Why You Have A Skin Condition - Functional Medicine Doctor Explains_en (auto-generated)
hello everyone welcome back this is Dr Maria zian today we will be discussing the role of functional medicine in diagnosis and especially in treatment of skin conditions and skin is the largest organ of our body and I usually stop here when I say that because I should say the skin is the largest external organ of our body as the gut is actually the largest organ of our body and a lot of people don't know that but the skin is the largest external organ and of course this is something that we see we see our skin every day and most people if not all do pay attention to how their skin looks there are many skin disorders that are benefited from functional medicine approach some but not limited to our eczema psoriasis contact dermatitis acne rosacea atopic dermatitis that actually falls under eczema Vitiligo autoimmune skin conditions and more and more and more in approach to skin disorders it is very important um to understand that just like a famous metaphor says that your eyes are windows to your soul in the same way I view the skin the skin is a window to an inside condition of your body so it's essentially a window into your almost to cellular condition cellular representation and cellular health of your whole organism so that's why um the rash or eczema or whatever the diagnosis is is not just that it's not just the skin diagnosis there is usually much more to it and before I delve into how we deal with um or how we approach skin disorder in our Clinic I would like to point out that um there are of course differences on how conventional medicine looks and treats skin disorders and how functional medicine does that and as you the viewer viewers of our Channel um are educated on that already I assume however it is important to sort of delineate that difference when we see patients come in let's say with eczema which is a very common diagnosis and we see of course more eczema in um colder times of the year it starts in the late fall or rather flares up in the late fall in many people and then gets worse in the winter and finally gets better by May so we uh that's a very common pattern but there are people who do not follow their pattern and that pattern and there are of course different types of eczema I'm just using the most common and basic um example here so when we see a patient with eczema um conventionally so this is a conventional approach conventional approach is to tell the patient oh your skin needs more moisture please moisturize it and do it more than once a day especially if it's um if it's in the winter and then if eczema is bad enough we do end up prescribing a topical steroid cream so what's wrong with that approach by itself it's not wrong um and especially in a sense of that um uh topical steroid creams are fine and they are very helpful if you use them sparingly meaning me that this is not a chronic cream so usually in conversation with our patients I always stress the importance of um not doing the topical cream for more than two weeks at a time so I usually tell them you know use it twice a day for no more than two weeks at a time or less because you really don't need to finish the whole course if you see the results earlier however what kind of approach is that is that really a Curative approach and that's where one of my personal dis satisfaction is with conventional medical approach because I feel that there's so much more that we can gain from the condition of the person's body and this is a little clue um skin clue that we get but instead of really looking deeper into that we are giving this patient a steroid cream and see you later type of thing and yes the truth is most people do get better with a topical steroid cream but is it sustainable because what happens that periodically we get a call from patients like that and of course they need um another refill and we try not to do that and now we try to delve in a little deeper so uh looking at this from functional medicine standpoint it's almost like putting a Band-Aid on uh this problem because patient comes to you with this condition and um really you're just giving him a Band-Aid and sometimes this Band-Aid could be uh sustainable meaning that it could actually work for some time it's not u a quick fix for some patients so it could work for some time and people could say oh wow I got cured I got that topical steroid cream and all is wonderful um and and it's gone but usually uh unfortunately this condition does come back and that's why the conditions that I listed you know like exzema atopic dermatitis and many um rashes especially autoimmune rashes or contact dermatitis and um other rashes that I didn't mention such as hives they do come back because there's something in the body that keeps triggering them and the goal of the functional medicine provider is to find that trigger or as we say in functional medicine to get to the root cause of this problem and that's where the fund begins because now you're not just putting a Band-Aid on the problem but you're trying to investigate what is happening why is this person developing this condition why now and uh why does it look like this specifically and of course it it is also important to look is it a severe manifestation or is it mild how often does it come on be the history taking in functional medicine is extremely important because that's really it's it's um being a detective who is gathering Clues um to what is going on is it something that's there's a correlation with something we do of course ask lots of questions in our conventional approach as well however the more questions you ask and especially sometimes asking just openend ended questions um the more information we will get from the patient and the more information could come out that patient didn't even think that it would be related but in reality there is a causal relationship between this specific something and the onset of this rash so there is nothing wrong with prescribing topical steroids