Mayo Clinic Dermatologist: 5 Small Habits for Healthier, Younger, and Amazing Skin

Hey, it's friend Mal, and welcome to the Mal Robbins podcast. I'm so excited about the conversation today because we have one of the single most respected dermatologists at the Mayo Clinic that is running two different research labs. She is here to teach you what your skin is trying to tell you about your health. Isn't that cool? You can know more about your body, your health, and how well you're going to age just by looking at your skin. And right now, you might be ignoring things that need your attention, whether it's dry skin, rash, brown spots, acne, thinning hair, psoriasis, other common skin conditions, could be telling you something on the surface about your overall health beneath your skin. Dr. Serenia Wiles discovered that there are only five things you should do right now that have a major impact on the health of your skin and the health of your skin has a major impact on your overall health. And today, she's going to share those five things with you. What you learned today from Dr. Wiles will leave you feeling smarter and more empowered about your skin and your overall health. I want to invite you to stick around later in the episode to hear all about something called The Clean Slate brought to you by our new sponsor, Mrs. Myers. It's something that will help you clear up both physical and mental space and you're going to absolutely love this. Hey, it's your friend Mel and welcome to the Mel Robbins podcast. I'm really excited for today's conversation. I think you're going to be blown away. It's an honor to spend this time together if you're a new listener or somebody shared this episode with you. I just want to personally welcome you to the Mel Robbins podcast family before we jump in. You're going to love this episode. We're going to learn today what your skin reveals about your health with one of the most incredible medical experts we have ever had on the show, Dr. Serenia Wiles. Dr. Wiles is a dermatologist, physician scientist, and one of the leading researchers working at the intersection of regenerative medicine, skin aging, and longevity at the Mayo clinic. Wait to hear these credentials. She earned both her MD and PhD from the Mayo Clinic Alex School of Medicine, completed a research fellowship at the Harvard STEM Cell Institute, and then completed her dermatology residence and advanced training at the Mayo clinic. Today, she leads the regenerative dermatology and skin aging laboratory at Mayo clinic. She is also the medical director of the Center for Ethetic Medicine and Surgery and an associate professor at the Mayo Clinic. Holy cow, are we in for an unbelievable episode today? Please help me welcome Dr. Serenia Wiles to the Mel Robbins podcast. It's great to be here, Mel. It's incredible to have you here, so thank you for taking the time out to teach us about our skin and what our skin is trying to tell us about our health. Would you start by speaking to me and the person who's here with us about what could change about our life or our health or how we feel if we take to heart everything that you're about to teach us about our skin? I am so passionate about this, Mel. Your skin is more than a beauty scorecard. It is actually information. It's a two-way conduit between the outside world and the internal systemic health that you experience. Your skin is your check engine light. It reflects your overall health. If something is starting to go wrong in your body, it can often times show up on the skin as different signs. So pay attention to the clues that it's giving you. In addition, it's a great way to influence your overall health in those distant organs, too. That's the part that's key to take away is that you have the power to influence your health that starts at the level of your skin. It's fascinating that we can look at our skin not as a beauty scorecard, because I think so many of us, particularly when you're upper in age like me, like 57. I start to look at all the things that I don't like what it looks like, but I don't even know how to look at my skin and see it as an engine check light that might be indicating something else that's a deeper issue. Exactly. And it could be really small signs. It's the all of a sudden moment that a lot of people describe to me. They say, "All of a sudden, I see this change in my skin. All of a sudden, this brown spots popped up. All of a sudden, this fine line is over here. This redness is now, and my skin is flushing." Yes. It's these all of a sudden moments have actually been brewing for months on end. So the conversations actually been started long time ago. And when you see that all of a sudden spot, you have to take a moment to see what's the damage it's been doing. And for you, I want you to know that what's happening on the skin is really a dashboard and reflection of what's happening at your overall health. So this is not vanity. This is actually a reflection of your health. Okay. That's really cool. Because I probably, and like most people that walk into your office or walk into a dermatologist, and you're like, "I have this thing under my nose or I have this thing on my face or my skin is suddenly this way," or, "This is happening and it's now a problem." And the first thing that you said is what's appearing on the surface can reveal hidden issues underneath that started a while ago. Am I tracking? That's right. A lot of times patients walk into my office, and within the first five minutes, they're saying something like, "I'm really sorry to be talking about this. I know this is vanity. I have this concern." But that's not true. I immediately shift the conversation and say, "Skin care is health care. I want you to be concerned about changes in your skin because of the structure that it's showing and changing actually is a reflection of function that's happening underneath. And that's a very important conversation because it affects patients' quality of life. I would love to hear what your skin reveals about what's happening in your body and what changes, maybe early warning signs that something deeper is going on. It can tell you about autoimmune dysfunction. It can tell you about inflammation happening underneath. It can give you clues to disease processes like kidney disease, diabetes, chronic liver function, dysfunction. All of that can present on your skin. Saraiases is a really good example. So when patients have moderate to severe psoriasis, oftentimes they're at a higher risk for heart failure. There was one study that showed that if you have severe psoriasis, you're at about six fold increase risk to your 10 year heart disease and heart event risk. This includes heart failure, heart attacks and stroke. Wow. Why is skin health and the optimized function of your skin so important for your overall health, Dr. Riles? So your skin is your largest living organ and it's your largest regenerative organ. So it really every 30 days, you're getting a new layer of skin and it has this incredible power of influencing health because if you think about it, it's our way to the outside world. What does your skin do? Okay. So the skin does eight different types of functions. We love to study this in our lab. So we study skin repair and wound healing. So every a little kid who gets a cut or a scrape needs a bandaid. They have a boo boo. I have two little kids at my own. So the repair idea is that your skin naturally heals and it allows you to regenerate that skin every 30 days like we talked about, but this repair slows with age. So you heal much faster when you're younger than with older age. So wound healing is a big and important part of how the skin functions. The other function is secretion and absorption. The skin is an active secretive. Your skin is either oily or dry. It creates oils. It creates sweat. It absorbs topical things. So this is how we apply medications to your skin through your skin. Sensation is key. This is how we sense and perceive the world. This is how we connect, love, touch. It's all through the skin. It is also how you know when you have a paper cut, right? So when you have a paper cut, you don't know how much your skin is a good sense or till you do barrier defenses is really what the skin is known for keeps the outside out, right? The skin is a great protector. The outside world exposes that to UV, pollution, particulate matter, hard chemicals. So the skin really keeps a lot of that out. And then vitamin D synthesis, people don't talk about this enough, but vitamin D is this incredible hormone that supports our bone health, that supports our brain health. And that starts at the level of the skin. It's a conversation that your skin has with UV and we allow that to make healthy vitamin D to support our bone and overall health immune surveillance. So the skin has its own microbiome. Lots of friendly microbes that live on the skin, but we also monitored the skin to make sure that no one bacteria or microbe over exaggerates or proliferates. So it really helps to keep that down. Your skin actually has its own immune system. So the localized immune system that's outside of the blood immune system. And then finally, like we didn't have enough different functions to do, it's a great thermoregulator. So what does that mean? This allows us to regulate temperature melt. So this is how we can cool the body and be perceptive to the outside world evolution has really prioritized how the skin and the fat underneath it play a big role in thermoregulation. I am so excited to dig into this. So if our skin is doing all this cool stuff and it's part of the overall function and health, and there's this two way relationship between what's happening on the surface and what it's communicated to your deeper health inside your body and what your inside body is connecting to the surface of your skin and you've already taught us that if something suddenly appearing, we got to go back and try to understand what's been happening because this might be a signal. What is happening under the surface of the skin, Dr. Wiles, as we age? So because the skin is this beautiful living organ, I want you to think about its influence from the outside in and the inside out. So the aging process within the skin is a two-way influence. So the outside in, we're having stressors from the environment which we collectively call the exposeome. So this is UV light, the pollution, particulate matter, the ozone smoking, all of that influences the skin from the outside and aging process. The inside out signaling is just as important. So these signals look like metabolism. So your metabolic changes, also looks like your hormonal changes, your genetics. So it's that two-way conversation that really drives the surface and that colliding of the world that drives the surface changes. You have two studies