[Amy Risley] Total Skin Nerds is brought to you by Skinfix. We're clean, clinically active, and on a mission to help heal your skin. Welcome to Total Skin Nerds. I'm Amy Risley, the CEO of Skinfix, and a first rate skin nerd myself. On this episode, my guest is Dr. Howard Murad, the legendary dermatologist who started his own pioneering skin care company at the age of 50. Now 81 and having trademarked the term, "the father of modern wellness," Dr. Murad is passionate about finding ways to counteract the kind of cultural stress that isolates us, depress us, and makes us all look worse for the wear.

Stay tuned now as Dr. Murad explains the most damaging stress factors, breaks down what they do to our skin, and reveals how to reverse the damage in surprising ways like diet, mindfulness, motivational messaging, journaling, connective tissue care, and more. Plus, new insights into the microbiome, a comprehensive plan for happiness, and how Dr. Murad's positive outlook on life began as a young Iraqi immigrant with an onion sandwich. Stick with me, nerds. Don't go away.

Dr. Howard Murad, we're so excited to have you on Total Skin Nerds. And it's such a pleasure to be here with you today in Los Angeles.

[Dr. Howard Murad] Thank you for having me. It's my pleasure.

[Amy Risley] Dr. Murad is a man of many, many firsts in the world of skincare and the world of medicine. And one of the first to really look at cultural stress and the importance of stress and how it relates to our total physiology, our entire body and our health, including our skin health. And would love to talk to you a little bit more about what cultural stress is.

[Dr. Howard Murad] Absolutely. I love it. That's my favorite subject.

[Amy Risley] How have you defined cultural stress?

[Dr. Howard Murad] Well, I'll give you a history of it in my background. Way back in 2003, actually before that, I saw my patients coming to see me, and they were downtrodden. They were unhappy. They felt less worthy. They felt they weren't perfect enough. And I couldn't understand what was going on, and I asked them, "What's happening? Why are you feeling this way?"

"Well, there's too much traffic. More is expected of me. Everybody seems to be better than I am. I don't have time to be with anyone." And that was just the beginning of what was to happen in the future. The next big time that happened was in 2007. The advent of the iPhone, and the start of what happened with that. Now we can't do without it.

So essentially what's happened to us because of the way society is, the modern wellness experience is a difficult one. Because it's very hard to deal with it. If you think about what begins to happen, we tend to stay home more because everything gets delivered to us. We don't even have to think about it sometimes. It gets delivered without even any AI.

[Amy Risley] Of course.

[Dr. Howard Murad] Then we sit and watch TV, and all the Netflix shows and all the other shows that are on. Disney, everybody has something. Hulu. So we sit and sit. And we're in an environment where we're just sitting.

[Amy Risley] Yes. Sitting is the new smoking, right?

[Dr. Howard Murad] The sitting disease. Yeah. So that's a real challenge. And we end up to have more chronic disease, more loneliness and social isolation, and depression.

[Amy Risley] Well it's interesting. I always say to my kids, social media really should be called anti-social media. Because kids are getting together less these days. Teenagers are getting together less and socializing less because of social media. And that social interaction is so important to us as human beings.

[Dr. Howard Murad] Absolutely. The human touch is so critical, and we don't get enough of that. So many people are now living alone in social isolation.

[Amy Risley] Yes.

[Dr. Howard Murad] And even communications. We don't pick up the phone even. We end up texting. And then we spend all this time on social media, and we're just sitting and don't have any human interaction.

[Amy Risley] Yeah. It was interesting, one of the studies that you published I was reading last night talked about how with the advent of computers and technology, originally we thought that it was going to be really good for old people who were living in isolation to have access to the world through computes. And actually it's turned out to be the opposite.

[Dr. Howard Murad] Absolutely the opposite. Because they're just sitting at home alone, and nobody's there to talk to them.

[Amy Risley] It's not a replacement for human contact.

[Dr. Howard Murad] Not at all.

[Amy Risley] We're a social species. So let's talk a little bit about what this isolation and anxiety and stress is actually doing to us physiologically and particularly to our skin. How did you see it manifest?

[Dr. Howard Murad] Well it all goes back, believe it or not, to the idea of water.

