57 - Kiran Krishnan
===
Kiran Krishnan: [00:00:00] The microbes play a very important role in how that barrier system is structured and how it functions. Knowing that the skin [00:00:08] grows from the inside out. We do know that we do need to nourish the skin from the inside out.
So having a healthy gut is still a really important [00:00:16] part of having healthy skin because you still have to absorb nutrients through the gut that end up building the layers of skin from the inside out
[00:00:24] Welcome to the wild and well, a collective podcast where we believe empowered health is your superpower. We have combined our [00:00:32] expertise in medicine and nutrition to bring you the latest research, expert insights and success stories of people on a mission to live a big life. [00:00:40] So buckle up and get ready to learn how to live wildly well.
Welcome back to [00:00:48] another episode of the Wild and Wild Collective podcast. Today's guest is someone that you may have heard before on one of our [00:00:56] earlier episodes. In fact, two early episodes, because Gran is one of the most Incredibly [00:01:04] knowledgeable people when it comes to gut health and the microbiome space.
We have brought them back after high demand and we're actually [00:01:12] going to be tackling a slightly different topic today, which I cannot wait to share with you. Spoiler alert, skin health, leaky skin, [00:01:20] and the concept of how this is all interwoven into our microbiome. So, Kuran is a research [00:01:28] microbiologist and a health and wellness expert who aims to make complex information understandable to everyone.
He's founded a number of successful [00:01:36] health and supplement companies over the last 20 years, including co founding and leading Microbiome Labs, one of our favorite [00:01:44] probiotic companies. The preeminent microbiome therapeutic focused brand among healthcare professionals. He is [00:01:52] currently a co founder and partner in three other companies that aim to revolutionize wellness care.
He has conducted and published several [00:02:00] research studies in scientific journals. He has published chapters in scientific textbooks, reference books, and has a global patent and has sought after [00:02:08] speaker on human health and the microbiome. So. Without further ado, I am so grateful [00:02:16] that we have managed to have Graham back on the podcast.
Thank you so much for your time today.
Sheree: Well, thank you [00:02:24] so much for coming back on the podcast. You were one of our favorite guests personally, and I think from our listeners [00:02:32] and today's episode, we are diving into, I think, a topic that can post a lot of vanity, but also [00:02:40] we're going to look at it from a very different angle as well as the aesthetic side of things, and that is skin health.
And so can [00:02:48] you give us a, a brief overview of where your research in the area of skin health and what you're noticing in the industry at the moment [00:02:56] and how that relates to the microbiome and our internal health.
Kiran Krishnan: Yeah, absolutely. Well, it's a pleasure to be back and thank you again so much for having [00:03:04] me.
This is a topic that's near and dear to my heart because I am, Very focused on barrier systems in the body, [00:03:12] right? So I spent a number of years on leaky gut that also translated to leaky brain and did a lot of work on the gut brain access as a [00:03:20] result of that. And then we know that the skin is arguably the largest organ in the body.
And and it's primary function [00:03:28] is as a barrier different than the gut barrier, which is a lot more of a dynamically permeable system where the gut barrier is [00:03:36] supposed to allow a lot of things through, but then prevent a number of things from entering. And if the gut barrier becomes dysfunctional, it becomes [00:03:44] leaky.
And so we know it as leaky gut. But the skin is. primarily a barrier. And the skin is also part of how [00:03:52] body and your immune system translates and figures out what's happening in the environment around you. And the skin also has a [00:04:00] massive density of microbes on it. So like any other part of the body where microbes out number your cells, in this case, in the case of skin, [00:04:08] it's 35 to one for every single skin cell you have on your body.
You've got 35 microbes, 35 bacteria [00:04:16] specifically. So, so when you have that high of a density of microbes on a given organ, it is more than likely that the [00:04:24] microbes often dictate how that organ functions. This is true in the large bowel, in the lining of the gut, in the enteric nervous system, [00:04:32] all of these areas.
We have huge densities of microbes. They dictate how that organ system functions. So it's no surprise that when we look at the [00:04:40] skin, the barrier function and the immunological function of the skin is dictated by the microbes that are on the skin. [00:04:48] And if the microbes on the skin start becoming dysfunctional or dysbiotic, you start to see the typical issues that we see on the skin, [00:04:56] starting with inflammatory conditions like acne, eczema, psoriasis, all the way to age related [00:05:04] symptomology.
