Explained (2018–…): Season 3, Episode 7 - Your Skin - full transcript

[upbeat music playing]

[narrator] There's a reason skin care
commercials don't zoom in that close.

And if they do,
it's this pristine, animated landscape.

A real close-up of skin
can be a little unsettling.

Ew!

Ew. What is that?

[gasps]

[narrator] Even the most perfect skin
is a rough and broken terrain,

crisscrossed with oily gullies
and studded with hairs.

And in this strange land,

there be dragons.



Scientists believe these Demodex mites
are on the face of every adult human.

There are almost certainly some burrowed
into your face follicles right now.

And they are far from alone.

Our skin hosts vast herds
of bacteria, fungi,

and even miniscule viruses.

This isn't a harmful infestation.

In fact, we need many
of these microscopic passengers

to keep our skin healthy.

But skin care companies
tell a very different story.

Mainly, that what you need

is an overwhelming array of products.

[announcers] The first
acne-proofing gel cleanser.

-Hyaluronic acid serum.
-Micro-sculpting cream.

It's a cleanser and a mask.



Hydration is the foundation
of healthy skin.

Wake up to younger-looking skin
in just five…

-[voices overlapping]
-[silence]

[narrator] Can we trust all these products
to do what they promise?

And is there some secret
to healthy, beautiful skin?

[man 1] Let's begin with the skin,

by taking a look at it
from the doctor's point of view.

She has lovely skin.
That's what I was most impressed by.

[man 2] If you keep your skin clean,
there's less chance

that a disease will be able
to get started.

If my skin's fresh and healthy-looking,

I guess it's 'cause
I've gotten down to basics.

From your chin to your ears.

From your nostrils to the temples.

[man 3] The healthy skin
is a beautiful skin.

[Okonedo] If there's one thing the experts
want you to know about skin, it's that…

It is our largest organ.

Our largest organ.

Our largest organ.

[Okonedo] Skin is your immune system's
first and best line of defense.

I like to use the analogy of a brick wall.

So, the bricks are the cells,

and the mortar is our natural oils.

[Okonedo] This wall, the epidermis,

is completely rebuilt about once a month.

New cells are born down here

and make their way to the surface,
where they flake off.

The pores you can see are actually
the openings of hair follicles.

They're nearly everywhere on your body,
not just the places that look hairy.

Glands attached to the follicles put out
an oily, waxy substance called sebum.

[Skotnicki] That helps lubricate our skin
and acidify our skin.

[Okonedo] Your skin's pH isn't neutral.
It's closer to five.

And that makes it harder
for harmful bacteria to grow.

If your protective brick wall breaks down,

it's easier for foreign particles
or germs to get in.

Your immune system will leap into action,

your skin will get red and itchy.

And this whole army of immune cells
will detect and attack the intruders.

And then, of course, there's the most
remarkable feature of your skin.

The host of creatures who call it home.

Billions of years before we evolved,

microbes colonized
every corner of the globe.

From Arctic glaciers,

to sulfurous pools,

to volcanic vents in the ocean floor.

When skin finally showed up,

that was just
one more habitat to colonize.

You actually have trillions
of different bacteria, fungi,

viruses, protozoa,

even small insects.

The skin has a very striking diversity
of different environments.

[Okonedo] Your face is an oily marshland.

Your armpits are dark, wet jungles.

Your forearms are dry savannas.

Your microbiome is first formed
when you are born into the world.

You're suddenly populated
by your mother's biome,

and that forms
the sort of concrete foundation

that's going to stick with you
for the rest of your life.

[Okonedo] And as you grow,
it continues to develop,

shaped by your experiences.

[Oh] So, that can be

where you live,

if you have pets,

who you live with,

and who you encounter on a regular basis.

Each of us
have kind of a unique signature.

[Okonedo] Scientists spent
the last couple of decades

learning which species live where.

Now they're trying to figure out
what all those critters are up to.

There's a bacillus bacteria
living in between our toes

that eats a compound
in our sweat called leucine,

and it contributes
to that rank and sweaty foot smell.

Why on earth would we want
to coevolve with this microbe

that produces bad odors?

It turns out that this bacillus

is a very potent inhibitor
of fungal infections.

[Okonedo] Our feet produce
a weird amount of leucine.

