This is Open Mind. Today, we're peeling back the layers, literally and figuratively, on what your skin reveals about your health. It's often where underlying health issues become visible, and most people don't realize that skin health comes from the inside out and can't be fixed by expensive lotions and potions. They may be helpful, but not if you don't get the foundations right. Did you know that your skin is not just a protective shell, it's actually your body's largest organ, making up about 10% of your total body weight. Your skin says a lot about your overall health, and it's like a window, revealing what's going on beneath the surface. There's a lot of common skin problems, things like acne, psoriasis, eczema, and rosacea, and they're not just bad luck or random, or just some unfortunate occurrence. They're signals from your body that something deeper needs attention. In functional medicine, we're in the business of the medicine of why. We ask why is this happening? Not what disease you have, but why? Now, conventional medicine focuses on what? What's the diagnosis? What's the disease? And what do you need to give to fix it? What disease? What drug?

It could be steroids or topical agents that sometimes might be necessary, but mostly can be avoided with diet and lifestyle changes. And of course, you're going to avoid their troubling side effects that sometimes come from the treatments. So if you're struggling with different skin issues like acne, rosacea, eczema, psoriasis, and you're curious about what they might be telling you about your internal health, what's going on inside your body, I want you to stay tuned to this podcast because we're about to uncover how the best skin care starts from within and why understanding the why behind your skin's condition is the key to achieving lasting and radiant health. Hi, I'm Dr. Marc Hyman, and welcome to Health Hacks. Here's the deal. The doctor often will say, Okay, you have dry, scaly, itchy, white patches on your skin. I know why you have those. It's because you have psoriasis. Well, psoriasis is just a name that we give to people who have those symptoms. It doesn't tell you about the cause. And psoriasis can have multiple causes. We're going to go down and dig deep into that. And you have to treat the right cause or a patient won't get better.

Now, in functional medicine, we We want to understand the full picture by looking at all the relevant signs and symptoms and your medical history. And we do a bunch of diagnostic tests to help figure out what's going on at the root of the problem. And we then address the root causes by optimizing your nutrition, healing your gut, removing toxins, optimizing your nutritional status for the right supplements, getting the root cause. You're going to learn that the root causes today are not the same for each individual with exactly the same diagnosis. If you have 10 people with eczema or 10 people with psoriasis, they may have different causes and need different treatments. And not just a one-size-fits-all prescription, which is what we get in traditional medicine. In fact, no two people have the same cause for the same skin condition. The good news is there's a lot you can do to optimize your skin health from the inside out. I always say beauty comes from the inside out, not the outside in. Now, the inside out approach to skincare doesn't just mask the problems, it addresses the root causes. If you have terrible skin, you can put a lot of makeup on, but that doesn't fix your skin, right?

Now, if you got a lot of inflammatory stuff, you can put you a bunch of steroids on your skin, but that's not going to get rid of the cause. I'm going to share a case with you in a little bit, but it's pretty impressive. Functional medicine is really about addressing the root causes, and the side effect is that the rest of your health gets better, too. It's a good side effect. Let's get started on this journey to decode what your skin is really revealing about your health. Let's start with the top skin conditions that people suffer from. Acne, that's a big one, right? It's when the pores of your skin clog and produce black heads and white heads and other types of pimples or cystic acne, which is horrible. It's pus-filled painful bumps on your skin. Acne is the most common skin condition that people experience. About 80% of people ages 11 to 30 will at least have some mild form of acne. It's also common during perimenopause and menopause. All right? So you just go through puberty and menopause, you get a hit on both ends. Now, eczema is another common skin condition that caused your skin to become dry, itchy, bumpy, red, inflamed.

And it basically weakens your skin's barrier function. And your skin This barrier is responsible for helping your skin retain moisture, protecting your body from outside elements. And it's a dermatitis. We call it anything that's inflamed is an itis. So dermatitis just means inflamed skin. It affects over 31 million Americans. It's a lot of people running around itchy and unmiserable, right? Infants are really prone to it, about 10 to 20% have it, and there's reasons for that. It has to do with C-sections, breastfeeding, microbiome issues, depletion of the microbiome. In fact, most infants are born to mothers who've taken antibiotics, which destroys a key bacteria called Bifidobacterium infantis that is necessary to regulate immunity, and often kids have low levels of this, and they need to have it replaced. Actually, the good news is you can actually give it to your babies. Souris is a different form of dermatitis that is a little bit different than eczema. It's actually an autoimmune condition in which the immune system mistakenly attacks healthy skin cells, and that leads to rapid skin cell turnover and thick scaly patches on its plaques. It's really uncomfortable. It's painful, it's itchy, and people often get joint pain.

That's psoriatic arthritis. It's one in three people with psoriasis get this psoriatic arthritis, which is more serious because that destroys your joints. And about 3% of the population has psoriasis. Now, dry skin, we all know what that is. It's basically the skin's automated to retain moisture, and that can lead to rough, scaly, itchy skin. And it can have a lot of causes, like thyroid issues or food sensitivities or nutritional deficiencies like omega-3 fats. And so you might have just dehydration, but it can be a lot more. The term for it is called xeroderma, which basically means dry skin. There's all these medical names, but they don't really mean anything, and they don't tell you anything about what's going on or why. Another big problem that he will have is acne rosacea or rosacea. This is a common inflammatory skin condition. It causes redness on the face, like usually on the cheeks, other parts of the body, sometimes the eyes. It can basically sometimes cause little pimples and swelling, and it affects about 14 million people. You've seen this, people have that red lines on their face. Sometimes alcoholics have it, and you get dilated blood vessels, and it's pretty disfiguring and miserable.

