Penelope Cruz and Gwyneth Paltrow’s go-to doctor wants you to understand why your skin is connected to your gut

In her book, Younger Skin Starts in the Gut, Dr Nigma Talib explains how digest-ageing and gut-flammation can impact the skin

A typical visit to a skin specialist would involve multiple rounds of skin assessments and, in due course, prescription of treatment plans comprising pills or in-office services or both. However, an encounter with Dr Nigma Talib is barely close to the conventional yardstick. A naturopathic doctor and medical aesthetician, Talib gloats an august roster of clients from Gwyneth Paltrow and Penelope Cruz to Sienna Miller, Rosie Hunington-Whitley and Charlotte Tilbury. She started her practice in 2001 in Vancouver, and has, over the years, gone on to create her  eponymous beauty and wellness brand. 

What makes Talib and her approach unique is her rudimentary emphasis on one’s gut health to decrypt the mishaps it is fueling for the skin. She started off as a naturopathic doctor in her 20s and 30s, and as she went about treating her patients’ gut and hormonal issues, she noticed an enhancement in their skin. That’s what propelled her to also venture into the skincare space, especially the anti-ageing terrain. Her research and approach to treatment pertaining to topical concerns combined with health improvement has made her one of the most sought-after doctors among those looking to achieve youthful-looking skin.

While ageing is the most common concern that she works with, Talib also offers comprehensive inside-out therapies and treatments—from dietary programmes to rejuvenating facials. In a chat with The Established, she walks us through the gut-and-skin relationship, her beauty solutions and how treatments are perceived differently across the world. 

Explain naturopathy to us. What is it all about?

Naturopathic medicine is a form of medicine that looks at the root cause of why somebody has an illness or a skin concern. Anything chronic—think chronic fatigue, skin inflammation, migraines, hormone and gut imbalances, insulin resistance, weight gain and the likes fall under the umbrella of a naturopathic doctor. Think of us as biochemical detectives; we’re looking at root causes and clues from lab tests. I am also able to assess one’s overall health and well-being by looking at their tongue and skin and palpating the abdomen to figure out areas of bloating. We look at health from the bottom-up approach instead of the conventional top-down approach which, to me, is not very scientific. The real science in medicine comes from looking at cellular health. While most people think of naturopathy as a non-science, it is actually ironic. We look for the ‘whys’ of a problem as opposed to just prescribing a drug. Naturopathic medicine also taps into various tools and mediums—from food intolerance and allergy checks to gut microbiome and urinary hormone assessments—in lieu of conventional lab tests that might not reveal much. If you want to live long, you’ve to live optimally, and that’s what naturopathy is all about.

As a naturopathist, what does a typical consultation with you look like?

When you’ll come in, I will first look at any lab tests that you may have done personally because my reference ranges to presume you’re optimally healthy are different from those to the conventional health model. I’ll then run a set of tests that will help with the data I need; I’ll run a viral panel, inflammatory panel, liver panel, glucose and insulin panel (more than 90 per cent of the results are always abnormal). I’ll do a gut microbiome stool analysis (I know it’s a crappy job, but one has to do it), and might also run a food intolerance test if you’re not sure about something that you’re eating that might be causing a problem. Once we have all the results, I will put together a plan for that individual on the basis of what they eat, their lifestyle and diet, and also recommend supplements. Usually, it takes about 3-6 months to see evident results, although people start to notice a difference within just two weeks of making changes. It’s a very satisfying job. 

Why do you emphasise inside-out beauty?

Most of your immune system—about 80 per cent—is located in your gut and so are your feel-good hormones. If we don’t treat the gut, anything that we do/apply topically or superficially is not going to work as well as if you have balanced hormones and a balanced gut. When you’re happy and feeling good, you look good versus when you’re depressed or feeling down, you’re not going to smile as much, you’ll eat the wrong foods and it’s going to show—it’s a domino effect. So by treating the inside, the outside will more than certainly improve; I’ve seen that with all my patients in the last 20 years, and it works!

As a doctor who travels around the world, how, according to you, are in-office consultations and treatments perceived differently in India from the West?

In American culture, it’s very normal for someone to have a naturopathic doctor as well as a conventional doctor; for some patients, I am their only doctor. In India, there is an emerging holistic community growing, and I am seeing and hearing that from my patients as well. If you look at a lot of our ancient therapies—take a honey and turmeric blend, for instance, that works well for a cough as well as for the skin. We actually thrived on holistic medicine; we must revisit the practices that our ancestors performed since that’s where the answers lie. It’s only a matter of time because Indians are more aware and want to take more control over their health—it’s evolving and exciting.

