♪ ♪ Hi, I'm Dr. Matthew Zyrs and welcome to Derms on Drugs, a new video podcast brought to you by Scholars and Medicine. Derms on Drugs is where cutting-edge Derm meets the medical comedy. I'm Matt Zyrs and each week I'm joined by my residency buddies, Dr. Tim Patton and Dr. Laura Ferris, and we use our 60 years of combined Derm experience to debate, dissect, and discuss the hottest topics in Dermatology. It's everything you need to know to be on the cutting edge of Derm. It's where you get to have some fun listening to us do the work of a journal club. So join us every Friday here at Derms on Drugs on Apple Podcasts and Spotify and in Scholars and Medicine. So let's go ahead and get into it. This week we've got a very special episode, and I am going to pass it off to Dr. Patton to kind of take us through one of the most interesting articles that I've seen in, say, the last six months. Dr. Patton, once you go ahead and take it from there. Yeah, so I'm going to talk about an article that is available online as of October in 2024 in the journal. Investigative Dermatology, it's by Cuchera at Al and it's titled "Evaluation of Benzene Presence and Formation in Benzell Proxide Drug Products." The article reported the results of tests that were performed on multiple over-the-counter BPO products. Do you know, was this the first, like, peer-reviewed article that you saw? Because I know the Benzell Proxide thing came out a while ago. March 2024. So this is October. Right. But in March, it wasn't like a peer-reviewed article, right? It was just like it was FDA citizen petition or something. All right. So this is like the first big peer review. Yeah, it was like an official, official article. Okay. All right. Okay. All right. All right. All right. Well, our guests might have more to tell us about this. Yeah. They may be able to look a little bit better. All right. So they looked at multiple over-the-counter BPO products to see if they could detect Benzell. Why do we care about Benzell? It's listed as a known human carcinogens. So that's bad. We can't avoid it entirely. It's all around us. It's around us right now. We're getting killed by Benzell. But we should make sure that we are being exposed to as little as it as possible. So this study performed four tests and I completely understood all of them. I have mostly this equipment in my basement. I actually don't have this. If I screw up any of these tests, that is totally my fault. All right. So first test, they took 111 BPO products. They incubated them for 20 minutes at 37 degrees Celsius. That is body temperature. And then they measured Benzell levels using GCM, a gas chromatography mass for something. 34% of the products tested at Benzell levels above two parts per million. That's the limit that is set by the FDA. Figure one shows the results from some of the products tested, proactive, like doing horribly. What are you guys doing proactive? The next test looked at one specific BPO product, Epsilon, it contains encapsulated BPO. When the product was kept at two degrees Celsius, even after 12 days, amount of Benzell was negligible compared to heating the BPO product to 50 degrees for normal people. That is 122 degrees Fahrenheit. Linear increase in Benzell over time. Did they also tested at room temperature? No, why not? Because honestly, they said they ran out of Epsilon. Why did you why did you test it at 50 degrees? That doesn't that just doesn't seem clinically relevant. They they make a note in the text that anecdotally something something or other at room temperature. There's no detectable BPO. All right. So last week BPO were benzene because I would hope no no detectable benzene. I'm sorry. All right. I would hope there was detectable BPO in the Epsilon. Yeah. Otherwise, it's not going to work. All right. So then the last two tests were, hey, let's what's it like when you put this on the skin? Does it like evaporate into the air and basically poison you from a vapor test? So they did they put the really highest level, which was this cleanser by proactive, which that's kind of a weird test to do, right? We put a cleanser on you, wash it off. It's not like you put it on your skin and leave it there. But they took this really, really high product that they put it on these plates. They did 24 hours in the dark and then they did it after exposing it to UVAB for a couple of hours. Figure three shows of the results of these and parts per billion. They converted that to like how many micrograms does this mean? So for the dark study, four micrograms of benzene and the UV BPO product, it would be 14.7, are dearly exposure, maybe on the order of 100 or 300 micrograms. So I guess those are small total amounts. And it was a product with really high levels of benzene. And like I said, it was a cleanser. So that's not really how we use cleansers. We don't put them on their skin. But even with the worst product and and