Dermatologist Answers More Skin Questions From Twitter | Tech Support

I'm Dr. Muneeb Shah, a board certified dermatologist,

and I'm here today to answer

more questions from the internet.

This is Skin Support.

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@Mia Pinchoff asks,

How many layers of skin do we have, ballpark?

It depends on

how you look at the layers of the skin.

So there's really three major layers of the skin.

There's the epidermis,

which is everything from this purple upwards, the dermis,

which is where your collagen is.

And then there's the hypodermis, which is your fat

and the muscle and everything that's below that.

You'll hear a lot of times five layers of the skin,

but they're not talking about the entire skin in general.

They're talking specifically about that epidermis layer,

which has four when you're looking at the face.

And it has five layers when you're looking

at the palms and soles.

@Ryan M Stryker asks, is it possible

that your lips can become addicted to ChapStick?

So a lot of times people like those fragrance

and flavored lip balms,

but it turns out that those a lot

of times are irritating the skin, which makes you want

to actually apply them more often.

Not just that, but if you're somebody who's using flavored

lip balms, it's gonna make you lick your lips more often.

And that licking of your lips has enzymes in it

that actually breaks down the skin

around it making you want to apply it more.

So my recommendation, avoid fragrances in your lip balms.

Avoid mint in your lip balms.

Avoid any flavors in your lip balms

and use something that's gentle and fragrance-free.

And you'll probably see a huge benefit

and you won't have to apply it as often.

@Clough72 asks, What causes dry skin?

So there's a few things that cause dry skin.

One, it's your genetics, two, it's your environment,

and three, it's things that you potentially are doing wrong.

So from a genetic perspective, a lot of people

with eczema are atopic dermatitis,

they have dry skin because they have abnormal lipid content

in that epidermal layer of the skin.

Low lipids like ceramides

or abnormal lipids, can cause you

to naturally have drier skin.

The second thing is the environment.

So if you're in a condition that gets very cold,

you have low humidity.

We know that when the humidity drops in a room within one

day, your skin actually becomes dehydrated from losing

water to the environment.

And then the third thing is things

that you potentially are doing wrong.

So using very harsh cleansers, over scrubbing the skin

or using hot showers.

Now think about it like this.

When you're washing your dishes with cold water,

you notice it doesn't remove the oils that well,

but when you wash your dishes with hot water

or warm water, it removes oils much more effectively.

And the same thing happens in your skin.

When you take a hot shower,

it strips away all those natural oils which can

make your skin more dry.

@Cosmodamag asks, Why is vitamin D

so important for the skin?

So it's not actually that vitamin D is important

for the skin, it's that the skin is important

for your vitamin D levels.

About 90% of the vitamin D in your body comes from the skin.

So sunlight actually converts cholesterol into vitamin D,

producing most of the vitamin D in your body.

Only about 10% comes from your diet.

Vitamin D is super important to bone health in general.

So there's something called rickets.

When you have low vitamin D levels,

your bones actually become very, very soft and they bend

and they break very, very easily.

JMictt asks, How does one get rid of an ingrown hair?

So what you see here is actually a hair follicle

and outside of that hair follicle, you're growing that hair.

Now that's normal hair growth,

but with an ingrown hair, that hair can actually grow out

and turn back into the skin, or sometimes it gets trapped

and it never makes it out of the skin.

While it's embedded in the skin,

that can actually cause quite a bit

of inflammation and irritation.

And so what you'll actually notice is

a red and painful bump.

Now your body can sometimes push out that ingrown hair,

but what ends up happening a lot of times is

that you actually need to get it physically extracted

by a dermatologist or an esthetician that can find the root

of that hair and pull it out.

Now, you could do this at home if you clean the area

and you use tweezers, but definitely be careful

because you can develop a worsening infection.

Now if you wanna prevent these ingrown hairs from happening,

avoiding much shorter hair.

So if you, if you don't shave your hair very short,

that can prevent ingrown hairs.

And if you use a glycolic acid exfoliant,

that can also prevent ingrown hairs.

And I've noticed in my own personal experience using an

electric trimmer prevents ingrown hairs from me compared

to using a traditional razor.

