How to Improve & Protect Your Skin Health & Appearance | Dr. Teo Soleymani
Dr. Teo Soleymani, a double-board-certified dermatologist, discusses science-backed protocols for skin health, appearance, and longevity. Topics include sun exposure, sunscreens, retinoids, nutrition, and treatments for common conditions like acne, psoriasis, and vitiligo.
Deep Dive Analysis
19 Topic Outline
Skin Turnover and Stress Effects on Appearance
Impact of Caffeine, Nicotine, and Alcohol on Skin
Hydration, Moisturizers, and Skin Cleansing Practices
Addressing Dry/Flaky Scalp and Dandruff
Cost vs. Efficacy in Skincare Products
Sun Exposure: Benefits, Risks, and Skin Cancer
Mineral vs. Chemical Sunscreens and Their Safety
Oral Supplements for Sun Protection (Polypodium)
Nutrition, Gut Microbiome, and Anti-Inflammatory Diets for Skin
Retinoids vs. Retinol for Skin Health and Anti-Aging
Laser Resurfacing and Exfoliation for Skin Improvement
Red Light Therapy and Phototherapy for Skin Conditions
Understanding and Treating Psoriasis
Vitiligo: Autoimmune Skin Depigmentation and Cancer Risk
Acne: Causes, Dietary Triggers, and Management
Rosacea: Types, Triggers, and Treatments
Eczema: Genetic Factors, Triggers, and Immune Response
Pimple Popping, Corticosteroids, and Tattoo Considerations
Monitoring for Skin Cancer and HPV-Related Cancers
9 Key Concepts
Skin Turnover
The surface of the skin completely renews itself approximately every 28 days. This regenerative capacity allows the skin to heal and adapt, making it a dynamic organ.
Acute vs. Chronic Stress
Acute stress causes immediate vasoconstriction, making skin appear pale, while chronic stress, mediated by cortisol, breaks down collagen and elastin, leading to accelerated skin aging.
Mineral Sunscreens
These sunscreens, primarily containing zinc oxide and titanium dioxide, are considered physical blockers. They protect the skin by reflecting and absorbing ultraviolet radiation without undergoing chemical changes, making them generally preferred for safety.
Chemical Sunscreens
These sunscreens contain organic compounds (e.g., oxybenzone, octocrylene) that absorb UV radiation and dissipate it as heat through a chemical reaction. Concerns exist regarding their systemic absorption and potential endocrine disruption.
Retinoids vs. Retinol
Retinoids are prescription-strength, biologically active forms of vitamin A that directly bind to retinoic acid receptors, increasing skin cell turnover and collagen production. Retinol (with an -OL) is an inactive prodrug that requires a two-step conversion to become active retinoic acid, and over-the-counter versions are often unstable and less effective.
Selective Photothermalysis
A principle in laser dermatology that allows specific skin structures (e.g., blood vessels, pigment) to be targeted and treated with light energy while leaving surrounding tissues undisturbed, minimizing collateral damage.
Psoriasis
An immune-mediated skin condition characterized by red, scaly patches, primarily caused by an overactive immune system producing messenger molecules (interleukins) that accelerate skin cell turnover. It is not solely due to excess skin proliferation but immune dysregulation.
Vitiligo
An autoimmune skin disorder where the immune system attacks and destroys melanocytes, the cells responsible for producing skin color, leading to depigmented patches. Interestingly, patients with vitiligo have a lower incidence of skin cancer due to enhanced immune surveillance.
Eczema (Atopic Dermatitis)
A common inflammatory skin condition often linked to a genetic barrier defect (e.g., filaggrin gene), allowing environmental allergens to penetrate the skin more easily and trigger an overactive immune response.
10 Questions Answered
Acute stress causes vasoconstriction, making skin look pale, while chronic stress increases cortisol, which breaks down collagen and elastin, accelerating skin aging and reducing suppleness.
Caffeine's effect on skin is minimal and transient, though high intake may increase sebum. Nicotine is a known vasoconstrictor that accelerates skin aging and impairs wound healing. Alcohol is a diuretic, causing short-term dehydration and puffiness, and chronic use can disrupt the gut microbiome and worsen skin conditions like rosacea.
Choose a non-comedogenic, fragrance-free moisturizer. Ointments (like petrolatum) are best for dry or eczema-prone skin, while lighter lotions or creams are better for acne-prone skin, with pump bottles generally containing lighter formulations than jars.
Cleansing frequency depends on individual skin oiliness and lifestyle; over-cleansing can strip natural oils and disrupt the skin microbiome. Mild, fragrance-free, hypoallergenic cleansers like Dove white bar soap, Cetaphil, or CeraVe are generally recommended, especially for sensitive skin.
