as a bad thing. Right. So if you’re not protecting your skin during your endurance training, then you’re actually causing more problems. You know, we talked about vitamin D being important, too much sun actually is a detriment to your vitamin D production. So I think there’s this balance that athletes need to keep in mind and to protect themselves during that process.
Rob Pickels 7:26
Yeah, I’d like to talk about that balance and a little bit, but I want to start with where you were going too much sun for the endurance athlete. Is there ever too much of a good thing? How does too much sun, you know, physically affect the skin? Right? Because we have these rays that I can’t see, you know, shooting down from the sun? And I always think of sunburns. I don’t know if it’s that simple. But where are we going with too much damage because you’re in the sun all the time.
Dr. Lela Lankerani 7:52
So if you’re in the sun all the time, you are getting the UVA and UVB exposure, right. And so you’ve got UVB causing sunburns, which can ultimately to skin cancer down the line. And then you’ve got UVA, which causes photo aging. So now you’re talking about wrinkles, sunspots, and that nature. So if you have too much UVB and UVA exposure, and you’re not protecting your scan against those harmful rays over time, it’s going to lead to long term problems. So that’s what I mean by too much sun exposure. Sure, you can be in the sun, you just got to protect it. You know,
Rob Pickels 8:29
it’s interesting that the two different UV rays A and B. So I think that you said UVB was a maybe a shorter wavelength and a was a longer wavelengths that they have, you know, very different long term results within the skin. How does UV be the shorter wavelength? How does that actually cause burn, and then eventually skin cancer thereafter.
Dr. Lela Lankerani 8:50
So your UVB rays have more energy, and it damages the DNA in the skin cells. When you have DNA mutations and the skin cells. Eventually, those mutations will cause those skin cells to grow out of control and develop a mass of tumor. And so it’s UVB that’s the most harmful Ray, for our athletes, and for people in general who like to be exposed to the sun in terms of the UVA. Yeah, it’s not as damaging to the skin, but you’re going to start to see the aging side effects, the wrinkles, the sunspots, the the creepiness of the skin, you know, people will start to complain about why is my skin so thin and crepey it’s because you’re losing that collagen and elasticity from the harmful rays.
Trevor Connor 9:38
If I remember correctly, UV B really only penetrates the epidermis, which is that upper layer where I’m UVA can actually get down into the dermis, the primary layer and that’s where
Rob Pickels 9:49
the collagen is going to be right deeper into the skin and the dermis. Interesting and
Dr. Lela Lankerani 9:54
that’s yeah, that’s where you get that skin aging problem because it is going deep into the collagen.
Rob Pickels 9:58
I remember that page from the bio He textbook years and years ago.
Dr. Lela Lankerani 10:05
Trevor Connor 10:07
So I think we need to flip this around though and talk about the fact that sun exposure is also healthy, we do need it. And I think everybody knows about vitamin D. But there’s other benefits such as releasing beta endorphins that you get from from sun exposure, you really can’t get any other way.
Dr. Lela Lankerani 10:25
You can, I mean, like we talked about vitamin D production being important, right? It’s good for your immune system, it’s good for your, you know, formation of your epidermal barrier, it’s good for mood, it’s good for basically cellular growth and repair. So you need a certain amount of vitamin D. And literature shows that you don’t need more than 10 minutes of sun exposure to get the proper synthesis of vitamin D. Vitamin D also helps with calcium absorption and maintaining phosphorus levels in our bloodstream, which then promotes normal bone mineralization, which we need as athletes as we know. But studies also show that if you go beyond 10 minutes, sometimes that sunshine can actually inhibit vitamin D synthesis. And so I tell my patients, yes, get a little bit of exposure, but you don’t need more than 10 minutes. Don’t let that be your excuse. You know, I’m I’m in it all day, to get my vitamin D, that’s absolutely false. You only need 10 minutes. And I tell my patients, a lot of times they can get their vitamin D, not only in their 10 minutes of sun exposure, but they can get it through foods, they can get it through vitamin D, fortified orange juice, milk, certain fishes like sardines and salmon. They’re all full of vitamin D. And so it doesn’t all have to come from the sunshine.
Rob Pickels 11:45
When you say 10 minutes. Are you is that 10 minutes of like unprotected sun if you’re got SPF 90 on it probably longer than 10 minutes, right?
Dr. Lela Lankerani 11:54
Yeah, yeah, I mean, ideally, you want to get out before 10am Or after 4pm. Because at between those hours, is when you got the highest UV exposure, right? You’re still getting a UV exposure, but it’s just at its peak between 10 and four. So you really want to get out there, you know, eight in the morning to do your walk without sunscreen is fine. Just no more than 10 minutes though.
Trevor Connor 12:17
One other quick thing to mention. I’m not sure this helps the conversation too much. But it’s just an interesting fact, called a vitamin D actually is a bit of a misnomer. It’s not actually a vitamin, it is a hormone. So vitamins are something that you have to get from your diet. And vitamin D, we can produce enough. So it’s not actually a vitamin, whatever, Trevor, gosh. My little back. No, I love it. Yeah, so go back to my brief story about my horrible visit to the dermatologist that I did to myself, you might appreciate this. I found out the biopsy they took of my Mole became the talk of the US dermatology world. It got sent all over the country, really, because nobody could figure out what was going on. And the funny thing was, I could have told them right away. Basically, somebody in San Francisco figured it out that I had a mold growing on top of a mole. Oh, that’s odd, though. The reason was, I had a normal mole on my shoulder and I crashed in a bike race and skin, my shoulder took most of the mole off, but not all of it. So another kind of bad mole that became cancerous grew on top of it. Sorry, I had to share that story. But I can tell you going to the doctor and having them tell me you’ve got a melanoma was actually kind of a scary experience. Sure. So I know that’s one of the concerns and the risks. So can you talk a little bit about that side of the sun exposure, the cancer risk?
Dr. Lela Lankerani 13:48
Yeah, so like, in my practice, most of the skin cancers I see fall under one of three categories. You’ve got basal cell carcinoma, squamous cell carcinoma, and of course, melanoma, I’d say basal cell and squamous cell are the two most common routine skin cancers that we pick up. And that’s usually due from too much sun exposure or an accumulation of sun exposure, melanoma, their thoughts that it’s not just environmental that it could be genetic. And so, you know, in terms of severity of cancers, melanoma is the most severe, it can go pretty quickly and it can take your life. Unfortunately, squamous cell is not as aggressive but it can, you know, get down into the lymph nodes and travel to other parts of the body and eventually hurt somebody long term. And then of course, basal cell is just skin deep. And so there are different risk factors for developing any one of those three, you know, fair skin, light eyes, light hair, the white out of Portuguese guy over here, Rob, you know, you are definitely at more of a risk than let’s say somebody who has a little bit more melanin in their skin or in their eyes or in their hair history of sunburns. And it doesn’t have to be recent, some earns even a bad sunburn and childhood. Eventually, those cells that you know, got damaged at 567, whatever your age can eventually turn into skin cancer down the line, because it takes time for these cancers to develop, they don’t just show up suddenly, excessive exposure to the UV, you know, to the sun to tanning booths, that’s a biggest nono in my book and most dermatologist books, you’ve used the tanning booth just one time, it increases your risk for skin cancer 25% Just that one time, high altitudes, you know living in Colorado, of course, you’re at a higher altitude closer to the sun. And you know, it’s sunny, what 300 days of the year,
Rob Pickels 15:40
not recently, I’ll tell you that.
Dr. Lela Lankerani 15:44
Family history, you know, if you’ve got a strong history Mom, dad’s cousins, brothers, anybody that has a history of skin cancer, you know, being that it could be a genetic component to it that increases someone’s risk to developing cancer, a weakened immune system, you know, or being on certain medications that lower the immune system. There’s certain like biologics that people take for their chronic rheumatoid arthritis or their psoriasis, that you’re lowering the immune system to reduce the inflammatory response. But in doing so you are increasing your risk of developing skin cancer potentially. And the last side note is people who have been exposed to arsenic people used to drink out of well water or have trace levels of arsenic, for whatever reason, husband’s trying to poison the wife or vice versa, that can increase the risk of skin cancer.