And, how is the skin of Indians different from that of the people in the West?

We have very different skin, in the sense that we’re more prone to acne and rosacea but the good news is that the quality of the skin is really resilient—great collagen and elasticity—and the most beautiful skin that I’ve seen. But there definitely is an issue about predisposition to post-inflammatory hyperpigmentation, so our skincare routines have to be about decongesting the skin. We have to be very careful with using lasers and IPLs (Intense Pulsed Light therapy) but also with our diets (Indian diets are heavy on oil that causes gut microbiome issues). I think a combination of environmental aggressors plus the typical Indian diet is what causes maximum damage. Looking at millet, steamed foods, vegetables and additional protein consumption can really help.

What is it like being a go-to doctor for celebrities like Sienna Miller and Gwyneth Paltrow? Are their skin concerns different from laypersons?

Their face is their office; they are constantly exposed to travel and congestion coming from wearing make-up, which can be quite tough on them. Having said that, I think their skin isn’t different from anyone else’s. However, in Hollywood, people really are focused on their health first. Gwyneth Paltrow, for instance, emphasises the importance of gut microbiome (she was the one who made me move to Los Angeles). They have to keep their skin looking the best without doing things that make them look artificial. People inject a lot of stuff into their faces; Paltrow and Sienna Miller, for example, keep away from injectables since it may hamper their expressions while acting. The approach towards bettering the skin remains the same, the concerns and their magnitudes could vary from time to time. 

How, in your opinion, has the anti-ageing beauty industry expanded in the last decade? What has led to this expansion?

Celebrities like Jennifer Lopez, Gwyneth Paltrow and Sofia Vergara are all my age; we’re entering our 50s and we’re proof enough that you can still be in your prime when you’re told that you’re not in your prime. There’s more awareness around skincare, but that also worries me because I don’t want people of the younger generation to think that skincare is your only answer—it isn’t. You have to start from within, only then will your skincare work ten times better on the outside. Beauty from within is the first step; peels, skincare and treatments follow. 

Can supplements and in-office treatments really help with reversing signs of ageing? If so, how, and to what extent?

We know that to be able to absolutely digest and absorb all the nutrients from our food isn’t practically possible; you need nutritional supplements. We realise that when we test for vitamin D. You can’t lie in the sun naked for 20 minutes a day, and even if you do, it won’t make a huge difference. Vitamins are absolutely essential, and thus, supplements are very much needed, be it vitamins A, C and E, zinc, selenium or iodine. What you eat is also going to help your gut microbiome and the intestinal barrier, especially if you have a poor digestive system (I call it digest-ageing, because your system is ageing and can’t absorb the best nutrients from your food).

From homoeopathy and supplements to in-office treatments, you’ve done it all. As a doctor, how do you strike a balance between all of these diverse mediums of treatments for your clients?

There’s no one-size-fits-all approach. I have a lot of tools in my toolbox; I have supplements, lab tests and facial treatments, basically, everything to treat someone who is chronically not feeling great or suffering from premature ageing. Everybody is different—I find the root causes behind a migraine or fatigue before quintessentially prescribing supplements, which, by the way, won’t be a requirement for everyone. We go through meticulous testing and understanding to devise a treatment plan. The drug-symptom approach doesn’t work for me; it might take longer but will promise effective results and longevity.

What are some of the in-office treatments best suited for Indian skin?

What is really great for Indian skin is acid peels—lactic acid, glycolic acid and salicylic acid. They really help with post-inflammatory hyperpigmentation. Radiofrequency is a fantastic one for lifting the skin and supporting collagen production. I wouldn’t recommend IPL for Indian skin, because it’s not suitable for sensitive skin. Microneedling with PRP (platelet-rich plasma) is an excellent solution for Indian skin as well. What I do differently is PRP and infusions of glutathione, ascorbic acid and kojic acid into the skin. The last one is Morpheus8, but you have to be a suitable candidate for this one.

What’s your take on personalised skincare? 

I think we have so many options when it comes to actives in skincare, which is why dermatologists and naturopathic doctors are good at finding out what suits you and doesn’t. It also saves you from the investment in the wrong products as well as the damage that slapping multiple products can cause. Less is more, that’s why I developed cutting-edge serums that are great for all skin types as they protect the skin barrier and microbiome. Personalised skincare is great, but the market is also flooded with options. 

Lastly, what’s your one skincare tip that applies to every skin type under the sun?  

Cleanse. People don’t clean their skin enough. Cleansing the skin without stripping it is really important. Use a detoxifying, non-stripping cleanser to keep the canvas clean for skincare products and make-up. Double cleanse, if need be.

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