It can affect a lot of people, but often people who are having fair skin or women after the age of 30 will get it. What are the root causes of all these symptoms? They all have the same underlying root causes and the same mechanism, which is inflammation. We're going to talk about what causes inflammation and how that leads to various skin issues. When you have a skin problem, it's often a manifestation underlying skin inflammation and inflammation in the body. That results from an interplay of a lot of different factors, mechanical factors, underlying biological, biochemical factors. What are the top drivers of inflammation? Inflammations causing all these skin issues Then why is there inflammation? In functional medicine, we keep asking why. Okay, well, you have a skin problem. Why is... You have a skin problem? Well, inflammation. Well, why is there inflammation? Well, let's get into that. It's everything from your gut to toxins to hormones. So many, many things drive inflammation. The biggest one for many people is hormonal imbalances. That, particularly what I mean is insulin resistance, which causes high testosterone, and that testosterone can cause large amounts of acne. Also stress, which is a significant factor, can also cause high cortisol and cause hormonal imbalances there.

A lot of nutritional deficiencies, everything from vitamin D, omega-3 fats to vitamin A, Zinc, and many, many things affect your skin health. Underlying underlying balances in your gut is one of the biggest drivers of skin inflammation, including what we call a sebo or small intestinal bacterial overgrowth and leaky gut, and also sebo, small intestinal fungal overgrowth. A lot of skin issues are related to fungal issues, particularly rosacea and psoriasis and eczema, by the way. It can be from poor metabolic health and coming from an inflammatory diet. A lot of the refined foods we eat, the refined oils or processed foods, they're highly You can be dehydrated. That can affect your skin, genetics sometimes. As I mentioned, this significant imbalance in your gut flora. Let's unpack these a little bit, and we'll start with the gut. When you have imbalanced gut flora, it's called dysbiosis. It's the opposite of symbiosis, which is a healthy balance. This is an imbalance in your gut flora. You get basically bad bugs that cause inflammation. The inflammation causes a leaky gut. The leaky gut leads to systemic inflammation, and that leads to skin issues. Basically, Basically, these imbalances are important because there's a huge relationship between your gut microbiome and your skin.

They call this the gut-skin axis. Now, many skin conditions show the same underlying root cause, which is a leaky gut. Now, when you go to your dermatologist, they're not asking for a poop test, but they should, and they should assess your food sensitivities and a leaky gut and your microbiome and figure out what's going on. And yet they don't do that because it's not in their paradigm. But you need to because if you don't, you're just going to be putting a on the problem and not dealing with it and not getting rid of it. So let's talk about leaky gut. What is a leaky gut? Well, there's a gut lining that is a single cell layer that's held together by something called tight junctions. They're like Lego connections. They're just these connections that you stick together and they stay together. The food is supposed to go through the cells, not between the cells. When those tight junctions are loose because of injury, because of inflammation, because of toxins, because of stress, because of dysbiosis, overgrowth of bad bugs, whatever the reason, too much gluten, you end up loosening those junctions and then food particles that are partially digested and bacterial toxins leak into your system, get across that single cell layer that's basically separating your body from a sewer, which is inside your gut lining.

And that poop and bacterial toxins and fungal toxins and food sensitivity leak in and get in touch with your immune system, which is right underneath your intestinal lining. That's where 60% of your immune system is. When you have a good healthy gut, you don't have a leaky gut. It keeps the nutrients going through. It keeps harmful substances out. But when they're damaged due to inflammation from all the things we talked about, the imbalance gut flora, the toxins and so forth, stress, then you get undigested food particles, toxins, microbes leaking in, and basically your immune system goes on high alert and creating antibodies, and then you end up with a lot of issues. So these skin conditions that we see, like eczema, psoriasis, acne, are often associated with a leaky gut. Okay, if a leaky gut causes these problems, then what causes a leaky gut? So we keep going, Okay, Skin condition, psoriasis, okay, caused by inflammation, okay. Well, why is there inflammation? Well, leaky gut. Well, why is there leaky gut? We keep going until we get to the end. That's the goal of functional medicine. So if you have a leaky gut, the number one cause is dysbiosis.

That's when bad gut bacteria outnumber the good ones, and that leads to inflammation, and that damages the gut barrier, and that is a big factor. If it's dysbiosis that causes leaky gut, what causes dysbiosis? I think you're getting the point here that functional medicine is all about being incredibly persistent about finding the why, and the why of the why of the why or the cause of the cause of the causes. Really important concept in functional medicine. And most medicine stops at the diagnosis, we start with the diagnosis in functional medicine. We start thinking and linking instead of naming and blaming. Naming and blaming is, Oh, you have all these skin things that look like this and that. The other thing, Oh, I know. You have eczema. That's what you have. Well, that's just naming the disease and then blaming the name for the problem. That's why you're itchy and scaly and why you have all this redness on your skin and ooosing. It's because you have eczema. No, that's just a name that we give people who have these same symptoms. So what's the cause? Question is, what causes, despite What's our diocese then? Well, it's primarily our diet because guess what?

You're not just eating for you, you're eating for that whole little ecosystem of bacteria that live in you. And when you feed them bad stuff, like ultra-processed food that's high in sugar, refined grains, and starches, it's low in fiber, that's low in essential nutrients for the gut health, you're getting into trouble. Then on top of that, they contain all this other stuff that actually causes a leaky gut, like gums and emulsifiers, food additives, preservatives, bad fats, refined oils, trans fat. They basically just feed all the bad bugs, and they call it inflammation, and that disrupts the gut lining. The other thing that can sometimes cause a leaky gut are certain foods. The biggest culprit here is gluten. If I see someone with psoriasis or eczema or acne, I'm thinking, or rosacea, I'm thinking wheat, gluten, top of my list. Dairy is right up there, particularly for eczema. Gluten, particularly more for psoriasis But you have to test and look. Now, some people have full-blown celiac disease, and I had a girl with severe eczema. I mean, not even any I had ever seen before. She was about three years old. She had eczema basically from top to toe.

