Transcript of Mayo Clinic Dermatologist: 5 Small Habits for Healthier, Younger, and Amazing Skin

Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. I'm so excited about the conversation today because we have one of the single most respected dermatologists at the Mayo Clinic that is running 2 different research labs. She is here to teach you what your skin is trying to tell you about your health. Isn't that cool? You can know more about your body, your health, and how well you're going to age just by looking at your skin. And right now, you might be ignoring things that need your attention. Whether it's dry skin, rash, brown spots, acne, thinning hair, psoriasis, other common skin conditions could be telling you something on the surface about your overall health beneath your skin. Dr. Surenia Wiles discovered that there are only 5 things you should do right now that have a major impact on the health of your skin, and the health of your skin has a major impact on your overall health. And today she's gonna share those 5 things with you. What you learn today from Dr. Wiles will leave you feeling smarter and more empowered about your skin and your overall health. I wanna invite you to stick around later in the episode to hear all about something called the Clean Slate, brought to you by our new sponsor, Mrs. Meyer's.

It's something that will help you clear up both physical and mental space, and you're gonna absolutely love this. Hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. I'm really excited for today's conversation. I think you're gonna be blown away. It's an honor to spend this time together. If you're a new listener or somebody shared this episode with you, I just want to personally welcome you to the Mel Robbins Podcast family before we jump in. You're going to love this episode. We're going to learn today what your skin reveals about your health with one of the most incredible medical experts we have ever had on the show, Dr. Saranya Wiles. Dr. Wiles is a dermatologist, Physician scientist and one of the leading researchers working at the intersection of regenerative medicine, skin aging, and longevity at the Mayo Clinic. Wait till you hear these credentials. She earned both her MD and PhD from the Mayo Clinic Alex School of Medicine, completed a research fellowship at the Harvard Stem Cell Institute, and then completed her dermatology residence and advanced training at the Mayo Clinic. Today, she leads the Regenerative Dermatology and Skin Aging Laboratory at Mayo Clinic, She is also the medical director of the Center for Aesthetic Medicine and Surgery and an associate professor at the Mayo Clinic.

Holy cow, are we in for an unbelievable episode today. Please help me welcome Dr. Saranya Wyles to the Mel Robbins Podcast.

It's great to be here, Mel.

It's incredible to have you here. So thank you for taking the time out to teach us about our skin and what our skin is trying to tell us about our health. Could you start by speaking to me and the person who's here with us about what could change about our life or our health or how we feel if we take to heart everything that you're about to teach us about our skin?

I am so passionate about this, Mel. Your skin is more than a beauty scorecard. It is actually information. It's a 2-way conduit between the outside world and the internal systemic health that you experience. So, Your skin is your check engine light. It reflects your overall health. If something is starting to go wrong in your body, it can oftentimes show up on the skin as different signs. So, pay attention to the clues that it's giving you. In addition, it's a great way to influence your overall health and those distant organs too. That's the part that's key to take away, is that you have the power to influence your health that starts at the level of your skin.

That's fascinating that we can look at our skin Not as a beauty scorecard, because I think so many of us, particularly when you're upper in age like me, like 57, I start to look at all the things that I don't like what it looks like, but I don't even know how to look at my skin and see it as an engine check light that might be indicating something else that's a deeper issue.

Exactly. And it could be really small signs. It's the all of a sudden moment that a lot of people describe to me. They say all of a sudden, I see this change in my skin. All of a sudden, this brown spot's popped up. All of a sudden, this fine line is over here. This redness is now— I'm— my skin is flushing.

Yes. Right?

It's these all of a sudden moments have actually been brewing for months on end. So, the conversation's actually been started a long time ago. And when you see that all of a sudden spot, you have to take a moment to see what's the damage it's been doing. And for you, I want you to know that what's happening on the skin is really a dashboard and a reflection of what's happening at your overall health. So, this is not vanity. This is actually

Okay. That's really cool, because I probably am like most people that walk into your office or walk into a dermatologist, and you're like, I have this thing under my nose, or I have this thing on my face, or my skin is suddenly this way, or this is happening and it's now a problem. And the first thing that you said is what's appearing on the surface can reveal hidden issues underneath that started a while ago. Am I tracking?

That's right. A lot of times patients walk into my office, and within the first 5 minutes, they're saying something like, I'm really concerned about this. I'm really sorry to be talking about this. I know this is vanity. I have this concern. But that's not true. I immediately shift the conversation and say, skincare is healthcare. I want you to be concerned about changes in your skin because the structure that it's showing and changing actually is a reflection of function that's happening underneath. And that's a very important conversation because it affects patients' quality of life.

I would love to hear what your skin reveals about what's happening in your body and what changes may be early warning signs that something deeper is going on?

Your skin is your check engine light. It can tell you about autoimmune dysfunction. It can tell you about inflammation happening underneath. It can give you clues to disease processes like kidney disease, diabetes, chronic liver function dysfunction. All of that can present on your skin. Psoriasis is a really good example. So, when patients have moderate to severe psoriasis, oftentimes, they're at a higher risk for heart failure. There was one study that showed that if you have severe psoriasis, you're at about 6-fold increased risk to your 10-year heart disease and heart event risk. This includes heart failure, heart attacks, and stroke.

Wow. Why is skin health—

Mm-hmm.

And the optimized function of your skin So important for your overall health, Dr. Weil? So,

your skin is your largest living organ, and it's your largest regenerative organ. So, it really— every 30 days, you're getting a new layer of skin. And it has this incredible power of influencing health because if you think about it, it's our way to the outside world.

What does your skin do?

Okay, so the skin does 8 different types of functions. We love to study this in our lab. So, we study skin repair and wound healing. So, every a little kid who gets a cut or a scrape needs a Band-Aid. They have a boo-boo. I have 2 little kids of my own. And so, the repair idea is that your skin naturally heals, and it allows you to regenerate that skin every 30 days, like we talked about. But this repair slows with age. So, you heal much faster when you're younger than with older age. So, wound healing is a big and important part of how the skin functions. The other function is secretion and absorption. The skin is an active secretor. Your skin is either oily or dry. It creates oils, it creates sweat, it Absorbs topical things. So this is how we apply medications to your skin through your skin. Sensation is key. This is how we sense and perceive the world. This is how we connect, love, touch. It's all through the skin. It is also how you know when you have a paper cut, right? So when you have a paper cut, you don't know how much your skin's a good sensor till you do.

Barrier defense. This is really what the skin is known for. Keeps the outside out, right? The skin is a great protector. The outside world exposes us to UV, pollution, particulate matter, hard chemicals. So, the skin really keeps a lot of that out. And then vitamin D synthesis. People don't talk about this enough, but vitamin D is this incredible hormone that supports our bone health, that supports our brain health. And that starts at the level of the skin. It's a conversation that your skin has with UV, and we allow that to make healthy vitamin D to support our bone and overall health. Immune surveillance. So the skin has its own microbiome, lots of friendly microbes that live on the skin. But we also monitor the skin to make sure that no one bacteria or microbe overexaggerates or proliferates. So it really helps to keep that down. Your skin actually has its own immune system. So the localized immune system that's outside of the blood immune system. And then finally, like we didn't have enough different functions to do, it's a great thermoregulator. So what does that mean? This allows us to regulate temperature, Mel. So this is how we can cool the body and be perceptive to the outside world, evolution has really prioritized how the skin and the fat underneath it play a big role in thermoregulation.

I am so excited to dig into this. So, if our skin is doing all this cool stuff, and it's part of the overall function and health, and there's this two-way relationship between what's happening on the surface and what gets communicated to your deeper health inside your body, and what your inside body is connecting to the surface of your skin. And you've already taught us that if something's suddenly appearing, we gotta go back and try to understand what's been happening because this might be a signal. What is happening under the surface of the skin, Dr. Weil, as we age?

So, because the skin is this beautiful living organ, I want you to think about its influence from the outside in and the inside out. So, the aging process within the skin is a 2-way influence. So, the outside in, we're having stressors from the environment, which we collectively call the exposome. So, this is UV light, the pollution, particulate matter, the ozone, smoking, all of that influences the skin from the outside and aging process. The inside-out signaling is just as important. So, these signals look like metabolism. So, your metabolic changes, this also looks like your hormonal changes, your genetics. So, it's that two-way conversation that really drives the surface and that colliding of the worlds that drives the surface changes.

You have 2 studies that you're excited about when it comes to the aging of your skin.

So research studies were finding that how you look, also known as your perceived age, can influence a lot of downstream health risk factors. There was a recent study that showed that when you look at cancer patients, they had a study looking at over 6,000 patients and did an AI facial image analysis and found that the patient's cancer survival and prognosis correlated with how they look, their perceived age, and those changes that they're seeing at the level of the skin actually has a biological influence, and it's showing cues that could be affecting their cancer prognosis and how they're surviving through this stage.

This is fascinating.

