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Chinn GYN, LLC

Personal Care for Your Personal Parts

best gynecologist
best gynecologist

Chinn Chats

The down & dirty on women's wellness


Mascne: A Window to Your Microbiome?

December 1, 2020

We know. You think it’s just vanity that has you worried about your skin. We know. American medicine has frequently portrayed skin as a cosmetic accessory only. We know. There’s a filter for that.  But mascne is more than a cosmetic concern.  It's more than a reason to opt for a filter or touch up your Zoom appearance.  Your skin's condition is a reflection of many of your body's functions. We don’t mean to beat a dead horse, but we are very invested in the care you take of your skin, which includes the products you apply to your skin. You see, your skin is not just a lovely suit that covers your guts & bones. Rather, your skin is a functional, dynamic organ that actively communicates to all of your other organs, is a conduit for moisture & hydration, & is a permeable filter that is designed to protect your insides from active exposure to viral, bacterial & fungal pathogens. Your skin is so good at keeping the critters out that it actively absorbs them, creating a barrier for your innards but also offering itself as a host for such organisms, particularly if the environmental condition is ripe for growth, as is the case behind the hot, moist mask you’re now wearing most of the time.

While we may think of our skin as simply the stuff we can readily see, where we might apply lotion or inspect for new moles, our skin actually covers the entire surfaces of our bodies, making it the largest organ of all. Your scalp is made of skin, as is the inside of your vagina and, actually, the inside of your bowel. While the skin inside our mouths, nostrils, eyelids, rectums, & vaginas is composed of a different sort of cellular matrix, these mucous membranes are actually a form of skin—albeit a more readily permeated filter lacking the keratinization of our external skin—it is a faction of the very same integumentary system that coats our heads & our feet & it serves very similar purposes—regulating transport into & out of the inner body. The tissue inside our guts & the tissue we wear outside our bodies is densely vascularized and richly innervated (which is why cuts & canker sores hurt—the disruption in our tissue integrity exposes thousands of extremely sensitive nerve endings), & it plays crucial roles in regulating the function of our immune, nervous & endocrine systems. Our skin is the primary interface with the external world, including that within our gut, which is exposed to all the elements of the exterior (pathogens included) that we decide to swallow, and, as such, our skin is essential in maintaining our bodies’ homeostasis.

Because the tissue lining our intestinal tracts is an extension of the tissue coating our bones, the gut & the exterior skin are inextricably related, so much so that GI disorders are often accompanied by (or only apparent from) changes in the skin—possibly in locations not at all near the GI tract. The bacteria, fungi & viruses that enter our mouths & hang out by traveling the length of the skin that lines our throats, stomachs & intestines, affect our digestion (& our hormonal production & our neurotransmitter production & our immune function) but they also affect our skin, such that things like eczema, psoriasis, & acne (yes, including your mascne) can frequently be traced to activity in our guts. Your mascne, for instance, is coming from—gross as it sounds—all the bugs that are escaping from your mouth, ricocheting off the barrier of your mask & landing back on your face, where the cozy, damp warmth of your breath creates an ideal environment for them to flourish, resulting in their growth on your skin & in your pores, which produces the lovely inflamed pustules we have been bemoaning since the onset of mandatory masking—as much as the masks might be keeping things out, they are also keeping things in & held right up against your skin.

Enter the winter: we are indoors more while wearing our masks, in heated, dry air that sucks the moisture from our skin, creating an environment that is inducing little microclimates on our external skin. Outside the mask, we are in a desert, while behind the mask we are in the heady humidity of a swamp. When we leave our warm, dry indoor environments, we often remove our masks to finally, freely breathe, allowing our humidity-drenched island of peri-oral skin to suddenly greet the brisk, dry wind of the alps.

With all this unexpected travel, it’s no wonder our skin is in a state this winter—sudden environmental changes make it difficult to maintain homeostasis, to regulate temperature, to calibrate the need for moisture release or retention, & our skin is decidedly confused by our erratic behavior. This is not the environment it’s used to---& it cannot acclimate to any one environment, because none of those environments abides. Our skin doesn’t know which way is up or which planet it’s on. And, this is more than a matter of cosmetic woe: it has implications for our systemic health.

