Our Beautiful Intelligent Skin A Functional Medicine Guide to Flawless Skin Dr. Dalal

Our Beautiful Intelligent Skin: A Functional Medicine Guide to Flawless Skin

dr dalal akoury author Dr. Dalal Akoury, MD
Functional Medicine Doctor
Anti-aging & Skin Care Expert

Funcion | Health | Beauty tips | Products risks | Safe skincare | Hydration | Sleep | Diet | Lifestyle | References

In this overview, Dr. Dalal Akoury, M.D, a functional medicine doctor who specializes in anti-aging medicine, shares some of the key principles to healthy skin from the inside out. Learn what our skin says about our health, common problems with skincare products, and practical tips to help promote skin health for a beautiful glow and appearance at any age.

Our beautiful skin, much more than appearance

I am often asked for my top tips to achieve a youthful appearance and flawless skin. And while there is a lot we can do to improve the appearance of our skin, we need to first recognize that our skin does much more than making us look presentable.

Just to give you an idea of how important healthy skin is to our overall health, here are a few interesting facts about our skin:

  • The skin is our largest organ. Indeed, our largest organ[1] is the one we actually “wear” on the outside. The skin plays a key role in supporting several important immunological and inflammatory processes.
  • The skin is one of our first lines of defense. Acting as a barrier, it is an intelligent natural mechanism of communication between our bodies and the external world. This communication is most optimized when the skin is healthy.
  • The skin is a part of our immune system. One of its many roles is to harbor immune cells that participate in both innate and adaptive immune responses. The specialized immune cells within skin tissue are essential in the fight against invading pathogens.
  • The skin has its own microbiome. In addition to the microbiome in our gut, the skin is home to a diverse community of beneficial bacteria[2]. A healthy skin microbiome is essential for maintaining skin integrity, as well as immune function.
  • The skin produces vitamin D. The “sunshine vitamin” is a hormone essential for healthy bones, heart, brain, muscles and immune system function[3].

As you can see, our skin is a powerful organ that goes way beyond appearance and beauty. Healthy skin is essential to maintain and optimize our health.

The skin is the mirror of our health

As eyes are the mirror of the soul, our skin is the mirror of our internal health. The skin is often the first visual presentation of symptoms and clues indicating potential imbalances in our hormones, microbiome, gut cells, and even cognitive function. That rash or skin issue that has been bothering you for some time, may be caused by an underlying condition in your body. The skin is something we pay extra attention in functional medicine, as it is one of the ways we are able to uncover the root cause of a patient’s health concerns. To give you an idea of how skin symptoms are related to other problems, here are a few common examples:

  • Skin ischemia. If you have reduced blow flow to the skin (ischemia of the skin), you may notice that some areas are shiny or pale compared to other areas. This can indicate that blood flow may be compromised in other parts of the body.
  • Skin Inflammation. Skin issues such as abscesses (accumulation of pus) and folliculitis (inflamed hair follicles), may be signs of an abnormal inflammatory response in the body, an autoimmune disorder, or problems in other organs, such as gut dysfunction or leaky gut syndrome. Clearly, these require much more than just a topical cream to fully resolve.
  • Hormonal imbalances. Our skin cells have large numbers of receptors for estrogen, progesterone, and testosterone[4]. Low levels of estrogen, which is a common problem with aging in women, causes a reduction in collagen, a protein that provides strength and resilience to skin cells[5]. This decrease causes changes to the skin we commonly associate with aging. It becomes thinner, drier, and less elastic. In fact, you can consume all the collagen in the world via a supplement, but without addressing the hormonal imbalance, your body may simply not be able to make enough.
  • Chronic stress. The fight or flight response, an automatic physiological reaction, is activated when we are under stress. When this occurs, blood supply is diverted to the muscles and heart to support optimal physical performance. Blood moves away from other areas such as the skin, kidneys, and sexual organs. While this short-term mechanism is designed to help protect us in dangerous situations, long term chronic stress often causes compromised blood flow and relative ischemia to the skin, which may present in a variety of ways.

