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If you already head to the doctor’s office once a year for an annual physical: good job. If you don’t, let this be your reminder to go ahead and book that appointment—and perhaps let go of some of your anxiety surrounding your check-up.

And yes, you should schedule an annual physical exam even if you feel relatively healthy. “Many of us may only visit a doctor when we are sick, but having a primary care doctor and an annual physical is important,” says Dr. Heather Viola, an assistant professor of medicine and primary care physician at Mount Sinai Doctors-Ansonia in New York City. “It’s important to establish a relationship with a physician that you trust, and this starts with yearly well visits.”

Here’s who should schedule an annual physical, what to expect at the appointment, and how to ease anxiety leading up to your yearly exam.

Why should you get an annual physical?

One of the reasons doctors advocate so strongly for annual physicals is because they’re important for catching “silent” disease early and treating it before it leads to a bigger problem, says Dr. Erika Kalabacas, a family-medicine physician at Northwell Health Physician Partners in Greenlawn, N.Y. She can recount numerous appointments where she has caught high blood pressure, diabetes, depression, and even breast and skin cancer at early and treatable stages. 

Your annual physical is also essential as a mental-health screening tool. “Your mental health is a big part of your physical health, and this is why we have included anxiety and depression screenings into the annual,” says Kalabacas. Mental-health issues have a way of flying under the radar, Viola says, as they “may not otherwise be addressed or identified if not for the routine visit.”

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Another important vital that’s measured and tracked at your annual physical exam is your weight. While Kalabacas concedes this can be a sensitive topic for many, she explains that by taking this measurement your doctor can help identify if there are any underlying causes for weight issues, such as thyroid irregularities, medications, side effects, or hormonal changes due to menopause. “Your primary care physician can discuss important diet and exercise recommendations, medications, or referrals to dietitians,” she says—stressing that since obesity is on the rise, and is the leading cause of almost all chronic diseases, it’s essential to make every effort to get ahead of it. 

Doctors caution against skipping annual physicals just because you consider yourself healthy. Viola believes these once-a-year visits—especially for young, healthy patients—are a great way to get to know your doctor better. Plus, they allow your provider to get to know you so that they can best help you stay healthy going forward, she says.  

What happens at an annual physical?

Sometimes called an “annual” or “yearly physical,” these appointments are essential for monitoring your health and taking proactive steps towards safeguarding it. During the appointment, a primary-care provider evaluates your overall health and your risk factors for chronic disease. 

The visit, which takes about 30 minutes, typically includes a blood draw, physical examination by your physician, an evaluation of your vital signs such as blood pressure and weight, and a review of your medical history and medications. Your doctor may also conduct age-appropriate screening tests for certain cancers and administer vaccines as necessary, as well as administer mental-health questionnaires—and, if necessary, provide you with resources such as therapy referrals or medications to treat anxiety or depression. You’ll also have the chance to ask your doctor any questions you may have regarding your health.

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A physical isn’t only about unearthing new problems. Rather, annual physicals are an important time to discuss preventive health: what you can do to stay healthy based on your individual risk factors and family history, says Viola. “By regularly monitoring your health, your doctor can identify and address any changes in your health and take steps to prevent chronic illnesses from developing or worsening,” she says.

“I generally recommend everyone meet with their doctor once a year for a well visit,” Viola says. “You can talk to your doctor about how often they should see you. For most adults, it’s once a year. For some younger, healthy adults, it may be less.”

How to prepare for a physical

Kalabacas and Viola share that you should do the following before your physical exam. 

After your exam, what’s next?

Before you even leave the office, there are some steps you can take to make the most of your visit. At the conclusion of your appointment, Viola always recommends asking for a recap of the visit if one hasn’t been provided. “Ask the doctor to repeat the instructions you’re supposed to follow, and ensure that you are on the same page,” she says.

Often, people won’t ask questions when their doctor is right in front of them, she says. Instead of this missed opportunity, advocate for yourself and don’t be afraid to make inquiries, says Viola. “If you are concerned or confused about a diagnosis or proposed treatment, always ask your provider to explain why they are choosing this path,” she says.

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One last thing to do before you wrap up your physical is to ask for a referral if needed. “If you would like to see a specialist, ask your provider who they recommend. It can be really helpful to see a specialist that your primary care physician works closely with and can improve coordination of your care,” says Viola.