[Amy Risley] Right. Okay.

[Dr. Howard Murad] So the one thing we can't do without is water. And we all know we're supposed to drink eight glasses of water a day to be healthy. And that's fine. I'm not against drinking water. But the real way to really get more hydrated is not that simple. And if I asked anybody, "Is your skin drier today than it was 10 years ago," the answer would be yes.

So a fact of life is we go from a stage of full hydration in our body to less and less hydration. We see it in our skin, but it affects every other organ in our body as well. And as the skin becomes drier, it becomes more wrinkled, more susceptible to cancer and things like that. The same begins to happen to the other organs in the body. Because when they're drier, they don't work well.

So we start off with skin. I'm a dermatologist. Very important for everybody we know to use moisturizers and sunscreens to prevent damage from the environment penetrating through your skin into the rest of the body through the bloodstream. But also to protect your skin and keep it hydrated as much as possible. So skincare is really healthcare. People don't realize it.

Next is doing exercise. People say, "Well I exercise, but I'm sweating. I'm losing water." It's true. You sweat. But you build muscle. Muscle is 70% water, fat is only 10% water. The more muscle you have the healthier you are, generally.

[Amy Risley] That was really astonishing to all of us, I think, when we were doing the preparation. I had no idea that having more muscle tone actually helps your body be more hydrated.

[Dr. Howard Murad] Be more hydrated. Very important.

[Amy Risley] It's interesting.

[Dr. Howard Murad] And then eat your water. Water rich foods are healthy for you. So any water rich food tends to be healthy, but think of a raw fruit or vegetable. Any one of them is at least 80% water, but also has antioxidants, vital nutrients, makes your body alkaline, resistant to cancer and bone loss. So you get all that benefit.

But the last one that's the hardest is stress. There's traditional stress, like a broken arm, a death in the family, that we deal with. Cultural stress is constant, pervasive, and ever increasing. And it never goes away. It only gets worse and worse and worse. We can't minimize it. All we can do is learn how to deal with it.

[Amy Risley] And one of the most interesting studies that I read that you published was the one with the 40 women that had read the 11 affirmations every day. Talk to us a little bit about that study. How was it conducted? What did you have them do, and what were the results of that?

[Dr. Howard Murad] Well that was looking at 11 specific cards. One was, "why have a bad day, when you could have a good day?" Another one, "Dance even though you don't hear the music." There were 11 cards. And we asked them to look at them twice a day and journal. We measured their blood pressure at the beginning. We measured their cellular hydration. And we did a Cohen Perceived Stress Test to measure their stress level.

At the end of one month, we had statistically improvement in the stress study. But more than that, in the journaling, there were all kinds of things that began to happen. People began to have more strength from within, and the power to do different things. As it turns out, those 11 cards encourage you by not specifically telling you to do anything, but encourage you to have more strength from within and have more gratitude.

[Amy Risley] They change your perspective. The whole idea of positive mental attitude really can shift your whole sense of self and well being.

[Dr. Howard Murad] Absolutely.

[Amy Risley] And do you see as a dermatologist when you talk to your patients about stress and you give them tools to help them mitigate the stress, things like affirmations, and getting more sleep, and getting exercise, do you see a physiological change in their skin?

[Dr. Howard Murad] Yes. When we are under stress, we tend to have more inflammation, more dryness. We tend to have more fine lines. So there are specific signs of stress that happen, ending up obviously in having less sleep and things like that as well.

[Amy Risley] Yes. One of the things that I read in one of your studies as well was this whole idea of mind body connection. And I thought it was pretty cool that the same receptors that communicate between the brain and the central nervous system also communicate with the skin barrier. Can you talk a little bit about that? That idea that the mind is directly connected to our skin.

[Dr. Howard Murad] It is absolutely connected. And actually some of the cells in embryology come from the brain. Like the melanocytes are actually neural tissue. So there is a direct connection.

[Amy Risley] Do you believe that by managing stress and managing wellness that you could reverse some of the thing that have happened to your skin, and essentially help to reverse the aging process? I mean I've seen people who've gone on elimination diets and started to exercise who look younger.

