Dermatologist Dr. Muneeb Shah returns to answer more of the internet's burning questions about skin and dermatology. Can the skin develop a dependency on chapstick? What causes dry skin? What lives on the skin's microbiome? If we shed skin cells everyday, why don't tattoos fade away?Director: Justin WolfsonDirector of Photography: Charlie JordanEditor: Richard TrammellExpert: Dr. Muneeb ShahLine Producer: Joseph BuscemiAssociate Producer: Brandon WhiteProduction Manager: D. Eric MartinezProduction Coordinator: Fernando DavilaTalent Booker: Mica Medoff, Paige GarbariniCamera Operator: Christopher EustacheGaffer: Rebecca Van Der MeulenSound Mixer: Lily Van LeeuwenProduction Assistant: Caleb ClarkPost Production Supervisor: Alexa Deutsch; Christian OlguinPost Production Coordinator: Ian Bryant; Scout AlterSupervising Editor: Doug LarsenAdditional Editor: Paul TaelAssistant Editor: Fynn Lithgow
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00:00 I'm Dr. Maneeb Shah, a board certified dermatologist, and I'm here today to answer more questions from the internet.
00:05 This is Skin Support.
00:07 @mia_pinchoff asks, "How many layers of skin do we have ballpark?"
00:16 It depends on how you look at the layers of the skin.
00:19 So there's really three major layers of the skin.
00:21 There's the epidermis, which is everything from this purple upwards,
00:24 the dermis, which is where your collagen is,
00:27 and then there's the hypodermis, which is your fat and the muscle and everything that's below that.
00:31 You'll hear a lot of times five layers of the skin,
00:33 but they're not talking about the entire skin in general.
00:35 They're talking specifically about that epidermis layer,
00:38 which has four when you're looking at the face,
00:40 and it has five layers when you're looking at the palms and soles.
00:43 @ryanmstryker asks, "Is it possible that your lips can become addicted to ChapStick?"
00:49 So a lot of times people like those fragranced and flavored lip balms,
00:53 but it turns out that those a lot of times are irritating the skin,
00:56 which makes you want to actually apply them more often.
00:59 Not just that, but if you're somebody who's using flavored lip balms,
01:03 it's going to make you lick your lips more often.
01:05 And that licking of your lips has enzymes in it that actually breaks down the skin around it,
01:11 making you want to apply it more.
01:12 So my recommendation, avoid fragrances in your lip balms,
01:16 avoid mint in your lip balms,
01:17 avoid any flavors in your lip balms,
01:19 and use something that's gentle and fragrance-free,
01:22 and you'll probably see a huge benefit and you won't have to apply it as often.
01:25 @celos72 asks, "What causes dry skin?"
01:30 So there's a few things that cause dry skin.
01:32 One, it's your genetics.
01:33 Two, it's your environment.
01:35 And three, it's things that you potentially are doing wrong.
01:38 So from a genetic perspective, a lot of people with eczema or atopic dermatitis,
01:42 they have dry skin because they have abnormal lipid content
01:45 in that epidermal layer of the skin.
01:47 Low lipids like ceramides or abnormal lipids can cause you to naturally have drier skin.
01:51 The second thing is the environment.
01:53 So if you're in a condition that gets very cold, you have low humidity,
01:56 we know that when the humidity drops in a room,
01:59 within one day, your skin actually becomes dehydrated
02:02 from losing water to the environment.
02:04 And then the third thing is things that you potentially are doing wrong.
02:07 So using very harsh cleansers, over scrubbing the skin, or using hot showers.
02:13 Now think about it like this.
02:14 When you're washing your dishes with cold water,
02:16 you notice it doesn't remove the oils that well.
02:18 But when you wash your dishes with hot water or warm water,
02:21 it removes oils much more effectively.
02:23 And the same thing happens in your skin.
02:25 When you take a hot shower, it strips away all those natural oils,
02:28 which can make your skin more dry.
02:30 @cosmodamage asks, "Why is vitamin D so important for the skin?"
02:35 So it's not actually that vitamin D is important for the skin.
02:38 It's that the skin is important for your vitamin D levels.
