Derm-it Trotter! Don't Swear About Skincare.

That “sandpaper” patch you keep rubbing might be more than dry skin. We sit down with board-certified dermatologist Dr. David Cleaver to talk about sun damage, actinic keratoses, and why outdoor life in rural communities can quietly build a lifetime of precancerous change. If you have a history of tanning, years of farm work, construction, or just a lot of time outside, this conversation will help you connect the dots between chronic UV exposure and the day-to-day reality of prevention.

We dig into photodynamic therapy (PDT), a light treatment that targets a whole field of sun-damaged skin, not just the spots you can see. We compare PDT with liquid nitrogen freezing and topical field therapy creams like 5-fluorouracil and imiquimod, including why “less homework” can matter for real patients with real schedules. We also break down red light versus blue light PDT, how depth of penetration plays into the choice, and why many practices treat more often in fall and winter when sun avoidance is easier.

You will hear the honest version of the patient experience too: incubation time, what the light can feel like, how cooling devices and protocol tweaks can improve comfort, and what recovery looks like over the following one to two weeks. We also talk about newer directions, including FDA-approved red light use for superficial basal cell carcinoma in select cases, plus other emerging and off-label areas dermatologists are watching.

If you want practical skin cancer prevention that goes beyond “watch and wait,” press play. Subscribe, share this with someone who lives outdoors, and leave a review to help more people find it. What would you want to know before trying PDT?

DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.

Most skincare and dermatology treatments don’t fail because the medicine is weak. They fail because real life is messy, routines are hard, and “use this twice a day” turns into “I’ll start tomorrow.” We sit down with returning guest Dr. Steve Feldman, a board-certified dermatologist and dermatopathologist who researches medication adherence, to unpack what actually happens between the prescription and the bathroom counter.

We talk candidly about why topical treatments for psoriasis and eczema are uniquely challenging, how objective tracking (like smart bottle caps) changed what we thought we knew, and why the mindset shift matters: don’t blame the patient, redesign the system. Dr. Feldman shares behavior-based tactics you can use immediately, including environmental cues, written instructions, simpler dosing, and why frequent follow-up works like piano lessons. If you’ve ever felt guilty about not using a cream exactly as directed, this conversation replaces shame with strategy.

A highlight is the “three-day sprint” approach for scalp psoriasis using clobetasol, built around short timelines, realistic coaching, and accountability that mirrors why people floss right before the dentist. We also explore the future of patient engagement with AI in healthcare, including automated check-ins that may feel surprisingly supportive, plus persuasion tools like anchoring and the outsized power of a single story.

If you care about better outcomes in dermatology, skincare routines, and patient-centered care, hit play, then subscribe, share this with a friend who’s struggling with a regimen, and leave a review with your biggest adherence challenge.

DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.

A painful lump in your armpit is bad enough. Now imagine it keeps coming back, forming tunnels under the skin, draining on your schedule instead of yours, and forcing you to plan your day around bandages and friction. That’s the reality for many people living with hidradenitis suppurativa (HS), and it’s why we wanted a clear, practical conversation about procedures that can actually help.

We’re joined by Dr. Nader Aboul-Fettouh, a board-certified dermatologist and Mohs surgeon, to break down what HS is at the follicle level and why chronic inflammation leads to nodules, abscesses, scarring, and sinus tracts. Then we get specific about HS procedures and where they fit alongside modern medical therapy like biologics. We talk through intralesional Kenalog injections for fast flare relief, why standard incision and drainage tends to recur, and why deroofing can be such a high-satisfaction option when the same spot keeps flaring.

From there, we zoom out to the bigger toolbox: excision for long-standing scar “balls” that no medication can penetrate, plus niche and emerging options like cryoinsufflation, laser hair removal, CO2 laser ablation, photodynamic therapy, IPL, and even Botox for sweat and friction. We also cover real-world constraints that patients and clinicians face, including healing expectations, skin type considerations, and insurance coverage.

If you’re trying to build a smarter HS treatment plan or you care for patients with HS and want procedural options you can confidently discuss, listen now. Subscribe, share this with someone who needs it, and leave a review with your biggest HS question.

DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.

Psoriasis can look like “just plaques,” but the biology underneath is a lot bigger and a lot more hopeful than most people realize. We sit down with Dr. Naiem Issa, a board-certified dermatologist and dermatologic surgeon involved in dermatology research and drug development, to unpack what psoriasis really is: a genetically primed inflammatory disease that shows up on the skin, but also signals from within. We talk practical triggers patients actually recognize, from emotional or surgical stress to infection and skin trauma, and why the Koebner phenomenon can make injured skin a new target.

We build a clear map of the immune pathway clinicians rely on when picking modern psoriasis treatments. We walk through the immune “funnel” from TNF to IL-23 and TYK2 signaling, and finally to IL-17, the key effector cytokine that helps drive rapid skin turnover, scaling, and inflammation. If you’ve ever wondered why your care team keeps mentioning cytokines, interleukins, or “biologics,” this is the plain-English framework that connects those terms to what you see in the mirror and how you feel day to day.

We also get specific about IL-17 inhibitors and why “same class” doesn’t mean “same drug.” Blocking IL-17A alone, blocking IL-17A plus IL-17F, or blocking the IL-17 receptor can lead to meaningful differences in speed of clearance, durability, and what happens if you pause treatment. We discuss pharmacokinetics, withdrawal-arm trial data, time to flare, and the reassuring concept of recapturing response after restarting. We close with how we think through safety first, comorbidities like inflammatory bowel disease, joint involvement and psoriatic arthritis, injection preferences, and shared decision making.

If you found this helpful, subscribe, share it with someone navigating psoriasis treatment options, and leave a review with the question you want us to tackle next.

DISCLAIMER: The views and opinions expressed in the Derm-it Trotter! podcast are those of the host and guests and do not necessarily reflect the views or positions of the guests’ or host’s institution or employers. The Derm-it Trotter! Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.