A great complexion starts below the surface.
"Your skin really is a window into your overall health," says Whitney Bowe, MD, a clinical assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai. "It can reflect your hormones, stress level, and other things going on in your body."
That's why you may need to go beyond your derm to solve tricky skin puzzles, from brown spots to acne breakouts. Here, four specialists give their best beauty advice, working from the inside out.
Outsmart Stress to Look Younger
The Psychiatrist Says: When the going gets tough, your body pumps out the stress hormone cortisol.
"If it stays elevated, as it does with chronic stress, skin can react in all sorts of ways," says dermatologist Amy Wechsler, MD, who is also an adjunct clinical assistant professor in psychiatry at Weill Cornell Medicine in New York and an expert in how the mind affects the skin.
Cortisol breaks down collagen, which causes wrinkles; it promotes inflammation, which can trigger acne or rashes; and it can increase water loss in skin, creating dryness and sensitivity. Basic stress management may dial down cortisol and calm your skin. Try deep breathing, yoga, whatever works, says Dr. Wechsler.
"And get seven and a half to eight hours of sleep a night. Cortisol levels are low then and skin has a chance to build collagen and repair itself," she adds.
The Derm Adds: A retinoid can rev up collagen production as well as skin cell turnover, which helps keep pores clear. Try an OTC formula with at least 1 percent retinol. Salicylic acid or benzoyl peroxide can help with acne, and anti-inflammatory ingredients like chamomile can calm redness. Rashes may need an OTC hydrocortisone cream, says Wechsler.
Rebalance Your Gut for a New Glow
The G.I. Doc Says: "Everyone has a mix of good and bad bacteria in their gut — and these bacteria compete for real estate," says Rebekah Gross, MD, a clinical assistant professor of medicine at NYU Langone Medical Center.
When the bad bugs win, they pump out an inflammatory substance that can affect your skin; studies have linked a gut imbalance to acne and rosacea.
"And anecdotally, gastroenterologists know that when people have an unhealthy gut, their skin can look dehydrated and sallow," Dr. Gross says. "Once their bacteria is back in balance, patients tell me their skin looks clearer and brighter."
A good-gut diet is key for healthy skin (and a happy tummy, too). Make friends with fermented foods because they contain probiotics — live bacteria or yeast that keeps your gut in balance. (Miso soup, sauerkraut, yogurt with active cultures, kimchi, and kefir all fit the bill.) If you are lactose intolerant (or just hate sauerkraut), you could also consider taking aprobiotic supplement.
The Derm Adds: For treating skin inflammation, many derms,including Dr. Bowe, prefer a natural approach, relying on products with skin-soothing botanicals like rose extract, chamomile, green tea, aloe, and cucumber. Rose also has antibacterial properties to fight acne, and its high levels of vitamin C may help boost skin repair and wake up your complexion, she says. Topical probiotics are also gaining buzz for their anti-inflammatory effect on redness and acne-prone skin, though research is still in its early stages.
To counter dry skin, moisturize it like crazy. For dullness, try using an AHA product a couple of times a week. Glycolic acid will also help smooth fine lines and brighten your skin.
A probiotic pill may come with skin benefits; just stick to research-backed ones with Lactobacillus or Bifidobacterium.
Don't Let Hormones Mess With Your Looks
The Ob-Gyn Says: Up-and-down hormones are behind a slew of skin gripes. When estrogen starts to gradually decline in your forties, your complexion can become dry and wrinkle prone.
"Skin has a hard time maintaining moisture and produces less collagen," says Mary Jane Minkin, MD, a clinical professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine.
Too much estrogen (it surges during pregnancy and when you're taking certain oral contraceptives) can rev up your pigment-producing cells, which makes brown spots pop up when you spend time in the sun. A boost in estrogen is also responsible for melasma, a condition that causes brown patches even without UV exposure, says Dr. Minkin.
Male hormones called androgens, including testosterone (yes, women make this too), may also cause trouble. Androgen levels climb naturally mid-cycle and can trigger increased oil production, which could bring on breakouts — even in your thirties and forties.
Your gyno can help you figure out if you've started on the path toward menopause; if so, step up the moisturizing (we'll get to that in a second). If you take birth control pills and brown spots and splotches are your problem, talk to your doctor about switching to a brand with a low dose of estrogen. The right pill may also halt breakouts.
"Oral contraceptives suppress testosterone, and that can help clear skin up," says Minkin.
The Derm Adds: Use a hydrating cleanser that won't strip skin's lipids; then, "smear on a rich cream or oil," advises Wechsler.
For brown patches, wrinkles, and breakouts, retinol again is your best bet.
"Double your efforts by layering a collagen — boosting peptide on top," says Kavita Mariwalla, MD, a clinical assistant professor of dermatology at SUNY at Stony Brook University.
You want a cream with moisture power from ingredients such as safflower or olive oil, ceramides, or shea butter.
Clear Up Allergies (and Your Skin)
The Allergist Says: Got super-dry, itchy skin? Allergies may be the sneaky culprit.
"Eczema is often associated with indoor allergies such as sensitivity to dust mites in your home," says Clifford Bassett, MD, a clinical assistant professor of medicine at NYU Langone Medical Center.
Food allergy sufferers may also have skin-related complaints like hives, itching, and eczema. The first step is to figure out what you're reacting to so you can steer clear of it. A thorough evaluation with an allergist can help pinpoint possible causes.
"If the specific trigger is unclear, you may benefit from patch testing that's designed to detect possible skin allergies," says Dr. Bassett.
For itchy rashes andeczema flare-ups, a doctor may prescribe a topical steroid cream. Oral antihistamines can be used to treat hives and may also improve eczema if there's an allergic trigger. (While old-school formulations were notorious for drying out skin, newer versions are less likely to make you parched.)
The Derm Adds: "The goal with eczema and rashes is to restore the skin's protective barrier so allergens stay out and moisture stays in," says Bowe.
For that, derms suggest making your shower warm, not hot, and no longer than 10 minutes. Use a mild cleanser, then once you're out of the shower, moisturize your face and body immediately. You want to slather on a fragrance-free body lotion that has barrier-strengthening natural oils or lipids such as ceramides, as well as humectants like glycerin.
Again, products with natural anti-inflammatory ingredients (aloe, chamomile, green tea) can help quell redness and irritation. Some dermatologists also like to use whole-milk compresses to soothe skin.
"The fats in milk have an excellent moisturizing and anti-inflammatory effect," Wechsler says.
This story originally appeared in the May 2016 issue of Dr. Oz The Good Life.
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