My top tips for a beautiful and healthy skin

Dr. Akoury's top tips for a beautiful & healthy skin at any age Avoid risky skin care products Know your skin type Exfoliate, but be gentle Nourish your skin with healthy oils Stay hydrated Get your beauty sleep Beautify your skin from within with proper diet Consider other lifestyle factors Stress, exercise, and more Functional Medicine


Ideally, when trying to improve skin health always consider both the outside (what you put or do to your skin), and factors that affect your entire body (nutrients, lifestyle). Keep in mind, when it comes to skin care there is no one size fits all approach. We often work with our patients to tailor treatments to their unique needs and preferences.

But there are several things anyone can do to take care of their skin inside and out:

1 – Be mindful with skin care products

Have you ever tried to read what’s on the label of a skin care products only to find out you couldn’t recognize half of the ingredients?

You are not alone. In fact, when it comes to skin care, more often than not, omitting something can be even more powerful than adding something. So, it is very important to be mindful with what you put on your skin. Many skincare products, cosmetics, and soaps contain harsh ingredients that can disrupt your skin’s microbiome and kill the good bacteria. Even worse, many products contain toxins that can penetrate through the skin and enter the body’s circulation.

In addition to products you apply on your skin, the same concerns apply to laundry detergents or softeners. For some people, they may even need to be aware of clothes made of synthetic materials.

2 – Avoid xenoestrogens

Xenoestrogens are artificial substances that can bind to estrogen receptors in the body due to their very similar molecular structure. These harmful compounds are commonly used in skin and hair care products (for example, parabens), but also can be found in our foods (for example, pesticides)[6]. Unfortunately, this is a common problem as many products contain these ingredients. Reading the label can be a challenging, yet a necessary step to protect your health.

I can’t stress this enough. Hormonal balance is vital for a healthy skin. That is why we need to do our best to minimize our exposure to xenoestrogens. They are just that destructive.

3 – Know your skin

You are unique and so is your skin. There is no one size fits all approach that works for everyone to optimize skin health. Even if a product is all natural and organic, it still may not be the best fit for you. Understand your skin and what type of nourishment works best. If you are not sure, work with a skincare professional that can help personalize the best approach for your skin.

4 – Exfoliate, but be gentle to your skin

Exfoliating your skin can help remove dead skin cells from the top layer. When properly done, the result is smoother, healthier looking skin. It is important however to avoid harsh methods or products, as these can cause more harm than good.

Some of my favorite ways to exfoliate, which also help with skin regeneration, circulation and lymphatic drainage include using a loofah and gentle dry brushing (a body massage technique using a dry, stiff brush).

5 – Nourish your skin with healthy oils

Certain oils are loaded with vitamins, minerals, antioxidants, and other healthy nutrients that are easily absorbed. These oils can help soften, moisturize, nourish, and improve the appearance of your skin. Some of my favorite oils include carrot, moringa, almond, and coconut.

These types of skin-friendly oils should not be confused with essential oils that are highly concentrated. Essential oils should always be diluted before using on the skin.

6 – Stay hydrated

Hydration is essential to support the health, function, and appearance of the skin. Effective hydration, however, means a lot more than just drinking water. Water needs the right vehicle for proper absorption and utilization of minerals and other nutrients.

Good options for healthy hydration include oxygenated, ionized, or living water that is electrically charged. Adequate hydration can help maintain the elasticity and integrity of the skin.

7 – Get your beauty sleep

The importance of sleep for our health cannot be stressed enough. This also applies directly to the health of the skin. Sleep is the time where most of the healing, regeneration and housekeeping processes take place, including the regulation of our hormones. Not surprisingly, studies have shown a link between sleep deprivation and an increase in intrinsic signs of aging, such as uneven pigmentation, fine lines, and reduced elasticity[7].

