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[upbeat music playing]
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[narrator] There's a reason skin care
commercials don't zoom in that close.
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And if they do,
it's this pristine, animated landscape.
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A real close-up of skin
can be a little unsettling.
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Ew!
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Ew. What is that?
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[gasps]
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[narrator] Even the most perfect skin
is a rough and broken terrain,
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crisscrossed with oily gullies
and studded with hairs.
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And in this strange land,
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there be dragons.
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Scientists believe these Demodex mites
are on the face of every adult human.
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There are almost certainly some burrowed
into your face follicles right now.
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And they are far from alone.
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Our skin hosts vast herds
of bacteria, fungi,
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and even miniscule viruses.
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This isn't a harmful infestation.
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In fact, we need many
of these microscopic passengers
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to keep our skin healthy.
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But skin care companies
tell a very different story.
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Mainly, that what you need
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is an overwhelming array of products.
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[announcers] The first
acne-proofing gel cleanser.
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-Hyaluronic acid serum.
-Micro-sculpting cream.
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It's a cleanser and a mask.
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Hydration is the foundation
of healthy skin.
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Wake up to younger-looking skin
in just five…
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-[voices overlapping]
-[silence]
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[narrator] Can we trust all these products
to do what they promise?
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And is there some secret
to healthy, beautiful skin?
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[man 1] Let's begin with the skin,
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by taking a look at it
from the doctor's point of view.
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She has lovely skin.
That's what I was most impressed by.
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[man 2] If you keep your skin clean,
there's less chance
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that a disease will be able
to get started.
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If my skin's fresh and healthy-looking,
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I guess it's 'cause
I've gotten down to basics.
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From your chin to your ears.
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From your nostrils to the temples.
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[man 3] The healthy skin
is a beautiful skin.
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[Okonedo] If there's one thing the experts
want you to know about skin, it's that…
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It is our largest organ.
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Our largest organ.
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Our largest organ.
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[Okonedo] Skin is your immune system's
first and best line of defense.
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I like to use the analogy of a brick wall.
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So, the bricks are the cells,
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and the mortar is our natural oils.
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[Okonedo] This wall, the epidermis,
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is completely rebuilt about once a month.
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New cells are born down here
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and make their way to the surface,
where they flake off.
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The pores you can see are actually
the openings of hair follicles.
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They're nearly everywhere on your body,
not just the places that look hairy.
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Glands attached to the follicles put out
an oily, waxy substance called sebum.
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[Skotnicki] That helps lubricate our skin
and acidify our skin.
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[Okonedo] Your skin's pH isn't neutral.
It's closer to five.
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And that makes it harder
for harmful bacteria to grow.
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If your protective brick wall breaks down,
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it's easier for foreign particles
or germs to get in.
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Your immune system will leap into action,
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your skin will get red and itchy.
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And this whole army of immune cells
will detect and attack the intruders.
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And then, of course, there's the most
remarkable feature of your skin.
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The host of creatures who call it home.
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Billions of years before we evolved,
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microbes colonized
every corner of the globe.
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From Arctic glaciers,
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to sulfurous pools,
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to volcanic vents in the ocean floor.
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When skin finally showed up,
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that was just
one more habitat to colonize.
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You actually have trillions
of different bacteria, fungi,
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viruses, protozoa,
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even small insects.
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The skin has a very striking diversity
of different environments.
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[Okonedo] Your face is an oily marshland.
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Your armpits are dark, wet jungles.
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Your forearms are dry savannas.
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Your microbiome is first formed
when you are born into the world.
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You're suddenly populated
by your mother's biome,
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and that forms
the sort of concrete foundation
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that's going to stick with you
for the rest of your life.
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[Okonedo] And as you grow,
it continues to develop,
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shaped by your experiences.
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[Oh] So, that can be
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where you live,
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if you have pets,
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who you live with,
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and who you encounter on a regular basis.
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Each of us
have kind of a unique signature.
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[Okonedo] Scientists spent
the last couple of decades
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learning which species live where.
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Now they're trying to figure out
what all those critters are up to.
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There's a bacillus bacteria
living in between our toes
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that eats a compound
in our sweat called leucine,
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and it contributes
to that rank and sweaty foot smell.
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Why on earth would we want
to coevolve with this microbe
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that produces bad odors?
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It turns out that this bacillus
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is a very potent inhibitor
of fungal infections.
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[Okonedo] Our feet produce
a weird amount of leucine.
