In conversation with dermatologist, Dr. Julie Russak, on COVID-19, taking a pause, and taking care of ourselves amidst the uncertainty of the global pandemic.
What are your thoughts on COVID-19? Where do you feel we are in overcoming this?
The whole world is standing still right now, it is literally on pause. And after the initial shock and grief, I think we have been able to really take this time as an opportunity to think about how we want the world to be after we can reopen.
“Life’s biggest lessons come with full force either making us stronger or breaking us into pieces. This one, even though it has shaken us to the core of our beings, has made us stronger to deal with what remains of life. It has also made us focus more on where we are needed rather than what we need. All our efforts have been directed towards proving ourselves to be selfless beings earning gratification as well in the process. Kindness knows no limits, and we have proven so to each other.”
What do you think is one thing that we should be taking away from this?
How small our world is. Before COVID-19 we all lived in different countries, with different socioeconomic and cultural values. In the blink of an eye, due to this tiny particle, we realized how quickly and suddenly we are all in the same boat with the same problems and the same hard questions to confront. We need to put aside our differences and see that we have so much more in common and that only together we can overcome this. We are all humans living on the same planet and we need to take care of each other and our planet.
As our pace of life changes and we are taking more time to take care of ourselves, what are some self-care rituals that you would recommend to boost our skin health and glowy complexion while we are staying home?
Having a routine is extremely important, not only from just a purely psychological point of view but also from a physiological point. Keeping a schedule in terms of when you go to bed and when you wake up and maintaining a normal circadian cycle keeps your cortisone levels spiking at a normal physiological range. We need those spikes to regular our metabolism. When it’s out of order, too high, or cortisone levels are exhausted (adrenal fatigue), that we start noticing problems. Maintaining a healthy diet, with high protein and low inflammatory foods, keeps overall inflammation low, decreases the breakdown of collagen, and contributes to the improved repair of skin. Good circulation is also very important for healthy, glowy skin, therefore regular exercise can contribute to your complexion too.
Since most of us are now working from home, what are some benefits of a makeup-less work day?
Your skin is free to breathe! We can skip multiple steps of priming, caking cover-up and contouring with products that may contain toxic particles, and hopefully take this time to apply antioxidants, to moisturize the skin and create gentle regiments to renew and replenish. I want to stress the word gentle. I have several patients that started noticing red, irritated skin after the first few weeks of quarantine and we tried to investigate what mysterious diseases they could possibly have; it turned out to be the overeager use of all the skincare products that they’ve accumulated but did not have time to use before. For example, “I’ll try an AHA cleanser in the morning, glycolic acid at night, and then that retinol cream that my dermatologist wanted me to start last winter. And then I can do a mask and use my ultrasonic brush daily…” – yikes! We can completely destroy the skin’s protective barrier if we follow this time of regimen and our skin just starts falling apart. Sometimes less is more, and it’s all about consistency.
What are some key supplements we should all be taking for skin health?
There are many different supplements that can benefit your skin but don’t forget that the skin is a real reflection of your internal house. If your body is healthy on the inside, then your skin will be healthy on the outside. Supplements that decrease inflammation and heal your gut are the supplements that will also benefit your skin. We must remember that skin is one of the fastest renewing organs, so it needs the energy to create its new, healthier house. It needs the energy to create collagen, which is the building block of the skin, so taking protein supplements is extremely important right now. High levels of protein overall can help to heal your gut, which allows you to better absorb nutrients. This will decrease inflammation, and also provide the building blocks for collagen synthesis. Additionally, taking probiotic supplements may not seem directly related to the skin, however, they help to heal the gut and increase in the absorption of nutrients, which are important for your skin as well for your body overall.
Another factor to consider? The benefits of multiple additional micro and macronutrients. We know that vitamin C is a cofactor for collagen production, but it also helps greatly with the body’s detoxification processes. Magnesium and zinc contribute to normal protein synthesis, so they are cofactors for collagen production as well. We also know that taking vitamin C and E helps our body to repair the damage that happens from the outside environment due to UV radiation and environmental free radicals. All of these supplements are important, but we also have to keep in mind that it’s not what we eat, it’s what we absorb. What matters is what nutrients our body is able to properly absorb, and there are a number of studies that show that taking nutrients in pure supplemental form might not be the best for absorption. We must keep in mind what nutrients are important for us and where we can get them from whole foods – and I don’t mean Whole Foods the health foods store – I mean whole foods as a source of nutrients. This is where we see the most benefits from vitamins.
