256: Understanding Your Skin's Circadian Rhythm w/ Michelle Jeffries, MD

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Did you know that your circadian rhythm affects your skin? Are you ready to find out what it means by your skin having its OWN circadian rhythm?

If you've wondered why your skin feels different at different times of the day (super itchy at night, but fine during the day), today's guest will explain why!

My guest today is Michelle Jeffries, D.O., FAAD, FAOCD. Dr. Michelle Jeffries is a board-certified Integrative Dermatologist in private practice in Phoenix, AZ and is the CEO and Founder of The SkinClock Method. She is a triple board-certified osteopathic physician in Dermatology, Pediatric Dermatology and Integrative Medicine. Dr. Jeffries also has a Masters degree in Psychology and is an Institute for Functional Medicine Certified Practitioner. Her unique training and background has led her to a comprehensive “inside AND out” approach to skin health that blends the principles of holistic beauty with the natural health cycles of your body, universal laws of nature, ancient teachings, modern dermatology, functional nutrition, and spiritual consciousness for truly holistic skincare.

Join us as we discuss how clock genes work in alignment with your circadian rhythm and how that can affect skin health.

Have you dealt with poor sleep patterns and aligned your body's circadian rhythm to the betterment of your skin? Share with me in the comments!

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

In this episode:

  • What is your body's circadian rhythm (and what does it have to do with your skin)?
  • What are clock genes?
  • Why your skin dries out at night (and becomes itchier)
  • The importance of aligning your clock genes with the rhythms of the world
  • What ancient civilizations knew that modern tech and research are discovering
  • Thoughts on blue light blockers and red light therapy


“Shift workers who actually are awake at night and asleep during the day, they actually have different rhythms that they do throughout the day. And unfortunately they're more at risk for diabetes, heart disease and cancer, psoriasis, other things. So the research has shown when you're not aligning with those rhythms, a lot of the other systems in the body get out of sync.” [7:52]

“If we don't eat during active periods of the day and we're eating at night and we're eating when we're supposed to be resting, then that can just throw that whole gut clock out of lap, too. And then that will send mis-signals to the body because then the body has all these nutrients (to process).” [15:37]


Connect with Dr. Jeffries online

Follow Dr. Jeffries on Instagram | Facebook

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256: Understanding Your Skin's Circadian Rhythm w/ Michelle Jeffries, MD FULL TRANSCRIPT

Jennifer Fugo: Dr. Jeffries, I am so excited to finally have you here on the Healthy Skin Show. Thank you for joining us.

Dr. Michelle Jeffries: Thank you so much. I am so excited to be here. We've been talking about this forever and it's happening, so I'm just so excited.

Jennifer: I know. It's so great to have you. You talk about a lot of really interesting things. I loved your presentation at the, goodness, that was 2021 Integrative Dermatology Symposium. And that was where we really started saying we got to get an episode on the show together. And I love that what you're going to be talking about today has to do with this. We're going to, we're going to define all these terms everyone, the circadian rhythm and how that impacts the skin. We're going to talk about clock genes and all sorts of stuff. So it's really important for you to understand that there's more to your skin than just your skin. So with that said, how about let's start with what is a circadian rhythm, just so people can understand, because I think it's a term we throw around a lot, but everybody might not actually know what that is.

Dr. Jeffries: Yes. It's one of those lovely Latin terms. It has Latin roots, just like a lot of the medical terminology. So if you break it down, circa means about, and diem means day. So a circadian rhythm is a rhythm that happens within a 24 hour period or a day. And it's actually related to the earth and the moon and how everything is rotating. And so it's interesting that it's related to just how the planet operates that we're living on.

Jennifer: That is awesome. And so in terms of the body and how it shows up in the body, what does that look like then? There's obviously hormonal connections and whatnot.