She had vaginal eczema, so she had to go pee when she was in my office and went to the little bathroom in my office, and I heard her screaming, just peeing because it hurts so much to pee on all the raw, red, inflamed skin. And it turned out she was celiac, and She had also significant yeast overgrowth. So basically, I gave her an elimination diet and an antifungal, and it all went away. And then I found out she was having something that I think had some gluten in it that she didn't know. It was like nut milk or something that had some additive or something that had some gluten in it, like barley malt, I think that was, and soy milk or something. She ended up actually still having a reaction. We got her off that and finally got her all better. Now, there's a lot of other foods besides dairy and wheat, but eggs can be problematic for some people. Soy, tree nuts, different things. But you have to see what reacts to you. Also, you can do testing to figure it out. The people can react to all sorts of components of food.

These foods then, again, create a leaky gut. Then the proteins get through there, interact with your immune system, you create antibodies, you create inflammation, and this whole cascade of inflammatory skin conditions. And then you get things like psoriasis, eczema, acne, and so forth. Now, what about psoriasis? Now, psoriasis is a big one, and I You know when you've seen this commercial, the heartbreak of psoriasis? Well, it's pretty awful to have because you're just miserable, itchy, and disfigured even with these horrible plaques that are all over your body. And worse, you can get the arthritis, which then destroys your joints. So it's really a serious condition. Now, people with psoriasis tend to have higher prevalence of celiac disease. And it's one of the factors that I see is people who eat gluten and are reacting to it, one of the manifestations can be psoriasis. Studies have found higher levels of what we call anti-glycan antibodies against the gluten. So antibodies against gluten, protein glycan, are called anti-glycan antibodies. And they see this more in psoriasis patients with controls. And I've seen this in my practice over many years. A big study, meta-analysis reported that psoriasis patients have a 2.4 times higher risk of elevated antigliden antibodies, with 14% testing positive for IGA antigliden antibodies versus 5% of healthy controls.

Basically, that's three times the level of reactions to gluten. They may not have full celiac. They may just have slightly elevated gluten antibodies. Now, elevated celiac antibodies did not correspond to biopsy-confirmed diagnosis of celiac. There's a whole phenomena called non-celiac gluten sensitivity. I think this might be worth a whole Health Act podcast in itself, talk about gluten, because everybody's gluten free here and there, and they don't know what they're doing. It can sometimes not be necessary, but it is a real problem. A lot of people, maybe up to 20% of people, have some type of non-celiac gluten sensitivity. When you do that, when you have the psoriasis, it's a reaction to the gluten. And the gluten itself can cause another problem, which is more leaky gut. Gluten can trigger the production of xonulinin in your intestinal lining, which is a compound that promotes the disruption of those tight junctions and the disruption of the gut barrier and leads to a leaky gut. And then it becomes even worse because then the gluten proteins get through. And then the second layer is your immune system starts react and creates a systemic inflammation. So it's a big problem.

There are other factors that can cause psoriasis. Yeast overgrowth is a big one. I talked about that little girl. Also, the other issue is that you can have heavy metals like mercury. I've had a number of psoriasis patients with heavy metals that we finally got the metals out and their system cleared up. I had one patient, I'll just tell you a quick story from Cleveland Clinic, who was a 50-year-old business coach. She had psoriatic arthritis, terrible plaques, was on a drug that caused about 50 grand a year for that. Still not taking care of it, but maybe slightly improving the symptoms. She had severe migraines, depression. She was prediabetic. She had reflux, and she had terrible irritable bowel, with bloating, distension, digestive issues. Rather than give her a bunch of drugs, she was on a bunch of drugs, by the way. She was on drugs for depression, for her migraines, for her prediabetes, for her psoriasis, for reflux, for IBS. She was on drugs for everything from every specialist. They're all great standard care, but it didn't really deal issue. I was like, What's causing all this problem? I was saying inflammation. It's probably her gut.

I basically put her on an elimination diet. I gave her things to clear out the bacterial overgrowth and the fungal overgrowth and the antibiotic and any fungal, rebuilt her gut with probiotics. When in the sixth week, she came back and her symptoms were completely gone, No more psoriasis, no more arthritis, no more migraines, no more depression, no more prediabetes, and no more reflux, and no more irritable bowel, and she was off all her medication. Now, it doesn't always go that way. That was a great case, but she really had a tremendous response just by dealing with the root cause. Acne is another I want. I love taking care of acne patients because it's so easy, and most people don't realize what's driving it. Now, the big one is dairy. If you have acne, stop dairy. I know when I have dairy, I'll get pimples. It's almost a guarantee. It's a well-described phenomenon It has to do with all the hormones in milk. There's often 60 different hormones in milk naturally, and they're often treated with hormones to increase milk production, like growth hormones. They disrupt our hormones, human hormones. They increase sebum production, clogged pores, and they contribute to acne.

