The Truth About Exfoliation and A Healthy Skin Barrier with Osmosis

0:00Hey guys, welcome back to Skin Anarchy. This is your host Ekta and I'm really excited about our guest today because we're welcoming him back after a couple of years. A lot of you might recognize his wonderful skincare brand, Osmosis. We hosted him before about it, but welcome back, Dr. Ben Johnson. I'm so excited to host you. Oh, yeah. I'm so excited to be here. Thank you, Acton. Yeah. No, I'd love to dive in. You've been such a trailblazer, you know, in the space of skincare, obviously dermatology, but also bringing that to the OTC space and really kind of bringing products that actually work for various skin conditions.

0:31And I'd love to talk to you about that, you know, in terms of when was it in your career when you realized that traditional dermatology and the model was kind of flawed? I mean, out of the outset, I could see that, because we all know the damaging effects of antibiotics, Accutane, steroids, but it just has been a growing trend that they're using these as their only strategy and they're just never seemingly looking for the source of skin conditions. And if you're not trying to troubleshoot and listen to your patient about their dietary habits and what the influences those have, it can be really disheartening for the patients.

1:09And I know a lot of your listeners have probably had that experience. So yeah, the idea here was, listen, that's not good enough. You know, we're in a day and age now where we can use our mental faculties to explore all the possible reasons why people's skin suddenly changes. And you know, that's the thing. It's like sudden change in your skin just to say, oh, your body just does that. You know, what are you going to do? It doesn't work for me. And so right now there's a few like epidemics I'll call them of skin issues. And so more needs to get out to the consumers and your listeners that let them know that they can empower themselves here.

1:45And they don't always have to just rely on what is oftentimes unsatisfactory answers. Yeah, no, you know, I love that you're saying this because there was a point where like, I've been doing this podcast now for four years. And there was a point where I stopped and I was like, there's so many outdated drugs in dermatology. I feel like there's so many things that are being used and they're actually damaging people in some ways because I was put on antibiotics when I was a teenager I remember that and I remember thinking even at that time as a kid like I don't really want to be on an antibiotic much less something like Accutane so there is a flaw in the way that it's being approached you know when it comes to things like acne or even more severe conditions like eczema there's this almost like very aggressive immediate reaction that happens, right?

2:30From that classic allopathic response, you know, or that treatment that you get at a dermatologist's office. So it's very off-putting in some ways. Yeah. I just think people must be so frustrated and not to mention that a lot of times these toxic approaches aren't even working well. So, you know, it's really just getting down to understanding what environmental exposures are involved in creating these issues and what we can do about it in our diets and realizing where the minefields are. Right. Right. Now, I know, like with your skincare line, you take a very unique approach and it's a different approach, which moves away from things like, you know, really harsh exfoliation or peels or these just really, I think, aggressive treatments, right, that people do.

3:11Why do you think the industry has been so obsessed with something like exfoliation? And I mean, can you educate us a little bit on exfoliation in general? Yeah. Well, first of all, I would say I've heard that epidermal barrier health is a trend now. I'm so glad to hear that. And so it does seem to be coming around. And even these damaging procedures, you just keep seeing them dial them down and try to pitch them in different ways or actually reduce the inflammatory effects that they're creating because they also realized that it was too much. And so what was it just the other day, I heard a pitch for high intensity ultrasound where they just realized, oh, we just need to do it for fewer minutes because it took, well, you know, a decade of damaging people's skin permanently with things like I'm thinking right now of Thermage where now they're like, oh, well, now we just know we do it for, you know, shorter periods of time and we let pain be the tell for when we stop.

4:11And it's like, oh my God. But when are we talking about the fact that damage itself does not create a rejuvenation event? So the summary of exfoliation is that it dehydrates the skin. It causes increased sun damage because when you lose the protective fat, part of what that fat does is it reflects light. So you're getting a natural UV protection from those 15 layers of stratum corneum and from the lipids that are intertwined. And so when you tear that down, you're dehydrating, which people find themselves constantly complaining about dry skin and don't realize they're doing it themselves. Oily T-zone, a common complaint, is also something that's caused by exfoliation.

4:51And so, you know, what's the point? Well, the goal was to increase the turnover rate because they think more new younger cells are coming in. I have news for everyone. You're not getting newer cells. Like your skin is going to produce a similar level of cellular, let's just call it age, whether you push them to go at a faster rate or not, that, you know, that it's not going to change the, let's just say the age of the cells of your skin. Now, yes, it's also true that when you exfoliate, oftentimes the effect on the skin is harmful enough that there's some plumping. So sometimes people are like, well, I like it because my fine lines look better, but But that is not the way to improve your fine lines.