Funcharacteristicaly asks, What is sweat composed of?

What makes it smell?

How might sweat on one part

of the body differ from another?

There's two major forms of sweat gland.

So one is your eckrin sweat gland.

So when you get sweaty palms

and soles, that's majority eckrin sweat.

It's pretty much just water and salt.

And that sweat is actually usually pretty odorless.

Now when we think about body odor, the type of sweat gland

that's producing body odor is something called

the arine gland.

And those arine glands are pretty much not

active until puberty.

And those are the ones that you find in the armpits,

the groin, underneath the breast,

and that's the one that produces that odor of smell.

A lot of people don't realize that when you sweat arine

sweat, it's actually odorless when you secrete

it onto the body, it's mostly composed of lipids.

And then you actually have bacteria on the skin that convert

that solution into something that smells bad, ammonia

and short chain fatty acids.

And so if you eliminate the bacteria that's converting

that sweat, you can actually eliminate body odor.

So things like benzo peroxide

and chlorhexidine washes are really good at

eliminating body odor.

@Rojaaesthetics asks, What is the skin's microbiome?

I don't wanna freak anyone out right now,

but if I was to scrape your skin right now

and look at it under the microscope,

you would have essentially a jungle

of organisms living on your skin.

Every single one of you, I don't care

how much you wash your face, you would have bacteria,

you would have fungus,

and you would have little mites crawling

around on your skin right now.

And that little jungle is actually called the microbiome

and they usually live in harmony

and cause no problems to the skin.

In fact, when there's a good healthy mix

of things growing on your skin, it's actually good for you.

And it's when one type of organism starts to sort

of lead the jungle is when you start

to develop things like acne.

@Fschic asks, How TF is the skin in organ?

So an organ is supposed to be a collection of tissue

that all serve the same purpose.

The skin is considered an organ

because its function is to protect you from the environment

and also to keep things in the skin.

So if you don't have your skin,

which we actually see in people

that have severe burns all over the body,

you dehydrate very quickly

because all the water in your body evaporates

and you get infections very quickly

because your skin's not protecting you from the environment.

@FaMeDeLaFleur asks, Does retinol cream really work?

I personally use retinol,

so I certainly hope that it works.

If you're a skincare enthusiast

or even if you're on social media,

you probably hear about all kinds

of crazy trending ingredients all the time.

And most of them don't stand the test of time.

But retinol on the other hand,

which is a vitamin A derivative

that we find in skincare, has been around now for 50 years

and the data is only getting better.

And so Tretinoin, which is the active form of retinol,

it's found in prescription products,

is incredibly effective.

And then retinol is converted to Tretinoin in the skin

and is a very effective over the counter version

of this vitamin A derivative.

@Realnutritious asks,

Do you know what really causes wrinkles?

With time, there's two things that happen.

So first you wanna look at yourself as a grape

when you're a child.

You're filled with juicy fluids

and you don't have any wrinkles.

And then you lose that volume with time

and you become more like a raisin.

And what is that volume that you're losing?

Collagen, fat, bone, your skin starts

to move in the direction of gravity

and then you form wrinkles.

One of the most important contributors

to aging is sun exposure and also diet.

Diets high in sugar cause glycation,

which actually damages your collagen.

And when you lose that collagen, your wrinkles start

to become more prominent.

And so to avoid wrinkles, you want

to protect yourself from the sun.

You want to use healthy diets that are low in inflammation

and you also wanna do things that replenish the collagen

like use things like retinol.

@TrentonFerg asks

If we shed skin cells every single day,

how is it that people have tattoos?

This is such a good question.

So when we look at our skin shedding every day,

we're actually talking about that epidermis layer

of the skin that kind of sloughs off every day.

So that's that very top layer of the skin.

But below that where all your collagen is hanging out,

that's your dermis and that's actually

where they deposit tattoos

and that's why you don't shed off your tattoos.

And interestingly, the particles of tattoo are too large

to actually move and have your body

remove them from the dermis.

And so they actually just hang out there in the dermis.

@CBQ Beauty bar asks,

What does an LED light therapy mask do?