8 – Beautify your skin from within

The foods we eat have a powerful effect on our health, including our skin. Also, there’s no magical diet plan for skin that works best for everyone, although there are a few basics that apply to most people:

  • Cut sugar. Sugar breaks down collagen and elastin, which over time can reduce your skin firmness and elasticity. The same concerns apply to too many processed or refined carbs.
  • Avoid canned or processed foods. These are often loaded with toxins, refined sugar, and carbs, and very low in actual healthy nutrients.
  • Limit inflammatory foods. Especially dairy, gluten, and refined vegetable oils.
  • Limit high heat cooking. May increase free radical damage.
  • Eat fresh, organic raw dark leafy greens and low glycemic fruits. We have all heard this before, and these nutritional powerhouses are loaded with vitamins, minerals, phytonutrients, and antioxidants. I find that a diet high in nutrient-rich foods can make a huge difference in the way people look and feel. For healthy sweet options, include moderate amount of low glycemic fruits like berries.
  • Eat enough omega 3 fatty acids. These healthy fats are essential for skin function and appearance[8]. Good sources include wild small fish, flax seeds, and chia seeds.

9 – Other important lifestyle consideration for healthy skin

In functional medicine, we always consider the whole person, rather than “isolating” specific systems or organs. Your skin is no exception. Your unique circumstances, the way you live your life and how you interact with your environment can all affect your overall health and the health of your skin.

  • Manage stress. Be mindful about the sources of the stress in your life. Work to effectively manage stress with relaxation practices such as yoga or meditation.
  • Movement and exercise. Helps increase blood flow, oxygen, and nutrient delivery throughout the body, including the skin. Make sure however not to overtrain, as it can have a negative effect on your skin.
  • Be kind with the sun. Spending time outdoors with some sun exposure offers many benefits, especially as it helps synthesize vitamin D. However, sun safety is critical to minimize the risk for skin damage. Depending on your skin type, and where you live, practice safe sun exposure, and use high-quality SPF sunscreen.

Final Thoughts

Maintaining beautiful skin well into old age goes hand in hand with living a healthy lifestyle. All the fundamentals of good health also apply to healthy skin. Managing stress, getting restorative sleep, eating a diet rich in nutrient-dense foods, and staying well hydrated are great ways to start nourishing your skin from the inside-out.

Any skin concerns that flare up should be evaluated as a potential clue to an underlying health problem or a sign of exposure to an environmental trigger. When you use your skin as a way to gauge your overall health, this makes the journey to wellness even more powerful.


  1. Swann G. The skin is the body’s largest organ. J Vis Commun Med. 2010 Dec;33(4):148-9. doi: 10.3109/17453054.2010.525439. PMID: 21087182.
  2. Grice, Elizabeth A, and Julia A Segre. “The skin microbiome.” Nature reviews. Microbiology vol. 9,4 (2011): 244-53. doi:10.1038/nrmicro2537
  3. Mostafa WZ, Hegazy RA. Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res. 2015;6(6):793-804. doi:10.1016/j.jare.2014.01.011
  4. Pelletier G, Ren L. Localization of sex steroid receptors in human skin. Histol Histopathol. 2004 Apr;19(2):629-36. doi: 10.14670/HH-19.629. PMID: 15024720.
  5. Thornton MJ. Estrogens and aging skin. Dermatoendocrinol. 2013;5(2):264-270. doi:10.4161/derm.23872
  6. Paterni I, Granchi C, Minutolo F. Risks and benefits related to alimentary exposure to xenoestrogens. Crit Rev Food Sci Nutr. 2017;57(16):3384-3404. doi:10.1080/10408398.2015.1126547
  7. Paterni I, Granchi C, Minutolo F. Risks and benefits related to alimentary exposure to xenoestrogens. Crit Rev Food Sci Nutr. 2017;57(16):3384-3404. doi:10.1080/10408398.2015.1126547
  8. The Linus Pauling Institute’s Micronutrient Information Center (MIC), Essential Fatty Acids and Skin Health
Dr. Dalal Akoury, MD

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