Once the appointment is over, ask the front desk staff what the best way to contact your provider is if you have any follow-up questions. Many doctors use an electronic health system where they share blood work results via the patient portal. 

The timeline for receiving your lab results and having your doctor review them may be a few days to a few weeks. “Most doctors will call or write you a message within a few days with their recommendations,” says Viola. “Ask your doctor what to expect in regard to your results: ‘Should I expect a phone call to review?’ ‘Will you write to me through the patient portal?’”

What to do if you’re anxious about your physical

If you’re feeling anxious or nervous leading up to your exam, you’re not alone. Both Viola and Kalabacas share that it’s common to be nervous about visiting your doctor, especially a new one. “But remember, they are here to help you,” says Viola.

To quell nerves, Kalabacas says having a list of questions to “direct the appointment towards your needs,” bringing a friend or family member for support, and choosing a primary care physician that you are comfortable with can all help. (To that last point, Kalabacas says some of the best referrals for primary care providers come from loved ones; Zocdoc is another great option to find a local physician that accepts your insurance.)  

“The most important thing is to show up. We know it’s hard, and we do our best to make you feel comfortable,” says Kalabacas. “We are here to educate and guide you; you ultimately make the decisions.”

The goal is to become more proactive about your health instead of reactive. “You should feel empowered by knowing more about your health, because then you can control your health outcome,” Kalabacas says.

I’m at a mall in Rockville, Md., but instead of enjoying the comfort and convenience of a one-stop shopping experience, I go to a place called Capital Cryo, looking to get some voluntary pain. Soon, the tall cryotherapy tank is filling with a cloud of super-chilled gas: evaporated liquid nitrogen, one of the coldest substances on Earth.

“Okay,” the technician says. “Get in.”

Being a newbie, I gape at the temperature display: -205°F. Wearing only my underwear, I step in, and my skin temperature plummets, making my skin tingle. My adrenaline surges and breath speeds up, more reactions to the shocking freeze. After three minutes, tingling turns into aching. What started as cold has shifted to pure pain. Just in time, the technician stops the machine.

While dressing, I catch a wave of relief, a chariot of well-being I will ride the rest of the day. I wonder if it’s purely psychological—or maybe I’m experiencing hormesis, when the body adapts to stress in healthy ways. Over the past decade, scientists have increasingly found that certain forms of pain and agitation, in moderate amounts, trigger benefits for mental and physical health. Researched examples include cardio exercise, weightlifting, ice and steam baths, high-heat saunas, fasting from food, eating spicy peppers, and even holding your breath.

Only a masochist with unlimited free time would pursue every painful option. How should busy adults prioritize them? Which forms of hormesis actually boost health, and how? 

Why hormesis works

Pain starts with stress, and stress shows up at a cellular level. When humans and other lifeforms get stressed out, the balance of oxygen in our cells gets disrupted. In response, the mitochondria—bean-shaped structures that supply cells with energy—ramp up their efforts to help with overcoming the challenge. 

In the process, the mitochondria spit out a waste product, called reactive oxygen species. With persistent exposure to toxic stressors like cigarette smoke, heavy metals, or chronic emotional strain, this waste may weaken the cells and cause proteins to misfold, which could eventually cause disease.

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Hormetic stress, however, is more manageable. We bend but don’t break—partly thanks to a protein called Nrf-2. The protein flies into action, entering the nucleus and heading to the twisted ladder of DNA in each cell. There, it grabs the rung with the molecules that signal the cells to make a team of smaller proteins for fighting stress. They clean up the oxygen waste, transforming the hazmat cleanup sites into prime real estate. They also detoxify and repair cells throughout the body, boosting health and resilience.

It’s a lemons-to-lemonade process by which stress actually becomes beneficial. Promising research links hormetic stress to the prevention of cancer, dementia, and heart disease.

More than exercise

The most researched type of hormesis is exercise, where the muscles are deprived of oxygen—alerting Nrf-2 to action, which kicks off the benefits. In addition to working out, though, a range of other uncomfortable activities trigger the Nrf-2 pathway and other cellular reactions that can strengthen our bodies.

Such stressors include caloric restriction or intermittent fasting, where people have fewer calories per day or take long breaks from eating without reducing their overall calories. Both approaches stress the cells, activating the body’s protective pathways. 

