DoctorOz: Fibromyalgia: The Disease Your Doctor May Miss | S4 | Ep 49 | Full Episode

On the Dr. Oz show, are you always exhausted and in constant pain? It's one of the diseases your doctor misses most. This is a life-threatening disorder. Fibromyalgia. You can look at a patient and really not see it on them. Why did it take so many years for medicine to accept this was real? The latest treatments and discoveries. Plus, You're wasting your time and you're wasting your money. the one anti-aging product you're not using. It works immediately. Next. Today, I'm talking about one of the diseases that doctors miss most. Here are some of the symptoms. You're exhausted. You're tired. You can't get out of bed or your arms and legs are sore. You could have a constant backache, joint pain, or a throbbing headache. Even brain fog. Is this your normal? If so, you may be one of 6 million people who have what is called fibromyalgia. Today, I want to get you to the right diagnosis. Joining me is Dr. Jennifer Caudill, who is at the forefront of treating patients with fibromyalgia. Thank you for joining us. Thank you. So could you please help folks understand what fibromyalgia is? Absolutely. Fibromyalgia is a chronic pain syndrome. It can be very debilitating for patients. Patients often complain of a number of symptoms. Probably the main one is widespread pain. So they have pain all over their bodies and the muscles and the connective tissues. And usually this pain lasts for at least 3 months or longer. But in addition to the widespread pain, patients have other symptoms such as the ones you mentioned. Headache, fatigue, insomnia, etc. So it's really the combination of both the pain and these other symptoms that creates this condition. You know, it's sort of thought of almost as an invisible condition because quite honestly, you can look at a patient and really not see it on them. But on the inside, they're really struggling with it. What kinds of folks are at risk for this? Well, this condition most commonly affects women. This condition may run in families. We also know that it can coexist with other medical conditions. Things like rheumatoid arthritis, lupus, etc. And we also know that sometimes, and this is a theory, that there may be stressors or traumas that actually might even bring on the condition in the first place. And should folks think of it as a life-threatening disorder? Actually, Dr. Oz, yes, it's shocking. But yes, this is a life-threatening disorder. Now, fibromyalgia is not a deadly condition. People can live very full lives with this condition. But it is life-threatening. And when I say that, I mean in the sense of the holistic sense. Patients' quality of life is affected. You know, I have patients in my practice that have fibromyalgia and I've heard them say things like, you know, Dr. Cottle, I feel like I can't get up out of bed in the morning because I have so much pain. I feel like I've been hit by a bus. They can't live their life to the fullest. They can't go to work. They can't see their family and friends. So in this respect, yes, fibromyalgia absolutely threatens the quality of life that patients have. So, you know, it takes folks, I'm going to share this with everybody, an average of three doctor visits, three doctor visits before getting a proper diagnosis. Now, why is that? Right. It's pretty alarming, actually. And it's unfortunate. We have to keep in mind that fibromyalgia is a condition that there is no blood test or X-ray for. And this is one of the things that makes it so complex. That and the fact that every patient with fibromyalgia, they have many different symptoms, as you mentioned, but every fibro patient presents very differently. So each fibro patient is is usually different from the other. So when I went through medical school for most of my practice, we didn't think fibromyalgia even existed. Why did it take so many years with all these patients giving us complaints that in retrospect where this condition for medicine to accept this was real? You bring up a really great point. You're absolutely right that in the medical community, even though these symptoms have been going on for years, it really wasn't until about 1990 that we that the medical community established diagnostic criteria for really diagnosing fibromyalgia. You know, this is a condition that the term a hypochondriac or, oh, the patient's just stressed out or they're just overwhelmed. Those are really inappropriate terms with this condition, because we now know that this is truly a medical condition with important diagnostic criteria and also important treatment options as well. So essentially what we're saying is you have to play a role in helping us, helping medicine understand your problem. So here are some main categories of fibromyalgia symptoms. Pain. You've heard that mentioned a couple of times. Fatigue and insomnia, depression and anxiety and irritable bowel syndrome. There are many other symptoms and they can vary from patient to patient. As Dr. Carter mentioned, I want you to meet Judy, who had most of these symptoms and yet she spent years searching for the right diagnosis. About four years ago, my health took a dramatic turn. It all began like I had the flu. My body hurt. I was nauseous, dizzy, and I could not get out of bed. My doctor told me I had a virus was affecting my whole body. I couldn't say, oh, I have a headache or my legs hurt. It was just everywhere. I went to my ears, nose and throat doctor, a neurologist. I even was telling my gynecologist any and every test they could do. They did. Nobody had any answers. The doctors told me that I was just stressed. At this point, I started to mentally break down. The doctors were making me feel like I was a hypochondriac. I