It's almost as if our bodies
are laying out a feast for these bacteria

so they'll keep us
from getting athlete's foot.

Then there's Staphylococcus epidermidis,

which is found at different sites
all over the body.

Yeah, we love staph epidermidis.

It can recruit immune cell types

that allow us to heal wounds
and combat infection.

-They can kill pathogenic bacteria.
-[bacteria shouts]

[Okonedo] Antibiotics can do that too.

[bacteria scream]

Though helpful bacteria
are often collateral damage,

and some pathogens are evolving
resistance to these drugs.

It's a terrifying trend around the world,

especially in hospitals.

Julia Oh's lab is genetically engineering
a strain of epidermidis

to attack one of the most common
antibiotic-resistant bacteria.

Basically like a search and destroy bot.

[Okonedo] This souped-up epidermidis
only attacks

when it senses
this one particular pathogen.

[Oh] And then produces
a kind of napalm in response.

[Okonedo] And finally,
scientists think that microbes

train our immune systems
to tell friend from foe,

so we only react to things
that are actually harmful.

We don't know exactly what would
happen without our microbiomes.

We've never made germ-free people.

But we have made germ-free

mice.

They grow up not having been exposed
to any live microbes.

They live their lives in a bubble.

And these mice
have all sorts of different defects.

[Okonedo] Without that microbial boot camp
in early life, their immune systems are

confused.

They might ignore real threats,

while overreacting to harmless substances,

even attacking their own cells.

Children are growing up
in more sterile environments,

and more and more of them
are coming down with the disorders

of an overactive immune system.

Eczema, allergy,

asthma, hay fever.

I mean, it's skyrocketed.

[Okonedo] But not in Amish country.

Scientists report that Amish kids

have surprisingly low rates
of asthma and allergies.

[Hamblin] Amish children grow up
with lots of siblings,

spend lots of time outdoors,

and tend to have stables

of lots of different animals,
right up against the house.

[Okonedo] They're exposed
to lots of different microbes,

and that seems to help them develop
a well-trained immune system.

The secret to healthy skin

is partly just not messing up
your microbiome.

And for hundreds of thousands of years,
humans pretty much left theirs alone.

Until they created civilization.

All over the world, humans started
to wash their skin with water,

often as part of religious rituals.

Then more and more of them
packed into cities,

and communicable diseases flourished
as they never had before.

In the mid-19th century,

scientists discovered the culprit.

Germs.

Some of the first microbes we discovered
were the ones that do us harm.

Cholera pandemics
had killed millions around the globe.

The plague had wiped out
nearly a third of Europe.

And in the US,

tuberculosis was responsible
for a quarter of all deaths.

The idea came to be that maybe
we should wash these things off.

[Okonedo] We'd been using
different forms of soap for centuries,

mostly to clean laundry.

But now, public health officials started
pushing for its regular use on skin.

[man 1] The aim of this technique

is to reduce the number
of pathogenic organisms.

[man 2] And that's the special reason
why people wash with soap.

In the early 20th century,
you had the soap boom.

There were beauty soaps

bath soaps,

health soaps,

all of them
fundamentally the same product.

[Okonedo] Luxury soaps for the wealthy

were more expensive,
but functionally identical.

It became a branded product,
and with that came advertising.

[Okonedo] Soap makers pioneered 
the marketing tricks

that are still used today.

Like celebrity endorsements.

This one features women's rights luminary
Elizabeth Cady Stanton.

This ad,

with its sensual embrace

and risqué slogan,

was one of the first ever to prove

that sex sells.

What these products were selling
was actually a sense of superiority,

whether that be to another race,

to another class.

[Okonedo] Soap ads often deployed
racist caricatures,

depicting people with darker skin
as dirty.

Or as savages, who needed
the civilizing influence of soap.

Soap was about beauty,

and beautiful skin was white skin.

[Hamblin] Basically, if there was
an insecurity that was really deeply held,

the soap industry found a way
to prey upon it and promise a solution.

[Skotnicki]
Soap would transform your life.

You would be more socially acceptable.

Saying it's going to make you glow
and make you find a husband.

[Okonedo] And soap companies
used science-y language

to bolster their claims.

They made their pitch to housewives

by funding and producing
daytime radio dramas.