however that is essentially I look at it as a temporary measure and if it's possible I try not to do that I try to talk patient um my patient out of it and try to look into the causes of this condition and um basically trying to eradicate this condition in the difference between conventional and functional medicine approach is that in conventional medicine the doctor cures treats and hopefully cures the patient in functional medicine it's more of a partnership of course the physician um the nurse practitioner PA whoever is seeing the patient the medical provider they are there to treat the patient to make them better however it is a complete partnership meaning that if patient doesn't um participate in this partnership then the results may not be all that satisfying because there may be no results and unfortunately there is no guarantee because some causes are very hard to find and in addition of course we do need patient not only be fully present and aware but to be completely compliant with the treatment because let's say if somebody comes to us with rosacea for example and rosacea has many causes including by the way a genetic uh causality as well and um the first thing the the the simplest thing with a patient like that is of course they need to be very very diligent with their sunscreen they need to use sunscreen every single day including in the winter um and including indoors and by the way that's a good advice for for just anybody who wants to have a good skin and who wants to protect their skin from sunspots from sun damage and from skin cancers that are um uh due to the sun which are basil cell cancers sell cancers and more so however back to the patient with rosacea somebody with rosacea they do need to use sunscreen it it's really imperative and if the patient is not using sunscreen then really at that step I feel like there's not there is not a partnership there is more like a old-fashioned medical model when a physician prescribes something and patient uses it it either works or doesn't work but in a patient like that the patient who is non-compliant it is hard to get to the bottom of things I mean we still try and both in conventional medicine and of course much more so in functional medicine try to get to the bottom of it but if the patient is not into it so to speak then you can't really push that on a patient you try to help as much as possible so you know we would prescribe something specifically for rosacea but again if the patient is not using sunscreen then you know the the a lot of other creams will not work because the moment they go into the sun they get much redder than an average person just from a very short exposure or same happens for example basic example with hot showers many people say oh I have rash in a shower well hot water brings out any rash so it does stimulate your skin to get hot so it is something that really nobody can fix because if you keep showering with very hot water you will see that rash and thankfully that is a transient issue so I usually try not to get into um uh um a lot of conversation with the patient about that because if somebody really likes hot water let it be uh but of course yes hot water brings out all of the rashes so that's why just decreasing temperature tempure of the water not too cold of course in the uh during the winter that's not realistic but to have it less um hot would would definitely help but those are very minor um uh Minor Details so just to start discussing as to the causes of skin problems from the functional medicine standpoint um well let's start with number one number one is actually um U gut problems I know maybe somebody or some of you did not expect me to say that but gut microbiome I know those words are becoming more and more popular but this balance in bacteria of the gut is a huge huge contributor to for example acne and not only acne but many other skin conditions and it can work on many many levels it can work on the level of the um breakage in a gut barrier what we call leaky gut um informally or it can just work on the fact that the G gut is not absorbing the nutrients because something is broken with it and that of course brings us back to the diet but before we get to it of course it has to be diagnosed we need to know that there are serious disbalances of the gut floor of the gut micro uh of the gut microbiome and that of course is the um place to start so a lot of times in approach to skin issu we actually start with that that's a very big one the second uh another very big one which a lot of people know of is um food sensitivities food sensitivities and food intolerances um and I will for the sake of this discussion I will group them together although their food intolerances and food sensitivities are a little bit different from each other but um for example for acne um it eating sugary Foods eating pizza for example you're eating very greasy foods and unfortunately eating chocolate those types of things are not good because in most people not everyone of course they trigger an acne breakout and once I attended a very nice um dermatology conference uh where the speaker was a renowned um dermatologist whom I respect a lot and he said that oh it doesn't matter what um what acne patients eat they can eat pizza that this is all just that's not true and of course that was sort of strange to hear that but it always proves that we're human all of us make mistakes and of course I disagree with that and not only I but the science has shown more and more and more how what we eat is extremely important especially for our skin so definitely food sensitivity and a lot of patients by the way um know that because they would say oh I would I ate this chocolate I was stressed out I ate this chocolate bar and then I had a breakout so food sensitivity is probably is not a surprise for U many of you uh food obvious food sensitivities are are something that you have noticed that there is a correlation in approach to food sensitivities in general the key in that approach is that many times we don't