Dr. Doris Day
Clinical Associate Professor of Dermatology, New York University Langone Medical Center
With a unique human touch and a sharp point of view,Dr. Doris Day tells us about the effects of the modern world on our skin.
Behind The Business Woman
I have had many broad inspirations from philosophers to writers and scientists along my journey to becoming a physician. I really believe that being a doctor is a calling and a privilege, not just a job. You are a physician your entire life not just at work. It is service to others, and it requires a commitment to life-long learning. It is always about what we give our patients: education, science, art, and sometimes it is as basic and powerful as simply acknowledging their concerns, helping our patient love him (her)self, see the best in themselves and helping them make choices to be a happier, healthier person.
In my journey in the humanities, I started as an English major studying literature and philosophy and went through my own process of maturing, learning early (as a teenager) the value of life and love as well as the importance of living in the moment. My dad (who was a physician) has been a great source of inspiration in my life. He was driven by a deep passion for providing his patients with the best of care. He was a great teacher and made it clear that doctors have to know the science but, just as important is that we need to be healers who understand our patients and treat them as a whole rather than as a series of separate unrelated organ systems. He was also a poet and a singer.
Studying Medicine was initially a challenge for me because I did not start out in the sciences and didn’t think of myself as a scientist by nature. My early focus was more in the arts and humanities but learning the science was exciting and really helped me put everything together. Understanding how things work at the scientific, molecular and macro levels is critical because you cannot go to the abstract unless you get the concrete.
Very naturally, I became a Journalist because I wanted to educate. I felt people needed to understand their choices and understand that everybody has a role in their care and what follows. For me, it was about bringing it together in a larger context. These are not different hats that I wear, there are all the same but they exhibit in certain ways. As a dermatologist, I understand that the world is internal and external and that things like pollution, stress, sleep and diet greatly impact your skin and that skin is a reflection of the health of the body. I look for the different ways that people are missing to look at how I can help them feel at their best.
|In this modern world, we are stressed in more ways than ever before. Our skin is insulted in many ways: the ozone layer is diminishing, there is more pollution, many of us are less physically active, we’re not sleeping enough and our diet is not as good as it should be … There is a lot of stress affecting our bodies and little by little, it shows in our skin.
What is the specific role of pollution in all of this?
Our skin is under ever greater assault from pollution and toxic elements in the environment (especially if you live in a big city) that it has not yet evolved enough to neutralize on its own. This is mostly from oxidative stress which is defined as an over production of destructive reactive oxygen species (ROS) generated by three major components relating to pollution: Particle Matter (PM), gases and aryl hydrocarbon receptors (AhR)1. Among the primary pollutants, PM (Particulate Matter) have been documented to impact skin especially in an urban population2. Particle Matter carry on several hundreds of chemicals that are toxic to the skin. It is very important to use products that will help protect against the damage being done by the pollution particles and that will help repair damage. Some skincare companies have been looking at better understanding the impact of the pollution on the skin, as well as what is going on in the skin. It is fascinating to know that some companies are very strong in their science and are looking into the genomics which will help possibly associate a certain genomic pattern with a higher susceptibility to pollution. Some researchers have also looked at the combined effect of pollution with other elements like sun exposure3 and some skincare companies are coming up with ways to protect and help repair combined damage. This is a fast-moving field and we are going to be able to address this very soon.
What do you see in the skin? What does pollution really do to the skin?
What is the relationship between air quality and skin conditions?
What are your top anti-pollution ingredients?
High on my list are SOD (Superoxide Dismutase), niacinamide and other antioxidants as well as some exfoliating ingredients such as salicylic acid that will help get pollution particles off the skin and/or out of the skin. The first step starts with proper cleansing to take pollution and dust off the skin. The second step is about repairing the skin using ingredients for wound healing and skin repair such as copper, niacinamide, vitamin A, vitamin C, gluthathione and others.
If I could create my own dream skincare product against pollution, I would combine some barrier elements such as a Hyaluronic Acid (a form of HA layering the skin in a breathable way but not allowing the pollution to reach it) with some additional ingredients such as niacinamide, caffeine, glutathione and vitamin A and C and other plant and sea extracts to help bind pollution and inactivate it, to ultimately protect and help repair damage done to the skin.
Are there any promising ingredients on the horizon?
What about the measurement of the anti-pollution effects of products?
Your View on Skincare Education
What does the future of skincare look like?
My view of the future of skin care is one that is uniquely designed for each patient based on their genetics. It will be individualized skin care and will offer the right amount of protection and repair and help avoid premature aging of the skin. Unfortunately, it may be a while before that is available in a way that has strong scientific backing and at a cost that is reasonable for the average person. There are excellent options available today, but selecting the best products and knowing the order in which to apply them, can be very confusing. Everyone want to use the best product for their skin. Patients often get information from sources that are not at all scientific, but sound very serious and often provide false information. I spend a lot of my time dispelling myths about the danger of sunscreens or about some of the products that my patients use that sound natural but do not have any evidence-based medicine…but meanwhile cost a lot of money. I guide them and help them navigate. It is however amazing to see that as a Doctor, I only have so much power. What my patients read or see on social media sites from some celebrities has very often more power and credibility in their eyes than my advice being always grounded and anchored in science.
What should be the role of dermatologist on Social Media?
I’m a member of the American Society of Dermatologic Surgery and Chair of the Social Media Committee. My goal is to help doctors be represented as the authority in skin care and aesthetics. This is an area where we have to be careful as physicians to maintain a level of dignity and respect that gives us authority. We need to be relatable and accessible, but not fall into the trap of thinking we are models or celebrities. It can be a fine line and one that is too easy to cross. I am hopeful that as starting the Social Media Committee, we will able to help better direct our members and other doctors and increase awareness to help educate the public on the best products and treatments available and that doctors are the go-to for these services.
The goal is for us to convey (in our own style) information about the services we provide, what a dermatologist is, what a dermatologist can do for you both from a medical and an aesthetic standpoint. So that whenever you go and see any doctor you have a level of confidence that you are in the right place and you know what to expect.
We are here to educate, to talk about safety, efficacy, treatment outcomes AND to be the GO TO source for accurate and honest information about things that are cutting edge.
What are your final words to protect your skin from the pollution threat?
The threat from pollution is real and it is not getting any better any time soon. Protect your skin and your health by eating a high antioxidant diet, by properly cleansing your skin and by using skincare products containing ingredients specifically tested against the most common toxins in pollution.
1. Krutmann Jet al. Pollution and skin: From epidemiological and mechanistic studies to clinical implications. Journal of Dermatological Science 2014 2. Lefebvre MA et al. consequences of urban pollution upon skin status; A controlled study in Shanghai area. Int J Cosmet Sci; 2006 June, 38 (3):217-23 3. J Soeur et al. Photo-pollution stress in skin: traces of pollutants from particulates metter impair redox homeostasis in keratinocytes to UVA 1. J. Dermatol Sci 2017 Ma; 86.(2):162-169 4. Kim J. Kim EH et al. Symptoms of atopic dermatitis are influenced by outdoor pollution. J. Allergy Clin lmmunol 2013;132:495-7 5. Roberts WE; Pollution as a risk factor for the development of melasma and other skin disorders of facial hyperpigmentation- is there a case to be made. J. Drugs; Dermatol 2016 Apr; 14 (4):337-41.