Dr. Apple Bodemer on How to Improve Your Skin Health

Dr. Apple BodemerYour skin health has a significant impact on your quality of life. That’s one of the realizations that got me interested in dermatology during medical school. Over the years, I’ve come to understand that of all the organs in the body, the skin is often one that motivates people to make a health change. It’s hard for patients to feel strongly motivated about health changes that may impact other organs like their liver, because they can’t see it.  With the skin, as soon as a skin condition develops, patients see it.

As a practicing dermatologist, I think it’s important to be flexible and to meet patients where they are. My approach to helping patients with skin conditions is a little different from most conventional approaches. First, I assess the treatment direction the patient wants to take. Depending on whether a patient wants quicker results or wants to avoid drugs, I can offer specific options that fit that individual’s goals. The patient’s goals—not my agenda—are what’s important. Even if a patient it looking for more traditional pharmaceutical options, this doesn’t close the door on lifestyle changes. Often, I also discuss how diet and lifestyle affect the skin as well as inflammatory skin conditions. As a patient starts to see some improvement, they are often more open to moving forward with implementing a healthier diet, stress management techniques, and other lifestyle changes.

How Your Lifestyle Affects Your Skin

I often ask patients to pay special attention to their diet. I provide them with evidence of what we know about how diet can improve their specific skin condition and give them some practical suggestions. I promote plant-based food and foods with lots of fiber. When a patient is receptive, I recommend other changes, like cutting out dairy products. If someone has implemented a healthy diet, but still find themselves dealing with skin issues, I often inquire about their gut health. Constipation? Indigestion? Heartburn? All of these symptoms can indicate gut dysbiosis. This way I can get a better sense of whether there is another health issue involved and if additional tests or botanicals might be helpful. Here are some other issues I often discuss with my patients:

Hormones

Hormonal acne often affects women, teenage boys, and young men. When it comes to teenage boys, the treatment aim is to dampen their raging testosterone, so I often recommend increasing whole soy foods in the diet. These provide fiber and increase the levels of a sex hormone binding globulin which binds testosterone and allows it to be excreted.

Dietary Changes

I often challenge patients to give up certain foods for a few weeks, like dairy and wheat, which can trigger skin conditions. If a flare-up occurs when they reintroduce these foods to their diet, they will be able to identify the foods that trigger their skin conditions. Most of the time, patients will make healthier choices. I try to avoid the stigma associated with “falling off the wagon” when it comes to discussing diet. I find that when you give people the tools and information they need, they will usually make healthier choices over time.

Hydration

Proper hydration is often an undervalued aspect of health. While there have been relatively few studies of hydration’s impact on skin health, we do know good oral hydration improves circulation in the small cutaneous blood vessels which can lead to healthier skin. Remember, the skin has tiny blood vessels throughout, and without enough blood volume, the work of bringing nutrients to the skin and removing waste is impaired.

The moisture in your skin comes from your circulation. The word “moisturizer” is a misnomer. Creams, oils, or ointments don’t really add moisture to your skin from the outside. Instead, they lock in the moisture already in your skin and prevent it from evaporating.

Everyone’s skin is different. For older patients with dry flaky skin, rosacea, or eczema, coconut oil is great because it has antimicrobial properties and is rich in antioxidants. For teens with acne, just a few drops of apricot oil or jojoba oil, both of which are lighter oils, can help hydrate the skin. While people with blemish prone skin might be wary of applying oil to the skin, it is important to recognize that blemishes are due to excessive oil under the skin—not on the skin. Stripping of the skin of oil by using harsh toners, abrasive cleansers or too many over the counter medicated products can stimulates the oil glands to make more oil, which is what you don’t want. So, under-moisturization, not over-moisturization, is actually a bigger problem. Simply put, even if you have oily skin, you still should moisturize.

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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Personal challenge and motivation compelled me to pass my ABPS board exam. Measurement and confirmation of my own knowledge base reinforced my self-confidence. The ABPS, with its history of inclusivity, has allowed me to have a voice in the organization, while permitting me to impact overall national patient safety and care through certification. Participation in exam development afforded me the opportunity to witness the rigorousness of the exam process and psychometrically sound product, while developing meaningful collegiality, professional life enrichment, and warding off burn out.

Elizabeth Maxwell-Schmidt MD, FAAEP, FACEP
Emergency Medicine
Board certification through the American Board of Physician Specialties has served to substantiate my interest and additional training in several fields of medicine including Internal Medicine, Disaster Medicine, and Administrative Medicine. As a result, I have been able to serve my community in clinical, disaster response, and administrative medicine roles. Through the ABPS, I have become recognized as a leader in my various fields of interest.

Spencer Price MD, MPH, MBA
Internal Medicine, Disaster Medicine, Administrative Medicine
BCEM certification through ABPS has provided me with many opportunities. It has helped me demonstrate that I have special experience and expertise in Emergency Medicine beyond that obtained through my family medicine training. BCEM certification firmly established me as an emergency medicine specialist once I started working in emergency medicine full time. ABPS has also helped me network with other family physicians with a passion for improving rural and underserved emergency medicine practice.

Alex Beuning, MD, FAAEP
Emergency Medicine