Some research—mainly in mice—has linked caloric restriction to a lower risk of cancer, and scientists believe activation of the Nrf-2 pathway is partially why. More research on fasting in humans is needed, but other benefits may include better blood sugar and heart health.

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Certain foods, particularly plant compounds, have low-level toxins that also trigger Nrf-2. Examples are capsaicin in chili peppers, polyphenols in green tea, and sulforaphane in broccoli. Hormesis also comes from extreme temperatures. Studies show that the frequent use of saunas can boost heart health mainly through pathways related to heat stress, but also through Nrf-2. Hormesis is set in motion at the other end of the thermometer, too, as with cold plunges and cryotherapy.

Though these painful stressors are promising, more studies are needed. Even less is known about other potentially beneficial stressors, like holding your breath for an extended time (like a diver does). If you try one of the better-researched options, experts say to choose one that’s tolerable and helpful. Aim for just enough pain, without overdoing it. “Hormesis is sufficiently difficult that you have the chance to rise to a challenge,” says Rehana Leak, an associate professor of neuroscience at Duquesne University who studies hormesis. “You should feel satisfied that you surmounted something difficult.”

Less pain, some gain

Because many stressors work through the same pathways, experiencing one type on a regular basis may enhance resilience to additional types. Even the most pain-shy among us could start with easier challenges that prepare the body for the tougher ones. “There’s a lot of redundancy in the mechanistic pathways,” says Vienna Brunt, assistant professor of medicine at the University of Colorado, Anschutz Medical Campus. That means the cells’ ways of making stress beneficial, like Nrf-2, overlap and reinforce each other. “It’s very cool.”

The best approach for warming up to tough stressors may be to bring the heat. Researchers have found that getting into a hot tub or sauna can prime the stress pathways for exercise—providing a gateway for those who dread working out. “Regularly getting into the hot tub can, over time, condition people to hop into an exercise training program,” Brunt says. 

It may take more than four weeks of regular heat exposure to establish this cellular groundwork. “A lot of stresses come back to the same pathways that get activated and improve,” says Christopher Minson, a professor of physiology at the University of Oregon. He has found that exercising in the heat can improve exercise performance in the cold, though some people seem to benefit more than others.

Can we “cross-strain” for more benefits?

It’s possible that two or more hormetic stressors can be combined for greater benefits than you’d get with one stressor alone. These pathways “complement and communicate with each other,” says Ed Calabrese, a toxicologist and pioneering hormesis researcher at the University of Massachusetts. “It creates a lot of protection, but how do you optimize and control that in your everyday life? There’s still a lot we don’t know.” 

Exercise while fasting may be an example. Mark Mattson, a Johns Hopkins neuroscientist, has studied this connection in mice. Combining exercise and fasting in his lab led to better brain functioning in the hippocampus, critical for learning and memory, than either stressor alone. 

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Research in humans is needed, but both exercise and fasting cause our muscles to take up glucose from the blood— like Mattson saw in the rodents—prompting the body to switch to burning another type of fuel for energy, called ketones. “Exercise and fasting both promote this metabolic switch from glucose to ketones,” Mattson explains. “If you look at the cellular level, they’re engaging largely overlapping signaling pathways, and complementary ones. Nrf-2 is one, and there are lots of others.”

Minson has experimented with going for long bike rides while fasting. It gave him a psychological boost. “When I came into my lab, I was hungry but happy,” he says.

It could also be beneficial to regularly mix endurance exercise and heat, as with hot yoga. This pairing increases the fluid in our blood and how much blood is pumped with each heartbeat. The result is a more efficient cardiovascular system, says Larry Kenney, a professor of physiology and kinesiology at Penn State. “These regulatory adaptations are stressful but, combined, they lead to a resilient physiology,” Kenney says. 

It’s likely true that “the sum is greater than the parts” for a number of combinations, Kenney says. “Exercise and heat stress may be one of those,” he adds, while noting the need for more studies. Hydrate well and avoid extreme heat. 

Exercising with limited oxygen, like at high altitudes, is another hormetic pairing being researched. Yet another example is contrast therapy: switching between heat stress and cold stress. A handful of studies suggest that combining hot and cold baths in one session may increase blood flow, muscle oxygen, and sports recovery, compared to only hot or cold.

