Dr Dray Dismisses Adapalene Fat Loss Claims as Aging Coincidence

Dr Dray

Topical retinoids do not deplete facial fat pads, with observed volume loss driven by the natural onset of biological aging rather than skincare side effects.

AI-assisted summary of Can Adapalene Cause Facial Fat Loss? Dermatologist Q&A — original source. Check the original for full context.

Source published: 2026-08-23

Key ideas

Cosmetic 'dual retinoid' formulas combining retinaldehyde with adapinoid or HPR, along with vitamin C derivatives like THD ascorbate, lack rigorous human clinical trials demonstrating genuine collagen synthesis or bioavailable efficacy compared to standard L-ascorbic acid, retinol, adapalene, or tretinoin. (0:28)
Topical retinoids—including retinol, tretinoin, and adapalene—do not cause facial fat loss; the internet myth is a result of users starting anti-aging skincare at the exact age when natural, age-related volume depletion becomes noticeable. (12:24)
A systematic review of 1,185 acne patients found that 95% experienced lesion reductions using blue light therapy, validating at-home LED devices as an effective option despite a lack of head-to-head trials against gold-standard medications. (13:10)
While over-the-counter Epiduo (0.1% adapalene / 2.5% benzoyl peroxide) works for anti-aging via its adapalene component, switching from plain 0.1% adapalene makes no sense unless acne control is also needed, as benzoyl peroxide adds zero anti-aging benefit while increasing irritation and bleaching fabrics. (14:16)
Underarm irritation from standard antiperspirant-deodorants is frequently driven by high concentrations of synthetic fragrance rather than aluminum salts; odor can be managed without fragrance by using a benzoyl peroxide wash 2–3 times weekly, while severe sweating responds to 6-month Botox injections or oral glycopyrrolate. (18:41)

Detailed notes

## Background Published on YouTube by dermatologist Dr. Dray on August 23, 2026, this weekend Q&A addresses audience-submitted questions regarding popular skincare ingredients, device efficacy, and dermatologic conditions. According to the video description, the session covers cosmetic dual retinoids, vitamin C derivatives, Centella asiatica, sunscreen and makeup expiration, seborrheic dermatitis triggers, topical Volufiline, facial sweating, adapalene and facial fat loss, and deodorant alternatives for sensitive skin.

## TL;DR Dr. Dray critically analyzes trendy skincare claims, emphasizing that cosmetic ingredients like adapinoid, HPR, THD ascorbate, and Volufiline lack robust clinical trials in humans and cannot replicate proven actives like ascorbic acid or true retinoids. She dispels the persistent myth that adapalene or other topical retinoids cause facial fat loss, explaining that age-related volume loss merely coincides chronologically with starting anti-aging routines. Additionally, she offers practical dermatological guidance on using blue LED light for acne, weighing the pros and cons of switching to over-the-counter Epiduo, safely discarding expired cosmetics, and managing hyperhidrosis with Botox or oral medications.

## Atmosphere & style The video carries a direct, candid, and refreshingly no-nonsense tone, blending clinical expertise with dry humor and sharp analogies, such as comparing unproven vitamin C derivatives to fake plastic lemons. Dr. Dray speaks conversationally directly to the camera, balancing genuine empathy for viewers dealing with stubborn skin conditions with unapologetic skepticism toward expensive formulations and marketing gimmicks. Watching the session feels like receiving an honest, unvarnished clinic consultation that effortlessly cuts through commercial noise to prioritize science, safety, and common sense.

## Bulletin - [00:28](https://www.youtube.com/watch?v=DprHVOUpvaM&t=28s) Cosmetic 'dual retinoid' formulas combining retinaldehyde with adapinoid or HPR, along with vitamin C derivatives like THD ascorbate, lack rigorous human clinical trials demonstrating genuine collagen synthesis or bioavailable efficacy compared to standard L-ascorbic acid, retinol, adapalene, or tretinoin. - [12:24](https://www.youtube.com/watch?v=DprHVOUpvaM&t=744s) Topical retinoids—including retinol, tretinoin, and adapalene—do not cause facial fat loss; the internet myth is a result of users starting anti-aging skincare at the exact age when natural, age-related volume depletion becomes noticeable. - [13:10](https://www.youtube.com/watch?v=DprHVOUpvaM&t=790s) A systematic review of 1,185 acne patients found that 95% experienced lesion reductions using blue light therapy, validating at-home LED devices as an effective option despite a lack of head-to-head trials against gold-standard medications. - [14:16](https://www.youtube.com/watch?v=DprHVOUpvaM&t=856s) While over-the-counter Epiduo (0.1% adapalene / 2.5% benzoyl peroxide) works for anti-aging via its adapalene component, switching from plain 0.1% adapalene makes no sense unless acne control is also needed, as benzoyl peroxide adds zero anti-aging benefit while increasing irritation and bleaching fabrics. - [18:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1121s) Underarm irritation from standard antiperspirant-deodorants is frequently driven by high concentrations of synthetic fragrance rather than aluminum salts; odor can be managed without fragrance by using a benzoyl peroxide wash 2–3 times weekly, while severe sweating responds to 6-month Botox injections or oral glycopyrrolate.