This is a LED mask

and what you're noticing back here is some red light.

To be honest, I honestly thought this was a gimmick myself.

I did a lot of research on LED masks in general,

and it turns out they've done quite a bit

of study on light in general.

So LED basically produces light in different wavelengths.

When you look at what blue light does to the skin,

it actually has anti-inflammatory

and antibacterial properties of the skin.

So if you have acne,

it can actually target the porphyrins within your acne

causing bacteria to eliminate that.

And then when you look at red light, the wavelength

of red light between 600

and 700 nanometers can actually target the fibroblasts in

that dermis layer of the skin to induce collagen production.

We call that photo biomodulation.

And so red light actually has profound anti-aging benefits

and actually can help quite a bit with wrinkles.

ButterscothGgood3724 asks, Do you think medical grade

skincare is better than over the counter type items?

I am here to debunk this

and probably save a lot of use of money right now.

So medical grade skincare is purely a marketing term.

There is no standard definition of

what medical grade skincare is.

If a aesthetician, med spa, dermatology office,

or plastic surgery office is selling you skincare,

a lot of times they will tell you

that it's medical grade skincare.

It just means they're selling it from their office.

I could take a tube of toothpaste

and call it medical grade skincare

and no one is gonna stop me.

You would hate me, but no one is gonna stop me.

@JessRMorris asks,

My freckles are going wild because of the sun.

I love freckles so much please,

why can't they be on me all year round?

So what are freckles in the first place?

Freckles are little blotches of melanin,

which is basically the pigment of the skin.

And so your melanocytes,

which are the pigment producing cells of the skin,

get hyper activated and they produce little blotches.

Now I love freckles.

I think that they're beautiful, but they get worse

or more prominent with sun exposure

and they fade in the winter when you get less sun exposure.

So they're basically like mini tans,

which is a marker of sun damage.

And we do know that people that are prone

to freckles are more likely to develop skin cancer.

So if you're somebody who developed

freckles, please be careful.

Wear sunscreen. Your freckles will still be there.

They just won't be as prominent,

but it will also decrease her risk of getting skin cancer.

@SophiaKarim asks, How fast does hair grow?

The average is essentially half an inch a month.

It really depends on who you are,

but it depends also on what part of the body.

They all have different life cycles.

So the the life cycle

of the hair is much longer on the scalp than it is on the

eyebrows, and that's why your hair can be different

on different parts of the body.

But in general, to answer your question,

about half an inch a month.

@AR220323, So why are stretch marks permanent?

People have actually biopsied stretch marks.

What you find is a very thin epidermis

and you actually find a scar like pattern in the dermis

where the collagen bundles

and the elastic fibers are different than a normal skin.

And so those different collagen fibers are actually causing

that stretch mark to hang out for much longer

after the stretching and growing has occurred.

@VegasVandaI asks,

Why do we turn red when we get embarrassed?

How does this help us survive?

Well, we don't really know why this

could be beneficial for you.

What we do know is that what ends up happening,

what's actually causing that redness is

vasodilation of your blood vessels.

So they become dilated

and that increased blood flow appears

as redness when you're embarrassed.

@WandaLaplount, What exactly is psoriasis?

Psoriasis is an inflammatory condition in the body.

So what it looks like to you is plaques on the skin.

So you have redness.

On top of that redness is a micacious silvery scale.

It's not contagious at all.

But what's actually happening

underneath those plaques is inflammation.

It's really important to control that inflammation,

'cause not only is it affecting the skin,

but it's affecting other organs in the body

like the heart.

@Xo_Sophia asks, Products aside,

how many steps is your skincare routine?

My current skincare routine is eight steps,

but I feel like it needs to be 10.

I feel like it needs to be less, quite honestly.

Me personally, I have a three step skincare routine,

maximum cleanse, treat and protect.

Cleanse is just a simple cleanser.

Treatment is something that's targeted towards you.

So if you have acne, you're gonna use a treatment

that's targeted towards acne.

If you have dark spots, the treatment is gonna be targeted

towards dark spots and then protect.

@night, that means moisturize.

In the morning, that means wear sunscreen.