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It's almost as if our bodies
are laying out a feast for these bacteria
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so they'll keep us
from getting athlete's foot.
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Then there's Staphylococcus epidermidis,
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which is found at different sites
all over the body.
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Yeah, we love staph epidermidis.
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It can recruit immune cell types
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that allow us to heal wounds
and combat infection.
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-They can kill pathogenic bacteria.
-[bacteria shouts]
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[Okonedo] Antibiotics can do that too.
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[bacteria scream]
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Though helpful bacteria
are often collateral damage,
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and some pathogens are evolving
resistance to these drugs.
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It's a terrifying trend around the world,
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especially in hospitals.
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Julia Oh's lab is genetically engineering
a strain of epidermidis
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to attack one of the most common
antibiotic-resistant bacteria.
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Basically like a search and destroy bot.
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[Okonedo] This souped-up epidermidis
only attacks
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when it senses
this one particular pathogen.
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[Oh] And then produces
a kind of napalm in response.
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[Okonedo] And finally,
scientists think that microbes
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train our immune systems
to tell friend from foe,
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so we only react to things
that are actually harmful.
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We don't know exactly what would
happen without our microbiomes.
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We've never made germ-free people.
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But we have made germ-free
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mice.
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They grow up not having been exposed
to any live microbes.
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They live their lives in a bubble.
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And these mice
have all sorts of different defects.
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[Okonedo] Without that microbial boot camp
in early life, their immune systems are
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confused.
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They might ignore real threats,
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while overreacting to harmless substances,
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even attacking their own cells.
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Children are growing up
in more sterile environments,
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and more and more of them
are coming down with the disorders
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of an overactive immune system.
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Eczema, allergy,
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asthma, hay fever.
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I mean, it's skyrocketed.
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[Okonedo] But not in Amish country.
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Scientists report that Amish kids
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have surprisingly low rates
of asthma and allergies.
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[Hamblin] Amish children grow up
with lots of siblings,
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spend lots of time outdoors,
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and tend to have stables
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of lots of different animals,
right up against the house.
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[Okonedo] They're exposed
to lots of different microbes,
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and that seems to help them develop
a well-trained immune system.
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The secret to healthy skin
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is partly just not messing up
your microbiome.
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And for hundreds of thousands of years,
humans pretty much left theirs alone.
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Until they created civilization.
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All over the world, humans started
to wash their skin with water,
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often as part of religious rituals.
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Then more and more of them
packed into cities,
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and communicable diseases flourished
as they never had before.
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In the mid-19th century,
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scientists discovered the culprit.
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Germs.
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Some of the first microbes we discovered
were the ones that do us harm.
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Cholera pandemics
had killed millions around the globe.
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The plague had wiped out
nearly a third of Europe.
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And in the US,
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tuberculosis was responsible
for a quarter of all deaths.
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The idea came to be that maybe
we should wash these things off.
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[Okonedo] We'd been using
different forms of soap for centuries,
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mostly to clean laundry.
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But now, public health officials started
pushing for its regular use on skin.
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[man 1] The aim of this technique
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is to reduce the number
of pathogenic organisms.
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[man 2] And that's the special reason
why people wash with soap.
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In the early 20th century,
you had the soap boom.
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There were beauty soaps
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bath soaps,
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health soaps,
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all of them
fundamentally the same product.
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[Okonedo] Luxury soaps for the wealthy
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were more expensive,
but functionally identical.
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It became a branded product,
and with that came advertising.
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[Okonedo] Soap makers pioneered
the marketing tricks
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that are still used today.
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Like celebrity endorsements.
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This one features women's rights luminary
Elizabeth Cady Stanton.
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This ad,
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with its sensual embrace
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and risqué slogan,
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was one of the first ever to prove
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that sex sells.
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What these products were selling
was actually a sense of superiority,
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whether that be to another race,
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to another class.
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[Okonedo] Soap ads often deployed
racist caricatures,
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depicting people with darker skin
as dirty.
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Or as savages, who needed
the civilizing influence of soap.
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Soap was about beauty,
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and beautiful skin was white skin.
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[Hamblin] Basically, if there was
an insecurity that was really deeply held,
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the soap industry found a way
to prey upon it and promise a solution.
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[Skotnicki]
Soap would transform your life.
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You would be more socially acceptable.
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Saying it's going to make you glow
and make you find a husband.