And these "soap operas" soon moved to TV.

The makers of Ivory soap
owned The Guiding Light,

until it ended in 2009.

[man on TV] Presented by Ivory soap,
the most famous soap in the world.

By the mid-20th century,

at least in wealthy countries,
every person was using soap regularly.

[Okonedo] And they were using it
all over their bodies every day.

Soap is a simple enough chemical,

one that can clear away
the accumulated grime of civilization,

the chemicals that irritate your skin,
like pollution and makeup,

and disease-causing germs.

Washing with soap has saved so many lives,

but soap also erodes the mortar
in that brick wall,

disrupting your defenses.

And, because it's pretty basic,

soap can change the pH of your skin.

When we overclean and over-wash,
you're preventing it from doing its job.

You've messed with the chemistry
of your skin. You've changed the oils.

If the oil are sort of the soil
in which your microbial ecosystem grows,

you've messed with it enough
that what comes back

is a little imbalanced.

[Okonedo] Decades ago,

people didn't know about these
potential problems with overusing soap.

They just noticed
it could make you feel dry and itchy.

The industry
found a solution for that too.

[woman on TV] Soap dries your skin,

but Dove creams your skin while you wash.

[Okonedo] Dove contained a moisturizer.

That introduced this whole new idea
that you might need other products,

products to actually counteract
the soaps you've been using.

You need a second thing,

which opened the door
for a whole flood of other products,

besides just soap.

[Okonedo] In 1968,

Clinique debuted
with a three-step routine,

which they suggested
was as essential as brushing your teeth.

Some of those old soap makers diversified

and grew into international giants.

And new players entered the scene.

You had a huge explosion

of K-beauty brands
coming into the Western world,

and everyone went completely mad for it.

["Gidalyuh" by A-Dream, Sara Lynn Choi
& HYON D playing]

The Korean ten-step skin-care routine
was something I coined many years ago.

Around 2015

is when I started to see

more and more people
talking about the trend.

[Okonedo] For a few decades now,

South Korea has been trying
to increase exports of its cultural goods.

K-dramas,

K-pop,

and K-beauty.

[Cho] In Korea, skin is always first.

They really value skin
as being more important

than makeup or fashion.

They are quite brilliant.
They're using ingredients

that a lot of brands hadn't really
considered using in the past.

[Okonedo] Scientists
are still figuring out

if and how all these ingredients work,

but K-beauty products in general
have gotten enthusiastic reviews.

They were really well-made,

and also they were inexpensive.

If you're completely new to skin care,
and you wanna get started,

I would just recommend
going with a few basics.

If you're putting on sunscreen,
makeup, aftershave,

you wanna wash that stuff off
at the end of the day.

[Okonedo] There are now
a bunch of alternatives to soap,

like synthetic detergents
and oil-based cleansers,

that can be gentler
on the mortar of our walls. Still…

You'd be amazed at the number
of cleansers that strip your skin.

After you cleanse,
usually your pH is all out of whack.

[Okonedo] And that's where toners come in.

Generally, they move your skin
towards a healthy acidity,

just like your sebum does naturally.

Moisturizers can also help
repair the damage of cleansing.

We have moisturizers because
you have to put back what you've removed.

[Okonedo] Some moisturizers
actually mimic our natural mortar.

You probably don't need
to exfoliate when you're young.

Your skin does a good job
replacing itself naturally.

[Fetto] As you get older,

your skin cell turnover slows down.

Your skin starts to look really dull.

So you may want to exfoliate once a week

as you get older, 40 plus.

[Okonedo] Then there are
all the acne products.

Remember,
your skin is covered in hair follicles,

and they can get blocked
by sebum and dead cells.

If this blockage stays buried,
it's a whitehead.

Expose it to air,
and it oxidizes, darkening.

Bacteria can grow in these blockages.

Immune cells can rush in
to fight infection,

and dead cells start to pile up.

That's the white stuff inside of a zit.

We still don't fully understand
all the factors leading to acne,

genetics, hormones, bacteria,

all the stuff we put on our skin,
or how they interact.

Dermatologists argue
about the role of diet.

It seems like greasy foods
aren't a problem,

but sugary foods might be.

But we do know one thing.
Acne isn't caused by dirty skin.