The milk proteins are whey in caseing. They're regulating something called insulin growth factor I. We know that high IGF1 levels are associated with increased sebum production of acne. Basically, when you get dairy, you're getting all these hormones that drive other hormones that then cause more issues. Inflamation in the gut, meaning dairy can be an issue. You can get lactose intolerance that causes inflammation in the gut, and that may create more acne breakouts. What about skin milk? Well, a study published in the Journal of the American Academy of Dermatology suggests that skin milk milk, is actually more problematic than whole milk due to the glycemic impact in fewer vitamins, minerals, and essential fatty acids. So there's less fat, which means it's more sugar, more lactose, and you're ending up with endglactose and other milk sugars, and that might be a factor. Other things can actually cause an issue of stress. Stress can elevate your cortisol levels due to psychological stress, and that causes leaky gut. It also causes more prediabetes and insulin resistance, which causes more inflammation, which can cause more skin issues, and that will mess up your hormones. Everything is connected. The whole body is connected in one big web of biology, and we have to think about things in that way.

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Things you know make you feel better, even when it's impossible to make time for them, like the workout you try to squeeze between your kids' activities, work, and everything else you have going on, or before you know it, it gets pushed to tomorrow. Does that sound familiar? But it's these moments when you feel like you have no time for yourself when these non-negotiables are more important than ever. Those are the things that keep you strong, healthy, motivated, and prepared to take on everything life demands of you. So why not make therapy one of them? Betterhelp Online Therapy makes it easy to get started with affordable phone video or live chat sessions you can do from anywhere. And the option to message your therapist between sessions if anything comes up. Never skip therapy day with Betterhelp. Visit betterhelp. Com/healthhacks today to get 10% off your first month. That's betterhelph-e-l-p. Com/healthhacks. H-e-a-l-t-h-a-c-k-s. What about bacterial and fungal infections? I touched on that earlier, but they can really cause a leaky gut. The big one is small intestinal bacterial overgrowth or sebo. Really common, it's where bacteria migrate up from the large intestine. They're not supposed to be in the small intestine except the lower part, and they go up in the upper part.

Then when you have that, it causes all sorts of issues. You get bloating, distension, you get that food baby feeling. You often need to get treated with that with anti-microbials, it can be herbal or prescription like rifaximen, which can be very helpful, and it's not absorbed. But you need to really address the overall problem, which is why you're having this in the first place. Now, if you have sebo, it can make skin conditions worse, like acne, eczema, psoriasis rosacea. The other big one is fungal overgrowth. We call this CFO, some people call it Candida, but it's many other fungal species than Candida. They actually can also cause intestinal permeability problems or leaky gut. That allows toxins and inflammatory molecules to enter the bloodstream and worsen or trigger rosacea. In fact, you can actually treat the rosacea with any antifungals. My go-to is giving people antifungals, and also for psoriasis, This is incredibly helpful. Again, it's not common practice, although if you look at the literature and you just Google fungal/soriasis or fungal, fungus or fungal infections and eczema or whatever, you're going to find stuff. Now, there's certain medications, too, that can cause a damage to the gut, anti-inflammatory drugs like Advil.

Acid-blocking drugs also really disrupt the gut because they prevent acid production, which is needed for digestion. Then when you have maldigested food, it goes in the small intestine, it It's an alkaline environment. It causes the growth of fungus and bacteria in there and is not good long term. Also, other medications may cause problems like antibiotics and so forth that disrupt the gut microbiome, and then they lead to dysbiosis and a leaky gut. What else can cause a leaky gut? Well, environmental toxins. That happened for me. I got a leaky gut from mercury poisoning and all kinds of skin issues that developed rashes and sores, and it was miserable. And That can be from, obviously, even topical exposure to pesticides and things can cause an issue. But it's mostly the slow levels that cause disruption on the inside. Heavy metals, petrochemicals, air pollution, they cause skin issues and they affect your gut function in part. There's also seasonal changes that affect skin, sunlight, humidity, dryness, sweating, showering, friction, dust, pollen, all those things. What are the consequences of having a leaky gut? Well, the most important consequence is it drives inflammation throughout your whole body, and the main driver of skin conditions is inflammation, so it's all connected.

A leaky gut also impairs the absorption of really important nutrients that you need for healthy skin, like vitamin A, vitamin D and E, vitamin K and Zinc, and omega-3 fats, and that leads to either insufficient or deficient levels. Now, what else can cause skin issues? Well, genes. Sometimes there's genetics involved in increasing your atopic risk, meaning your risk of having eczema or psoriasis. Hormone imbalances also can be a factor. If there's hormone imbalances, for example, from high levels of testosterone or DHT or DHEA, then that can be from puberty, menstrual cycle irregularities, PCOS, menopause, all these things start to change. Typically, high levels of androgens in women is caused by something called polycystic ovarian syndrome, which is typically caused by insulin resistance. That causes inflammation and leads to more sebum production if you're higher testosterone, and that can lead to clogged pores, and then you get more of these issues. So one of the root causes of high androgen levels is high insulin. We talked about this, and then why do you get high high insulin, high sugar, and starch diets, low fiber diets. Insulin binds to something called sex hormone binding globulin. And it makes more testosterone available in the circulation, which then increases sebum production and makes acne worse.

It can also contribute to psoriasis, so high insulin levels can cause psoriasis. In fact, a study of 21,789 postmenopausal women from the largest women's study ever, the Women's Health Initiative, found that higher baseline insulin resistance, which is measured through a calculation called HOMA-IR. Now, there's actually a new test from QuEST called Insulin Resistence Score, which is actually very accurate, and I would encourage people to get that test. It's really important that measure your insulin resistance resistance, and it's more effective than any other diagnostic. When they had a high level of insulin resistance, in this study, there was a significantly increased risk of developing psoriasis over 21 years old. Women with a high HOMA-IR, which is a measure of the insulin resistance, had a 39% higher risk of psoriasis compared to those with no insulin resistance. That's a lot. This suggests that insulin resistance is going to proceed and actually contribute to the risk of psoriasis. Also, high insulin levels cause other skin issues skin tags, which you'll get in the neck, armpits, the groin, and people with diabetes. It can cause also something called acanthosis nigrans, which is a darkening and thickening of the skin.