[Dr. Howard Murad] Yeah, absolutely there is. And by the way, a part of that study that was not published is that we took before and after pictures of several people who are on the study and we put them on an eight week program. And we looked at the before and after, and honestly, it looked like some of them had Botox or some sort of surgery. The inflammation, the redness had diminished. Fine lines were gone, even some of the deep lines. And there was nothing that we asked them to do, other than to look at those 11 cards and journal.

[Amy Risley] Wow.

[Dr. Howard Murad] That's all they asked to do.

[Amy Risley] I love this concept that, here you are a dermatologist and a pharmacist by trade and by training, and yet you are so focused on helping people and helping to make them happier. And focused on their mental wellness. Which you don't often hear in a dermatologist's office.

[Dr. Howard Murad] Yeah. Well you know, you really can see the whole person through their skin. It really shows. Everything about you shows on your skin. And I go back to the idea that skincare is healthcare. Once we understood it, once we understood how we could truly make your skin healthy. Wasn't just about the surgery that you do, or the topicals that you do. Because they are important. I'm not against those.

But everything else. How you eat. How you manage your stress, your exercise. All of that shows on your skin. And on the reverse, when you're not doing it it shows on your skin as well.

[Amy Risley] Right. One of the things you talk about as well is that stress enhances the inflammatory cascade and it causes some endocrine imbalance. But it also can affect the microbiome. Which I thought was really interesting and such a hot topic right now.

[Dr. Howard Murad] Absolutely. It's really important. And some of the research we're doing right now is looking at some specific microbiomes that are associated with wrinkles. There seem to be some. So when we look at how we can do a pre or probiotic that attack that specific microbiome, we can make maybe a difference in the appearance of your skin.

There's a lot of research into that whole idea. Every single one of us has a different set of microbiomes. Just like we have different fingerprints, our microbiomes are different. I could look at microbiome as DNA. In essence, everybody has their own specific microbiome. And that's a mixture of the different bacteria. There are good and bad bacteria.

[Amy Risley] So is the concept that there are certain pathogens or bad microbes for, in layman's terms, that reside on the skin that might cause, to your point, fine lines and wrinkles, or acne, or rosacea, and so you target those specific microbes? Is that the idea of -

[Dr. Howard Murad] Yes. The idea of -

[Amy Risley] [crosstalk 00:13:32].

[Dr. Howard Murad] An agent that will address those.

[Amy Risley] That's very cool. That's very new.

[Dr. Howard Murad] Yeah. We're working on that right now. And now we're going even deeper and we're looking at specific microbiomes that are maybe bad for your skin, causing more dryness or more susceptibility to breakouts or whatever. We're trying to find out. And then we can begin to target those specific microbiomes. So instead of just giving everything, taking one of these bacteria, there are thousands of different bacteria that you carry. Millions, or whatever. In it there's maybe one or two that are targeted. It's not happening yet, but it's happening.

[Amy Risley] That's the direction that it's going.

[Dr. Howard Murad] Yeah. We have trillions of bacteria within our body and on our body. And that's the different bacteria all together, and that's your microbiome. Look at it that way. And some of those are good ones, and some of them are not good. So what we're trying to do is encourage the good ones to stay healthy and encourage them to grow, and minimize the bad ones.

[Amy Risley] Yeah. So your products to target the microbiome, are they topical products?

[Dr. Howard Murad] Yes

[Amy Risley] That's really interesting. Talk to us a little bit too about connective tissue. Because we hear a lot about collagen, and we hear a lot about skin barrier, but we don't hear a lot about connective tissue in skincare. And you talk a lot about it and you've published studies on the connective tissue and the importance of it with respect to all of our organs, and then particularly the skin. Can you explain to us a little bit about what it is, what it's doing, and why it's so important?

[Dr. Howard Murad] Connective tissue is made predominately of elastin and collagen. And we can't do without it. So addressing that is very critical. Fact of life, as we get drier, one of the areas where we have the most water is in our collagen. Collagen, as you know, is a high percentage of water. And as a matter of fact, if we look at the epidermis itself, it itself has no water. It needs to get the water from the connective tissue. The dermis beneath it.

They're aquaporant pump stimulators that pump water from the dermis into the epidermis, into the basal layer. And that's where the water really comes from. So the idea of encouraging better connective tissue not only is helpful for wrinkles, but also the appearance of the skin. The superficial part of the skin that we see.

