Ep 198 – The Rogue Pharmacist: Psychodermatology

0:00:00.0 Maggie Staszcuk: Do you see yourself as the rebel who challenges the status quo on skin health? Learn how to be a critical thinker, discover innovative solutions to skin conditions, and facilitate individualized healing on a deeper level with Truth Treatment Systems. Truth Treatment Systems provides you the products and tools to unveil the truth behind skin conditions. Sign up for a wholesale account today at truthtreatmentspro.com and receive 10% off your first order. That's truthtreatmentspro.com. This podcast is sponsored by LAMPROBE. LAMPROBE is a popular aesthetic tool that enable skincare practitioners to rapidly treat a wide variety of common minor skin irregularities or MSI. 

 

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0:01:30.7 MS: Hello, and welcome to ASCP, The Rogue Pharmacist with Benjamin Knight Fuchs. In each episode, we'll explore how internal and external factors can impact the skin. I'm Maggie Staszcuk, ASCP's Education Program Manager, and joining me is Ben Fuchs, Skincare Formulator and Pharmacist. Hey, Ben. 

 

0:01:49.6 Benjamin Knight Fuchs: Hey, Maggie. Good to see you. 

 

0:01:51.2 MS: Good to see you. 

 

0:01:52.1 BF: You're getting really good at this, by the way. 

 

0:01:53.8 MS: It just rolls off the tongue. 

 

0:01:54.7 BF: It does. It does. I'm impressed. 

 

0:01:56.5 MS: On this podcast, we've talked a lot about, the gut-skin connection, but today we're notching things up to the brain and discussing a subject I think is really fascinating, the mind-skin connection. So in short, what is psychodermatology?  

 

0:02:10.0 BF: Well, in short, it's psychology and dermatology. It's the interaction between specifically the mind and the skin, but really it's part of mind-body medicine, what they call mind-body medicine. And until very recently, if you talked about mind-body, it was kind of woo-woo. You're sort of... You know, you lived in Boulder. You're sort of a weird hippy-dippy type kind of person, but now it's really being recognized. And interestingly, Hippocrates talked about psychodermatology. He talked about the relationship between the mind and the skin, and this was like a couple 100 years BC. So we've really... The mind-body thing has been something, and the mind-skin thing specifically, has been something that has been recognized in medicine historically through antiquity, but only recently has it gotten the kind of credibility that it really deserves. 

 

0:02:56.7 BF: And when you think about it, when we talk about the mind, the mind is the brain. The mind is what... You ever hear the saying, the mind is what the brain does for a living? Right?  

 

0:03:04.1 MS: Oh, that's cute. I haven't heard that before. 

 

0:03:06.4 BF: Isn't that cute? Yeah. So the brain is the physical representation of the mind, or the mind is the processes that the brain goes through. So the mind and the brain are related. The brain is producing chemicals and hormones, and the chemicals and the hormones and the neurotransmitters are affecting every part of the body. Why shouldn't they affect the skin? Does it make sense? I mean, just logically, there should be a relationship between the mind and the skin. So, logically, psychodermatology makes perfect sense. And as it turns out, we know that people have psoriasis, people have eczema, people have acne, have comorbidities oftentimes that are psychological. 

 

0:03:38.1 BF: A comorbidity is another illness associated with the primary illness, comorbidity. And we know that people have psoriasis and eczema and various immune conditions in the skin oftentimes have psychological comorbidities associated with it. And it makes perfect sense. The skin is receptive, the skin cell specific are receptive to things like cortisol, serotonin, dopamine. There's actually receptors for all of these things on skin cells themselves. And skin cells themselves produce stress hormones and various immune systems, cytokines and molecules that are associated with immunity. And when you think about what is the skin really, it's kind of a boundary, right? So of course, it's gonna be defensive. 

 

0:04:19.8 BF: And whenever there's a defensive response, there's gonna be chemistry that's associated with that defensive response that will affect the skin. And the skin is also not just physically defensive, it's psychologically defensive, in the sense that people judge us on our skin appearance. And so that can create a sort of defensive or stress response as well. So while psychodermatology has only recently become a thing, even though there's like I say, there's a historical aspect to it, it makes perfect sense. And so, as a skincare professional myself, and as a skincare, yourself as well as a skincare professional, estheticians and dermatologists and people who work with patients who have skin issues, we have to recognize that it's not always just physical. 

 

0:05:02.6 BF: And that's not just true about the skin, that's true about the entire body. Health challenges, and I'm a healthcare professional in addition to being a skincare professional, I always look to emotional and psychological and mental issues that are associated with physical manifestations of disease. And we have to recognize that sometimes the physical is just symptomatic of something that's going on at a deeper level. Now, certainly, you can have things that are strictly physical, like infections or something like that. But if you find as a healthcare professional or as a skincare professional that your patient is not healing and you're doing all the things right from a physical perspective, you always have to look to the psychological and the emotional kinds of causes or roots to the physical symptoms. 