using it in a way that we wouldn't use, the levels of benzene are really, really low. So, you know, that's the paper. So taking on face value, I'll get it face. What do you guys think? Benzene, are we worried? Are we not? Well, I, well, first I'll let you, I'll let you answer first. What did you, how did you feel after you looked at this article for the first time? So when I first looked at it, I thought, oh my gosh, this is like kind of frightening. And I guess it makes sense to get it really, really hot to accelerate what's going to happen. And this is mimicking real world. And you know, I thought, okay, I guess I should be warning patients or not using, you know, benzal peroxide. And I thought back to the sunscreen benzene stuff that we dealt with a couple of years ago. And, but, you know, on like kind of further critical review. And then looking at, you know, putting that into the context of real world application, I think it's less concerning. And then I kind of thought, you know, I'm interested to learn more like where did this all come from? Why did we start worrying about this? And, you know, why are we, are we making much to do about nothing? And, and I'll tell you, I had kind of a, when the benzene stuff first came out, I was like, this sounds like crap. Uh, this is ridiculous. I'm not going to blot. And then when this article came out, I was like, oh my god, this is in JID. It's been peer reviewed. This benzene sounds awful. Oh my god. I need to start telling everybody about benzene and good lord. I've been totally wrong. Uh, it was kind of my takeaway. And, and that's where I was putting it until Dr. Patton helped me find some, uh, alternative information that I'm now going to bring our guests in. Uh, so I've, we've got two really interesting people with us. So first Dr. John Barbieri, who is a dermatologist practicing a Boston, I believe at mass general, the Harvard system, uh, who's an extremely well known acne expert. And then we've got Dr. Michelle Wong, who is a PhD doctor, so a actual real doctor, not like the rest of us, uh, who is a cosmetic chemist, uh, who actually really understands kind of the methodologies that were, that were used. And so first, uh, just say hi to the two of you guys and appreciate you coming on the show. Thanks for having us. We'll be here. So let's just kind of get started here. So Michelle, take us through, well, you know what actually I'm going to give people the thing that they really want to hear first. So, so John is an very well known acne expert here in the United States. John, yes or no, in your opinion, should terms be like terrified or worried at all about benzene in benzoyl peroxide? No, I definitely don't think we should be terrified. I do think this is an important issue for us to think about how we can optimize the safety of these products, but I definitely don't think we need to be going to people's houses and like hitting the benzoyl peroxide out of their hands before it kills them either. You're going to take it off the acne guidelines? Yeah, I think it's still going to be in the guidelines. Okay. All right. Okay. So let's, let's kind of get into this. So Michelle, you know, you are a chemist. And so you understand all of this stuff in ways that, and John, I don't know if you happen to be a chemist as well, but me, Pat and Ferris sure aren't. And so kind of take us through, you know, were the methods valid? If they weren't valid, you know, how are they not valid? Like how would, how do you think about this? So I think the biggest problem is the way they've interpreted the data. So they've presented their methods as realistic, which if you actually analyze like the temperatures they use, the UV exposure they use, it's not really reflecting real world situations. And they do claim that it is in the discussion. And I think it's one of those things where in peer review papers, most of the time, people are looking at the methods, they're peer-reviewing that part. And then the discussion is kind of like hand wavy. Everyone expects some sort of puffery in the discussion. And so it doesn't really necessarily reflect realistic use. So they did actually publish another case. I love it anytime somebody uses the word puffery. You've got me, you've got me sold at puffery. All right. Sorry for interrupting. Yeah.