I wanted to also share this other great Danish twin-twin study where they looked at twins and saw how their perceived age impacted their overall health. And the older of the twins actually had more changes that are declining— poor cognitive health, poor physical function, and just that perceived age look of how someone shows up actually correlates with poorer survival, shorter telomere length, and shorter telomere function. So these are cues that are telling us that the skin is more than vanity. It's not necessarily that structural change, but it's the underlying function that could also be reflecting through that structure.

So if your skin is aging quicker

and

you're losing the structural function, that your skin is supposed to be performing, all those different things you just said, it puts you at greater risk for other things.

Exactly.

Dr. Weil, how do I actually know how my skin is aging, if it's doing a good job, if it's like really not aging well?

So when patients come to see me, we do a full facial exam and a body skin exam, and we start to look for these key signs on the skin.

Okay.

So now we have this technology that can actually use an AI-integrated system to look at your facial image, and it can do a facial scan to give you a predictive analysis of the different parts that age over time. Are you interested in getting one of these facial scans, Mel?

Well, I'm actually nervous. I saw the team setting up some piece of equipment out there, and so I kind of knew this was coming, and I'm dreading it because I'm afraid that all those decades in the '70s and '80s when I was slathering on oil and trying to burn myself are gonna come back to haunt me. And yes, I'm gonna do this even though I'm nervous, and I will narrate this. So if you're listening, we are gonna take you out of the studio. going to walk into our offices here in Boston. If you're watching this on video on YouTube right now, you're about to see the behind the scenes. You're going to see the team in the middle of a busy production day. And so we're just going to take you right along with us. I love it when we get out of the studio. So let's go.

Let's do it.

Here we go. I'm a little nervous. Okay, this machine actually looks like one of those foil things at my elementary school best friend, Jodi Brickin, and I would hold up, oil ourselves up, and then try to get sunburnt in the Michigan sun.

This is actually a very advanced technology that does look very similar to that, but it's going to allow us to capture all different angles and mirrors, and there's flashing lights in here to look at your skin.

Do I leave my glasses on?

So you can take your glasses off. This is a curved camera, and I would like you to look Right here in this middle of the screen.

Oh, just like they do at the airport. Here we go.

Just like that. You're gonna see some flashing lights. Okay. And it's processing, so we did good. Let's give that a few moments here. And you can come back here with me, Mel. Okay, let's go through this report. So here, the higher the number is really looking at a percentile, right? So 100% is what you wanna get on the report card.

So let me just tell So, the person listening, they're measuring spots, wrinkles, the texture, the pores, the UV spots, the brown spots, the red areas. Go through it.

Let's start with spots.

So, you say that when you have this, you want to see a high number like 100% or 90% or 80%. Exactly.

So,

I've got a 9, which feels like a D- on spots.

So, the spots is a combination of multiple different— so wrinkles, textures, pores. multiple different textural surfaces and combines it into one. So it's measuring brown spots, it's measuring red spots, it's measuring other types of pigment changes. It's also measuring some surface-level changes that you can see with pore sizes too. All right, so let's go through the next step. This is wrinkles. So here—

Oh my God, they're all on my forehead.

It's showing static wrinkles. These are normal lines. These are supposed to be there. You want to see texture on your skin. You want to see movement. Okay. Remember, the skin is a muscle. But it's a 9. It's a 9%. I mean, certainly this could be a hydration factor too. Okay. So a lot of times just getting enough water and putting moisturizers, this is gonna bump up your score easily.

Great.

Okay. Texture changes. So do you need more stylized—

And I'm like 999. This is like D minus, D minus. What does this tell you?

These 9%iles, they're still giving you some clues, and it's telling you that you need some changes that are more— we could talk about what actives you're putting on your skin. Maybe do you need more antioxidants here? Do we need to be thinking about what's in the oils?

I don't know if I'm putting enough active on my skin. That's probably why this is a 9.

Yeah.

Okay, let's talk about my pores.

Your pore size is doing really well. So 77th percentile.

I'm nice up right here.

That's right. That's right. So, and pores, we actually think about as they're really static. Everybody has different pore sizes that change with time, but we want to look at pores as ways that the skin allows particles to be absorbed inside. So pore size actually can be a good thing. thing. Okay. Um, and then UV spots. This is the most important change.

Okay, what is that? The screen, for you listening, went from like a high definition, you know, the Time magazine covers where it's like a way too close portrait and you see everybody's pores. That's what this looked like. Now it looked like you hit a filter and it's a pencil illustrated graphic novel version of me.

Exactly. And actually, this mask, Mel, it actually goes around and highlights the area that it's So it doesn't do the entire face, just the key components that are sun-exposed. So the nose, the forehead, the cheeks area. And you have a really good score for, for the UV spots. And this is telling me this is subcellular damage, Mel. So I can tell from this that you're doing a great job putting sunscreen on.

That shocks me, given my childhood. My number is 83. I thought this would be a 0 because I spent my childhood trying to get burned so it would turn to tan. But I do wear just a basic moisturizer that has sunscreen in it every day. Highest number is brown spots. Highest

number,

94%. What does that tell you?

So brown spots, it's pigment that's presenting on the skin. So what brown spots and UV spots, 2 of your highest scores, Mel, 94% brown spots, 83% UV spots. That's telling me that you're excelling at having skin resilience from a pigmentation standpoint. Red areas, it's 46%. So what is red showing you? I think about red primarily as low-level inflammation on the skin, and what this is showing is it can be broken blood vessels, it can be how the circulation is popping up on the skin. Some in the mornings or at nighttime, this can change during flushing. So if patients have rosacea, they can see more prominence in red. So you're—

And I see a lot of like breakage around here. I do tend to get very red, especially in menopause. Like I've noticed that I go and flush faster. I stay redder faster. It looks like things are breaking in my face faster. I don't know.

This is one of the most common things that we see in perimenopause and menopause. So red, low-level inflammation, and damaged blood vessels. And if you want to know, Mel, are you ready?

Oh, God.

For the true skin age?

Okay.

This is the calculated age of—

Oh, my God. I'm not ready to be that old. I'm 61. I'm not ready to be 61.

It is—

I thought I'd be better. I had some above the line.

This is an average, though.

61?

So I don't want this to be a means to an end. This is not a structural report card, right? This is a conversation. This is information that we can influence. And these are cues that we can actually take back and see what are the different things that can reset.

Wow. Okay. Well, I now want to find out what to do, and I would assume almost everything that we're going to recommend applies to all of us.

That's right.

Okay, great. Let's go talk about how I bring that number down.

That's right.

I love this. And we're going to take you back into the studio. Come on. You got to see behind the scenes as we are doing this. That's really cool.

It's, it's information. It's impressive.

Okay, here we go. I did not expect 61. I'm still, like, feeling like, oh, God. So, for the person who's kind of like me that feels as though you really kind of screwed it up, you have slathered a bazillion products on yourself, you spent way too much time in the sun, what is the good news about the state of your skin now and what is possible if we apply the pillars that you're about to talk about that really support the longevity of your skin? skin span and the function of your skin?

The good news is that your skin can reset. Your skin can listen to cues that's coming from your internal health and different ways that we're activating your stress cues and managing resilience, your sleep cues and getting better hours of sleep, your diet and hydration. How do we optimize those things that you can control? And if not, trying to be better, 1% better every day, different types of environmental stressors and topicals. So, if we think about the skin span pillars, it's interconnected system.

How many pillars are there for skin span?

So, there's, there's 5 pillars.

What are the 5 pillars for skin span?

The 5 pillars of skin span are sleep, diet and hydration, movement, stress reduction or recovery from stress, and then topicals and treatments.

Great. Okay. And we're gonna go through one by one, but I gotta hit the pause button. We need to shine a light on our amazing sponsors because they're the reason we can do this for free and have Extraordinary researchers come in and don't go anywhere. We'll be right back.

The good news is that your skin can reset. Your skin can listen to cues. So if we think about the SkinSpan pillars, it's interconnected system, diet and hydration, movement. Welcome back.

It's your friend, Mel Robbins. Today, you and I are here getting this incredible behind-the-scenes conversation at the Mayo Clinic with Dr. Saranya Wyles, dermatologist, physician scientist, one of the leading researchers in regenerative dermatology and skin aging at the Mayo Clinic. Today, she's showing you what your skin can reveal about deeper health issues. So, I'm a dermatologist. health problems. I'm loving this. So, Dr. Weil, let's just keep going. So you said the first pillar is sleep. Dr. Weil, how does sleep affect skin repair, inflammation, and the way your skin ages?

So the first important thing to think about with sleep is that your skin is on a circadian clock. So if you were to think about your skin health and what it's doing during the daytime and nighttime hours, at daytime it goes into defense mode. So it goes into protection from the outside world. So everything about your skin, of how it's producing oils, how water secretion, its barrier function. We talked about its immune surveillance capacity, barrier protection. So, it's in defense mode. It's fighting against the outside world, the outside damage, UV pollution, visible light, all of these things that are creating damage. It's protecting against that. So, it's in a very active mode. And then at nighttime, it switches into offense, more like a repair regeneration. So, your skin doesn't sleep at night. It actually shifts into repair mode. And this is why sleep is critical for skin health because when you're sleeping is when your skin is actually regenerating and repairing the damage that could have accrued during the daytime. So, if we look at some studies, there's actually been a study that's looked at good sleepers. So, good sleepers had 30% better epidermal barrier recovery compared to poor sleepers.