[Amy Risley] Interesting. So a topical will help by trapping that water and keeping it in. And the connective tissue will help feed the skin barrier from the inside.

[Dr. Howard Murad] Right. The problem with what you put on your skin is the water tends to maybe get into the cells a little bit. But the cells themselves, in order to get their water, the basal cell, there's a pump system that pumps water from the connective tissue into the cell itself.

[Amy Risley] Interesting.

[Dr. Howard Murad] It's called aquaporance.

[Amy Risley] And you talked about drinking water, and you talked about eating water, but is there a more efficient way? What is the most efficient way, I guess, to get water into the cells? Into the body?

[Dr. Howard Murad] You need water itself. But the transport of the water is important, and what comes along with the water may be important as well. So when we drink water, it goes right through you. When you eat water as foods, it's in the structure so it's gradually released. And over time, the water goes into the cells instead of going through you and then not have any later on.

[Amy Risley] Interesting.

[Dr. Howard Murad] And while you're getting that, you're getting all those other phytonutrients that are helping you.

[Amy Risley] Right. You talk a lot about water on a cellular level. So what really is the water, what function is it performing at the cellular level?

[Dr. Howard Murad] So in order for the organelles in the cell to work, they need to be in a water rich environment. As there's less and less water, there's more toxins in the cell and it can't function as well.

[Amy Risley] Okay.

[Dr. Howard Murad] So getting water into the cell is important. And it's a matter topically of adding these aquaporant stimulators in the topical agents that you apply, plus osmolytes. Osmotic pressure areas that encourage water from the ingredients that you're putting on your skin to penetrate into the cells. So that helps there topically. But also manufacturing more collagen and elastin.

As we get older, as you know, our tendons become weaker and drier. And we begin to have knee problems, back problems, things like that. And also wrinkles. So eating foods that encourage the cells that make the collagen to have more. Eating different foods, antioxidants, and B vitamins. Trace minerals, and something called glycosaminoglycans, GAGs, an example of which is glucosomine.

[Amy Risley] Okay. Will help to stimulate collagen production.

[Dr. Howard Murad] Absolutely. To make the fibroblasts which makes collagen, that's how it needs those nutrients to make it.

[Amy Risley] How do you feel about drinking collagen drinks, or taking a collagen powder in your coffee? Is there any value in actually ingesting collagen itself?

[Dr. Howard Murad] Well collagen itself is a good protein. But your body needs to make its own collagen. It can't make collagen out of eating those. Because that's used as energy and so on, and that's it. So you need the other things. The trace minerals, the B vitamins, the antioxidants, and also the glycosaminoglycans for the fibroblasts to make collagen.

[Amy Risley] Okay. And you talked about certain ingredients in skincare that can help with driving water into the epidermis and holding water. What kinds of ingredients are important to have in skincare?

[Dr. Howard Murad] Well, there's two types of agents. One of them that attract water, like hyaluronic acid, and agents that prevent water loss like the various agents that do that. So the combination of the two will help. But again, it's a temporary thing because that's just a topical. You also need to have what I call internal skin care. Eating supplements, actually, that contain what I've been talking about, and also the foods that contain it.

[Amy Risley] I was really interested in your whole philosophy of inclusive care. This idea that while you're a dermatologist and you have a skincare line, and external is important, but you put equal value on internal. To your point, supplements and then emotional.

[Dr. Howard Murad] They're all connected. As I was saying before, they're all encouraging more hydration. When you exercise, you're building more water because of muscles. When you're eating your water, you're getting more water that is likely to go into the cells with antioxidants and things like that. When you reduce your stress, you're going to reduce that loss of water. We all know when we're under stress, we have underarm perspiration, sweaty palms, things like that.

[Amy Risley] Okay. Interesting.

[Dr. Howard Murad] So we lose water when we're under stress.

[Amy Risley] Interesting. Do you believe that there's a connection between stress and a damaged skin barrier as well?

[Dr. Howard Murad] Again, I think it's all connected.

[Amy Risley] Yes.

[Dr. Howard Murad] I think we can't do one without the other. It helps to have any one of them. But really to get the real benefit, it's got to be all four.