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[Okonedo] And soap companies
used science-y language
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to bolster their claims.
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They made their pitch to housewives
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by funding and producing
daytime radio dramas.
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And these "soap operas" soon moved to TV.
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The makers of Ivory soap
owned The Guiding Light,
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until it ended in 2009.
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[man on TV] Presented by Ivory soap,
the most famous soap in the world.
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By the mid-20th century,
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at least in wealthy countries,
every person was using soap regularly.
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[Okonedo] And they were using it
all over their bodies every day.
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Soap is a simple enough chemical,
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one that can clear away
the accumulated grime of civilization,
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the chemicals that irritate your skin,
like pollution and makeup,
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and disease-causing germs.
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Washing with soap has saved so many lives,
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but soap also erodes the mortar
in that brick wall,
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disrupting your defenses.
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And, because it's pretty basic,
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soap can change the pH of your skin.
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When we overclean and over-wash,
you're preventing it from doing its job.
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You've messed with the chemistry
of your skin. You've changed the oils.
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If the oil are sort of the soil
in which your microbial ecosystem grows,
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you've messed with it enough
that what comes back
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is a little imbalanced.
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[Okonedo] Decades ago,
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people didn't know about these
potential problems with overusing soap.
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They just noticed
it could make you feel dry and itchy.
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The industry
found a solution for that too.
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[woman on TV] Soap dries your skin,
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but Dove creams your skin while you wash.
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[Okonedo] Dove contained a moisturizer.
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That introduced this whole new idea
that you might need other products,
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products to actually counteract
the soaps you've been using.
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You need a second thing,
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which opened the door
for a whole flood of other products,
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besides just soap.
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[Okonedo] In 1968,
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Clinique debuted
with a three-step routine,
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00:12:07,101 --> 00:12:10,313
which they suggested
was as essential as brushing your teeth.
246
00:12:10,396 --> 00:12:13,066
Some of those old soap makers diversified
247
00:12:13,149 --> 00:12:15,235
and grew into international giants.
248
00:12:16,069 --> 00:12:18,404
And new players entered the scene.
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You had a huge explosion
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00:12:20,698 --> 00:12:23,826
of K-beauty brands
coming into the Western world,
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and everyone went completely mad for it.
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00:12:26,287 --> 00:12:29,666
["Gidalyuh" by A-Dream, Sara Lynn Choi
& HYON D playing]
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00:12:34,003 --> 00:12:38,091
The Korean ten-step skin-care routine
was something I coined many years ago.
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00:12:38,174 --> 00:12:40,551
Around 2015
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is when I started to see
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00:12:42,512 --> 00:12:45,682
more and more people
talking about the trend.
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00:12:45,765 --> 00:12:47,392
[Okonedo] For a few decades now,
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00:12:47,475 --> 00:12:51,437
South Korea has been trying
to increase exports of its cultural goods.
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00:12:51,521 --> 00:12:52,689
K-dramas,
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00:12:53,356 --> 00:12:54,482
K-pop,
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00:12:55,233 --> 00:12:57,110
and K-beauty.
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00:12:57,819 --> 00:13:00,697
[Cho] In Korea, skin is always first.
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00:13:00,780 --> 00:13:04,617
They really value skin
as being more important
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00:13:04,701 --> 00:13:07,161
than makeup or fashion.
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00:13:07,245 --> 00:13:10,248
They are quite brilliant.
They're using ingredients
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00:13:10,331 --> 00:13:13,626
that a lot of brands hadn't really
considered using in the past.
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00:13:22,510 --> 00:13:24,304
[Okonedo] Scientists
are still figuring out
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00:13:24,387 --> 00:13:26,764
if and how all these ingredients work,
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00:13:26,848 --> 00:13:30,351
but K-beauty products in general
have gotten enthusiastic reviews.
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They were really well-made,
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00:13:32,312 --> 00:13:34,314
and also they were inexpensive.
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00:13:35,565 --> 00:13:39,694
If you're completely new to skin care,
and you wanna get started,
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I would just recommend
going with a few basics.
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00:13:42,947 --> 00:13:46,367
If you're putting on sunscreen,
makeup, aftershave,
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you wanna wash that stuff off
at the end of the day.
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00:13:49,120 --> 00:13:51,581
[Okonedo] There are now
a bunch of alternatives to soap,
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00:13:51,664 --> 00:13:54,042
like synthetic detergents
and oil-based cleansers,
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00:13:54,125 --> 00:13:57,545
that can be gentler
on the mortar of our walls. Still…
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00:13:57,628 --> 00:14:01,174
You'd be amazed at the number
of cleansers that strip your skin.