5:31You don't want to wound your skin anymore and create more challenges than your skin already has. So one of the things we all understand is your skin has trouble keeping up with the ongoing damage on a day-to-day basis as it is. And so anything you do to add to that damage is going to make it even harder. And where the consumer gets confused is they see an improvement from the effect. And so they think that must mean the skin has benefited. and they just need to understand that that's edema, that's swelling in the skin and it is not serving you the way that you think it is. So yeah, I try to push people away from exfoliation.

6:09I'm glad that trend is somewhat fading in many respects. But again, people don't realize most retinols cause this. You know, if you're using an AHA, of course it's causing it. So they may think, well, I'm not exfoliating because they don't see it happening, but they need to be mindful of the ingredients they're using as well. No, that's such a great set of points that you've made, because I think that with exfoliation, you know, I can't tell you how many times I've been scrolling right on social media. And I've seen these girls that have like the little heart sponges and they're like using them with cleanser and they're rubbing their face and then they have a peel that they're doing at home.

6:44And it's like, oh, my gosh, you know, like you're literally ripping your face off at the end of the day. That's what's going on. And so it's crazy. Like it's gone way overboard. And I think also a lot of people I've heard say, well, if I don't exfoliate two, three times a week, my skin just doesn't glow. And it's like, well, you know, I mean, I think that's like a big thing, right? As people say that, like, it doesn't feel like my skin is refreshed looking or whatever. And it's just like, well, there must be something else we can use to still get that, right? Here's where I would go with that.

7:16Because one of the biggest reasons for aging, I can't remember if we talked about this a few years ago, but one of the biggest reasons for aging is a loss of circulation in the skin over time. And so the idea of glow is an interesting one because if you wound the skin, you might actually see an increase in circulation and that might give you more of a glow. And that's what they're identifying. But there are ingredients for that. You know, niacinamide is a vasodilator. That means that the blood vessels expand for your audience. And so that ingredient alone can add a glow if it's in your products.

7:48If you use a stimulating product, meaning you have ingredients that are getting deeper into the skin, that are asking the skin to do more, they actually have like a chemical message. They're sending in a request for more activity that on its own will also trigger the skin to increase its activity. And that's been my approach to sort of an inside out approach to getting more turnover and to getting more glow is to say, let's let's ask the skin to do more while keeping your barrier intact. That way you are moist. That way you are protected from the environment in the sun. And to me, it's just so logical.

8:24And that's also part of the, you know, going back to the dermatology conversation. I think still today, 75 % of dermatologists would tell you, you should have exfoliation in your daily routine. So it's wild when the science tells us that that's actually not a good idea. Yeah, that's what's crazy to me is because we keep hearing these conflicted opinions. And at the end of the day, though, I do see what you're saying because it is a protection mechanism. And also one of the biggest arguments I think any physiologist would make, right, is that there's nothing going on in your body that doesn't serve an actual purpose.

8:57Like the body is the most intelligent machine. So if we look at it from that perspective, there is a reason why we have a certain amount of dead skin cells that are usually at the top. You know, they serve their purpose. There's real logic behind that. So when you're taking that off, yeah, you're really messing with normal human physiology, which is going to eventually lead to pathology. That's, I think, the most common sense way to think about it. I'd love to actually get your opinion on this because I love your products, by the way. I think they're all wonderful. Yeah, no, I really mean that.

9:26And I've been using them for some time now because we first connected a few years ago, you know, so I got to try them back then and I'm still using them. And one of my favorite ones, as basic as this step is, is the cleansing. I love your cleanser and I use it. Yeah. I use it regularly, like literally morning and night. And it's made the biggest difference for me because, yeah, because I feel like the cleansing step for me was something I was doing wrong or something. I don't know. Like maybe I was just for many years not doing it because when I properly just started cleansing my face without something that's super harsh, it almost balanced everything out to where I don't get those random acne breakouts, you know, for the adult acne and whatnot.

10:05So I want you to talk a little bit about this step and what cleansing actually is supposed to do for our skin rather than what people are doing now. Yeah. You know, it's funny because cleansers are sort of like everyone's got one and there are a lot of choices you can make. I would say the majority of skincare lines usually throw an alpha hydroxy in and have an exfoliating cleanser. And the real challenge is finding the right balance of surfactants so that you don't pull too much of the fat off the skin. Because the bottom line is dirt on the skin is stuck to fat. And so it's this fine line of how much dirt do I want to remove in order to feel clean and look clean and be healthy clean as far as the skin goes versus over cleaning.