Trevor Connor 16:37
So this actually really surprised me. I did kind of dig into the research to see what was out there with athletes. And certainly, I know you’ll talk a little bit about this people involved in water sports, and surprisingly, people involved in winter sports. Lots of research showing increased risk. But there was a study done in 2020. So only a couple of years ago in Spain, were even saying the introduction, they were surprised that they are the first study of cyclists and sun exposure. And so they surveyed about 1000 cyclists in Spain. And were shocked to see that a little over 3% of them had had a melanoma, which is way, way, way above the normal population average. So it’s a very real risk. Oh, it’s
Dr. Lela Lankerani 17:26
a definitely huge risk. I mean, I had a mole in my early 20s. That was changing. I got it removed and it was borderline melanoma. And so it was kind of an eye opening for me because I you know, I abused the sunshine growing up, I did a tanning booth here and there. I didn’t know I was going to do this for a living and you
Rob Pickels 17:45
dabbled in the tanning booth?
Dr. Lela Lankerani 17:46
I did? I did. And who did it? It was the 80s and 90s.
Rob Pickels 17:51
But you didn’t inhale? I didn’t.
Dr. Lela Lankerani 17:54
Exactly. But you know, you think back like God, I was stupid. I did all this stupid stuff, thinking I was invisible. Or if this only happens to old people, you know, and it’s just, we do stupid things. When we’re younger, we are maybe too lazy to think about putting it on every day. Because it’s such a chore, you know, and it’s very important. Just it takes a few minutes. You know,
Trevor Connor 18:15
triathletes deal with a lot of things that affect their skin, they deal with sun exposure, but they also deal with pool water, which can really dry out the skin. So let’s hear from triathlon coach Ryan Bolton and his thoughts on protection from both the sun and the water.
Ryan Bolton 18:32
When I was a kid, I grew up in the generation where, you know, we tried to get as like tan as possible. And I think I’m regretting it now that I’m nearly 50 years of age. But my athletes, it’s a conversation I have just because of an I think being in Kona, a big part of when you’re training and racing here is protecting yourself from the solar gain. And by doing that is like by putting on like heavy, heavy sunscreen. And I mean, it’s critical. Because once you start getting a burn on your skin or anything like that, I mean, performance is going to start going down. It’s something that I preach to my athletes all the time. On a personal level. Now, I’m really, really adamant and maybe it’s from vanity, about moisturizing after being in the pool in chlorine. But also just I mean chlorine with you know, anything with with clothes, with my hair with skin, because I do feel like especially if you’re in it all the time it really, really beat you up. But with my athletes, I find the same thing. And I think younger athletes now are way more in tune with it than I was when I was young. And they’re really taking care of themselves more after exposing themselves to those conditions to let’s move on because right now you’re my least favorite guest because out of everything you mentioned, I’m batting like 75%. So let’s move on from all of the risk factors there. You know, everybody knows that you should wear sunscreen, right? Everybody knows that you should eat your vegetables too. Not enough people do it. You know, so I would love to get on to the how do you protect yourself from the sun topic? And, you know, for me, I oftentimes think of sunscreen, whether that’s chemical or mineral, or maybe you know, I came from the apparel world, maybe it’s apparel that you’re wearing to protect you. So let’s start with the sunscreen side of things. How does sunscreen plan to this equation? And I’m particularly interested in how does sunscreen match up to UVA and UVB protection? Is that something that we need to be thinking about as consumers? Or do we just let the suncare you know, company take care of that, and we just buy the product off the shelf?
Dr. Lela Lankerani 20:37
Naps, why not? Okay, so basically, you’ve got your UVA and you’ve got your UVB and we’ve already discussed how the UVB causes the sunburns. And the UVA causes basically your aging, right. So when you’re looking for sunscreens, there’s two types. There’s a mineral and there’s a chemical, what’s the difference? Well, I keep it simple. I tell my patients, if you cannot pronounce the ingredient, it’s probably a chemical, right. So you’re talking the strew, it’s oxybenzone. It’s a benzene, it’s parabens, it’s home, you know, homosalate, if it’s a mineral, you’re talking zinc and titanium oxide. That’s it, we keep it simple with minerals. So I encourage patients to go with the mineral sunscreen over the chemical. Now, chemicals are more readily available, and they’re usually cheaper. But in my opinion, what makes mineral better is it actually provides a physical barrier. So think of it that way, or that you just put on to the mineral sunscreen that UVA and UVB is not going to get absorbed into the skin, it’s actually going to reflect it’s like an armor. So nothing is coming through. Versus a chemical sunscreen, you’re basically absorbing the UV rays and converting it to heat in the sun. So or in the skin, excuse me, so that you’re still gonna get color, you’re still gonna get damage, maybe not as much. But there’s still damage happening with chemical sunscreens potentially, with mineral you’re you’re more protected.
Rob Pickels 22:09
Interesting. So let me let me get this straight, the chemical sunscreens that are going to absorb into your skin. What you’re saying is the UVA and the UVB rays actually enter your skin as well. But the chemical sunscreen converts that from a UVA or UVB into heat, presumably before it is able to do damage or deep enough, but it obviously has entered your skin so it’s going to do some damage before it gets converted.
Dr. Lela Lankerani 22:38
Yes. But you’re absolutely right. You’re taking those harmful rays, and you’re converting it to hate. And so we’re hoping that that chemical sunscreen is going to prevent DNA damage in the skin cells, right? Because it’s no longer harmful ray. So, I mean, I’m sure you guys have heard and athletes. You know, I’ve heard a couple years ago there was this whole hoopla over the safety of chemical sunscreen. And there’s no, there hasn’t been today any conclusive evidence saying that chemical sunscreens cause cancer. I think there was concern that maybe it was causing reproductive, of hormonal issues, but there has been no evidence to show that and then in my opinion, the risk of not wearing sunscreen is greater than the potential risk of what’s it doing for your overall health. And I’m sure people would argue but
Rob Pickels 23:27
yeah, there’s maybe a lot of people who, you know, mineral sunscreens seem like they’re a bit more expensive. Maybe people can’t afford that. And so they go with a chemical sunscreen. And I think that maybe some people were thinking, Well, I just I shouldn’t wear sunscreen, because the sunscreens bad for me. But in this case, I think it’s pretty clear that wear sunscreen, if it’s chemical, it’s chemical, it’s better than doing nothing without question.
Trevor Connor 23:49
So I’m probably the only one here we’re old enough to remember this. But they didn’t used to call it sunscreen back in the 70s and 80s. It was actually called suntan lotion. Because of what you were talking about. People do use the chemical and the idea was they still wanted to get their tan but they didn’t want to burn. Nobody was concerned about cancer or skin health back then it was it was all about tanning.
Rob Pickels 24:12
It was red didn’t look good. So right, right.
Dr. Lela Lankerani 24:15
You know, talking about the protective clothing that you touched based on like, Yeah, same thing. It’s like a mineral sunscreen, the sense that you’ve got this tight knit fiber that is providing an amount of protection because now again, those rays cannot come through those fibers if you’re wearing a long sleeve rashguard right. So, you know, is it easier just to throw on a rash guard than to have to sit there and reapply sunscreen every couple hours? Absolutely. But you know, again, it’s it’s user’s preference. Not everyone wants to wear a long sleeve shirt when they’re in the water.
Trevor Connor 24:51
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Dr. Lela Lankerani 25:35
Correct. So your dark fabric colour is actually more protective than your light fabric color. It absorbs more heat, perhaps, but you’re deflecting those rays better. And then of course, you want to go with more densely knit fibers and not loosely knit fibers, because again, if it’s loosely knit, you’ve got more penetration into the skin of those rays.
Rob Pickels 26:00
Yeah, I think that we’ve all either been the person or seeing the person that wore a mesh Jersey, and ended up with a beautiful sunburn on their back. Usually your bib strap area is fine. So you get a very odd sunscreen on your back. But you know, if anybody is looking for clothing that is specifically designed, or at least fabric that’s been tested, then look for a up F rating, right, we’re all familiar with SPF being associated with a sunscreen. But up F is the rating that’s used when we’re talking about a fabric of physical, you know, softgoods barrier,
Dr. Lela Lankerani 26:35
right. So the other issue with sunscreen besides which one to get is I think a lot of people don’t realize that it’s not meant to last all day long. So, you know, I got people are like, Oh, I put on my sunscreen, but they put it on at eight in the morning. And then they wonder why they’re toast by 4pm. Even if it says water resistant sunscreen is only meant to last 90 minutes. And I try as a general rule of thumb to tell people you need to reapply it every two hours, because you’re either going to sweat it off, rub it off, swim it off. And so it’s really important to reapply, which is the part that most people fail at because again, it takes time, it’s messy, etc. And then the other part of the problem is no one ever puts enough on. You know, we do a very thin half assed film on our skin. And again, it’s not covering everything. So for the face, you want at least a nickel sized dollop. And then for the body, you need at least either two shot glasses or two tablespoons of sunscreen. And that’s every two hours you have to do that amount.