And so the aging of the skin is very much a factor of microbial changes to the skin. And the problem with all that is not only [00:05:12] is it an issue as you're going through that process where this appearance of the skin becomes less favorable, right? We, none of us want, [00:05:20] Age, skin, none of us want inflamed skin, none of us want acne and so on.
So not only do those things appear and then degrade the [00:05:28] look of the skin, but ultimately what it does is it compromises the barrier function of the skin. And what we'll get into is how [00:05:36] that compromised barrier function then acts as an independent risk factor for chronic conditions outside of the skin.
[00:05:44] So conditions like osteoporosis, cardiovascular disease, Alzheimer's autoimmune conditions. You would never think that [00:05:52] something on your skin, a dysfunction on your skin could lead to bone loss, but it absolutely does. And this has been validated by some [00:06:00] very large scale studies over almost 60 years.
Christa Elza: Yeah, that blows my mind that the skin could actually be infecting [00:06:08] because commonly I'll think, okay, something internally is affecting the outward appearance of the skin and, I think most people can say, yes, I [00:06:16] understand that.
The skin is like a big mouth, we need to be careful what we put on top of it. Transdermal medications can go through the skin, right? So can toxins, [00:06:24] but for the skin and the integrity of the skin to actually be affecting the internal body to [00:06:32] me is fascinating. And I think we were talking a little bit off camera around the blending of functional medicine, which is what I [00:06:40] focus on root cause medicine internally and aesthetics.
And where do those kind of lines. Between, looking good. Yes, but that [00:06:48] also is health in general, right? And so tell me a little bit more about the study. I'm really fascinated. The study that was [00:06:56] showing how the skin affects internally, bone, even bone.
Kiran Krishnan: Yeah, absolutely. So, when you think about the crossroads of [00:07:04] functional medicine and skin health that's an area of real interest to me because there's a lot of skin practices, right?
Of course, there's dermatology [00:07:12] and then there's aesthetics and then there's cosmetology and lots of different ways of trying to improve the look of your skin or deal with pathologies on the [00:07:20] skin. Where functional medicine can come into play to me is functional medicine being focused on root cause drivers, [00:07:28] functional medicine can skirt past the issue of trying to mask symptomologies of the skin and really get down to what's [00:07:36] happening that is causing the inflammation on the skin, causing the acne development, causing the eczema, rosacea, or even things [00:07:44] like acne.
Causing the aging of the skin or premature aging of the skin, right? And when you start digging into the root cause of some of those things you start [00:07:52] to understand that the microbiome on the Skin is a major driver of those conditions and a dysbiotic microbiome. So I see [00:08:00] functional medicine playing a role in skin in two ways Number one is providing people with an opportunity to improve the look of [00:08:08] their skin By improving the health of the skin You Right, rather than the various techniques that are there just to mask dysfunctional [00:08:16] skin.
Number two, that improving the health of the skin also improves the individual's overall health. [00:08:24] Now, that study that confirmed this is something called the Baltimore Longitudinal Study of Aging. It's a fascinating study in that it [00:08:32] was started like almost 60 years ago. And this is an a unique aging study in that.
Normally what the [00:08:40] way researchers study aging and age related issues is they take a cohort of individuals that are say in their 80s right now, and [00:08:48] then they compare them to a cohort of individuals who are currently in their 20s and 30s, right? And they look at their cells and mitochondria and [00:08:56] pathologies and biochemistry and so on, and they try to discern a difference between.
What is happening in an 80 year old and what's happening in a 20, 30 year [00:09:04] old? The issue with that is it's not necessarily a fair comparison because that 80 year old went through a lot of different [00:09:12] things than the current 20 year olds go through, right? Their world is very different when they were 20 40 and so on than the current [00:09:20] 20 and 30 year olds.
So you're not really comparing apples to apples. So these researchers had the foresight to say, The best way of studying [00:09:28] aging is taking individuals and following them over the next 60 years and then and documenting their choices, their [00:09:36] lifestyle, their diet, all of the things that they do, and then measuring how that affects their body and measuring how that affects their [00:09:44] outcome in particular that we're looking at.
The development of chronic disease and the risk of mortality. Right? So those are the end points that we're [00:09:52] looking at. The study ends for an individual when they pass. And so now they've collated all of this data from the last 60 years [00:10:00] and the fascinating thing. There's lots of data that's come out of it, but some of the fascinating things that the study has revealed was [00:10:08] that aged skin was one of the best predictors of the development of chronic disease and mortality.