@Mahaaaay asks,

Does anyone have an SPF recommendation for people of color?

I'm sick of these brutal white casts.

So first, what is a white cast?

It's that pasty white appearance

that you see when people are wearing sunscreen.

Some of you might remember

that famous Mark Zuckerberg surfing picture where he has

that amazing white cast over the face.

As a dermatologist, I loved it.

But it's not necessarily the thing that most people want

to have when they're walking around outside.

So when you're looking at sunscreens, you have your chemical

and you have your mineral sunscreens.

Your chemical sunscreens are pretty much invisible

a lot of the times nowadays.

You can have a chemical sunscreen

that is completely see-through,

and then you have your mineral sunscreens that are zinc

and titanium dioxide.

And no matter how good the sunscreen is,

they're still gonna have a little bit

of white cast when you're looking at

those mineral sunscreens.

So if you're somebody who wants

to completely avoid a white cast, opt for something

that's more of a chemical sunscreen.

Now a lot of people are concerned about chemicals.

I'm personally not worried about chemical sunscreens.

The only ingredient I tell my patients

to avoid is oxybenzone.

Otherwise, the rest have been

shown to be safe and effective.

@ApolloHerbs asks, What's the difference

between a serum, a cream, and a lotion?

So there's no strict definition in

what any of these things mean.

It really has to do with the the heaviness

of the product overall.

A serum is gonna be the

lightest weight version of their product.

It's almost gonna be like a liquid.

A gel is gonna be a little bit closer to a cream,

but it's gonna be a little bit more liquidy.

Then a lotion is a little bit heavier than a gel,

and then a cream is a little bit heavier than a lotion.

And then an ointments a little bit heavier than a cream.

@EmilySera asks, Am I the only weirdo

who wonders why blackhead are black

and yet yellow when squeezed out?

You're definitely not the only weirdo,

'cause I personally have asked this question

many, many times before.

When you actually are secreting this,

what's happening in in your pore essentially is

that you have oil glands

and skin cells that are sloughing off into the pore

and they're clogging the pores with all of that sebum

and sebaceous filaments.

Sebaceous is essentially just the technical term for oil

and it's naturally a yellow substance.

But then at the tip of it, the tip closest

to the surface is exposed to light and air.

And with exposure to light and air, that yellow is oxidized

and so it becomes black

and it becomes what we call a blackhead.

But once you push it out, you still have that yellow natural

substance underneath it.

@Just_DDee asks, Question of the day,

why do we all have fingerprints?

So we know that fingerprints develop at roughly 20 weeks

when you're still in the womb.

And it's a combination of things,

but it's actually led mostly by genetics.

There's a few things too that contribute to this.

So it could be the amount of amniotic fluid like slushing

around when you're in the womb.

It could be the movement patterns.

It could have to do with gravity to some extent.

But we do know that genetic programming plays a really big

role because if you were to scrape off your fingerprints,

you would actually grow back the same

fingerprints throughout your entire life.

They actually never change.

It's been debated why we even have fingerprints

and actually nobody knows,

but we do believe

that fingerprints actually do add some grip.

And so that's the running thesis.

But we actually have no idea how this beautiful body works.

@PureRadianceHW asks, #Skincare,

does the weather affect your skin?

So let's talk about the extreme conditions,

winter and summer.

So in the winter, it's very dry.

It's very cold, and so people's skin tends to get very dry.

You lose a lot of moisture from your skin into the

environment, and a lot of people need

to use more moisturizing products.

Now, just because it's the winter

and you're not getting as much sun exposure,

doesn't mean you don't need to wear sunscreen

because you still get UVA

and UVB exposure,

especially if you're skiing in high altitude.

So definitely wear sunscreen in the winter as well.

Now, when we look at the summer, the extreme conditions of

that heat, humidity.

So your skin tends to not be as dry,

but you're exposed to much more sunlight,

and this is where you're gonna be

more diligent about sunscreen.

If you're out at the beach and you're gonna be in the sun

all day, reapplying your sunscreen every two hours

is gonna make a big difference.

That wraps up Skin Support. I hope you learned something.

We'll see you next time.

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