know our food sensitivities because what happens as a result of eating certain food doesn't happen right away it happens later it can happen next day so you can have acne due to a certain food that you eat all the time but you don't know that you're sensitive to it because you don't have immediate symptoms to it and the symptoms that you have let's say you have well acne and let's say you have mild bloating and some GI symptoms in addition to it and you take it that that's just normal that's just the way you are but that's not the way you are that's that's basically your food sensitivity so that's why a food sensitivity testing plays a big role um as well and of course food intolerances um uh is something that uh to be um to be aware of that that is the key in many skin conditions so um the next is uh micronutrient deficiency so those are deficiencies of um minerals and vitamins such as for example zinc or vitamin A B D um and uh those are very important because testing for micronutrients is a little bit different just from just um it's different from having just a regular serum or your blood tested micronutrients is those minerals and vitamins tested inside of the cell so you really want to have that because that's more precise that's more accurate when you that's why it's called micronutrients and sometimes the re the data the number the value of uh micronutrient is different than the one from a conventional serum lab so that is why it is so important to have that tested as well zinc is a very big player in um skin health and also in hair loss so it's very very important to know the zinc value and to take supplements if you need to take zinc supplements um I would like to throw here another little fact that we see it sometimes is actually people who take vitamin B12 too much there is such a thing that people who essentially overdose on vitamin B12 and they have high vitamin B12 and they can develop all kinds of rashes as a result and sometimes it's difficult to diagnose because we're so um programmed to think that most people are are vitamin B12 deficient that we don't think of that that somebody could be actually overdose overdosed and to have too high of a level of vitamin B12 so that's also very important the next one is hormonal cause of skin disorders and that is we see a lot of course in acne uh but also I would like to add to it um just in general different types of dermatitis acne rosacea and also um older uh people acne especially in women you do see uh postmenopausal or param menopausal acne and uh periodically I see um female patients who say to me oh I used to have a great skin all of my life I had a wonderful skin and now I have all this breakouts and pimples I thought that I that that would never happen to me because I never had it as a teenager so and those are um often they do have hormonal causality to it and hormonal I mean androgens progesterone estrogen uh those are all important hormones that that do play role and um we do test for that um one of the tests that uh we use when there's a suspicion for hormonal cause is a Dutch uh complete test uh which is um actually a great test to um look into that uh another hormonally related is um a stress test which is a u looks into a level of cortisol and it reflects your stress level and also looks into um into your whole hormonal um situation right now because obviously it does change and a lot of times well I I should say overwhelmingly frequently I do see patients who would say to me something that yes I've been through a lot of stress it is a very stressful time for me or you know somebody died or there's illness in the family I mean they're big stressors and that that's life we we do unfortunately go through stresses in our lives and how we deal with them you know nobody's always prepared that's completely human so and our body reflects that our body reflects uh these stresses and um stress is not just a word so stress has a material implication meaning that stress is not just bad emotions or bad feelings stress turns into a certain hormonal changes in your bodies and those bodies lead to certain diseases and conditions so that's why management of stress is one of the cornerstones in functional medicine and you can't really talk to the patient only about medical issues without discussing how to manage stress because that's that's that's truly a biggie and of course the last one which is sort of I look at it as like a throwaway bucket is um inflammation of the whole body like if you have some kind of processes other processes going on that um your whole body is inflamed for whatever reason and inflamed I mean internally there are s processes um for example like uh inflammation if you're fighting a cold or fighting some disease then you your skin actually can manifest that as well so the skin becomes a byproduct of um uh manifestation of those uh inflammatory processes that are going on in your body so we see that as well and usually in that case the skin rash or whatever skin condition it is shortlived in most people shortlived as long as the inflammatory response subsides and you're back to your regular um level but if you're not of course the skin issues may even get worse unfortunately so um so these are sort of groups of causes that can lead to skin issues and the important part is to know where to start in conversation with the patient it is important as to where to start and not to um overwhelm the patient and also listen to the patient to get the clues as to what is going on and where would be the most um um efficient in terms of the time and financially way to focus on to eradicate this problem instead of just prescribing topical steroids again I'm not against topical steroids I prescrib them myself but I think it's very unsatisfying and very temporary way of helping somebody so very exciting topic so this was just a little overview because there are just so many skin issues um that are addressed with functional medicine in a proper way as I think so thank you very much for listening until next time