was spending time and money trying to figure out what's wrong with me, and I was left with no answers and frustration. It was the worst year of my life. Finally, I went to one more doctor and he told me that, indeed, I did have something wrong. It was called fibromyalgia. And just somebody telling me that they could help me, I felt like, oh, my God, I could breathe again. Thanks for sharing your story. So you spent a lot of time, a lot of money, a lot of effort to get the right diagnosis. How did it feel when you were told that it was all in your head? I felt like I was mad, I was angry, I was upset, but I was scared because I went through test after test after test. You know what I mean? I had brain scans. I had sonograms. I had blood work. I had upper GIs. I had everything done. And they kept saying, sorry, there's nothing wrong with you. And I'm like, a woman who takes care of four kids 24-7 and, you know, a family and I'm laying in bed and now we're on the third month. I can't get out of bed. It angers me, I've got to say, because I hear these stories all the time and I'm called about fibromyalgia by you, our viewers, all the time. And this is a very common scenario. In fact, I heard you had to bring your family with you to the doctor's office. Why is that? Because I felt like I needed an advocate to say she's telling you the truth. You know, she can't get out of bed. She lives a very good life. You know, she's always happy. She's always doing. She's never sitting still. And here she is in bed 24-7. Did any doctor ever directly say you're a hypochondriac? Yeah. You know, I kept coming back to my doctors because I knew I was sick and I didn't know what was wrong. And the one doctor said, you know, maybe it's in your head, you know, like you're being a hypochondriac. And I don't even know what to say, I'm speechless. I went home and I cried. I cried and I cried because then I started thinking, am I crazy? You know what I mean? I have a huge social circle. You know, then I'm like, I'm not going to tell anybody I'm sick anymore because if the doctors think I'm a hypochondriac, you know, my family and my friends might start thinking there's something wrong with me. It was very sad. So how'd you finally get the right diagnosis? A year and a half later, you know, I'd been sick for the whole year off and on, usually three months at a time. And then a year and a half later, it came back real strong, real fast. And I was in the middle of planning something big. And I went back to my regular doctor and I said, I'm sorry, something is wrong with me and I need help now. And he had said to me, OK, I will send you to a rheumatologist within three months of meeting. I mean, within 15 minutes of meeting with my rheumatologist, he said, I know what you have and I'm going to make you better in 15 minutes, 15 minutes. But my regular doctor did say your back might be up against the wall here. He said, I'm going to be honest with you. Most doctors don't think that fibromyalgia is real. So, you know. How do you feel that moment 15 minutes into your office visit when you had a diagnosis? I felt like I'm going to live again. You know what I mean? I'm going to be that person I was a year and a half ago. And, you know, I was trying to hide it from my kids. So I'm like, you know, they're going to see their mom back and, you know, we're going to get through this and I'm going to sit down on the computer and I'm going to research this. I'm going to find out as much as I can. I was just so happy. I got to say, I mean, the story that you're sharing with me, I wish it was unique. Dr. Carter mentioned this is a classic scenario. There are millions of women who are wandering around right now because most people with fibromyalgia don't know they have it, who are either feeling it's in their head or being told it's in their head. So what do you have to say to those folks? You know, I love doctors. I think they're great. But you are the best advocate for yourself and you have to say to the doctor, no, something is wrong and you have to keep moving forward till you find the answers because you know yourself better than anybody else. And if I would have just quit, I feel like I'd still be home sick in bed. You probably wouldn't be. And there are many people who still are at home watching right now because they can't get out of bed. Yeah. We're walking around with a diagnosis like this or something else. It's not just about fibromyalgia. This is about a lot of problems. We just don't have our arms around yet because we just have this much of health figured out. We got this much more to figure out. That's called doctor to doctor. Yes. I'll have an open discussion about this. Has it gotten to that point now where we have to ask patients to strong arm their doctors? In a sense, yes. It's really important for patients to be advocates. I appreciate really what you're saying. This is actually something I say to my own patients all the time and even family and friends. The relationship between a patient and a doctor is just that it's a relationship. So you as a patient, me as a patient, you as a patient, we have to feel comfortable with our physicians. We have to feel like we can talk to our doctor and that we're being heard. Doctors, on the other hand, we have to be good listeners. We have to do proper physical diagnosis and physical exams and also hear the patient's story. So this really is a collaboration. And I absolutely agree that if you're not comfortable with your doctor, I've said this to many people, find someone else, find someone who you really can have a productive collaboration with, because that's especially what's needed with this condition in particular. Well, I'm proud of you for hunting and pecking