that you're excited about when it comes to the aging of your skin. So research studies were finding that how you look, also known as your perceived age, can influence a lot of downstream health risk factors. There was a recent study that showed that when you look at cancer patients, they had a study looking at over 6,000 patients and did an AI facial image analysis and found that the patient's cancer survival and prognosis correlated with how they look. Their perceived age and those changes that they're seeing at the level of the skin actually has a biological influence and it's showing cues that could be affecting their cancer prognosis and how they're surviving through this stage. This is fascinating. I wanted to also share this other great Danish twin-twin study where they looked at twins and saw how their perceived age impacted their overall health. And the older of the twins actually had more changes that are declining poor cognitive help, poor physical function. And just that perceived age look of how someone shows up actually correlates with poor survival, shorter telomere length and shorter telomere function. So these are cues that are telling us that the skin is more than vanity. It's not necessarily that structural change, but it's the underlying function that could also be reflecting through that structure. So if your skin is aging quicker and you're losing the structural function, that your skin is supposed to be performing all those different things you just said, it puts you at greater risk for other things. Exactly. Dr. Wells, how do I actually know how my skin is aging? If it's doing a good job, if it's like really not aging well. So when patients come to see me, we do a full facial exam and a body skin exam and we start to look for these key signs on the skin. So now we have this technology that can actually use an AI integrated system to look at your facial image and it can do a facial skin to give you a predictive analysis of the different parts that age over time. Are you interested in getting one of these facial scans now? Well, I'm actually nervous. I saw the team setting up some piece of equipment out there. So I kind of knew this was coming and I'm dreading it because I'm afraid that all those decades in the 70s and 80s when I was slathering on oil and trying to burn myself are going to come back to haunt me. And yes, I'm going to do this even though I'm nervous and I will narrate this. So if you're listening, we are going to take you out of the studio. We are going to walk into our offices here in Boston. If you're watching this on video, on YouTube right now, you're about to see the behind the scenes. You're going to see the team in the middle of a busy production day. And so we're just going to take you right along with us. I love it when we get out of the studio. So let's go. Let's do it. Here we go. I'm a little nervous. Okay. This machine actually looks like one of those foil things at my elementary school best friend, Jody Brickin. And I would hold up, oil ourselves up and then try to get sunburn in the Michigan sun. This is actually a very advanced technology that does look very similar to that. But it's going to allow us to capture all different angles and mirrors and there's flashing lights in here to look at your skin. Do I leave my glasses on? So you can take your glasses off. This is a curved camera. And I would like you to look right here in this middle. Just like that. You're going to see some flashing lights. Okay. And it's processing. So we did good. Let's give that a few moments here. And you can come back here with me, Mel. Okay. Let's go through this report. So here, the higher the number is really looking at a percentile. Right. So you 100% is what you want to get on the report card. So let me just tell the person listening. They're measuring spots, wrinkles, the texture, the pores, the UV spots, the brown spots, the red areas. Let's start with spots. So you say that when you have this, you want to see a high number like 100% or 90% or 80%. Exactly. So I've got a nine, which feels like a D minus on spots. So the spots is a combination of multiple difference of wrinkles, textures, pores. So it kind of takes multiple different textual surfaces and combines it into one. So it's measuring brown spots, it's measuring red spots, it's measuring other types of pigment changes. It's also measuring some surface level changes that you can see with pore sizes too. All right. So let's go through the next step with this is wrinkle. So here, oh my god, they're on my forehead. It's showing static wrinkles. These are normal lines. These are supposed to be there. You want to see texture on your skin. You want to see movement. Okay. Remember the skin is not. It's a 9%. I mean, certainly this could be a hydration factor too. Okay. So a lot of time just getting enough water and putting moisturizers. This is going to bump up your score easily. Great. Okay. Texture changes. So do you like nine, nine, nine? No, it's like D minus D minus what is this telling you? These nine percentiles, they're still giving you some clues and it's telling you that you need some changes that are more. We could talk about what active is you're putting on your skin. Maybe do you need more antioxidants here? Do we need to be? I don't know if I am putting an active on my skin. That's probably why this is a 9. Yeah. Okay. Let's talk about my pores. Your pore size is doing really well. So 77 percentile. Nice right here. That's right. That's right. So and pores we actually think about as they're really static. Everybody has different pore sizes that change with time. But we want to look at pores as ways that the skin allows particles to be absorbed inside. So pore size actually can be a good thing. Okay. And then UV spots. This is the most important change. Okay. What is that? The screen for you listening went from like a high definition. You know the time magazine covers where it's like a way too close portrait and you see everybody's pores. That's what this looked like. Now it looked like you hit a filter and it's a pencil illustrated graphic novel version of me. Exactly. And actually this mask mel it actually goes around and highlights the area that it's analyzing. So it doesn't do the entire face. Just the key components that are sun exposed so the nose, the forehead, the cheek area. And you have a really good score for for the UV spots. And this is telling me this is subcellular damage mel. So I can tell from this that you're doing a great job putting sunscreen. That shocks me. Given my childhood. My number is 83. I thought this would be a zero because I spent my childhood trying to get burned. So it would turn to tan. But I do wear just a basic moisturizer that has sunscreen in it every day. Highest number is brown spot. Highest number. 94%. What is that tell you? So brown spots, it's pigment that's presenting on the skin. So what brown spots and UV spots, two of your highest scores mel and 94% brown spots, 83% UV spots. That's telling me that you're excelling at having skin resilience from a pigmentation standpoint. Red areas, it's 46%. So what is red showing you? I think about red primarily as low level inflammation on the skin. And what this is showing is it can be broken blood vessels. It can be how the circulation is popping up on the skin. Some in the mornings or at nighttime, this can change during flushing. So if patients have rosacea, they can see more prominence in red. So you're and I see a lot of like breakage around here. I do tend to get very red, especially in menopause. Like I've noticed that I go and flush faster. I stay red or faster. It looks like things are breaking in my face faster. I don't know. This is one of the most common things that we've seen perimenopause in menopause. So red, low level inflammation and damaged blood vessels. And if you want to know mel, are you ready? Oh god. For the true skin age. Okay. This is the calculated age of oh my god. I'm not ready to be that old. I'm 61. I'm not ready to be 61. It is. I thought it'd be better. I had some above the line. This is an average. So I don't want this to be a means to an end. This is not a structural report card, right? This is a conversation. This is information that we can influence. And these are cues that we can actually take back and see what are the different things that can reset our skin barrier. Wow. Okay. Well, I now want to find out what to do. And I would assume almost everything that we're going to recommend applies to all of us. That's right. Okay. Great. Yeah. Let's go talk about how I bring that number down. That's right. I love this. And we're going to take you back into the studio. Come on. You got to see behind the scenes as we are doing this. That's really cool. It's information. It's impressive. Okay. Here we go after you. I did not expect 61. I'm still like feeling like oh god. So for the person who's kind of like me, that feels as though you really kind of screwed it up. You have slathered a bazillion products on yourself. You spent way too much time in the sun. What is the good news about the state of your skin now and what is possible if we apply the pillars that you're about to talk about that really support the skin span and the function of your skin? The good news is that your skin can reset. Your skin can listen to cues that's coming from your internal health and different ways that we're activating your stress cues and managing resilience, your sleep cues and getting better hours of sleep, your diet and hydration. How do we optimize those things that you can control? And if not trying to be better, one percent better every day, different types of environmental stressors and topicals. So if we think about the skin span pillars, it's an interconnected system. How many pillars are there for this skin span? There's five pillars. What are the five pillars for skin span? The five pillars of skin span are sleep, diet and hydration, movement, stress reduction or recovery from stress and then topicals and treatments. Great, okay, and we're gonna go through one by one. But I gotta hit the pause button. We need to shine a light, our amazing sponsors because they're the reason we can do this for free and have extraordinary researchers come in and don't go anywhere. We'll be right back. Your skin can listen to cues. So if we think about the skin span pillars, it's an interconnected system, diet and hydration, movement, stress reduction or recovery from stress and then topicals and treatments. - Welcome back, it's your friend, Mel Robbins. Today you and I are here getting this incredible behind the scenes conversation at the Mayo Clinic with Dr. Serranya Wiles, dermatologist, physician scientist, one of the leading researchers in regenerative dermatology and skin aging at the Mayo Clinic. Today she's showing you