[Amy Risley] Do you feel that sleep's an important element of total wellness?

[Dr. Howard Murad] Absolutely it is. We can't do without it. What's happening because of of cultural stress, we have less and less sleep.

[Amy Risley] Yes.

[Dr. Howard Murad] We're spending more time on our computers, our cell phones. And we don't have enough time that we're really getting sleep.

[Amy Risley] Yes. I mean, you talked about in one of your articles just even the buzz of the phone or the constant notifications that are coming in all the time are disrupting our quietude and in a lot of cases our sleep. I got my children alarm clocks for Christmas that mimic the sunrise so that they can't have any excuse to have their phones or devices in their bedrooms anymore.

[Dr. Howard Murad] Good.

[Amy Risley] They say they need them for alarms. So I've replaced them with alarm clocks. Because it's just that constant being on all the time that's just -

[Dr. Howard Murad] And even if there's nothing happening, if you're accustomed to looking at your cell phone, "Hey, maybe somebody sent me an email. Let me look."

[Amy Risley] Yes.

[Dr. Howard Murad] Even though there was none sent.

[Amy Risley] And how important can it be, really?

[Dr. Howard Murad] Usually not.

[Amy Risley] Exactly. Do you see teens who are suffering acne or skin issues, do you see more emotional issues related to that with that group of?

[Dr. Howard Murad] I can't say it's specifically that, but I do see. Because I have teenage grandchildren.

[Amy Risley] Yes.

[Dr. Howard Murad] And I think they are under so much more pressure and so much more stress than I ever was. Just because the way society is. And certainly, again, it affects every organ in our body.

[Amy Risley] So much comparison happening with social media and media in general. And I loved one of your quotes. "Be imperfect. Live longer." You're perfect in your imperfection. I love that idea. And I have teen children, and I do believe I agree with you that there's just so much more stress related to social comparison and social expectations than we ever had. We just didn't know what was going on with our friends half the time.

[Dr. Howard Murad] Absolutely. And you're never going to be good enough. Because everyone's taller or skinnier or whatever than you are. And I don't know if you noticed, but the idea of selfies. I know people who take 200 selfies a day of themselves. What is that about? Why do we need to keep looking at ourselves? And then when you look, you're looking at the flaws. You're not looking at the good things about your skin. So that's depressing. And I don't know if you se that with any of your children that they're taking a lot of selfies.

[Amy Risley] Yep.

[Dr. Howard Murad] But somehow, I don't understand it. I think it's negative.

[Amy Risley] Yep. And then using the filters to make them look different. It's interesting. It's a whole new world that, to your point, you were really the father of this concept of cultural stress. And I think it's such an important conversation that we need to start having more of to really understand what the impact is on our physiology and our longevity and our mental health. Because it's definitely impacting it.

Talk a little bit about your family background. Your family immigrated to the US from Iraq. You grew up in Queens. Talk about how that's maybe informed your perspective on life, and your optimism, and your whole thought system about being positive.

[Dr. Howard Murad] Well, a couple of things. I like to say when you look at adversity, you look at it as an opportunity. And one way that I could describe that is we came to the United States. We were relatively well to do. We moved into a nice house. But in the fullness of time, my father became bankrupt and we had to move to a little walk up apartment. Six children and parents.

[Amy Risley] Wow.

[Dr. Howard Murad] But actually I think it was a good thing, because it realized for me, and here's one thing that I like to say. My father would say, sometimes you didn't have enough to eat, and he's say, "We can have an onion sandwich, and at least we'll be full. And so we're going to be happy and we're going to be together."

[Amy Risley] I love that.

[Dr. Howard Murad] And so it gave me an idea of, what's the worst thing that could happen to me? I will have an onion sandwich, and I'll be happy and live together. And the idea there is, I was willing to take risks. I was willing to take opportunities and look at them and say, "What about this? How about this? I'll be willing to take that chance to be okay."

And again, a lot of it is I was fortunate to have parents that did have that kind of idea where they made everything as good as possible. My father used to always say, "I hope you'll be happier than me and older than me." He was always smiling. And he lived to be 100.

[Amy Risley] Wow.