10:53And then I'm now I've got significant loss of lipids that are going to result in my skin feeling dry. And so some people, they love the aggressive cleanser because your skin feels so tight afterwards, but that tightness is a sign of damage. That tightness means you have overstripped your lipids on your skin and that'll be a problem for you for a variety of reasons. So we tried to find the right balance of that. I don't know if you have the cleanse or the Purify. Purify. Purify is the one I love. I love that one. Yeah. And so that one uses enzymes to get any dead skin cells that might be on the surface.

11:30And the reason why we use that option is because it doesn't pull lipids away, has no impact on lipids whatsoever. And so you still get a gentle cleanse, but it's refreshing. But I do want to speak to something that's really interesting because I see the ads for the post-cleanse wipes, right? A lot of people have And they love to like put the wipe across their nose and then show the screen. And you're like, whoa, there's still more dirt on my face after I washed. Oh, no. And I just want to remind all the listeners, dirt on your face is actually not a problem. And you don't want to cleanse to the point where you don't see anything at all, because at the whole point of you certainly want to get your makeup off.

12:08And, you know, there's always that balance and Purify does a pretty good job of it. But yeah, there's certain types of makeup that are going to require their own, you step and most women are used to that. But just remember that you're not supposed to cleanse to the point where some alcohol or really aggressive lipid remover isn't pulling off all the lipids on that part of your face that will show dirt. And that's okay. It's okay to have a little bit of dust on the face. It doesn't cause any harm at all. Your skin is actually designed to tolerate it really well. For all of us who have had kids, they can run, you know, three, four days easy.

12:44yeah and they don't break out from it they don't there's no infection from it so it's not it's just a matter of you're not trying to get to the point where you're so clean that when you take one of those alcohol wipes and rub it across your skin it doesn't show any grime that's going too far and that's the balance people need to take that makes a lot of sense and i think what you had mentioned earlier i mean if you are wearing a heavy layer of makeup every day like that's fine where you're using something to remove that makeup before you but for skin purposes right when it's actually just your skin, you don't need to be going crazy with the three-step cleansing routine.

13:19Like, you know, it's kind of wild these days. And to your point, you don't need the scrub brush and some people love it. You know, there's those rubber vibrating devices and all of that is a bit overkill, but you know, some people run sebum heavy, you know, they run, I don't want to even say oily. They just, they have a lot of natural sebum in their skin. They can tolerate these things. I'm not going to say that everyone can't get away with it, but generally I find for just about everybody, a modest cleanse is really the goal because the lipids on your skin are one of the most important. Hey, you know, just go into the microbiome on the skin, which I believe the skin's microbiome is created by our own DNA and it is easily replaced if you have the lipids present.

14:04But if you keep stripping your lipids, your microbiome is damaged and that'll be part of your skin's issue. You've got to keep your lipids on your skin, not just for moisture, but for the microbiome. And so that's another important reason. No, that's actually really such a great point that you bring up because in research for something like cancer, we often study like cancers, but more importantly than just the cancer cells, we'll study their micro environment. And I think this is like an example of how important it is for like, it's not just that your cells are there, but it's important what the environment they're existing in is so that's the same principle that i'm relating to when you speak of the microbiome is i think this is what no one's really discussing is that yeah it's one thing to have a certain species of bacterium in whatever synergy they're existing in but it's a whole different conversation to then talk about what is actually supposed to be on the skin to feed them to help them grow to help with the cell signaling between them you know like those kind of things are really what the microbiome and a healthy microbiome boils down to much more than the bacterial species you know so it's like that's a very very i think very in-depth conversation that needs to be had in the scientific community is this idea that the microbiome yeah it's great and it's impacted by many things including what you eat and what you run into in the environment but it's more importantly the things we've talked about here which is over exfoliation making sure that you're not stripping everything away so that those bacteria, what are they going to eat?

15:35What are they going to feed off of? You know, what are they going to interact with? So, yeah. You know, one of my biggest talking points these days has been about epigenetics and the shifting of our existing bacteria based on the environment, because in the gut, it's a huge issue right now. And I think people have been sensitized since COVID. There's something changed in our bacteria's response to everyday supplements. But yeah, when it comes to the skin, the same thing, those bacteria are going to shift into survival mode and you're not going to get the best performance from them when they do that.