So, what that means is that if you're getting about 7 to 9 hours of sleep and you're considered a good sleeper, you actually have better barrier resilience. Your skin can stay hydrated for longer, that can protect you from the outside environment, environment and really allow you to function at its best. The opposite is also true. So, in another study with 24 middle-aged women, they look at consecutive nights of sleep lost. So, for women that had 2 consecutive nights, that's how long it took. So, 2 consecutive nights of 3 to 4 hours of sleep disrupts your skin barrier. So, overall, we saw that their hydration went down, their water loss went down, meaning that you're losing more water through your barrier. So, that was a statistical significant So, with just 2 consecutive nights, you can really shift your skin's hydration and barrier capacity.

Dr. Weil, this is so fascinating, and it also explains why so many of the creams you see market it as repair. But I've never heard anybody say that your skin has 2 modes: protection mode during the day and defense and repair mode at night.

So, there are signals that are during the morning that your genes are sending out that's like, turn on defense mode. And then the signals that send on at night, that's like, turn on protection.

Okay, hold on. Let me just see if I just got something. I love it when we're having a conversation and you start to feel smart. Don't you love that as you're listening and watching, that by just being with Dr. Weil, you feel smarter? So can I give something back to you? And I want to see if you're listening or watching, if you're starting to get this too. So Dr. Weil, What I am learning is that sleep impacts how your skin ages and functions and what it looks like.

Mm-hmm.

Because your skin has 2 modes and it's driven by the circadian rhythm. And if you're up during the day and you're on the offense mode, right? Yeah. That's during the day.

During the day, you're defense.

Okay. So if I'm up during the day and I'm on defense, I, my skin has gotta be protecting me from the world and the UV and all these, uh, people running around and oh my God, pollutants. And you know, oh my God. And now of course it's dehydrated. It's working. Then I go to lay my head down on the pillow with the circadian rhythm, and my skin is like, oh my God, okay, I can go on offense mode, meaning I can take a proactive step forward while this, you know, you know what is sleeping.

Isn't that beautiful?

And I can repair, and I can shed, and I can take care of myself so that when she wakes up again, we can go back into it. And if you are not getting good sleep, your skin cannot go into that mode. And if you're like, now I'm thinking about why I looked terrible when I had babies.

Mm-hmm.

Why I started to look like I had been sleeping under like a dumpster or like out camping when I got perimenopause, because my sleep was interrupted every 2 to 3 hours.

Mm-hmm.

So if your sleep is interrupted every few hours and you're not getting a good night's sleep, Your sleep pattern is confusing your skin. And so it's probably jumping, wait, are we in offense? Are we in defense? Is she awake? Is she up? Are we— what is happening here? And then you start to look red and puffy and saggy and crepey, describing myself here. But it makes perfect sense.

Mm-hmm. You haven't built the time for recovery for your skin to bounce back.

And if you then— and this is why I've probably done everything wrong. I run to the drugstore cuz I think I look like an old hag and I'm exhausted. And then I reach for a cream that says repair, and then I slather it all over my face. And then I wake up 5 times at night. That cream is not going to be as effective because my own sleep pattern is confusing my skin's job.

That's exactly right, Mel.

Oh my God. This makes so much sense. Mm-hmm.

It's the interconnected, don't put on the topicals and not perform from the inside out too. Wow. It's a two-way street.

Wow.

Mm-hmm. I wanna say one more thing about sleep. So, if you're listening and you're thinking, you know, sleep is free, but I have trouble getting to sleep and staying asleep and falling asleep. So, magnesium is a supplement that you can take. Magnesium threonate is one. It actually influences at the level of the skin an expression of certain types of genes and enzymes that can influence your skin to make better hyaluronic acid, better types of matrix proteins, and help that sleep function better in addition to support matrix function and, and production.

Dr. Weil, I wanna ask you a question about the magnesium because we have had world-renowned researchers, medical doctors, scientists come on and talk about magnesium. But as a normal person,

mm-hmm,

there's all these different types of magnesium.

Mm-hmm.

And you said theonate, there's the G one, there's the other ones. Is there a particular thing that a normal person should look for? And what time do I take it?

So, magnesium L-threonate is the one that helps with sleep, especially.

The T one?

The T one. Okay. L-threonate. And then, the time to take it is really depend— an hour before sleep, 1 to 2 hours before sleep is the time to take it.

Okay.

And so, you want to activate these cues to help your body calm down. The way that I look at magnesium is both from the lens of sleep, but also from the lens of the skin. And this is where it becomes really powerful, because not only are you activating one mechanism to help you sleep better, you're activating the other mechanism to help the skin cells produce better matrix, and it is a supporting cofactor to produce vitamin D.

Wow. Okay, great. So, Dr. Weil, does the position you sleep in affect your skin?

So, for me, the goal is that you're getting enough sleep. So, that 7 to 9 hours of sleep, and sleeping on your face and on your stomach is probably not ideal. And the part of the reason is because at nighttime, you also lose water from your skin, and that's intentional. When you're repairing and rebuilding, your skin So, you lose water. It's another reason why I tell people to have a humidifier in your room. So, at night when you're sleeping, especially for that repair regeneration, a humidifier will help optimize and defray that water loss. But at nighttime, you also don't wanna be kind of suffocating the water loss that's naturally happening.

So, the second pillar that you mentioned was diet and hydration. And I'm realizing right now that I've been hydrating this entire conversation with an iced coffee. Switch it for water. But let's start with diet. while I switch the coffee off the table and put water on. What does your research, Dr. Weil, say about nutrition slowing or improving the way your skin ages?

So, the data around skin and diet is quite good. So, it's this skin-gut axis of how your skin and your gut health are interconnected and related. And a lot of this is known if we look at acne patients, too. There's a randomized 12-week trial for acne patients that they follow these patients, and they put them on a low glycemic index diet. This means low-sugar, low-carbohydrate diet. And they found that these patients had a 23% improvement in their acne flares just by switching their diet. So it's—

Wait, hold on. Say that again. Because the person who is having an acne flare-up— and does this count for all kinds of acne? Stress acne, hormone acne, systemic acne? Like, all of it?

Yes, all of it.

So if you're having an acne flare-up, what was that research?

When you have a low-glycemic— so low-sugar, low-carbohydrate

And what are some of the low-sugar, low-carb diets that would be out in the world that people are like, oh, that kind of diet?

So, if you want to think about fruits and vegetables, beans, and dark green leafy vegetables.

More whole foods.

More whole foods, plant-based.

More fat, more protein, plant-based, that kind of stuff.

Exactly.

Gotcha.

Versus a high sugar index. Even fruit can sometimes be in that category.

Okay. Wow.

Mm-hmm. So, that really shifts that and reduces the acne flares, but it goes beyond that. So, glycation is how sugar is broken down. how sugars stick together. So, it's sticky sugars that happen in your skin, and the sugar sticks to something called collagen and elastin that's present in your skin.

Okay.

So then, it stays there for a long time and influences and breaks down your skin matrix.

Okay.

So, when you have these glycation end products, this is why sugar is bad. And the goal is, like, try to limit sugar. I know it's super hard when you're cruising around your Target aisle and you're trying to figure out, what do I get my kids? Like, which is the best back-to-school snack? You know, the goal is to try to see If you can try to have those low sugar, more healthier choices, more plant-based and whole food, whole grain-based, those are gonna help shift the conversation in reducing glycation for long-term. And it really starts when you're younger because the glycation is a buildup of the story over time.

What's interesting is, you know, I'm thinking about how much time I've spent in the makeup aisle trying to buy things to cover things up. And what I'm starting to realize is that it's the other aisles, like the foods you're choosing to eat and prepare, the magnesium that you might take to help you get a better night's sleep, that is the first line of thinking and defense when you wanna take better care of your skin and to have your skin function, age, and look better.

Exactly. And there are other cues that you can do and supplements like fiber. So say that you are about to have a sugary piece of dessert, right?

Okay.

The goal is to try to bring in fiber as close to it as you can.

What do I put on my sundae?

Maybe some flaxseeds, or try to eat, you know, beans or something around the time that—

Does vanilla bean in the ice cream count? Probably not.

Okay. Nice try. Fiber, fiber, it can come in lots of different ways.

You can even add it to your water. Well, I wouldn't think skin fiber. Yes. I think pooping fiber.

Yes.

I think gut health fiber. I don't think, if I want better skin, I better have a little more fiber, and I better have a little more protein, and a little bit more More veggies, and like the inside out of that creates glowing skin.

That's exactly right. So, it's that inside-out connection. And again, it's coming back to how interconnected everything is. Your gut health is reflected on your skin. A leaky gut, oftentimes for patients with eczema, presents as leaky skin. They have broken leaky barrier, and a lot of times they're seeing some GI distress too that goes along with it.

So, a first-line treatment when you see eczema, In addition to other factors that you have as a dermatologist at the Mayo Clinic, is let's change your diet.