02:42 About 90% of the vitamin D in your body comes from the skin.
02:46 So sunlight actually converts cholesterol into vitamin D,
02:50 producing most of the vitamin D in your body.
02:52 Only about 10% comes from your diet.
02:54 Vitamin D is super important to bone health in general.
02:57 So there's something called rickets.
02:59 When you have low vitamin D levels, your bones actually become very, very soft,
03:02 and they bend and they break very, very easily.
03:05 @jmict asked, "How does one get rid of an ingrown hair?"
03:08 So what you see here is actually a hair follicle.
03:11 And outside of that hair follicle, you're growing that hair.
03:13 Now that's normal hair growth.
03:15 But with an ingrown hair, that hair can actually grow out
03:18 and turn back into the skin, or sometimes it gets trapped
03:21 and it never makes it out of the skin.
03:23 While it's embedded in the skin, that can actually cause
03:25 quite a bit of inflammation and irritation.
03:27 And so what you'll actually notice is a red and painful bump.
03:30 Now your body can sometimes push out that ingrown hair.
03:33 But what ends up happening a lot of times is that you actually need to get it
03:36 physically extracted by a dermatologist or an esthetician
03:39 that can find the root of that hair and pull it out.
03:41 Now you could do this at home if you clean the area and you use tweezers.
03:44 But definitely be careful because you can develop a worsening infection.
03:47 Now, if you want to prevent these ingrown hairs from happening,
03:50 avoiding much shorter hair, so if you don't shave your hair very short,
03:54 that can prevent ingrown hairs.
03:56 And if you use a glycolic acid exfoliant, that can also prevent ingrown hairs.
03:59 And I've noticed in my own personal experience,
04:02 using an electric trimmer prevents ingrown hairs for me
04:04 compared to using a traditional razor.
04:06 Fun Characteristically asks, "What is sweat composed of?
04:10 What makes it smell?
04:11 How might sweat on one part of the body differ from another?"
04:14 There's two major forms of sweat glands.
04:16 So one is your eccrine sweat gland.
04:18 So when you get sweaty palms and soles, that's majority eccrine sweat.
04:22 It's pretty much just water and salt.
04:25 And that sweat is actually usually pretty odorless.
04:28 Now, when we think about body odor, the type of sweat gland that's producing body odor
04:32 is something called the apocrine gland.
04:34 And those apocrine glands are pretty much not active until puberty.
04:38 And those are the ones that you find in the armpits, the groin,
04:40 underneath the breast.
04:41 And that's the one that produces that odorous smell.
04:44 But a lot of people don't realize that when you sweat apocrine sweat,
04:47 it's actually odorless when you secrete it onto the body.
04:50 It's mostly composed of lipids.
04:52 And then you actually have bacteria on the skin that convert that solution
04:55 into something that smells bad, ammonia and short chain fatty acids.
04:59 And so if you eliminate the bacteria that's converting that sweat,
05:02 you can actually eliminate body odor.
05:04 So things like benzoyl peroxide and chlorhexidine washes
05:07 are really good at eliminating body odor.
05:09 @roha_aesthetics asks, "What is the skin's microbiome?"
05:13 I don't want to freak anyone out right now.
05:15 But if I was to scrape your skin right now and look at it under the microscope,
05:19 you would have essentially a jungle of organisms living on your skin.
05:23 Every single one of you, I don't care how much you wash your face,
05:25 you would have bacteria, you would have fungus,
05:28 and you would have little mites crawling around on your skin right now.
05:31 And that little jungle is actually called the microbiome.
05:34 And they usually live in harmony and cause no problems to the skin.
05:38 In fact, when there's a good healthy mix of things growing on your skin,
05:41 it's actually good for you.
05:42 And it's when one type of organism starts to sort of lead the jungle
05:46 is when you start to develop things like acne.
05:48 @fs_chick asks, "How TF is the skin an organ?"
05:53 So an organ is supposed to be a collection of tissue that all serve the same purpose.
05:57 The skin is considered an organ because its function is to protect you from the environment
06:02 and also to keep things in the skin.