 

0:05:44.7 MS: So as an esthetician, of course, there's always going to be that psychological component, maybe your client has acne and then they're feeling self-conscious. 

 

0:05:55.2 BF: Yeah, it could be a circle. Right. 

 

0:05:58.1 MS: But, I also am well aware of the impact of stress, then releasing cortisol and increasing the sebum, and then now you have acne. 

 

0:06:07.2 BF: Like you have self-esteem issues, perhaps, and then they show up as a immune problem on the skin, which makes your skin worse, which makes your self-esteem problems worse, which makes your skin worse, and you get this downward vicious spiral. And the only way to really break that kind of downward vicious spiral is to go right to the emotional cause, right to the self-esteem issue. And look at our culture. We have a culture where... And even the skincare business, where we kind of... We run roughshod on people's self-esteem. In fact, we take advantage of... Not only do we take advantage of low self-esteem, but we sort of encourage it sometimes. 

 

0:06:39.2 BF: I don't mean we necessarily, people listening to this podcast, but the business of skincare is kind of like, there's an element of you're not good enough or you're not pretty enough or you could be prettier or you could be better. And we have to really be cautious of that as estheticians. And I know when I'm formulating skincare products, I'm formulating it for the health of the skin. And my message is you are beautiful. You just maybe need a little nutrition or a little bit of to remove some kind of immune stimulant or work on your digestive system. But you're inherently, not only people inherently, but their skin is inherently beautiful. The skin is an amazing, amazing organ and structure, and if there is some kind of issue that's going on with the skin, we don't wanna make people wrong about it, we just wanna kind of say, "Hey, maybe you're missing some vitamin C or maybe you're eating the wrong food or maybe there's a digestive health issue." 

 

0:07:28.3 BF: We want to be really careful about making people wrong about how they live their lives or about how their skin is because that can exacerbate the problem. And we already have a, we have a business where that lends itself to, "Oh, I'm not okay." And we have to be really careful about that, I think. 

 

0:07:42.1 MS: So you're talking about benefiting the health or the immunity of the skin. How can we improve the mind-skin connection is... 

 

0:07:50.0 BF: Self-love. 

 

0:07:50.6 MS: So you're saying it is strictly about self-care?  

 

0:07:53.5 BF: Self-love is probably the most important thing. Learning to love ourselves. And I don't mean that in an ego kind of way, but just the fact that we're alive. Just the fact that we're beings on earth. We're deserving of love, just for that. And then, in terms of self-care, there's this thing called mindfulness. I'm sure, everybody's talking about mindfulness now. Mindfulness is really a hard word to describe, but I have a definition for it. My definition of mindfulness is paying attention to your mind. Mindfulness is watching how your mind works, watching how your thought processes work. A lot of times we just think thoughts and we go about our business and we don't realize that there is a thing called a thought process. 

 

0:08:28.8 BF: There is even just... Some people don't even know that there's a thing called thinking. We all have a voice in our head, right? Do you know there's some people who don't know they have a voice in their head? And when you tell them they have a voice in their head, they'll say, there'll be a voice in their head saying, "What voice? There's no voice." And it's actually the voice in their head. It's thus, we become, disengaged from our thought processes. 

 

0:08:47.5 BF: And because we are what we think literally via our hormones, every time you think a thought, biochemistry has changed, biochemistry is produced. So we literally are what we think. If you're not mindful, if we're not paying attention to thought dynamics or the dynamics of our mental natures, then we become a victim of our conditioning and our programming. And unfortunately, our parenting is not always great because our parents oftentimes were victims of their conditioning and their programming. 

 

0:09:11.5 BF: And then the culture wants us in a way to be not feel good so that we go out and buy deodorant or that we go out and buy things to make us better, material goods or things for our bodies. So we have to really kind of pay attention to our programming and our conditioning and how our mind works, otherwise, we're gonna become victims of it. So self-love is probably the number one most important thing. Just loving yourself because you have a body, just loving yourself because you're part of nature. 

 

0:09:38.4 BF: And then be mindful, paying attention to your thought dynamics. One of the best things you could do, and I talk about this all the time, is meditation. And meditation doesn't have to be, woo-woo or, ohm or anything like that. It could be just sitting still and watching how your mind works, watching the nature of your... Watching your mental nature. And the mental nature is connected to the emotional nature. Mind, every time you have a... Every time you think a thought, you have a feeling. And every time you have a feeling, you have a thought. In fact, they're two sides of the same coin. 