Our skin does a great job, generally, of keeping organisms out of our bodies. However, the more permeable areas of our skin are those attached to orifices that are direct routes into our bodies. Therefore, pathogen invasion at any of the sites of mucous membranes mentioned above can more easily penetrate the more permeable barriers of these layers of skin & invade our inner cavities & our bodily fluids. Additionally, disruptions in our skin barrier caused by inflammation, picking, scrapes, cuts, or other injuries can allow transmission of pathogens our skin would ordinarily keep outside of our bodies. For this reason, a tiny cut on your foot can result in a horrid infection in your brain, as in a case study of a college lacrosse player who was hospitalized with herpetic encephalitis he contracted from a communal shower. Diagnosis was delayed, &, although his outcome was positive, paying particular attention to his skin could have prevented significant pain & suffering.

It is essential, then, that we pay particular attention to the integrity of our skin in our current atmosphere of scaling, flaking, redness, irritation, pimple-popping, picking, & product application. Any of these things can be the precursor to a disruption in our skin that can result in systemic harm. Not only that, but the application of topical products to our skin does not stay on the specific expanse of skin to which we might apply said products. Nor does anything we inject into our skin simply reside quiescently where it has been placed. Topical agents are frequently utilized via application to the skin in order to result in a desired effect on an unrelated bodily system. For instance, contraceptive patches control our ovarian function & nitroglycerin cream stops vasospasm in our hearts. Lest you mistakenly think that the things we do with our skin are benign, please also consider that, in numbing your skin for painful procedures (e.g., excisions, laser treatments, tattoos, IV placement, etc.), it is essential that the provider is mindful of your degree of exposure to the anesthetic agent, as too much absorption can have deleterious effects on your heart & your brain.

This is the reason we are committed to providing a no-tox approach to your skincare concerns. We are mindful of the chemicals contained in all topical products, as they do not just vanish when you wash them from the surface of your skin. In fact, compounds used in personal care & beauty products have been found to linger in the skin (& the bloodstream) for weeks after the original application & can accumulate to result in damage to non-integumentary systems in your body. We love the Environmental Working Group for their commitment to screening personal care & beauty products for chemicals known to be harmful. (You can download their fantastic app or consult their Skin Deep database to review the ingredients in products you regularly use.) As women, we tend to be more concerned with the appearance of our skin & are the largest demographic of consumers of topically applied personal care products. We may not be checking the ingredients list on these products, &, even if we are, we may have no idea what some of the listed compounds actually are or the effects they may have. As women, our skin is more susceptible to the potential effects of anything topically applied (please reference our Chinn Chat from September 2019).

We are frequently asked why we do not provide Botox & fillers in our clinical setting. The reason is very simple: we have a complicated relationship with pharmaceutical companies & feel strongly compelled to protect women. While we would like to believe that these large, extremely wealthy companies have our patients’ best interests at heart, we are inclined to believe that their profit margin creates a conflict of interest that prevents them from prioritizing health above all else. Skin care products & beauty enhancers that are injected into or applied topically to the skin do not just affect the skin, but the study of their effects has been largely limited to the responses of the skin.

Our commitment to you is to help you preserve your appearance while protecting the health of your skin as a vital organ that is constantly & actively communicating with the innerworkings of your body to preserve your health & to regulate your temperature, manage your fluid balance, your immune responses, your digestive processes, your brain’s signaling, & your hormonal release, among other things. We are here to protect what protects you from the top of your head to the tips of your toes. If you are struggling with winter skin woes, before you apply Vaseline to your chapped lips or Retin-A to your blossoming mascne, let us know what’s bothering you. We will work with you to help you find the best solution to your integumentary concern, whether it’s affecting the skin of your scalp (or the hair growing out of it) or that lining your insides, without jeopardizing any of the biological functions of your beautiful, absolutely essential skin.