Treating the individual as a whole has always been of vital importance to Serena Mraz, MD, a Board Certified Dermatologist who practices at Solano Dermatology in the Northern Bay Area of California. In recent years her interest and research of the microbiome and its effect on aging and beautiful skin is high-lighted in this recent interview with Aesthetic Insider™. Can we attain beauty from the inside out? Read below to find the answer!
What piqued your interest in the microbiome?
My interest in the microbiome really started a while ago, probably over 10 years ago, and it was a very serendipitous situation. I was invited by my son’s school teacher to give a presentation to the class about the skin. As I began to prepare my presentation, making sure to include information on skin care and sun screen, the teacher also asked if I could present information on the microbiome. At that time I knew a little bit about the microbiome but his request prompted me to do a little deep dive and then, as I became more intrigued with the importance of the microbiome in health and wellness, I became fascinated. The more I learned, the more I wanted to learn.
How does the microbiome affect the skin?
As dermatologists we have known for many years that there is a direct link between the microbiome and skin disorders such as rosacea, and that the digestive system can have an effect on other skin disorders such as acne. What we have learned, however, is that the microbiome can also affect hormones and health and can drive disease and aging if it is in a state of dysbiosis, or more plainly, is out of balance. The microbiome is a very complex and intricate system and scientists are learning more and more each day about how it affects our body inside and out, including the health and beauty of our skin.
Is there an internal and external microbiome and how does it affect us?
We do indeed. We literally have trillions of micro-organisms that live within our digestive track (or gut), and they also live in our mouth, on our skin, around and in our eyes, our nose, you name it, they’re everywhere. These microbes outnumber our own cells and DNA by more than 10 to 1. Not only do they outnumber and control our own cells, they quite possibly control the epigenome. Our DNA expression is very dependent on the epigenome and these external factors, so the microbiome plays a key role with immunity and with overall health. Ultimately the health of the microbiome has a lot to do with the outward appearance and health of our skin. Healthy skin looks hydrated and youthful, unhealthy skin looks dry, damaged and aged.
Can we share our microbiome?
Technically, yes. Research shows that the external microbiome extends about 3 feet out from the human body. Therefore, anyone within three feet of you can share your microbiome, and vice versa, you can share theirs. More recent studies show that the microbiome gets into a mother’s milk so during breastfeeding not only is the mother passing on her microbiome to the infant through her milk, they are also sharing each other’s microbiome during the skin-to-skin contact action of the child feeding, helping develop the child’s immune system. Which means we can also share our microbiome when holding hands, or simply touching another person.
How important is the microbiome to overall health?
The microbiota plays a very key role in immune system regulation and in helping us develop immunity against diseases of our skin, lungs, etc. Most of us want to steer towards living a healthier life, rather than one plagued with disease, so developing and maintaining a healthy microbiome, both inner and outer, is very important to general health and wellness. It is important to note that the microbiome is very malleable and changes every single day. It changes with every action and every lifestyle choice that we make, or don’t make. It drives our health and wellness and while starting out with a good microbiome in early childhood is highly desirable, the journey needs to continue on throughout life, and how we each choose to live it affects our overall health.
What can we do to keep the microbiome strong and healthy?
There are several lifestyle factors that have been proven to extend life and quality of life, and those are diet, exercise, adequate sleep, no smoking and moderate [or abstaining from] alcohol intake. All five of those factors directly affect the microbiome. So not only are they good for other reasons, but they positively affect the microbiome. Also, if you look at the Blue Zones (Okinawa, Japan, Ikaria, Greece, Sardinia, Italy, Nicoya, Costa Rica and Loma Linda, California), areas discovered by National Geographic Fellow and author Dan Buettner to inhabit people who live the healthiest and longest lives, there are also other factors including friendship, family, social and personal connections, and close community over isolation. What we are able to learn from the combination of lifestyle factors, and Blue Zone activities is that living a whole, well-balanced life can help build a robust and healthy microbiome. Other Blue Zone factors to consider are that people in those regions that lived a long, healthy life also incorporated walks in fresh air and local and organic food sources as a daily staple in their diet.
Does food have an impact on the microbiome and skin health?
What we put inside our bodies eventually shows up on the outside and that goes for food intake. Fresh, natural foods are best for a health body and a healthy microbiome. I recommend that my patients eat a lot of vegetables, some fruits, but to stay low on sugar as it causes glycation and a breakdown of the collagen which we know is essential to healthy and youthful skin tissue. I also recommend fermented foods although not everyone loves them like I do, but even a small portion each day can help build a healthy microbiome and act as a probiotic. I also suggest steering clear of processed/packaged foods, foods with preservatives of any kind, and foods that have been grown with pesticides, or animals raised with hormones and anti-biotics. Processed foods of any kinds are very detrimental to the health of the microbiome all of which shows up in the body and the skin in all forms of eczema, acne, dehydrated and hormone imbalanced skin.
Can isolation affect the microbiome?
Socialization and interaction with other human beings helps to improve the diversity of the skin microbiome. I actually think it’s one of the best things we can do for the skin microbiome. Just like the microbes in our gut, even though they don’t cross the blood brain barrier, skin microbes produce metabolites that can affect us in a positive or negative way. Additionally, these microbes in our gut actually communicate to the brain through the vagus nerve which scientists say has a lot to do with mental health and the connection to the gut microbiome. What happened during the COVID pandemic is that everybody was told to stay at least six feet apart and to isolate, therefore, there was no exchange of microbiota due to distancing and isolation. During that time, I saw many of my older patients experience a profound acceleration of aging in just two to three years, which was striking and stunning, and extremely sad. So, isolation, I think, is not healthy for any of us for so many reasons, but there is a physical reason with regard to the microbiota.
Does being out in nature have a positive effect on the microbiome?
Absolutely. There are studies that show the direct correlation of being in nature, actually touching trees, grass, sand, ocean water, etc., does improve our microbiome diversity and most certainly on the skin. Plus the added benefit of sunshine, exercise and tranquility really does have a positive effect on the body and brain too.
Are there skin tests that can measure the external (or internal) microbiome so we can learn how best to optimize the skin?
The microbiome is a living, moving and ever changing micro-biotic system that changes constantly. We all have a unique microbiome – as unique as a fingerprint. Healthy lifestyle factors are the first line to keeping the microbiome in positive balance. When the internal microbiome is off, or is in a state of dysbiosis, people may have a whole host of symptoms including stomach upsets, sensitivities to certain foods or they may have rosacea, fatigue, mood alterations, autoimmune disease or a whole host of specific and /or nonspecific symptoms. I would recommend healthy lifestyle practices as a first line measure to keep the microbiome in a healthy balance and consider further investigation and/or professional guidance if needed. However, on the external microbiome of the skin, we can do a skin PH balance test as a rough proxy of the external microbiome balance. A lower PH is an indication of a healthy balance of lactate producing micro-organisms. Utilizing a skin PH balance test, we can recommend exosomes, retinoids, peptides, hydroxy acids, moisturizers and/or other treatments to help restore balance and thereby attain optimal skin health.
To watch the full interview with Dr. Mraz CLICK HERE, or listen to the podcast CLICK HERE. To learn more about Dr. Mraz, visit www.solanoderm.com.