Dear Doctor: Whitney Bowe
The dermatologist and Pore House physician advisor speaks about her holistic approach to skincare, why she champions clean beauty, and the impact of the gut-brain-skin connection.
As one of the most in-demand dermatologists in the country, Dr. Whitney Bowe knows how hard it can be for patients to get access to dermatological care. Due to rapid growth in her practice, Dr. Bowe had to cap her patient list — which includes TV personalities and Grammy Award-winning artists — two years ago. To continue to help those she cannot treat, Dr. Bowe grows her community through social media, where she answers important questions from people struggling with skin concerns and interviews experts on popular topics in skin health. Read on to learn about her commitment to holistic care, why she believes clean beauty is here to stay, and how she hopes the pandemic will change the way patients seek and approach skin health.
How did you get started in medicine and what inspired you to choose your specialty?
When I was 10 years old, my family and I took a trip to the Caribbean. During our stay, we enjoyed a regional dish called conch chowder. Unfortunately, everyone in my family got ill shortly afterward. Though my family members recovered, I was seriously ill even after we returned to the States, and was in and out of the hospital that entire year. At first, the doctors were unclear about what was causing the problem, so they gave me antibiotic after antibiotic.
What they didn’t know was that I had a parasite, which cannot be effectively treated with antibiotics. So they kept administering more and more broad-spectrum antibiotics, which ended up causing more harm than good. I developed a type of infection called Clostridium difficile colitis (C. diff), which can happen when antibiotics kill off your healthy microbiome and a single pathogen overgrows in your system.
Thankfully, my doctors finally realized what was going on and I recovered my health fully. But I emerged from that experience not only with a strong desire to be my healthiest and happiest self, but also with a profound respect for the delicate balance between the good and the bad of our body’s microbiome. I followed this interest throughout my studies and into medical school.
During my rotations in medical school, I participated in an acne clinic where I interacted with patients who were difficult to connect with at first. At the start, most of them wouldn’t make eye contact with me, or they’d wear big baseball caps or use their hairstyle to cover their faces. As their therapy progressed and their skin cleared up, their psychological transformation was astounding. Their personalities finally came out. They started auditioning for school plays, going on dates, and becoming the best versions of themselves. Seeing firsthand how our skin directly influences our confidence in ourselves helped draw me toward the field of dermatology.
Can you tell us about your holistic approach to skin health and how it shapes your dermatological philosophy?
I view the skin as the window to your overall health. The skin is our largest organ, and it truly reflects how healthy we are on the inside. The food that we eat; the supplements that we take; and how we exercise, sleep, and manage stress all impact the health of our skin. Treating the skin from the outside in will never get at the root of the problem. In order to make sustainable, long-lasting changes to our skin, we have to look at the bigger picture.
When I work with my patients, my followers on social media, and my readers, I always delve into a comprehensive, holistic, and integrative approach to the skin. I talk about practical changes they can make in their daily lives that can have meaningful effects.
In my practice, I also utilize a lot of cutting edge technologies, including injectables and devices. But I always explain to my patients that if you want to get the most out of each procedure, you have to complement it with what you’re doing at home. I emphasize that diet, exercise routines, and stress management habits are just as important as the procedures we do in the office.
It’s also one of the reasons I’m so vocal on social media about lifestyle management. Since my practice is capped and I can’t help as many patients as I’d like in-person, I use my platform to help spread this vital information: you don’t have to spend a tremendous amount of money in the office to make impactful changes to your skin.
Speaking of which, you’ve embraced media and social media as a way to educate and inform patients. What do you see as the strengths, or pitfalls, of this mode of information sharing?
I love the community-building aspect of social media. My Instagram community is incredibly supportive. I genuinely look forward to checking in on that channel and engaging with my followers in a supportive and authentic way. I’ve recently started a new Instagram series called #dermdialogues where I answer questions that my followers submit, or I invite experts to engage in honest conversations on trending topics in the world of skincare.
I’m very transparent with my followers, and I try to answer as many of their questions as I can. The pitfalls or challenges of using social media to communicate are that I can’t provide medical advice. When individuals ask about their specific skin issues, I’m forced to answer in generalizations because I can’t advise people without examining them and doing a proper patient history.
It’s not quite the same as treating my own patients, who get a more personalized experience. Of course, I also can’t perform procedures through social media, and that’s one of the parts of my practice that I enjoy most. I love working with my hands and physically interacting with patients. Though I find that social media complements my practice nicely, it could never replace those in-office interactions that I cherish.
Let’s talk about the gut-brain-skin connection. What do you wish more people understood about this relationship?
The gut, brain, and skin are intimately connected. If you’re experiencing emotional or psychological stress — which I think we all are in the era of Covid — that alone can slow digestion. If you’re also eating a diet high in processed foods that are devoid of fiber, you’re going to slow digestion even more. And when digestion slows, it creates a shift in the type of bacteria in the gut, called dysbiosis.
This imbalance of gut bacteria can create increased permeability in our intestinal lining, meaning that the irritants that are supposed to be maintained within our intestines will begin to leak out into the bloodstream and trigger inflammation throughout our bodies — which will show up in the skin. This inflammatory cycle can lead to acne, rosacea, or eczema flare-ups, depending on which condition you’re genetically prone to.
But if we start to dial down our stress levels through proper sleeping, deep breathing techniques, or exercise — and if we improve our dietary choices by replacing refined carbs with whole foods that reflect the rainbow — we can restore the balance of bacteria in our gut. This restoration can help reseal our gut lining and stop the inflammatory cascade from triggering or worsening inflammatory changes in the skin.