It's common in high insulin levels. It increases the triggering of what we call keratinocytes, which again causes thickening of the skin. It can lead to dry skin. Too much sugar in the body pulls fluid from your cells and actually caused you to do that in order to get enough fluid to to excrete the excess sugar. It's a vicious cycle. What other hormones can be a factor? Well, thyroid hormones are a big factor because one in five women and one in 10 men have low thyroid function. When you have low thyroid function, it affects everything in your body, including your skin, your hair and your nails. And dry skin can be a symptom of low thyroid function. When you have hypothyroidism, everything slows down. You slow down your metabolism and you can have dry skin and reduce sebum or oil in your skin. Sex hormones are another factor. We talked about testosterone, fluctuations in estrogen, progesterone during a woman's cycle, during menopause, perimenopause. They can increase skin sensitivity, they can increase redness, flushing, and they can even cause acne rosation. Also high cortisol, number one. That's a big factor in skin issues. Chronic emotional stress, psychological stress, increases something called cortisol.

That's your stress hormone. That makes inflammation worse and triggers or worsens skin flarrops by affecting immune and inflammatory pathways. It also increases semen production inflammation leading to acne. People are on steroids, often acne, not just androgens, but also cortisol. Then it can create this vicious cycle of suppressing immune function. They can be used as a treatment for eczema and psoriasis, but they also aren't great because they weaken the skin and the collagen. People with high cortisol actually get stretch marks. You see that. Certain infections may be a factor, and this is not uncommon. For example, Staph aureus, which is a common skin bacteria. It produces these super antigens that activate the immune system and cause local inflammation, and they can worsen things like eczema or atopic dermatitis, psoriasis. There's also even a strong association between certain bacteria and rosacea. One of the topical treatments for rosacea is Flajol or metronidazole. So it's an oral treatment. Might be helpful, but there's often a way to fix the gut and get rid of this imbalance in the first place. There's also a growth of something called demodex mites. These are skin mites. They can trigger an immune response and inflammation in rosacea patients.

Research is also linked in infection with HPalori, which is a bacteria that causes stomach ulcers, and they can cause acne rosacea. So somebody's got to check that and treat the gut that way. Also, there's a lot of nutritional deficiencies that cause skin issues because they regulate your immune system. They regulate inflammation. So omega-3s are a big regulator of inflammation in your body, and 90% of us are low on that. And if you have omega-3s, not only are you more prone to these other things like eczema and psoriasis, you also get other issues with your skin, like dry, scaly, patchy spots if you're omega-3 deficient. This is an essential fatty acid. It's like essential vitamin. You need it, and you can't get it from your body's own production. Your body has to get it from food. This is a small wild fish, but you can also take it. I recommend taking it. Also, a lot of other nutrients are important for skin, like Zinc, Selenium, vitamin C, vitamin A. Often people are low in vitamin A, get these little bumpy spots in the back of their arm. That can be also from thyroid or even food sensitivities.

Vitamin D is important, vitamin E, great for skin. Antoxidants are also really because they help reduce inflammation. Lifestyle factors will drive inflammation. If you're dehydrated, if you don't sleep, if you're not exercising, if you're stressed, all important. Also, there's environmental factors that can mess your system up, like mold and environmental allergens. Allergy is actually common in people have eczema, and this might be not a true food sensitivity, but more of a true allergy. It's like a peanut allergy. But people have eczema, tend to have more IGE-related allergies and react to all kinds of things, including environmental stuff. Sometimes people use chemicals on their skin that cause issues, like harsh chemicals and soaps, detergents, cleansers, a weird microbeads, plastics. Actually, all these plastics cause abrasion, break open pores, and they can actually work in worse than acne. And also alcohol-based skincare products dry the skin. They're not good. Also, aging is not great for our skin. Our skin produces less sebum. It loses its ability to retain moisture. It becomes drier. There's less collagen production. And that, of course, affects skin elasticity, hydration. So typically, those are the things that are driving the skin conditions. But what's the conventional medicine approach to inflammatory skin issues?

Well, it's not taking care of all these issues. You get to a dermatologist, right? And most Some of these treatments are aimed at reducing inflammation or suppressing the immune system to help calm symptoms, but they don't address the root cause of the inflammation. For acne, what it'll do, it'll give you benzoproxide, which is a topical treatment to kill bacteria. Use retinoids like Retin A or They give you acutane to reduce inflammation. They give you antibiotics, which may change the gut flora, like erythromycin, clindamycin, which can be problematic and really cause more long-term problems. One of the stories I often see is when kids are in their teenage years, they'll often get antibiotics for years for acne. Later on, they'll have secondary effects, even if they've stopped the antibiotics from the damage they've done to their gut, which then causes leaky gut dysbiosis, and that leads to autoimmune diseases. It's often a common story to start out with gut issues, skin issues, get antibiotics, and then get autoimmune disease. They'll also do a lot of hormonal treatments with oral pills like birth control pill. They use something called spurnalactone, which is often regulating testosterone that contributes to acne.