## Key takeaways - [00:28](https://www.youtube.com/watch?v=DprHVOUpvaM&t=28s) So-called 'dual retinoid' products pairing retinaldehyde with adapinoid or HPR are marketing inventions; adapinoid and HPR (a retinoic acid ester) are cosmetic ingredients without robust human clinical data proving they act like true bioavailable retinoids. - [02:55](https://www.youtube.com/watch?v=DprHVOUpvaM&t=175s) Pure L-ascorbic acid remains the only vitamin C form backed by reliable human evidence for collagen synthesis, whereas lipid-soluble derivatives like THD ascorbate and ascorbyl tetraisopalmitate rely on petri-dish studies and have unproven conversion rates in living skin. - [05:06](https://www.youtube.com/watch?v=DprHVOUpvaM&t=306s) Claims that pairing Centella asiatica with retinoids or vitamin C boosts collagen production 3 to 4 times are unsubstantiated, though centella compounds (madecassoside, asiaticoside) are proven supportive adjuncts for barrier soothing and wound healing. - [06:36](https://www.youtube.com/watch?v=DprHVOUpvaM&t=396s) A sunscreen labeled with a month/year expiration (e.g., 12/26) remains valid through the final day of that month, after which it must be discarded completely because preservative failure leads to emulsion separation, uneven UV filter dispersion, irritation, and microbial risk. - [07:01](https://www.youtube.com/watch?v=DprHVOUpvaM&t=421s) Long-term doxycycline (such as 8 years of continuous use) risks bacterial resistance and microbiome disruption without curbing sebum production, whereas isotretinoin (Accutane) can clear recalcitrant seborrheic dermatitis by directly shutting down the sebaceous lipids that feed Malassezia yeast. - [08:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=521s) Prestige moisturizers like the $195 SkinCeuticals Advanced RGN6 offer little clinical advantage over affordable drugstore alternatives like CeraVe, as both brands share L'Oréal corporate formulation architectures and basic active ingredients like 2% niacinamide. - [09:22](https://www.youtube.com/watch?v=DprHVOUpvaM&t=562s) Topical Volufiline cannot restore lost under-eye fat pads or facial volume; the clinical study claiming it increased breast volume is flawed, and precise structural volume restoration cannot be achieved with a cream. - [10:14](https://www.youtube.com/watch?v=DprHVOUpvaM&t=614s) Facial and scalp antiperspirants rely on aluminum salts that frequently irritate facial skin; persistent cranial or facial hyperhidrosis is often better managed with scalp Botox injections (lasting ~6 months) or oral glycopyrrolate. - [11:12](https://www.youtube.com/watch?v=DprHVOUpvaM&t=672s) There are no safe or effective at-home treatments to remove skin tags; clinic removal fees ($150) reflect un-reimbursed overhead costs and pathology exams to rule out malignancy rather than a high-margin dermatologist profit center. - [12:24](https://www.youtube.com/watch?v=DprHVOUpvaM&t=744s) Retinol, tretinoin, and adapalene do not cause facial fat loss; users mistakenly blame retinoids because people typically begin anti-aging routines at the exact stage of life when natural age-related fat pad depletion begins. - [13:10](https://www.youtube.com/watch?v=DprHVOUpvaM&t=790s) Blue light LED masks have legitimate evidence for treating acne by targeting acne-causing bacteria—supported by a systematic review where 95% of 1,185 patients saw improvement—even though head-to-head trials against prescription standards are lacking. - [14:16](https://www.youtube.com/watch?v=DprHVOUpvaM&t=856s) Over-the-counter Epiduo (0.1% adapalene + 2.5% benzoyl peroxide) should only replace plain 0.1% adapalene if a user needs additional acne control, because benzoyl peroxide provides no anti-aging benefit while adding dryness, irritation, and fabric bleaching. - [16:56](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1016s) Water-containing liquid and cream cosmetics expire much faster than anhydrous powders due to preservative degradation and bacterial growth; mascara is the highest-risk item and should be discarded every 3 months to prevent styes and eye infections. - [17:54](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1074s) 'Natural' deodorants are functionally identical to standard deodorants—acting primarily as underarm fragrances to mask odor rather than blocking sweat with aluminum—and heavy fragrance in these sticks is frequently the true culprit behind axillary rashes. - [18:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1121s) People who develop contact dermatitis from traditional antiperspirants or scented deodorants can control body odor at the source by washing the underarms 2 to 3 times a week with an over-the-counter benzoyl peroxide cleanser to reduce odor-causing bacteria.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=DprHVOUpvaM&t=0s) Introduction to Weekend Skincare Q&A