Dr. Jeffries: Yeah. This is one of the most fascinating things I think about our human body is that we are actually aligned to be on this earth and we have different rhythms that align with the 24 hour cycle of the earth. And it's incredible because there's different parts of where we live in this world and our bodies will align with that rhythm. So in some parts, the daylight hours are a lot longer and other places the nighttime is longer. Also seasons change, too. And so our bodies adjust and it's not just us, it's plants, it's animals, it's insects. Even microbes adjust to these different light conditions. And so there's a whole process physiologically that happens in the human body. And we knew about this in ancient times. There's a lot of native American cultures and ancient Indian cultures, ancient Egyptians, everybody tried to align with different light rhythms. And it's just within the past maybe 20th century that we've really broken it down into modern technology and science and how it works in the body.

Jennifer: And so how does that play in with the skin? Because from what I have read, your skin actually has its own circadian rhythm. So what does that mean?

Dr. Jeffries: Yeah, so the skin actually has a rhythm of day and night where certain processes of the skin operate during the day, and then they go more dormant at night and then other things get activated. And this is all controlled by our perception of light and dark. And it actually starts with our perception of light and dark in the eye. So we have little receptors in our eye that determine the gradients of light. And then they send messages to a little tiny, tiny, tiny part of our brain called the suprachiasmatic nucleus. So I just talk about as the SCN, because who knows what suprachiasmatic nucleus means, but it's this little part in our brain. And then that sends different signals depending on the activation or deactivation of that to the rest of the body, including the skin. And so all of our cells and our skin can actually tell time. But not only just our skin. Our gut, our hormones, our nervous system, our microbes that live on our skin. It is incredible. So as soon as I started learning about this, I just became super, super fascinated of well, how the heck can our skin know if it's day or night? How does that work? It was incredible. So it's incredibly fascinating.

Jennifer: It is. And so I had mentioned before about clock genes. So what are they and is how is this connected to your circadian rhythm?

Dr. Jeffries: So clock genes, the way that it came about, figuring them out is interesting. In the 1700s, there was an astronomer and he noticed that different plants opened during the day and closed at night. And then there was a mimosa plant that actually was able to open and close at its own rhythm, even when it was kept in the dark. So after that, a lot of research came about to discover, well, what is going on with the genetics of the plant maybe, or what processes are happening. And as technology has advanced and we've learned a lot about molecular technology, there's been a lot of advancements of figuring out the genes that get turned on and off depending on light.

Dr. Jeffries: And so in 2017, the actual Nobel Prize was awarded to three researchers that figured out the systems of clock genes. So clock genes are within all of the cells of our body. They get turned on and off depending on the signals that they receive from the body. So let's say that it's light out. Certain cells have a signal that they'll receive from that perception that happened in the brain when the light came on. The brain sends a signal throughout the body, and then it releases different neuromodulators or hormones or signals you can think of. Okay, we're going to turn these things on and we're going to turn these things off. And it's the clock genes that get turned on or off that regulate that process.

Dr. Jeffries: So then when some get turned on, certain things happen and when some things get turned off, then the other things happen. So we know that we are actually are aligned to be on this earth because we have these rhythms of certain things that happen just perfectly during the day and certain other things that really need to repair at night. So we can talk a little bit about that too, in the skin. That's where it gets really fascinating, too.

Jennifer: Yeah. And I would imagine then, so for people who struggle with insomnia or work say the third shift where they're not really, their whole system is flip-flopped, I would assume then this would be difficult, almost counterintuitive to their own biology in a sense. It's contradictory because your body is not operating the way it's supposed to. Would that be a correct assumption to make?

Dr. Jeffries: A hundred percent. You actually hit on a way that we do research on clock genes and humans. So a lot of the research was on plants and microbes and mice is the other thing that a lot of people research with clock genes. Clock genes in mice, because they're mammals, we try to extrapolate it into humans, but mice are nocturnal. So all of the research, you almost have to flip of okay, so they're active during the night, but we're usually not. So then you had to flip it. So the research is like, we need to know how this works in humans. So shift workers who actually are awake at night and asleep during the day, they have different rhythms that they do throughout the day. And unfortunately they're more at risk for diabetes, heart disease and cancer, psoriasis, other things.