A lot of patients find benefit from reducing gluten out of their diet with just having autoimmune diseases and celiac disease for sure. But you can also see that for patients that are eczema prone.

Tell me, Dr. Weil, about fiber and skin.

So, there was a study in 2025 from the UK Biobank, which is a large Okay, over 200,000 people were scanned in this biobank data, and they found that those individuals that had a high-fiber diet actually had lower psoriasis flares. So, psoriasis, that inflammatory skin condition, just by keeping your diet high and rich in fiber, and this probably works because it kind of defrays the sugar spikes. So, patients that take good high-fiber diets, they don't have their glucose that are spiking so much. Yeah. And when you control that, your skin glycation, and when you control the skin glycation, you have better, healthy skin.

And you know what, Dr. Weil? You're glowing as you say all that. So, you must eat a lot of fiber, but you're all— I'm also very excited about— I didn't think I'd get that excited about skin. It's exciting. This is really cool to learn about.

Yeah.

I've heard you have a secret skin smoothie. I want you to talk to me about this smoothie and the benefits of putting specific ingredients, Dr. Weil, in your smoothie.

Okay. So, this is something really special that I shared with my grandmother. I think there's a lot of wisdom that we can learn from our mothers and grandmothers. And every morning my grandmother would say, don't forget your ABCs. Now, I grew up in South India, in Chennai, and we called her Thathi. So, Thathi would say, okay, don't forget your ABCs. And what she meant was your apples, beets, and carrots.

Oh, ABC, apple, beet, carrot. Okay.

Apples, beets, and carrots. So, when I had kids, this is what I turned to. I said, I don't know what to feed them, so let me take this these and stick them in an Instant Pot. So what ended up being my grandmother's recipe ended up being a convenience factor for me. This is what my kids ate almost every day.

By Instant Pot, do you mean like a Crock-Pot?

A Crock-Pot.

Okay, so like any slow cooker. So we're talking, you've got a busy life, we don't have time to do a cooking show, and neither do you in your life. So you're going to take Instant Pot, Crock-Pot, whatever you want, you're going to chuck in carrots, apples, and beets?

Carrots, apples, and beets.

And do you leave the skin on?

I do. And that, and I'll tell you why. There's research behind this.

Talk to me.

So, my in-laws are apple farmers, so I'm really passionate about apples.

No way.

They are.

That's the cutest thing ever.

And the reason why you keep the apple peel on is because it's got quercetin in it. And quercetin lives on apple skin, which is a type of flavonoid, which is a type of anti-senolytic. So, when we think about, you know, these senescent or zombie cells, well, how do we target them? How do you get rid of them? There are natural products and fruits and vegetables that exist that can target and reduce those presence of those cells. And this is one of them. Okay, this is a really cool fact, Mel. So, with flaxseed and chia seed, you're getting alpha-linolenic acid and you're also getting fiber. And I love this fact because fiber is something that we know that we need to get for healthy skin. We just talked about reducing your glycemic index. In addition to that, did you know that chia seeds also have calcium in it?

They do?

They do. So, 2 tablespoons of chia seeds has 180 milligrams of calcium. That's about half a cup of milk.

Wow. So, for somebody that can't tolerate dairy.

Exactly.

Wow.

2 tablespoons.

I'm like trying to follow the recipe. So, we're throwing this in the Crock-Pot. How much of the flaxseed and the chia seed do you put in?

I usually do like 1 or 2 tablespoons of each.

Okay.

And then the turmeric, throw a little bit of turmeric in there. And then I use coconut water as the base. So, coconut water has a lot of electrolytes. So, it's gonna power you through that day. It's gonna give you a lot of the magnesium there too that you're gonna need. And really, this combination that comes together will hold you strong. You can even add protein to it in the beginning of the morning if you're trying to just get up and go.

Okay, now let me just get technical here, 'cause I wanna make sure I know what I'm doing. Am I only cooking down the ABCs so they're mushy? And then once they're mushy, which I can do while it's at work, then I can put that in like, you know, a storage dish. And then in the morning, I take a scoop of the mush, some turmeric, some flaxseed, some chia seeds, And then I pour in my coconut water.

Yeah.

If I want a little protein, throw that in there, and then I zap it.

That's right. And this could look like a lot of different versions for you. You know, do what's convenient. Maybe it's blueberries, spinach, and yogurt, but it's what works for you and making it a consistent habit.

Amazing. Dr. Weil, what does turmeric do for your skin?

So turmeric activates a lot of anti-inflammatory pathways, so it really helps your skin defense mode. So you're about to walk out the door and you're going into the world fighting against all of these different pollutants and antioxidants, right? So, that creates inflammation. By having turmeric and other of these products in your smoothie, you actually can start helping your skin fight inflammation earlier on.

Awesome. I feel very empowered by this. And here's the other thing I love about this. What's discouraging about your skin is that everything is a product marketed to you, and everything that you're talking about exists in your daily life, and not only is good for your overall health, But it's amazing to know and very empowering to know that every one of these levers that you can pull are almost no money. You're gonna eat anyway.

Mm-hmm.

And they also increase not just the health of your skin and not just how it looks and how glowing you are and all that stuff, which it will, but it also makes you feel better and it's impacted to your overall health, which, you know, you said in the beginning, it's all connected 'cause this is the biggest organ.

Mm-hmm.

As someone who has 2 centers at the Mayo Clinic, Dr. Weil, how much water do you need to drink in order to feel healthy? order to have healthier skin?

Yeah, so when you think about hydrating your skin, there's a little bit of a myth that goes around, okay? So, the myth around hydrating your skin is that people think drinking water is enough to hydrate their skin barrier.

It's not.

But it's not.

It's not.

You actually need to apply moisturizer. So, dehydration can show up on your skin, but when you rehydrate, you also need to apply moisturization. So, a lot of the studies are showing that only a portion of water that you drink shows up on the skin, right? So, you have to think about the hydration needs can really shift. It can be affected by your climate, the humidity, and a lot of different things. So, how much water do you need to drink? For women, it's about 2 liters a day.

Well, translate that. What, what is a liter?

It's about 11 to 12 cups.

So, I have a large wide-mouth Mason jar right here. I, I love to drink out of these, and I typically drink 2 of these a day, and one of the— this is like 4 cups each.

Perfect. So, about 8 cups is good enough, but if you can try to get to 10 or 12

Why?

For women, especially if you're in perimenopause and menopause, your baseline water loss has increased, and our levels of stress as women have increased. So, so you're just losing more water every day just by—

We're sweating it out, ladies.

So, just aiming for about 10 cups is, is, is key for women. And for men, it's 2 additional cups more than that, so 12 to 13.

Wow. Now, you also said that it's the inside and the outside. So what am I doing on the outside to hydrate my skin? Because I know people have told me before, my own dermatologist, maybe even other medical experts, but can you remind us what is the thing we're looking for that is hydrating when you put it on your skin?

So the skin needs humectants. So humectants are ingredients that pull water So, these are going to be like glycerin, ceramides. These are going to look like colloidal oatmeal can reduce inflammation and calm the skin.

Oatmeal is hydrating.

Oatmeal is. It's finely ground. It's called colloidal oatmeal. This is actually FDA approved. So, if you go in a lot of the brands for eczema moisturizers and lotions, it'll say that it has an FDA seal on it, and it says National Eczema Foundation approved for eczema skin. So, broken skin can get a lot of benefits from colloidal oatmeal. because it has the ingredients to calm the skin down. The other humectant, AKA something, an ingredient that pulls water in, is beta-glucans. So beta-glucans is another active that you can look for in the ingredient list. So these are gonna pull water in. You also wanna look for moisturizers that are tub lotions that you can scoop out versus pump lotions.

Why?

Because tub lotions are thicker and they hold more moisture in there versus pump lotion. To get it out of the pump, they actually have to add water Which is counterintuitive. There's more liquid in there, it rubs on nicely, but it also evaporates and loses the barrier faster.

Wow. I wouldn't have thought that pumping it to get it out through that little thing actually makes it less concentrated.

It's a thinner lotion. The tub lotions are thicker.

So, Dr. Was, I just had this image of you either at the grocery store, Target, or CVS, or somewhere else, and you've got your 2 kids, and it's a Saturday, and you're pushing your cart, cart, and then you see somebody like me just staring at the aisles, and I'm reaching for something that you know is a giant waste. Is it hard for you to not walk up to people and be like, just buy that one down there?

I have this Target moment all the time. So whenever I'm in Target, I am so tempted by people looking at products and just seeing what ingredients there are. I just want to go up to them and be like, hey, I've been there, can I just help you? And I just wanna help you pick out, especially if they're in the baby aisle and they're like choosing between different products, what do I choose? Which ingredients? I just wanna go up and be like, try this, you know, this is good for sensitive skin, or this is better for this type of eczema-prone skin, just to help 'em out, you know? And it's so tempting, but I have to resist myself. But this is a key conversation. People are overwhelmed with what's out there in our grocery stores and over the counter, which is a good thing because it's accessible.

Hmm.

But it also, the choices make it seem like they're insurmountable and harder decision-making.