- Yeah, so they had two papers. They actually had one earlier in environmental health perspectives, which was the one where they presented their petition data on higher temperatures. So they heated up the benzal peroxide and measured the benzene. Benzal peroxide breaks down to make benzene, and that breakdown is faster with things like heat and UV. Sort of like that. I don't know if you remember from high school chemistry, but if you heat stuff up, you get more energy in there, you get more bonds breaking, you get more stuff happening. So they heated it up and they decomposed it and they measured how much there was, but then with their temperatures they used, they linked it to situations where it wasn't entirely realistic. So one example is, I mean, the 37 degrees and skin temperature, 37 degrees is like more internal temperature. Skin is a lot colder than somewhere deeper in your body. So skin is probably closer to room temperature than 37 degrees. It's like a good 10 degrees Celsius below. So 37 Celsius, I'm Australian. So I'm going to keep saying so. - So if you're a scientist, feel free to jump in. - For us Americans, 10 degrees Celsius is about 18 degrees Fahrenheit. So we're looking instead of 98 degrees, 80 degrees is probably skin temperature. - Yeah, so one of the main experiments they did was putting it at 70 degrees Celsius, which is 158 Fahrenheit, I know this one. And they said this was the temperature of a supposed hot car. But if you actually just go on Google and just look up hot car temperature, you'll see that it's actually usually 50 to 60 or 130 to 140 degrees Fahrenheit, which is a good chunk below. And they left it in there for two weeks. So it turns out they referenced a paper where they had a hot car parked in the full sun in Atlanta. And that day was like almost 40 degree day. So they had that in there for two weeks, which not really realistic, unless like global warming gets really hard. - 40 degree day for again, for all of our Americans, is probably like 110 Fahrenheit ballpark. - Yeah, so not super realistic for the JID with the UV. So they put it under a lizard lamp for I think a few hours. But I did some recalculation. So I recalibrated it to the UV index, which is largely UVB, which is what Benzl Proxide absorbs. So kind of similar to waiting the UV by sunburn. So it turns out to be the equivalent of a full summer's day worth of UV with UV index nine. That's like low for Australia, probably quite high for most of the US. And of course that was with the cleanser as Tim mentioned. Generally you don't go outside for a full summer's day with cleanser on your face. And again, that was still quite low. And also if you're outside, that Benzl is going to be drifting off. There's actual ventilation. It's going to be massively diluted. The main way we're exposed to Benzl is through inhalation. Not a lot goes through skin, but if you inhale it about half of that goes into your blood. I assumed a lot of it went through your skin. Yeah, you might think that, but our skin is actually a pretty good barrier to most things. And Benzl is one of them. So most of the studies done on skin exposure is with occupational exposure. Workers like having their hands in Benzl for hours. Usually it's like mechanics because petrol has 1%, which is I think 10,000 POS per million, Benzl. And so that gives you a sort of indication of POS per million, which is the unit they tend to use. So has anybody actually done this study just by measuring serum Benzl level? So have people who use Benzl proxide every day and see if you can detect serum Benzl? Yes, I can take that one. We've sorted it on that study. So using enhanced, there's data on Benzl levels. There's also data on what kinds of medication people are using. So we did a study using enhanced looking at people who were using Benzl proxide canadian products. We matched them, the people who were not trying to control for any other kind of lifestyle, socioeconomic, et cetera, variable that we could to make these people as similar as possible in every other way. And we found there's absolutely no difference in the likelihood of them having detectable blood benzene and no difference in the levels of blood benzene when they were detected between those two groups. So-- No, Johnny, I would have jumped in and asked you a question there for a second. So I'm big into dietary nickel. And dietary nickel is something where the normal blood tests are looking for like nickel toxicity where like, oh, my God, you'd have to bathe in nickel to be able to get it. They're not useful for detecting what I would call normal amounts of nickel that you would get in your diet. The testing that they did in NHANES for Benzl, if there was a clinically relevant-- potentially clinically relevant amount of benzene beginning to people's body, would it have picked it up? My understanding is yes. Again, I'm not an expert in the NHANES method. I wasn't there doing it. I didn't do that part of the study. But I think their methodologies viewed as relatively robust. And the fact that they do detect benzene and a number of individuals in both group, it's not just like everyone zero. And they're having a poor effect. They're detecting benzene in people because it's unfortunately around us in our daily lives. And they're not finding differences in those who are exposed to benzoproxide containing products. OK. That's going to be the answer in the end, right? And did you get to that now? I'm there. Yeah. Right. It's an observational study. So it