06:04 So if you don't have your skin,
06:05 which we actually see in people that have severe burns all over the body,
06:08 you dehydrate very quickly because all the water in your body evaporates
06:11 and you get infections very quickly because your skin's not protecting you from the environment.
06:15 @famedelaflore asks, "Does retinol cream really work?"
06:20 I personally use retinol, so I certainly hope that it works.
06:23 If you're a skincare enthusiast, or even if you're on social media,
06:26 you probably hear about all kinds of crazy trending ingredients all the time.
06:29 And most of them don't stand the test of time.
06:31 But retinol, on the other hand, which is a vitamin A derivative that we find in skincare,
06:35 has been around now for 50 years, and the data is only getting better.
06:40 And so tretinoin, which is the active form of retinol,
06:43 it's found in prescription products, is incredibly effective.
06:46 And then retinol is converted to tretinoin in the skin
06:49 and is a very effective over-the-counter version of this vitamin A derivative.
06:52 @realnutritious asks, "Do you know what really causes wrinkles?"
06:56 With time, there's two things that happen.
06:58 So first, you want to look at yourself as a grape when you're a child.
07:02 You're filled with juicy fluids and you don't have any wrinkles.
07:06 And then you lose that volume with time and you become more like a raisin.
07:10 And what is that volume that you're losing?
07:12 Collagen, fat, bone.
07:14 Your skin starts to move in the direction of gravity, and then you form wrinkles.
07:18 One of the most important contributors to aging is sun exposure and also diet.
07:22 Diets high in sugar cause glycation, which actually damages your collagen.
07:26 And when you lose that collagen, your wrinkles start to become more prominent.
07:29 And so to avoid wrinkles, you want to protect yourself from the sun.
07:32 You want to use healthy diets that are low in inflammation.
07:35 And you also want to do things that replenish the collagen, like use things like retinol.
07:39 @trentonferg asks, "If we shed skin cells every single day, how is it that people have tattoos?"
07:46 This is such a good question.
07:48 So when we look at our skin shedding every day,
07:50 we're actually talking about that epidermis layer of the skin that kind of sloughs off every day.
07:54 So that's that very top layer of the skin.
07:56 But below that, where all your collagen is hanging out, that's your dermis.
08:00 And that's actually where they deposit tattoos.
08:02 And that's why you don't shed off your tattoos.
08:04 And interestingly, the particles of tattoo are too large to actually move and have your body
08:09 remove them from the dermis.
08:11 And so they actually just hang out there in the dermis.
08:13 @cbgbeautybar asks, "What does an LED light therapy mask do?"
08:18 This is a LED mask.
08:19 And what you're noticing back here is some red light.
08:22 To be honest, I honestly thought this was a gimmick myself.
08:24 I did a lot of research on LED masks in general.
08:27 And it turns out they've done quite a bit of study on light in general.
08:30 So LED basically produces light in different wavelengths.
08:33 When you look at what blue light does to the skin, it actually has anti-inflammatory
08:38 and antibacterial properties of the skin.
08:40 So if you have acne, it can actually target the porphyrins within your acne-causing bacteria
08:46 to eliminate that.
08:47 And then when you look at red light, the wavelength of red light between 600 and 700
08:51 nanometers can actually target the fibroblasts in that dermis layer of the skin to induce
08:56 collagen production.
08:57 We call that photobiomodulation.
08:59 And so red light actually has profound anti-aging benefits and actually can help quite a bit
09:04 with wrinkles.
09:05 Butterscotchgood3724 asks, "Do you think medical-grade skincare is better than over-the-counter
09:12 type items?"
09:13 I am here to debunk this and probably save a lot of use of money right now.
09:17 So medical-grade skincare is purely a marketing term.
09:22 There is no standard definition of what medical-grade skincare is.
09:25 If a esthetician, med spa, dermatology office, or plastic surgery office is selling you skincare,
09:31 a lot of times they will tell you that it's medical-grade skincare.
09:34 It just means they're selling it from their office.
09:36 I could take a tube of toothpaste and call it medical-grade skincare, and no one is going
09:40 to stop me.