There's side effects from these. You can get burning, dryness, irritated skin, flaky skin, gut imbalances. So not a great idea for a lot of these drugs. What about eczema? How do doctors treat that? Well, they use steroids, topical steroids, immune suppressants, biologics, which are very serious. They're very expensive and suppress your immune system. They'll use antihistamines, moisturizers, emollients. All that stuff is fine. They use UV therapy, phototherapy, which is fine, but it doesn't really deal with the cost. What about psoriasis? What do they treat that with? Well, again, steroids, immune suppressants like methotrexate, cyclosporin, biologics, these TNF alpha inhibitors, interleukin inhibitors, PDE inhibitors, PDE4 inhibitors. They don't really cure the problem. They just manage it. What about rosacea? Well, again, they'll use antibiotic treatment and inflammatory creams. They'll use metronitisal, as I mentioned, or flageol, tetrocycling. But again, they don't deal with the cost. How do I think about treating skin issues using the model of functional medicine. The way I handle these skin issues is basically the same way I deal with anything else. Get to the root cause. Identify the imbalance. I address the cause. It's usually diet and lifestyle. Help the body repair, regain balance, fix the get rid of toxins, balance hormones.

It's basically following the functional medicine foundational principles of how you treat somebody. Then the body's natural intelligence basically takes care of the rest. If you're working with a functional medicine doctor, where you come see us at the Ultramunis Center, we'll take care of you. It's important to start with comprehensive lab testing to look at the root cause. We mentioned, for example, the fungal overgrowth, the bacterial overgrowth, or deficiencies in nutrients, or increase in risk of thyroid issues with certain problems, or other factors like gluten, which may be tested on lab testing. So you need to look at these things, heavy metals. Now, sometimes you may not need them, but probably you mostly need to figure out what's going on. And the other thing that I look at are some of these specialty tests, like food sensitivity testing, allergy testing, testing the stool microbiome, testing for bacterial overgrowth, we call it Ceebo test, which looks at methane, hydrogen, sulfide in the gut. We look at food sensitivities with Cyrex testing. We'll look at HPalori if you have rosacea through either a breath test, stool test, or even antibodies. We'll do food allergy, IGE profiles, and you can really look at a lot of this stuff.

Now, I co-founded a company called Function Health to help you identify stuff, and there's ways you can check for indoor and outdoor allergies on that. With the IGG testing, you can look at a celiac panel, and you can go to an independent lab, but you need to find someone who's going to work with you to do this, where you can be autonomous and do it on your own and check gluten and food allergies and nutritional deficiencies. Many things I talked about, thyroid, omega-3s, heavy metals, insulin resistance. All these things are in the basic function health initial set of tests that you get when you're a member. You can go to functionhealth. Com/mark. There's a lot of people in the waiting list, but that allows you to jump the waiting list of 200,000 people, and it'll help you get those tests at a very reasonable cost, including hormones that we're going to talk about. What else you need to test? Hormones, testosterone and other hormones like Dihydrotestosterone, Andrewsteindione, IGF, stress hormones like cortisol, toxins like lead and mercury, looking at your white count, whether you high levels of neutrophils or lymphocytes, eosinophils, can tell you a lot about what's going on with the gut microbiome, with what's reacting in your body.

We look at nutritional deficiencies like omega-3, Zinc, iron, vitamin D, magnesium, all part of the panel. We look at your metabolic health, like insulin glucose. Basically, you get a full assessment of what's going on. Most people are pretty surprised by what they find because people have stuff. If you don't look, you won't find it. There's a long time between often diagnosis and the onset of problems because doctors don't look. What do you do if you want to treat this? How do you approach this? How do I think about this as a functional medicine doctor? Well, the first step is to get rid of the bad stuff and put in the good stuff. That's basically all functional medicine is. It's being a detective, find all the bad stuff, gut issues, food sensitivities, toxins, hormonal dysregulation, whatever, get rid of it, and then add in the good stuff, the right food, nutrients, etc. The first thing is to get rid of the foods that potentially can be triggering inflammation in the skin. The most common cause is food. I would try elimination diet, and that's really a three or four weeks. You get rid of the most common allergens and the potential triggers, including dairy, gluten, soy, eggs, peanuts, tree nuts, shellfish, corn, processed food, sugar, caffeine, alcohol, nitrates.

Now, you can do a more limited one. It's a little easier. I call it the 10-day detox diet. You can have eggs in that and nuts, but it takes out most of the grains and dairy, gluten, all the ultra-processed food, and it usually works for most people. You can check that out, 10-day detox diet. Is the book, and lots of resource on that. What you can eat, though, is as important as what you don't eat. You need lots of anti-inflammatory foods, whole unprocessed foods, veggies, fruit, nuts, seeds, good quality protein, healthy fats. Some gluten fruit grains might be helpful. The second phase is the reintroduction. You want to do it slowly, one food at a time, every three days, no more. For example, eat dairy for three days and see if you react, and then eat gluten for three days and see if you react. You don't want to add everything back at once by going to have a pizza, which is going to cause a problem because you don't want to know what's what. Then you might feel like crap and don't know what was causing it. The challenge phase is after you've identified food reactions, you can actually wait a little longer, maybe another few months, try to heal your gut, and then try to rechallenge your body to see how much you can tolerate.

If you're really having a reaction, like if you have dairy and you get eczema, well, just don't eat it. You're not going to be able to eat it. Or you might try sheep or goat. That'll really help you identify what's working. Now, there's some tests that you can to help track which foods are reacting, but almost the gold standard is what we call elimination provocation testing. That allow you to know which to take in your back in your diet and which to keep awake. I had one patient who was really quite amazing. She was a young woman in her 30s who was literally allergic to her boyfriend because of his sweat. She would have these horrible rashes all the time anyway. Her face was all red. She had itching everywhere. She was reacting to everything. It was really horrible terrible that she was struggling so much. And so what I said, just do an elimination diet. Let's get your gut sorted. Give her probiotics, give her Zinc, give her fish oil, give her vitamin D, give her good resources to help heal her gut, and see what happens. And it was quite amazing. She basically quit all the inflammatory foods.