what your skin can reveal about deeper health problems, I'm loving this. So Dr. Wiles, let's just keep going. So you said the first pillar is sleep. Dr. Wiles, how does sleep affect skin repair inflammation and the way your skin ages? - So the first important thing to think about would sleep is that your skin is on a circadian clock. So if you were to think about your skin health and what it's doing during the daytime and nighttime hours, at daytime it goes into defense mode. So it goes into protection from the outside world. So everything about your skin of how it's producing oils, how water secretion, its barrier function, we talked about its immune surveillance capacity, barrier protection. So it's in defense mode, it's fighting against the outside world, the outside damage, UV, pollution, visible light, all of these things that are creating damage, it's protecting against that. So it's in a very active mode. And then at nighttime it switches into offense, more like a repair regeneration. So your skin doesn't sleep at night, it actually shifts into repair mode. And this is why sleep is critical for skin health because when you're sleeping is when your skin is actually regenerating and repairing the damage that could have accrued during the daytime. So if we look at some studies, there's actually been a study that's looked at good sleepers. So good sleepers had 30% better epidermal barrier recovery compared to poor sleepers. So what that means is that if you're getting about seven to nine hours of sleep and you consider good sleeper, you actually have better barrier resilience. Your skin can stay hydrated for longer, it can protect you from the outside environment and really allow you to function at its best. The opposite is also true. So in another study with 24 middle-aged women, they look at consecutive nights of sleep lost. So for women that had two consecutive nights, that's how long it took. So two consecutive nights of three to four hours of sleep disrupts your skin barrier. So overall we saw that their hydration went down, their water loss went down, meaning that you're losing more water through your barrier. So that was a statistical significant change. So with just two consecutive nights, you can really shift your skin's hydration and barrier capacity. - Dr. Wells, this is so fascinating. And it also explains why so many of the creams you see market it as repair. But I've never heard anybody say that your skin has two modes, protection mode during the day and defense and repair mode at night. - So there are signals that are during the morning that your genes are sending out that's like, turn on defense mode. And then the signals that send on at night that's like turn on protection. - Okay, hold on. Let me just see if I just got something. I love it when we're having a conversation and you start to feel smart. Don't you love that as you're listening and watching that by just being with Dr. Wells, you feel smarter. So can I give something back to you? And I wanna see if you're listening or watching if you're starting to get this too. So Dr. Wells, what I am learning is that sleep impacts how your skin ages and functions and what it looks like because your skin has two modes and it's driven by the circadian rhythm. And if you're up during the day and you're on the offense mode, right? That's during the day. - During the day you're defense. - Okay, so if I'm up during the day and I'm on defense, my skin has gotta be protected me from the world and the UV and all these people running around and oh my God, pollutants and, you know, oh my God, and now of course it's dehydrated. It's working very hard. Then I go to lay my head down on the pillow with the circadian rhythm. And my skin is like, oh my God, okay. I can go on offense mode, meaning I can take a proactive step forward why this, you know, you know what, sleeping. - Isn't that beautiful? - And I can repair and I can shed and I can take care of myself so that when she wakes up again, we can go back into it. And if you are not getting good sleep, your skin cannot go into that mode. And now I'm thinking about why looked terrible when I had babies, why I started to look like I had been sleeping under like a dumpster or like out camping when I got parry menopause because my sleep was interrupted every two to three hours. So if your sleep is interrupted every few hours and you're not getting a good night's sleep, your sleep pattern is confusing your skin. And so it's probably jumping, wait, are we in offense? Are we in defense? Is she awake? Is she up? Well, what is happening here? And then you start to look red and puffy and saggy and creepy, describing myself here. But it makes perfect sense. You haven't built the time for recovery for your skin to bounce back. And if you then, and this is why I've probably done everything wrong, I run to the drugstore 'cause I think I look like an old hag and I'm exhausted and then I reach for a cream that says repair and then I slather it all over my face and then I wake up five times at night. That cream is not going to be as effective because my own sleep pattern is confusing my skin's job. That's exactly right, Mel. Oh my God, this makes so much sense. It's the interconnected, don't put on the topicals and not perform from the inside out too. It's a two-way street. Wow. I want to say one more thing about sleep. So if you're listening and you're thinking, sleep is free, but I have trouble getting to sleep and staying asleep and falling asleep. So magnesium is a supplement that you can take. Magnesium three and eight is one. It actually influences at the level of the skin an expression of certain types of genes and enzymes that can influence your skin to make better hyaluronic acid, better types of matrix proteins and help that sleep function better in addition to support matrix function and production. Dr. Wells, I want to ask you a question about the magnesium because we have had world-renowned researchers, medical doctors, scientists come on and talk about magnesium, but as a normal person, there's all these different types of magnesium and you said, "Theonate, there's the G1, there's the other ones." Is there a particular thing that a normal person should look for and what time do I take it? So magnesium three and eight is the one that helps with sleep, especially-- The T1. The T1, three and eight, L3 and eight. And then the time to take it is really dependent hour before sleep, one to two hours before sleep is the time to take it. And so you want to activate these cues to help your body calm down. The way that I look at magnesium is both from the lens of sleep, but also from the lens of the skin. And this is where it becomes really powerful. Because not only are you activating one mechanism to help you sleep better, you're activating the other mechanism to help the skin cells produce better matrix and it is a supporting co-factor to produce vitamin D. Wow, OK, great. So Dr. Wells, does the position you sleep in affect your skin? So for me, the goal is that you're getting enough sleep. So that seven to nine hours of sleep and sleeping on your face and on your stomach is probably not ideal. And the part of the reason is because at nighttime, you also lose water from your skin. And that's intentional. When you're repairing and rebuilding, your skin bear is a little bit open, so you lose water. It's another reason why I tell people to have a humidifier in your room. So at night, when you're sleeping, especially for that repair regeneration, a humidifier will help optimize and defray that water loss. But at nighttime, you also don't want to be kind of suffocating the-- water loss that's naturally happening. So the second pillar that you mentioned was diet and hydration. And I'm realizing right now that I've been hydrating this entire conversation with an iced coffee. That's what you're for. But let's start with diet while I switch the coffee off the table and put water on. What does your research doctor Wiles say about nutrition, slowing or improving the way your skin ages? So the data around skin and diet is quite good. So it's this skin gut access of how your skin and your gut health are interconnected and related. And a lot of this is known if we look at acne patients too. There's a randomized 12-week trial for acne patients that they follow these patients and they put them on a low glycemic index diet. This means low sugar, low carbohydrate diet. And they found that these patients had a 23% improvement in their acne flares just by switching their diet. So wait, hold on. Say that again. Because the person who is having an acne flare up and is this count for all kinds of acne? Stress acne, hormone acne, systemic acne, like all of it. So if you're having an acne flare up, what was that research? When you have a low glycemic, so low sugar, low carb diet. And what are some of the low sugar, low carb diets that would be out in the world? I'd be like, oh, that kind of diet. So if you want to think about fruits and vegetables, beans, and dark green leafy vegetables, more whole foods plant-based, more protein plant-based, that kind of stuff. Exactly. Gotcha. Versus a high sugar index, even fruit can sometimes be in that category. Okay. Wow. So that really shifts that and reduces the acne flares. But it goes beyond that. So glycation is how sugar sticks together. So it's sticky sugars that happen in your skin. And the sugar sticks to something called collagen and the last and that's present in your skin. Okay. So then it stays there for a long time and influence and breaks down your skin matrix. Okay. So when you have these glycation end products, this is why sugar is bad. And the goal is like, try to limit sugar. I know it's super hard when you're cruising around your target aisle and you're trying to figure out what do I get my kids? Like, which is the best back to school snack? You know, the goal is to try to see if you can try to have those low sugar, more of healthier choices, more plant-based and whole food, whole grain-based, those are going to help shift the conversation in reducing glycation for long-term. And it really starts when you're younger because the glycation is a build-up of the story over time. What's interesting is, you know, I'm thinking about how much time I've spent in the makeup aisle trying to buy things to cover things up and what I'm starting to realize is that it's the other aisles like the foods you're choosing to eat and prepare. The magnesium that you might take to help you get a better night's sleep that is the first line of thinking and defense when you want to take better care of your skin and to have your skin function, age and look better. Exactly. And there are other cues that you can do and supplements like fiber. So say that you are about to have a sugary piece of dessert, right? The goal is