Peter Lio, MD discusses highlights from his lecture Controversies in Integrative Dermatology on Friday, November 4, 2022 at the PA/NP Elevate-Derm Conference in Tucson, Arizona.

In this video

Dr. Lio frames integrative dermatology as bringing together conventional, evidence-based treatment with therapies from other traditions in a coordinated way — "ultimately we're really just trying to get the patient better using all the tools in our toolbox." But he doesn't shy away from the legitimate criticisms. He points to "snake oil" approaches where patients use things that may even have evidence against them, and warns that even harmless-seeming remedies can hurt patients by delaying optimal care.

He also stresses that the FDA regulates the product, not just the ingredient — so a product claiming to contain aloe vera won't necessarily do what a study of a different formulation showed. And he cautions against the assumption that "botanical must be safe," noting that patients on "poly supplements" mixing 10 or 15 herbs sit far from the evidence and can face liver toxicity or heavy metal contamination. Still, with an open mind, good patient communication, and areas where safety data rise to the top, he believes clinicians can practice integrative derm in a way that enriches everybody and helps the patient get better.

  • Integrative dermatology means coordinating conventional, evidence-based care with complementary therapies — using every tool in the toolbox to get the patient better.
  • Beware the "snake oil" approach: some remedies have evidence against them, and even low-harm ones can hurt patients by delaying optimal care.
  • The FDA regulates the final product, not just the ingredient — a supplement listing aloe vera won't necessarily replicate the results of a differently formulated study.
  • "Botanical" does not equal safe; poly-supplement patients mixing many herbs risk liver toxicity and heavy metal contamination, and sit far from the evidence.
  • With an open mind and strong patient communication, clinicians can lean on the integrative areas where safety and evidence rise to the top.