While excessive UV exposure can cause premature aging and increase skin cancer risk, some sun exposure is beneficial for overall wellness, mood, and vitamin D synthesis. The key is to avoid burning and prolonged exposure beyond one's skin tolerance.
No, mineral-based sunscreens (zinc oxide, titanium dioxide) are generally preferred as they act as physical barriers and have no known systemic absorption concerns. Chemical sunscreens have raised concerns due to systemic absorption and potential endocrine disruption, leading the FDA to re-evaluate their 'safe and effective' status.
Yes, a high-protein, anti-inflammatory diet, rich in complete proteins and fruits/vegetables, can improve skin health and reduce inflammatory conditions like psoriasis, eczema, and acne. High glycemic index foods and certain dairy products (skim/nonfat) can exacerbate acne.
Retinoids are prescription-strength, active forms of vitamin A (e.g., tretinoin, adapalene) that directly promote skin cell turnover, reduce skin cancer risk, and increase collagen and elastin. Retinol (over-the-counter) is an inactive precursor that requires conversion and is generally less effective and stable.
Certain laser resurfacing treatments, particularly non-ablative fractionated lasers, can improve skin appearance, reduce the risk of skin cancer by eliminating mutations, and activate genes associated with more youthful, healthy skin cells.
The most important factor is family history. Beyond that, an annual full-body skin exam by a board-certified dermatologist is recommended, including all skin surfaces. For individuals with many moles, mole mapping or AI-based software can aid in surveillance.
22 Actionable Insights
1. Get Annual Skin Checks
Schedule an annual full-body skin exam with a board-certified dermatologist to survey for skin cancers, as they can develop anywhere, including sun-protected areas, and early detection is crucial.
2. Use Prescription Retinoids
Obtain a prescription-strength retinoid (e.g., tretinoin, adapalene, tazarotene) from a dermatologist, as these effectively increase skin turnover, reduce skin cancer risk, and promote collagen and elastin growth for healthier, more youthful skin. Over-the-counter retinols are generally ineffective.
3. Avoid Nicotine Products
Refrain from all nicotine use, including smoking, vaping, and oral products, because it causes chronic vasoconstriction, leading to accelerated skin aging, poor wound healing, and a net negative impact on skin health.
4. Adopt Anti-Inflammatory Diet
Consume a high-protein, complete protein, anti-inflammatory diet, prioritizing animal-sourced proteins, fruits, and vegetables, to improve overall skin health and reduce the severity of inflammatory conditions like psoriasis, eczema, and acne.
5. Moderate Sun Exposure
Expose yourself to some sunlight for overall wellness and mood benefits, but always avoid burning or prolonged exposure that causes skin redness, as excessive UV can lead to premature aging and skin damage.
6. Prioritize Physical Sun Barriers
Utilize physical barriers such as shade, protective clothing (long sleeves, pants), and hats as they are consistently shown to be more effective than topical sunscreens for comprehensive UV protection.
7. Choose Mineral Sunscreens
Select mineral-based sunscreens containing zinc oxide and/or titanium dioxide (SPF 30+, broad-spectrum) over chemical sunscreens, due to concerns about chemical absorption into the bloodstream and potential endocrine disruption.
8. Limit Alcohol Consumption
Reduce or avoid alcohol intake, especially higher concentrations, as it acts as a mild diuretic, causing skin dehydration and hollowing, and can disrupt the gut microbiome, negatively impacting skin health.
9. Use Gentle, Fragrance-Free Cleansers
Cleanse your skin with mild, fragrance-free, hypoallergenic, and non-comedogenic products (e.g., Dove white bar soap, Cetaphil), and avoid over-cleansing, which strips natural oils and eradicates the beneficial skin microbiome.
10. Do Not Pop Pimples
Refrain from picking or popping pimples, as this physical trauma recruits matrix metalloproteases (MMPs) that break down collagen and elastin, leading to permanent acne scars.
11. Get HPV Vaccination
Consider getting the Gardasil vaccine, which covers cancer-causing HPV strains, as HPV is increasingly linked to various cancers, including squamous cell carcinomas in sun-protected areas, and guidelines now extend to adults up to their late 40s.
12. Select Appropriate Moisturizer
Choose a non-comedogenic moisturizer tailored to your skin type; use greasier ointments for dry or eczema-prone skin, and lighter lotions for acne-prone skin, to provide effective barrier protection and minimize water loss.
13. Adjust Showering Frequency
Shower and cleanse your skin based on its oiliness and your activity level; daily cleansing is not medically necessary for everyone, especially older individuals or those with dry skin, but always cleanse after sweating.