Dr. Jeffries: So the research has shown when you're not aligning with those rhythms, a lot of the other systems in the body get out of sync. Another example is jet lag. When you're going across time zones and you're not on the rhythm of the day and night cycle of where you live and you're trying to operate somewhere else halfway across the world, if anyone's traveled internationally, you know that your sleep is off, your mood is off, your eating cycle is off. It takes you a long time to just get aligned with that rhythm and get through that jet lag. So shift workers and jet lag are prime for research of this in humans to see how that all works. So you are exactly right.

Jennifer: And how do the clock genes then connect to what's happening at the skin? I think this is actually really helpful, too, for people who are struggling with, and I'm just going to throw this idea out there. A lot of people complain their skin feels drier and itchier at night. So I don't know if you can also touch on that. But what's the connection between the two?

Dr. Jeffries: Yeah. So the research has shown that the skin has a rhythm where certain processes are activated during the day, and then other processes are active at night. So during the day, our oil glands are more active. We're producing more oil because our daytime skin activities is about protection. So you want to think of daytime in the skin. We want to protect ourselves from pollution and all of the harmful sometimes rays of sun if we're outside a lot. Our body has these built in processes of weather and temperature changes to combat those during the day. And then in the evening, it has processes to allow repair and cell growth and all of the different calming mechanisms. Part of that is the skin is less oily and actually it's more leaky. So you probably have heard of the term of leaky skin. Well, it gets worse at night because we lose a lot more water at night because the cells don't have as much oil production.

Dr. Jeffries: Also the temperature of the skin is going down, so there's not as much blood flow as well. And so there's all these different repair mechanisms that are going on. And so the itching is classic and more dry at night. We could use this though to our advantage, because at night is probably when we're going to get better penetration of moisturizers and of different prescription medicines that we put on the skin that will help that barrier repair, will help that leaky skin, that will help us calm that itch. So it's a very good time. We can use the timing of these rhythms to our advantage.

Jennifer: That's so fascinating. It's interesting. A lot of clients have complained to me that at night, they might be relatively okay all day. And then all of a sudden it's 7:00 or 8:00 at night, or they're getting ready to go to bed and they just feel like their skin is completely dried out or they'll wake up in the middle of the night with an itch attack. And they're just clawing at their skin and the flakes all over the sheets are pretty intense. So is it common though, to see someone who has say pretty intense eczema or psoriasis or something like, that is it exacerbated at night, because of this natural circadian rhythm, it just is worse? Or what's your thoughts on that?

Dr. Jeffries: So for sure, the rhythm of the skin and that opening and less blood flow and the water loss issue and needing to repair is a huge, huge part of it. So that is usually why as dermatologists, we recommend thicker moisturizing creams at night to help seal in that barrier. Additionally, there is a part of the brain where during the day we're very active. Our brain is focusing on all of the things that are going on in the world and we're interacting with the world. And at night we finally can calm and feel what's going on inside of our body and start to be aware of all of those processes that are going on inside our body. So our awareness shifts to the outside world, to their inner world and our inner body. So I feel like it's not just the skin. There's other parts of our body that interact with that timing.

Dr. Jeffries: So the circadian rhythm has a a different mechanism in the nervous system and in the gut health, as well as our skin and our hormones and all of it links together and synchronizes. And then when we're out of sync or having inflammation in our skin, that plays a role too. Our hormone goes through cycles of cortisol spikes or release of cortisol in the morning to wake us up. But when we're really stressed, we might have those spikes later at night, and then our skin might itself be stressing us out because it's bothering us. And that might trigger a feedback loop of cortisol being released, and then we're more inflamed and itchy too. So it's a big network of all these different rhythms coming together. And they're either synchronized where things are going well, or things are a little bit out of sync and we're having symptoms and issues.

Jennifer: Do you find, too, because I talk a lot about the gut and the gut connection to skin on the Healthy Skin Show. Is there any connection between what the clock genes and what's happening at the level of the skin and what's happening within the GI track as well? Because I tend to find that microbes seem to be, especially unfriendly ones seem to be more active at night. We always hear parasites are more active at night, fungus, et cetera. What do you see in the research that you found has been interesting on that front?