wasn't designed for that purpose. There's always the potential for unmeasured confounding. They're relatively small sample sizes. So I wouldn't take it as like that's the answer. But I do think that it's reassuring. We also did another study looking in a larger cohort in trinetics of 27,000 individuals who are using benzoproxide again trying to match them as best we could to individuals who were and saw dermatologists for like a mole check. And again, here we were looking at cancer. So that's ultimately care about, right? Are you at high risk of cancer? And with the mean follow-up of over seven years for both groups, we didn't detect any differences in hematologic or internal malignancies between the groups. So again, all the caveats of observational data on measured confounding. But I do think both of those studies give us some reassurance that in real world use conditions, people who are using benzoproxide containing products don't seem to be at higher levels of having detectable benzene, they're blood, or increased risk of cancer. And as your doctor pointed out earlier, just do the thought experiment. Take the worst products that Valichere is, you know, including in their studies. And just think about the absolute level of benzene in those products. As Dr. Ong mentioned, absorption through the scan is less than like one to five percent. So it's not like it's going to give you skin cancer from being on your skin. The risk is that it aeroslizes you and you hail it. And if you think about the quantities of benzene that are even in those worst products that Valichere is testing, and if you give them the benefit of the doubt that all that testing is right, which is a whole secondary issue. But let's assume it's right. Let's take the worst product. That absolute level of benzene is very small compared to unfortunately the benzene we get exposed to from just existing in the modern world. And so when you do that thought experiment, that's kind of reassuring too, that it makes sense. That's probably not going to create a clinical risk. It's just like UV is a known human carcinogen. And when you sit inside a building, there's something UV goes in the window. You're getting exposed to some. There's no safe level of UV. But the actual risk of that is probably relatively low. Oh, John, I'm going to argue with you there, because we had a guest on a couple weeks ago, Dr. Richard Weller from the UK, who's actually shown that UV is highly beneficial from a cardiovascular perspective. Oh, yeah. There's that aspect of it too. But from a skin cancer standpoint, there's sort of a skin cancer. There's no safe level of benzene for lymphoma. But the dose makes the poison. You can have a low enough level where it's not really clinically relevant. Yeah. I mean, that's-- I tell people that all the time that if you want to look hard enough, like water is a horrible-- I always like-- I don't know, Michelle, I'm sure, in chemistry in the chemistry road, people talk about this all the time. But the horrible dangers of dihydrogen monoxide, which has killed more people than any other chemical in the history of the world-- in fact, a tablespoon of it can be absolutely lethal in thousands of people a year die from exposure. And the famous studies about this are you can get almost everyone to agree that dihydrogen monoxide should be banned in all shapes and forms. And of course, dihydrogen monoxide is water. You can make anything sound awful if you try hard enough. So what could you-- Michelle, could you maybe go into the lab valescher itself? This is not their first sort of rodeo of telling us that things that we wouldn't expect to kill us are going to kill us. Can you go into those details a little bit? Yeah, sure. So valescher has had a sort of history of submitting lots of petitions. I can't remember if this is maybe number 7 or something, but they started off with Zantak. Actually, they started off with something before Zantak. I think it was Val Sarton. But they found NDMA in Zantak and in Metformin. You might remember those cases. Zantak's been withdrawn from the market. But now that's been questioned. So they had Zantak. They tested it. And they found NDMA, which is a carcinogen. They FDA started investigating. Actually, it was like a worldwide investigation. It was like all the regulatory agencies around the world started investigating. And eventually, the FDA realized that what Valescher did was they heated it up too much. So GCMS is gas phase chromatography. So you need to heat up your thing until it's a gas and then pass it through a column. And it turns out when they heated it, the Zantak decomposed. And there's a photo in an FDA presentation where it's actually black. Zantak does not start off black. It starts off white. the little arm.