So just, should you stay away from fragrance given that you're, the purpose of the moisturizer is really to hydrate your skin?

Yes. So fragrance-free, unscented, you wanna look for both of those words.

Oh, okay. This is a dumb question. You ready? Those are different.

Those are different. And this is gonna shock you. Unscented can mean that they're actually adding fragrance in to mask the scent away.

Whoa. So unscented doesn't mean it's free of fragrance. Unscented means you're not gonna smell anything, but we might have added something to cover the smell.

Exactly.

Whoa. The 3rd pillar for better skin is movement. Dr. Weil, what does regular exercise and movement do for your skin, and how can movement help your skin age better?

I have some really cool studies here, so I'm like so excited. I love your studies. So your skin responds to exercise. So there are some really great human data that supports this. So in a small randomized study with older adults, they found that the skin healed faster, in an average of 10 days faster, in the group that exercised compared to the group that didn't exercise.

Really?

It impacts wound healing.

Why?

Exercise actually secretes out positive signals for your body to reduce inflammation, to help metabolic signaling, metabolic health. So, one of the things that the body releases, they're called exosomes, or extracellular vesicles. They're really fun. They're like text messages that your body sends to each other and sends signals of benefit, but they can also send signals of harm. But depending on where it's coming from, with exercise, this can actually be a positive cue to send circulating beneficial exosomes all around to all distant organs, including the skin. And these messages can help that repair process

I wanna just remind you as you're listening and watching that Dr. Weil runs 2 centers at the Mayo Clinic, one of which is researching and focuses on wounds.

That's right. So we—

So you know what you're talking about.

I, I love my research lab. Um, we have a, the Regenerative Dermatology and Skin Longevity Lab. We are part of the Department of Dermatology. It's a good team.

So is there something about the circulation that helps skin heal? too?

Yes. Those exosomes that are coming through are coming through the circulation. So, they help create better blood flow, better messages that are going all around. So, just overall, this idea, Mel, is getting back to homeostasis. I'm gonna— I'm gonna break this word down because it's one of my favorite words.

Homeostasis.

Homeostasis.

Okay.

Homeostasis means reestablishing balance. So, it's the yin and yang of your body. We love studying regenerative medicine in our lab, and the skin being the largest regenerative organ is because it constantly is going through the leverage of enduring stress and breaking down and being resilient to stress. There was another study, a 16-week study in 56 middle-aged women. They looked at cardio versus resistance training, and what they found was in these patients, they had better skin elasticity, and the upper layer of their skin, which holds the collagen and elastin, Which

kind of training?

This is with weightlifting and strength training.

Okay. I'm so glad you said that, because every medical doctor that has come on in every single field has said, for women in particular, strength training, resistance training, non-negotiable for every aspect of your health. So, if you were about to say cardio—

It's a combination, but resistance training plays the bigger role.

Okay.

For sure.

Why?

Because the skin and muscle are super interconnected, you know, we have a constant communication. So, those strength training, those signals actually transcend to the skin. And this is actually why I tell my patients who are on GLP-1 medications, who have that weight loss that they're experiencing, that strength training becomes a very important part of their conversation because it can help tighten their skin elasticity.

Well, that makes sense, because as you're teaching us, the skin is the largest It's a living organ. It's sending information in, it's receiving information out. And the more you're pumping up your muscles, the more it must plump up and pump and tighten up your skin.

Mm-hmm.

I'm so grateful that you're here. I could listen to you all day talking about this. This research is fascinating. I feel smarter hanging out with you. So thank you for that additional benefit for having you here. And it's also just so practical. We're gonna take a quick break, and I want you to give a little attention to our sponsors because they're the reason we can do this for free and have extraordinary researchers come in. But while we do, share this episode with someone you love who's overwhelmed by skincare, whose bathroom's overflowing with products, or who just is struggling with their health and their skin. You know, they want the clear research-backed answers about what their skin needs. And stay with us, because when we come back, Dr. Weil is taking us into the next pillar of her holistic roadmap for extending skin longevity, the framework that shows you what really matters when it comes to keeping your skin healthy and resilient as you age. We'll be right back.

You are serving your overall health. By listening to the skin, it's a bidirectional conversation. It provides us clues and information of how your overall health is functioning. And by looking at the skin, we also have the power to influence our overall health.

I love this conversation today. Dr. Saranya Wyles, dermatologist, physician scientist, one of the leading researchers in regenerative dermatology and skin aging at the Mayo Clinic. Today, she's showing you and me what our skin reveals about our deeper health. Dr. Weil, let's jump back into these pillars. The 4th pillar is stress. How does chronic stress impact your skin?

So, let's talk about cortisol. This is the stress hormone, and we've all heard about it. Cortisol receptors are part of your skin, and this is really fascinating why they're part of your skin. So, your skin has this neuroendocrine system, fancy way of saying it's part of the fight or flight mechanism. Right? And it's evolutionarily there because your skin plays an active role in that defense. You're going out into the world, it's receiving all of the external damage from the outside world first. So, it has to be frontline defense mode and reducing the inflammation. It has to be part of that fight and flight response. So, there are natural cortisol receptors that are part of your skin. And it's partly there also because it's this adaptive response. So, because it encounters stress, it can create adaptive signals. signals to defray the stress too. It's helping you combat stress. Why is this important? So, this means that when you're in stressful situations, your skin knows it, and it perceives it. So, if you're on an airplane, in high-altitude situations, your skin is stressed.

Is that why I'm puffy on a plane?

You can be, yes.

Wow.

Yeah.

Okay.

UV, UV damage, that stresses out your skin. This is an interesting study. Did you know that the stress of going through a divorce can impact your skin barrier recovery? They did this study, and they found that in 28 healthy women aged between 21 and 45 years old, the process of marital separation showed up on their skin. They had worse total epidermal water loss, meaning their skin lost more water. And when they took the tape strip, which is the top layer of the skin, and evaluated it, that barrier strength was not affected, but your ability to recover from injury was affected.

Wow. That doesn't surprise me.

Mm-hmm.

Because that's extraordinarily stressful.

Very stressful.

Does stress lead to hair loss, Dr. Weil?

Yes. And stress can show up in the hair in a different way. So, hair grows in different cycles. So, we grow, rest, shed, grow, rest, shed. And at any given time, our hairs are always cycling between them. And we actually have normal shedding seasons. So, in the spring, you're supposed to shed a little bit more than the other seasons. So, with these different cycles, their stressors can actually shift the hair from these growth phase or resting phase into this shedding phase.

Okay.

And this can show up about 3 or 4 months after that stressful event. So, say you've kind of had loss of a family member, loss of a pet, a surgery, an illness, a very stressful work situation, whatever that is that occurs, it'll take about 3 or 4 months to be reflected on your skin and your hair. So, it's an important clue to pay attention to, but it is a reversible clue.

First of all, Dr. Weil, how much shedding of hair? 'Cause there are those periods where I've looked down on the floor of the shower, or I have, you know, washed my hair, and I run my fingers through my— and I'm like, what is this? Like, this is like a wig in my hands. And then I start to get worried, like, how much is too much?

So everybody experiences a natural, normal shed every time you wash your hair. Every time you wash your hair, it's in the hundreds, but you do lose hundreds of strands of

hair.

Hundreds of strands of hair. And it can vary. There's a lot of different structures within hair. Typically, you can see about hundreds of strands of hair that are lost.

And tell me about this 3-month thing with your hair, Dr. Weil, because I got my hair dyed on Monday night, and Eeny, shout out Eeny, who has done my hair for well over a decade, said to me, as she grabbed my hair and she turned around and she said, And she's like, what are you doing? Your hair is the worst I have ever seen it. What should you do? Sleep better, eat better? Is there something to do?

Yes, I am a big fan of pumpkin seed oil.

What?

Yes, I'll tell you about this. This is a, there's actually studies around pumpkin seed oil. It's a supplement. So in a study where they supplemented 400 milligrams of pumpkin seed oil and they followed these men for about 24 weeks, and these were men that are having male pattern baldness, And they had shown that it actually can shift the androgens that influence hair loss and allow the pathways. So, there's actually an analog that comes from pumpkin seed oil that can help reduce those types of signals and can support a healthier hair follicle environment.

No kidding.

Mm-hmm.

Wow. I'm putting that in the cart.

Mm-hmm.

When I go shopping next. Okay. Talk to me about nails. And are hair and nails part of skin? Like, is this like a different thing?

No, it's all interconnected.

I'm so glad you brought it up. Okay, wait, hair and nails are part of skin? What part of skin?

Hair, nails, and your mucosal surfaces.

What is a mucosal surface?

So this is your inside of your mouth.

Okay.

And, and your lips. Okay. So all of that is connected. It's all one organ that we study within dermatology.

Okay, so let's talk about nails.

Yes.

Let's say your nails are breaking, or you got ridges or white spots. What does that tell you?

So your nails can reflect nutrition deficiency there too, and it can have aging patterns. So ridges, for instance, those can be just seen with normal aging, and it's okay to see those But you wanna pay attention because pigment can also show up on your nails. So when you see pigment, both white patches and brown or black patches.