In these [00:10:16] individuals. Now, most of us would say, well, that's maybe because the skin is a reflection of an unhealthy insight, right? That's a logical thing to [00:10:24] think. However, they were pretty clear that the dysfunctions that they could measure on the inside, for example, the immune [00:10:32] dysfunctions or the chronic low grade inflammation and the things that are driving disease pathologies, all of those things, [00:10:40] Proceeded the age skin.
The age skin preceded those issues and the age skin caused a barrier dysfunction [00:10:48] where the skin is no longer acting as an active barrier and dysbiosis on the skin means an overpopulation of [00:10:56] pathogenic or opportunistic organisms on the skin that then leach Toxins and things like that into the dermal and then into the [00:11:04] circulatory system as well, right?
So all of these things are going past the epidermal layer now entering into deeper layers of the skin, recruiting immune [00:11:12] cells to the region and those localized inflammatory responses then start becoming systemic. after it starts to [00:11:20] occur on a larger surface area. There's also direct risk, for example, of fungal overgrowth on the [00:11:28] skin like Malassezia and Alzheimer's.
So that's one of the drivers, for example, of central nervous system inflammation [00:11:36] and the development of plaques and dysfunction in the central nervous system. Is the presence of fungal overgrowth on the skin, especially on the [00:11:44] face, right? And the face and scalp even and so they're showing that the presence of pathogens on the skin and the loss [00:11:52] of the barrier function of the skin is an independent risk factor for the development of chronic disease and mortality.
And [00:12:00] the thing is, it was the best predictor. In this study of when an individual is going to develop chronic disease and likely face a [00:12:08] high rate of mortality. So we can't ignore the skin anymore as a mere cosmetic component of our body. We have to [00:12:16] think of it as much as we think about our gut, as much as we think of our brain, our liver and all the other organ systems, right?
We've always just had this, [00:12:24] It's an outer facade. It's the cosmetic component of our being but it's not, it's a very active and complex organ [00:12:32] that becomes dysbiotic for many reasons.
Sheree: That's so, like, fascinating, and I think for [00:12:40] someone listening, even as myself, the first thing that pops into my mind is, okay, so, I'm so used to thinking about what I put into my body [00:12:48] and nourishing my gut microbiome, and I know that my skin is a reflection of that, and now we're flipping it on its head and going crazy.
Right? It's actually the [00:12:56] reverse as well, that we really have to consider. There's a lot of low tox movement and I love it. Like, we're moving away from putting [00:13:04] toxins on our skin and that, cause we know that they're going to be absorbed. Someone listening to this going, okay, maybe I've started the [00:13:12] low tox side of things, or I'm really now concerned that I've got all these pathogens on my skin , where does someone even start in terms of [00:13:20] nourishing their skin barrier or supporting their skin microbiome?
Kiran Krishnan: Yeah, I think it starts with that low talks movement, [00:13:28] right? So I think it's a matter of starting to tackle, personal care products one by one, start with a lotion or your deodorant or your [00:13:36] soap and go Okay, i'm gonna find the cleanest version of this product that works for my chemistry my biology I've been doing that [00:13:44] myself for the last five six years where I've been I started with deodorant.
I was trying to find the cleanest deodorant with the fewest ingredients that works for me, the cleanest [00:13:52] lotion, the simplest soap you certainly don't want anything antimicrobial to be used on your skin. And then, for women or anyone else [00:14:00] that wears makeup daily, that's also something that's really important because, makeup hat can have a negative effect on the microbiome of [00:14:08] your face, which means that, and of course, we're not going to stop wearing makeup, and we want to make sure that we are, either a using a [00:14:16] primer that's healthy for the skin that provides a little bit of barrier between the skin and the makeup.
We've been doing a little bit of work on that [00:14:24] ourselves. And then of course, when you come home, one of the first things you should do is just remove the makeup. And when you're and recover the skin, the [00:14:32] microbiome of the skin we had developed this biome balancing serum which is really like our key focus and how do you try to help and [00:14:40] recover the skin microbiome?
We've been using it for acne, redness eczema and other. Clearly dysbiotic [00:14:48] conditions. We've also now completed one study on aging of the skin in a very short amount of time And then we also now have done a [00:14:56] bunch of tests on using it as a primer To provide a layer of protection between the skin and the makeup.