09:40 You would hate me, but no one is going to stop me.
09:42 @jessrmorris asks, "My freckles are going wild because of the sun."
09:46 I love freckles so much.
09:48 Please, why can't they be on me all year round?
09:51 So what are freckles in the first place?
09:53 Freckles are little blotches of melanin, which is basically the pigment of the skin.
09:59 And so your melanocytes, which are the pigment-producing cells of the skin, get hyperactivated, and
10:04 they produce little blotches.
10:06 Now, I love freckles.
10:07 I think that they're beautiful, but they get worse or more prominent with sun exposure,
10:11 and they fade in the winter when you get less sun exposure.
10:13 So they're basically like mini-tans, which is a marker of sun damage.
10:18 And we do know that people that are prone to freckles are more likely to develop skin
10:22 cancer.
10:22 So if you're somebody who developed freckles, please be careful.
10:25 Wear sunscreen.
10:26 Your freckles will still be there.
10:28 They just won't be as prominent, but it will also decrease your risk of getting skin cancer.
10:32 @sophiakareem asks, "How fast does hair grow?"
10:36 The average is essentially half an inch a month.
10:39 It really depends on who you are, but it depends also on what part of the body.
10:43 They all have different life cycles.
10:45 So the life cycle of the hair is much longer on the scalp than it is on the eyebrows, and
10:49 that's why your hair can be different on different parts of the body.
10:51 But in general, to answer your question, about half an inch a month.
10:54 @ar220323, "So why are stretch marks permanent?"
11:02 People have actually biopsied stretch marks.
11:03 What you find is a very thin epidermis, and you actually find a scar-like pattern in the
11:08 dermis where the collagen bundles and the elastic fibers are different than a normal
11:12 skin.
11:12 And so those different collagen fibers are actually causing that stretch mark to hang
11:16 out for much longer after the stretching and growing has occurred.
11:19 @vegasvandai asks, "Why do we turn red when we get embarrassed?
11:25 How does this help us survive?"
11:26 Well, we don't really know why this could be beneficial for you.
11:29 What we do know is that what ends up happening, what's actually causing that redness is vasodilation
11:34 of your blood vessels.
11:35 So they become dilated and that increased blood flow appears as redness when you're
11:40 embarrassed.
11:41 @wanda_laploont, "What exactly is psoriasis?"
11:46 Psoriasis is an inflammatory condition in the body.
11:50 So what it looks like to you is plaques on the skin.
11:53 So you have redness.
11:54 On top of that redness is a micaceous silvery scale.
11:58 It's not contagious at all, but what's actually happening underneath those plaques is inflammation.
12:03 It's really important to control that inflammation because not only is it affecting the skin,
12:07 but it's affecting other organs in the body like the heart.
12:10 @exo_sophia asks, "Products aside, how many steps is your skincare routine?"
12:16 My current skincare routine is eight steps, but I feel like it needs to be 10.
12:20 I feel like it needs to be less, quite honestly.
12:22 Me personally, I have a three-step skincare routine maximum.
12:26 Cleanse, treat, and protect.
12:29 Cleanse is just a simple cleanser.
12:31 Treatment is something that's targeted towards you.
12:32 So if you have acne, you're going to use a treatment that's targeted towards acne.
12:35 If you have dark spots, the treatment is going to be targeted towards dark spots.
12:38 And then protect at night, that means moisturize.
12:41 In the morning, that means wear sunscreen.
12:43 @mahey asks, "Does anyone have an SPF recommendation for people of color?
12:50 I'm sick of these brutal white casts."
12:52 So first, what is a white cast?
12:54 It's that pasty white appearance that you see when people are wearing sunscreen.
12:58 Some of you might remember that famous Mark Zuckerberg surfing picture where he has that
13:02 amazing white cast over the face.
13:04 As a dermatologist, I loved it, but it's not necessarily the thing that most people want
13:07 to have when they're walking around outside.
13:09 So when you're looking at sunscreens, you have your chemical and you have your mineral
13:13 sunscreens.
13:13 Your chemical sunscreens are pretty much invisible a lot of the times nowadays.
