This Is Why 99% of Skin Conditions Don't Heal — And What Dermatologists Won't Tell You
What this video covers
On The Dr. Hyman Show, Dr. Mark Hyman hosts his first dermatologist guest, Dr. Mamina Turegano, a conventionally trained dermatologist who now practices integrative and functional dermatology. They argue that chronic conditions like acne, eczema, psoriasis, and rosacea are systemic problems that show up on the skin, and that mainstream dermatology’s topical creams and immune-suppressing drugs manage symptoms without addressing root causes. The conversation ranges from gut and hormone testing to skin aging, collagen, sunscreen safety, and Turegano’s own skincare routine; Hyman closes with a pre-order announcement for his book “100” on living 100 healthy years.
Key points
- Turegano says she takes a full history — diet, sleep, stress, hormones, menopause, environmental exposures, exercise — before treating, and identifies gut health and hormones as the two biggest overlooked drivers of acne, eczema, psoriasis, rosacea, and hair loss, pointing to established links such as higher rates of SIBO and H. pylori in rosacea patients.
- Hyman claims insulin resistance is central to skin health and cites Function Health data: 65% of the company’s more than half a million members have high insulin by Quest’s reference range, while he argues the optimal fasting insulin is under 5 — his own, he says, is 2 to 3.
- Hyman recounts a Cleveland Clinic comparison in which, he says, functional-medicine patients with psoriasis or rheumatoid arthritis outperformed the rheumatology department’s drug-treated patients “across the board,” and tells of a psoriatic arthritis patient on the biologic Stelara whose psoriasis, arthritis, migraines, reflux, irritable bowel, pre-diabetes, and depression all resolved within six weeks on rifaximin, an antifungal, probiotics, and his 10-day elimination diet — she stopped all her medications on her own and lost 20 pounds, he says.
- On aging, Turegano explains that cell turnover slows from roughly two weeks in babies to four-plus weeks in older adults, collagen and elastin break down, and fat and bone resorb; she cites a small study of about 60 midlife women in which strength training, compared with aerobic exercise, produced a thicker dermis, which she links to better insulin sensitivity, lower inflammation, and healthier mitochondria.
- Turegano ranks sun protection as the single biggest lever against skin aging — she says studies attribute roughly 80% of skin aging to UV — followed by cutting sugar (which she says glycates collagen and makes it brittle), sleep, exercise, and polyphenol-rich foods; topically, she puts retinoids and vitamin C after sunscreen.
- She says collagen peptide supplements have supportive data but notes much of it is industry-backed, and she describes topical exosomes as promising but still “the wild, wild west” with little safety data; she calls beef tallow as sun protection the most overrated trend, saying it does not protect skin from the sun.
- On sunscreen chemistry, Turegano notes the FDA classifies mineral sunscreens as generally recognized as safe while chemical sunscreens are not in that category because they absorb systemically — though she stresses chemical sunscreens remain effective and no human harm has been shown — and she pushes back on Hyman’s “if you wouldn’t eat it, don’t put it on your skin” rule, arguing the skin is a strong barrier and some foods, like lemon juice, damage skin.
- Hyman discloses sponsor relationships woven into the episode, including Timeline Nutrition’s Mitopure urolithin A, which he says he takes and whose science he reviewed, along with Seed probiotics and other products.