to try to bring in fiber as close to it as you can. What do I put on my Sunday? Maybe some flaxseeds or try to eat, you know, beans or something around the time that does vanilla bean in the ice cream count? Probably not. Okay. Nice try. Fiber, fiber, it can come in lots of different ways. I think I think gut health fiber, I don't think if I want better skin, I better have a little more fiber and I better have a little more protein and a little bit more veggies and like the inside out of that creates going skin. That's exactly right. So it's that inside out connection. And again, it's coming back to how interconnected everything is. Your gut health is reflected on your skin. A leaky gut often times for patients with eczema presents as leaky skin. They have broken leaky barrier and a lot of times they're seeing some GI distressed too that goes along with it. So a first line treatment when you see eczema in addition to other factors that you have as a dermatologist at the Mayo Clinic is let's change your diet. A lot of patients find benefit from reducing gluten out of their diet with just having autoimmune diseases and celiac disease for sure, but you can also see that for patients that are eczema prone. Tell me Dr. Wiles about fiber and skin. So there was a study in 2025 from the UK biobank, which is a large biodata. Over 200,000 people were scanned in this biobank data. And they found that those individuals that had a high fiber diet actually had lower psoriasis flares. So psoriasis that inflammatory skin condition, just by keeping your diet high and rich in fiber. And this probably works because it kind of defrays the sugar spikes. So patients that take good high fiber diets, they don't have their glucose that are spiking so much. And when you control your glucose, you're controlling your skin glycation. And when you control the skin glycation, you have better healthy skin. And you know what Dr. Wiles? You're glowing. Yes, you say all that. So you must eat a lot of fiber, but you're all I'm also very excited. I didn't think I get that excited about skin. It's really cool to learn about. Yeah. I've heard you have a secret skin smoothie. I want you to talk to me about this smoothie and the benefits of putting specific ingredients Dr. Wiles in your smoothie. Okay. So this is something really special that I shared with my grandmother. I think there's a lot of wisdom that we can learn from our mothers and grandmothers. And every morning my grandmother would say, don't forget your ABCs. Now I grew up in South India in Chennai. And we called her Thathi. So Thathi would say, okay, don't forget your ABCs. And what she meant was your apples, beets, and carrots. Oh, ABC. ABC. Carrots. Okay. So when I had kids, this is what I turned to. I said, I don't know what to feed them. So let me take these and stick them in an Instapot. So what ended up being my grandmother's recipe ended up being a convenience factor for me. This is what my kids ate almost every day. By Instapot, do you mean like a crackpot? A crackpot. Okay. So like any slow cooker. So we're talking you've got a busy life. We don't have time to do a cooking show. And neither do you in your life. So you're going to take Instapot, crackpot, whatever you want. You're going to chuck in carrots, apples and beets. Carrots, apples and beets. And you leave the skin on. I do. And I'll tell you why there's research behind this. Talk to me. So my in-laws are apple farmers. So I'm really passionate about apples. No way. They are. That's the cutest thing ever. And the reason why you keep the apple peel on is because it's got quercetin in it. And quercetin lives on apple skin, which is a type of flavonoid, which is a type of anti-scenolytic. So when we think about, you know, these senescent or zombie cells, well, how do we target them? How do you get rid of them? There are natural products and fruits and vegetables that exist that can target and reduce those presence of those cells. And this is one of them. Okay. This is a really cool fat meal. So with flax seed and chia seed, you're getting alpha linoleic acid and you're also getting fiber. And I love this fact because fiber is something that we know that we need to get for healthy skin. We just talked about reducing your glycemic index. In addition to that, do you know that chia seeds also have calcium in it? They do. They do. So two tablespoons of chia seeds has 180 milligrams of calcium. That's about half a cup of milk. Wow. So for somebody that can't tolerate dairy. Exactly. Wow. Two tablespoons. I'm like trying to follow the recipe. So we're throwing this in the crock pot. How much of the flax seed and the chia seed you put in? I usually do like one or two tablespoons of each. Okay. And then the turmeric, throw a little bit of turmeric in there. And then I use a coconut water as the base. So coconut water has a lot of electrolytes. So it's going to power you through that day. It's going to give you a lot of the magnesium there too that you're going to need. And really this combination that comes together will hold you strong. You can even add protein to it in the beginning of the morning if you're trying to just get out. Okay. Now let me just get technical here because I want to make sure I know what I'm doing. Am I only cooking down the ABCs so they're mushy? And then once they're mushy, which I can do while it's at work, then I can put that in like, you know, a storage dish. And then in the morning, I take a scoop of the mush, some turmeric, some flax seed, some chia seed, and then I pour in my coconut water. If I want a little protein, throw that in there and then I zap it. That's right. And this could look like a lot of different versions for you. You know, do what's convenient. Maybe it's blueberry, spinach, and yogurt, but it's what works for you and making it a consistent habit. Amazing. Dr. Wells, what does turmeric do for your skin? So turmeric activates a lot of anti-inflammatory pathways. So it really helps your skin defense modes. You're about to walk out the door and you're going into the world fighting against all these different pollutants and antioxidants, right? So that creates inflammation. By having turmeric and other of these products in your smoothie, you actually can start helping your skin fight inflammation earlier on. Awesome. I feel very empowered by this. And here's the other thing I love about this. What's discouraging about your skin is that everything is a product marketed to you and everything that you're talking about exists in your daily life and not only is good for your overall health, but it's amazing to know and very empowering to know that every one of these levers that you can pull are almost no money. You're going to eat anyway. And they also increase not just the health of your skin and not just how it looks and how glowing you are and all that stuff, which it will, but it also makes you feel better and it's impacted to your overall health, which, you know, he said in the beginning, it's all connected because this is the biggest organ. And somebody who has two centers at the Mayo Clinic. Dr. Wiles, how much water do you need to drink in order to have healthier skin? Yeah, so when you think about hydrating your skin, there's a little bit of a myth that goes around. Okay, so the myth around hydrating your skin is that people think drinking water is enough to hydrate their skin barrier, but it's not. You actually need to apply moisturizer. So dehydration can show up on your skin, but when you rehydrate, you also need to apply moisturizing. So a lot of the studies are showing that only a portion of water that you drink shows up on the skin, right? So you have to think about the hydration needs can really shift, it can be affected by your climate, the humidity, and a lot of different things. So how much water do you need to drink? For women, it's about two liters a day. We'll translate that. What is a leader? It's about 11 to 12 cups. So I have a large wide mouth mason jar right here. I love to drink out of these, and I typically drink two of these a day, and this is like four cups each. Perfect. So about eight cups is good enough, but if you can try to get to 10 or 12 cups, that's better. Why? For women, especially if you're in perimenopause and menopause, your baseline water loss has increased, and our levels of stress as women have increased. So you're just losing more water every day, just by sweating it out, ladies. So just aiming for about 10 cups is key for women. And for men, it's two additional cups more than that, so 12 to 13. Wow. Now you also said that it's the inside and the outside. So what am I doing on the outside to hydrate my skin? Because I know people have told me before, my own dermatologist, maybe even other medical experts, but can you remind us what is the thing we're looking for that is hydrating when you put it on your skin. So the skin needs humectants. So humectants are ingredients that pull water in. So these are going to be like glycerin, ceramides. These are going to look like colloidal oatmeal can reduce inflammation and calm the skin. Oh, oatmeal is hydrating. It's finely ground. It's called colloidal oatmeal. This is actually FDA proof. So if you go and then a lot of the brands for eczema, moisturizers and lotions, it'll say that it has an FDA seal on it. And it says national eczema foundation approved for eczema skin. So broken skin can get a lot of benefits from colloidal oatmeal because it has the ingredients to calm the skin down. The other humectant aka something an ingredient that pulls water in is beta-glucans. So beta-glucans is another active that you can look for in the ingredient list. So these are going to pull water in. You also want to look for moisturizers that are tub lotions that you can scoop out versus pump lotions. Why? Because tub lotions are thicker. And they hold more moisture in there versus pump lotion to get it out of the pump. They actually have to add water, which is counterintuitive. There's more liquid in there. It rubs on nicely, but it also evaporates and loses the barrier faster. Wow. I wouldn't have thought that pumping it to get it out through that little thing actually makes it less concentrated. It's a thinner lotion. The tub lotions are thicker. So Dr. Was. I just had this image of you either at the grocery store or target or CVS or somewhere else and you've got your two kids and it's a Saturday and you're pushing your cart. And then you see somebody like me just staring at the aisles and I'm reaching for something that you know is a giant way. Is it hard for you to not walk up to people and be like, just buy that one down there. I have this target moment all the time. So whenever I'm in target, I am so tempted by people looking at products and just seeing what ingredients there. I just want to go up to them and be