13:18 You can have a chemical sunscreen that is completely see-through.
13:21 And then you have your mineral sunscreens that are zinc and titanium dioxide.
13:25 And no matter how good the sunscreen is, they're still going to have a little bit of white
13:28 cast when you're looking at those mineral sunscreens.
13:30 So if you're somebody who wants to completely avoid a white cast, opt for something that's
13:34 more of a chemical sunscreen.
13:35 Now, a lot of people are concerned about chemicals.
13:37 I'm personally not worried about chemical sunscreens.
13:39 The only ingredient I tell my patients to avoid is oxybenzone.
13:42 Otherwise, the rest have been shown to be safe and effective.
13:45 @ApolloHerbs asks, "What's the difference between a serum, a cream, and a lotion?"
13:51 So there's no strict definition in what any of these things mean.
13:54 It really has to do with the heaviness of the product overall.
13:58 A serum is going to be the lightest weight version of their product.
14:00 It's almost going to be like a liquid.
14:02 A gel is going to be a little bit closer to a cream, but it's going to be a little bit
14:06 more liquidy than a lotion is a little bit heavier than a gel.
14:09 And then a cream is a little bit heavier than a lotion.
14:12 And then an ointment's a little bit heavier than a cream.
14:15 @EmilySarah asks, "Am I the only weirdo who wonders why blackheads are black and yet yellow
14:21 when squeezed out?"
14:22 You're definitely not the only weirdo because I personally have asked this question many,
14:26 many times before.
14:27 When you actually are secreting this, what's happening in your pore essentially is that
14:32 you have oil glands and skin cells that are sloughing off into the pore and they're clogging
14:36 the pores with all of that sebum and sebaceous filaments.
14:39 Sebaceous is essentially just the technical term for oil, and it's naturally a yellow
14:45 substance.
14:45 But then at the tip of it, the tip closest to the surface is exposed to light and air.
14:50 And with exposure to light and air, that yellow is oxidized.
14:54 And so it becomes black and it becomes what we call a blackhead.
14:57 But once you push it out, you still have that yellow natural substance underneath it.
15:01 @JustDD asks, "Question of the day, why do we all have fingerprints?"
15:07 So we know that fingerprints develop at roughly 20 weeks when you're still in the womb.
15:12 And it's a combination of things, but it's actually led mostly by genetics.
15:15 There's a few things too that contribute to this.
15:17 So it could be the amount of amniotic fluid slushing around when you're in the womb.
15:21 It could be the movement patterns.
15:23 It could have to do with gravity to some extent.
15:25 But we do know that genetic programming plays a really big role because if you were to scrape
15:29 off your fingerprints, you would actually grow back the same fingerprints throughout
15:32 your entire life.
15:33 They actually never change.
15:34 It's been debated why we even have fingerprints and actually nobody knows, but we do believe
15:40 that fingerprints actually do add some grip.
15:42 And so that's the running thesis, but we actually have no idea how this beautiful body works.
15:46 @PureRadianceHW asks, "#Skincare, does the weather affect your skin?"
15:52 So let's talk about the extreme conditions, winter and summer.
15:55 So in the winter, it's very dry, it's very cold.
15:58 And so people's skin tends to get very dry.
16:00 You lose a lot of moisture from your skin into the environment and a lot of people need
16:04 to use more moisturizing products.
16:06 Now, just because it's the winter and you're not getting as much sun exposure doesn't
16:09 mean you don't need to wear sunscreen because you still get UVA and UVB exposure, especially
16:14 if you're skiing and in high altitudes.
16:16 So definitely wear sunscreen in the winter as well.
16:18 Now, when we look at the summer, the extreme conditions of that, heat, humidity.
16:21 So your skin tends to not be as dry, but you're exposed to much more sunlight.
16:25 And this is where you're going to be more diligent about sunscreen.
16:27 If you're out at the beach and you're going to be in the sun all day, reapplying your
16:30 sunscreen every two hours is going to make a big difference.
16:32 That wraps up skin support.
16:34 I hope you learned something.
16:35 We'll see you next time.