14. Treat Dry/Flaky Scalp
For dandruff (seborrheic dermatitis) or psoriasis, use shampoos containing zinc or ketoconazole to reduce yeast overgrowth, or consult a dermatologist for topicals to dampen the immune response, without damaging hair.
15. Choose Cost-Effective Skincare
Opt for simple, inexpensive skincare products, as more expensive options are not necessarily better and often contain additional ingredients, including fragrances, that can be problematic for skin.
16. Consider Oral Sun Protection
Supplement with polypodium (50-480mg daily or an hour before sun exposure) to increase your skin’s tolerance to UV, reduce burn risk, and help block the effects of visible light, especially useful for sun-sensitive conditions or when topical sunscreen reapplication is difficult.
17. Adjust Diet for Acne
Avoid high glycemic index foods, sugary processed foods, and nonfat/skim dairy products, as these can increase insulin response and inflammation, exacerbating acne flares.
18. Manage Rosacea Triggers
Identify and avoid personal triggers for rosacea flushing and redness, such as UV light, spicy foods, hot beverages, and emotional stress, and consult a dermatologist for persistent breakouts or redness.
19. Diligent Eczema Management
For eczema, consistently moisturize with occlusive products (e.g., ointments) to repair the skin barrier, avoid environmental allergens and fragrances, and consult a dermatologist for topical or systemic treatments to calm the immune system.
20. Consider Non-Ablative Laser Resurfacing
Explore non-ablative fractionated laser resurfacing with a dermatologist, as it can improve skin appearance, reduce skin cancer risk by activating genes for youthful, healthy skin cells, and has less downtime than ablative lasers.
21. Use High-Powered Red Light Panels
Consider using high-powered red light and near-infrared light panels to improve vascular flow, aid post-procedure recovery, support hair regrowth, and potentially offer pre-treatment protection against UV damage.
22. Ensure Safe Tattoo Practices
If getting tattoos, ensure the artist uses clean, sterile equipment and be aware that certain colors (e.g., reds with cinemates) can cause allergic reactions; regular skin checks by a dermatologist are crucial for tattooed skin due to challenges in mole surveillance.
6 Key Quotes
You have new skin, brand new skin every 28 days. So the surface of your skin turns over about every month.
Dr. Teo Soleymani
There is not a shred of evidence that anything more expensive works better than anything cost effective.
Dr. Teo Soleymani
I absolutely do not think that sun avoidance is a healthy thing.
Dr. Teo Soleymani
The genetics loads the gun, for example, and maybe even pulls the hammer. But what in the environment is the trigger?
Dr. Teo Soleymani
Everybody should be on a prescription-strength retinoid, which is different than over-the-counter retinol.
Dr. Teo Soleymani
The skin's a biosensor. The entire skin, hair, nails is a biosensor. So you can utilize the skin as the first barometer of illness.
Dr. Teo Soleymani
2 Protocols
General Skincare for Healthy, Youthful Skin
Dr. Teo Soleymani- Manage stress through effective reduction techniques.
- Avoid nicotine use (smoking, vaping, oral forms) due to vasoconstrictive effects.
- Minimize alcohol consumption, especially high-percentage alcohols, to prevent dehydration and microbiome disruption.
- Use a non-comedogenic, fragrance-free moisturizer suited to your skin type (ointment for dry, lighter cream/lotion for oily).
- Cleanse skin as needed, but avoid over-cleansing to protect the skin microbiome; use mild, fragrance-free cleansers.
- Protect skin from excessive UV exposure using physical barriers (hats, clothing, shade) and mineral-based sunscreens (SPF 30+).
- Consider oral supplements like Polypodium for enhanced sun protection, especially if active or unable to reapply sunscreen.
- Adopt a high-protein, anti-inflammatory diet, rich in complete proteins, fruits, and vegetables, while minimizing high glycemic index foods and skim/nonfat dairy.
- Incorporate a prescription-strength retinoid (e.g., tretinoin, adapalene) into your routine to increase skin turnover, reduce cancer risk, and promote collagen/elastin growth.
- Consider non-ablative fractionated laser resurfacing annually or biannually for improved appearance and reduced skin cancer risk.
- Avoid popping pimples to prevent scarring and excessive immune response; if a white-tipped pimple must be addressed, use a warm compress without pushing or squeezing.
Monitoring for Skin Cancer
Dr. Teo Soleymani- Gather your family history to understand your genetic predisposition for skin cancer development.
- Schedule an annual full-body skin exam with a board-certified dermatologist.
- Ensure the dermatologist examines every square inch of your skin, including hair, between toes, and genital areas.
- If you have numerous moles, consider utilizing tools like whole-body photography or mole mapping to track changes over time.
- Be aware that skin cancers can develop in sun-protected areas, including genital regions and the mouth, sometimes due to HPV.