285. Your Skin Tells the Truth in Ways You Never Expected - Dr. Vali, Dr. Barbara Sturm, & Danica Patrick

0:11Gary Brecka:Hey guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist Gary Brecka. Let me ask you something. If your skin is breaking out, aging faster than it should, losing elasticity overnight, or just not glowing the way it used to, what's the first thing you reach for? A new cleanser, a new serum, maybe a laser appointment? What if I told you that the skin is not the problem? What if the skin is just the messenger? Every dermatologist I've ever respected has told me the same thing. True skin health starts from the inside out. It starts with your hormones, your gut, your stress load, and the toxic inputs you might not even be aware of.

0:47Gary Brecka:The serum on your bathroom counter is the last 5 % of the equation. The first 95 % is what's going on internally. Today, I have three people who proved that. Dr. Shawana Volley is a double board certified cosmetic dermatologist who will not touch your skin unless she's asked you about your sleep, your hormones, and your gut. She's seen adrenal fatigue show up as wrinkles. She's even reversed skin aging by fixing the inside first. Dr. Barbara Sturm built one of the world's most respected skincare brands on a foundation of anti-inflammatory science because her background wasn't dermatology. It was orthopedics.

1:21Gary Brecka:And she's gonna tell you why some of the most popular products in the world are borrowing from your future. And Danica Patrick is going to tell you something that stopped me cold. Within hours of removing her breast implants, her face started producing oil again. Her scalp woke up. Her body started to function again. That's not a skincare story. That's a detoxification story. Skin is your largest organ. It talks. And today we learn how to listen. Let's get into it. The vast majority of your talk, and obviously as a double board certified cosmetic dermatologist, you know, skincare and you know, the skin, you know, what makes it youthful, what makes it healthy, how it grows, how it ages.

2:00Gary Brecka:And from a medical perspective, but the vast majority of what you talked about was healing the skin from the inside out, youthifying the skin from the inside out. So can we back up a little bit for the people that didn't have the benefit like I did of attending your talk, which I really found fascinating. And And it's so incredible how much of what you do, I not only do with my private clients, but I also deeply identify with. I just never really correlated it to all of these positive skincare outcomes. So I'd love to unpack, you know, what a typical consult with you is like and where you start with somebody's skincare journey.

2:44Well, we have the privilege of meeting all different types of people and different types of ethnicities, different types of personalities. So I think as practicing physicians, you need to be aware of everything and experience in everything. I specialize in cosmetic dermatology, medical wellness, regenerative medicine, longevity. So we've always looked at everything inside out. We've never been like, oh, you've got some acne or you've got some rosacea. We've always been, what's the root cause? Whole person. Whole person, where's the inflammation coming from? So we've always looked at you. You know, it's easy for us to give you thick hair, perfect skin, contour your body to suit your gender, ethnicity, your silhouette.

3:14But on the inside, we're actually coming first with mood, concentration performance sleep libido gut health fertility immune system musculoskeletal we're looking at you on the inside out rather than the outside in because the problem i've got is if you've got an inflammatory skin condition and i'm just doing some laser and resurfacing you with some exosomes and some fun stuff on the outside or topically like you mentioned yeah i'm not fixing the root cause it's going to come back you're going to be unhappy and you're not she's not a

3:41Gary Brecka:very good doctor right what are the major things in your opinion that cause skin to accelerate it i want to get specific yeah um you know conditions of skin like acne wrinkles what have you but what are some of the just the major offenders of healthy skin that we do to our bodies from the inside out i think it's just general lifestyle things right so right now we're all living multi-hyphenate lives we've got multiple roles our bodies weren't designed in that manner so you're a man you're you're supposed to be a hunter gatherer. I'm a woman. I'm supposed to be a protective provider. Yet we're both entrepreneurs.

4:16We're both burning the candle at both ends. We've got both got multiple businesses and multiple roles. Right. We're pushing our body to limit that we've never pushed it. I need the ultimate human. Right. So, so if our body hasn't caught up with what we're supposed to be doing, then physiologically, we have to look at you on the inside and optimize that. And that's why I always say, let's, when I take a consultation, the first thing I do is I Diagnosing your skin is easy for me. Diagnosing what's happening on the outside is easy. And the first three questions I always ask is, who referred you? Because for me, it's like, what kind of aesthetic are you looking for?

4:51Right? And you can tell that from their friends? Yeah. But also, what kind of journey have you had? You know, did your friend refer you to me because you're perimenopause and so she? And we fixed the inside first before we came on the outside. Wow. And then I ask, how old are you? If you're in your 20s, you've got social media pressure, you've got lifestyle pressures going on, you're trying to establish yourself. If you're in your 30s, you might have had just your babies and you want to return back your body or you might be starting a new role in the C-suite in your late 30s. If you're in your 40s and 50s, you might start your next phase of life.

