Your skin is a check engine light: 5 pillars of skin health

Skin is not a beauty scorecard. According to Dr. Serena Wilds, a Mayo Clinic dermatologist and physician scientist, it works like your check engine light. In a conversation with Mel Robbins, Wilds explains how to read what your skin is telling you and which five pillars help it age better.

Skin care is health care

Changes that seem to appear "all of a sudden", such as new brown spots, flushing or a fine line, have usually been brewing for about three months. Your skin is a dashboard of your overall health. It can reflect autoimmune dysfunction, inflammation, kidney disease, diabetes and liver problems. Severe psoriasis, for example, comes with about a sixfold higher ten year risk of heart failure, heart attack and stroke.

The skin is also your largest living and regenerative organ, renewing itself about every 30 days. It repairs wounds, secretes oil and sweat, absorbs topical medicines, senses touch, blocks UV, pollution and chemicals, makes vitamin D, hosts its own microbiome and immune system, and regulates temperature.

How your skin ages

Aging comes from two directions. The outside in factors are the exposome: UV light, pollution, particulate matter, ozone and smoking. The inside out factors are metabolic and hormonal changes and genetics. Perceived age also matters. A study of more than 6,000 cancer patients linked facial age, read by AI, to survival, and a Danish twin study found the older looking twin had worse cognition, physical function and survival. The good news is that your skin can reset.

The five pillars of skin span

1. Sleep

Your skin runs on a circadian clock. By day it is in defense mode, protecting you from UV and pollution. At night it switches to repair and regeneration. Good sleepers show about 30 percent better barrier recovery than poor sleepers, and two consecutive nights of three to four hours of sleep already weaken hydration and the barrier. A repair cream cannot do its job if your sleep keeps confusing your skin.

Practical tips: aim for seven to nine hours, take magnesium L threonate one to two hours before bed, avoid sleeping on your face or stomach and run a humidifier in your room.

2. Diet and hydration

In a 12 week trial, a low glycemic diet improved acne flares by 23 percent. Sugar sticks to collagen and elastin in a process called glycation, which breaks down the skin matrix. A UK Biobank analysis of more than 200,000 people found that a high fiber diet was linked to fewer psoriasis flares. Eat fiber close to sweets to blunt the sugar spike. For eczema, gluten reduction can help some people.

Wilds shares a family recipe, the ABC smoothie: apples with the peel on for quercetin, beets and carrots cooked until soft, then blended with one or two tablespoons of flaxseed and chia, turmeric and coconut water. Two tablespoons of chia carry about 180 mg of calcium.

Drinking water is not enough to hydrate your skin barrier. Women need about 10 cups a day and men about 12 to 13. Then apply moisturizer with humectants such as glycerin, ceramides, colloidal oatmeal and beta glucans. Pick tub lotions over pump lotions, which are thinner. Choose products labeled fragrance free, because unscented may still contain masking fragrance.

3. Movement

Older adults who exercised healed skin wounds about 10 days faster. Exercise releases exosomes that carry beneficial signals to distant organs, including the skin. In a 16 week study of 56 middle aged women, resistance training improved skin elasticity more than cardio. Strength training also helps people on GLP-1 medicines keep their skin firm.

4. Stress

Your skin has cortisol receptors and its own neuroendocrine system, so it feels stress. In 28 women going through marital separation, barrier recovery was worse. Stress can also push hair into the shedding phase three to four months later. Wilds mentions pumpkin seed oil at 400 mg for 24 weeks in men with pattern hair loss. Pigment changes on nails need a dermatologist, because dark patches can be melanoma.

5. Topicals and treatments

Peptides are short chains of amino acids and are mostly not regulated by the FDA, apart from drugs such as GLP-1 medicines. Wilds likes topical copper peptides but advises against the injectable "glow stack" of BPC 157, TB 500 and GHK copper.

By day, use an antioxidant such as vitamin C with ferulic acid and a broad spectrum SPF 30 or higher, reapplied regularly. Tinted sunscreen adds iron oxides for visible light protection. In a UV camera test, mineral, chemical and tinted sunscreens blocked UV, while coconut oil and beef tallow did not. Keep sunscreen in your car, because UV passes through windows. At night, use copper peptides, a retinoid you can tolerate and a barrier moisturizer with beta glucans.

Jowls and GLP-1 face changes

Jowls are mostly a descent problem tied to bone loss, so care for your teeth and bones, then ask about microfocused ultrasound. On GLP-1 medicines, each 20 pounds lost can mean about 10 percent facial volume loss. Build muscle early and wait for weight to stabilize before collagen stimulating devices.

Conclusion

The face gets the marketing budget, but the whole organ deserves care. Listen to your skin and give it sleep, food, movement, calm and smart topicals.