Okay.

When you have pigment changes, you need to go see a dermatologist. And this is because especially when it's dark brown, you wanna be evaluated to make sure it's not a melanoma.

Okay.

Now pigment changes can also happen during pregnancy and postpartum, or if you're darker skin types, you can also see changes in your nails, but really paying attention to changes those check engine light that we talked about, they can be check engine light on your nails too. And they can give you clues even for liver dysfunction. Cirrhosis has a telltale sign that we look for on the nails. Fungal infections can also present as yellowing discoloration on the nails. So there's different aspects that your nails can provide for clues of what's going on on the inside.

The 5th and final pillar that you mentioned is topicals and treatments. And Dr. Weil, I would love to have you unpack something I see everywhere and I do not understand. What is a peptide?

So, peptides are short amino acids. They're like little Legos, so you can put them together to build a bigger protein. So, when you think about it, you take these pieces and it can function into a different type of protein. And we're familiar with GLP-1 medications. These are part of the peptide family. But think about these peptides as keys that can open up a door that could mean nothing or very limited, or it can open a very powerful door as the one that has opened with GLP-1s and weight loss medication.

Okay, so this is something that acts like a key to unlock something that is inside your body. Right. Okay. How do I know what key is gonna work and whether or not something is safe or it's complete marketing BS? because it seems like that word is slapped on everything right now.

Yes, peptides have really gained a lot of traction right now with the longevity movement and the wellness space as well. You know, you have to be really cautious. It can be applied topically or it can be applied injectables. Peptides currently are sourced very differently, and they're not FDA regulated at this point, although some of them can be FDA regulated and medications like the GLP-1 medications.

But the vast 99.9% of things, So, like with most things, no testing, no FDA regulation, proceed with caution. Is that what you're saying?

Proceed with caution, but I'm hopeful. I'm actually a fan of peptides being tested in the positive way. So right now the FDA's creating new shifts with 503 compounding pharmacies and what are gonna be bulk compounded. This is actually giving people a safer way to access peptides, but the key is to take that and create evidence-based clinical trials.

peptides that are getting injected, unless it's something like a GLP-1 that has been clinically tested. Dr. Weil, is that safe?

So, outside of that, you're just creating an experiment on your own. You're becoming— the body is a pincushion. They're applying different types of combinations of peptides. You're working with your physician to figure out what's the right version for you. Anecdotally, we're hearing benefit, but we can't generalize that and provide guidelines without having clinical trials.

Gotcha. So, you're basically running an experiment on yourself.

Correct.

Um, what about topicals? Are there topical ingredients that are, quote, peptides that you're excited about, even if they don't have the FDA approval yet?

I'm a big fan of the topical copper peptides. There is evidence behind this. There's data that's showing that it can actually help the dermal-epidermal junction and create collagen, and it can be delivered topically as well. So a lot of times, I want to do a myth Busted right now. Okay. I wanna talk about this Glow Stack peptide. So right now, a lot of people are really excited about, and it's become really popular, Mel, this Glow Stack. So this Glow Stack is BPC-157 peptide, TB-500 peptide, and the GHK copper peptide. And it's an injectable combination.

For your skin?

For your skin. That's what they say. If you inject this stack combination, then that creates skin glow.

Okay.

But From a research perspective, the first 2 peptides, while I'm excited about those for different reasons, they don't have any skin-generating data. And the GHK copper works really well as a topical, so we don't need to go the injectable route. Because if they are injecting it, I'd be worried about copper levels and at what point do we need to be doing additional testing. So, that stack is something that I don't recommend. Instead, I say use the topical copper peptides.

What What non-peptide topicals do you recommend?

So I like to think about your daytime and nighttime skincare differently because we talked about the circadian rhythm shift.

Yes. And in the daytime, you're on defense, protecting yourself against the world.

Yep.

And on the nighttime, your skin goes into an offensive mode while you sleep, kind of like your brain.

Yes.

Repairing and shedding.

Yes. Exactly. So, in the daytime, you want those defense ingredients. You want a really good antioxidant. We talked about antioxidants earlier. They're gonna go in and fight free radical damage, any damage that's coming from the outside world. They'll turn down the noise on that.

Okay.

So, you could buy vitamin C, vitamin C, E, ferulic acid.

Okay.

That's a really good combination. You could buy platelet exosomes. So, these can come in, start building it, and creating more barrier resilience over time. You also want a really good sunscreen.

Dr. Weil, teach us about sunscreen. All right,

Mel. Sunscreen is one of the best things you could be doing for your skin. It protects your skin barrier from the outside UV exposure. So I want you to be using a broad spectrum SPF 30 or greater and reapplying the sunscreen regularly. But do you wanna be put to a test?

Yes.

Okay.

Uh-oh, she's coming over, everybody. She's got a tray. I'm gonna narrate this for you if you're not watching on YouTube. Okay, you have a tray that has So

I've got a tray here with different types of sunscreen in the bottom. So

I have

a mineral sunscreen.

Yep.

I have a chemical sunscreen and I have a tinted sunscreen. So these are 3 different versions that you can get at the drugstore. And then at the top I have beef tallow and I have coconut oil. So a lot of times we're seeing beef tallow and coconut oil within our sunscreen products. So it's not just in the ingredients, So we're gonna test all of these and see against a UV camera.

Okay.

How well these actually protect you from UV rays.

Okay. What is real and what is BS? Here we go.

All right, Mel, I'm gonna apply these.

Okay.

Forearm here, and we're gonna start from the top, which is we're gonna do just a sunscreen. So we'll do mineral sunscreen over here. Then I'm going to go into a chemical sunscreen.

And she's using a different finger.

I am.

Because this is very much a research project. Now this one's rubbing in. This is more like moisturizer.

Exactly. You

can't even see it. What is the chemical in a sunscreen that blocks a UV ray?

So there's a lot of different types of chemicals. We actually just got a new chemical filter called bemitrazole, B-E-M-T. This is the first sunscreen filter that's been approved in our market in over 20 years.

Wow.

Exciting for us. But these sunscreen filters basically can absorb the UV and then reduce it into heat energy and release it out.

Okay.

Okay. So we have the mineral, So I'm gonna put a physical at the top, a chemical next, and then I'm gonna put a third sunscreen on.

Tinted. Is

a tinted sunscreen.

This one looks sort of like body foundation. Mm-hmm.

Kind of has a nice glow to it.

Yes.

But the tint is because the tint has iron oxides in it, and this is really important for visible light protection. So I love a tinted sunscreen for patients with melasma-prone skin, 'cause visible light can actually impact their skin there.

See, I thought a tinted sunscreen was just to make me look like I had smoother, nicer foundation skin, actually any property in the tinted. I thought it was like UV makeup.

Yes. Yes. It's partly that, but it's the iron oxide that gives them that tint, which actually confers protection too.

Great.

Okay. So now the last 2, these are more of the natural products that people talk about. The first one is coconut oil that's gonna go on there. And then the last product is beef tallow.

Okay. There's a lot of noise online about the tallow thing.

Exactly. It's actually actually now getting into a lot of natural sunscreen products, but we don't have a lot of evidence in the sunscreen filter world about beef tallow. But we are applying this because a lot of people are learning about this in this way.

And they think it can be a sunscreen.

Exactly.

Okay, so here we go. Let's see what's gonna— now, what— now you're picking up a scanner on your phone.

A UV camera.

Okay. What do you see if it's

When it's blocking, you see a black line.

And she's using an app right now to basically scan my arm, and it's showing with UV light which one of these 5 things is actually blocking the light. And so the one that is mineral, you're like, that sucker's— that's blocking.

It's blocking. So this is gonna confer protection of UVA, UVB protection, broad spectrum. The next one down is the chemical sunscreen. This is also doing a great job. Look at that black line that's going across here. I am pretty

impressed.

This is such a great protection because that's also showing that it's rubbed in really nicely so you don't visibly see it on the skin. But when you actually look at it on this UV camera, it's showing good protection.

Great. Okay.

Third one down is a tinted sunscreen. Again, we don't see that on your skin, but under the UV camera, we see that protection right over here. And this is again showing that nice dark color conferring protection from UV rays. And then the bottom, we have coconut oil and beef tallow, which are not showing any change here.

Meaning there's no protection.

There is no protection from the coconut oil and the beef tallow, which we've applied right here.

Wow. It's amazing that you can see that.

I just want people to be aware that these are actually oils. Yes. So when you go out there with coconut oil and beef tallow, you're actually creating more disposition to burn. So, you want to be careful with these products, especially when they're in sunscreen. You actually have a higher risk for burning with coconut oil and beef tallow.

Wow.

Out in the sun.

Amazing. I love knowing the facts and the science.

That's right. A little experiment here, but it really talked us through of how we can see it.

Thank you for showing us that. Dr. Wells, you recommend that we keep sunscreen in our car. Why?

Let me show you why, Mel.

Okay.

This image was published in the New England Journal of Medicine, and this shows you a picture of a truck driver. driver who has significant sun damage on the left side of his face from driving in his truck.

