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Dr. Apple Bodemer on Optimizing Skin Health

Dr. Apple BodemerAs a practicing dermatologist, I would argue that the skin, the largest organ of the human body, is the most important. It is our immune system’s first line of defense, blocking microbes, viruses, bacteria, and fungus from entering our system and causing problems. As our interface with the world, the skin is supplied with an abundance of nerve endings which contributes to how we experience our environment.

When patients come to see me for help with skin conditions or advice on skin health, I take an approach that’s different from conventional dermatology. As an example, I often begin by discussing how diet and lifestyle affect the skin and inflammatory skin conditions. Depending on patient preferences—whether a person wants faster results or wants to avoid systemic medications, for instance—I can offer specific options that fit each individual’s needs. Through this integrative medicine approach, I am able to offer patients a broader palette of options.

There are a number of recommendations that I commonly offer people with chronic inflammatory skin conditions. I often suggest that patients eliminate dairy from their diet, especially patients with blemished-prone skin and patients prone to cysts. Dairy products tend to exacerbate these conditions and, because they impact hormone levels, they may also play a role in some types of hair loss.

I also talk to my patients about the importance of sleep in maintaining good skin health.  Sleep is an under-recognized tool when it comes to managing overall health, not just skin health. When we don’t sleep properly, our stress hormones escalate, wreaking havoc on sex hormones levels as well.  Both have negative effects on our skin and can impair proper skin barrier function.

The most common condition I see is skin cancer, so UV protection is one of my main topics of discussion. I tell patients that in order to minimize risks for skin cancer, proper UV protection is a must. But diet also plays a role.  I recommend a diet high in fruits and vegetables. Studies show that people with diets rich in fruits and vegetables have less risk for both melanoma and nonmelanoma skin cancers.

As for UV protection, I tell patients that applying sunscreen should be their backup plan, not their primary form of UV protection. It is important to avoid the strong midday sun when possible and to seek shade as much as you can when outdoors—especially during peak hours.

One underutilized form of protection I recommend is UV protective clothing. Look for the symbol that says UPF 50.  This means that that the piece of clothing will only allow 1/50th of the UV radiation it is exposed to, even when wet. All clothing protects us, but regular fabric loses a measure of UV protection when wet. While lighter colors and looser-weave fabrics generally don’t provide as much protection as darker colors and heavier fabrics, the UV protective clothing comes in light and cool fabrics that maintain UV protection even when wet.

Hats, gloves, and sleeves are also among my list of recommendations. Gloves and sleeves are particularly useful for people who spend a lot of time gardening, golfing or any outdoor sport. Hats are great if they provide good skin coverage. A 3-inch hat brim will cover three-quarters of your face, and a 4-inch brim will cover your entire face. Baseball caps may look cool and shade the eyes but don’t offer much protection. Plus, they leave the delicate skin of the neck and ears exposed.

When it comes to sunscreen, people usually don’t apply enough of it. A palmful should cover a body in a bathing suit—a palmful because that’s the amount used in studies that determine a product’s SPF (sun protection factor). Sunscreen should be reapplied every 2 hours and after getting wet. And, given that sunburns cause DNA damage that contributes to skin cancer, you should avoid getting burnt, no matter what your risk factors are.

Apple Bodemer, MD,  is an associate professor in the dermatology department at the University of Wisconsin-Madison. She is a Diplomate of the American Board of Integrative Medicine (ABOIM), which is governed by the American Board of Physician Specialties® (ABPS).

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