and not leaving all that stuff behind because it would have held you back. Yes. Thank you. Thanks for your story. Coming up, could your pain and exhaustion be fibromyalgia and you don't even know it? Find out what to look for when we come back. Up next, here's what we've learned. What's really going on inside the body. It's an early warning system gone awry. You may have fibromyalgia and not even know it. Wow. It's not all in your head. And later, one of the best aging racers. The powerful anti-aging secret I want you all to use is. Are you ready? Stay with us. So let's start talking. Now the web to have an international conversation about health and wealth. This is a no embarrassment zone. There's no topic that's off limits. I came to work today. I'm so lucky. And make sure you're sharing this information with the people you love. You're good to go. Be sure to subscribe to my channel. You don't miss anything. And remember to check back often to see what's new. Now back to the show. I drink a lot of coffee. Could caffeine trigger a fibromyalgia flare up? If you've noticed your symptoms get worse after caffeine, you should try to cut back. Start by filling up your mug with half decaf and half regular. Talking about fibromyalgia. Now millions of you have it and most don't even know it. Tamara is here because like so many of you, she wrote to me asking if her symptoms were a sign of fibromyalgia. So can you describe those symptoms, Tamara, for me? Basically, I've noticed that I've been extremely fatigued. I've been experiencing some back pain recently as well as I'm at times I feel like a foggy brain, if you will. And when I get out of bed in the morning at times, I'm just like, I feel like almost a sandbag. I'm so exhausted. I'm so tired. I feel horrible. That sandbag analogy. I hear that sometimes. That's pretty, that's pretty good clue. You might have fibromyalgia. How long have you had those symptoms for? Going on for about a, about a year. But the fatigue has increased over the past couple of months or so. It's a long time. Yeah, that's lovely. Let me explain to you Tamara and so many folks what's really going on. We believe inside of fibromyalgia. Is that okay? Yes. Come on back here. This is what your body looks like. And simplistically, we put little cables here to represent the pain you may feel, but the game in fibromyalgia is not about the muscles or the joints or the, or the hands and the feet. I know that's where we sense the pain. It's about the pain dial in our brain and we have a pain dial up there to help us regulate how we feel pain and how long we feel a pain. That's a good thing Tamara, because if you bang your arm into something and you have pain, let's turn this on a little bit. You want to sense that pain, right? You want to know you're in pain. It's an early warning sign. Something's wrong. When you hit your arm, you pull it away and the pain goes away. That's how it's supposed to function. But in fibromyalgia, here's what we've learned. This pain dial, it gets turned way up and it's stuck on full and your entire body begins to even though you only banged your head. Wow. So the brain is overreacting. It's an early warning system gone awry. That's the fundamental reality of what goes wrong in fibromyalgia. So now we've got to figure out what to do about that. Thanks for telling us your story. Doctors often diagnose these symptoms as MS, as Lyme disease, as back pain, migraines, even menopause, a whole constellation of problems. In reality for many times, folks, it's really fibromyalgia. So let me bring in world expert Dr. Sean Mackey is the chief of pain management at Stanford school of medicine. Thank you for joining the show. You've got some big news about fibromyalgia and if you can, what is it that you have discovered that we never knew existed before? They could help us make sense of this ailment. I think we've got some exciting news that for the first time we understand that fibromyalgia is probably not a disease of the muscles, the joints, the ligaments, the tendons, but instead it's fundamentally a condition or a disease of the brain and specifically the nerves and the neurons that are processing pain within the brain. And what we've learned is that there's a real distinction between someone who's healthy and someone who has fibromyalgia and the way they process normal sensations. Somebody with fibromyalgia and taking normal sensations up from their body, they perceive it as painful. It's as if the volume gain, much like you just very elegantly showed here, the volume gain has turned all the way up to 10 so that they're getting excruciating pain and pain such as the brain can't ignore it. Now the other thing that's going on is that that normal pain alleviating functions that all of our brains have is all haywire in fibromyalgia. Bottom line is that while fibromyalgia is in the brain, it's not all in your head. So what do you think is causing fibromyalgia? What's causing the head to respond differently? Well, that's the million dollar question. And we know that there are some genetic factors that play a role here, but it really takes an episode that triggers it. It needs something like a minor or significant trauma and injury. Sometimes it's an infection or the flu. Sometimes it's a little bit of post-traumatic stress. And I've had patients who after minor motor vehicle accident can get a traumatic PTSD and go on to have fibromyalgia. We've learned that all of this sets this cascade up in the brain and also sets our stress and our home run system out of whack. So I've often thought diet made a difference. Am I correct in that assumption? You know, there's been no specific food that's been shown to trigger fibromyalgia, but what we have found is that