[Dr. Howard Murad] It was a combination of things, I think. I was fortunate. Everyone has a different way of looking at life. But the idea of, for me, as looking at opportunities in your challenges is very important.

[Amy Risley] Well I like the fact, too, that you don't focus on failure. And you talk a lot about that in some of the things you've written. And there's no fear there. Because to your point, what's the worst that can happen? I can pick myself up and carry on.

[Dr. Howard Murad] Right. I could have an onion sandwich. Have you ever had one?

[Amy Risley] Yes. No, but it sounds really good actually. I love it. But that's so important. And here you are today, 80 years old and still contemplating business opportunities. And still working so hard to write books and spread the message about cultural stress. You're not slowing down. You're not on the golf course. It's pretty incredible.

[Dr. Howard Murad] Well thank you.

[Amy Risley] I want to talk a little bit too about your background as a pharmacist, and how that's informed some of your formulations. You were way ahead of the curve with antioxidants and with glycolic acids and HAs. Was that informed by your background as a pharmacist, or how did you think to use some of these ingredients in your topical formulations?

[Dr. Howard Murad] I'm sure it had an effect. I like to look at that story a little bit differently. The idea of, again, challenges and opportunities. So when I started college, I wanted to be an engineer. It was the time of Sputnik. The Russians had had this space thing called Sputnik, and we didn't, and everyone wanted to do that. And unfortunately I couldn't' do so well in Statistics, one of the classes. And math, which I thought I was good in, I was not doing well in college with that.

My brother who is a pharmacist, he said, "Well why don't you go to pharmacy school? You like science, and you'll have a job when you're done. And it'll be good." And in the back of my mind, I thought, well, I'd really like to be a doctor but those other people are probably smarter than me. They're probably, I don't know if I'll get in.

But I went to pharmacy school. And as I was graduating, I was studying with a friend. And his uncle came by who was a physician in L.A. and said, "You guys should apply to medical school," and this and that. And I said, "I probably won't make it." But then I did apply, and I did get into medical school.

[Amy Risley] I love that. Fearlessness again.

[Dr. Howard Murad] It's like a lot of people, they limit themselves because they say, "Well I can't do it." They don't even try. So for whatever reason I was willing to try. And then when I was at medical school, I wanted to be a surgeon. And Uncle Sam sent me to Vietnam, and had my fill of surgery. But the second year I was attached to the dermatology clinic. And I decided I liked dermatology.

So it's like looking at life and going through the idea of challenges, and ideas, and creating new things. And not limiting yourself to being what you think you want to be. [crosstalk 00:29:45].

[Amy Risley] Or what your parents think you should be.

[Dr. Howard Murad] Right.

[Amy Risley] What somebody else thinks is a good career. Follow your own heart.

[Dr. Howard Murad] Who should be. Absolutely. And also follow your heart all the way through. Don't limit yourself in whatever you do. I mean, as a dermatologist I was a very busy dermatologist. I saw a lot of patients. But over time, I got more interested in some of these other things.

I tell people, whatever you think you could do, you probably can do 10 times that. And also, don't ever try to emulate. Don't try to be like somebody else. Because you're never going to be as good as them because that's who they are. You're a unique individual. I sat allow the unique you to blossom, because you have unique talents. You don't know what they are. I didn't know I'd do well in [inaudible 00:30:39]. But I did find that out. So the idea of encouraging people to be the best that they can. Which is way beyond what they could.

[Amy Risley] I love that. And you started your skincare line at the age of 50?

[Dr. Howard Murad] Yes.

[Amy Risley] I'm 50 this year in May, and a lot of people think that's the end of the line.

[Dr. Howard Murad] No, no. That's the beginning.

[Amy Risley] Well I'd love to think it's the beginning. I feel like it's the beginning.

[Dr. Howard Murad] Yeah. You're young enough to have the energy, and you're smart enough to have gone through a lot of challenges.

[Amy Risley] Have the wisdom. Or some of the wisdom.

[Dr. Howard Murad] Got the wisdom. Yes.

[Amy Risley] Yeah. And what inspired you to center your study around written affirmations?