like, hey, I've been there. Can I just help you and I just want to help you pick out, especially if they're in the baby aisle and they're like choosing between different products. What do I choose which ingredients? I just want to go out and be like, try this. You know, this is good for sensitive skin or this is better for this type of eczema prone skin. Just to help them out, you know, and it's so tempting, but I have to resist myself. But this is a key conversation. People are overwhelmed with what's out there in our grocery stores and over the counter, which is a good thing because it's accessible. But also the choices make it seem like there's insurmountable and harder decision make. So should you stay away from fragrance given that your the purpose of the moisturizer is really to hydrate your skin? Yes. So fragrance free, unscented. You want to look for both of those words. Okay, this is a dumb question. You ready? Those are different. Those are different. And this is going to shock you. Unscented can mean that they're actually adding fragrance in to mask the scent away. Whoa. So unscented doesn't mean it's free of fragrance. Unscented means you're not going to smell anything, but we might have added something to cover the smell. Exactly. Whoa. The third pillar for better skin is movement. Dr. Wiles, what does regular exercise and movement do for your skin? And how can movement help your skin age better? I have some really cool studies here. I'm like, so excited about it. So your skin responds to exercise. So there are some really great human data that supports this. So in a small randomized study with older adults, they found that the skin healed faster in an average of 10 days faster in the group that exercise compared to the group that didn't exercise. Really? It impacts wound healing. Why? Exercise actually secretes out positive signals for your body to reduce inflammation to help metabolic signaling, metabolic health. So one of the things that the body releases, they're called exosomes or extracellular vesicles. They're really fun. They're like text messages that your body sends to each other and said signals of benefit, but they can also send signals of harm. But depending on where it's coming from, with exercise, this can actually be a positive cue to send circulating beneficial exosomes all around to all distant organs, including the skin. And these messages can help that repair process that you're seeing. I want to just remind you as you're listening and watching that Dr. Wiles runs two centers at the Mayo Clinic, one of which is researching and focuses on wounds. That's right. So you know what you're talking about. I love my research lab. We have the regenerative dermatology and skin longevity lab, we're part of the Department of Dermatology. It's a good team. So is there something about the circulation that helps too? Yes, those exosomes that are coming through are coming through the circulation. So they help create better blood flow, better messages that are going all around. So just overall, this idea, Mel, is getting back to homeostasis. I'm going to break this word down because it's one of my favorite words. Homeostasis. Homeostasis. Okay. Homeostasis means reestablishing balance. So it's the yin and yang of your body. We love studying regenerative medicine in our lab. And the skin being the largest regenerative organ is because it constantly is going through the leverage of enduring stress and breaking down and being resilient to stress. There was another study, a 16 week study in 56 middle aged women. They looked at cardio versus resistance training. And what they found was in these patients, they had better skin elasticity and the upper layer of their skin, which holds the collagen and last in improved. This was what kind of training? This is with weightlifting and weight strength training. Okay. I'm so glad you said that because every medical doctor that has come on in every single field has said for women in particular strength training, resistance training, non-negotiable for every aspect of your health. So if you were about to say cardio, it's a combination, but resistance training plays the bigger role. Okay. For sure. Why? Because the skin and muscle are super interconnected, you know, we have a constant communication. So those strengths training, those signals actually transcend to the skin. And this is actually why I tell my patients who are on GLP1 medications who have that weight loss that they're experiencing. That strength training becomes a very important part of their conversation because it can help tighten their skin elasticity. Well, that makes sense because as you're teaching us, the skin is the largest organ. It's a living organ. It's sending information in. It's receiving information out. And the more you're pumping up your muscles, the more it must plump up and pump and tighten up your skin. I'm so grateful that you're here. I could listen to you all day talking about this. This research is fascinating. I feel smarter hanging out with you. So thank you for that additional benefit for having you here. And it's also just so practical. We're going to take a quick break. And I want you to give a little attention to our sponsors because they're the reason we can do this for free and have extraordinary researchers come in. But while we do, share this episode with someone you love who's overwhelmed by skincare, whose bathrooms are overflowing with products, or who just is struggling with their health and their skin. You know, they want the clear research back answers about what their skin really needs and stay with us because when we come back, Dr. Wiles is taking us into the next pillar of a holistic roadmap for extending skin longevity. The framework that shows you what really matters when it comes to keeping your skin healthy and resilient as you age will be right back. you are serving your overall health. By listening to the skin, it's a bi-directional conversation that provides us clues and information of how your overall health is functioning. And by looking at the skin, we also have the power to influence our overall health. I love this conversation today. Dr. Saronu Wiles, dermatologist, physician scientist, one of leading researchers and regenerative dermatology and skin aging at the Mayo Clinic. Today, she's showing you and me what our skin reveals about our deeper health issues. Dr. Wiles, let's jump back into these pillars. The fourth pillar is stress. How does chronic stress impact your skin? So let's talk about cortisol. This is the stress hormone, and we've all heard about it. Cortisol receptors are part of your skin, and this is really fascinating why they're part of your skin. So your skin has this neuro endocrine system, fancy way of saying it's part of the fight or flight mechanism, right? And it's evolutionarily there because your skin plays an active role in that defense. You're going out into the world. It's receiving all of the external damage from the outside world burst. So it has to be frontline defense mode and reducing the inflammation. It has to be part of that fight and flight response. So there are natural cortisol receptors are part of your skin, and it's partly there also because it's this adaptive response. So because it encounters stress, it can create adaptive signals to defray the stress, too. It's helping you combat stress. Why is this important? So this means that when you're in stressful situations, your skin knows it, and it perceives it. So if you're on an airplane and high altitude situations, your skin is stressed. Is that why I'm puffing on a plane? You can be. Yes. Wow. Okay. UV, UV damage that stresses out your skin. This is an interesting study. Did you know that the stress of going through a divorce can impact your skin barrier recovery? They did this study and they found that in 28 healthy women aged between 21 and 45 years old, the process of marital separation showed up on their skin. They had worse total epidermal water loss, meaning their skin lost more water. And when they took the tape strip, which is a top layer of the skin and evaluated it, that barrier strength was not affected, but your ability to recover from injury was affected. Wow. That doesn't surprise me. Because it's extraordinarily stressful. Very stressful. Does stress lead to hair loss, Dr. Wiles? Yes. And stress can show up in the hair in a different way. So hair grows in different cycles. So we grow rest shed, grow rest shed. And at any given time, our hairs are always cycling between them. And we actually have normal shedding seasons. So in the spring and the fall, you're supposed to shed a little bit more than the other seasons. So with these different cycles, their stressors can actually shift the hair from these growth phase or resting phase into this shedding phase. Okay. And this can show up about three or four months after that stressful event. So say you've kind of had loss of a family member, loss of a pet, a surgery and illness, a very stressful work situation, whatever that is occurred, it'll take about three or four months to be reflected on your skin and your hair. So it's an important clue to pay attention to, but it is a reversible clue. First of all, Dr. Wiles, how much shedding of hair? Because there are those periods where I've looked down on the floor of the shower or I have, you know, washed my hair and I run my fingers over and I'm like, what is this? Like this is like a wig in my hands. And then I start to get worried, like how much is too much? So everybody experiences a natural, normal shed every time you wash your hair. Every time you wash your hair, it's in the hundreds, but you do lose hundreds of strands of hair. Hundreds of strands of hair. And it can vary. There's a lot of different structures within here. Typically, you can see about hundreds of strands of hair that are lost. And tell me about this three-month thing with your hair, Dr. Wiles, because I got my hair dyed on Monday night and iny, shout out iny, who has done my hair for well over a decade, said to me as she grabbed my hair, and she turned around and she's like, what are you doing? Your hair is the worst I have ever seen it. What should you do? Sleep better? Eat better? Is there something to do? Yes. I am a big fan of pumpkin seed oil. What? Yes. I'll tell you about this. This is a, there's actually studies around pumpkin seed oil. It's a supplement. So in a study where they supplemented 400 milligrams of pumpkin seed oil, and they followed these men for about 24 weeks. And these were men that are having male pattern baldness. And they had shown that actually can shift the androgens that influence hair loss, and allow the pathways. So there's actually an analog that comes from pumpkin seed oil that can help reduce those types of signals and can support a healthier hair