anecdotally people who eat a healthy diet, rich in whole grains, fruits, vegetables and anti-inflammatory diet do seem to do better. And speaking of inflammation, we're now learning that inflammation is probably playing a role here, but not the type of inflammation that you see in arthritis, but more inflammation along the nerves and in the neurons in the brain. And what's exciting about this is that our group and others are now using this information to target that inflammation as new therapies for fibromyalgia. Thanks for the hard work you do on this. It's groundbreaking work. Now chronic pain, extreme exhaustion. If these symptoms sound like you, your first line of defense may not be your general interns up next. I'll tell you what kind of doctor you should see. Stay with us. Coming up, how to find the right doctor for fibromyalgia. Plus, you brought a unique therapy today that I adore trying to help the body heal itself. And later, fight the signs of aging deep under your skin. Is it part of your daily routine? Cheap, easy to use. Don't go away. So let's start talking. Not a way to have an international conversation about health and wellness. This is a no embarrassment zone. There's no topic that's off limits. I came to work today. I'm so lucky. And make sure you share this information with the people you love. You're good to go. Be sure to subscribe to my channel. You don't miss anything. Remember to check back often. Now back to the show. I've heard chamomile tea can alleviate the symptoms of fibromyalgia. Is that true? There's no direct evidence that chamomile tea works to help fibromyalgia, but it can relax you and help you feel ready for sleep. I'm not talking about fibromyalgia. I don't want you wasting your time or your money anymore. Going from doctor to doctor to get the diagnosis that you need. Dr. Doddle help us with this. What is the kind of doctor folks ought to be looking for advice from in order to make this diagnosis correctly? Sure. I think it's a great way to start out, to start out with your primary care physician that can be your family doctor that can be your internist, but you might need a specialist, in which case you might see a rheumatologist. Now a rheumatologist is a specialist who really focuses on musculoskeletal diseases as well as many others. And they often see lots of fibromyalgia patients. So this is a great place to go. We also think that neurologists might be a great place to go as well because now we're learning so much more about how fibromyalgia affects the brain. So rheumatologists and neurologists, these are two specialists you should all ask for if you're in hot end pecking for the right diagnosis. All right, let's get the treatment. We know there are three FDA approved medications that can help fibromyalgia symptoms, but you brought a unique therapy today that I adore. It's called osteopathic manipulative treatment. And Dr. Martin Levine is joining us. He's an osteopathic physician who uses these practices in his practice to teach us a little bit. Who would this be appropriate for? I'm sorry. Yeah. Carol. Yes. Thanks for being the guinea pig today, Carol. So osteopathic manipulative treatment is performed by osteopathic physicians. It's really a way that physicians are able to diagnose and treat musculoskeletal problems with our hands. And really the idea is we're trying to help the body, the patient's body heal itself. So Dr. Levine here, one of the things that he was doing initially was feeling for muscle spasms in our patient's neck. And he's now stretching out the neck muscles to kind of relieve some of those muscle spasms. Now it's important to remember that OMT or osteopathic manipulative therapy is treatment is fantastic for fibro patients, but there are other treatment options, meditation, yoga, cognitive behavioral therapy, et cetera. But this is one great option. And ideally who benefits the most from these treatments? Most fibro patients will benefit from it. If you're concerned about whether this is a good option for you, make sure you speak with your osteopathic physician about that. But most patients can really tolerate OMT very well and actually be very successful. Dr. Levine now is doing a structural exam on our patient's back looking for other muscle spasms. And now one of the things he's going to do is he'll lie our patient on her back. And this maneuver really is an attempt to restore the patient's body movements and joints back to their normal range of motion. Oh, I hear the cracking. I like that. I hope Carol's okay under there. Stop moaning and groaning, Carol. And so, um, this is one of the treatments that he routinely performs as many osteopathic physicians do. This is great for a lot of, um, pain conditions. OMT can be used for things other than fibromyalgia. So other chronic pain conditions, headache, um, arthritis, uh, low back pain, you name it. But this is a, this is a great option. How are you doing? You're okay in there. You keep working here with Carol. Enjoy. This actually doesn't look very helpful. Well, I've actually referred patients for this. And I think this type of osteopathic manipulations are worth considering as an alternative, especially for conditions like fibromyalgia. Coming up next, the thing you need to take in order to get five years off your face and look younger. Find out what it is. It's coming up. Next target your worst wrinkle areas and say goodbye to them. Younger, newer skin fills in that space. The powerful anti-aging secret that should be in your medicine cabinet. Is it a moisturizer? Is it a lotion? Is it something else? Find out. So let's start talking. Now the web to have an international conversation about health and wellness. This is a no embarrassment zone. There's no topic