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  • (percussive music)

  • - Hi, I'm Dr. Dendy Engelman.

  • I'm a board-certified dermatologist in Manhattan

  • and I work for Manhattan Dermatology and Cosmetic Surgery.

  • I'm here to take a deep dive into

  • the Go to Bed With Me comments section

  • in order to get to the bottom of some of

  • your burning questions.

  • In this episode, we're gonna talk specifically about

  • process, tools, and injectibles.

  • First step, we're gonna talk about process.

  • (percussive music)

  • The first comment is from Mona Sabbar.

  • "Dear Doctor, I'm really concerned about dairy products

  • "and their relation to acne.

  • "Can you explain it briefly, thank you," heart.

  • Okay Mona, you are exactly right.

  • Dairy does play into acne and there are two things

  • in diet that can play into increased breakouts

  • and we used to think that it was chocolate

  • or greasy food and that's all kinda been debunked

  • and the two things that really have been shown

  • and proven in the dermatologic literature

  • for making increased breakouts are dairy

  • and high glycemic index foods, so those are foods

  • that spike our blood sugar really quickly.

  • So what I tell patients every day is pay attention

  • to your diet and how it affects your skin.

  • If you feel like you had an indulgent weekend of pizza

  • and ice cream and you're breaking out on Monday,

  • then maybe we have some interplay with dairy

  • being a culprit in our breakouts.

  • So let's try to eliminate that as much as possible.

  • The good news about skin is that if it's good

  • for your body, it's probably good for your skin as well,

  • so we have to think about healthy living,

  • clean eating, drinking a lot of water.

  • Probiotics to take are not only good for gut health

  • but they also are great for skin health

  • and so that can be an easy way to implement

  • some tiny changes that not only make you look better,

  • but make you feel better as well.

  • So Vee V said "celebrity skin is 70% procedures

  • "and 30% skincare."

  • I would put a pretty significant percentage

  • also on great genetics.

  • I mean we all are kind of dealing with the hand

  • we're dealt and certainly celebrities are born

  • with some pretty good hands in their appearance

  • and stature and figures.

  • That said, not all celebrities have great skin.

  • I treat a lot of celebrities and I help them

  • with a lot of skin issues, whether it's acne,

  • rosacea, sensitivities, and procedures are also

  • a big part of looking great.

  • I always have patients who come to me

  • and they just think that celebrities flawlessly

  • and effortlessly look amazing and that is not the case.

  • There's a huge commitment to both skincare

  • and procedures, almost weekly, in order

  • to maintain their looks.

  • One thing that I think patients can do at home

  • that is very much like celebrities is really just

  • stick to a good routine.

  • I mean there's not a ton of magic in the fact

  • that all these great products that we have at home

  • will not work if they just sit in the medicine cabinet,

  • and the people who I treat who are celebrities

  • are certainly dedicated to having good skin,

  • and they know that if they kinda slack off

  • on their products that really work for them,

  • then their skin doesn't look as great.

  • Maddie said "I watched a video where a dermatologist

  • "said that if you mix skincare products

  • "from different brands, you're mixing different chemistries,

  • "his words, and can cause irritation.

  • "Is there any truth to this?"

  • Maddie, I would say that there's probably

  • a little bit of truth in the testing.

  • I mean obviously if you're a formulator for skincare,

  • you want everybody to buy every product in your offering.

  • The reality is if you use an over the counter cleanser

  • and somebody else's vitamin C, and someone else's retinol,

  • it's probably gonna live compatibly together,

  • but we don't know because they haven't

  • been formulated together, and so there probably is

  • some truth to mixing chemistries, but I don't think

  • that it's gonna counteract the efficacy

  • of each individual product if you wanna mix and match.

  • That being said, you certainly want to make sure

  • that you're using the right products at the right time,

  • and there are certain chemicals just categorically

  • that you may not want to mix.

  • For example, you might not want to do a very strong

  • glycolic acid and then follow that with a retinol,

  • that's gonna be too irritating for the skin.

  • So it's not necessarily a formulator per se,

  • but just the active ingredient.

  • Lady S says "can we stop with the microtear BS and lies?

  • "There's literally no such thing."

  • Well Lady S, there is literally such thing,

  • and I see it all the time and the good news is

  • that we've gotten away from a lot of the harsh exfoliants

  • that are in a lot of formulas.

  • I mean when I think back to when I was an adolescent,

  • the St. Ives Apricot Scrub was one that had

  • like harsh particles in it, and that can cause

  • microirritation and tears over time.

  • Certainly under the eye, where that skin's very delicate,

  • around the nose if you ever look at people

  • and they have like these dilated vessels

  • that are there, those are areas where the skin

  • is very sensitive and prone to injury.

  • So we want to love our skin at home

  • and we don't want to do anything too harsh

  • in order to irritate it, but the reality is,

  • you can cause some injury in your skin

  • based on certain skincare products or even devices.

  • Munira Jamali says "you do know that clinical trials

  • "have proven there is no benefit

  • "to consuming collagen in your diet?