follicle in their hair. No kidding. Wow. Putting that in the cart when I go shopping next. Okay. Talk to me about nails. And are hairline nails part of skin? Like, is this like a different thing? No, it's all interconnect. Okay, but hairline nails are part of skin. Hair, nails, and your mucosal surfaces. What is a mucosal surface? So this is your inside of your mouth. Okay. And your lips. So all of that is connected. It's all one organ that we study within dermatology. Okay. So let's talk about nails. Yes. Let's say your nails are breaking or you got ridges or white spots. What does that tell you? So your nails can reflect nutrition deficiency there too. And it can have aging pattern. So ridges for instance, those can be just seen with normal aging. And it's okay to see those changes. But you want to pay attention because pigment can also show up on your nails. So when you see pigment both white patches and brown or black patches. Okay. When you have pigment changes, you need to go see a dermatologist. And this is because especially when it's dark brown, you want to be evaluated to make sure it's not a melanoma. Now pigment changes can also happen during pregnancy and postpartum. Or if you're darker skin types, you can also see changes in your nails. But really paying attention to those check engine light that we talked about, they can be check engine light on your nails too. And they can give you clues even for liver dysfunction. Serosis has a telltale sign that we look for on the nails. Fungal infections can also present as yellowing discoloration on the nails. So there's different aspects that your nails can provide for clues of what's going on on the inside. The fifth and final pillar that you mentioned is topicals and treatments. And Dr. Wiles, I would love to have you unpack something I see everywhere and I do not understand. What is a peptide? So peptides are short amino acids. They're like little Legos. So you can put them together to build a bigger protein. So when you think about it, you take these pieces and it can function into a different type of protein. We're familiar with GLP1 medications. These are part of the peptide family. But think about these peptides as keys that can open up a door that could mean nothing or very limited or it can open a very powerful door as the one that has opened with GLP1's and weight loss medication. Okay. So this is something that acts like a key to unlock something that is inside your body. Okay. How do I know what key is going to work and whether or not something is safe or it's complete marketing BS? Because it seems like that word is slapped on everything right now. Yes. Peptides have really gained a lot of traction right now with the longevity movement and the wellness space as well. You know, you have to be really cautious. It can be applied topically or it can be applied injectables. Peptides currently are sourced very differently and they're not FDA regulated at this point, although some of them can be FDA regulated and dedicated GLP1. But the vast 99.9 percent of things, no testing, no FDA regulation, proceed with caution. Is that what you're saying? Proceed with caution, but I'm hopeful. I am actually a fan of peptides being tested in the positive way. So right now the FDA is creating new shifts with 503A compounding pharmacies and what are going to be bulk compounded. This is actually giving people a safer way to access peptides. But the key is to take that and create evidence-based clinical trials. When it comes to peptides that are getting injected unless it's something like a GLP1 that has been clinically tested, Dr. Wiles, is that safe? So outside of that, you're just creating an experiment on your own. You're becoming the body as a pin cushion. They're applying different types of combinations of peptides. You're working with your physician to figure out what's the right version for you. anecdotally, we're hearing benefit, but we can't generalize that and provide guidelines without having clinical trials. Gotcha. So you're basically running an experiment on yourself. Correct. What about topicals? Are there topical ingredients that are, quote, peptides that you're excited about, even if they don't have the FDA approval yet? I'm a big fan of the topical copper peptides. There is evidence behind this. There's data that's showing that it can actually help the dermal epidermal junction and create collagen, and it can be delivered topically as well. So a lot of times, I want to do a myth busted right now. I want to talk about this glow stack peptide. So right now, a lot of people are really excited about and it's become really popular male, this glow stack. So this glow stack is BPC157 peptide, TB500 peptide, and the GHK copper peptide. and it's an inject. combination for your skin for your skin. That's what they say if you inject the stack combination then that creates skin glow. Okay. But from a research perspective, the first two peptides while I'm excited about those for different reasons, they don't have any skin generating data. And the GHK copper works really well as a topical. So we don't need to go the injectable route because if they are injecting it, I'd be worried about copper levels and at what point do we need to be doing additional testing. So that stack is something that I don't recommend. Instead, I say use a topical copper peptides. What non-peptide topicals do you recommend? So I like to think about your daytime and nighttime skin care differently because we talked about the circadian rhythms of shift. Yes. And in the daytime, you're on defense protecting yourself against the world. And on the nighttime, your skin goes into an offensive mode while you sleep, kind of like your brain, repairing and shedding and resting. Exactly. So in the daytime, you want those defense ingredients. You want a really good antioxidant. We talked about antioxidant earlier. They're going to go in and fight free radical damage. Any damage is coming from the outside world. They'll turn down the noise on that. Okay. So you could buy a vitamin C, a vitamin C ferric acid. That's a really good combination. You could buy platelet exosomes. So these can come in and start building and creating more barrier resilience over time. You also want a really good sunscreen. Dr. Raul, teach us about sunscreen. Alright, Mel. Sunscreen is one of the best things you could be doing for your skin. It protects your skin barrier from the outside UV exposure. So I want you to be using a broad spectrum SPF 30 or greater and reapplying the sunscreen regularly. But do you want to be put to a test? Yes. Okay. Oh, she's coming over everybody. She's got a tray. I'm going to narrate this for you if you're not watching on YouTube. Okay, you have a tray that has five different things on it. Tell us what's on there. So I've got a tray here with different types of sunscreen in the bottoms. Yep. A mineral sunscreen. Yep. I have a chemical sunscreen. And I have a tinted sunscreen. So these are three different versions that you can get at the drugstore. And then on the top, I have beef tallow and I have coconut oil. So a lot of times we're seeing beef tallow and coconut oil within our sunscreen products. So we're going to test all of these and see against a UV camera. Okay. How well these actually protect you from UV rays. Okay, what is real and what is BS? Here we go. Alright, Mel, I'm going to apply these for on here. And we're going to start from the top, which is we're going to do just a sunscreen. So we'll do mineral sunscreen over here. Then I'm going to go into a chemical and she's using a different finger. I am because this is very much a research project. Now this one's rubbing in. This is more like moisturizer. Exactly. You can't even see it. What is the chemical in a sunscreen that blocks UV ray? So there's a lot of different types of chemicals. We actually just got a new chemical filter called Bimetresol B EMT. This is the first sunscreen filter that's been approved in our market in over 20 years. Wow, that impressed. But these sunscreen filters basically can absorb the UV and then reduce it into heat energy and release it out. Okay. Okay. So we have the mineral at the top, a chemical next. And then I'm going to put a third sunscreen on is a tinted sunscreen. This one looks sort of like body foundation. It kind of has a nice glow to it. Yes. But the tint is because the tint has iron oxides in it. And this is really important for visible light protection. So I love a tinted sunscreen for patients with melasma prone skin because visible light can actually impact their skin there. See, I thought a tinted sunscreen was just to make me look like a head smoother, nicer foundation skin, not that there's actually any property in the tinted. I thought it was like UV makeup. Yes. Yes. It's partly that. But it's the iron oxide that gives them that tint, which actually confers protection too. Great. Okay. So now the last two, these are more than natural products that people talk about. The first one is coconut oil that's going to go on there. And then the last product is beef tallow. Okay. There's a lot of noise online about the tallow thing. Exactly. It's actually now getting into a lot of natural sunscreen products. But we don't have a lot of evidence in the sunscreen filter world about beef tallow. But we are applying this because a lot of people are learning about this in this way. And they think it can be a sunscreen. Exactly. Okay. So here we go. Let's see what's going to now. Now you're picking up a scanner on your phone, a UV camera. Okay. What do you see if it's blocking? When it's blocking, you see a black line. And she's using an app right now to basically scan my arm and it's showing with UV light, which one of these five things is actually blocking the light. And so the one that is mineral, you're like, that sucker, that's blocking. It's blocking. So this is going to confer protection of UV A UVB protection broad spectrum. The next one down is the chemical sunscreen. This is also doing a great job. Look at that black line that's going across here. I am protected. This is such a great protection because that's also showing that it's rubbed in really nice. And so you don't visibly see it on the skin. But when you actually look at it on this UV camera, it's showing good protection. Great. Okay. Third one down is a tinted sunscreen. Again, we don't see that on your skin. But under the UV camera, we see that protection right over here. And this is again, showing that nice dark color conferring protection from UV rays. And then the bottom, we have coconut oil and beef talo, which are not showing any change here. So meaning there's no protection. There is no protection from the coconut oil and the beef talo, which we've applied right here. Wow, it's amazing. You can see that. I just want people to