sample file was black and it turns out they generated the NDMA by heating up too much, which is kind of a running theme here. So they couldn't actually use any of their data because it was all not quite right. They had to rerun all the tests. With Metformin, that was also they detected it. They made a big fuss about it. It was in a whole bunch of newspapers. And it turns out, okay, so this might get a little bit into the weeds. But essentially with GCMS, you end up with a line and then a peak, like a little hump. And you measure the area of the hump. It turns out the hump for NDMA overlapped with the hump for something else. And so it got a lot bigger and they reported that all is NDMA. But it was, I think about half something else as well. So all their values were inflated, all their measurements. And so the risk was like a whole bunch higher than it should have been for just Metformin. So interestingly, pretty much every time a public health agency has made an announcement based on their own analysis of the data, they've always said something like there is not expected to be an actual adverse health effect from using these products. So the way that Valeschor presents their data, historically it's like a good order of magnitude above the risk of what the health agency's end up saying it is. So I think that's pretty reassuring in general for anything that comes from Valeschor. The big question is why? Like why are they doing this? So they mean, are they evil? Like why? I don't understand. In general, I like to think that most of these incorrect results are mostly from people genuinely trying to do the right thing and genuinely having their, just interpreting their results in an honest way. But Valeschor, I think there are a few other extra factors which might be relevant. So first off, in every petition, they do ask for the FDA to install them as like an extra layer of quality control for pharmaceutical/cismetics, which is kind of weird because the FDA has actually published papers specifically criticizing their methods, which is pretty unusual. So they specifically talk about like the double hump issue, for example, in one paper. But obviously like there's a lot of money in this sort of contract just like testing everything on the market. They did get a contract with the Department of Defence for this, which well done to them. They do also have ties with class action lawyers. There are some lawsuits that were filed before the petitions became public. So that kind of raises the question of, do they genuinely think this is in the public interest or is it some sort of financial motive? Well, Benzl Proxies specifically, a few people from Valeschor actually filed a patent over a year before the petition. And this patent contains the data on how much Benzl there is, similar amounts to their petitions and their studies. So again, big question mark about their public interest. And the Wall Street Journal has a couple articles about how these lawsuits were filed before the public announcements. They were also responsible for a dry shampoo story about Benzl and dry shampoo. And in the court filing, it seems like they sent a letter to Unilever to keep their testing info confidential. If they paid up, I think it was something like 1 million and then a quarter million every few months or something as a retainer. So supposedly that's been sent to more than one company. Extortion. And Michelle, I went in. Oh, a little legend. A little legend. You know, the patent thing is fascinating because I will tell you one of the reasons I was found this all credible is I couldn't think of a reason like why it's not like Valeschor is coming up with an alternative to Benzl Proxide that's like, oh, you should use our stuff instead of Benzl Proxide. But the patent that they filed on Benzl, I weigh to stabilize Benzl Proxide so it doesn't release Benzl. Well, once you've got a patent on that, you then need to get if you get people worried about Benzl and Benzl Proxide. Now everybody's going to want to use your method to make sure there's no Benzl and Benzl Proxide. So it I don't certainly don't know that there was anything, you know, nefarious going on here. But they certainly have a reason to want people to be worried about Benzl and Benzl Proxide. And it really becomes just a fascinating topic of sort of these kinds of, you know, webs of conflicts, potential conflicts of interest. And it's something, you know, I certainly even struggle with, right? I do a lot of work with a lot of drug companies. And then I talk about articles that get published. And so it's, you know, it's not like people are, you know, conflicts of interest are an innately a bad thing. But I think it's really important that we are aware of conflicts of interest, right? That's why we really try and make them well known whenever we're going continuing medical education or we're talking about a drug or a side effect or a benefit or whatever. So it's just fascinating. Man. John, I had another question about, you know, the practical advice you give