So I think there are some strategies [00:15:04] around that to try to reduce the damage, you also want to really reduce the use of products that have things like phthalates [00:15:12] sorbates, benzoates, right? All of these are preservatives that are very strong antimicrobials and they will kill bacteria.
and [00:15:20] microbes on your skin. You also want to try to avoid over cleansing. People do clean and shower actually too much. [00:15:28] And we want to be careful with what kind of detergent we use because we already have the issue of a lot of synthetic fabrics, that's not great for your [00:15:36] skin or engaging for your skin because there are microplastics and all that in these, in the synthetic fabrics.
But at least be careful of the types of [00:15:44] detergent you're using, if you can even just wash your clothes with soap nuts I don't know if you're familiar with soap nuts but they're no so that's where some of the [00:15:52] original soap comes from These are nuts that actually are surfactants And you I can't you can actually put them in a little soap nut bag And then you throw it in [00:16:00] your laundry and it's a surfactant So it suds up and it cleans the clothes without any sort of chemicals without any sort of fragrances and all [00:16:08] that so that you're keeping, the things you're putting on your body on your skin as clean as possible, right?
And I think at the end [00:16:16] of the day, what, like, I don't want to do is I don't want to scare people. I don't want people to feel overwhelmed. And I don't want people to feel [00:16:24] like there's no hope because they're like, I'm not going to give up my makeup. I'm not going to give up, the clothes I like and all that.
Perfectly fine, but I think there's steps we can [00:16:32] take in terms of helping to protect the skin that can go a long way in terms of how it appears, how resilient the skin is, [00:16:40] and then ultimately how it impacts your health as well.
Christa Elza: Yeah, I think that is a big. When you talk [00:16:48] about, when I'm talking with my patients to about functional medicine, sometimes it can be really overwhelming because our environment, our society doesn't really lend [00:16:56] itself to health altogether.
When it comes to convenience, the types of foods that we have, or the cleanliness of our water, or just the [00:17:04] chemicals that are that help make our clothes smell good. It is. It can be challenging to say, well, what do I have to cut out all of these things [00:17:12] that, that help me out that bring me pleasure or just help keep my life running smoothly.
I think when it comes to beauty, it can be [00:17:20] challenging to also find products that are healthy for the skin, but also work. Natural products [00:17:28] don't necessarily give us the results that we want. And so, I think much like anything, it's the long game. Like we, [00:17:36] really curious to hear some of the products that you guys have developed because I think it is a long game and I think people need to recognize it.
It's not going to just flip a switch overnight. [00:17:44] But also the efficacy of these kind of products that are also safe and actually Helping your body. I'm curious to know what, [00:17:52] how did you guys, how did you move from the gut microbiome to the skin biome and keep it effective?
Kiran Krishnan: Yeah. So that's a great [00:18:00] question. So then when, I worked on leaky gut and the gut microbiome for almost 10 years, we published a number of papers on it. The products we had [00:18:08] developed as oral probiotics some of the immunoglobulins and prebiotics and all that. We've shown in research to completely reduce or even [00:18:16] eliminate leaky gut and reduce all of the subsequent chronic low grade inflammation.
So we felt very proud about that. And to me, I was like, [00:18:24] okay, it's ready. I'm ready to move on to the next barrier system, which is a big problem, which is the skin. And took the same view of it as I [00:18:32] did in the gut because It's a cellular barrier system. It's much more complicated of a barrier than the gut lining is because it's much thicker.
There's [00:18:40] many more cell layers and there's more nuance to it. But nonetheless, the microbes play a very important role in how that barrier [00:18:48] system is structured and how it functions. Knowing that the skin grows from the inside out. We do know that we do need to nourish the skin [00:18:56] from the inside out.
So having a healthy gut is still a really important part of having healthy skin because you still have to absorb nutrients through the [00:19:04] gut that end up building the layers of skin from the inside out. You also have to, for example, be able to absorb phytoceramides from your [00:19:12] diet, your liver converts them to ceramides that gets sent to the skin to build the ever important ceramide layer in the epidermis [00:19:20] which is the fatty acid layer that Protects the skin really that's one of the key barrier systems in the skin where you've got this fatty [00:19:28] acid layer That's part of the epidermis that fatty acid layer is really important because most toxins are fat soluble Which means as a [00:19:36] toxin is trying to penetrate through the skin it gets trapped In that fatty acid layer, right?
And then moisture is actually on the other side of that [00:19:44] fatty acid layer And what the ceramide layer does is it prevents moisture from evaporating out of your skin because oil and water don't mix, right? so [00:19:52] even in the hot sun the Moistures cannot evaporate because of the fatty acid layer is blocking it So the [00:20:00] ceramide layer is critically important.