In addition to helping with all different forms of chronic skin conditions, like acne, rosacea, eczema, and psoriasis, these lifestyle changes can also help with skin aging. This is because fine lines, wrinkles, and the loss of elasticity and firmness are also exacerbated by inflammation. So if you decrease inflammation through these simple gut-brain lifestyle changes, you’ll start to see some real benefits in your skin health.
It’s safe to say that the clean beauty trend is on the rise. Are all clean beauty products created equal?
The demand for clean is absolutely on the rise, but I don’t believe that clean beauty is a trend. I think it’s a movement. Ironically, the world of clean beauty is a bit messy, mostly because the word “clean” is not currently an FDA-regulated term, meaning that there’s no criteria that need to be met in order to use the word “clean” in marketing materials.
Consequently, there are some brands and retailers out there that truly ascribe to the pillars of clean beauty, like Credo Beauty, but there are also brands that simply use the word for marketing purposes — which we call greenwashing. Ultimately, I think clean beauty is an important and evolving space, and I hope it will help get us closer to having better access to safe and effective products.
How would you recommend getting started on the clean beauty train?
Choosing products that aren’t created with potential carcinogens or endocrine-disrupting chemicals will go a long way when it comes to supporting a healthy body. However, I don’t feel it’s necessary to toss out all your products and immediately replace them with clean alternatives. Even small changes make a difference in your overall body burden or the cumulative amount of potentially harmful chemicals you are exposed to each day. While many clean skincare and makeup products are now able to deliver beautiful results, some are not quite there yet in terms of performance.
What’s more, some clean beauty products are loaded with fragrances and essential oils, which might sensitize or irritate sensitive skin. In these instances, brands and consumers falsely assume that just because something is “natural” that it’s inherently safe and good for the skin. Poison ivy is natural, but it’s not good for your skin! I gravitate toward clean brands that combine safe synthetics with safe naturals, and choose ingredients based on their safety and efficacy rather than simply because they are labeled “natural” or “organic.”
If you’re starting out your transition to clean beauty products, I like to take what I call a “clean and clinical” approach. Start with the leave-on products you use every day — or multiple times a day — like deodorant or moisturizer, and experiment with different clean beauty alternatives to see which perform best.
Lip balms are another great place to start, since the oral mucosa is very thin, and ingredients tend to penetrate readily through that very delicate, fragile layer. Once you find clean beauty options that you love as everyday products, the next stage I’d recommend is finding replacements for rinse-off products. Because rinse-off products are in contact with the skin for a much shorter period of time — and are therefore much less likely to be absorbed into the bloodstream — there’s no immediate rush to replace these. So if you have a favorite cleanser that’s not clean, you can wait until it runs out before you shift over to a clean product.
Take your time finding products that you like and that work well, and always start your transition with the products you use most often, or that cover sensitive or larger parts of your body.
Covid-19 has shed light on the importance of flexible and accessible healthcare — especially when it comes to virtual care. As one of the physician advisors of Pore House, how do you see the pandemic changing the way patients take care of—and prioritize—their skin health?
It’s always been a bit difficult for patients to see a dermatologist. There are only so many dermatologists in the country and there’s often a long wait time for in-person visits. In some ways, Covid-19 has highlighted this accessibility problem even further. But Covid-19 has also granted us a much needed push toward the world of remote care. Being able to interact with and counsel patients remotely has really helped increase patient access to dermatological care.
Pore House takes this evolution further by recognizing that today’s patient isn’t just looking for a quick prescription. They want a more comprehensive approach. Pore House helps patients navigate their skin condition using holistic methods, like those I described in regard to diet, exercise, and sleep. Of course, sometimes a prescription is necessary. But Pore House understands that the prescription is only one frame of a much larger and more comprehensive picture. What’s more, patients don’t feel rushed in this approach. Instead, they feel like they can really interact with a provider who is thinking about their complete health and wellness — rather than just the one specific skin issue they’re presenting with.
I’m hopeful that dermatology, and healthcare in general, will use this time to think about how to permanently increase accessibility with some form of virtual care, and that patients will leverage this newfound access to seek out more forms of holistic and comprehensive care.
Vital Signs
Favorite podcast of the moment? The MindBodyGreen podcast. Jason is the best host!
Where is your favorite place to go for a walk in New York? Right outside my house with my 9-year-old! We walk all over the neighborhood together, holding hands. Now that it’s getting colder, we’re doing indoor dance parties instead!
What tips can you offer parents whose kids are frustrated with distance learning? I’m a big fan of blue light glasses and computer breaks where they can get up and move. Dance, gymnastics, tag… anything that gets the blood flowing in between those long screen sessions.
As we continue to protect ourselves and our communities by wearing masks in public, how can we protect against “maskne”? Gently exfoliate twice a week with an AHA (glycolic acid and lactic acid blends are my go-to). Moon Juice makes an incredible exfoliator that I absolutely love.
What’s one healthful habit you’d love to see patients adopt? Massage your face when applying moisturizer! It boosts blood flow and helps bring nutrients and oxygen to the skin — while also forcing you to carve out a few mindful moments that can reduce cortisol levels, thus protecting skin from stress-related aging. It essentially turns skincare into self-care — which is increasingly important these days.
You can learn more about Dr. Whitney Bowe here.
Know a great female doctor in NYC? We’d love to meet her, introduce us here!