Dr. Dray kicks off part two of her weekend skincare Q&A, reminding viewers that the session will be added to the dedicated skincare Q&A playlist alongside the previous day's video and earlier sessions. Because all videos are fully chaptered and timestamped, viewers can easily scan the topics and jump straight to the exact questions they want answered if they do not have time to sit through the entire discussion.

[00:28](https://www.youtube.com/watch?v=DprHVOUpvaM&t=28s) Debunking "Dual Retinoid" Formulas: Adapinoid, HPR, and Retinaldehyde

A viewer asks for Dr. Dray's perspective on trendy "dual retinoid" products promoted for pore clearing and anti-aging, citing examples like Paula's Choice Clinical Pro Retinaldehyde Dual-Retinoid Treatment (formulated with 0.1% retinaldehyde and 0.16% adapinoid), The Minimalist Retinal 0.1% Face Serum (0.1% retinaldehyde and 0.5% adapinoid), and Sunday Riley A+ High-Dose / A.I. Adaptive Retinoid Serum (combining adapinoid with hydroxypinacolone retinoate, or HPR). Dr. Dray bluntly refutes the concept, asserting that she does not consider them dual-retinoid products in any way, shape, or form. Most are simply retinaldehyde serums dressed up with marketing buzzwords, and she quips that Sunday Riley's formula does not even contain true retinaldehyde—which is "no surprise there, and I'm sure that's the most expensive."

She explains that cosmetic alternatives like adapinoid and hydroxypinacolone retinoate (HPR) are purely cosmetic ingredients, not proven retinoids. Unlike true retinol, retinaldehyde, over-the-counter adapalene, or prescription tretinoin, these novel cosmetic compounds have no rigorous clinical track record demonstrating that they can deliver equivalent cellular benefits. While ingredient manufacturers craft compounds that look and smell like retinoids to help brands make marketing splashes, robust evidence on actual humans is lacking. HPR, widely promoted as a gentle alternative, is essentially a retinoic acid ester, and cosmetic esters are already notorious for failing to deliver the anti-aging results that consumers are after. She emphasizes that if someone is using and enjoying these products, there is no pressing reason to stop as long as they are tolerated, but buyers should recognize that these ingredients exist primarily to make formulas sound advanced and drive sales.

- **Adapinoid & HPR:** Cosmetic ingredients lacking robust clinical trial data; they should not be conflated with genuine bioavailable retinoids or prescription counterparts. - **Retinoid Esters:** Typically fail to provide meaningful anti-aging or collagen-building benefits in clinical practice. - **Brand Strategy:** Combining a trace retinoid with cosmetic novelties allows brands to claim "dual-retinoid" innovation at an elevated retail price.

[02:55](https://www.youtube.com/watch?v=DprHVOUpvaM&t=175s) Vitamin C Derivatives and Granactive Retinoids: The "Plastic Lemon" Dilemma

The viewer also inquires about tetrahexyldecyl ascorbate (THD ascorbate), ascorbyl tetraisopalmitate, and granactive retinoids, asking whether studies support their ability to build collagen with less irritation. Dr. Dray dismisses the hype, underscoring that none of these compounds possess robust clinical trials performed on living human beings. While in vitro studies on cells in a petri dish may show activity, she jokes that cosmetic manufacturers "can make a cell in a dish get up and do the polka," which means virtually nothing for a consumer's actual skin.