  • "Collagen is produced endogenously by your body."

  • Munira, you're half right.

  • Collagen is produced by the body but you can

  • increase your body's stores by oral ingestion of collagen.

  • And this is where it gets really tricky

  • 'cause not all ingestible collagens are created equally.

  • There are studies that have been documented

  • in our dermatologic literature that show

  • that they've not only traced it from ingestion

  • but it's been incorporated into the dermis

  • in meaningful amounts enough to decrease

  • the depth of crows' feet by 20% in just eight weeks.

  • Now it's not the only thing that we can do

  • to create collagen, you can also use retinoids

  • and you can use vitamin C, these are all

  • different ways topically to also do that,

  • because the problem with ingestible collagen

  • is there's no vegan form, and so it needs come

  • from an animal source and a lot of people

  • want to shy away from that and I understand

  • that's certainly a personal choice.

  • If that's something that you follow in the lifestyle,

  • then you can go at it in a topical application

  • in order to increase more collagen production.

  • The one that I recommend to patients

  • is called Verisol Collagen, V-E-R-I-S-O-L,

  • and that's the one that's really been proven

  • in the literature to support the skin,

  • increase total body stores of collagen,

  • it's not just helpful for your skin

  • but also for your joints because collagen

  • is one of the main building blocks and substances

  • of connective tissue.

  • Now let's get into the fun stuff, tools.

  • (percussive music)

  • "Are cleansing brushes, washcloths really necessary,

  • "and can you wash your face in the shower?"

  • Yeah, you can totally wash your face in the shower

  • and you don't have to have a cleansing brush or tool.

  • A lot of people, especially dermatologists

  • and those who are treating a lot of rosacea

  • or people with sensitive skin actually

  • are a little bit hesitant to recommend cleansing tools

  • because it can irritate the underlying skin condition.

  • So if you're happy about washing your face in the shower

  • and that's working for you and you don't have acne

  • or breakouts or any skin problems,

  • then by all means, continue to do that.

  • So if I were gonna rank things from most gentle

  • to strongest I would certainly say that hands

  • are probably the most gentle, we can obviously

  • regulate and feel how our pressure that we're using.

  • Then I would do like muslin cloth or something

  • very soft that is helping to remove

  • but not with any texture.

  • Then I would go to textured washcloth.

  • Then I would go to cleansing brushes.

  • The problem that I find with cleansing brushes

  • is that people sometimes get into trouble

  • by giving a lot of pressure.

  • You just want the brush to do the work,

  • so just hold it where it's barely contacting the skin

  • and it's gonna exfoliate for you, but people

  • who have acne kind of want to beat it up

  • and they're really angry with it

  • and they press into the skin, and then over time

  • that can exacerbate the acne that's underlying.

  • So we want to be really gentle in our cleansing,

  • we want it to be effective but you don't have

  • to spend a lot of money in order to get a clean face.

  • So So Zen asks "question, what is your opinion

  • "on at-home dermarollers?

  • "Who should use them, how and how often

  • "should they be used?

  • "Also, jade rollers.

  • "Do they have a scientific basis

  • "or are they just a gimmick?"

  • I like home dermarollers for certain indications

  • like those who have acne scarring,

  • but not on active acne.

  • I think that that can worsen existing acne,

  • so if it's old acne scarring where people

  • have textural irregularities, I do find

  • that you can get some improvement

  • with persistent at-home rolling.

  • We do in office procedures where we do

  • much more aggressive microneedling,

  • but some people can't afford that or they don't

  • have access to those who offer it,

  • so it's certainly better than nothing

  • and it can help with textural changes.

  • That said, we wanna be really careful with the products

  • that we're using when we're undergoing

  • these at-home dermarollers, because some things

  • can make it more irritating 'cause you've opened

  • up channels into the skin and so it's kind of

  • being absorbed deeper into the skin

  • and can be really irritating.

  • For jade rollers, I really like them.

  • I don't know if they're a gimmick or not

  • but I think that there's a lot to be said

  • about facial massage.

  • It's not as hot in the U.S. as it is in Asia,

  • but those who do this frequently really,

  • I find benefit for them.

  • Their skin looks better, it's less congested,

  • especially under the eyes and areas that tend to be

  • a little bit more puffy.

  • It helps to improve the lymphatic drainage

  • and so I'm a big fan of facial massage.

  • I think that it's great and if this is a way

  • that helps you to remember to do it,

  • even for five minutes a day,

  • it's not gonna hurt and it may help.

  • One of my favorite tools is one called Conture,

  • which is C-O-N-T-U-R-E, and it's basically like

  • a gym for your face, it uses pneumatic compression

  • to pull the skin up into the device

  • and then puts it right back down

  • and that increases blood supply, oxygenation,

  • and over time helps stimulate collagen.

  • So it's kind of a fix-all for whatever issue you're having,

  • whether it's pore size, fine lines, wrinkles,

  • you can use it on the face, the neck, the chest,

  • and so it's one that's kinda from here to here,

  • one size fits all and you just need one device,