[Dr. Howard Murad] I had one saying, "Why have a bad day, when you could have a good day?" And that was just something I said that was my mantra. But during the time that I had the retinal detachment, I had a month to just be home, and I couldn't do very much. And I began to listen to myself. And as I spoke, I began to write some of the things that I wrote. Like, "Be imperfect, live longer." Things like that.

And then when I started, when I went back to my patients, I began to write them on eight by 10 papers, and write them out and offer it to my patients. I would say, "Here. I'd like you to take one of these home." And it became a thing. People used to come back just to get a card.

[Amy Risley] That's great.

[Dr. Howard Murad] So one thing led to another. At this point, I have over 600 of what I call, "insights." They call them affirmations. Whatever. But I really saw that that was a thing that seemed to help my patients. Because they would take these eight by 10 pages, and they would put them on top of their refrigerator or something like that. And it seemed to make a difference in their life. And I would guess it'll help their skin.

So I created them in smaller cards. I picked 11. I can't tell you specifically why I picked them. They just called to me. They did have some meaning to me. So we did that study that I spoke about before, where people looked at these specific 11 cards twice a day and journaled. And we could see an improvement in their stress level at the end of one month.

[Amy Risley] [crosstalk 00:32:58].

[Dr. Howard Murad] And I worked with a psychologist and gave him all the raw data, and put together where each of those sayings had meanings. Like if I give the word, "forgive yourself," to 10 different people, they'll have 10 different opinions of it, but it'll be basically encouraging you to have more gratitude.

So the words encourage more gratitude, more strength from within, and more ability to function in a more healthy way. And the results have been really exciting. I've given it to a lot of people, and they say, "I've been looking at those cards and it really has helped me."

[Amy Risley] Can we talk a little bit more about the definition of aquaporants?

[Dr. Howard Murad] Aquaporants are like pump systems. It's made of various amino acids. And different cells have different aquaporants. There's one for kidneys, one for skin, things like that. And what they do is to encourage the cells themselves to have water within them. So sometimes we have too much water in it. The aquaporants allow the water to come out of the cell. But generally we need more water in the cell. So it pumps it out from the connective tissue. It's a way of getting water into the cells.

[Amy Risley] Okay. So and this is this idea that if you have more muscle tone, you have more water. And that water can then be transported into the cells through the aquaporants?

[Dr. Howard Murad] No.

[Amy Risley] No.

[Dr. Howard Murad] Not necessarily. If you look at your body as made out of connective tissue, like tendons, ligaments, things like that, and actually cells. So the cells themselves get water from the connective tissue. That's how they -

[Amy Risley] [crosstalk 00:34:57].

[Dr. Howard Murad] And the other thing we have to understand is we are constantly in motion. We know that our skin turns over every 30 days, so you have new skin every 30 days. You have new gut maybe every five or six days. Every cell in your body is turning over. Your body's constantly producing more cells. And as they are producing more cells, we want to make them as healthy as possible.

So we want them to have as much water as possible, so you need to eat foods that help connective tissue. And you also need foods that will, let me give you maybe a bad example. If we look at what we call agents that are, let's say, if inflammation is bad. It's not necessarily bad, because inflammation in some cases is good. When you have a cut in your hand and it's just a small cut, your body gets inflamed right around it and then it forms a scab and it heals and it goes away. But bad inflammation, if you had a third degree burn, that's terrible.

So what I'm trying to get to is the idea that we need to look at what we eat in your cells. So let's say I can tell you that fried bacon bits are not good for you. And if that's all you eat, your body can only make the cell membrane out of fried bacon bits. I'm making that up. Because that's all there is.

Another way to look at it, and your body is a factory constantly producing new cells. Let's make believe you're a car factory. And you don't put any glass in the factory, and you only give them cardboard. So people put instead of a windshield, they'll put cardboard. So the idea of eating the foods that are going to be healthy for you. And so the more you eat those good foods, the less likely you are to have things that are damaging. I don't know if that, does that ...

[Amy Risley] Yeah, that makes a lot of sense. What I find so fascinating, Dr. Murad, about you, is that you're a dermatologist. And yet this is all so beyond the scope of what most of us think of as dermatology. I mean when we talked about you earlier before this podcast, we said, "He's a guru." But it's just very cool. I think for people to understand that yes, you're a dermatologist, and yes, that's your educational background and you know a ton about skin and you can help them with their skin. But you're so focused on the whole picture and the whole person. And that's pretty extraordinary. Not a lot of dermatologists I think in the world talk to people the way you do.