16:09And so you really want to keep that barrier intact as much as possible. Absolutely. And I would actually love to dive into that whole idea of inner balance is also very, very important when we're talking about skin issues. I'd love for you to talk about this gut health and everything that we need to understand from this holistic perspective about what it takes to truly have healthy skin from the inside out. Oh boy. So I get so excited these days because one of the biggest things, and I don't think I was speaking this way last time we talked, I was trying to make a probiotic under the same premise that we all have good bacteria and more good bacteria has to be better.

16:45But then I started to really see all the amazingly exotic strains that are present. And they're primarily only available to labs. You know, they're not available to the consumer right now. But if the consumer only knew the thousands of strains that we all have different variations of, and they're so exotic. And so then I started, I put my, you know, I put my hat on. I was like, huh, well, then how are we getting exposed to these strains in our zero to two age, which is when everyone is told that their microbiome is formed. If, you know, these strains aren't in the Gerber baby food, they're not in the milk powder.

17:19Yes, they're in some of the breast milk if you're breastfeeding your child, but you have a different microbiome than them. So it doesn't even appear that you're getting them from the breast milk. So what must be happening here? And I came to the conclusion that I'm absolutely convinced of, which is our DNA is 100 % responsible for each of our own microbiome. And it builds all of these trillions of cells in order to manage our gut based on our other DNA preferences. So there's all these different things because, you know, there's that book, Eat Right for Your Blood Type, which I saw a lot of people resonate with.

17:53It's not to me 100 % true, but what it means is your blood type is also genetic. And so the same thing, your microbiome and your blood type are being created by the same code, the same source code, right? And so in understanding that idea that it doesn't really matter as much, well, it doesn't matter what you eat. It matters a great deal what you eat. If you eat horrible food, then your microbiome forms poorly. But the point being that food in general will feed the microbiome. And then I started to explore, well, what about prebiotics then? So how does that work in the concept of how we restore our gut health?

18:31And I realized that in prebiotics like inulin, they have a bias towards the lactobacillus family. And that actually is shown to increase weight gain. And so people who are taking inulin are more likely to gain weight over time. And it's a distortion of your DNA decided microbiome. So I learned that sea buckthorn and actually oils like olive oil, things like that are actually the best prebiotic that you can take. It's not kimchi. It's not sauerkraut. It's not fermented this or that. In fact, all of those things distort the microbiome from what I'm learning. And we made a prebiotic supplement called Recovery.

19:09And it really has helped so many people restore digestive health. The problem is right now, as I mentioned, since COVID, there seems to have been an epigenetic shift. So your listeners know like epigenetic shift is just when your cells modify, in particular, these good bacteria that we have, they will modify certain aspects of their behavior, certain proteins that they make, all based on the situation that they're in. They all want to survive and they sometimes won't survive in different ways. So I'm going to throw something at you. I don't know if you agree with or not, Ecta. It's a theory that I believe is that Dr.

19:47Beauchamp and Louis Pasteur were fighting over back in the early 1900s. And that is that most infections are actually a shift of your good bacteria into a bad form of itself. And that as a result of what we're seeing right now is some crazy stuff. So what I'm finding is people have very little tolerance for magnesium, creating mucus excess in their gut. It's a wounding event. Citric acid, which is in so many foods, it's in most sour drinks, is creating a wounding event that's creating excess mucus. And I'll tell people what that causes in a second. But then you have oral B12 and probiotics. As I just said, you can't do probiotics because probiotics are trying to dictate to your microbiome, a new population and your microbiome doesn't like it.

20:35And so what's happening in the stomach, and this is, you know, I guess controversial because I've not heard anyone else say it is H. pylori is for those people don't know H. pylori is the bacteria that was, I don't know, discovered a decade or two ago to be associated with ulcers in the stomach, but it's also become an epidemic in every day. And I know that when I hear other physicians talk about it, they're like, oh, it's an infection and you get it from your partner, you get it from family members. I have not found that at all. What I have found is it's an epigenetic shift of your normal stomach bacteria, and we call it H.

21:11pylori, And it's coming from B12 probiotics and what's in multivitamins more often than you can believe. And how it presents on the skin is super fascinating. And one of my favorite things to talk about, because now when you watch TikTok, you just watch and see how many people have this condition. It's redness around the nostrils, not redness on the nostrils, because I've skin. I do skin mapping and I've associated redness on the nostrils with acid reflux. but redness around the nostrils is, and by the way, H. pylori will cause that, but redness around the nostrils and capillaries around the nostrils and bumps around the nostrils.