The thing is, when you have a dysbiotic You Microbiome. So let's say you have an overgrowth of staph [00:20:08] aureus, which is a opportunistic and a pathogen on your skin. Staph aureus causes a breakdown of the ceramides in that local [00:20:16] area. So then you've got an, a local area where the bacteria is becoming excessively dry and irritated, and [00:20:24] then also more penetrable to toxins.
So then you got toxins going in. Moisture coming out. So as the moisture comes out, the area becomes [00:20:32] dry. As it becomes dry, it becomes itchy, right? And so people tend to scratch it and people tend to get to irritate it a little bit. More and more [00:20:40] toxins go in. As toxins go in, it recruits the immune system to that area.
Now the immune system comes there and starts bombarding it with an [00:20:48] innate immune response. You've got a red and irritated area. That red, irritated, dry, flaky area now becomes [00:20:56] eczema,
All: right?
Kiran Krishnan: So it all starts with the presence of staph aureus. So all forms of dermatitis even [00:21:04] autoimmune related inflammatory plaques on the skin, like psoriasis and all that are associated with having an overgrowth of a pathogen like staph [00:21:12] aureus.
Now on the flip side, you have the beneficial commensal staph epidermidis. If staph epidermidis is on the skin, it does [00:21:20] the opposite. It actually facilitates the rebuilding of the ceramide layer. It helps up regulate some of the epigenetics to [00:21:28] trigger the skin to recruit more ceramides from the diet into that area to rebuild it.
And then the ceramides that are being pushed [00:21:36] out, it actually converts that from a fatty acid into free fatty acids, which act as a pH reducer. [00:21:44] And that pH reducer is key to maintaining the pH of the skin. Below four and a half the reason why you need to maintain the ph of the skin [00:21:52] below four and a half is if you don't You get fungal overgrowth
All: Right,
Kiran Krishnan: and so so that just the difference in those two microbes, right?
Having staph [00:22:00] aureus in that spot versus staph epidermidis means you're gonna have eczema, psoriasis, irritated, dry, inflamed skin [00:22:08] that has a barrier issue now, or having staph epidermidis, you're going to have a healthy, resilient, protective [00:22:16] skin that is the right pH, that is resilient to moisture loss, that doesn't have irritation of plaque or immune activation in that area, right?
[00:22:24] So when you think about the skin and then how to modulate the skin microbiome, there It's really about just favoring the staph [00:22:32] epidermidis in this case versus the aureus. So how do you do that? Right? Normally the idea as people had in the gut and so on was use [00:22:40] antimicrobials.
Well, you can't do that because is going to kill both the epidermis and the aureus. And then you don't know what's going to come back faster. [00:22:48] So what you really need is something called a quorum sensing agent. A quorum sensing agent is a transient microbe [00:22:56] that shows up there that actually favors and works with the staph epidermidis to fight against the staph [00:23:04] aureus.
This is exactly the approach we took in the gut because in the gut Antimicrobial therapy all the time doesn't work because it's hard because you can kill a lot [00:23:12] of good stuff along with the bad stuff. So it's really hard to terraform the gut with just hitting it and bombarding with antimicrobials.
So you need things [00:23:20] in there to actually shift the ecosystem. And so when you look at the skin microbiome, what you start to realize is [00:23:28] about 70 percent of the microbes on the skin, Are permanent residents of the skin and their levels tend to shift depending on the [00:23:36] environment and what's going on 30 percent of the microbes found on the skin at any given time are transient, meaning they're hopping on the skin from the [00:23:44] environment and some of them have a effect on the skin for the period that they're on there and then they hop back off right [00:23:52] or they get washed off in the shower and things like that right.
So we started looking at quorum sensing microbes that are transient that can hop on the [00:24:00] skin, select the Staphylopodermidis, bring down the growth of the Staph aureus, and then hop off, right? Because [00:24:08] microbes, they do this better than any other compound. So we worked with the spores for decades in the gut, So we said, let's try the sports because they're really [00:24:16] good at doing this quorum sensing in other parts of the body.
Sure enough, we found that when you use the right combination of spores on the [00:24:24] skin, they do that exact type of quorum sensing. And they can absolutely modulate and change the microbiome in a very short [00:24:32] amount of time. Right. And so that was what we came up with. First, we said, okay, we want a quorum sensing serum.