Trevor Connor 27:41
So that’s the last question I want to ask you about the sunscreen going back to that study that I cited. I think it was over 80% of the people surveyed said yeah, they understood that sunscreen was important that they needed to do it to protect their skin. But only 39% Use sunscreen and including some of the people who had had melanoma still didn’t use sunscreen. So how do you convince people that this is something you need to do? Because I think you’re right. Most people go it’s an inconvenience. I’m fine.
Dr. Lela Lankerani 28:10
I just scare people to death.
Rob Pickels 28:13
Pictures, disgusting pictures?
Dr. Lela Lankerani 28:15
Absolutely. Like, I’ll just use my kids. For example, I do what I do. We live in Austin, Texas, we have a pool. So we’re in it, you know, we’re all in it. And at a very young age, I showed the children what melanoma and squamous cell and basal cell looks like and it’s not all pretty, right? And can disfigure you and it can kill you, it can do all the things and I thought, well, maybe I can just scare them into using it. And now you know that they’re their own agents, they put it on without me even reminding them and they’re really good about it. And so it’s like brushing your teeth, you know, you educate, and you tell people at a younger age to start thinking about it more than maybe our generation who, you know, we didn’t have sunscreen, we had suntan lotion, or we didn’t put on sunscreen until after the fact that we were already burned. And so I think the general public, especially the younger generation, they have a better knowledge about the harmful effects of the sun more so than us.
Rob Pickels 29:13
Yeah, let’s talk a little bit deeper about sunscreen, not suntan lotion or sunblock. That was that was the term I feel like when I was a kid it was sunblock, and that’s probably a misnomer. Let’s talk a little bit more about sunscreens and how the ingredients affect UVA and UV b like like I’m thinking we have zinc oxide and titanium oxide. Is there a reason that we have both do we need both if we just if we don’t care if we look old, and we just want to avoid cancer? Do we go for one ingredient? When we’re standing at the shelf looking at the 120 different options in front of us? How do we choose the one that’s that’s best for us? All right,
Dr. Lela Lankerani 29:51
this is what I tell my patients so you want to choose a broad spectrum sunscreen stopping that’s going to cover both UVA and UVB, right. So that’s number one. And most sunscreens will say that on the label. Second, you want to choose an SPF between 30 and 50. And this goes for chemical or mineral. So I usually say between 30 and 50 is all you need anything above 50 SPF is only going to protect your skin 1% More from the harmful effects. I don’t know if it’s worth the trouble or the expense honestly. And so I keep it simple between 30 and 50, UVA and UVB, which is going to be labeled on your sunscreen bottle as broad spectrum protection. And then forget the water resistance forget like, you know, dermatologist tested, that’s all garbage. The problem is no one reapplies. And so when you’re standing in front of the shelf, and you got all these options in front of you 30 to 50, UVA and UVB. And that’s it. Now in terms of what’s better mineral for sure. And titanium and zinc oxide are both ingredients do you need to have both on your label, no one or the other will suffice. They’re both minerals. And they’re both providing that physical protection so that nothing penetrates through to the skin.
Rob Pickels 31:13
Great in terms of individual ingredients. Obviously, you brought up some some health care or some health concerns, some endocrine concerns that people were worried about. Maybe there was nothing conclusive at this point. But we also hear about things like reef safe and other terms like that. Is there anything deeper that people ought to be looking for beyond broad spectrum 30 to 50, and those details,
Dr. Lela Lankerani 31:36
okay, so if you’re traveling to Hawaii, or Australia, where you know, reef safety is important. Basically what that means is don’t bring any chemicals into our country or state. So chemicals is what’s the problem with the reefs, so it’s harmful to the reefs life cycle. So that basically means you’re looking for a mineral sunscreen when you’re traveling to a reef safe beach. And that’s it’s just that simple. It’s just that simple.
Rob Pickels 32:03
Right? So mineral is the answer no matter what.
Dr. Lela Lankerani 32:06
Honestly, that’s how I look at it. Like in our household we use strictly mineral. My daughter is really sensitive to chemicals, she always gets a weird rash when she tries someone else’s sunscreen. So we just keep it simple. In our house we do mineral, some easy drugstore brands that you know are easy for our guests who are listening to look for Sarah they see to fill a vino Eucerin. Neutrogena, all of these products that I’m mentioning, they all make a mineral sunscreen. And some of them make a hybrid. Some of them make like a part mineral part chemical hybrid sunscreen. Why is that important? Most people will complain, Oh, well, the zinc or the titanium is too thick. And I look like a mine when I wear it. It’s formulated a lot better these days where it doesn’t give you that white pasty look, you just rub it in and it goes shear into the skin so you don’t look crazy. So we’ve come a long way with the way we formulate sunscreen these days so that people will use it, you know,
Rob Pickels 33:10
most important thing, one thing that I want to throw out there, and this is combining a couple things that we’re talking about, and that’s the reapplication. I will say that I try to use mineral sunscreen, especially in my daily life. And oftentimes at the beginning of rides or runs, I’ll put on a mineral sunscreen. But when I take sunscreen with me and oftentimes I do because I’m doing longer rides, I’m not gonna lie, I oftentimes take a chemical sunscreen with me for that because it’s just so much easier to reapply when you’re sweaty and have a little bit of dirt on you and everything else. So I think I have a little travel tube of like banana boat or something like that, that hangs out in my handlebar bag on my gravel bike. Well, this is what
Dr. Lela Lankerani 33:51
I say like anything is better than nothing. Right? And so, like, I’ve got a lot of patients who play tennis or golf where I practice because most of them are retired and can do those things all day long. And I say Okay, first thing in the morning, that sunscreen should be thought of as lotion, right? Don’t think of it as sunscreen. Just think of like okay, just got out of the shower. My skin’s dry. I want to put some of this lotion on. Okay, so you’ve got your application from head to toe, then you’re out golfing or playing tennis and now you’re like, Okay, so I need to reapply this every two hours. How am I going to do that without my hands getting all greasy or slick? And now I can’t hold my golf club or I can’t hit properly the tennis racket with a tennis racket. So pack the chemical or mineral they make it sunscreen spray and reapply with the spray. Because you’re right. You don’t have to touch it now. Okay, you just spray get a good thin layer. Don’t let it half of it go in the air. Get it on the skin and that’s your reapplication. It’s better than nothing. Is it as good as rubbing the cream on? Probably not. But it’s better than nothing. I feel for the athletes out there like I’ve been to many races that my husband’s done and I’m saying they’re gone, or they have no time they’re in it to win it. There’s no time to sit there and re up, apply properly. Right? And I wish like in the transition zones, it would be genius. And I know it’s gonna cost a ton of money, but it’d be genius if they have like some sort of like, spray that just comes at you as you’re passing through that transition zone.
Rob Pickels 35:22
It’s like the MR. at the restaurant, right? You just run through it. It’s like a carwash. That’d be amazing.
Dr. Lela Lankerani 35:28
Exactly. I just, I mean, that would be great. But I’m sure it costs a ton of money to have that continuously spray, you know, but that would be a way to, you know, offset that time it takes for these athletes to reapply, as they should
Rob Pickels 35:43
love it. Perfect. I think that the the theme of this episode is it’s better than nothing, you know?
Trevor Connor 35:50
Anything’s better than nothing. I think another important point to make, which would love it, if you expanded on this is certainly hope we’ve scared people enough to get them to use sunscreen to get them to use protection, but not so much that you avoid the sun. Because I do think it’s important to remind everybody getting sun exposure is important. And there have been studies that show that people who avoid the sun tend to see a higher rates of all cause mortality.
Dr. Lela Lankerani 36:20
Yeah, absolutely. Like I’m not impractical. I’m not a hermit crab, I am out I want my my family, I want my friends, I want my patients to stay active, right? That’s more important than staying inside being scared of the sun, getting outdoors, getting that vitamin D, staying active, releasing those endorphins. Third, it’s all important to our general well being. Protect yourself. That’s it, you know, you want to go have fun, have fun, but just protect yourself. It’s not that hard.
Rob Pickels 36:48
Well, that’s a lot about the sun. And I do want to say that when I’m out riding my bike and doing other sports, I do tend to run into some other issues that go beyond the sun. And so I’d love to shift gears a little bit. And I don’t know, I don’t know if people want to listen to us talk about this stuff. But I know for a lot of people when they’re out riding their bike a lot, maybe for multiple days, especially if they’re not good about doing their laundry, then a quote unquote saddle sore can be, you know, a very demanding topic for the cyclists among us. I want to ask this, but do you do you see saddle sores in your practice?