5:22You might have come out of a divorce. You might have, you know, the emptiness, emptiness. Something else is happening. So I need to know what stage of life you're in. And the third thing I always say is, what do you do? What kind of psychosocial pressures are on you? Explain to me what role you have in society. What do you do? Are you a mother of four at home and you're running a small business as well. Are you a CEO of a hedge fund that you have to like stay up 18 hours a day about all the time? And then the key thing is we don't move to it. Let's look at your skin, Gary. The next thing we move to is let's talk about your mood, sleep, energy, immune system, gut health, libido.

5:54We go to the inside immediately.

5:55Gary Brecka:Love that. Before we even look on the outside. Now, are these, do you do that by, so first you obviously do the consult. You get a profile of what the person is like, what stage of life they're in. But after that, what kinds of testing, because you can't just say mood, hormones, libido. I mean, we need data, right? So where do you get that data? What kind of lab tests are you running? And what do you think are key markers to be looking at that might be markers that would indicate that you have accelerated skin aging? Yeah. So my patients are seeking me out aesthetically on the outside because they might have fine lines and wrinkles, folds in their face so they don't suddenly like loss of definition.

6:31They might find that their hair is thinning. They've got receding hairline. they might find that they've got mid abdominal weight gain which they didn't normally have so the metabolism has changed right they might find i've got you know aesthetically they've got some cellulites and stretch marks they're unhappy in certain places they're not always taut and tight as they used to be right so their body has changed aesthetically on the outside right but they haven't identified why it's changed from the inside out so in terms of markers we do subjective

6:57Gary Brecka:screening first now there's how big of a role does stress play in this because you're getting to people's lifestyle choices. And a lot of us live very stressful lives. You know, we're constantly on the go, but we're also constantly engaged and entertained. We're also always immersed in something. And that puts a lot of stress on us, right? Not just to perform, but to look the way that everyone looks on Instagram to perform at what everyone expects us, the level they expect us to perform. And, and we talk about, you know, stress being so detrimental, but what is it about stress what is the link between stress and the skin right okay so we can generically call it stress but what stress does is it causes something called oxidative stress so free radical damage it causes breakdown of collagen okay so glycation breakdown collagen turns around gives you fine lines wrinkles open pores oiliness it can inflame your acne uberization pigmentation but if we go back to cellular cause pathophysiologically on a cellular level you've got the beauty layer of the skin which is the epidermis you've got the medical layer of the skin which is the reticular dermis in reticular dermis you've got these great things called building blocks called fibroblasts they produce collagen elastin hyaluronic acid gags all the good stuff stays in the medical layer of the skin right by the age of 21 this is degradating this is already going down with by a gift from god you're already aging it's a gift that we don't ever want to open it's a gift that we don't want right so you've already got that on top of it you've got a pigment called melanin, which some of us will get pinky purpley and some of us will get brown pigmentation.

8:29So that comes up with sun trigger, hormonal trigger, environmental trigger. So all these things, when you've got oxidative stress and free radical damage going on, this gets enlightened and inflamed.

8:39Gary Brecka:Because this is in the deep layers of the skin. This is in the deep layer. So then if you've got fibroblast, the building blocks breaking down, that means you're going to get the collagen breaking down. You're going to get the good stuff, like the roadblocks, the architecture of the skin breaking down. is you're going to get the laxity. You're going to get the fold. You're going to get the fine lines and wrinkles. You're going to look dull. The skin's not going to be glowy, right? Things aren't going to be as tight and taut as they used to be. Right. But then also on the beauty layer, there's something called epidermal cellular turnover.

9:09God's given us the best organ, like the human body's best organ. We both say it openly. Right, no doubt. But the skin is one of the biggest organs. And what it does every day, it renewals and turns over. It repairs itself.

9:20Gary Brecka:Right. But when the beauty layer is a bit broken, then that doesn't happen either. So then suddenly you're exposed to environmental toxins coming in and causing more inflammation. I think the first thing you said about me was the inside. Yeah. So for me, I don't diagnose collagen degradation because it doesn't present like that. You're presenting with adrenal fatigue or you're presenting with other features, right? And then it's a byproduct of the stress that you're going through.

9:46Danica Patrick:Yeah. So I'm not focused on collagen, collagen, collagen. and I'm focused on getting the inside correct first. I love that. So if we've got adrenal fatigue, then I'm working on that. Is it NAD? Is it peptide program? Can I move the needle?