[Dr. Howard Murad] Yeah. I don't think there are many, if any.

[Amy Risley] Yeah yeah. It's pretty cool. I'm sure and I actually know from personal experience that you've been a mentor to a lot of people. There are people that I work with who talk about you incredibly fondly, and you've been so helpful to them in their career and in their personal life. Who have been your mentors, or people that have really taught you important lessons and helped you on your journey?

[Dr. Howard Murad] I think primarily it had to be my parents. There was not a spoken word, but there was an expectation that I would be successful. And I think I was fortunate that way. I know that when you study psychology, if you have at least one parent who believes in you and encourages you, you have an opportunity. If both of them treat you like you're worthless, it's going to be a challenge.

But I don't specifically have any one person. I could say, I don't know, when I give a presentation, I always have this person. I can never pronounce his name. [Negropolate 00:39:11]. But anyway, in 1937 he was a Nobel Prize winner. His favorite saying is, "Discovery is seeing what everybody else has seen and seeing it differently." Something like that.

So the idea of everybody has, all of these things that we're talking about. But just looking at it in your own way and learning from yourself is important. And it's nice to have all of those other things, but learning from yourself.

[Amy Risley] Listening to your inner voice.

[Dr. Howard Murad] Yeah.

[Amy Risley] But you say your parents, there was an unspoken word to be successful. And yet, your father said to you, "I hope you're happier than I am, and I hope you live longer." So it sounds like he defines success as -

[Dr. Howard Murad] As happiness.

[Amy Risley] Being fulfilled and being happy.

[Dr. Howard Murad] Yeah. Right.

[Amy Risley] Which is really nice.

[Dr. Howard Murad] Right.

[Amy Risley] Wow, Dr. Murad, this was really fun, incredibly interesting, and we're so glad that you gave us your time. I know you're extremely busy. Thank you for doing this today.

[Dr. Howard Murad] Thank you so much. It's been wonderful being with you.

[Amy Risley] You can learn more about Dr. Murad's work by signing up for his weekly modern wellness digest on his website, www.doctorhowardmurad.com. I learned so much from talking with Dr. Murad. Here are the three things I can't stop thinking about.

One. There are far more factors that hydrate your skin than I realized. It's more than just what you drink and how you moisturize. It's what you eat, how you emotionally react to your environment, and how you exercise. My approach to hydration is about to become far more holistic than ever before.

Two. I'll be paying more attention to collagen production, which means more B vitamins, trace minerals, and glucosamine for me. And three. Dr. Murad told us that part of staying positive is refraining from judging ourselves, and too much self judgment comes from taking selfies. Because selfies are part of cultural stress, they may actually be bad for your skin. To have Dr. Murad answer your questions about stress and skincare, follow us and DM us on Instagram at Skinfix Inc. watch our feed for his answers.

Thank you for listening to this episode of Total Skin Nerds. Please come back next time when our guest will be Dr. Will Cole. And please subscribe to our show on iTunes and Spotify. Total Skin Nerds is produced by Rob Corso, Casey Kahn, and Howie Kahn for Free Time Media. Our theme music is by John Palmer. Special thanks to Leslie Goodman, Jenny Chen, Catherine Spears, Cara Canning, Jane Meredith, and Meghan Collins. And I'm your host, Amy Risley. Til next time, nerds.

Total Skin Nerds is brought to you by Skinfix. We're clean, clinically active, and on a mission to help heal your skin.

Speaker 4: Total Skin Nerds is a podcast created to educate. It is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical advice. If you are looking for help with a skin concern, we would encourage you to seek the advice of a board certified dermatologist, functional medical practitioner, or other qualified healthcare provider.

You can find a registry of board certified dermatologists in the US at find-a-derm .AA.org, and in Canada at dermatology.ca. For a registry of qualified functional medical practitioners, you can visit IFM.org. Thank you so much for joining us on this episode. We hope that you enjoy listening to Total Skin Nerds as much as we enjoy making it.

June 30, 2022