Holy cow. This gentleman looks like he has a face that the left side is 80 or 90 years old, and the right side is like 60 years old. And the left side has the sun damage because your left side is facing that window as you're driving.

And you're still getting that UVB and UVA rays that are coming through that window. Even if it's tinted, you should still apply sunscreen in your car.

Which is why you need it in your car.

Exactly. Most of us are getting sun damage during our drive into work and our drive home from work. So, you really underestimate the power, and most of us are being pretty good by putting sunscreen on, but keep sunscreen in your car so that when you're driving, you can reapply. And if you're listening right now, you're in your car, I would try to get that sunscreen practice started.

Okay. So, you need to be moisturizing and sunscreening in the morning.

Yes.

Now, let's talk about what you do at night.

So, at nighttime, you're getting into repair mode and regenerate mode, right? So, now you're applying those peptides. So, the copper peptides is great, especially for underneath the eye. You can also apply actives like retinols and retinoids. With retinoids and retinols, you want to be driving this space carefully. If you're over-exfoliating your skin, you're over-inflaming your skin.

Mm-hmm.

So, if you're putting on a topical tretinoin, No, in, and you're peeling a lot, you need to cut it back. It's like your skin's on the treadmill and it's just going, it's exfoliating, it's turning over, turning over. You've got to slow that speed down. So you may actually need to switch to an over-the-counter retinoid that is less potent so that you can tolerate it more and build that consistency over time. So those are really helpful factors. I also recommend at nighttime barrier moisturizer. So you can look at products that have those humectants that we talked about, beta glucans to really strengthen up the barrier overnight.

I can't help but use this as my personal dermatology session. And I am just going to say the one thing I can't stand— like, I didn't think about my body that much because I can't see my back. But the thing I have to stare at all the time is my face. And I really hate my jowls. What is happening to the structure of your face? as you age and your skin starts to hang there like a purse you don't want?

Mm-hmm. So, this is a normal aging process that is actually a structural change. Your skin is not the problem when it comes to the jowls. Really? No, your skin is actually just reflecting what's happening. Let me show you something with a cake that we can take a look at, and we'll talk about what's really happening.

Okay, great. We have our executive producer going outside. This is a fun episode because we, as you're watching, are taking you all over the place. And I'm doing my best to narrate it, but I just hate this. And so I just first want to understand what's happening and second, want to understand, do I just have to live with this? Is this— is this Mel Robbins' version of radical acceptance? And I know it's a sign of aging and I want to age gracefully and I don't want to look 30 when I'm 70 or 80. I want to look my age. But energized and vibrant and, you know, just healthy. And my jowls make me feel like a sad old hag.

Well, Mel, I'm sitting across from you right now, and you look amazing. But really, let's talk about the structural problem that's happening with jowls.

Okay. And I'm gonna describe this because she has in front of her a beautiful cake. And imagine you're at a wedding and they give you a big old triangle slice of cake, and it's multilayered. So there's like the, uh, red velvet on the top, then we got the buttercream icing, then we've got the vanilla cake, and then at the bottom, we've got a chocolate fudge. And so we got, we've got these 3 layers with the frosting in between.

It smells really good.

Oh God, we're gonna have to have a piece when we're done.

So there's actually 2 other pieces to the cake, Larry Mel. The disc that it's sitting on and the platter that it's sitting on. And this becomes important part of this analogy. So let's talk you through it. So what's happening within your skin is actually reflected on the layers of the cake. So your skin has 3 different layers.

Okay.

So you have the epidermis. This is the part that normally sheds out. And, you know, we talked about— So that's the top layer. Regenerative top layer. Okay. That's the red velvet. And then the second part is your dermis. This is where your collagen, elastin, all those matrix proteins live. This is the scaffold of your skin.

Okay.

And then in the bottom, this is your hypodermis, which is where the fat lives, how you regulate your temperature. And then over here, this disc that it's sitting on, this is the We're gonna call this the ligaments and the muscle now.

In my face?

In your face.

Okay.

And this has become the Spanx of your skin, if you will.

My Spanx.

Your Spanx. The superficial muscular aponeurosis. That whole system holds everything up. Okay?

Okay.

And then—

It's not working. It's not working. It's not working. It's okay. And then is that the bones?

This is the bone. Okay. That's right. The platter is the bone. And that is such an important piece of what's happening when we think about jowl structure. Okay? Okay.

Okay.

So, let's talk about what happens with age is we start to see a shift in our bone health. So, I'm gonna move the cake down over here from this higher sitting platter.

It's sitting on a beautiful marble pedestal, like you would see in a nice bakery.

And now, it's going onto a shorter plate.

What happened to my bones?

Your bones are decreasing, and you're, you're gonna see a loss of bone health and osteopenia, osteoporosis, all the things that you think about for your bone health that's happening, it happens on your face.

Oh my God.

All of those things. And so that's important to think about. So there are easy things we could do for each of these layers to start helping your skin structure, right?

Okay. Because it helped the jowls.

Because it helps the jowls. Because what you are seeing is a descent problem. It's a gravity problem.

A who? A descent? A gravity problem.

Gravity.

So I am— if I'm losing bone density, the skin that used to be held up by the is now gripping on for dear life to what's left and sagging down below my jawline.

Correct. Yeah. And the fat loss, there's all these compartments lose a little bit, but most of it is bone structure. Also your dentition. People underestimate the power of dental care, 'cause with age you start to see more crowding of your teeth. And when your teeth crowds, it can actually change the appearance of your jowls and your, your jawline as well. So, it's that dentition, you're— so brushing and flossing, those are super easy things that you could do at home. Eating your green leafy vegetables, that can help your vitamin D and calcium uptake.

I'm doing all of that. So, those are all— If it's not helping, what am I doing? How— what do you do about your jowls?

So, once you've optimized all of the systemic things, right?

Yes. I'm hanging on every word.

I want you to go to your dermatologist and talk about high-frequency, micro-focused ultrasonic. Okay. So these are non— sometimes they're called non-invasive facelifts. So this is an energy that's delivered through ultrasound waves that can help tighten the Spanx layer, the superficial muscular aponeurosis. It can be applied for your neck. It can be applied for the lateral, the sides of the face. It works for some people. It needs multiple treatments and making sure you're being consistent with it.

We'll see. I'll report back.

So, Mel, speaking of different skin changes that you're seeing, I have another cake. Okay. Because I want to show you what the GLP-1 medications can be doing to your skin and facial structures.

Oh, great. I have our executive producer Tracy coming in with another cake. Oh, whoa. So the first cake is just like what you would expect at a bakery. There's a clean slice. It looks like a great cake. The other cake is the same. It's got 3 layers. It's the red velvet, it's the vanilla, it's the chocolate, it's the plate, it's the bones. But the cake looks like one of your kids took a fork or their fingers and started digging out at the layers. It looks like somebody basically ate part of the cake without slicing it.

Yeah, so what you see at the surface level for skin for patients on GLP-1 medications is laxity, or looser skin. A lot of patients that are on these medications, they kind of talk about it as Ozempic face. It's a commonly used term, But what that actually means is that it's shifting the way your skin is naturally sitting because you've lost the underlying support structure from the fat layers, your muscle has gotten leaner, and you're seeing different changes. So let me demonstrate for you.

Are you gonna cut a slice of this sucker? Oh my God, no, she's not. She's not cutting a triangular slice. She's going for the bottom layer.

Yep. This is the hypodermis. This is the fatty layer of your skin.

Okay.

So I'm gonna go all the way across. How am I doing?

You're doing really good.

And this is gonna kind of just remove that fat structure. For every £20 of weight that you lose on a GLP-1 medication, that's a 10% facial volume loss.

Wow.

So that—

And what's happening is the bottom layer of this cake, these 3 layers of your skin structure, structure, the fat layer is going away. She's now lifting the cake off the platter. She's putting it on a plate, and all that's left is the red velvet and the vanilla. So just the top 2 layers, because the fat is gone. So what does that mean for somebody on a GLP-1? And what does a Ozempic face mean, Dr. Weil, from a medical perspective?

From a medical perspective, it's that you've lost the healthy adipose structure, the healthy fats that's present on the face. And technically, it's not accelerated aging. Okay. So, what's actually happening is that you've just experienced weight loss on the face. I wanna share here that GLP-1 medications have really been transformative for so many patients.

Incredible tool.

It has been an incredible tool, and that's the first and foremost priority within their portfolio. But what we see as a side effect side effect is that the medications can influence facial volume loss. And when you have this, this is a perceived older appearance look, right? Think about a child. They have these beautiful— they call them baby cheeks, right? Yeah. My 6-year-old right now has the best smile because her cheeks puff up. And that means that that facial volume, especially in that midface, confers youth. So, we associate that midface volume with youth. So, when you start to lose that midface volume on GLP-1s and that decline and the sagging that can happen.

Yes.

From the elasticity and the stretch of the skin. It's actually the opposite effect of pregnancy. With pregnancy, you have a slow increase of skin stretch. With weight loss, you have a quick, rapid loss, and you have an involution, and you have that, the skin that can sag down. Yes. So, it's— so, that's what you're seeing here.