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00:14:01,257 --> 00:14:04,844
After you cleanse,
usually your pH is all out of whack.
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00:14:04,927 --> 00:14:07,430
[Okonedo] And that's where toners come in.
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00:14:07,513 --> 00:14:10,975
Generally, they move your skin
towards a healthy acidity,
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00:14:11,059 --> 00:14:13,186
just like your sebum does naturally.
284
00:14:14,520 --> 00:14:17,648
Moisturizers can also help
repair the damage of cleansing.
285
00:14:17,732 --> 00:14:20,526
We have moisturizers because
you have to put back what you've removed.
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00:14:20,610 --> 00:14:24,155
[Okonedo] Some moisturizers
actually mimic our natural mortar.
287
00:14:25,073 --> 00:14:27,784
You probably don't need
to exfoliate when you're young.
288
00:14:27,867 --> 00:14:30,787
Your skin does a good job
replacing itself naturally.
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00:14:30,870 --> 00:14:32,163
[Fetto] As you get older,
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00:14:32,246 --> 00:14:35,666
your skin cell turnover slows down.
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00:14:35,750 --> 00:14:38,002
Your skin starts to look really dull.
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00:14:38,086 --> 00:14:40,588
So you may want to exfoliate once a week
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00:14:40,671 --> 00:14:42,632
as you get older, 40 plus.
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00:14:44,342 --> 00:14:46,302
[Okonedo] Then there are
all the acne products.
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00:14:46,386 --> 00:14:49,680
Remember,
your skin is covered in hair follicles,
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00:14:49,764 --> 00:14:52,558
and they can get blocked
by sebum and dead cells.
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00:14:53,309 --> 00:14:56,396
If this blockage stays buried,
it's a whitehead.
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00:14:56,479 --> 00:14:59,399
Expose it to air,
and it oxidizes, darkening.
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00:15:00,441 --> 00:15:02,735
Bacteria can grow in these blockages.
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00:15:02,819 --> 00:15:05,363
Immune cells can rush in
to fight infection,
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00:15:05,446 --> 00:15:07,448
and dead cells start to pile up.
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00:15:07,532 --> 00:15:09,867
That's the white stuff inside of a zit.
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00:15:10,535 --> 00:15:13,538
We still don't fully understand
all the factors leading to acne,
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00:15:13,621 --> 00:15:15,873
genetics, hormones, bacteria,
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00:15:15,957 --> 00:15:19,377
all the stuff we put on our skin,
or how they interact.
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00:15:19,460 --> 00:15:22,088
Dermatologists argue
about the role of diet.
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00:15:22,171 --> 00:15:24,757
It seems like greasy foods
aren't a problem,
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00:15:24,841 --> 00:15:26,926
but sugary foods might be.
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00:15:27,009 --> 00:15:30,888
But we do know one thing.
Acne isn't caused by dirty skin.
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00:15:30,972 --> 00:15:34,350
I had pretty bad acne as a teenager.
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00:15:34,434 --> 00:15:36,227
I was under the idea
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00:15:36,310 --> 00:15:39,355
that if I used soap
and washed three times a day,
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00:15:39,439 --> 00:15:41,357
I could get off
whatever these microbes were
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00:15:41,441 --> 00:15:43,901
that was causing me to break out.
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00:15:43,985 --> 00:15:48,030
And it seems pretty clear
that I was probably making things worse.
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00:15:48,698 --> 00:15:51,325
[Okonedo] Some scientists think
the best way to treat acne
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00:15:51,409 --> 00:15:53,828
might be to add bacteria to our skin
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00:15:53,911 --> 00:15:57,206
to establish a balanced,
healthy microbiome.
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00:15:59,917 --> 00:16:02,628
[Fetto] So, the word anti-aging…
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00:16:05,089 --> 00:16:06,215
It's a problem.
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00:16:06,299 --> 00:16:09,218
It makes it automatically feel like
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00:16:09,302 --> 00:16:10,970
there is something wrong
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00:16:11,053 --> 00:16:13,514
with you having wrinkles.
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00:16:13,598 --> 00:16:17,101
You want to age.
That is a natural process of life.