21:48So it can extend out a bit like an inch or two and down. And it oftentimes will lead to perioral dermatitis because what ends up happening when you have H. pylori and most people know it, they're like, I have stomach problems. Like when I eat certain foods, I really don't feel good. Or they are starting to develop perioral dermatitis, which I believe is caused by excess candida in the gut, and or they develop other digestive issues, bloating and things like that. And it's all because their supplement they were taking affected their stomach bacteria in this way. And it's an epigenetic shift. And just to finish that thought, the one other place I see this is SIBO.

22:26So a lot of people say, oh, bacterial overgrowth, how did it happen? I don't see it as that. I see it as when people take antacids or acid blockers or otherwise heavily dilute, or they drink alkalinized water, or they heavily dilute their meals with water or other beverages, the food that's coming out of the stomach hits the small intestine and is not good. It's toxic food. It's poorly digested food. And that changes the bacteria and causes SIBO. So I've found like these two things, SIBO and H. pylori are the two big things coming out of this problem. And the problem is they're going to the doctor and the doctor's giving them antibiotics for it.

23:06And they don't realize that it's their supplement they're taking that's going to keep them having it. They're not going to get better. And antibiotics can kill the H. pylori strain, but it takes six weeks. It's really aggressive therapy. And yet you get it right back and they get so frustrated. And so once people realize that it's our environment, once again, influencing things, it's a real eye-opener for them no that's huge i love everything you said i didn't want to interrupt you at all because it's very very actually cutting edge you know your your insights here because h pylori for many many years people have just said oh yeah this is the bacteria that causes ulcers you know but then yeah they don't understand that no once it can actually survive that dna methylation that takes place is what allows it to then change its microenvironment so you're right Like that epigenetic shift that actually is allowed to occur because we've now taken too many PPIs or histamine blockers or whatever, right?

24:01That's actually allowing it to go through this epigenetic modification, which then will in turn modify its microenvironment. And then that microenvironment will allow for the development of downstream cancer, which is often what happens with H. pylori infections. You end up leading to like, you know, an actual cancer. so that's like a very like great example i think of how everything happens in the body and i agree with you where you know the microbiome and studying the microbiome we do need to put an emphasis on this idea that epigenetic modifications don't just happen in the human genome they're also happening in the microbiome's genome you know what i mean that's why you know when they say things like everybody's microbiome is like a fingerprint it's different it's more true than ever because how those bacteria process every nutrient that we take in, everything that we want to absorb, whether it gets absorbed or not, this is what plays a role in all of that.

24:58So it's more important now than ever for a lot of people. I mean, I would say medicine to start focusing on this, but even brands that are making stuff like probiotics, right? They're making all of these products. It's important to understand what is the actual need of this population of bacteria that we call our microbiome? Like what's the actual need? Because we've now come into a society where we've destroyed a lot of our natural defenses. That's why everyone has an autoimmune disorder. You know what I mean? That's why everyone's breaking out with like allergic reactions to everything because over time we've created an environment for ourselves where - I mean, you know, the US uses twice the amount of pesticides of any other country in the world and pesticides not only being carcinogenic are horrible for the microbiome.

25:45And so kids who grow up in farming communities or eat a lot of foods that have pesticides, they're the ones with leaky gut. They're the ones who have food intolerances. And it all stems back to this epigenetic shift that triggered something else you said. Oh, I was thinking of one of the things I hear a lot these days, you know, it's kind of a fad is the carnivore diet. Yeah. One of the things I hear from people that start on it is like, oh, well, I have like diarrhea for two weeks. Well, what you're doing there is your microbiome is trying to figure out how is it going to feed off of only meat.

26:18Yeah. And so and then it does. And then you don't have that diarrhea after that. But that's not necessarily a good thing. Now you've again, once again, shifted your microbiome into warrior mode and your system won't do as well in that. In my opinion, I know some people swear by that, but I don't see that as being a good long term healthy option, maybe a short term weight loss option, if anything. but yeah yeah yeah no that's a really great point and you know this actually brings up something for me because right now there's a lot of brands out there they're talking about longevity science and longevity science when they talk about that they always bring up epigenetics and i have a kind of a problem with that because epigenetics can be positive or negative you know i mean it doesn't always mean it's it's not always a positive term in every way right that's what consumers don't seem to like understand yet is that when someone says to you this is causing epigenetic modifications, that could mean a bad thing, like a very bad thing.