I had pretty bad acne as a teenager.

I was under the idea

that if I used soap
and washed three times a day,

I could get off
whatever these microbes were

that was causing me to break out.

And it seems pretty clear
that I was probably making things worse.

[Okonedo] Some scientists think
the best way to treat acne

might be to add bacteria to our skin

to establish a balanced,
healthy microbiome.

[Fetto] So, the word anti-aging…

It's a problem.

It makes it automatically feel like

there is something wrong

with you having wrinkles.

You want to age.
That is a natural process of life.

[Okonedo] Below your epidermis
is a thicker dermis layer

that's woven through with proteins
called elastin and collagen.

When your skin is stretched,
this matrix helps it bounce back.

And as we age, we produce less and less,

which allows the skin to fold and wrinkle.

Certain things speed up this process.

Toxins, pollution,

and the sun's UV rays,
which can also cause cancer.

A pigment called melanin
produced in these cells

can block some of these rays.

The more melanin you have,
the darker your skin is.

And that extra protection
means darker skin seems to age slower.

But we still need SPF,

because we are still susceptible
to the UV rays of the sun.

[Okonedo] Most other
anti-aging ingredients

aren't backed up by a lot of evidence.

The only thing
that's really been proven scientifically

with good studies

is retinoic acid and retinol.

[Okonedo] These spur
the production of collagen,

but can irritate your skin and shouldn't
be used by pregnant women.

To recap,
your skin is doing a lot naturally,

so try to avoid using, or overusing,
products that mess that up.

A lot of exfoliating scrubs
and harsher, foamy soaps

can damage your brick wall.

Look for cleansers with a low pH.

And if you're concerned
about a skin condition,

talk to a dermatologist.
There might be treatments that can help.

But don't worry too much about a few zits.

The idea that we all need to be completely
rid of these things all the time

is artificial.

The industry has a way
of pathologizing irregularities

that are not actual medical issues.

Having pimples

is not necessarily a problem.

[Okonedo] Just like a century ago,

skin care ads today play up
science-y images and language.

The latest buzzwords
are pre and probiotic.

These products are supposed
to enhance your skin microbiome.

We don't have evidence
that any of these products

are helpful in themselves.

[Okonedo] But in one respect, 
the industry appears

to have radically changed.

[Fetto] We may look at
advertising right now

and believe that

the skin care industry
is incredibly inclusive.

But that's just forward facing.

So many brands that I speak to,

the journey their product has taken

from conception

to when it actually hits the shelves,

in no part of that journey

has there been anyone
that is not Caucasian.

[Okonedo] When Dove released 
this ad in 2017,

some saw ugly echoes of an earlier time.

Dove apologized, and took down the ad,

but Dove's parent company Unilever
sells products

that are designed to whiten your skin.

[Fetto] Quite a few brands, huge brands,

have developed skin-lightening creams,

and they've been selling those for years.

Following the death of George Floyd

and all the protests
that happened all over the world,

rather than taking
these products off the market,

they just changed their names.

It's solved nothing.

What is the messaging?

Whiter is better.

[echoing] Whiter is better.

[Okonedo] We're told we need to have
lighter skin, cleaner skin, dewy,

glowing, poreless skin.

And we need more products to get us there.

We are using
way too many products on our skin.

If we're healthy doing less,

why don't we do less?

I use water only.

I always wash my hands.

I'm very good about
washing my hands with soap,

but the rest of my body is just water.

You both get used to the feeling,
and your body seems to adapt a little bit.

Oh my God. I mean,

that would not work for me.
It just wouldn't.

I think my skin would freak out.

So I don't think
any skin needs 15 products,

but I don't think every skin
only needs three products.

[Okonedo] And remember, products aren't
the only way we influence our skin.

Skin is actually a beacon
for our overall health.

[Hamblin] How we're sleeping,
how we're eating,

how much stress we're under.

[Okonedo] Staying hydrated, exercising,
spending time outdoors.

All of those factors really have an impact
on what your skin looks like.

There are so many different ways
to take care of your skin correctly.

There are so many different ways
to do it right.

You are a unique individual.
You have co-evolved with your microbes.

Skin care can be a fun place

to discover
that unique part about yourself.

And…

there are lots of ways to be normal.

[closing theme music playing]