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Back at Capital Cryo, I tried contrast therapy. After using their infrared sauna, I went straight to the cryo tank. But the technician stopped me, looking astonished. “You need to towel off first!” With sweat on my skin, she explained, I was asking for frostbite. Good to know. 

Even when done safely and correctly, not all combinations benefit everyone. “You might get an additional benefit, but maybe not,” Minson says. “It will come down to a lot of individual variability.” 

Leave time for recovery in between bouts of stress. “If you’re not recovering, you’re not going to have an adequate adaptation,” Minson says. Any stressors, especially combinations, should be approached gradually and conservatively. 

Some combos overwhelm the body. If you take plant supplements after exercise, the additional hormetic stress of these mild toxins may diminish the benefits of the workout, research shows. “It’s going to not allow you to adapt as well,” Mattson says, while noting it’s nearly impossible to get such high amounts of antioxidants from natural foods. “Some supplements use doses that are through the roof,” Leak adds. “Because the phytochemicals in broccoli are helpful, that doesn’t mean we should take 1,000 times the concentration.” 

Other research suggests that the hormetic stress of cryotherapy may likewise interfere with exercise’s benefits. Overall, human studies on hormetic combinations are limited. “There’s a big void,” Mattson says. The best approach is to speak with your doctor, then try the researched combos and monitor your energy levels, blood panels, and other health metrics like resting heart rate.

Calabrese recognizes that supplements can be excessive, but he’s strategic about taking the ones with plant nutrients like moringa that he says have evidence-backed hormetic benefits. He tests his blood to ensure the pills aren’t damaging his liver. “I’m really cautious,” he says. “I’ve studied everything that I do.”

The future: hormesis mimics

A growing list of “hormesis mimics” work to trick our cells into launching their programs for adaptive responses. People feel no discomfort from these internal stressors even as they elicit the beneficial action deep within our cells. 

Some researchers find that red light therapy, for example, is a hormesis mimic that could help heal the body. When our cells are exposed to this light, they produce cellular waste. We’re blissfully unaware as this waste prompts Nrf-2 to stimulate repairs and healthier cells. 

It’s unclear if such “easy hormesis” can deliver equally profound benefits as the anguish of exercise. Regardless of the type of stress, Leak thinks it’s all in the experience. “If you don’t go through anything painful,” she says, “you simply will not grow.”

It’s no surprise that the skin care industry is having a moment. Instagram influencers are hawking expensive products left and right, and young TikTok users are continuously sharing their latest “must-have” products from Sephora.

Two terms that consistently get mentioned when people talk about their skin care routines online are “retinoids” and “retinol.” These products are touted for their ability to reduce fine lines and wrinkles and stimulate collagen production for younger looking skin. But are they as effective as everyone says? 

Below, we cover everything you need to know about retinoids and retinol so you can figure out if they’re a good addition to your skin care routine. 

What are retinoids and retinol?

Retinoids are a class of prescription medications that are derived from vitamin A, says Dr. Alexis Livingston Young, a dermatologist at Hackensack University Medical Center. Retinol is a type of retinoid that is available over the counter. 

The main difference between the two is that prescription retinoids are already active, whereas over-the-counter retinol has to be converted by the body into the active form. Because prescription retinoids are already in their active form, they likely work faster and better, Young says. She notes that the actual effectiveness of retinol is hard to assess since it isn’t regulated by the U.S. Food and Drug Administration (FDA).

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Retinoids are the gold standard product for anti-aging, Young says. There is decades of academic research supporting its ability to stimulate collagen production, reduce fine lines and wrinkles, diminish hyperpigmentation, and unclog pores. “Of all the anti-aging products that have ever been talked about, we have the most data for retinoids—really solid, decades-long data to back up the claims,” Young says.

After sunscreen use, many dermatologists actually recommend retinoids as the best thing adults can use every day for their skin health. “I think of sunscreen as brushing your teeth, and retinoid use as flossing your teeth,” says Dr. Heather Goff, director of cosmetic dermatology and associate professor of dermatology at UT Southwestern Medical Center in Dallas. 