Dr. Lela Lankerani 37:29
I do. I see a lot of weird stuff. But let’s let’s talk
Rob Pickels 37:32
about those babies. You know, what, what the heck is a saddle sore? How do we treat these things? Let’s get them out of our lives. Okay, so
Dr. Lela Lankerani 37:40
a saddle sore is when you’re sitting on your sit bones, right? So you’ve got your technical term as ischial tuberosities. That is the bottom of your pelvis area that penetrates onto that saddle, right? So you’re putting pressure on that saddle and it’s causing this weight bearing frictional problem, right? That is show tuberosity or sit bones. And it causes a reduction basically, in your barrier when you have all that friction, especially if you’re sweating to death if you got a poor fitting saddle in the first place. Right. So that’s important to have the right size saddle for your bum. But also, are you wearing a chamois? Are you wearing a bike short that has the padding that will protect you from that frictional mechanics. So a get a proper saddle that fits your touch, be get a cycling short that has a good chamois in the middle and see I think a barrier cream has everything you know, like almost like a diaper rash cream with a barrier cream that has the zinc oxide, maybe some petrolatum and maybe an antifungal component to it like decitabine or AMD ointment. Applying that to your inguinal creases or anywhere that there’s folds and friction that’s going to cause sweat and bacteria to harbor is important to prevent that.
Rob Pickels 39:06
Yeah. So with that saddle sore, is it an actual infection that’s occurring in the skin what’s happening there?
Dr. Lela Lankerani 39:14
I mean, it can so if you’ve got this bone that’s just constantly grinding against, you know, the flesh of the of your skin. It mean besides a sore, you can get like an abscess or a pimple that’s really sore there. But if it breaks down the actual skin like I think of it as a callus, if you will, you can introduce an opening in the barrier, which then introduces your skin to a bacterial infection or fungal infection. So it really just all depends how much trauma has happened to the skin in that area.
Rob Pickels 39:47
Yeah, I think the general chafing for cyclists is bad news in general. I oftentimes have relied on formulations that I’ve bought, you know from companies like Matt alchemy, I’ll throw that name out there. You know, it’s Interesting your your homebrew one that you mentioned they’re using some some desert 10 Maybe I think I heard a topical antibiotic in there. Well, that’s super interesting. You were chafing guy, Trevor, you change over there if Trump.
Trevor Connor 40:11
I used to a ton. I mean, I before I learned all the tricks, I always had some sort of saddle short going on and a shammy technology has also improved. But some of the things I’ve learned, wash your Shami all the time, when I have talked to people who have constant saddle sores. Prakash asked, How do you watch your Sami and usually an answer like, oh, every third or fourth use and you go now? Yeah, nasty. Pretty nasty.
Dr. Lela Lankerani 40:40
Well, and from what I understand is because I mean, I spend but I don’t wear shammies I probably should, but you’re not supposed to wear underwear underneath the the bicycle shorts, right? So you’re right, like, you’ve got all this sweat and bacteria and fungus. And God knows what else just sitting in your shorts. And if you’re not washing it after every ride, that’s just straight up nasty.
Trevor Connor 41:03
It’s pretty gross. You know, another little trick I’ll give people if you’re doing a lot of training, or you’re doing all that really long ride is the double whammy the double Shami, you wear two pairs of cycling shorts. What so then most of the friction is between the two shammies and not between the Shammi and your skin. And I can’t tell you how many training camps. The double Shami got me through?
Rob Pickels 41:26
Wow. I have never as somebody who is designed shammies for a company. I have never even heard of this before Trevor,
Trevor Connor 41:33
I do it all the time. And let me tell it Yes, it is a lot of padding. If I’m going out and doing a two hour ride, I don’t want to do it. But when you’re out for your third six hour ride and three cities something right? Got you, you don’t regret it at all
Rob Pickels 41:49
do you have to lower your saddle a little bit because you’re now like six inches off your bike.
Trevor Connor 41:54
The outer Shami that I have is a really old pair that super thin. It’s clapped out because of that issue. It would not be a pair of shorts I would ever wear just on their own. But it’s just having that little extra padding. But yeah, dropping your saddles, probably a little bit of a good idea.
Rob Pickels 42:11
I am learning new things about you.
Trevor Connor 42:13
QUESTION I want to ask you Lila is I have talked to a lot of cyclists who get a bad saddle sore, they go and see their dermatologist, and the dermatologist wants to remove it. And my experience is when you get that surgery, it’s usually they regret it because they end up with a scar and that scar hurts and they’re stuck with it for life.
Rob Pickels 42:36
And for clarification at this point, we’re talking about something we’ve moved beyond just like chafing and surface issues. And people might have felt this where now there’s like a hard something or other that’s kind of inside your skin and it’s very painful to sit on.
Dr. Lela Lankerani 42:50
So basically, you know, your saddle sore could be like, like I said, what we call an abscess or for Runkle, which is just this deep pocket of basically inflammation that will heal from that constant trauma, or you could develop scar tissue. You know, from again, the mechanics where you have just as hard not like you said, and when you do surgery to remove it, you’re cutting these things out and stitching the area up well now, you could have potential loss of nerve feeling in the area, you’re sitting on potential worsening of a scar that some people develop a keloid, which is a red ropey scar that feels itchy and painful to touch. And so I would say surgery is your last ditch resort to removing a saddle sore, and it’s never, not anything we ever want to do to somebody who’s active.
Trevor Connor 43:39
Let’s also hear from Dr. Andy Pruitt and his thoughts about saddle sores and how to treat them. You could
Dr. Andy Pruitt 43:45
almost write a whole book, at least a chapter on saddle sores, like what are saddle sores, that’s a huge category of things. So there are saddle sores that are caused by friction. Dry Shammi are dirty Shami would you’ve gotten some dirt from a gravel race, for example, all sudden you’ve got friction, now you’ve got an abrasion, that can be a saddle sore, long term pressure. If you’ve ever heard of a pressure ulcer, that’s when people are bedridden for a long period of time, they get ulcers on their heels and on their bottom, the same kind of things we sometimes can get between ourselves and our saddle, and that’s a pressure sore. And those have to be fixed. By relieving that pressure. Some of us either saddle change or Shammi change. If they fester and become a pimple or a boil and you treat it like a normal pimple or a boil. The key I think is good bike fit, good Shammi choice, good laundry, good self hygiene. Those are things the way you can prevent saddle sores, if you get them. You treat them like a wound, if you will, whether they’ve opened up or not. It is still a wound.
Trevor Connor 44:48
And are there specific concerns for women when it comes to skin issues on the saddle? Well, you know,
Dr. Andy Pruitt 44:53
we all have body oil, and we all have hair down there. And in today’s society, we’re all treating our gut rooming differently. So women tend to be the shaven or lasered or L natural. Those are your three choices, right? So if you’re shaving that leaves a stubble, and that that can be an issue that stubble rubs into the Shami and it can become an infected hair follicle. So all men, men and women both bring body oils, sweat and grime to the saddle sham interface. But women bring some unique things to it. And they have vaginal discharge and urinary leakage, that men typically don’t bring to the Shami. So that’s a whole, two more bacterial sources that can add to the potential of infection of a saddle sore.
Trevor Connor 45:40
So we had mentioned whether we want to talk about products, I will tell you, I’m trying to avoid getting into the gross conversations I have said some very large and very nasty saddle sores and edit. Certainly avoided the surgery route. But I will tell you one thing that I have found really helps interest your reaction to this is utter butter.
Dr. Lela Lankerani 46:01
Oh, yeah. I’ve heard a lot of patients talk about that. And I mean, it works, right. Yep.
Rob Pickels 46:06
Is that the same thing as bag balm?
Dr. Lela Lankerani 46:08
Yes. Yeah. Yeah. I mean, whatever, whatever it takes. Yeah, I mean, I mean, shoot for Crisco for all I carry, just whatever it takes to prevent that from happening.