So, what do you do if you're on a GLP-1, and you're starting to see Ozempic face, and you're starting to see, like, the skin sagging from the rapid weight loss?

So, this is where I think building up muscle is so key. We talked about this connection with muscle and skin and creating the strength training moments. So, these actually can impact the muscle on your face. Your face has muscle too, and this can be strengthened over time just by whole body strength training. You can create the right signals, the right exercise-induced exosome cues that can help build that and preserve that skin scaffold as you're going through these changes.

So, somebody who, So, for someone who is on a GLP-1 and experiencing awesome results with weight loss, but you are losing that third kind of fat layer in your skin, and now you're starting to have a saggier, older-looking face, the Ozempic face, strength training helps restimulate that in your face?

Strength training is part of the equation, and you wanna start it earlier on. So, when you're going on the Ozempic medication, and you know you're about to experience this, right? So, accelerated weight loss happens for some, not everybody. And when you're in that accelerated weight loss period, be thinking about all the additives you could do, like strength training, to help that. There's also biostimulation. Again, brings into the conversation, and what about radiofrequency microneedling or microfocused ultrasound? Those are other energy-based devices that could be collagen stimulating and collagen banking as you're going through that accelerated weight loss period. But, you want to be cautious because you want to wait for that weight to stabilize. So, once you've finished—

Mm-hmm.

Having that considerable weight drop, that's when you want to think about interventions at that time.

Got it. Very helpful. And the visual is fantastic. Let's remove the cakes. Here we go. So, Dr. Weil, if the person listening takes one thing away from this extraordinary conversation, what would it be?

You are serving your overall health by listening to the skin. It's a bidirectional conversation. It provides us clues and information of how your overall health is functioning. And by looking at the skin, we also have the power to influence our overall health. But really, the conversation is that it's okay. You need to be more forgiving to your skin, which is functioning in so many different ways. And the final thing I'll leave you with is that the face gets the marketing budget, but the whole organ deserves the care, and that is healthcare.

Ooh, I love that. The face gets the marketing budget of all these products, But the whole body is the healthcare.

Exactly.

This has been extraordinarily fascinating and empowering and fun. Dr. Weil, what are your parting words?

I'm so honored to have this conversation with you, Mel. And I have to say that to me, this was an experience that I manifested in a way. I thought in doing our research with my lab, looking at the skin and seeing the changes that it can confer for your overall health, I had I had this thought. I thought, wouldn't it be great if I shared this with just the world and how important it is to think about your skin and not just in a way that is being marketed to you, but really shift the conversation about how important it is for your overall health? And literally 3 months later, I ran into you in an elevator and we made that connection and here I am. So thank you for this opportunity to talk to your viewers.

You're welcome. And you know, there is something magical about this show. I really believe that. An elevator, the doors opened up, you walked in, you had on the coolest outfit, you had on one of those tags, you were here for like some big medical conference at Harvard or something like that, and you said hello. I said hello to you. I think I complimented your skirt or something, and then we started talking. We then find out that you're not even just incredibly dressed and super smart and really outgoing, you happen to be a rock star medical researcher doing unbelievable things, running 2 centers, and this research Yeah. So, yes, you did manifest this. Yes, it is important to say hello to people in elevators. Yes, it is important to put out in the world what you want to see and experience in the world, because when you do, extraordinarily magical things happen. So, thank you for having that intention. Thank you for being in that elevator. Thank you for doing the research that you do, and thank you for making us feel empowered and so empowered about how to take care of the largest organ in our body.

I definitely am leaving here really excited, and I can't wait to share this with so many people in my life. And, you know, I'm excited for you. I wanna thank you as well for making the time to listen to this or to watch this. And in case no one else tells you today, I wanted to be sure as your friend to tell you that I love you and I believe in you. I believe in your ability to create a better life. Thank you. life. And your health is the basis of having a better life. And everything you learn today is gonna help you make smart decisions that will make you feel better in your own skin. Alrighty, I'll see you in the very next episode. I'll welcome you in the moment you hit play. This segment is brought to you by Mrs. Meyer's. Now, you may think that you're ignoring the clutter around you, but your brain isn't. See, the little things in your home can affect you more than you realize. The noise, the clutter, even weird smells. All of these things can make it harder to relax or to get into creative headspace.

Mrs. Meyer's Premium Scented Oil Diffuser helps you keep your space calm with up to 60 days of long-lasting garden-inspired scent that fills your home. And you Deserve that. Physical clutter creates mental clutter. And one of the fastest ways to clear your mind is to clear your space. You may be trying to ignore all the distractions and the mess around you, but your brain can't. Let me give you an example. Have you ever been driving and all of a sudden you're getting close to where you need to go, but you're starting to feel lost and you're looking for building number 103, but you can't tell— wait, is it on the left? Is it on the right? the right. And as you're looking for the building, the music in the car, it's loud, it's playing. What do you do? Well, you just instinctively reach for the volume and you turn the music down in order to concentrate on where you're going. But have you ever stopped to consider, do you need your ears to find Building 103? No. So why do you turn the music down? Because while you think you can ignore all the distractions around you, your brain can't.

Turning down the music, silence, it helps you see because your brain has less to process. It can focus. See, when you turn down the music, you're giving your brain a clean slate. The same is true with life. When you walk into your office or your bedroom or your kitchen and it's just filled with bills and dishes or laundry, laundry. Of course, you're going to feel overwhelmed. And here's what's interesting. That physical clutter becomes mental clutter that you take with you when you leave the room. There's really interesting research around this. Researchers put about 124 college students into a virtual subway station. And for some of them, the space was super clean, right? Everything was neatly organized. It was a very clean subway For other people in the study, the subway station was just super messy. There was trash scattered everywhere. Construction materials were all over the place. And the students spent 8 minutes in that cluttery or clean physical environment. Then they took everyone and made them take a test that required them to focus and ignore all the distractions. Here's what they found. Here's what they found. The students who had been in the cluttered environment before the test made significantly more mistakes.

In other words, even when you're trying to tune out the mess around you, all of that clutter can make it harder for your brain to focus on what's right in front of you. So if you're feeling overwhelmed right now, wherever you see clutter, just take a minute and straighten it up. Maybe it's the corner of your desk where things are piled up. That always happens to me too. Your nightstand covered in books. It's got glasses with water in it, maybe reading glasses. The backseat of your car that's starting to look more like a garbage can. Maybe it's the chair in your bedroom that's morphed into a clothing rack. Just pick one space that makes you feel overwhelmed and then just tackle it. And every time you pick something up, you put it where it belongs. You clean one surface, you organize your fanny pack. That's exactly what you're doing. That's exactly what you're doing. You're turning down the music so you can focus. You're giving your mind a clean slate, and you will feel an immediate difference. You'll exhale, your shoulders will drop, your mind's gonna feel less cluttered, and that overwhelm and stress, it'll start to dissipate.

And that's what cleaning the mental slate is all about. It's a gift you give to yourself anytime you need it, because the fastest way to create a little more calm in your mind is to create a little more space right in front of you. I want to say thank you again to our new sponsor, Mrs. Meyer's. I love Mrs. Meyer's. They look to the garden for inspiration because they believe the best stuff in life is simple. So do I. Mrs. Meyer's premium scented oil diffuser provides long-lasting garden-inspired scents like rainwater, lavender, peony, compassion flower, which fill your home with calm. Don't get hung up on the noise, clutter, and weird Reclaim your space with Mrs. Meyer's. Find your outlet. Mrs. Meyer's Plug-In Scented Oil Diffusers. You got this. You're gonna do dynamite. I'm getting a free dermatology appointment from one of the world's leading experts at the Mayo Clinic. Let's go.

Let's do this.

You just go for it. Like, you don't have to ask permission at all. Oh, it looks fantastic.

Doesn't it look amazing? Mel.

My face broke it. What happened? 'Cause the other one's dead. I put too much Botox in it. We killed the machine. Okay,

let's do it again. Okay, so there are 9 items.

I'm just not as smart as you about this, so I'm like, what is a transcription?

I kind of wing it.

Okay, I love that about a scientist. Let's wing it, baby, in the kitchen. Coconut oil, not water. Okay, I was like, wait, I think I'm gonna have diarrhea. I don't think I should do oil.

C-E-R-A-M-I-D-E-S.

Bingo, you go to the next round. No, I'm just kidding.

Cardiac, uh, training as well as resistant training.

Cardio training. Cardio. Cardio. Okay. What is cardio training? Sorry. Sorry. Okay. I'm like, what the hell are we doing here? Is this a new franchise that's launched in, in Rochester, Minnesota only?

So let me rephrase. Okay. So what I want you to do when you've gotten to a situation where—

A situation.

My daughter says that word. A lot.

Amazing.

Okay, well, it sounds good.

Scott, yeah, you were dynamite. Oh, and one more thing, and no, this is not a blooper. This is the legal language, you know, what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment I'm just your friend. I am not a licensed therapist, and this podcast is not intended as a substitute for the advice of a physician, professional coach, psychotherapist, or other qualified professional. Got it? Good. I'll see you in the next episode.

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