One fascinating study that proves this point is from 1923, where they were trying to prove the benefits of milk in mice. One group of mice was given whole milk to drink, and the other group was given full milk constituents but in separate forms (the same concentration that is found in normal milk but as supplements, so casein, vitamin A, vitamin E, fats and so on). What they found was that only the mice that drank milk were happy, meaning they reproduced and lived longer and healthier. In other words, the nutrients that come from whole foods have synergistic effects that are different than their individual constituents.
Some specific supplements that Dr. Russak recommends: Turmeric, Beta Carotene, Lycopene, Polyphenols, Selenium
Oral versus topical supplementation for skin health? Is one better than the other?
Skin is designed as a protective barrier, it is designed to actually keep things from the outside out and not allow them to penetrate into the skin. Therefore, a lot of supplements that we put directly onto the skin actually don’t reach the subdermal layer of the skin where collagen synthesis and the repair of the skin happens. Therefore, oral supplements such as nutrients that act as cofactors for collagen production and peptides for protein synthesis are definitely better absorbed from the inside. However, there are definitely things on the outside that can benefit our skin, and by outside I mean things that can protect us from outside damage. Examples would be antioxidants, such as vitamin C and vitamin E, which work wonders when applied to the surface of the skin to help repair oxidative damage that happens due to the environment and UV radiation. My patients often ask me if they should use a cream with collagen in it. Collagen is a huge molecule and it will not get absorbed into the skin, however small peptides that act as the building blocks for collagen as signaling molecules to decrease inflammation and stimulate repair, when broken down into small pieces, are very effective. Di-and tri-peptides can be absorbed through the surface of the skin and promote healthy skin regeneration, decrease in the appearance of lines and wrinkles and slow down aging.
Can you tell us a bit more about the skin-gut connection? What are some warning signs that this is imbalanced and what can we do to fix it and support a healthy skin-gut connection?
As our knowledge about the gut and the Microbiome increases we understand the connection between the gut and the brain, and gut and the skin much, much better. We understand that a lot of signaling from the gut actually directs how we age, how fast we age, or how well we can repair our skin, therefore how well our gut functions directly leads to healthy skin. Much is being studied right now about the concept of a “leaky gut”. When you have a leaky gut, there is an imbalance between the gut’s microbiome function and the nutrients that are absorbed. When that is the case, a few things happen: One is that you’re not absorbing your nutrients well, so you don’t have enough cofactors for healthy skin production; two, you’re actually leaking out nutrients that are needed for skin regeneration. Leaky gut also contributes to increased inflammation in the body, and we do know that internal inflammation shows up in the skin. Skin becomes red and inflamed, you develop pimples, you develop broken capillaries. Inflamed skin is also not going to repair itself well, so the aging process happens much faster when there is internal inflammation
What would recommend to those of us that suffer from wrinkles and skin aging?
Stay healthy, the skin is an organ, it depends on your internal health. I think we are understanding this concept much more now than ever. During this time of external stress and uncertainty of the Pandemic, we see our internal health deteriorating, and we also see increased signs of aging when we look in the mirror. The concept of ‘beauty from within’ is much more relevant and obvious now than ever before.
What is one wellness practice that you couldn’t/wouldn’t go a day without doing?
My wake up routine, which is a combination of beauty and mindfulness. Before I get up, I move my silk pillow out from under my head, I lay flat on my back with my chin tilted upward to improve lymphatic drainage from under my eyes to minimize eye puffiness, and I go through 5 things that I am grateful for in my life. It helps me to start the day on a positive note and be grateful for each day. Staying positive is an active process and you have to train yourself to do it.
How would you advise maintaining our mental resilience in these stressful times? Are there any practices you would recommend?
Create a routine that includes some time just for yourself, whether it’s a meditation time or a bath. Most of us are living in quarantine now in close quarters and are not used to 24/7 proximity, even to loved ones.