In the latest edition of Beyond Topical, our series of interviews with experts on the various influencers of skin health, we’re pleased to bring you this interview with Dr. Julie Greenberg, a licensed Naturopathic Doctor (ND) and Registered Herbalist RH(AHG) who specializes in integrative dermatology. 

Dr. Greenberg’s journey has taken her from a successful career in finance (she holds a B.A. in Economics from Northwestern University and an M.B.A. from Stanford) to becoming a healthcare warrior after receiving a diagnosis of Hashimoto’s hypothyroidism that made her rethink everything she knew about health.

Having healthy, beautiful skin means different things for each person, and requires a holistic approach that takes into consideration your skin and health history, as well as your current skin state and significant influences from your everyday life. As with anything health related, there’s a certain amount of self-discovery necessary if you want to make impactful changes that support healthy skin function and symptom-free skin.

Having a problem with breakouts from masks, or other skin health issues? You’re not alone. Wearing a mask in public per the CDC’s guidelines is the right thing to do to help curb the spread of Covid-19, but it can wreak havoc on the skin—many of us have started experiencing dermatitis and acne in the areas covered by our masks. 

The issue is not necessarily that wearing masks are creating new symptoms—though that could be true if you are experiencing extremely dry or raw skin—but more that the skincare routines you may have relied upon to suppress these symptoms are no longer working in the new environment masks have created on the skin. 

The second annual microbiome conference was held in San Francisco recently. The talks ranged from scientists investigating individual microbial species that call the skin microbiome their home, such as Staphylococcus aureus and Proprionibacterium acnes, to entrepreneurs with biome-based products designed to improve skin health. 

Acne isn’t only for teens anymore—in fact, it affects more and more adults (primarily women) at an alarming rate. 54% of women over 25 experience some form of acne, which means that around half of us are attempting to tackle issues related to acne and aging simultaneously.

Suppose some of the approximately one trillion microorganisms that live on your skin are finding their living conditions objectionable, even intolerable. How would they let you, their god-like host, know about it?  If you were a commensal microbe living on the skin, Staphylococcus epidermidis, for example, and you just wanted to go about your business keeping your little part of the world relatively pathogen-free, you might consider sending a message in the form of an acne breakout, a rosacea flush or an undesirable rash.

Nothing’s more exasperating than conspicuous breakouts. We all get them, and we all spend a lot of effort trying to avoid them. A daily diet of topical antibiotics and antimicrobials prescribed to combat acne may work for a time, but ultimately, they can disrupt the skin’s microbiome balance. It’s now common knowledge that prolonged use of antibiotics kills off beneficial bacteria found in the gut microbiome, tipping the balance in favor of over-colonization by disease-causing pathogens. Similar to the gut’s microbial disruption-disease cycle, skin microbial dysbiosis can lead to skin problems ranging from redness, irritation, rosacea, rashes, eczema, resurgence of acne and adult acne to photosensitization.