Beware of side effects

Retinoids can be very effective, but they can also come with side effects like irritation, redness, peeling, and dry, flaky skin. “The stronger the retinoid is, the more likely it is to cause that sort of initial irritation,” says Dr. Shayan Cheraghlou, a dermatologist at Zitelli and Brodland Skin Cancer Center in Pittsburgh. This means that, for example, the prescription retinoid tretinoin could lead to more intense side effects than an over-the-counter retinol product. These side effects are typically temporary, Young says, and tend to improve after about three months of use.

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People with darker skin tones might also experience a temporary increase in pigmentation with retinoid use, says Dr. Asmi Sanghvi, a dermatologist at Bethany Medical Clinic in New York City and a clinical instructor of dermatology at the Icahn School of Medicine at Mount Sinai. Eventually, she says, this side effect will go away and the skin will improve.

Irritation from retinoids happens because the skin is changing on a cellular level, Goff says. Retinoids thin out the stratum corneum, which is the outermost layer of the skin that’s composed of dead skin cells. This can cause a lot of exfoliation in the early stages of use, Goff says. 

If the side effects you experience are mild, you don’t have to give up: it can take up to 12 weeks to see an improvement in hyperpigmentation, fine lines, and wrinkles with retinoid use, Cheraghlou says. “You don’t necessarily need to stop when that happens,” he says. “Obviously if it’s too much then you should, but you can usually get over that hump.”

Young adds that although patients with rosacea, eczema, and atopic dermatitis can use retinoids, they might not be able to break through the initial irritation phase. “It might just be too much for them,” she says. 

You should exercise caution if you use chemical exfoliants, like AHAs and BHAs, in your skin care routine. “Those are peeling agents so they can make the irritation even worse,” Cheraghlou says. And if you’re pregnant or trying to conceive, you should stay away from using both prescription retinoids and over-the-counter retinol, Sanghvi says. 

Age matters

Experts are concerned about a recent uptick in teenagers and children having elaborate skin care routines that include products with retinol. In fact, there was a proposed California bill that would have prevented the sale of products with retinol to children under 13, though it failed to advance as of June 2024.

There is no reason for children and teenagers to use over-the-counter products with retinol, Cheraghlou says. Retinoids protect our collagen and stimulate new collagen production, he says, but “teenagers don’t need to use it cosmetically for the collagen effects because we don’t start losing collagen in our skin until our mid- to late 20s.”

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Although kids should not use over-the-counter beauty products with retinol for cosmetic purposes, prescription retinoids are used in teenagers and pre-teens with acne, Sanghvi says. (The well-known medication Accutane is a retinoid.) But children and teenagers should only be using retinoids if they’re prescribed by a dermatologist to treat acne. 

Most people can begin using a retinoid or retinol around age 25 or 30, Young says. Goff adds that it’s safe to use retinoids consistently over the course of one’s life. 

Keep these best practices in mind

If you plan on adding a retinoid or retinol to your skin care routine, here are a few things you should keep in mind. 

If you’re always on the lookout for the latest skincare gadget, you may have already tried facial rollers, sculpting wands, and dermaplaning devices. And you may be curious about the red-glowing masks that you’ve seen making the rounds on social media.

Red-light masks use low levels of light-emitting diode, or LED, to stimulate skin cells, says Dr. Jennifer Sawaya, a dermatologist at U.S. Dermatology Partners Scottsdale in Arizona. “Red light is a type of visible light that has been clinically shown to rejuvenate the skin.” 

Instagrammers and TikTokkers claim the masks—which, face it, do make you look like a character from a sci-fi film—can minimize wrinkles, smooth your complexion, and even improve acne. But these masks can be pricey, costing anywhere from $100 to thousands of dollars, and similar but stronger treatments are available at spas and dermatologists’ offices.

So, do at-home red light masks actually work? Sawaya says studies have shown red-light therapy can benefit the skin, but seeing results depends on using the devices regularly. Here’s what you should know about red-light masks. 

What can red-light masks do for your skin? 

Red-light therapy has been used for decades in a variety of treatments. NASA first began using it to boost plant growth in space in the 1990s and then to speed up wound healing. The light’s ability to penetrate the skin was shown to help promote collagen and tissue growth. 

It’s also used in photodynamic therapy, which utilizes low-power red laser light to drive a cell-destroying chemical reaction that can treat conditions like skin and other types of cancer, psoriasis, acne, and warts, according to the Cleveland Clinic. 