that's off limits. I came to work today. I'm so lucky. And make sure you're sharing this information with the people you love. You're good to go. Be sure to subscribe to my channel. You don't miss anything. And remember to check back often to see what's new. Now back to the show. Dr. Oz reveals the one anti-aging product you're not using. You're wasting your time and you're wasting your money. Look younger overnight. It works immediately. That's the nice thing about it. I've asked everyone to circle their worst wrinkle, the area they wish looked smoother and younger. I did it to help us answer one big question. What's the most important product you can use to target that spot that you circled? Is it a moisturizer? Is it a lotion? Is it something else? Well, the powerful anti-aging secret I want you all to use is, are you ready? Alpha hydroxy acids. They're making a big comeback and we're now learning that they can fight the signs of aging deep under your skin, deep inside of you. Now they're cheap. They're easy to use. And by the end of today, you're going to know what type of alpha hydroxy acid is best for you. So we got to find out why you circled yourselves and where you went. Noreen, you want to join us first? Sure. Then if you don't mind. Sure. So you circled under your eyes. Yes. Why there? Because as I age, I look in the mirror and I want to cry. I want to walk out with my sunglasses because when I look at pictures, when I was younger, it looks smooth and I used to get carded up until I was 30. I swear I hit 35 and they're like, go ahead, get out of here. So you want to get carded going forward? Yeah, that would be great. Is that an aspiration? Many of you have getting carded. What do you do for your under eye wrinkles? I've tried every cream imaginable. So I do a nightly cream. Um, and I don't know if it works or not. I definitely feel a difference when I don't use it, but I've even done like for allergies. I think it's from rubbing my eyes. So I've used eye drops and you know, we're going to like our suggestions today. Thank you very much. I also have Tara here. How are you? Hi, good. How are you? Where'd you circle? I circled around my laugh lines. I should point out some people circle their whole face. It doesn't count. It doesn't count. Well, I'm glad you specified there. And why there? Well, um, when I look in the mirror now, I see the dimples. All right. And when you, when you see those wrinkles, does it make you feel a little older? You want to get carded also? Yes, I do. All right. Thank you for sharing those stories. So I'm going to show you how alpha hydroxy acids can help you smooth out the fine lines that you all hate the most. So I'm going to bring in dermatologist, Dr. Jeanette Graff. Thanks for joining us, Dr. Graff. Thank you. It's great to be here. You just got some good insights about the wrinkles and how they bother folks. Why is it that alpha hydroxy acids are making such a big comeback? Well, there's a lot of new research about alpha hydroxy acids. They are natural acids that are found in fruits and milk. And what they do is they take this dead skin cell layer, which collects as we get older, making our lines and wrinkles look deeper and it removes them and renews the skin. And nothing works as effectively as an alpha hydroxy acid. Now they are found, you know, these are weak acids, right? They're gentle ones. They're found in foods like sugar cane. They're found in milk. They're found in fruits like apples and lemons and oranges. And they're the ingredients in a lot of different products, right? They're in moisturizers, they're in cleansers, they're in masks. And because they're so widely used, it makes sense. They probably were used a long time ago as well. In fact, Cleopatra's anti-aging rituals a couple thousand years ago included a milk bath, which was basically to help exfoliate and to smooth your skin. It was a type of alpha hydroxy acid. So you're arguing, if I understand correctly, there's not a single woman in this audience or watching us right now on television who should not be using alpha hydroxy acids. Absolutely correct. So does alpha hydroxy acid work better in some age women than others? Actually, alpha hydroxy acids work well in all ages and all age groups. But if you're older, when you try it for the first time and you have a greater collection of dead skin, you will see a bigger difference. That'd be a good news for a lot of folks. That's right. The other thing I don't understand is why do we stop using it? Because it was there at the very beginning. So Noreen, if I can ask you a question. Yeah. Have you ever tried alpha hydroxy acid? I tried it a long time ago thinking I could avoid this, but it made my skin very dry and a little bit red. And I didn't think I could use it under my eyes to be honest. So. And did you have a reaction to it? Yeah. I felt like I got red dry skin from it. So then I stopped using it. Oh, so you thought it was from the alpha hydroxy acid? Yeah, I thought it was from that. So I don't know. And Tara, have you ever used it? No. Never tried it. Not that I know of. Not that you know of. I love that. Have you ever heard of it before? I've heard of that, but I hear of a lot of things and I'm busy. And when I have that moment to write something down, I run to the store to get it. And I'm not sure if that's in it. So not to grab, I mean, since it was there and probably, you know, that's really the beginning of our careers. Why do you think it changed? Why did it drop out of favor? Well, for exactly the reason that we heard, because initially when they first came out, many of the alpha hydroxy products were irritating. So there were a lot of complaints and then they fell out of favor with a number of people. Many