9:58Gary Brecka:Well, you find some ways that people recover from adrenal fatigue because we do see women whose cortisol is floored out. They're just not producing cortisol. I've burned out twice in my career. Have you really? Yeah, I've had significant burnout twice in my career. So how did you get your cortisol back? Yeah, so I've been completely floored. I was easily dominant with adrenal fatigue. Oh, dude, the worst. I had to go through rewiring myself. I had to do my routine NADs. I had to turn around. I went on peptide programs. I didn't just go on ACTH-139 and the adrenal fatigue ones. I went on SEMAC and SELAN as well to optimize my mood and cognitive resilience.

10:32Oh, SELANC. Yeah, yeah. So I went on those.

10:34Gary Brecka:And the anti-anxiolytic, that's peptide. Yeah. So I went on those. And then I went on a microdose on estrogen as well. Okay. But now I'm coming to perimenopause, so I'm now changing that up a little bit. So we work on the inside first before I'd work on the outside of your collagen degradation. on the outside, like I've said before, it's always virgin and non-virgin tools. What are you happy with? In my industry, everything is inflammation-based. It's me causing microtrauma, right? To up-regulate the cells, to wake them up. So it's either that, but there's a new area of medicine, which we spoke about in the Saudi conference called regenerative aesthetics.

11:05And what happens, do you remember the days when, you must do intermittent fasting. You must be a pro. You did 24-hour fasting from what I remember. Yeah, I did 24 or 72 sometimes. You're like a legend in fasting. And you notice that your skin just glows. Oh, it's unbelievable.

11:18Gary Brecka:The whites of your eyes, bing, they're bright. And your skin changes in three days, which is fascinating to me. And that's why sometimes I say to patients, you can't get access to me, but you can get access to my knowledge. You can go on intermittent fasting. You can go into autophagy. Your body can start repairing itself. It can start reducing the inflammation on the inside. Your skin will start glowing and repairing itself. You can do a detoxification, remove all these creams that you're putting in for the next seven days, and you'll notice that your skin barrier function will start waking up again.

11:48Danica Patrick:Wow. And your skin will start repairing itself. If you remove all the things that you use for your acne and stuff like that, leave it alone for a few weeks, your skin will wake up.

11:55Gary Brecka:Yeah. And you won't break out as much. Regardless of gender, and I always do this, regardless of gender, heritage, age, regardless of the 21-year-old sitting in the room, there's 16-year-old sitting in the room, then there's me, there's you, right? 30s, 40s, 50s, whatever it is. Regardless of gender and ethnicity, there's something that's going on in our skin for all of us, the same thing. There's only two things that are happening that we're synonymously feeling the same. We all have fibroblast degradation from the age of 20s, early 20s. Your collagen, elastin, your hyaluronic acid, your gags are all going down.

12:25So that gives you fine lines, wrinkles, open pores, oiliness. Then all of us, regardless of ethnicity, have some form of pigmentation. So in me, it's going to be brown. In you, it's going to be pinky, purpley, or vascular. So fair hair, fair skin, pinky, purpley, vascular. Brown hair, darker skin types, brown. So if I'm only just treating those two things, I'm going to, together with that, I'm going to give you the perfect canvas.

12:48Danica Patrick:so that's just two creams okay obviously they're my creams but they're just two creams with my patented formulation but if i was going to say to you that you're not going to bother with my skincare and you're going to go and use just two three products the only thing i would say to you is use an spf use a beta-glucan based serum beta-glucan based beta-glucan and i'd actually say to you wash your face with water yeah that's why i really do you and if you can tolerate a retin-a or retinol or something vitamin a derivative based because that's the strongest ingredient has the mass and amount of studies.

13:19There isn't anything that's been studied more in our industry.

13:22Gary Brecka:In retin? Yeah. Retin-A, retinol, retinal, whichever one you can tolerate, right? Once a week, twice a week, just to upregulate the fiberglass. And that's it. That's all I would start with. Dr. Vali just gave you the framework. Your skin is not a surface problem. It's a system problem. Adrenal fatigue, hormone imbalance, cortisol dysfunction. These are not abstract wellness terms. They are showing up in your face. And when you fix the internal environment, your skin follows. Here's the question Dr. Vali left us with. While you're fixing the inside, what are you doing to the outside? Because some of the most widely used products in the world are not helping.

13:57Gary Brecka:They're just actively making things worse. Dr. Starm did not come from a dermatology background. She came from orthopedics from 25 years of anti-inflammatory science. And when she looked at the skincare industry through that lens, she saw something that nobody wanted to talk about. Products that trigger the inflammatory cycle, destroy the microbiome, and leave your skin weaker every time you use them. Dr. Sturm created the Vampire Facial. She pioneered the use of exosomes in orthopedic medicine 15 years before it was a trend. Her brand is in every major city in the world. And she will tell you that the foundation of beautiful skin is not a product.

