August 19, 2024 • 2hr 46min

Dr. Teo Soleymani: How to Improve & Protect Your Skin Health & Appearance

Huberman Lab

In this episode, Dr. Andrew Huberman interviews Dr. Teo Soleymani, a double board-certified dermatologist and skin cancer specialist. They discuss evidence-based approaches to improve skin health, appearance, and reduce cancer risk. Dr. Soleymani provides insights on skincare routines, sun protection, nutrition, and treatments for common skin conditions.

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Key Takeaways

Skin turnover and structure: The skin completely renews itself every 28 days. It has three main layers - epidermis, dermis, and subcutaneous fat. The dermis contains blood vessels, nerves, hair follicles, and glands.
Stress impacts skin health: Acute stress can cause immediate changes in skin appearance through vasoconstriction. Chronic stress leads to breakdown of collagen and elastin, accelerating aging.
Caffeine and nicotine effects: Caffeine causes minor, transient vasoconstriction. Nicotine is more problematic, causing chronic vasoconstriction that ages skin faster.
Alcohol negatively impacts skin: It has a diuretic effect, drying out skin. Long-term use disrupts sleep and gut health, further damaging skin.
Hydration and moisturizers: Drinking extra water doesn't significantly impact skin hydration for most people. Using a non-comedogenic moisturizer appropriate for your skin type is more effective.
Sun exposure: Some sun exposure is beneficial for overall health and mood. Use mineral-based sunscreens (zinc oxide, titanium dioxide) and protective clothing to prevent damage.
Diet and skin health: An anti-inflammatory, high protein diet supports skin health. Specific foods like collagen supplements have limited evidence of benefit.
Retinoids are highly effective: Prescription retinoids like tretinoin increase skin cell turnover, reduce wrinkles and skin cancer risk. Over-the-counter retinols are much less potent.
Laser treatments can rejuvenate skin: Ablative and non-ablative laser resurfacing treatments can significantly improve skin appearance and health.
Regular skin checks are crucial: Get annual full-body skin exams by a dermatologist to monitor for skin cancers, which are very common but often treatable if caught early.

Introduction

In this episode, Dr. Andrew Huberman interviews Dr. Teo Soleymani, a double board-certified dermatologist and skin cancer specialist. They discuss evidence-based approaches to improve skin health, appearance, and reduce cancer risk. Dr. Soleymani provides insights on skincare routines, sun protection, nutrition, and treatments for common skin conditions.

Topics Discussed

Skin Structure and Turnover (5:45)

Dr. Soleymani explains that the skin completely renews itself every 28 days. The skin has three main layers:

Epidermis (outer layer)
Dermis (middle layer containing blood vessels, nerves, hair follicles, and glands)
Subcutaneous fat (deepest layer)

This constant renewal allows the skin to heal from injuries and makes it useful for studying diseases. The skin's ability to regenerate also enables various treatments to improve its appearance and health.

Impact of Stress on Skin (5:45)

Stress significantly affects skin health in both short-term and long-term ways:

Acute stress: Causes immediate changes through vasoconstriction, altering skin color and appearance
Chronic stress: Leads to breakdown of collagen and elastin through cortisol release, accelerating aging

Dr. Soleymani notes: "Stress plays a really important role. You see it both immediately and long term."

Effects of Caffeine, Nicotine and Alcohol (13:35)

Caffeine: Causes minor, transient vasoconstriction. Overall effect on skin is likely neutral to slightly negative.

Nicotine: More problematic due to chronic vasoconstriction, aging skin faster and impairing wound healing.

Alcohol: Has multiple negative effects:

Diuretic effect dries out skin
Disrupts sleep and gut health
Associated with poor lifestyle choices that further damage skin

Dr. Soleymani advises: "If you want to keep your skin healthy, if you want to look younger, I would refrain from nicotine use."

Hydration and Moisturizers (24:33)

Contrary to popular belief, drinking extra water doesn't significantly impact skin hydration for most people. Skin hydration is largely genetically determined.

When choosing a moisturizer, look for:

Non-comedogenic (won't clog pores)
Appropriate for your skin type (oily, dry, combination)
Ointments provide most occlusion, followed by creams, then lotions

Sun Exposure and Protection (50:20)

Some sun exposure is beneficial for overall health, mood, and vitamin D synthesis. However, excess UV exposure can damage skin and increase cancer risk.

For sun protection:

Use mineral-based sunscreens (zinc oxide, titanium dioxide)
Wear protective clothing and seek shade
Consider oral supplements like polypodium leucotomos

Dr. Soleymani notes: "I absolutely think that getting sun is healthy for us...I don't think you should burn, and I don't think you should be out long enough where your skin starts to turn red."

Nutrition for Skin Health (1:30:13)

Diet significantly impacts skin health through effects on inflammation and the gut microbiome. Dr. Soleymani recommends:

High protein, anti-inflammatory diet
Fruits and vegetables (as tolerated)
Omega-3 fatty acids (preferably from fish)

He notes limited evidence for specific "superfoods" or supplements like collagen improving skin appearance.

Retinoids for Skin Health (1:42:58)

Prescription retinoids like tretinoin are highly effective for improving skin health and appearance:

Increase skin cell turnover
Stimulate collagen production
Reduce fine lines and wrinkles
Decrease skin cancer risk

Dr. Soleymani strongly recommends prescription retinoids over weaker over-the-counter retinols: "If you want a retinoid, get a prescription for it. The over-the-counter stuff is not very effective, if at all."

Laser Treatments (1:49:45)

Laser resurfacing treatments can significantly improve skin appearance and health:

Ablative lasers: Remove outer skin layers for dramatic results but require longer recovery
Non-ablative lasers: Target deeper skin layers with less downtime

Benefits include reduced wrinkles, improved texture, and even decreased skin cancer risk.

Common Skin Conditions (2:04:10)

Dr. Soleymani discusses several common skin conditions:

Psoriasis: Autoimmune condition causing rapid skin cell turnover. Treated with topical medications, phototherapy, and systemic drugs.
Vitiligo: Autoimmune destruction of pigment-producing cells. Treated with topical medications, phototherapy, and new JAK inhibitor drugs.
Acne: Caused by excess sebum, bacteria, and inflammation. Diet (especially high glycemic foods) can worsen acne.
Rosacea: Chronic inflammatory condition causing facial redness and bumps. Triggers include alcohol, spicy foods, and temperature changes.
Eczema: Chronic itchy, inflamed skin often related to barrier defects and allergies. Treated with moisturizers and anti-inflammatory medications.

Monitoring for Skin Cancer (2:30:15)

Regular skin checks are crucial for early detection of skin cancers:

Get annual full-body skin exams by a dermatologist
Monitor moles for changes in size, shape, or color
Be aware that skin cancers can occur in sun-protected areas

Dr. Soleymani emphasizes: "About 5 million Americans will be diagnosed with one of the non-melanomas this year...It's about one in four Americans at some point in their lifetime will develop a skin cancer."

Conclusion

This comprehensive discussion with Dr. Teo Soleymani provides evidence-based insights into maintaining healthy, youthful-looking skin and reducing skin cancer risk. Key takeaways include the importance of sun protection, a healthy diet, stress management, and regular dermatologist visits. Effective treatments like retinoids and laser resurfacing can significantly improve skin health and appearance. By implementing these strategies, individuals can better care for their skin throughout their lives.