Rob Pickels 46:21
And for those of you who listen to our bikepacking episode with Chris case, Crisco might be the only thing you can find in the gas station. So
Trevor Connor 46:28
just in case people are wondering back bomb and utter butter, what they are is an ointment. So it’s like Crisco, but they have anti bacteria in them,
Rob Pickels 46:38
but you can’t use it in your pie crust. No. It’s pretty gross. I think if you guys don’t mind, I would love to move on from from this. Yeah, I was gonna say maybe a less painful topic, but that topic I want to move on to is Road Rash. So there’s pain involved in here. Oh, I can talk a lot to this. Right. Yeah, cyclists man, we crash if you’re Trevor, you crash more than most. You know, how do we deal with Road Rash? You know, we’re not not a cut, right? But your skin has kind of just been ground a little bit as you’re sliding along the road. How do we take care of this?
Dr. Lela Lankerani 47:17
So that’s considered a basically a nasty abrasion. Right? You’ve skinned yourself, you’ve got a hopefully gravels been washed out of there after you’ve stood up but you have a compromise into your epidermal barrier. Right? And so I tend to keep things really simple in terms of skincare healing ointments, I love Vaseline. I love Aqua four. And it does wonders to heal the skin. You know, if someone’s got a really bad burn, I will sometimes prescribe silver silver Dean which helps to kind of heal things faster. But are we start with Aqua, for for Vaseline and tell patients to keep that area covered so that there’s less further injury to the area and allow that skin to heal. I don’t know what’s your guys’s experiences with road rashes and what you’ve done to make them heal faster. But like I said, I think Hawk aquifer and Vaseline are two great nonirritating SAVs that people can use to heal that skin.
Trevor Connor 48:17
So let’s do a hot take your what’s your opinion of target or
Dr. Lela Lankerani 48:20
I like to aegerter? What is that what you guys been using for it?
Trevor Connor 48:23
So about 12 years ago now back when I was on a cycling team that was sponsored by Dr. Andy Pruitt. Yeah, he gave us a whole ton of tag a term and this is before it was easy to get tagged or at a pharmacy. So I can tell you where we are at the race. Other teams would sneak into our van and try to steal our tag it or Oh, it’s
Rob Pickels 48:43
Dr. Lela Lankerani 48:43
Yeah, it is it is we use it in our office.
Rob Pickels 48:47
Now for those who aren’t aware. tegaderm is basically it’s a medical grade adhesive plastic is maybe the best way. It’s kind of like medical grade saran wrap, that you just tear skin and it covers large areas, they make big pieces of tegaderm. Your whole thigh has Road Rash on it, you can tegaderm that baby in it kind of is like a new layer of skin. You can say that is a barrier from the outside. Right?
Dr. Lela Lankerani 49:16
Correct. Correct. And it’s got like a moisturizing effect to it. It’s got the antibacterial effect to it. So it kind of covers all aspects of what could possibly go wrong with your skin once you’ve compromised the epidermis.
Trevor Connor 49:28
Just to have my I’m not just the president. I’m also a client moment. This has tagged him on my hand right now. There
Rob Pickels 49:34
you go. Proud of you, Trevor. Nice. No, can I ask when I’ve used tegaderm in the past and you mentioned this moisturizing effect, for lack of a better term things can get a little bit soupy inside. Is that a good thing? Is that a bad thing? Should I be changing it so that we don’t want things to dry out? Right? But if there’s like fluid, is that good or bad?
Dr. Lela Lankerani 49:59
Hey, Yeah, I would say it’s time to change it out. Like I try to. Yeah, I mean, again, like, I know that stuff is not cheap. I know it’s, it’s, you know, not maybe always easily accessible. But I think a daily dressing change is always encouraged, right so that you don’t have that fluid and that master ration that can happen from that excess of moisture. So
Trevor Connor 50:22
when I’ve gotten bad road rash, I have replaced the bandaging every day, like you said, it dries your responses, I want to keep it moist, but I want it to be new moisture I wanted to tag team has the the Add to bacterial property. And then the other thing I will say is as painful as it is, when you have that crash, clean it cleaner right away, or have them clean it. I had a race where I got some bad road rash, and just went final slap on the tag a Derm, I did not clean it out. And it got pretty bad. And I ended up going into the shower with a piece of steel wool and going to work on my leg. And that was not a pleasant experience. Yeah, you
Dr. Lela Lankerani 51:03
want to flush any of that debris up,
Rob Pickels 51:06
if you can have anyone else clean your Road Rash for you. In my opinion, the hardest thing in the world harder than any effort I’ve ever put myself through is scrubbing my own road rash. It’s inflicting pain, that is so hard to do on yourself. But when I do that, and I’m interested in your thought, Here, I have these iodine scrubbers. One side is like an iodine sponge and the other side or like these little fingers, you know that sort of get in there. In your medical sort of opinion. I’ve heard good and bad things about using iodine on abrasions, some say it can break down and cause damage. Others were like, No, it’s a great antibacterial. Should we be doing this? Or should we just be using soap and water.
Dr. Lela Lankerani 51:49
So I tend to say just use smile soap and water. But you know, when we do surgeries in our clinic for to remove these skin cancers, we use iodine all the time as an antimicrobial antibacterial prep, right. So I mean, if you’ve got a road rash, and you’re trying to keep it clean, that finger like thing that you just described as like your debris movement, right, that’s your debris meant to get all the gravel, dirt and whatever else out of there to keep it clean. And then the iodine provides that extra antimicrobial and antibacterial effect, which it might be great to do it as soon as you develop that road rash. But would I encourage people to do it on a daily basis? Absolutely not. Because I think that can slow down the healing process. And so maybe the iodine Scribe is a great like, as soon as that happens, use it, but thereafter just use mild soap and water.
Trevor Connor 52:41
So before we move on, let’s hear from Dr. Andy Pruitt. And his thoughts on road rash and how to treat it.
Dr. Andy Pruitt 52:49
Day in vertical is probably the safest way to avoid Road Rash. But if you’re a cyclist, ultimately, gravity is going to win the contest at some point in time. And speed actually is a bit of your friend and that if you if you’re going a little bit faster, you tend to slide on the pavement, which dissipates the impact stress. So you don’t necessarily break something. But however, your lycra soon disintegrates with the friction and the heat. And then your layers 123 layers of skin begin disintegrated the longer you slide. So road rashes is inevitable I think if you’re if you’re a cyclist, so the first thing is that is it just Road Rash, or is there a hematoma underneath the hip and the elbow are the primary suspects for road rash, right? So in both of those are fairly bony. So you can get a hematoma in the tissue. And that’s a pooling of blood and fluids from the impact. So if you’ve got Road Rash on top and then a hematoma, the situation is actually more serious because the bacteria from the road rash and infiltrate the hematoma and then you’ve got a septic potential. So I think that my first warning is how hard did you hit? Is this just Road Rash? Or is there a significant bruise or pooling of fluid that’s occurring at the hip or at the elbow below the road rash, so that and that makes it a significantly different conversation and you should go to the emergency room, consider having the hematoma addressed, as well as the road rash, or if it’s just Road Rash, you know, you’ve got to get home. And that’s the key part, right? So if, if the bicycle still functioning, or there’s a follow up car, you gotta get home and get in the shower. And as painful as it sounds, that Road Rash needs to be scrubbed. And that can be done at home with some sterile four by four gauze, if you will, and some antibiotic soap. You really need to clean out the debris. If there’s discoloration in the wound itself that can be asphalt oil that’s come off the road and it can be grime. So you really want to pay attention to anything that’s not fleshy or red, fleshy colored or red in this wound and get that thing clean. Scrub it with a pulsating shower is really the key to get the debris out of out of the wound. Most drugstores now have some wound coverings tegaderm. I hate to give plugs to brands, but tegaderm is a skin covering wound covering that works really, really, really well. And that’s an adhesive that you put directly over the wound. And that covering can last stay on there for several days at a time, but the wound will produce a fluid, an extra date fluid. So underneath the sealant that you’ve put onto the sea through dressing, there can be a buildup of alarming looking, but it’s really benign fluid. And so you do want to drain that out of there, whether that’s poking a little hole in the in the dressing or peeling up a little bit of this and draining that fluid out of there, the athlete would like to get rid of a dressing as quickly as possible, right. But the bottom line is you want to keep that wound wet, it’s going to heal best if it’s wet. If you allow it to scab over, it’s gonna take a lot longer to heal, and you’re more likely to get a scar out of it if you let it dry out. So the bottom line rules for this kind of wound is if it’s dry, make it wet. If it’s wet, let it dry. So the happy medium is in the middle, where that wound is going to heal the quickest. And without scarring, do you need to put an antibiotic ointment on it? Some say yes, some say no, some say that ointment kind of suffocates the wound and doesn’t let it air out. And so I think that if you have no signs of infection, I probably would go with a sterile dressing, sterile nonstick dressing, or tegaderm. Like seal covering after has been clean. Make sure you watch for signs of infection, which would be a fever, nausea, or red streaks from the side of the wound towards your, towards your groin if it’s a hip towards your armpit if it’s an arm, and that’s really a sign that there’s an infection, and you need to seek some further medical care. As the loom begins to dry out, then you got to make that decision. Is it time to let this thing scab over? How long can you tolerate a wet dressing, so road rash can drag on but there’s no reason you can’t ride with it. Right it can drag on and you can if you’ve if you’re watching the tour right now, you see guys bandage for the entire week, they crashed the first day. And there’s they’re still wearing their dressings at the end of the tour or tours long enough that sometimes those dressing those wounds heal before the end of the tour. So just make sure that you obey the signs of potential infection.