people, right? I mean, there's like two ways you could go about it. You could take all this data on face value. Like, don't read into the details. There were products that did really well, even with these unrealistic experiments, cleaning clear, a quite neutrogen of Walgreens. None of the products, even with the crazy testing of vouchers seemed to be doing here. None of those reached that two parts per million set by the FDA. So you could say use those. You could tell them to refrigerate the product with the Epsilon data, certainly. But that kind of lends, like maybe more creams than you need to. And so the opposite way is to be like, yeah, this lab is kind of shady and don't believe anything. They say, just use whatever you want. Is there an in between which way do you lean towards? I think there's a few parts of that question. So first, you bring up, there's a lot of heterogeneity in the different brands in their most recent paper in the journal, and that's gave dermatology. And we actually took a look at their data and article on JAMA dermatology. And when we did that, we found a lot of that heterogeneity is actually explained by the formulation of the product and potentially some of the manufacturing conditions. Like, how much heat might it, the product being exposed to when they're making it? And so I think you can actually look at that heterogeneity. And it's an important opportunity for us to think about the supply chain, but how we formulate and distribute these products and opportunities to make them safer overall. I would be a little bit careful of like extrapolating those like this brand is good and this brand is bad. Like they went to, you know, a store and product like it could be very different if they bought it from a different store. We don't know how replicable those findings are. So I wouldn't use those the call out products. But I do think it gives us some good hypotheses to test in terms of what kinds of strategies when making a product keep them to having the lowest levels of benzene. In terms of actual suggestions for patients kind of from a common sense approach, I tell people like, you know, benzal proxy products, they do have the potential to break down into benzene when exposed to high temperatures. So, you know, try to store them at room temperature or cooler. I don't actually think we need to say refrigeration. Gallicia is never shown that refrigeration is helpful comparing refrigeration to 50 degrees shows 50 degrees is bad. It doesn't show refrigeration is good. I have no idea like you pointed out why they do room temperature. To me, that's the obvious comparator if you want to make that claim. That's so important. Even if you only had enough product you want to do room temperature versus cool, but they didn't do that. I'm not sure why maybe we'll find out at some point. But so I don't tell people necessarily need to refrigerate it. It probably is better just because in general, cool or slow as things down. I think room temperature is likely fine. Our data when we looked at it didn't show any real risk with room temperature storage. Each 100 days closer to the expiration date you get on the products is associated with less than a one part per million increase in benzene. So I'm not so worried about that. I just say room temperature will air if it's past the expiration date or more than a few months throw it out. And I do think it has some implications for direct to consumer things. If you buy something on Amazon and sits on your porch on a hot weather and, you know, Florida for five days while you're on a trip, that might actually lead to me. Meaningful benzene. And so I do think we can be a little bit thoughtful about shipping things like direct to consumer stuff, not maybe an important part of counseling. But beyond that, I think just common sense handling of the product is all we really need to do right now until we learn something more that changes our data. So John and Michelle got an interest. So Pat and actually brought up something related to this a few days ago that made me, right? So I send a fair amount of prescriptions now to these compounding pharmacies that, you know, are putting, you know, these three ingredients together that you can't get together in, you know, any other way, especially for rosacea, that kind of stuff. And like, if I was like, do we need to be worried about that stuff? Like none of that's been tested. Like is you, we don't know what the hell's in there. Like this. I'm still not worried about it because I figured that, you know, the pharmacies are reputable. They're not trying to like whatever they're. Do you think there's any concern around that kind of stuff, you know, based on, you know, your experience in Michelle John, do you, do you either of you think, you know, is your answer, like, no idea? Or like, ah, maybe? Like what's, how would you think about that? I think with compounding, there's always a risk. compounding like the