For the [00:24:40] skin that helps rebalance the microbiome of the skin because most of the beneficial bacteria you want to have on the skin [00:24:48] are already there. Their numbers tend to be low in comparison to some of the opportunistic organisms in people with affected skin. So [00:24:56] we started with acne. We said, okay.
Acne is a great case because most people with acne, unless it's a, it's severe [00:25:04] hormonal acne, most people with acne have acne because they have an overgrowth of a version of a bacteria called cutie bacterium acnesis, [00:25:12] right? Cutie bacterium acnesis is A not an opportunistic, but it can be an opportunistic pathogen depending on the serotype you have and [00:25:20] the opportunistic version Can create acne in individuals.
So we took a handful of individuals who've had severe [00:25:28] inflammatory acne on their face and they've been through accutane. They've been through doxycycline They've been through lots of different treatments and it's not really [00:25:36] improving significantly We did a skin swab and we saw Sure enough, they have 60, 70 percent of the microbes on their [00:25:44] skin are cutic bacterial magnesis.
So it goes along with this, with the what we're seeing as the outcome of the skin with the inflamed acne [00:25:52] lesions. So then we started treating them once one time a day with the spore based serum. And then we followed them at four weeks, at eight [00:26:00] weeks, 12 weeks. What we saw is within four weeks, almost a 70 percent clearance.
of their acne lesions. And then we [00:26:08] saw that when we swab the skin, the cutic bacteria magnesis went from almost 70 percent of the microbes down to about [00:26:16] 16%, right? So that shift in the prevalence of that bacteria, Went exactly along with [00:26:24] the reduction and the disappearance of all those inflammatory lesions, right?
And so we did this again and again, and then we ended up doing a 317 [00:26:32] subject trial on this and over 90 percent of the participants saw a clearing of their lesions and their [00:26:40] occasional redness. And then most of them also reported all of the quality. Improvements in the skin, better hydration, better tone, better clarity and [00:26:48] all of that as well.
So it started to become clear that without doing a whole lot more, just by using a quorum [00:26:56] sensing agent, we can re shift the microbiome of the skin back towards balance. And then that then has a [00:27:04] profound effect on what the skin looks like, right? So then that's when we started doing more work on things like aging and so on.
Sheree: [00:27:12] I'm so fascinated by this. And I know that it worked with a lot of people who come in for acne. And it's always been something that we treat from the inside [00:27:20] out, right? I'm first thing that I go to is gut health and then liver health and working and making sure your detoxification systems are optimized.
Now, [00:27:28] you mentioned that these, Pathogens can come in from our environment. So where are we? First part of my question, is where are [00:27:36] we getting these pathogens from in the first place? And now that you've seen through the research that you're actually able [00:27:44] to apply something topically, right. With we've been taught for so long, topically doesn't really work to treat the root cause.
How important is diet and [00:27:52] how important is our internal system in treating things like acne?
Kiran Krishnan: Yeah, so when you look at most of the [00:28:00] pathogens that cause skin issues, they tend to be residents on our skin for the most part, right? But what is supposed [00:28:08] to happen is a healthy, diverse skin microbiome.
is supposed to control their levels. The moment their levels get beyond [00:28:16] a healthy normal, then they start to elicit symptomology on our skin. So, for example, we all have staph aureus on our [00:28:24] skin, right? Some people have a more pathogenic version. Mersa, for example, is a more pathogenic version of Staph aureus because it's drug [00:28:32] resistant, and so there's different versions like that on different people, but we all have colonization by Staph aureus.
But we all also have colonization [00:28:40] by Staph epidermidis, and whether or not you develop a condition on your skin, like atopic dermatitis or eczema, You're going, it [00:28:48] is about the balance between your staph epidermidis and staph aureus, and then you throw off the balance by the choices we [00:28:56] make, right? So that's really where it comes down to.
And then the acceleration of aging. Of the skin is also that kind of [00:29:04] factor. For example, what's really clear about the microbiome and skin aging and when I say aging, the development of fine lines and [00:29:12] wrinkles, hyperpigmentation, dryness of the skin, thinness of the skin. And then that discoloration, that the non-uniform [00:29:20] coloration of the skin, all of those factors.