When it comes to vitamin C, ascorbic acid (L-ascorbic acid) remains the singular gold standard backed by reliable science for collagen synthesis. Brands heavily promote lipid-soluble or buffered derivatives—which Dr. Dray colorfully nicknames "the la-di-da-di derivatives," including THD ascorbate and sodium ascorbyl phosphate—as gentler, more shelf-stable, and better penetrating. However, there is no dependable proof that these molecules reliably penetrate living skin and efficiently convert into active ascorbic acid to stimulate fibroblasts. To illustrate the absurdity, Dr. Dray presents a vivid analogy: selling these derivatives as gentle vitamin C is like holding up a fake plastic lemon and claiming it is a "non-sour lemon object." While technically non-irritating, it does nothing for someone trying to bake a lemon meringue pie; it simply occupies space on the shelf to catch the shopper's eye without delivering real biological results.

```mermaid flowchart TD accTitle: Efficacy of Ascorbic Acid versus Vitamin C Derivatives accDescr: Diagram contrasting active L-ascorbic acid with cosmetic derivatives like THD ascorbate and sodium ascorbyl phosphate.

subgraph Proven["Proven Bioactive Path"] A["Pure L-Ascorbic Acid"] -->|"Directly utilizes cellular pathways"| B["Stimulates Collagen Production"] A -.->|"Side effect"| C["Potential for Irritation"] end

subgraph Unproven["Cosmetic Derivatives ('Plastic Lemons')"] D["THD Ascorbate / ATIP / SAP"] -->|"Marketed as stable & gentle"| E["Topical Application"] E -->|"Unproven conversion rate in human skin"| F["Unreliable Collagen Synthesis"] end ```

[05:06](https://www.youtube.com/watch?v=DprHVOUpvaM&t=306s) Can Centella Asiatica Multiply Collagen Production Three to Four Times?

Addressing a question about whether pairing *Centella asiatica* with topical retinoids or vitamin C can enhance collagen synthesis by "a factor of three to four times," Dr. Dray calls it an extraordinarily bold marketing claim with zero clinical substantiation. While she has never encountered credible studies demonstrating a three-to-fourfold increase in collagen from this combo, she acknowledges that *Centella asiatica* and its isolated active triterpenes—such as madecassoside and asiaticoside—possess genuine merit.

Extracted centella compounds have documented wound-healing, burn-repair, and soothing properties both in topical studies and systemic evaluations, making them a rational supportive element in an anti-aging regimen. They can comfortably coexist with well-formulated ascorbic acid or retinoids to soothe the skin barrier and foster a healthy extracellular environment. However, consumers should recognize centella as a beneficial adjunct rather than a miraculous multiplier of anti-aging efficacy.

[06:36](https://www.youtube.com/watch?v=DprHVOUpvaM&t=396s) Demystifying Sunscreen Expiration Dates

When asked whether a sunscreen labeled with an expiration date of "12/26" expires on December 1st or December 31st/January 1st, Dr. Dray clarifies that the product remains valid through the entire stated month, officially expiring on January 1st.

Once that date arrives, however, the product should be thrown away immediately rather than salvaged for body use. Over time, the preservative system inevitably degrades. Once preservatives fail, the emulsion can separate, active UV filters lose their uniform dispersion, the formula becomes significantly more irritating to the barrier, and microbial contamination poses a legitimate infection hazard.

[07:01](https://www.youtube.com/watch?v=DprHVOUpvaM&t=421s) Seborrheic Dermatitis, Doxycycline, and Sebum Regulation

A viewer writes in about dealing with persistent beard-area redness that has eluded diagnosis for years. The individual has taken doxycycline daily for eight consecutive years, and their physician is now considering Accutane (isotretinoin). They ask whether long-term antibiotic use could have triggered or exacerbated seborrheic dermatitis. Dr. Dray states that doxycycline does not routinely cause seborrheic dermatitis; in fact, its anti-inflammatory properties often suppress facial erythema. However, keeping a patient on systemic doxycycline for eight unbroken years is deeply problematic due to the severe risk of bacterial resistance and microbiome disruption, which theoretically could disrupt skin flora and facilitate *Malassezia* yeast overgrowth.

