Ask an Expert: Wellness in Mind, Body and Skin

We spoke with Dr. Vivian Shi, board-certified dermatologist and Assistant Professor of Medicine in Dermatology at the University of Arizona, about the current wellness trend as it relates to skin care.

BB: “Wellness” has really taken hold as a concept—we’re starting to understand that our mind, body and environment all play a role in our wellbeing. What are your thoughts on the mind-body connection as it relates to skin?

Dr. Vivian Shi: For centuries, people have known that stress can have harmful effects on skin. We also know that certain foods can help, and others can worsen skin health. But only in the past two to three years have we really had evidence-based data showing why stress can worsen the skin barrier and eczema, or that dairy and sugar worsens acne, or spicy foods and alcohol worsen your rosacea or sensitive skin.

We now know that when we undergo emotional stress, it directly triggers something called neurogenic inflammation. Mental stress causes inflammation in other organs of the body—including our skin.

Food is the same way. The gut and the skin are very well connected. We now know that for rosacea and sensitive skin, eating spicy food, drinking alcohol and getting sun exposure can activate nerves within the skin which then transmit a tingling and burning sensation message to the brain. These signals can then cause skin inflammation and tell the blood vessels to dilate and flush. These are very intricate processes and we're just in the infancy of understanding how they all work together.

Do you think that people who struggle with skin issues should pay closer attention to what they eat?

There are inside-out and outside-in approaches to skincare. It would be so awesome if someone could say, "Gluten is the root cause of your eczema," but, unfortunately, there is no one root cause. So, we really have to tackle skin health from multiple angles.

The recent research has shown that your skin barrier is not fully functioning at a young age. For example, the skin barrier on the cheeks doesn’t fully mature in most kids until they’re seven years old, so you often see kids with eczema on their cheeks. For the longest time, we theorized that certain food allergies might be damaging the skin barrier and causing eczema. Now we’re learning that it may be the other way around! A defective skin barrier may trigger food allergies—it’s paradigm-changing. In other words, not only should we repair the skin to improve eczema, but repairing the skin barrier early and effectively may prevent certain allergies. It’s a very big deal in the dermatology and allergy medical community.

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