If our eyes are the windows to our soul then our skin is the mirror of how we live our lives which includes what we eat and the environment we surround ourselves with. This even includes people. Yes, toxins come in the form of relationships, emotions even our behaviour, as well as the chemicals and pollutants we find ourselves exposed to regularly. We don’t have to “sell our souls” in our quests for eternal youth and have a hidden portrait that grows more gruesome with each negative habit like in The Picture of Dorian Grey. Neither is our skin’s karmic fate predetermined. There are many lifestyle choices that can help manage the affects of bad habits and even change genetic predisposition to skin issues such as eczema, rosacea and acne.
In order to understand how to help our skin retain its youth, we have to understand its structure and function. Our skin serves as the first line of defence against environmental factors such as chemicals, allergens and infections while also providing a role in temperature regulation and water loss. This outermost layer of the skin called the skin barrier is formed by multiple fine layers of keratinocytes (skin cells). The cells have tight junctions that enable the keratinocytes to stick closely together, quite like bricks in a building, which ensures optimal barrier function within its many different roles. The skin barrier is commonly the target of many skin products on the market that tout a variety of benefits including repairing damage, cleansing, moisturising, reducing the signs of aging and more. Contrary to what many of these products claim, they can actually negatively affect the skin barrier.
The Skin Microbiome
One of the key components of a healthy skin barrier is the skin microbiome. This is a diverse and active community of micro-organisms, bacteria, viruses, and fungi, that are essential for the skin barrier and the other layers intact and functioning well. They are constantly policing the barrier through different interactions (physical, chemical and immunological) to keep everything balanced and healthy. Physically, skin microbes actually contribute to the integrity of the skin barrier while chemically, they secrete the components of the skin that help retain its youthful appearance and prevent it from dehydration. Immunologically, they control the production of a variety of innate immune factors that enhance immune functions to protect the skin internally and externally.
Chaotic though they may seem, the interactions are well controlled and delicately balanced with the relative abundance of the microbiome determined by a variety of factors such as age, genetics, lifestyle, environment, antibiotic use, toxin exposure and obesity. These “special forces” with which we are armed, prefer a pH that is slightly more acidic in a range of 4.5-5.5. Though all of the interactions are normally controlled, they are vulnerable to continuous exposure to internal and external factors that disrupt their delicate balance.
Is is really important to have guidance with the skin practices you keep and the products you choose. Following advice on social media without guidance can be detrimental to your skin microbiome and barrier. The overuse of strong ingredients like exfoliating acids, peels or retinoids and frequent washing of the skin with alkaline products that contain toxic ingredients disrupt the acidic pH of the skin and kill our “special forces”, potentially leading to problems including inflammatory skin conditions such as infections, autoimmune disorders and allergic disease.
The Gut Microbiome, Immune Health and The Gut-Brain, Skin Axis
Other toxic exposures that make the skin pH more alkaline are pollution, UV and chemical exposure. Additionally, it is even more important to make sure you are following a lifestyle that includes whole-food nutrition, good sleep hygiene, exercise and supplementation where needed to protect our “special forces”. Cumulative evidence has demonstrated that the skin barrier has a bi-directional connection with other barrier sites such as the intestine, lung and brain through which each resident microbe communicates. When there is a change in the gut flora (dysbiosis) from damage to our “special forces” they talk to other microbes and signal inflammation throughout the body and in the brain.
Irritable bowel diseases like Celiac, Ulcerative Colitis and Crohn’s and functional bowel disorders like small intestinal bacterial overgrowth (SIBO) and gastro-oesophageal reflux disease (GERD) are often only described in terms of the gastrointestinal symptoms but they also have symptoms that impact the brain such as mood disorders, sleep disturbances, and cognitive issues like brain fog and poor memory or fatigue because of the gut/brain/skin axis of communication. Many people who have these gut disorders also have skin problems like eczema, rosacea, acne and psoriasis. Furthermore, trauma and adverse childhood events (ACES) have an impact on the nervous system predisposing mood disorders such as depression and anxiety that also manifest as psoriasis and other skin conditions.
Maintaining a healthy skin microbiome and all of its connections through whole food nutrition, exercise, good sleep hygiene, reducing toxin exposure, maintaining positive social connections and seeking psychological counselling or trauma based interventions can be extremely beneficial in preventing or treating these common skin conditions from the inside out.
Deirdre Nazareth, DO, ND, Msc, IFMCP