people still use them, but I have to say there's two reasons. One is the formulations today are completely different. So they're pretty safe to use and they've kind of perfected them. So all skin types can use them. And depending on where you use them, you can use them around the eye area and eye creams. You can use them on the face and serum form. You can use them on the body on different areas. But the other thing is there we're bombarded by so many skincare products today that it's hard for consumers to know what they should be using. So it's great that we're revisiting this topic because it is so important. Oh, well, once I understood the research on alpha hydroxy acid, I felt really passionate about getting this out because so many folks ask questions around skincare and we've got, sometimes we think we have the basics, but I think a lot of it is marketing. Let me show you all why I think it's the most important thing for you to have in your skincare collection. So here's an animation of what your skin looks like. Many of you complain that you sort of have a dullness to your face. The reason for that is the old skin cells lie there and they sort of hang out and they cause these little valleys and crevices and that reflects the light weirdly. So you look dull when you look in the mirror. Now if you put on alpha hydroxy acids, they coat the entire surface of the skin, but they also go deep under the skin. That makes sense. When it goes through the skin, it creates a new environment for the cells lying under there. Now that environment makes these cells vulnerable and it makes these cells more likely to die quickly. That's a good thing because that means that those older cells leave faster. They allow new vibrant, young cells to come to the surface. They don't have those nooks and crannies and valleys, so they don't reflect the light in weird fashions. And because of that, you'll have that more youthful looking skin. And if I'm hearing correctly, you may even see this benefit more in folks who are a bit older. So it's a smart thing to revisit. So Noreen and Tara, since you know, you've got huge aspirations of getting carded again. What I'm going to do when we come back is talk about why alpha hydroxy acids are the most valuable tool to help those wrinkles. So up next, the mistake you're making every day that's aging you. You're going to be surprised to find out what you are doing wrong. Up next is your nightly routine doing more harm than good. Nine steps. We could take care of several of those steps. Plus you have to be able to find the right kind of alpha hydroxy acid. Don't you? The best choices for your skin type. You can get them in serums. You can get them in cleansers. You can get them as moisturizers. Don't go away. So let's start talking. Now the web to have an international conversation about health and wealth. This is a no embarrassment zone. There's no topic that's off limits. I came to work today. I'm so lucky. And make sure you're sharing this information with the people you love. You're good to go. Be sure to subscribe to my channel and don't miss anything. Remember to check back often to see what's new. Now back to the show. Dr. Oz, Ada here for your wrinkle report. About five years ago, I started noticing the deep wrinkles under my eyes. They just keep coming. I think it's stress and lack of sleep, whatever it is. Dr. Oz, is there a way we can slow the process on this? Can you help me please? We're talking about your aging skin. Let's bring in Julie who says her daily anti-aging skincare routine is a very involved process. So you took some video of your typical nighttime routine. As you all watch it, how many steps do you go through? Describe this for us. There's about seven, eight, sometimes nine. It could go on forever. Nine steps. Why so many things? You know, I'm trying to get rid of these wrinkles. I have a young, young daughter. So I just, I feel like I've got to do something with these things. It is dizzying. It really is. So how long have you been doing this for? You know what? Over 20 something years, 20 years, nine steps a night. Yes. And anyone can bow for me. If they look in my bathroom cabinet, I have every product out there. You can imagine what your life must be. They don't know what I do in there. They have no idea what I do. When you were trying to buy an anti-aging beauty product, what do you look for? You know, I look for anything that says anti-wrinkle smoothing cream, anything that has to do with wrinkles. I buy it. So Dr. Graf seems like she's got everything covered. Is she missing anything? Well, I think that we could actually save you some time because we could probably cut out three of those steps. And just by adding an alpha hydroxy acid, we could take care of several of those steps. Do you exfoliate Julie? I do. I use a little brush. I use scrubs. I use micro bubbles. I use everything. So a lot of different ways of exfoliating. This is a part of the story that I only learned recently. I'm fascinated by alpha hydroxy acid. How would you compare that to other exfoliants that Julie's using? I would say that alpha hydroxy acids are smart. So when you put them on your skin, there is a reaction that happens because of how they interact with your skin. Whereas a physical abrasive or something that's mechanical, you control. So it can sometimes be to the point of too much of a good thing or not enough. So that's where I like alpha hydroxy acids. Now you hear so much though about different acids. I mean, glycolic acid, salicylic acid. What, I mean, are they all the same thing? No, they're different. Salicylic acid is a different type of acid, but glycolic acid is one type of alpha hydroxy acid as is lactic acid, citric acid. I'm going to cover