Are attributable to a lowered diversity on the skin microbiome [00:29:28] and a shift in the dominance of certain types of bacteria. So, the age skin is marked by an increase of a certain [00:29:36] class of bacteria. Versus younger skin, right? And that class of bacteria that's increasing in age skin [00:29:44] Doesn't do the job that the healthy skin microbiome is supposed to do so fine lines and wrinkles for example [00:29:52] Healthy skin microbes actually activate the synthesis of collagen and elastin fibers Right, so you can take all the collagen you want as a [00:30:00] supplement It's not necessarily going to be effective in your skin unless you've got the triggers You On the skin to activate the synthesis of collagen [00:30:08] and elastin fibers in the skin, and your microbes control that right?
Oxidative function. So antioxidants we know are very important [00:30:16] because oxidative damage to the skin is a huge part of the aging of the skin. Most microbes control oxidative damage on the [00:30:24] skin. Hyperpigmentation, for example, is an issue where your melanocytes that produce the pigment, the melanin pigment are becoming [00:30:32] senescent because of oxidative damage.
So if you get exposed to too much UV radiation or even blue light radi irradiation from the, from [00:30:40] your monitors and your phones, and there's too much oxidative damage, the melanocytes become senescent. which means they become zombie cells, which is a [00:30:48] factor of age. And so they sit there, they don't die, they don't undergo apoptosis.
They just sit there and produce a lot of melanin and you get [00:30:56] dark spots. That's why we call them age spots, right? Because as you age, your risk for senescence increases. As it [00:31:04] turns out, microbes on the skin trigger the apoptosis of the melanin, of the melanocytes to stop them from [00:31:12] producing too much melanin when they become senescent, right?
So we need microbes to do all these things to maintain the health of our skin. And [00:31:20] as those functional microbes start to die down and dysfunctional microbes start to grow, you start to get more age spots, more fine lines, more [00:31:28] wrinkles, bigger pores. And so on, right? So the microbes that cause problems on your skin are already on [00:31:36] your skin and they're often being controlled by the beneficial microbes on your skin.
But our choices that we [00:31:44] make that negate the function of the beneficial microbes gives a leg up to the dysfunctional microbes and they start to overgrow. So it's the [00:31:52] same thing that happens in the gut, right? We know in the gut that most of the dysfunctional microbes in the gut are already there They're already part of the [00:32:00] commensal flora It's just a matter of diet and lifestyle and choices that we make that then favor the growth of the dysfunctional microbes [00:32:08] So it's this like delicate ecological balance and unfortunately, we have so many behaviors that Shift the balance towards the dysfunctional [00:32:16] microbes.
So then coming back to your question about how important that is diet and all that with regards to skin health, I think it's half the [00:32:24] story still. I think for the most resilient skin and to really, really reduce impact on the skin or effects that [00:32:32] we see on the skin, we need to tackle both.
So I'll give you an example of why that is, right? Okay. So if you have a dysfunctional gut, [00:32:40] you then tend to have a dysfunctional immune system, right, because your gut and your immune system go hand in hand. And the immune system in the [00:32:48] gut is the central command center for immune systems throughout the body.
The immune system in the gut is telling the other immune cells that are [00:32:56] roaming around the body what to react to and what not to react to. Now, all the intelligence of the roaming or roving immune cells comes from the [00:33:04] central command center, which is in the gut. So the gut is dysfunctional and your immune system in the gut is dysfunctional Then the immune response [00:33:12] throughout the body tends to be dysfunctional meaning you have a loss of tolerance Your immune system tends to be over reactive tends [00:33:20] to be over inflammatory and doesn't tolerate things as well.
So imagine then if you have the double whammy where you have sitting [00:33:28] on your skin too much staph aureus Right? The pathogen. And that Staph aureus is breaking down the ceramide layer, [00:33:36] producing toxins, and causing an immune trigger. Now you've also got a messed up gut. And because you've got a messed up gut, your [00:33:44] immune system tends to be overreacting to almost everything.
So now that trigger from the Staph aureus is going to cause a much more profound [00:33:52] inflammatory response in that region, and it'll spread to throughout that region in a much faster. The other thing of a [00:34:00] dysfunctional immune system is when it comes there and starts attacking and it starts attacking your own skin cells, it may accidentally develop an affinity, [00:34:08] an antibody against your own skin cells, and it starts attacking that same thing everywhere else.
This is how you develop psoriasis other [00:34:16] autoimmune like conditions, right? It starts with the trigger, the immune system takes over, goes haywire, and starts attacking the same thing it sees [00:34:24] everywhere else in the body. So now your gut and your messed up immune system, because of your messed up gut, Is driving a [00:34:32] much more profound response to the dysbiosis on the skin, right?