She got off gluten and dairy, sugar. She went on the 10-day detox diet. She had a complete resolution of her symptoms, and she has no more reactions, and she's doing great. So the body can heal. First thing you have to do is quit all the bad foods, right? Get rid of not just the food sensitivities, but all the inflammatory foods, all the ultra-processed food. Gluten and dairy are the number one and two culprits when it comes to inflammation in the diet. Of course, besides sugar, refined sugar, flour, all that stuff is really bad. All the inflammatory fats, refined oils we eat. You want to be eating a low glycemic, nutrient-dense, Whole Foods, anti-inflammatory diet. I jokingly call it the vegan diet. And what does that do? Well, it balances your blood sugar. It's higher in protein, in micronutrients, phytochemicals, fiber, good fats. That helps you balance your blood sugar and your hormones. You don't get all the hormonal surges, you don't get the high androgens. It helps reduce inflammation in your body in general, and it makes your skin look better and makes you younger-looking. It also provides a lot of the essential nutrients we need for skin health.

You also want a lot of polyphenols. These are really important. These are colorful plant compounds like phenolic acid, flabinoids, steelbing lignins, resveratrol. These are just all these incredible medicines in food that help reduce inflammation and reduce oxidative stress. A lot of the damage in skin is because of inflammation and oxidative stress. It helps repair damaged DNA and damaged lipids. It improves all your skin damage you might have had and reduces skin lesions. It inhibits the growth and the stimulation of T cells, which is good in psoriasis, and it accelerates wound healing, which is awesome. These polyphenols can increase the benefit because they help decrease the expression of IGE receptors, and we call tole-like receptors on mast mast cells. Mass cells are the cells that are releasing histamine that cause eczema. Mast cells are like the guards of the immune system. They help protect you from infections and allergies by releasing the things that you don't like, but they have a benefit like histamine. These mast cells have IGE and TOL receptors that when they come into contact with an allergen, like a pollen or pet dander or pathogen, like some toxin, they cause them to release histamine and all these other inflammatory cytokines and itching.

You You've had a histamine reaction when you get a bug bite, for example. If we decrease the expression of IGE and TOLAC receptors on the mast cells, it helps prevent too many of these cells from releasing histamine, and it makes you feel better with less allergy symptoms. The big question is, how do you eat for better skin health? What are the skin-supporting nutrients and where do you get them? Both phytochemicals and polyphenols and good fats and all the stuff we need. There's a lot of these things we need. All right, so what else do you need to do besides focusing on eating skin supporting nutrients? Well, focus on your gut health. What we do and what I do in functional medicine is double down on the gut. I basically do an elimination diet, an anti-inflammatory diet. It's basically an addition diet. I eliminate the bad stuff and add in the good foods. Then I focus on gut health as the next step for fixing the skin, which is so counterintuitive. Your dermatologist is probably not talking to you about your digestive system or your gut symptoms. Oh, am I bloating? Oh, go see the gastroenterologist.

Well, no, that's the problem. That's why you're having skin issues. You have to treat the bacterial overgrowth, the fungal overgrowth, all that stuff. You can use herbal products. I use oregano, for example. I'll use something called kendebacetam, AR, and BR, which are great natural anti-microbials, both antifungals and antibacterials that help. You can get those on drhymen. Com. I have a supplement store. I've sourced the best quality products, or you can maybe find them somewhere else, but be careful of the source. It's also important to repair the gut lining, and there's a lot of things that help do that, like bone broth, the amino acid and glutamine, different kinds of colostrum. I use SPI Protect from orthomolecular. That's a great product that helps support the gut healing. In fact, in a 12-week, double-blind, placebo-controlled trial published in Nutrition, patients with acne who consumed lactoferrin-enriched fermented milk, like colostrum, basically. They show significant improvements in their acne symptoms compared to those who consume fermented milk without the lactoferrin, which is beneficial compound from colostrum. The lactoferrin group experienced a 38% reduction in inflammatory lesion count, a 23% reduction in total lesions, and a 20-point reduction in the acne grade, which is the way to categorize acne severity.

That's pretty impressive. Even further, the sebum content went down by 31% in the lactoferrin group. Really, really awesome. Now, you want to eat prebiotic and probiotic-rich foods. Those are important. You want to have the right bacteria. There's a lot of versions of these bacteria, but I'm just going name a few. We need a diverse array of bacteria to help support our gut health. I'm just going to name a few probiotics like Lactive Bacillus Rhamnosus, Gg, Lactive Bacillus kci, Paracacii, Lactive Bacillus acidophilus, Bifidobacterium longus, Bifidobacterium lactus, Lactive Bacillus plantarium. There's a lot of different strains, all which are available in a multi-strain probiotic that we use, I like seed, for example. They modulate the immune system and they help reduce inflammation. You can get them also from food, right? Fermented foods like yoga, kefir, sauerkraut, kimchi, miso, tempe, all great. The probiotic supplements are in capsules, powders. I would encourage higher doses like 5 to 10 billion, even more. Other supplements are also important for your skin health. Vitamin D is essential, right? It helps maintain skin barrier function and immunity and helps regulate the cells that produce keratin in the skin. It also is effective for improving psoriasis and eczema, too.