Dr. Jeffries: Yeah. It is fascinating to know that there are clock genes in our gut and in the microbes that live in the gut. So what ends up happening as far as my understanding, is that when we have an ingestion of food, that actually can be one of the external triggers, just like light triggers some of the processes, food is another way that can trigger clock genes to go on a cycle. And our gut is the first place that gets those nutrients. And what that does is activate, okay, there's food here. We must be during an active eating phase. We're going to go ahead and make sure that the gut moves. So we move the food through. So gut motility gets activated in the genes and those smooth muscles. Also, the little enzymes that are supposed to digest the food get activated as well. And it says, okay, we got to break down this food. We need these nutrients for everything. So that gets activated as well.

Dr. Jeffries: And then that whole process, as it goes through the gut and the liver releases things, the gallbladder, the bile acids and that all goes through the process of the gut as we're processing food. And then the microbes get their nutrients from the food that we eat. So there's the good ones that love certain things and then help us promote some health. And then they release things that help promote health. And then we have the gut bacteria that aren't as healthy for us. And if we're feeding those, those get activated and those do different things.

Dr. Jeffries: And so what ends up happening if we don't eat during active periods of the day and we're eating at night and we're eating when we're supposed to be resting, then that can just throw that whole gut clock out of lap, too. And then that will send mis-signals to the body because then the body has all these nutrients. It's going into the bloodstream. And then they're trying to [proc 00:15:57] all of the other parts of our body, our muscle skeletal tissue, all of the other organ systems, not just the skin are trying to get those micronutrients and they're doing it when they're supposed to be resting. So it's almost like waking someone up and okay, we're eating now, even though you're dead to sleep. We're waking you up and you got to eat right now. And you're like, “No, no, I'm sleeping. I'm trying to rest.” So you can think of yourselves as doing these different dances, depending on what we're doing with our body.

Dr. Jeffries: The classic other stimulus is blue light when we're looking at all of our screens and we're doing that beyond what the normal rhythm of the day and night cycle is. We're also retraining our brain and our systems to be awake when we're really supposed to be sleeping and resting. So all of these things weave together. There's some analogies of an orchestra and you have a conductor which would be that SCN in your brain that's guiding how everything should be. Okay, light's on, we're going, we're moving, we're releasing cortisol. We're going through the day. And then it signals the flute section and the strings and the drums and everybody starts to get in sync. And then the conductor quiets everything down and says, “Okay, we're, we're going to go quiet in this area and quiet in that area.” So that analogy helps.

Dr. Jeffries: But then if the orchestra is playing for a ballet or a play, then we have this whole other external world that's interacting and moving with the rhythm of the music, but then they can do their own things, too. And they might impact what's going on. So you have all these different internal, external systems layering on top of each other and interacting. So all of it matters, the gut, the sleep, the skin cycle, our stress levels, our hormones, all of it.

Jennifer: Well, I have to ask as well, because as you're talking about this, I was reminded about how in Chinese medicine, they have their own clock and at night from like, I think it's 1:00 to 3:00 AM is when the liver, that's the liver time. Are you familiar with anything in terms of the liver's clock jeans or how the liver plays a role in all of this? I just thought I'd ask. I'm just curious.

Dr. Jeffries: Yeah. The traditional Chinese medicine and also other ancient practices of medicine have tapped into this. So yeah, we have all of this clock genes and medical words, but they've known about this. They've known that there's different times of day where different processes are active and inactive. And the liver is very intimately related to the skin. And in Chinese medicine during that timeframe in the middle of the night, if you're waking up, then you might have an issue with processing things that liver functions, and liver also emotionally has to do with anger and a sense of acceptance and belonging and all of these other emotional parts too. And if we're struggling with some of those, sometimes those are the thoughts that we wake up with at that time of night, too. So traditional Chinese medicine has blended together all of these.