Rob Pickels 57:44
Alright guys, well, I know you know, I’m a cyclist. It’s my first love in the world. But not everybody that listens to our show is a cyclist only. So runners and swimmers. We’re going to talk about some stuff for you and I don’t swim much. So let’s move to running next. What are some of the common maladies that a runner sees? And how do we prevent them? Or how do we deal with them once they’ve occurred? I see
Dr. Lela Lankerani 58:07
a lot of shaping with runners you know, you’re sweating to death you’re running these like you know marathons or these endurance length rather than sprints. And you see that that sweat that salt, the you know, breaks down the epidermal barrier. Once again, it’s always about breaking down the epidermis, but in your body folds, you know where you’ve got armpit folds, you’ve got five fold, you got bud folds, you got boob folds, you got all the folds, those are the areas that that shaping starts to create a breeding ground for yeast and we all have yeast on our skin that’s normal part of our normal skin flora, just like staph is but too much of that starts to break down the skin and creates a rash situation called inter traigo which is basically a yeast infection and it can be painful, it could be burning and red and just a basically like your jaw Craw, you know or Dockage it’s basically that so I think it’s important that you know that runners wear sweat wicking material. I mean, cotton’s always ideal but cotton does not wick away sweat, it actually just absorbs it. So I would recommend that I would recommend getting those anti shave creams. I don’t know, you know, again, what brands you guys like but I know my husband’s always, you know, looks like the deodorant stick and he’s always putting in all his nether regions. So when he goes for as long runs, he doesn’t have those skin problems afterwards.
Rob Pickels 59:40
Yeah, I know. Gosh, when I was working at a fleet feet and dealing more with runners and triathletes that Body Glide. I think that that’s the stick that you’re talking about was was really important and this is something I think that people can apply everywhere. You know, I know that people use it under under their arms right because their arms then causes a little bit of chafing on their, maybe their tricep and their chest. Or as you said, in the nether regions, you know, I’m beginning to think that dermatology might be the grossest of the medical professions for what it’s worth, but
Dr. Lela Lankerani 1:00:13
now it’s awesome. You know, a lot of times like patients gets that point where they already have this rash. You know, we have to prescribe them an anti yeast cream with a little cortisone cream to help heal and then help reduce the over accumulation of the yeast. I mean, it’s an easy fix, but if you can prevent it, that’s always better, right?
Rob Pickels 1:00:33
Yeah. And that’s where maybe some itchiness, some redness? Those are the signs that you’re looking for that say, Hey, maybe you should go see somebody for this. And is this something that you should just treat topically like go down to the pharmacy, or do you need to start seeing dermatologist here? Well, I
Dr. Lela Lankerani 1:00:47
mean, I have a lot of patients who start off with like, just the over the counter stuff, and they’ll get like, you know, lamb muscle or they’ll get hydrocortisone, they’ll make their own little MacGyver concoction and a lot of times it works. A lot of times patients will get like just this dusting powders like Zia. zorb is one of those like antifungal like, powders for your shoes, you can put it in your body folds to prevent but I think when you add powder before you go for a sweaty run, it just turns into the pro soupy mess. So, so I think like, you know, always try treating at home if you know what’s going on with your skin. But if you get to the point where things aren’t healing, then yeah, an appointment to the dermatologist would be great.
Rob Pickels 1:01:26
The dermatologist is your friend. Yes. So when I think runners I think two things in one ear toe and toenail issues. And then the other thing is blisters is this stuff that you’re seeing in your clinic and how do we work with it?
Dr. Lela Lankerani 1:01:40
Oh, yeah. Well, so in terms of toes, like no, my husband has a runner toe which I’m always like, that’s a huge callus that I just want to work after. And he’s like, don’t touch it. Don’t touch it. I need it. It’s this protective little, you know, padding but a lot of toenail issues I see I see a lot of hematomas which is basically an accumulation of blood under the nail plate. So you’ve got your nail bed, and then your nail plate sits on top. If you’ve got poorly fit fitting shoes are too tight, and you’ve got that pounding pavement situation going at all times. You can develop a hematoma and lose your nail. I see a lot of times what we call para Nikias, which is just inflammation of the skin around the nail so you get these like painful red skin with a little bit of pus drainage along the edge think of it almost like a hangnail, if you will. We’re just it hurts you know when you go to touch it and it’s basically a bacterial and again a yeast inflammation situation because of the trauma to that nail. And then last but not least, I see a lot of people with like nail bed lacerations. Just yeah, it’s all that mechanical wear and tear that causes toenail problems.
Rob Pickels 1:02:52
And is this something that is just about better fitting shoes? Or how do we treat you know, maybe take the hematoma, for example, is this something that you know, you have to see a dermatologist for and maybe they’re draining that because you don’t want to lose your nail right at the end of the day, you want to try to keep your toenail or you want to get rid of that baby.
Dr. Lela Lankerani 1:03:11
However you want to keep your toenail but a lot of times that hematoma just lifts it up and you’re you’re just lost. You know, your toenail just goes by by and a new one grows in, it just takes a long time to grow in. And it’s painful when you’re waiting for that to come in. But I don’t typically see a lot of toenail problems because people either take care of it or they just dismiss it as not a big deal. I’ve never really drained a hematoma unless it was painful for somebody. So for something like that, I’ve never seen anyone come to my office asking me to drain their hematoma of their nail. Now I got a question for you guys. Because you know, there’s silicone toe pads, which I don’t know, do they even stick on? Like if you’re running and you’re sweating? Do those silicone toe pads even stick on when someone’s performing a long race?
Rob Pickels 1:03:55
This is way outside my jurisdiction. I don’t run anything long.
Dr. Lela Lankerani 1:04:01
Okay, I really don’t know what to do to prevent all these issues, I would say definitely, you know, proper fitting shoes, maybe if there’s time to do a sock change if it gets all sweaty and gnarly in there. Do that. But again, most athletes, I know, they’re so competitive. They just, they just keep on truckin because they’ll deal with their problems later because they want to win, right so
Trevor Connor 1:04:24
well. I’m gonna give a real easy one which I have learned the hard way. Because my my right foot I have lost my big toenail five times now. Yeah. Keep your toenails trimmed and keep them really short. Yes. Because what happens to me is I’m in a race and pushing really hard and several times I’ve just caught the toenail on the shoe and it takes it right off inside the shoe.
Dr. Lela Lankerani 1:04:49
So is this true? Yeah. Because if your nail is beyond your skin, that has more of a chance to lift right? So keeping it short, there’s no lifting at all. So Yeah.
Trevor Connor 1:05:03
I’m seeing on Rob.
Rob Pickels 1:05:04
I know that the best part is I love that you aren’t fazed by any of this like that you dermatology is recalling right? I’m like squirming over here.
Dr. Lela Lankerani 1:05:13
I love it. Nothing grosses me out. But it’s not for everybody.
Trevor Connor 1:05:19
I will certainly tell you if there’s ever a call for foot models and Boulder, I’m not getting the job.
Rob Pickels 1:05:24
Yeah. No, you’re the what not to do. Like,
Trevor Connor 1:05:28
yes, I’m the before. Yeah,
Rob Pickels 1:05:30
okay, let’s I don’t like toenails. Let’s move off from toenails. How about blisters? What the heck do we do with a blister?