that in a moment, but I want to show you first why it's so important to use products that can strip away that dead layer of skin because otherwise you're wasting your money. A lot of those chemicals you're putting on your face aren't actually getting to the skin where they need to be in order to help you achieve that young youthful skin that you desire. So come on over here. So I built you a little flower garden. Thank you. You like flowers? I love flowers. All right. So this is actually a metaphor for your skin and these youthful, beautiful flowers down below here are the young skin cells that need to feel the nutrients that you give them. When you try to put creams, serums, chemicals on your face to allow you to age more gracefully, you need the chemicals, the plant food, so to speak, to get to the plants. But on our face we naturally have old dead skin cells and there's a covering with those dead skin cells. It makes it really hard for the plant food to get to where it needs to go. You see those plants aren't getting any of this at all. Nothing's happening. Nothing's going through whatsoever. You're starving your skin cells that need the nutrients and you're wasting your time and you're wasting your money. This is true for all of you who've circled parts of your face. That's why the first thing you need to do when you're going to put something that might be beneficial on you is to get rid of these other skin cells. The old stuff you don't want there. So alpha hydroxy acid wipes all this away. And by doing that, you now have an environment where you can take nutrients, whatever those serums and creams and potions you're using, and you can get that material to these young skin cells that desperately need it. So now you can water the skin just where it needs to be. That's why exfoliation is so important. So Dr. Graf, how much more valuable would Julie's anti-aging solutions be if she was able to do this? Well, just from your excellent demonstration, you can see dramatically different. It will be dramatically improved because it's like removing a barrier to your house. It's opening a door so you can enter. Think of all the ingredients that are just sitting on your skin, not getting in because that layer of dead skin is blocking. Now the key question here is if you want to get these flowers, nutrients that they want, you have to be able to find the right kind of alpha hydroxy acid, don't you? That my friends is a pretty critical decision. So coming up next, the best anti-aging match for every skin type. Find out what's right for you. Coming up the best alpha hydroxy acid for your skin type. How's it feel Sharon? It feels smooth. The most effective way to use it. It's a really good moisturizer for oily and combination skin. And how to work it into your daily routine. Next. Dr. Oz's show. So let's start talking. Now the way I have it in national conversation about health and wealth is a no embarrassment zone. There's no topic that's off limits. I came to work today. I'm so lucky. And make sure you're sharing this information with the people you love. You're good to go. You should have subscribed to my channel. You don't miss anything. Remember to check back often. Now back to the show. Hi, Dr. Oz. It's Debra here with my wrinkle report. I have these annoying wrinkles under my eyes that started in my forties. I've tried creams. I've tried concealers. Nothing works. I guess it's just the normal aging process or maybe I'm dehydrated. What can I do about this? Dr. Oz. So what's the best type of alpha hydroxy acid for dry, for oily or for combination skin? Let's bring in sisters, Sharon and Alicia. Sharon says her skin is very dry. Is that correct? It is very dry. And have you ever used alpha hydroxy acid before? I use alpha hydroxy probably 15 years ago, but as soon as I put it on my face, it just burned and I had to wipe it off immediately. So Dr. Graff, common complaint. Should Sharon give it the alpha hydroxy acid another shot? Definitely. Also 15 years ago, they were more irritating, but for someone like you, Sharon, whose skin is dry or for darker skin tone patients or patients with sensitive skin conditions like rosacea, I recommend the polyhydroxy acids. Now I'm going to put some on your hand. This is in a serum form. You can get them in serums. You can get them in cleansers. You can get them as moisturizers and you dab this around your face and just blend it in. All my wrinkle spots. I would put it everywhere because what it does is it helps to even out your skin tone too. So just think what's in that dead skin cell layer, age spots, wrinkles, everything looks accentuated. So when you exfoliate that top layer, the skin looks brighter and more even toned and you can just blend it in. Yeah, it feels very smooth. So it's a new generation of an anti-aging serum. And how often should Sharon be using it? Sharon could use this every night. And this is a serum. So you could put your moisturizer on right over it. Or if this is fine, you can just leave it and sleep like this. So is this sufficient just to use this by itself? If it's moisturizing enough for you, if you have dry skin, you may want to put a moisturizer over it. But I also like it on the neck, on the chest. These are areas that have aging skin. You can put it on the back of your hands. But in theory, you could just use the alpha hydroxy acid, use nothing else besides that. If your skin doesn't feel dry, then you're good to go. You're good to go. Most of the time, if you're using a serum, you may want to put a moisturizer over it because the serums are very concentrated. So they may be a little bit tight where they may make your skin feel a little tight. So you may want to put a moisturizer over it. How's it feel Sharon? It