Dr. Jeffries: There is actually a lot of literature on the liver and clock genes. I haven't dove exactly into that. I've been more interested in wow, ancient practices are linking up to things that we're just now figuring out in our technology, but they've known about it. So the focus of what I've been looking into is the gut and the skin and the nervous system. But the liver itself, when I did Google the clock genes and the liver, it is one of the areas that has a ton of research. So I'm not familiar with all of it, but it's totally fascinating because the liver does hundreds of functions of our body. So it has a lot of integrations with all the other systems, too. So it's a great, great question. A great way to explore it.

Jennifer: Yeah. It's just so, so fascinating to see how interconnected the different systems are. And this is just another layer to it. I think it might also help to explain for some individuals that you're not broken if you're struggling at night more, but this helps you to understand that there is something physiologic going on that may be contributing to an exacerbation of symptoms. For someone who maybe has a compromised skin barrier and they're really struggling at night, is there anything that they could begin to do that you recommend as a dermatologist that could be helpful at all? I know you said about using thicker moisturizers and whatnot, but even from a lifestyle perspective or just anything to help maybe… I don't know, come in more alignment with the clock genes. Is there some way that we could not be fighting against our own biology?

Dr. Jeffries: Yes. There's so many little things you can do and some people just want to do them all all at once. And for some people it can be just a few little tweaks and then it makes a big difference and then you can build on them. So you want to think of our skin and all of the other body systems is we need to rest and restore. So the theme of what you would do in preparing for sleep and preparing for rest and preparing your skin to not be inflamed and to calm is we got to calm the body on all those levels. So you want to think of you want to calm the mind. So there can be a lot of stimulation on our computers and conversations maybe we have with people late at night sometimes could be upsetting or soothing depending on what we're doing. Sometimes the TV, we're watching things that are stressful and getting that feedback.

Dr. Jeffries: So definitely training the mind to relax at night and doing things that relax you. So maybe sitting on a cozy chair with a blanket and maybe just meditating or spending time with your pet, drinking maybe a cup of tea that has some herbs in it that are relaxing can be helpful. Really maybe stepping outside and looking at the stars or paying attention to what the world looks like around you at night, sitting by a fireplace or ambient light. Being sure you're dimming the lights in your home can be very, very helpful, too. And then our stress levels, sometimes we have time alone and that's when our mind goes crazy. And we think oh my gosh, I should have done this today and I forgot this. So if those thoughts are coming up, have a journal, write them down, get them all written down. So that way you're clearing your mind, you can handle them the next day.

Dr. Jeffries: What I really like to do, too, is listen to music or listen to a meditation that just clears my mind and so that I'm not caught up in those thoughts anymore. And so I don't worry about, gosh, did I remember to do this thing earlier or did I close out this one thing or different things go through our mind. So really closing the mind and refocusing it.

Dr. Jeffries: Also when we're getting ready for bed, cooling the room so that our body naturally, the body temperature cools. If our room is hot, it's going to think that we still need to be awake because remember our body temperature is elevated during the day and then cooler at night. So cooling the room, too, can help calm our skin, can help reset those clocks as well. Some people do like to go in a warm bath and then cool their body down. And sometimes that contrast is helpful, too.

Dr. Jeffries: And then once we're in bed, really doing those moisturizers to seal in that barrier. People also might want to do different repair things. So sometimes it's prescriptions that they need to help heal their skin. So that would be a good time, I need some prescription, healing things. Also different salves that are a little bit more healing. Sometimes different oils can be very helpful at night and soothing on the skin, too.

Dr. Jeffries: And so the other piece is your gut. You do want to not eat a couple hours before you go to bed. Let your body be in the phase of digestion where it's okay, we're we don't have to actively process food. We can rest and restore. We can release the nutrients. And then your body has all of those nutrients to do all of that repair and growth at night while you're resting.

Dr. Jeffries: So that's just a few things. I know there's many, many more, but just pick one or two. Don't let it be overwhelming. Think okay, this is going to resonate with me. Okay. That didn't fit. I don't want to necessarily do that.