Dr. Lela Lankerani 1:05:36
Know that this is a situation when if you’ve got a painful blister, and it’s just putting so much pressure and you’re like, I got to relieve it, somehow you get a sterile needle, you pop that sucker and drain that fluid out. And that fluid could be either blood, or it could be just what we call cero sanguineous, which is more of a clear sterile fluid. But I mean, it’s definitely again, from poor fitting shoes, or wearing those socks that are just saturated and sweat and water. And again, like there’s really nothing you can do about it. Once you get it, you get it. And all you can do about it is just let it heal or pop it and let that dry scab fall off on its own eventually,
Rob Pickels 1:06:15
but pop it pop it and leave the skin on. Right? You don’t want to move that layer. And
Dr. Lela Lankerani 1:06:20
absolutely not. Because that skin is basically your band aid, right? If you remove that skin, even though it’s dead and necrotic at this point, you’re removing your body’s own band aid and you’re opening that now to infection to bacterial infections mainly.
Trevor Connor 1:06:36
So I guess the last sport that I think is important to talk about here is swimmers I know they have some of their own unique challenges. I don’t know many of them, because most of my challenge with swimming is just keeping my head above water.
Rob Pickels 1:06:49
No survival. Yes.
Dr. Lela Lankerani 1:06:52
The biggest thing I do with swimmers is just you know the wetsuit. Right? So you’ve got the wetsuit that’s providing that second skin for either protects you from the weather in the water, or the temperature in the water, just to protect your skin from all that excessive exposure to chlorine or saltwater. The biggest problem that I ever see is, again, that shaping right getting that Road Rash right along the neck, where there’s that constant rubbing of the fabric or the neck line against that neck as you’re doing your strokes. So I would say that’s probably the biggest thing I see with swimmers is when they’re wearing that wetsuit, they’ve get thing that’s shaping around their arms, around their neck, around their ankles. And I think you know, from what I understand from my husband, the best thing to do is again, using that, is it that Body Glide or that shaving cream, just getting it on anywhere in everywhere that you might be ripping that wetsuit on and off of you and where there’s that junction of cloth against skin.
Rob Pickels 1:07:54
Something you mentioned, as you were just talking was was I believe saltwater and chlorine. How do those chemicals, I guess maybe salt water is not a chemical, but how does that affect our skin? I’m not a swimmer. I’ve obviously swimming pools and whatnot. But I could only imagine that you’re doing some damage when you’re swimming in chlorine water every day, how do we prevent that damage or deal with it?
Dr. Lela Lankerani 1:08:16
So I see a lot of patients who have really sensitive skin or they have a history of eczema, or atopic dermatitis, which is a fancy way of saying eczema. And that chlorine really dries out the skin. And so I encourage people who are in the chlorine, whether it’s for recreational or long term, you know, endurance thanks, once they get out of this pool to rinse the body off of that chlorine, not just water, preferably a mild so and get that chemical in that, you know, potentially dehydrating product off of the skin and then to moisturize immediately afterwards. So you know, not everyone’s affected by the chlorine, but a lot of people are and they start to get all Raschi from it, especially they’re in it all summer long or if they’re in it all year long.
Rob Pickels 1:09:02
I don’t know if you can speak to this. I’ve certainly seen some maybe more haircare product that’s marketed directly to swimmers because of the chlorine. Is there anything unique about a particular shampoo that helps out or is it whatever you’re using is perfect. Just make sure you’re using it? Yes, whatever
Dr. Lela Lankerani 1:09:19
you’re using is perfect. Like my daughter, she swims twice a week at the local swim center. And you know, her hair definitely gets really dry and brittle from all that chlorine. So I tend to tell her before she puts her swim cap on to put a conditioner in her hair before she throws a swim cap on so that you know if any water does get into her cap, which it always does. At least her hair doesn’t become brittle over time and straw like
Rob Pickels 1:09:46
great. I think the other thing that you see with swimmers right as we move beyond chlorine is they’re kind of wet all the time. They’re in a wet environment. I think that you know I was talking with some people on our staff and you know farming farming for topics here. You know, when somebody mentioned cargo rot, I had never heard of this before. I don’t know if that’s an industry term. But, you know, she described it as what seems like it might be like a fungal infection that occurs, or at least because of an abrasion around where your goggles are around your eyes. And she said, you can see in some people, yeah, they just have like these red lines, right where their goggles are.
Dr. Lela Lankerani 1:10:21
Yeah, and actually, I don’t I’ve never heard of that term, either. I’d asked my husband about that one, like, what the heck is goggle? Right? And he’s like, never heard of it. And so I don’t know if it’s necessarily a fungal infection. You know, our skin has yeast, like I said, but when I see that rang around the eyes, like a wreck who and like, to me, it’s more of a contact dermatitis, okay, that maybe that person is more allergic to the rubber or the latex that that Goggle is made out of, or it’s a frictional thing again, like where you just got that constant abrasion going against those tight fitting goggles. And it just irritates the skin and you get the, you know, the red scaly skin like in and around that area. And it’s, you know, simple to fix. However, it’s not simple when you’re truly allergic to that maybe what your goggles are made up. I had a scuba diver lady, oh, god years ago, she came to see me because she’s like, every year at the same time, I get this rash around my face. And so I asked her about her hobbies. And she’s like, why scuba dive, and I’m just like, I’m in scuba diving all my life. But for some reason, all of a sudden, she was allergic to the rubber in her scuba gear. And, you know, I was like, you’ve got two choices here, you either deal with it, and continue to do what you love, or you stopped doing it. Right. So of course, she continued it but was ready to deal with the consequences of it. That’s all that matters.
Trevor Connor 1:11:47
Before we get into our final suggestions, let’s hear from ex pro Steven Hyde and his overall suggestions about taking care of your skin when you’re training
Stephen Hyde 1:11:56
and sunscreen. And I’ll tell you I hate sunscreen is awful feeling on my skin I hate like my hair sticking down on my arms. And I hate the feeling of sweat pouring out of it. But put it on like Don’t be a baby, just put sunscreen on. I watched multiple people in my family and my friends get skin cancer cut off a little bit and they spent a quarter of the time that I do in the sun. So you know one thing that I’ve done in the last couple of years in my old age is I wear a lot more boxes. If it’s a module in terms of temperature, I’ll just push them so you know I can I can handle sunscreen on my legs a whole lot more than that. So just just go for once and eventually kind of start cooling off with the sweat.
Rob Pickels 1:12:45
There are more female athletes in endurance sports than ever before. Yet, until recently, female athletes simply follow the advice and protocols that have been designed and tested on men. This is now rapidly changing. And there are a host of experts bringing light to the perils and pitfalls associated with female athletes falling guidelines that are male specific. Check out our latest crafted coaching module coaching female athletes for expert guidance on coaching women. So we’re getting toward the end on the end of the episode, we did a great conversation about sun, how that damage can lead to sunburns and photo aging and skin cancer. We talked about some specific sports but what I’d love to do now is to really to zoom out take a big picture look, we’re all people how do we just take care of our skin better in general regardless of whether or not we’re an athlete, but what are just some basic skincare tips things that you should be doing so that you have healthier skin throughout your life.
Dr. Lela Lankerani 1:13:46
Sure, I’m just going to start with the basics a shower right so everyone should be showering every day. I think people tend to like the extreme temperature of their water you know really scalding hot because it feels good but it actually dries out your skin so I usually recommend in the shower to go lukewarm water to choose a mild so you know anything perfumey and anti bacterial can be a little caustic to the skin so choosing a mild cleanser that maybe doesn’t have all the bells and whistles and smells to it would be a better choice and to moisturize when they get out of the shower so they keep that skin nice and supple. Because as we get older we tend to dry out and then for doing other things like you know, swimming in chlorine water that’s going to further draw you out so just starting with that, okay, that’s number one. Number two, eating a healthy diet. You know, like food is medicine in my opinion, and I think you can watch how you eat what you eat to maintain a healthy skin. Yeah, I tend to coach my teenagers especially who have acne on you know, avoiding processed food, avoiding the high sugar contents drinking more water less Gatorade eating A diet less than saturated fats and less fried foods and just think of like a healthy Mediterranean diet, right? Eating more healthy fats and not Chick fil A fats. And if you do that, I mean, I can’t tell you how many patients I see who have acne who don’t need the antibiotics, because they’ve changed their diet around and then their skin has cleared up magically from just that, because all those foods I mentioned dairy, sugar, fats, the saturated fats, unhealthy fats, they all cause an inflammatory state, right. And so a lot of our skin elements are inflammatory. And so moderating what you eat and bringing that inflammatory state down, your skin magically clears up, not always, but most often, you’ll see a change in your skin if you you follow a good healthy Mediterranean diet. And then in terms of protection, we’ve talked about sunscreen being important, right? I think every day every one no matter what time of the year you’re in, or what climate you’re in, you need to wear sunscreen every day, UVA, UVB protection every morning. And then, you know, a lot of patients will ask me about well, what do you think about vitamin C? What do you think about retinol? I think Vitamin C is a great antioxidant, and it offers an extra layer of protection against free radicals. And so I tend to recommend vitamin C and sunscreen as your morning routine. And then at nighttime, I recommend doing a retinol if anyone’s concerned about anti aging, or how do I reverse some of the damage I’ve already done to my skin? I think Retinol is a wonderful tool.