the formulations just aren't really tested as much as an off-the-shelf product. So in general, I would probably not really go for the compounding option if it's an option. Yeah, it's really hard to say just because there's so much variability with how it's compounded, what it's compounded into, what sort of base cream they're using, that kind of thing. Okay. And so the part of that takeaway is maybe it's worth getting to know if you do, if you send compounded scripts, maybe it's worth talking to the pharmacy you send it to just to make sure that you're comfortable with them, that you've kind of done your due diligence. But it's another interesting topic that just really never, it wasn't on my radar before this. Well, John and Michelle, I really want to thank you guys for coming on. This has been such a fascinating conversation. And I really hope it's going to give our listeners a kind of a different perspective on this whole benzene and benzoproxide issue. Anything to either of you would like to say before we sign off? I'm saying, you know, I do think this is an issue I'm glad we're talking about it. I think we need to take it seriously, but not also means not over-react. Let's not freak out and start doing too much. One really, in general, a lot of the clinical data, just the thought experiments suggest that it is probably safe to use benzoproxide products when handled appropriately. You all right? Yeah, and I'd also add that sometimes things that you think would improve might not necessarily improve it. So, like, I don't actually really like the fridge advice because benzene is gas, well, it's very volatile, it turns into gas. And fridges are usually airtight. So, it could actually be if you have a room temperature tube sitting in your bathroom, which is relatively well ventilated, compared to putting it in a fridge where it's trapped. And fridges, I mean, you're only decreasing the temperature by like 20 degrees Celsius. If you think about actual energy with, like, Kelvin, the other temperature scale, it's not actually decreasing it by that much. So, you might actually be trapping the benzene and then getting a giant whiff every time you open the fridge. So, yeah, it's best not to over-react when the risk is not that good. So, before we go, I do want to put a plug in for Michelle's YouTube channel, where she just said it was the first place that I really was introduced to Dr. Wong. So, what is your, is there a name for your, you have a name for your shot? I actually don't know very much how YouTube works. Is that your main platform or what's your channel called? It's called Lab Muffin Beauty Science and yet that is probably my main channel these days. And what? John also has a great channel, but I feel like most dermatologists probably know about that. What? What kind of stuff do you cover on there? Like, is it all sort of benzene or benzoproxide or is it into, you know, does this product work? Does that product not work? How did that, like, what is your channel like? I mostly break down the science behind different beauty products for a general audience. I talk about skincare, mostly hair care these days because lots of people have tons of questions about that. There's things like rosemary oil. There's a lot of debunking of trends. Interesting. But that is something that we as Durham's going to ask a lot about. And it's just hard to keep up on. I mean, it's really hard to keep up on, you know, does this work, does that work, whatever. So I think a channel like yours is super useful and coming from somebody who knows what they're talking about and is reputable. And they're really well done videos. I mean, I've watched a few of them now and you just, you do a really nice job. So I really want to encourage everybody to check it out if you're interested. And again, it's tell us the name again, lab, where the hell did name lab muffin come from? I needed a name to start. I was never going to start if I didn't think up a name. I thought up the first name. I could change it later. Didn't change it. It's been 12 years. Okay. So lab muffin on YouTube. And really, I got to just tell everybody they are really well done videos and really entertaining. I actually really enjoyed watching them. So thanks guys for coming on today. And again, really appreciate it. So thanks for joining us this week for this fascinating conversation with Dr. John Barbieri and Dr. Michelle Wong. If you've got questions, comments or ideas for topics we should cover on the show, shoot us an email at
[email protected]. Again, that's questions at termsondrugs.com. And hope you learned a few things from the interview today. Hope maybe you laughed once or twice. And mostly, I hope you're planning to join us next week. And until then, I'm Matt Zyrus. I'm Tim Patton. I'm Laura Ferris and we are Dermsondrugs.
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