As an anti-aging treatment, low-level light therapy with red and infrared wavelengths can improve how skin cells work, explains Dr. Heather Rogers, a dermatologist at Modern Dermatology in Seattle. Cells absorb energy from the light, which makes them more efficient in using oxygen and producing the compounds cells use for fuel. 

“With more fuel, the cells become more active and better at doing their jobs, including DNA repair, collagen synthesis, and calming inflammation,” she says. 

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As you age, you start to lose collagen, a protein that gives your skin structure and elasticity. Sun damage can also deplete it. So boosting collagen production can make wrinkles and fine lines less apparent. 

A 2019 company-sponsored study published in the Journal of the American Academy of Dermatology suggested that low-level red and infrared light stimulate biomarkers that are linked to anti-aging skin benefits, and daily at-home treatments could improve the signs of early aging and sun damage. 

In other words, red light can help “rejuvenate” your complexion, Sawaya says. “Specifically, studies have shown that red-light therapy can reduce the appearance of wrinkles, pigmentation, broken blood vessels, and improve the skin’s elasticity and hydration.” 

Red light isn’t the only color of visible light that can benefit the skin. 

Another company-sponsored study published in the Journal of the American Academy of Dermatology in 2018 found that red- and blue-light therapy could help treat mild to moderate acne. The research suggested that blue light may reduce acne-causing bacteria on the skin, while red light minimized inflammation. Sawaya says blue light may also decrease the activity of oil glands, which encourages acne.

Blue light may also help treat mild psoriasis, according to the American Academy of Dermatology. 

How to get the best results from an at-home red light mask

It can take time to see results from red-light therapy, and it may not work for everyone, says Dr. David Kim, a dermatologist at Idriss Dermatology in New York City. He recommends consistently using a red-light mask three to five times a week for at least a couple of months if you’re interested in minimizing the signs of acne, treating acne, or smoothing your complexion. 

“Figure out your habit and stick to it,” suggests Rogers, who wears a red-light mask before her morning skincare routine and before bedtime.

Read More: What’s the Best Skin-Care Routine?

The masks are most effective when used on clean, dry skin so the light can be well absorbed by the skin, Sawaya says. Sometimes, the masks can dry out your skin, so Rogers suggests moisturizing afterward. 

When purchasing a red-light mask, make sure the product has been cleared by the U.S. Food and Drug Administration (FDA), which classifies medical devices, including light therapy masks, into different categories, and follow the manufacturer’s directions, Sawaya adds. Most products state whether they’re FDA-cleared. You should use the mask for only the time recommended; most brands suggest using products for about 10 minutes at a time. 

For skin improvements, the ideal wavelength for red light is about 640 nanometers and about 830 nanometers for infrared light, Rogers says. 

How at-home masks differ from in-office versions

At-home red light masks can be beneficial, but Kim says they’re not as “robust” as the LED therapy offered in dermatologists’ offices or spas.

“At-home red and blue light LED masks use much lower energy levels than what you would expect in an in-office treatment,” Sawaya explains, so you likely need to use them daily to see results.

Still, at-home versions can complement in-office light treatments, Rogers says, adding that if you use your mask at home—while also taking good care of your skin by moisturizing and diligently wearing sunscreen—you may need fewer in-office treatments.

There are several red-light masks available. Rogers says her favorites are by Celluma and Omnilux, and she suggests choosing a full-face mask or ones with larger panels instead of handheld wands for more uniform treatment. 

“For best outcomes, the device needs to be touching or nearly touching your skin to ensure the energy is being absorbed into your skin,” she explains. 

Are red light masks safe? 

At-home LED masks are generally safe for most people, as they use relatively low levels of energy, Sawaya says. 

However, if you have sensitive skin or are sensitive to light, you should avoid the masks unless your doctor gives you the OK, she notes. 

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Light therapy can also worsen melasma, a condition that causes blotches to form on the skin, Rogers says. Visible light, including red and blue, might also worsen hyperpigmentation or melasma for people with darker skin tones, Kim adds. 

If you’re using a red-light mask daily and not getting the anti-aging results you’re hoping for, or you’ve noticed dryness, pigmentation shifts, or other skin changes, Kim suggests seeing a dermatologist. Doctors can recommend the best treatments based on your skin type and individual needs.