So to me, what you have to do to really have resilient skin is [00:34:40] remove the negative signal from the skin, which is reducing the staph aureus. So you don't have that negative signal. You don't have that barrier [00:34:48] breakdown and then be also modulating the skin, the microbiome so that your immune system can respond appropriately when it needs [00:34:56] to, and not overtly All the time, right?
So that one, two punch I think is incredibly important for resilient skin.
Christa Elza: [00:35:04] I think I find it interesting, in describing this with infants and children with eczema and like how that happens [00:35:12] so early in life that dysbiosis, right? bringing this up because I think a lot of, parents can be frustrated with how do I help my kid?
I [00:35:20] was 1 of those 18 years ago. My son had eczema. And there's so many different potions and everyone's got their own advice to of what to [00:35:28] do. And it really does come down to it's certain microbes that are living there. I think what's interesting though, is that the baby skin and [00:35:36] you think the immune system is more robust at this age.
What kind of is, do you find a different driver? I guess is what I'm asking for [00:35:44] infantile eczema versus adult eczema. Do you find it's different? Is there different solutions?
Kiran Krishnan: No, I think the drivers are about the same. I think one [00:35:52] of the reasons why a lot of kids are, we're seeing this increase in prevalence in eczema and skin related manifestations is because, of course [00:36:00] we still have about 35 percent of births are C section, right?
So they're not getting exposed to the right microbes on the skin [00:36:08] early on. We also have this poor practice of, even the babies who are vaginal birth, cleaning them off and washing them too quickly, right? [00:36:16] We bathe. Children and babies and infants too often. And, I know I have friends who've used soaps on their infants, right?
And you [00:36:24] really shouldn't be using a soap on an infant just yet, right? With baby skin, it's really should just be warm water. And then on top of that, if the baby's [00:36:32] not nursing enough if they've had a course of antibiotics because of an ear infection, if mom went through antibiotics because of group B strep during [00:36:40] birth, All of those things set up dysbiosis in the gut, and then they also have this dysfunctional ecosystem on the skin, because their [00:36:48] skin microbiome is not developed yet very well, right?
They are in part counting on engagement with mom and dad and close family [00:36:56] members to provide them some skin protection. This is part of why that skin to skin contact becomes so important for infants and babies. And [00:37:04] so imagine a mom and dad skin is dysbiotic and they have a bunch of staph aureus on there and the baby's sitting there skin to skin.
You're transferring some of that staph [00:37:12] aureus, which is now creating triggers on the baby's skin. The baby's immune system is immature, not really knowing how to handle it. And it just creates [00:37:20] a robust response overtly. So I think it's just that combination of Too much sterility, [00:37:28] dysfunctional guts in our babies, lack of proper inoculum of the baby's skin.
And then the environment that the baby is in is [00:37:36] hyper sterilized, most people that I've ever gone to see their baby when they're, they want you to do a hand sanitizer before you see the baby. Right. And they're [00:37:44] hyper sterilizing everything around them. All of that has a huge impact on the baby's skin microbiome, gut microbiome, and [00:37:52] thereby their resilience and their immune responses.
So I think, to me the logical approach then to, to a baby's skin microbiome is [00:38:00] let the baby Play in the dirt. Just playing in the dirt will have a huge improvement on their skin and their skin conditions. Not bathing them too [00:38:08] much, not using harsh soaps using more warm water a couple times a week.
And then, of course, mom and dad taking care of their skin, because you're [00:38:16] going to be constantly transferring microbes among family members, right? And so it has to be a household game. The microbiome [00:38:24] side of it.
Christa Elza: Yeah, I find that interesting because, they'll say, well, eczema is genetic and it's passed down.
And what you're suggesting here is [00:38:32] it's not necessarily in the DNA. It's on your skin that you're just passing on.
Kiran Krishnan: That's exactly right. Yeah. So same, same with things [00:38:40] like allergies food intolerances, anxiety to a degree depression, metabolic dysfunction, all of [00:38:48] those things, which we used to see in patterns and families, they're not necessarily genes there.
It's in the ecosystem that they're [00:38:56] passing down. And then that's the more ready area in which it shows up. So absolutely, I think, mom has sensitivities and [00:39:04] all that, and those are the microbes of the baby's encountering, the baby will likely have the same sensitivities.
If you love this episode, [00:39:12] be sure to leave us a review, download and subscribe. If you know someone that could also benefit from this conversation, please share. That's how we spread empowered health. [00:39:20] We'll see you again for another episode of the Wild and Well [00:39:28] Collective.