feels smooth. She got a dab on her nose. I'd like people to complain about it. It's going to smooth it out a little bit. Okay. I love sisters. Let's take a look. Yeah, very good. You did a good job. Does it burn? Not a bit. No, I could keep it on now. I'm not like grabbing the wash rag and trying to get it off as quickly as possible. So your sister, Leisha has a very different kind of skin. You argue your skin is oily. My skin is very oily. Yes. It's shiny all the time. I'm shiny and I'm usually always blotting or, you know, trying to put more powder on to cover up the shine. It just, it's just a mess. It's like an oil slick. Oh, huge oil slick. You know, it's like, you know, bright, shiny light. When I walk out in the sun. Dr. Grant, what do you recommend for oily skin? So we already covered dry skin for oily skin. I recommend glycolic acid. Glycolic acid is the strongest of the alpha hydroxy acids. It penetrates quickly. So if you have oily or acne prone skin glycolic acid is great to use. You can use it in a light lotion or in a cream and you would put it on much the same way as, yeah, just a little bit on your face. Just rubbing a small amount. You could also, you spot it distributed and put it everywhere. I would also recommend that you could use a cleanser that contains glycolic acid also. No, how about that spot there? She's trying to help you. Oh, it's priceless. But never changes that while they're, while they're bickering over here, what about the in between skin types? So if you're not dry and you're not oily, what do you recommend? Combination normal skin types. I like lactic acid, which is, we know comes from sour milk. Lactic acid is great because it moisturizes it. It exfoliates. It's found pretty widely and you can use it. You find it in a lot of body moisturizers also because it's great for the body. So it's a really good moisturizer for oily and combination skin. And just to make it clear for everybody, what is the most effective way to use alpha hydroxy acid? Once you find the right kind for your skin type, but what's the, what's the formula for that? The best, the most effective form is either a serum, a lotion or a cream because they are leave on products. So when you put them on your skin, the alpha hydroxy is able to stay there. If you use, you can add a cleanser for added benefits, but if you use just a cleanser, you're rinsing it off. So you're not going to get as lasting benefits. And what about sun exposure? Cause I know once you've taken that superficial layer of skin off, you've taken protection off as well. That's right. And the alpha hydroxy acids will make the skin more sensitive to the sun. So absolutely every single day of the year, you should use a broad spectrum sunblock UVA and UVB with an SPF of 30. Otherwise you're wasting all the benefit of what we're trying to do here. Thank you very much. You guys can keep equivalent over here. Coming up next, your best works of art inspired by this show. I'm showing off your masterpieces. Dr. Oz's show. So let's start talking. Now the web to have a national conversation about health and wellness is a no embarrassment zone. There's no topic that's off limits. I came to work today. I'm so lucky. And make sure you're sharing this information with the people you love. You're good to go. Be sure to subscribe to my channel and don't miss anything. And remember to check back often to see what's new. Now back to the show. I love to answer all those personal questions you send in. But today I'd like to show off some of the other fun things that you sent me. Here are some of my favorite pieces of art. And this sketch came from Linda. I think it's pretty respectable. That's pretty good rendition. Put my head like this. Yeah. That looks like me pointed ears. I look like Spock there a little bit. It's good. This next one is from Alex. He's a fan in the UK. Check out the detail here on those vegetables. Very healthy. They're smiling. I love lettuce. And here's another one from Alex. She's very, very active, makes a very clear fashion statement. Don't you like, come on, be on. I like that. That took a lot of time to make. It's very, very innovative. Here's another one that blew me away. It's from Alvaro. Look at this game. I can play this game. I like that. I like that. My funny bone is anatomically correct. And this last one here comes from my youngest fan, Brian. This is a bit experiment, you know, experimental, but I will definitely hang this on my fridge. Now I've got a couple of folks in the audience. Marissa is here with her masterpiece. How are you Marissa? Are you happy with it? I'm very happy with it. What was the hardest part of my face to draw? Your jawline. It's because it's big. Not really big. It's more wide. I'm pretty good here. I was watching your show actually. And that's when I decided to do it and it took me about the length of your show. Well, I'm very flattered. You took the time to do it. Thank you very, very much. Dr. Oz is the angel by our sides. Oh, thank you very much. Thank you. This represents, um, my sisters and I, and you Dr. Oz, I know is a big advocate for women's health and, and we are as well with breast cancer awareness. So it, this is my sisters. And then there you are. Four sisters. Yes. Oh my goodness. What was your dad's life like? Well, I'll tell you what, getting dressed with four sisters this morning was incredible. So, uh, you know, we're very close, very close in age. So I can imagine the fight for the bathroom. Yes. I'm very honored. You included me. And I have my own little pink ribbon with my doctor's jacket on and I even have a little angel loop here. Thank you very much. You should have subscribed to my channel. You don't miss anything. And remember to check back often.