If you want to get ahead in life, you need to be comfortable in your own skin. But you also need to take good care of it because as your body’s largest single organ—the average person has around 20 square feet—your skin is both your billboard and your medical report card.
“As a dermatologist, of course, I want us to look beautiful,” says Dr. Michelle Henry. The founder of Skin & Aesthetic Surgery of Manhattan, she has shared her skincare expertise with the likes of The New York Times and Vogue and on Good Morning America and CNN. “I care about our glow; I think about our complexion.”
But she is also aware of all the things skin can reveal about one’s health. “Dermatologists often call ourselves ‘skinvestigators’ because the skin is always telling about what’s inside,” she explains. “It could tell us about your cardiac health. It could tell us about autoimmune conditions. It could tell us about your nutrition. Our skin is just really critically important to all aspects of our health, in addition to our beauty and making sure that we lead in the world and look as good as we feel inside.”
With that in mind, Henry talked WayMaker Journal through some of the particular needs of Black skin, drawing on her years of experience both as a practitioner, specializing in high-risk skin cancer treatments and aesthetic surgery, and teacher (she chairs the education committee of the American Society of Dermatologic Surgery).
Diet is critical, she says, so aim to avoid big swings in your overall weight. Ensure that you are always well hydrated (see sidebar). Be alert for things that may cause skin issues; for instance, does milk lead to a breakout? “We know that dairy is one of those things that can really trigger acne,” she says. “I hate to say it because I have a horrible sweet tooth, but all of those sweets, that chocolate, those things that we like—anything that makes your insulin kind of peak a little bit—make your pores sticky and can cause acne.”
[The] Bottom line, you have to take care of yourself in an integrated way, because “any area of lack is going to show on your skin.”
That old saying about the importance of beauty sleep is true. “Your mental health is important,” Henry says, “really holistically caring for yourself.”
She offers advice as someone who struggles with sleep (“If I get more than six hours, it’s a win. If I get eight hours, I feel untouchable”). Try meditation, she suggests. “It’s one of those things where we have fairly good data that it can really help our overall mental health, our physical health, our cardiovascular health. It’s a really great way to calm the mind.”
Try to keep away from technology: Turn your cellphone off at night because blue light disrupts sleep. And don’t try to fall asleep with the television on; that will affect your sleep cycle. Aim to go to bed at the same time every night.
“I’m definitely not an expert at it, but it really is important and critical to focus on and think about sleep hygiene, because it really will not only make you look better, but extend your life.”And while we’re on the subject of sleep, whatever you do, don’t go to sleep with your makeup on. “That’s the worst thing you can do,” Henry warns, “because you’re wearing it all day, and it’s sticking to pollution and bacteria, and then you fall asleep with it. Not only are you going to get acne, but you can get accelerated aging because it’s just poking holes in your collagen.”
Keeping it clean
Henry is one of only a small number of Black dermatologists in the country, who comprise just 3% of the profession—a significant minority, given some of the distinct differences between Black and white skin care.
“I always say that my white patients are my wrinklers and my shrinkers and my Black patients are my sinkers and my saggers,” Henry explains.
Black faces don’t typically get fine lines and wrinkles early on; rather, they tend to lose fat below the eyes that causes relatively early sagging. “A lot of my white colleagues, when they’re doing filler, they start on the lips or on the cheeks,” she says. “I’m doing lots of filler around the eyes because that’s how we age, because we have a relative lack here.”
If you think of your bones and structure as a table and your skin as a tablecloth, when you age it’s like the table gets smaller but the tablecloth remains the same size, she says by way of illustration. “So we start to get laxity, we start to get sagging… we’re just aging differently. And so if you’re treating Black patients, you have to have a different eye and you have to be able to read age differently than others.”
Keep that aging process in mind, Henry says. “The skin you have before your 20s is probably the skin you were born with. That was your gift. The skin you get after your 20s, in your 30s, that’s all you—that’s based on how you ate, how you slept, how you drank, whatever behaviors you had. That’s the skin you earned.”
Henry doesn’t have a problem with makeup, though she says that using it “comes with other responsibilities.” To start with, regular makeup wearers should use a good cleanser, one that is going to get rid of any oil, dirt and debris. “If I’m on camera or whatever, I actually use a retinoid before I put on my makeup because I just want that kind of microscopic block, that microscopic exfoliation, keeping the makeup from clogging my pores.”
Henry is a big champion of retinoids, whose high vitamin A helps exfoliate the skin. “They’re probably one of the most transformative ingredients in all of dermatology because it’s helping to turn over the skin to unclog the pores,” she explains. They help fight acne in brown skin and can help lighten dark spots—a common issue with aging—and ensure an even skin tone.
“If you can tolerate a retinoid, I think you should be using it because it’s so critical to fighting fine lines and wrinkles to stimulating collagen. It’s basically all the things we need as we’re getting older… it’s one of the most critical ingredients I use in my skincare.”