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00:16:17,768 --> 00:16:20,563
[Okonedo] Below your epidermis
is a thicker dermis layer
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00:16:20,646 --> 00:16:24,317
that's woven through with proteins
called elastin and collagen.
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00:16:24,400 --> 00:16:27,570
When your skin is stretched,
this matrix helps it bounce back.
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00:16:28,196 --> 00:16:30,907
And as we age, we produce less and less,
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00:16:30,990 --> 00:16:33,367
which allows the skin to fold and wrinkle.
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00:16:33,951 --> 00:16:36,579
Certain things speed up this process.
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00:16:36,662 --> 00:16:38,706
Toxins, pollution,
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00:16:38,789 --> 00:16:41,918
and the sun's UV rays,
which can also cause cancer.
333
00:16:42,001 --> 00:16:45,171
A pigment called melanin
produced in these cells
334
00:16:45,254 --> 00:16:47,173
can block some of these rays.
335
00:16:47,256 --> 00:16:49,634
The more melanin you have,
the darker your skin is.
336
00:16:49,717 --> 00:16:53,429
And that extra protection
means darker skin seems to age slower.
337
00:16:53,513 --> 00:16:55,056
But we still need SPF,
338
00:16:55,139 --> 00:16:59,101
because we are still susceptible
to the UV rays of the sun.
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00:16:59,185 --> 00:17:01,270
[Okonedo] Most other
anti-aging ingredients
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00:17:01,354 --> 00:17:03,773
aren't backed up by a lot of evidence.
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00:17:03,856 --> 00:17:07,193
The only thing
that's really been proven scientifically
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00:17:07,276 --> 00:17:08,986
with good studies
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00:17:09,070 --> 00:17:11,155
is retinoic acid and retinol.
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00:17:11,906 --> 00:17:14,242
[Okonedo] These spur
the production of collagen,
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00:17:14,325 --> 00:17:18,287
but can irritate your skin and shouldn't
be used by pregnant women.
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00:17:20,248 --> 00:17:23,834
To recap,
your skin is doing a lot naturally,
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00:17:23,918 --> 00:17:27,463
so try to avoid using, or overusing,
products that mess that up.
348
00:17:28,047 --> 00:17:31,467
A lot of exfoliating scrubs
and harsher, foamy soaps
349
00:17:31,551 --> 00:17:33,469
can damage your brick wall.
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00:17:33,553 --> 00:17:35,930
Look for cleansers with a low pH.
351
00:17:36,013 --> 00:17:38,391
And if you're concerned
about a skin condition,
352
00:17:38,474 --> 00:17:41,519
talk to a dermatologist.
There might be treatments that can help.
353
00:17:42,019 --> 00:17:44,689
But don't worry too much about a few zits.
354
00:17:44,772 --> 00:17:48,276
The idea that we all need to be completely
rid of these things all the time
355
00:17:48,359 --> 00:17:49,819
is artificial.
356
00:17:49,902 --> 00:17:53,739
The industry has a way
of pathologizing irregularities
357
00:17:53,823 --> 00:17:55,908
that are not actual medical issues.
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00:17:55,992 --> 00:17:57,994
Having pimples
359
00:17:58,077 --> 00:18:00,621
is not necessarily a problem.
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00:18:01,539 --> 00:18:03,541
[Okonedo] Just like a century ago,
361
00:18:03,624 --> 00:18:07,128
skin care ads today play up
science-y images and language.
362
00:18:07,211 --> 00:18:10,548
The latest buzzwords
are pre and probiotic.
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00:18:10,631 --> 00:18:14,010
These products are supposed
to enhance your skin microbiome.
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00:18:14,093 --> 00:18:17,179
We don't have evidence
that any of these products
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00:18:17,263 --> 00:18:19,098
are helpful in themselves.
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00:18:19,682 --> 00:18:22,143
[Okonedo] But in one respect,
the industry appears
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00:18:22,226 --> 00:18:23,811
to have radically changed.
368
00:18:23,894 --> 00:18:26,272
[Fetto] We may look at
advertising right now
369
00:18:26,355 --> 00:18:28,190
and believe that
370
00:18:28,274 --> 00:18:32,194
the skin care industry
is incredibly inclusive.
371
00:18:32,820 --> 00:18:34,822
But that's just forward facing.