Jennifer: Any thoughts on red light therapy in terms of using a red light? I've seen different things. Some people will say, and I've personally found red light units to be too stimulating in the later part of the day for me personally, but then I've talked to other people who feel like they're just fine. Any thoughts on using red light therapy in terms of the clock genes and circadian rhythm?

Dr. Jeffries: Yeah. This area is really fascinating. So at night we get exposed to a lot of blue light. And so the way to combat that blue light is to wear blue blockers, which actually change the light to more of a reddish orange tone. And there's apps that you can do on your computer. I have that flux app on my computer. I have my phone set where even at night, everything goes more red. And so at night I do like to wear blue blockers if I'm going to watch TV or do something several hours before I go to bed and do that.

Dr. Jeffries: However, sometimes it's just the fact that you're getting a stimulation of light, even red light can be stimulating. So some people are just, their eyes are more sensitive to that perception of light. So sometimes relying on just the blue blockers or trying to just, oh, I'm just going to modify it and do red light, it isn't enough. Sometimes we really do need that dimmed light that's natural. And some people actually have a lot of stress going on in their lives and things are going on. And you'll hear, “Oh, I went on a camping trip and I came back and I just felt so much better.” Well, not only did they get out of the rhythm of their crazy, stressful life and disconnect from technology and different things, but they actually had to work with the day and night rhythm of the sun coming up at a certain time and it going down and there weren't all these lights and devices, so they didn't need blue blockers or all of these things. So there's really something to be said about us aligning with the earth that we're on and our rhythms and trying to really mimic those at night instead of artificially trying to hack them.

Jennifer: Yeah. And I think that was one thing that my associate, Michelle, and I shared in the sleep series, for anybody who wants to dive into that as well. Because I think that's a really nice complement to this conversation is that everybody's different. So like I just shared, for me, I can't really do red light later in the day. It's too stimulating. Even my computer, as you said, I have the flux app on it. It'll get very orange, but just being in front of my computer, I can't wind my mind down at night. So it is interesting that people just… My husband can sit in front of his computer. He doesn't have any change in color or anything and he's fine. He can go to sleep, no problem.

Jennifer: But it is really fascinating that how the inputs, the various inputs, whether they're external or even the internal inputs like gut bacteria and your gut microbiome and the food that you eat and whatnot, can really make a big difference in your daily experience and obviously how our genes are. Our genes are all different. So this is just so fascinating. And it'll be interesting to see as, especially as you continue to do research in this area, what you find and discover, I think this is going to be a really great area of exploration, especially as you were saying because of the leakier skin barrier and whatnot, so hopefully too, it'll shed some light on what could be more beneficial for people down the road as well, who are dealing with compromised skin barriers to begin with.

Jennifer: But thank you so much, Dr. Jeffries, for being here. I really appreciate it. And I want to let everybody know that you do see patients. Can you let everybody know where you practice and where you're located?

Dr. Jeffries: Yeah. So I'm in Phoenix, Arizona. And I work for a private practice group. There are 12 of us in the group, so I am one of 12 and we are in Phoenix, Arizona.

Jennifer: Cool. And they can find you at drjeffries.com as well as on Facebook and Instagram. I'll make sure to put all the links there. And I just want to thank you again, and I hope that we can have you come back. I know it took a while to coordinate this interview, but I would love to have you back on the show to talk about your many other areas of expertise in terms of skin issues and how you approach it from an integrative perspective.

Dr. Jeffries: Oh, I would love that. There's so much more to talk about on this and just all of the integrations of the skin with the rest of our body. So I really love your podcast and all of the information that you're providing and it's nice to have the exploration expand out so much like you do. So it's been an honor to be here and a pleasure.

Shift workers who actually are awake at night and asleep during the day, they actually have different rhythms that they do throughout the day. And unfortunately they're more at risk for diabetes, heart disease and cancer, psoriasis, other things. So the research has shown when you're not aligning with those rhythms, a lot of the other systems in the body get out of sync.