Normal vitamin D in labs is said to be over 20 nanograms per deciliter, some labs say 30, but it should be 45 or more. And that's not going to be enough for psoriasis flares, and we really should aim for higher concentrations. In fact, higher levels of over 100 may not be harmful and actually are protective against psoriasis flareups, and more might be better. You have to watch your levels, make sure it get toxic. But anybody can take 5,000 units a day. My favorite is vitamin D Supreme from Designs for Health. You can take vitamin D3 from pure encapsulations. They have up to 10,000 1,000 a day from that. It can be helpful. But you have to test. You have to know what your levels are. Test before, test after a few months, get the dosing right. Vitamin A also really important. It promotes skin growth and renewal, particularly in the form of retinol. It helps regulate the production of sebum, the growth and shedding of your skin cells. It's really important for your gut lining integrity, prevent a leaky gut. It's also essential for your immune system functioning. When you have enough vitamin A, it enhances turnover of cells, allows the new cells to replace the old ones, and that leads to smoother and more even skin.

That's why retin A is used for wrinkles. A lot of food sources, retinol is the preformed version of vitamin A, which you can get from only animal foods like liver. It's the best source, fish, egg, yokes, Carotenoids are a pro-vitamin A. They're not an active vitamin A. They can be converted into vitamin A, but some of them don't do that well. But they're obviously in the orange and yellow vegetables, carrots, sweet potatoes, pumpkin, butternut squash, red bell peppers. Also, it's in leafy green, spinach and kale. But the conversion rate from carotenoids, the vitamin A is low, maybe anywhere from 8 to 60 something %. People eat a lot of carrots or sweet potatoes can develop caroteneemia, which can turn their skin in orange yellow color. I had that once. I decided to drink a lot of carrot juice at one point in my life, and all of a sudden my skin turned orange. I had to stop that. But that doesn't get converted to vitamin A as well. Now, you might want to supplement. You might actually need vitamin A as a supplement between 2,000 to 5,000 units a day. You don't want to take an overdose of that.

Cod liver oil is great. It's a good source of vitamin D, omega-3s, and even vitamin A. My favorite omega-3 is really important because omega-3s are so important for skin health. They make your hair lustrous, your skin nails strong, your skin clear and shiny and moisturized. The one I like is Big Bold Health omega-3 rejuvenate. It's got extra anti-inflammatory compounds, and it's really great for you. It's the one I take every day. I usually do about 2,000 milligrams a day, which is two capsules. Zinc picolinate is really good for your skin, too. Zinc is really important. You can do thorn zinc picolinate, about 30 milligrams a day. If you have acne, you might need more, up to 50 milligrams. Zinc can sometimes interfere with the absorption of other minerals like copper. If you're taking Zinc supplements for a long time, you might want to think about adding a little copper or have a multi that includes copper. What else is good for your skin? Well, there's something called evening primrose oil that has a very special fat called GLA. Gla can reduce inflammation It helps different skin conditions like eczema, psoriasis, and dermatitis. It helps your skin look great.

It helps elasticity and firmness. It makes you look younger. You can get it from Evening Primrose oil, from hemp oil, spirulina, borage oil. Actually, one of my tricks was there's an oil that contains both flax oil and borage oil. I think it's called Barlean's Omega Twin. When people have dry skin in the winter, I have them put it on their skin, and it's amazing to clear everything up and make your skin look great. What other nutrients are good for your skin? Well, selenium is important, about 55 to 2,000 micrograms a day. I like selenium with thiamine. Vitamin C, also important for collagen and inflammation, is a great antioxidant. I like liposomal vitamin C from Designs For Health, about 1,000 milligrams a day. Vitamin E, also really important. It's a great antioxidant. It helps skin healing, repair, moisturize your skin. My favorite is Metagenics E-Complex, and it has a mixture of tocofferols, not just alpha-tocofferol, which is the main one in most vitamins, but also delta and gamma, which are more anti-inflammatory and antioxidant. There's some herbs that can help, like curcumin. Designs For Health curcumin is great. Curcuma veil, it's called curcumaVale. 400 milligrams a day is great.

Again, you can order these online, but I also go where I curated the best products, and I did a lot of work on finding the best in the market. Most of them were physician-grade, and you can go to drheimen. Com to learn more about them and check it out. Proper hydration is really important. A lot of people are dehyd. Often, I encourage people to use electrolytes with their water at least a couple of times a day. Use half your weight in ounces of water per day. If your weight is, let's say, 180 pounds, you need 90 ounces. Also, light is great for your skin. Ultraviolet B phototherapy is very good. It helps with different skin disorders like psoriasis and eczema. There's narrow and broadband. You want to be careful. It can burn the skin, but it reduces general inflammation and helps the skin barrier and decreases the overgrowth of cells, like hyperplasia, which is called overgrowth of cells, and it can do that for psoriasis. So UV phototherapy is really good for reducing the abnormal thickening of the skin and by targeting the hyperactive immune pathways for psoriasis. The UVB also helps promote healing and can normalize the skin's immune response, and that can help the healing process and reduce the severity and frequency of flareups.

But I would just say that if you don't deal with the other causes, you can do all the UVB you want. It's just going to basically make you symptomatically a little better, but it won't get rid of the problem. If you do want to do it, you can try it in conjunction with everything else. But I wouldn't just do it alone. You probably could do it two or three times a week. The frequency depends on how severe it is and your response and so forth. But basically start with a low dose and you gradually address the frequency, duration, intensity of the sessions based on your progress. Now, there are home units. You can get UVB phototherapy at home through lamps, bulbs, handheld devices. You can get natural sunlight. It's free, hard to control the dose. But bottom line is your skin is a window to your overall health. Things like acne, rosacea, eczema, psoriasis, they're not just random annoyances. They're signals that something deeper is going on. Now, true skincare starts from within. By embracing an inside-out approach to skincare, focusing on gut healing foods and tackling the root causes, you can unlock lasting, radiant health and beautiful skin.

And thanks for joining me on this journey to uncover what your skin is telling you about your health. I'll see you next Tuesday on HealthX.