Rob Pickels 1:16:36
Can I ask when you say vitamin C? Are you talking topical vitamin C or supplementing in your diet?
Dr. Lela Lankerani 1:16:42
I’m talking more topical. But of course vitamin C and your citrus fruits is very healthy overall. So but I’m talking mainly topical serums that contain vitamin C. Yeah.
Rob Pickels 1:16:53
And then you mentioned retinol at the end there. I’ve heard retinol can be a little bit difficult and make your skin more sensitive to sun exposure. Is that true? And is that why you’re recommending it at night and not in the morning?
Dr. Lela Lankerani 1:17:07
Correct. So you know, retinol acts like a chemical peel. It’s like a vitamin A derivative. And when you’re applying it, you’re getting almost this microscopic peel to the skin it’s removing, you know the top dead skin cell layers and so that makes you more sensitive, in general right to the sun and the sun actually D nature’s the RET mall ingredients. So this is why we don’t recommend it during the daytime. We recommend it at night so that you don’t have the denuclearization of the vitamin A
Rob Pickels 1:17:37
one other thing I’d love to talk about you had mentioned shower temperature earlier, I shower like twice a day every day because like I shower first thing in the morning and then I exercise and I shower after that, is there anything should I not be doing that? Should I not be washing my hair or using so how do I keep myself from all of this exposure keep myself healthier.
Dr. Lela Lankerani 1:17:59
I to shower two to three times a day. I don’t know how I have any skin left on me honestly. But if again, if you’re just doing the mild soaps, the lowers water temperature and your moisturizing after you get out of the shower, you can shower eight times a day. It’s not a problem. But I think where people run into the problem is they’re taking the hot scalding showers, they’re not applying moisturizer afterwards. And that’s when the skin starts to really dry out and cause rashes potentially. Now in terms of hair, when you over shampoo, you tend to again dry out the scalp and dry out the hair. And so I typically recommend just shampooing the scalp three times a week. If you’re sweating a lot, then I would say shampooing everyday would be fine because when you sweat, you increase your sebum production, which then can lead to dandruff and you know, oily scalp. And so in that situation shampooing the scalp every day is not a problem. But if you’re not sweating all the time, and three times a week is more than enough for shampooing the hair.
Trevor Connor 1:19:00
Well, I hate to say it but we’re a little over an hour. So I think it’s time to wrap up the show. Thank you for all the great suggestions and advice that you’ve given. Like I said, this is our first time diving into the subject of skin. So this has been really revealing even for Rob and myself and it’s been appreciated. But we finish out every show with a one minute what’s the most salient thing that you’d like our listeners to take from the episode. So let’s start with you. What What would you like everybody to remember from this?
Dr. Lela Lankerani 1:19:34
I just would like everyone to remember that daily sun protection is paramount, especially if you’re training in it. And it’s really easy to find the sunscreens these days. They’re a lot more user friendly. There are a lot more elegant to apply on the skin so there really should be no excuse as to why someone should not use it. Okay, so I definitely think people should aim for looking for a sunscreen that’s mineral based, that covers both the UVA and UVB spectrum, I think they need to at least think about between an SPF of 30 and 50. Because anything below is just not going to cut it. And anything above is unnecessary. And I really can’t stress the importance of re application every two hours. I mean, that’s where people run into the most problems. And by whatever means necessary, if that means just spraying it on after that original application with the cream, fine. That’s better than nothing like I had said earlier. So that’s number one. Number two would be if you are exposed, or if you have a history, if you are fair skinned or, you know, just exposure at an accumulation of exposure, I think having a dermatologist do your yearly skin checks will be one less thing that you need to stress that about, you know, let us stress out about your skin so that you don’t have to. And so making those yearly skin checks would be another important thing for those athletes that are exposed for years and years and years. That’s about my two most important take homes about that.
Trevor Connor 1:21:09
I think that was a good take home. So appreciate it. Rob.
Rob Pickels 1:21:12
Yeah, I’ll help him next. I think that there are so many great take homes from this and that everyone who’s listening probably has something that’s very salient to them. But the thing I want to do is just emphasize what Lila said last and our risk of skin cancer, or long term bad effects from the sun. They have been occurring and accumulating our whole life. Everything starts when you’re a kid. And I know unfortunately, I suffered a very severe sunburn when I was a child. And you hope and you wish that oh, well, that was back in the past. It’s not going to affect me today. But we need to unfortunately, we need to understand that it does. And we need to use that to make better decisions as we move forward. And we can’t necessarily change our past. But we can begin affecting our future by beginning appropriate skincare and sun routines now, but also, as you said, get checked out by someone I remember the first time and I have yearly skin checks with my dermatologist. But I remember I put it off for a couple of years, there was a few years where I’m like, I know I really should do this. But there was maybe a little bit of a self conscious nature a little bit of Well, I don’t have a problem now nature. And I think that a lot of people get into that mindset. But it’s better to begin this before there’s a problem than to begin this after there’s a problem. And I think oftentimes when we talk about maybe melanoma and skin cancers, catching that stuff early is life changing for the better, you know, so get out there do it this year, it’s the middle of summer you can go get a skincare check now and get one next year and get one the year after that. But it’s important for your overall health.
Dr. Lela Lankerani 1:22:53
May is melanoma Awareness Month and so like you know, I usually tell patients like maybe take your birthday month and make that your yearly skin exam or you know, if you think of melanoma think of May May in melanoma, right, I’m gonna make me your, you know, annual. So
Trevor Connor 1:23:11
it’s a good way to do it. Because I can tell you from experience I became very aware of melanoma in January after my 50th birthday. My takeaway on this, we have talked in the past on the show about how I’ll have athletes tell me they that they want to get really serious, and they’re gonna bump their training volume up to 18 or 20 hours a week. And my response is always I get you have the time to do that. But do you have the tools? Do you have the processes in place to be able to handle that? And often the answer that is no. So I think maybe some of our listeners have have listened to this episode and gotten skin care that’s kind of mundane. But I can tell you if there’s one thing that I’ve seen stop people from getting serious about their training, it’s because of that skincare, I have seen more than a few cyclists bump up to 20 hours a week. They get two weeks in of that sort of volume. And by the third week, they are a mess of saddle sores and blisters and abrasions. And their next week is five hours because they can’t even get on the bike anymore. I certainly remember one the first training camps I did. The final day was a seven hour ride. And I think I sat on my saddle a total of 30 minutes over that seven hours because I was in that much pain. And I could tell you all the experience riders at the center had very detailed from experience practices to take care of the skin so that they could keep sitting on that saddle. You know, one last thing I’ll throw in if this helps convince people and we’ve talked before about how there’s this type of inappropriate inflammation that you see in endurance athletes, that’s called SRS where they just get this systemic inflammation it kind of looks like sad. abscess. Will sepsis is the actual sepsis is your body fighting bacteria. And if you have these abrasions and you’re getting bacteria into the system, you’re getting yeast into the system, your body has to fight that and that can contribute to that inappropriate inflammation and that’s going to prevent you from training. That’s going to hurt your training adaptation. So this sounds mundane, but I’m honestly gonna say as an endurance athlete, it’s one of the most important things you can do with that, Leila. It was a pleasure having you on the show. Thank you so much.
Dr. Lela Lankerani 1:25:29
Thank you so much for having me. I’ve enjoyed this. Sorry, I couldn’t speak to the all the athletic problems because I’m not a huge athlete. But hopefully impart some wisdom. You
Rob Pickels 1:25:41
most certainly did. Thank you. That was another episode of bass talk. Subscribe to fast talk. Wherever you prefer to find your favorite podcast. Be sure to leave us a rating and review. The thoughts and opinions expressed on bass talk are those of the individual. As always, we love your feedback, tweeted us at Bastok labs or join the conversation at forums dot Bastok labs.com. Learn from our experts at fast talk labs.com Or help keep us independent by supporting us on Patreon. For Dr. Laila lung Karani Ryan Bolton Steven Hyde, Andy Pruitt and Trevor Connor. I’m Rob pickles. Thanks for listening