Protecting your hair
It’s easy to overlook good care of skin that’s not exposed to the elements. “I always tell people, your scalp is just an extension of your face, and we’ve just been neglecting it for years and years and years,” Henry says. If your scalp is unhealthy—if it’s inflamed, or if you have excessive dandruff—that could contribute to what she calls the “huge epidemic of hair loss” that is being experienced in the Black community. “Any inflammation on the scalp is confusing the scalp from focusing just on growth and allowing it to focus on other things. So a healthy scalp is absolutely critical.”
Don’t be too quick to dismiss the warning signs as you’re just being “tender-headed,” Henry says. Discomfort and pain could be signs of real conditions that need treating: “I have so many patients come in, they’ve lost 40-50% of their hair, and they just thought that they were tender-headed and that’s why they had this discomfort. If you’re having pain, if you’re having discomfort, if you have redness on your scalp, it is so important to see your dermatologist because we can save hair better than we can bring it back. So, it’s always better to find it early.”
Henry has a word of caution for what some people call “protective” hairstyling but which is probably just more convenient. “Nothing is protective if you’re doing the same thing every day,” she says. For instance, wearing braids for three months. “Our follicles are really just meant to hold the hairs they’re meant to hold and we’re adding a ton of excess weight, we’re adding a ton of excess pressure. We’re doing styles that are just staying in the same position for a very long time. That’s trauma and that’s inflammation. And we get hair loss; we call it traction alopecia.” Those kinds of styles are fine, she goes on, just be sure to rotate them.
Another concern she has is people using heavy products or only co-washing (just using conditioner). “A lot of my naturalistas will just only co-wash with like a light conditioner, but we have to actually clean the scalp at a certain point. You need to have a cycle where you’re actually using shampoo to get rid of dirt, oil and debris on the scalp because you’ll get inflammation, and you’ll get hair loss [if you don’t].”
Some co-wash products do have cleansers in them, “and that’s fine, but sometimes we’re just using conditioner and so that becomes a problem and I’ll have girls come in with inflamed scalps for that.” If you straighten your hair, be careful not to use too much heat.
Coloring can be dangerous, especially if you’re leaving it to someone who may not be an expert. “Just make sure you’re doing it well,” she says. “If you’re doing it at home, I prefer a rinse. Maybe leave the more permanent colors, the more damaging processes, to your hair stylist, who has been trained to do this.”
Above all, pay attention to any symptoms. Pain or discomfort should be a telltale sign. “For so long, we’ve just gotten used to hairstyling hurting,” Henry observes. “I remember being a kid and just thinking it was normal that I should hurt after I had my hair done or after I had my braids: ‘Of course I’m going to have a headache.’ And it shouldn’t be that way.”
Doing your homework
What about Botox and similar treatments? Henry says sure, take advantage of them, recognizing that “I can just use a little, but get a lot from it. I can start earlier and not have to do a ton later. That if I start using these lasers and these treatments earlier, I don’t have to have a facelift when I’m in my 50s, 60s, whatever.”
However, be wise. Remember that you need to go to “someone who knows my face, who knows how I age, who understands my aesthetic, that’s not trying to force me into an aesthetic that’s not for me, and understands diverse beauty in a way that they can honor it with those treatments and not try to obliterate it with those treatments.”
As part of that, she says, be sure to vet your provider. “Because this is kind of more of a cash pay industry everyone wants to do it; everyone wants to make a little bit of income. Everyone wants to do a weekend course and they’ll post on their Instagram [that] they’re an expert. And that’s how we get in trouble, because it takes a lot of treatments, a lot of mistakes, to be an expert… if you look up and you’re in a garage or a basement, you’re probably in the wrong place, right?”
This skin thing isn’t only for the ladies, of course. Guys have their own issues, from balding to razor bumps. Henry is pleased to report an uptick in male patients, among them men who are going up in the world and are looking for a cosmetic boost to their sense of confidence.
Addressing hair loss, providing anti-aging and rejuvenation procedures doesn’t have to mean “feminizing,” Henry says. “If you want a more masculine look, we can do that, too.”
As men age, their jaw lines are shrinking: “All of that structure, we can give it back to you with products that are well suited for you. [And] I’m doing liposuction on my male patients who similar to women are getting that kind of midsection fullness that as we get older, it’s just so hard to get rid of.”
DR. MICHELLE HENRY: MY WAYMAKERS
My first waymaker was my mom. She was a nurse, and I remember her taking me on Take Your Daughter to Work Day. I was with the nurses, but I was watching this little secret group of doctors in their huddle, and I was like, “I wanna be over there.” So she talked to them, and they gave me a little white coat and a stethoscope. I was seven, and it was one of the best days of my life; that was it, I knew I was going to be a doctor.
Another waymaker was another family member, my great-aunt; she actually died of breast cancer. In the last six months of her life she knew that she was passing. I was about eight at that time, and I spent hours sitting on her knee, talking about all things in life: how a lady should behave, what I should do, that I should save patients like her. Until I was in medical school, I thought I was going to be a breast oncologist and I’m actually a skin cancer surgeon, so I didn’t divert completely.