14:33Gary Brecka:It's the elimination of the thing that destroys it. What exactly is inflammation? And why is it so critical to understanding inflammation in skin health? So inflammation is immune response we need. So when something enters the body, virus or bacteria, we need inflammation to appear to fight those things that come into our body. So we need it. But if inflammation becomes chronical and on a high level, then inflammation can be quite dangerous for us because it degrades our tissue. It starts chronical diseases, autoimmune diseases. So inflammation goes together with all the things we don't want. It can cause cancer.

15:13and regarding our skin, everything we don't like about our skin, redness, impurities like cystic acne, wrinkles, whatever we don't like about our skin goes together with inflammation. So it's very important to bring inflammation under control.

15:31Gary Brecka:Yeah, I like to talk about inflammation as a necessary balance to survival. You know, not all inflammation is bad. If you were walking down the street one day and you stepped off a curb and you twisted your right ankle. How does the body know to heal the right ligament and leave the left ligament alone? Well, the way that it knows the tissue is injured is if that ligament received a small tear, you broke a cell in that ligament called a fibroblast. And what that cell will do is it will start signaling into the bloodstream to say, hey, I'm hurt, I'm hurt, I'm hurt. That signal is inflammation. These are interleukins and cytokines.

16:08Gary Brecka:And what happens is, is that as that signal enters the bloodstream, a very special cell in your bloodstream called a platelet is listening for that signal. And as it cruises by in the bloodstream, a platelet bursts and it drops off growth factors. So think of a platelet as a pinata and the confetti inside the platelet as growth factors. These are the healing power of the human body. How many of you heard of platelet-rich plasma, PRP injections? The vast majority of you. So all PRP injections are doing is taking the vast healing power of the human body and concentrating it in a single location.

16:42Gary Brecka:You draw your blood, you spin it down, you remove the platelets and the plasma, and you re-inject that into your knee, your hip, your shoulder, your rotator cuff, and it actually accelerates healing. You can do the same thing with things like peptides. How many of you have heard of BPC-157? This is a pretty woke audience. I hate that word, woke, but I don't mean woke, but I mean aware of health. But so BPC-157 is a peptide. And what this peptide does is it amplifies the signal of inflammation. So that torn ankle that I was talking about, maybe it was sending an inflammatory signal into the bloodstream at a level two.

17:22Gary Brecka:So it was whispering into the blood that it was injured. If you could make it scream into the blood, then as the platelets are cruising by, more platelets will migrate to that region and they will drop off growth factors and accelerate the wound healing process. One of the reasons why I'm so fascinated by peptides is they capture the body's innate ability to perform its own function. You can rewind your pituitary to a more youthful level of growth hormone secretion. You can lengthen your telomeres with telomerase lengthening peptides like an epitalon. You can actually reduce inflammation by putting peptides like BPC-157 into the bloodstream, TB500 into the bloodstream, and actually accelerating wound healing.

18:04Gary, this is amazing for any acute injury. So I want to bring it back to the skin because we're doing on purpose a lot of injuries to our skin. For example, who's using retinol? So with retinol, we cause a lot of inflammation on a daily or three times a week basis. So what's happening with the inflammatory response here? Because you basically start this inflammatory response on a constant basis. What happens to our healing factors? What happens to all the emergency help? Do they exhaust? But what's happening if you use retinol on a constant basis?

18:46Gary Brecka:If you use retinol on a constant basis, you're borrowing from your future. You're using an inflammatory response to call blood flow and to call tissue regeneration to that site, but you're dismantling the long-term capacity for the skin to repair itself. So if you do it in an acute phase and you use all these peptides and everything your body has to offer, then it's amazing to use that inflammatory response. But if you do it on a regular basis, you kind of run out of your healing factors. You kind of exhaust your system. You always call inflammation back to the site. and that is a little bit of a dangerous situation besides that you constantly destruct your skin barrier constantly disbalance your microbiome yes we have a microbiome on our skin so the organ skin is getting harmed every day by skin care ingredients and this is what we have to think about look we are all sitting here and we are listening to Gary and we love him but we want to know they are here to see you but we want to know So what actually can we learn to stay healthy, to stay young, to stay in good shape?

19:53And when we want to hear that, we talk about our organs like heart, liver, kidneys, whatever. Who thinks about the skin? The skin, oh, well, whatever. It's a playground for marketing. You know, whatever marketing gives us, you know, we just put it on our skin and let's crop it off. Let's make it red. And like, oh, have you heard of this machine? machine and you know whatever you know makes your skin wet and inflamed it's what we shouldn't be