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00:18:35,448 --> 00:18:38,367
So many brands that I speak to,
373
00:18:38,451 --> 00:18:40,828
the journey their product has taken
374
00:18:40,911 --> 00:18:42,747
from conception
375
00:18:42,830 --> 00:18:45,124
to when it actually hits the shelves,
376
00:18:45,207 --> 00:18:47,418
in no part of that journey
377
00:18:47,501 --> 00:18:51,380
has there been anyone
that is not Caucasian.
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00:18:52,882 --> 00:18:55,718
[Okonedo] When Dove released
this ad in 2017,
379
00:18:56,385 --> 00:18:59,305
some saw ugly echoes of an earlier time.
380
00:18:59,388 --> 00:19:02,224
Dove apologized, and took down the ad,
381
00:19:02,308 --> 00:19:05,144
but Dove's parent company Unilever
sells products
382
00:19:05,227 --> 00:19:08,189
that are designed to whiten your skin.
383
00:19:08,272 --> 00:19:10,274
[Fetto] Quite a few brands, huge brands,
384
00:19:10,358 --> 00:19:13,152
have developed skin-lightening creams,
385
00:19:13,235 --> 00:19:15,237
and they've been selling those for years.
386
00:19:15,988 --> 00:19:18,407
Following the death of George Floyd
387
00:19:18,491 --> 00:19:22,536
and all the protests
that happened all over the world,
388
00:19:22,620 --> 00:19:25,331
rather than taking
these products off the market,
389
00:19:25,414 --> 00:19:27,541
they just changed their names.
390
00:19:27,625 --> 00:19:29,460
It's solved nothing.
391
00:19:29,543 --> 00:19:31,003
What is the messaging?
392
00:19:31,087 --> 00:19:33,172
Whiter is better.
393
00:19:33,255 --> 00:19:35,091
[echoing] Whiter is better.
394
00:19:35,174 --> 00:19:38,761
[Okonedo] We're told we need to have
lighter skin, cleaner skin, dewy,
395
00:19:38,844 --> 00:19:40,554
glowing, poreless skin.
396
00:19:40,638 --> 00:19:43,516
And we need more products to get us there.
397
00:19:44,266 --> 00:19:48,354
We are using
way too many products on our skin.
398
00:19:48,437 --> 00:19:50,523
If we're healthy doing less,
399
00:19:50,606 --> 00:19:52,566
why don't we do less?
400
00:19:52,650 --> 00:19:54,735
I use water only.
401
00:19:55,403 --> 00:19:56,737
I always wash my hands.
402
00:19:56,821 --> 00:19:59,281
I'm very good about
washing my hands with soap,
403
00:19:59,365 --> 00:20:02,618
but the rest of my body is just water.
404
00:20:02,702 --> 00:20:07,498
You both get used to the feeling,
and your body seems to adapt a little bit.
405
00:20:08,207 --> 00:20:09,959
Oh my God. I mean,
406
00:20:10,042 --> 00:20:12,962
that would not work for me.
It just wouldn't.
407
00:20:13,045 --> 00:20:15,172
I think my skin would freak out.
408
00:20:15,256 --> 00:20:19,218
So I don't think
any skin needs 15 products,
409
00:20:19,301 --> 00:20:22,805
but I don't think every skin
only needs three products.
410
00:20:23,597 --> 00:20:27,518
[Okonedo] And remember, products aren't
the only way we influence our skin.
411
00:20:27,601 --> 00:20:30,896
Skin is actually a beacon
for our overall health.
412
00:20:30,980 --> 00:20:33,023
[Hamblin] How we're sleeping,
how we're eating,
413
00:20:33,107 --> 00:20:34,650
how much stress we're under.
414
00:20:34,734 --> 00:20:38,571
[Okonedo] Staying hydrated, exercising,
spending time outdoors.
415
00:20:38,654 --> 00:20:42,366
All of those factors really have an impact
on what your skin looks like.
416
00:20:42,450 --> 00:20:46,287
There are so many different ways
to take care of your skin correctly.
417
00:20:46,370 --> 00:20:48,956
There are so many different ways
to do it right.
418
00:20:49,039 --> 00:20:52,626
You are a unique individual.
You have co-evolved with your microbes.
419
00:20:52,710 --> 00:20:54,336
Skin care can be a fun place
420
00:20:54,420 --> 00:20:57,631
to discover
that unique part about yourself.
421
00:20:57,715 --> 00:20:59,175
And…
422
00:21:01,844 --> 00:21:04,263
there are lots of ways to be normal.
423
00:21:05,181 --> 00:21:08,976
[closing theme music playing]