be aware that these are actually oils. So when you go out there with coconut oil and beef talo, you're actually creating more disposition to burn. So you want to be careful with these products, especially when they're in sunscreen, you actually have a higher risk for burning with coconut oil and beef talo. Wow, amazing. I love knowing the facts and the science. That's right. A little experiment here, but it really talked us through of how we can see it. Thank you for showing us that. Dr. Wells, you recommend that we keep sunscreen in our car. Why? Let me show you why, Mel. Okay. This image was published in the New England Journal of Medicine. And this shows you a picture of a truck driver who has significant sun damage on the left side of his face from driving in his truck. Holy cow. This gentleman looks like he has a face that the left side is 80 or 90 years old. And the right side is like 60 years old. And the left side has the sun damage because your left side is facing that window as you're driving. And you're still getting that UVB and UVA rays that are coming through that window, even if it's tinted, you should still apply sunscreen, which is why you need it in your car. Exactly. Most of us are getting sun damage during our drive into work and our drive home from work. So you really underestimate the power and most of us are being pretty good by putting sunscreen on, but keep sunscreen in your car so that when you're driving, you can reapply. And if you're listening right now, you're in your car, I would try to get that sunscreen practice started. Okay. So you need to be moisturizing and sunscreening in the morning. Yes. Now let's talk about what you do at night. So at night time, you're going into repair mode mode and regenerate mode, right? So now you're applying those peptides. So the copper peptides is great, especially for underneath the eye. You can also apply actives like retinols and retinoids with retinoids and retinols. You want to be driving this space carefully. If you're over exfoliating your skin, you're over-inflaming your skin. So if you're putting on a topical treadmill in and you're peeling a lot, you need to cut it back. It's like your skin's on the treadmill and it's just going. It's exfoliating, it's turning over, turning over. You've got to slow that speed down. So you may actually need to switch to an over-the-counter retinoid that is less potent so that you can tolerate it more and build that consistency over time. So those are really helpful factors. I also recommend at night time barrier moisturizer, so you can look at products that have those humectants that we talked about. Beta-glue cans to really strengthen up the barrier overnight. I can't help but use this as my personal dermatology session. I am just going to say the one thing I can't stand. I didn't think about my body that much because I can't see my back. But the thing I have to stare at all the time is my face and I really hate my jowls. What is happening? To the structure of your face, as you age and your skin starts to hang there like a purse you don't want. So this is a normal aging process that is actually a structural change. Your skin is not the problem when it comes to the jowls. No, your skin is actually just reflecting what's happening. Let me show you something with a cake that we can take a look at. And we'll talk about what's really happening. Okay, great. We have our executive producer going outside. This is a fun episode because we, as you're watching or taking you all over the place and I'm doing my best to narrate it, but I just hate this. And so I just first want to understand what's happening. And second, want to understand, do I just have to live with this? Is this just Mel Robbins version of radical acceptance? And I know it's a sign of aging and I want to age gracefully and I don't want to look 30 when I'm 70 or 80. I want to look my age but energized and vibrant and you know, just healthy. And my jowls make me feel like a sad old hag. Well, Mel, I'm sitting across from you right now and you look amazing. But really, let's talk about the structural problem that's happening with jowls. Okay. And I'm going to describe this because she has in front of her a beautiful cake. And imagine you're at a wedding and they give you a big old triangle slice of cake and it's multi layered. So there's like the red velvet on the top. Then we got the buttercream icing, then we've got the vanilla cake. And then at the bottom, we've got a chocolate fudge. And so we got, we've got these three layers with the frosting in between. It smells really good. Oh God, we're gonna have to have a piece and we're done. So there's actually two other pieces to the cake, Larry Mel, the disc that it's sitting on and the platter that it's sitting on. And this is becomes an important part of this analogy. Oh, so let's talk you through it. So what's happening within your skin is actually reflected on the layers of the cake. So your skin has three different layers. Okay. So you have the epidermis. This is the part that normally sheds out. And you know, we talked about regenerative top layer, that's a red velvet. And then the second part is your dermis. This is where your collagen elastin, all those matrix proteins live. This is the scaffold of your skin. Okay. And then in the bottom, this is your hypodermis, which is where the fat lives, how you regulate your temperature. And then over here at this disc that it's sitting on, this is the muscle. We're gonna call this the ligaments and the muscle in my face, in your face. Okay. And this has become the sphinx of your skin, if you will. My sphinx, your sphinx, the superficial muscular aponerosis. That whole system holds everything up. Okay. And then it's not working. It's not working. It's okay. And then is that the bones? This is the bone. That's right. The platter is the bone. And that is such an important piece of what's happening when we think about Jowel's structure. Okay. So let's talk about what happens with age is we start to see a shift in our bone help. So I'm going to move the cake down over here from this higher sitting platter. It's sitting on a beautiful marble pedestal like you would see in a nice bakery. And now it's going on to a shorter plate. What happened to my bones? Your bones are decreasing and you're, you're going to see a loss of bone health and osteopenia, osteoporosis, all the things that you think about for your bone health that's happening. It happens on your face. Oh my God. All of those things. And so that's important to think about. So there are easy things we could do for each of these layers to start helping your skin structure, right? Okay. Because it helps the jowel's because it helps the jowel's because what you are seeing is a decent problem. It's a gravity. Oh, a decent, a gravity problem. So I am, if I'm losing bone density, the skin that used to be held up by the bone is now gripping on for dear life to what's left and sagging down below my jawline. Correct. Yeah. And the fat loss. There's all these compartments lose a little bit. But most of it is bone structure. Also your dentition, people underestimate the power of dental care. Because with age, you start to see more crowding of your teeth. And when your teeth crowds, it can actually change the appearance of your jowels and your jawline as well. So it's that dentition. You're so brushing and flossing. Those are super easy things that you could do at home eating your green leafy vegetables that can help your vitamin D and calcium up. Doing all of that. So those are all what am I doing? How what do you do about your job? So once you've optimized all of the systemic things, right? I'm heading on every word. And I want you to go to dermatologist and talk about high frequency micro focused ultrasound. Okay. So these are not and sometimes they're called noninvasive facelifts. So this is an energy that's delivered through ultrasound waves that can help tighten the spank slayer, the superficial muscular ponorosis. It can be applied for your neck. It can be applied for the lateral the sides of the face. It works for some people. It needs multiple treatments and making sure you're being consistent with it. We'll see. I'll report back. So Mal, speaking of different skin changes that you're seeing, I have another cake because I want to show you what the GLP1 medications can be doing to your skin and facial structures. Oh, great. I have our executive producer Tracy coming in with another cake. Oh, whoa. So the first cake is just like what you would expect at a bakery. There's a clean slice. It looks like a great cake. The other cake is the same. It's got three layers. It's the red velvet. It's the vanilla. It's the chocolate. It's the plate. It's the bones, but the cake looks like one of your kids took a fork or their fingers and started digging out at the layers. It looks like somebody basically ate part of the cake without slicing it. Yeah. So what you see at the surface level for skin for patients on GLP1 medications is laxity or looser skin. A lot of patients that are on these medications, they kind of talk about it as ozemic face. It's a commonly used term. But what that actually means is that it's shifting the way your skin is naturally sitting because you've lost the underlying support structure from the fat layers. Your muscle has gotten leaner and you're seeing different changes. So let me demonstrate for you. Are you going to cut a slice of the sucker? Oh my God. No, she's not. She's not cutting a triangular slice. She's going for the bottom layer. Yep. This is the hypodermist. This is the fatty layer of your skin. Okay. So I'm going to go all the way across. How am I doing? You're doing really good. And this is going to kind of just remove that fat structure for every 20 pounds of weight that you lose on a GLP1 medications. That's a 10% facial volume loss. Wow. So that and what's happening is the bottom layer of this cake. These three layers of your skin structure, the fat layer is going away. She's now lifting the cake off the platter. She's putting it on a plate and all that's left is the red velvet and the vanilla. So just the top two layers because the fat is gone. So what does that mean for somebody on a GLP1 and what is it? A ZMPIC face mean, Dr. Wiles from a medical perspective from a medical perspective. It's that you've lost the healthy adipose structure, the healthy fats that present on the face. And technically it's not accelerated aging. So what's actually happening is that you've just experienced weight loss on the face. I want to share here that GLP1 medications have really been transformative for so many patients. It has been an incredible tool. And that's the first and foremost priority within their portfolio. But what we see as a side effect is that the medications can influence facial volume