 

0:10:06.4 BF: The emotions are the link between your thoughts and your body. So it goes, you think a thought, you get an emotion, and it shows up on your body. And it's in that direction. So by working backwards from your acne, which is showing up in your body, or your eczema, or your psoriasis, you'll start to see things. And once you start to see things, then you can start to work with them. So self-care, mindfulness... I'm sorry, self-love, mindfulness, meditation. And then probably, like we were saying earlier, how it's a circle, your physical nature also affects your mental nature. 

 

0:10:37.7 BF: So the kind of foods you eat, for example, can affect the sort of thoughts you're thinking. So making sure that you're working with the kind of foods you're eating, the kind of supplements you're taking, exercise, movement, relaxation. These are all things that are physical, but they too can affect the psychological or the mental aspects of how your body shows up. 

 

0:10:58.0 MS: So circling back, we mentioned that stress and cortisol go hand in hand, and that's stimulating sebum production. But what are some other ways that mood or that voice in your head is affecting the conditions or the things we're seeing on the skin?  

 

0:11:13.5 BF: Serotonin. Serotonin is your coping, is a brain chemical. Actually, it's primarily a digestive chemical, actually, a gut chemical. But it's also associated with our ability to cope. When your serotonin is low, you don't cope as well. You feel helpless in life. When your serotonin is high, excess serotonin, you become paranoid. So paranoia and poor coping are two ends of a spectrum. You wanna be somewhere in the middle. You don't wanna be paranoid and freaking out about everything, but you don't wanna feel like you're helpless in the world. So making sure that you're keeping your serotonin stable is very important. And serotonin is regulated by a lot of things. Food, for example, sugar, insulin. As it turns out, carbohydrates are important for producing serotonin. Sunshine, getting out in the sun is important for serotonin. Another hormone that's important for psychological aspects that may show up on the skin is dopamine. People are talking a lot about dopamine. 

 

0:12:09.9 BF: Dopamine is a very important neurotransmitter for helping you feel like you're successful. Our dopamine goes up when we have success. Even just reaching for the doorknob will raise your dopamine. If you hit the doorknob, people who don't make dopamine can't reach for the doorknob. They actually have a disease called Parkinson's disease. Have you ever seen that? That's where you shake, right? You can't make it to the doorknob. So succeeding in things, even just cleaning up your room, or finishing a project, or finding a mate if you're looking for a mate, all of these are ways that you can raise your dopamine levels and that can have positive effects that may alleviate dermatological issues or health issues. 

 

0:12:49.5 BF: So between serotonin and dopamine, you have your two major neurotransmitters that are involved with psychological well-being. And that's really what we're talking about with psychodermatology. And it's very interesting that we said about cortisol, I think cortisol is not only associated with psychological stress, but it's also associated with physical duress. And one of the most important biochemical correlates of physical duress is hypoglycemia, low blood sugar. So when your blood sugar drops, your cortisol will go up. When your blood sugar drops, you're gonna find yourself craving sugar. 

 

0:13:18.7 BF: So sugar cravings are a sign that you may have some hypoglycemia issues related to cortisol. And ironically, when you eat sugar, your body pulls the sugar out of your bloodstream, and you become hypoglycemic again, your cortisol goes up. So you eat more sugar, pulls the sugar out of your bloodstream, your cortisol goes up. And you get this kind of vicious spiral of, I call it the high blood sugar, low blood sugar roller coaster. And this will show up on the skin as not only oily skin, and oily skin is a classic sign of elevated cortisol, elevated stress hormone, but also blackheads, and also poor wound healing, and also thinning skin. All of these can be signs of excess cortisol production. And excess cortisol production is not only associated, as I say, with psychological duress, but also with physical duress. 

 

0:14:05.1 MS: That's really interesting. And aside from acne, I mean, if somebody is suffering from, say, like seborrheic dermatitis or other oily skin conditions, can that also be correlated with these cortisol problems?  

 

0:14:17.8 BF: Absolutely. Absolutely. Yeah. Cortisol is a bad guy. Well, you don't want to say it's only a bad guy, 'cause cortisol gets you up in the morning. Cortisol gives you energy to do things. Cortisol gets you out of a jam. So it's not like, it's not as simple as cortisol is bad. But elevated cortisol, chronically high cortisol, can definitely be problematic and can definitely show up on the skin. And it can also cause problems like anxiety and sleep insomnia, sleep problems, and depression, so there are a lot of psychological things that are associated with elevated cortisol. But as far as strictly physical, yeah, oily skin, blackheads, poor wound healing, internally immune problems, suppressed immunity, which again, can cause skin problems. So cortisol has a lot of impact on the physiology, on the skin, as well as on the psychology. 

 

0:15:08.6 MS: That concludes our show for today, and we thank you for listening. But if you just can't get enough of Ben Fuchs, the ASCP's Rogue Pharmacist, you can listen to his syndicated radio program at brightsideben.com. For more information on this episode or for ways to connect with Ben Fuchs or to learn more about ASCP, check out the show notes.