Skin doctor Yael Adler: ‘Soap doesn’t really help’

Your previous book The Skin was an international bestseller. What did you notice about this in your work as a dermatologist?

“People from distant countries fly to my practice in Berlin for a treatment. My practice was already full, so there is now a long waiting list. I am really not a ‘special’ dermatologist. I do speak to people for longer on average, often half an hour. That’s because of my holistic approach. I don’t just ask about the skin, but also about nutrition, psychology or sexuality. I also examine the blood and the intestinal flora.”

In your new book Discomfort you write about the whole body. What does a dermatologist know about the heart, penis, or colon?

“The skin is a mirror of the whole body. As a dermatologist I am therefore often the first to discover that someone has diabetes or a thyroid disorder. Of course I will refer that patient to an internist. But I often give nutritional advice that helps against the complaints, such as addition to regular medicine. For this I followed an extra training as a nutritionist. Nutrition plays a role in allergies, psoriasis, eczema, acne, aging, you name it. I may advise someone to take extra zinc or to take more eat fiber for a better composition of the gut bacteria, or I prescribe black tea for inflammation.”

Are these nutritional recommendations also proven by science?

“The results of many nutritional advice are often excellent. But in general, the advice from natural medicine has not been sufficiently researched and documented. Research is expensive and often not financially feasible, because there is no rich pharmaceutical industry behind it.”

Bad body odors and skin complaints are often caused by soap, you write. How did that happen?

“If you practice too much hygiene, you will smell and develop contact allergies. The standard soap washes off the skin’s own protective layer and disrupts the acidity of the skin for a long time. Bacteria that create bad odors get the upper hand over the skin’s own flora. Rather choose to wash with only water, or dilute apple cider vinegar, or buy a mild special washing gel with an acidity of five.”

Can that also be done with the pubic area?

“I often see people at my office who are afraid that they have a venereal disease because they have itching in the pubic area. But usually this is because they wash their pubic area with soap and damage it. Only water is best. Women can it is better not to clean the inside of the vagina with water, because it cleans itself.Vaginal rinses even increase the risk of cancer.”

Do anti-wrinkle creams help?

“Unfortunately not. Many expensive creams contain hyaluronic acid, for example. As you get older, the hyaluronic acid in your skin breaks down. Unfortunately, you cannot supplement that with a cream, because it does not penetrate the skin layers. A cream only makes the top stratum corneum moist for a few hours. The cosmetic industry promises everything they cannot deliver. Even if you have hyaluronic acid or botox injected, you do not always look more beautiful. At most, different. Don’t worry about wrinkles, they tell the story of you life.”

So what helps for beautiful skin?

“Eat a lot of fresh vegetables, fruit and fish. They nourish the skin from within. You can only protect the skin from the outside, with sunscreen against UV radiation and oil or fats against dehydration. Or use a cream with urea, which is a natural moisturizer. I also love shea butter, which is a natural fat that nourishes and protects the skin barrier.”

You advise people to regularly look at their skin. Why?

“Rough spots often develop on the nose, cheeks and ears. If they do not heal, go to a dermatologist, because such a spot can be a preliminary stage of skin cancer. You should always keep an eye on brown spots. And there are many more to discover more skin abnormalities, such as barley grains, visible blood vessels or fat bumps. With a hand mirror you can more easily view the skin around the anus or the genitals. This way you can see when there are abnormalities and it is better to go to the doctor.”

Your grandfather was also a dermatologist. What did you get from him?

“Unfortunately he had already died when I was born. My mother told me that he was often accosted on the street. ‘Look, doctor, I’m cured!’ exclaimed his grateful patients. I was fascinated by this and leafed through his medical books as a child. They contained beautiful drawings of skin diseases. Syphilis, shingles and rosacea were depicted with an eye for detail.”

Your husband is a dentist, you thank him in the back of the book. What advice did he give?

“For example, my husband told me that smelly breath usually originates in the mouth, and not in the body. So good oral hygiene usually helps. You can test this by breathing out through the nose with your mouth closed. also smells. My husband also helped with the chapter on snoring.”

Isn’t snoring normal?

“Snoring can be a symptom of allergies, polyps or swollen tonsils. Often the tongue falls into the throat and that can lead to shortness of breath. So you should always have it looked at by a doctor, especially if the snoring starts suddenly.”

Which taboo complaint are people most ashamed of?

“Anus problems are a difficult one. For example, I recently had a young father in practice, with pain in his anus. He did not even dare to show the problem to his wife. Only when he could no longer sit because of the pain did he come to the doctor and the anus needed urgent surgery. It turned out to be an anal fistula that had penetrated almost completely through the layers of tissue of the skin. If he had waited another day, the sphincter muscle would have been so damaged that the man would have become incontinent .”

Have you ever been shocked by a skin disease?

“I have been working as a dermatologist for more than 21 years and have seen a lot. People have nothing to be ashamed of. Only very extreme things can sometimes make me look up, such as a patient who had maggots in an open wound on his leg. I saw a man at the office because of a wart on his penis It turned out that his entire pubic area was covered with smaller warts It was a venereal disease I have no moral judgment but did tell him to inform the women he had been with They’d have sex, otherwise they would infect each other again and again. Usually I’m fascinated by skin diseases. As a dermatologist I use all my senses to find out what someone has. Sometimes I feel like a detective.”

Yael Adler (45) is a German dermatologist. She works in her private clinic in Berlin. She had been a well-known skin expert for years, especially on German television, when her book The Skin (2016) was published, a bestseller that has been translated into 31 languages. Discomfort is the sequel to this, and quickly became number 1 in the German bestseller list.

This article previously appeared in Plus Magazine March 2019. Not yet a Plus Magazine subscriber? Becoming a subscriber is done in no time!