loss. And when you have this, this is a perceived older appearance look, right? Think about a child. They have these beautiful, they call baby cheeks, right? Right. Six year old right now has the best smile because her cheeks puff up. And that means that that facial volume, especially in that mid face, confers youth. So we associate that mid face volume with youth. So when you start to lose that mid face volume on GLP ones and you see that decline and the sagging that can happen from the elasticity and the stretch of the skin, it's actually the opposite effect of pregnancy. With pregnancy, you have a slow increase of skin stretch. With weight loss, you have a quick rapid loss and you have an involution and you have that the skin that can sag down. So it's, it's, so that's what you're seeing here. So what do you do if you're on a GLP one and you're starting to see ozemic face and you're starting to see like the, the skin sagging from the rapid weight loss? So this is where I think building up muscle is so key. We talked about this connection with muscle and skin and creating the, the strength training moments. So these actually can impact your, the muscle on your face. Your face has muscle too. And this can be strengthened over time just by whole body strength training. You can create the right signals, the right exercise induced exosome cues that can help build that and, and preserve that skin scaffold as you're going to these changes. So somebody who is on a GLP one and experiencing awesome results with weight loss, but you are losing that third kind of fat layer in your skin. And now you're starting to have a saggy or older looking face, the ozemic face. Strength training helps re-stimulate that in your face. Stainting is part of the equation and you want to start it earlier on. So when you're going on the ozemic medication and you know you're about to experience this, right? So accelerated weight loss happens for some, not everybody. And when you're in that accelerated weight loss period, that's when you want to be thinking about all the additives you could do like strength training to help that. There's also bio stimulation. Again, brings into the conversation and what about radio frequency, micro needling or micro focused ultrasound. Those are other energy based devices that could be collagen stimulating and collagen banking as you're going through that accelerated weight loss period. But you want to be cautious because you want to wait for that weight to stabilize. So once you've finished having that considerable weight drop, that's when you want to think about interventions at that time. Very helpful. And the visuals fantastic. Let's remove the cakes. Here we go. So Dr. Wiles, if the person listening takes one thing away from this extraordinary conversation, what would it be? You are serving your overall health by listening to the skin. It's a bi-directional conversation. It provides us clues and information of how your overall health is functioning. But really the conversation is that it's okay. You need to be more forgiving to your skin, which is functioning in so many different ways. The final thing I'll leave you with is that the face gets the marketing budget, but the whole organ deserves the care, and that is health care. Oh, I love that. The face gets the marketing budget of all these products, but the whole body is the health care. Exactly. This has been extraordinarily fascinating and empowering and fun. Dr. Walsh, what are your parting words? I'm so honored to have this conversation with you, Mel, and I have to say that to me, this was an experience that I manifested in a way. I thought in doing our research with my lab, looking at the skin and seeing the changes that it can confer for your overall health, I had this thought. I thought, wouldn't it be great if I shared this with the world and how important it is to think about your skin in not just in a way that is being marketed to you, but really shift the conversation about how important it is for your overall health, and literally three months later, I ran into an elevator, and we made that connection, and here I am. Thank you for this opportunity to talk to your viewers. You're welcome. There is something magical about the show. I really believe that. I was in an elevator. The doors opened up. You walked in. You had on the coolest outfit. You had on one of those tags. You were here for some big medical conference at Harvard or something like that. You said hello. I said hello to you. I think I complimented your skirt or something. Then we started talking. We then find out that you're not even just incredibly dressed and super smart and really outgoing. You happen to be a rock star medical researcher doing unbelievable things, running two centers, and this research lab. Yes, you did manifest this. Yes, it is important to say hello to people in elevators. Yes, it is important to put out in the world what you want to see and experience in the world because when you do extraordinarily magical things happen. Thank you for having that intention. Thank you for being in that elevator. Thank you for doing the research that you do. Thank you for making us feel empowered and smart about how to take care of the largest organ in our body. I definitely am leaving here really excited and I can't wait to share this with so many people in my life and I'm excited for you. I want to thank you as well for making the time to listen to this or to watch this. In case no one else tells you today, I wanted to be sure as your friend to tell you that I love you and I believe in you. I believe in your ability to create a better life and your health is the basis of having a better life and everything you learn today is going to help you make smart decisions that will make you feel better in your own skin. Alrighty, I'll see you in the very next episode. I welcome you in the moment you hit play. You got this. You're going to do dynamite. I'm getting a free dermatology appointment from one of the world's leading experts at the Mayo Clinic. Let's go. Let's do this. You just go for it. Like, you don't have to ask permission at all. Oh, it looks fantastic. Isn't it amazing? Mel. My face broke it. What happened? This is the other one's dead. I put too much Botox in it. We killed the machine everybody. Okay, let's do it again. Okay, so there are violations. I'm like, I'm just not as smart as you about this. So I'm like, what is a transcription? That kind of wing it. Okay, I love that about a scientist. Let's wing it, baby, in the kitchen. Coconut oil, not water. Okay, I was like, wait, I think I'm going to have diarrhea. I don't think I should do oil. C-E-R-A-M-I-D-E-S. Bingo, you go to the next round. Cardiac training, as well as resistant training. Cardiac. Cardiac. Okay, sorry, sorry. Okay, I'm like, what a hell are we doing here? Is this a new franchise that's launched in Rochester, Minnesota only? So let me rephrase. Okay, so what I want you to do when you've gotten to a situation where a situation. My daughters does that word a lie. Amazing. Okay, sounds good. Good. Yeah, you were dynamite. This segment is brought to you by Mrs. Myers. Now, you may think that you're ignoring the clutter around you, but your brain isn't. See, the little things in your home can affect you more than you realize. The noise, the clutter, even weird smells. All of these things can make it harder to relax or to get into creative headspace. 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Because while you think you can ignore all the distractions around you, your brain can't. Turning down the music, silence. It helps you see because your brain has less to process. It can focus. See, when you turn down the music, you're giving your brain a clean slate. The same is true with life. When you walk into your office or your bedroom or your kitchen and it's just filled with bills and dishes or laundry, of course you're going to fill overwhelmed. And here's what's interesting. That physical clutter becomes mental clutter that you take with you when you leave the room. There's really interesting research around this. Researchers put about 124 college students into a virtual subway station. And for some of them, the space was super clean, right? Everything was neatly organized. It was a very clean subway station for other people in the study. The subway station was just super messy. There was trash scattered everywhere. Construction materials were all over the place. And the students spent eight minutes in that cluttery or clean physical environment. Then they took everyone and made them take a test that required them to focus and ignore all the distractions. Here's what they found. The students who had been in the cluttered environment before the test made significantly more mistakes. In other words, even when you're trying to tune out the mess around you, all of that clutter can make it harder for your brain to focus on what's right in front of you. So if you're feeling overwhelmed right now, wherever you see clutter, just take a minute and straighten it up. Maybe it's the corner of your desk where things are piled up that always happens to me too. Or your nightstand, covered in books, it's got glasses with water in it, maybe reading glasses, the back seat of your car that's starting to look more like a garbage can. Maybe it's the chair in your bedroom that's morphed into a clothing rack. Just pick one space that makes you feel overwhelmed and then just tackle it. And every time you pick something up, you put it where it belongs, you clean one surface, you organize your fanny pack. That's exactly what you're doing. You're turning down the music so you can focus. You're giving your mind a clean slate, and you will feel an immediate difference. You'll exhale, your shoulders will drop, your mind's going to feel less cluttered, and that overwhelming stress, it'll start to dissipate. And that's what cleaning the mental slate is all about. It's a gift you give to yourself anytime you need it, because the fastest way to create a little more common your mind is to create a little more space right in front of you. I want to say thank you again to our new sponsor Mrs. Myers. I love Mrs. Myers. They look to the garden for inspiration because they believe the best stuff in life is simple. So do I. Mrs. Myers premium-cented oil diffuser provides long-lasting garden-inspired sense like rainwater, lavender, peony, compassion flower, which fill your home with calm. Don't get hung up on the noise clutter and weird smells reclaim your space with Mrs. Myers. Find your outlet. Mrs. Myers plug-in-cented oil diffusers. Oh, and one more thing. And no, this is not a blooper. This is the legal language. You know what the lawyer's right and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I'll see you in the next episode.