Dr. Dray reviews the actual biological triggers of seborrheic dermatitis: - **Sebum Drive:** Excess sebum fuels *Malassezia* proliferation, creating inflammatory byproducts that trigger scaling and redness. - **Medication Triggers:** Drugs historically linked to flares include lithium, haloperidol, and surprisingly griseofulvin (an oral antifungal that paradoxically provokes outbreaks in certain individuals). - **Hormonal & Systemic Triggers:** Testosterone replacement therapy (TRT) directly accelerates sebaceous gland activity, while physical illness, stress, and seasonal weather shifts commonly precipitate flares. - **Treatment Mechanisms:** Doxycycline only tempers inflammation without reducing sebum excretion, which explains why it failed to cure the condition; by contrast, isotretinoin (Accutane) profoundly shuts down sebaceous lipid production, which is why it often successfully clears recalcitrant seborrheic dermatitis.

[08:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=521s) SkinCeuticals Advanced RGN6 vs. Affordable Alternatives

A viewer asks if the new SkinCeuticals Advanced RGN6 is worth purchasing as a daily facial moisturizer. Dr. Dray responds with candid skepticism: "If you want to pay $195 for a 2% niacinamide moisturizer, go right ahead."

She observes that while the formula is fragrance-free—unlike several other moisturizers in the brand's lineup—and features ectoin (a protective extremolyte and excellent humectant), basic 2% niacinamide creams are "a dime a dozen." She reminds viewers that SkinCeuticals and CeraVe operate under the same L'Oréal corporate umbrella, frequently sharing cosmetic formulation architectures, patents, and core ingredients across their portfolios. The primary divergence between the brands lies in high-end prestige packaging, targeted brand marketing, and a steep markup, making the $195 price tag unjustifiable from a clinical standpoint.

[09:22](https://www.youtube.com/watch?v=DprHVOUpvaM&t=562s) Volufiline for Under-Eye Hollows

Dr. Dray turns to a query asking whether topical Volufiline can restore lost volume in hollow under-eye areas. She immediately dismisses the idea, stating flatly that it is incapable of restoring lost facial fat pads or rebuilding depleted anatomical volume under the eyes. Volufiline remains an unproven cosmetic agent that cannot duplicate the structural support provided by medical procedures or natural tissue.

[09:27](https://www.youtube.com/watch?v=DprHVOUpvaM&t=567s) Why Topical Volume-Filling Serums Like Volufiline Don't Restore Lost Fat

Continuing her discussion on under-eye volume and topical "volume-filling" products, Dr. Dray explains that while brands like to pretend a topical product will restore lost volume, true restoration—where volume is placed precisely where you want it, to the exact degree you want, without over-correcting—cannot come from a bottle. She notes she has already made a couple of videos on volume-filling products, including a review of the volume-filling serum from The Ordinary.

Looking at the research behind the ingredient (Volufiline), she bluntly states that the study they conducted on women's breasts claiming to show an increase in breast volume was "bogus" and never actually demonstrated any kind of genuine fat restoration. While she empathetically acknowledges why consumers "want so desperately" for a topical cream to fix volume loss, it simply isn't reality. Hoping a topical cream will restore lost facial fat, she quips, is "literally... about the same thing" as hoping a cream is going to cure gallbladder disease.

[10:14](https://www.youtube.com/watch?v=DprHVOUpvaM&t=614s) Antiperspirant Options for the Face and Scalp

Addressing a viewer asking whether antiperspirants exist for the face and scalp, Dr. Dray confirms that companies do make them, though they come with a caveat. The active ingredients in antiperspirants that work to cut down the outflow of sweat are aluminum salts. These salts can be irritating at baseline, and they tend to be especially irritating when applied to facial skin, which limits many people's ability to tolerate them. However, for those who can tolerate them, she mentions that many people like the brand Carpe (noting she has no ties to the brand and has never personally used the product).

If facial and scalp sweating is something that "really, really bothers you" or if topical antiperspirants prove too irritating, Dr. Dray suggests two medical alternatives worth looking into: - **Neuromodulator scalp injections (Botox):** Although it comes with an upfront cost, a single round of injections gives you roughly six months of reduced sweat—"6 months and you're done." - **Glycopyrrolate:** An oral medication that systematically helps cut down on sweat output.

[11:12](https://www.youtube.com/watch?v=DprHVOUpvaM&t=672s) Why There Are No Safe At-Home Skin Tag Removals

A viewer shares that they had 5 to 10 skin tags removed from their neck about five years ago for $150, doesn't want to pay that fee again, and asks if there are any at-home treatments. Dr. Dray says no, explaining that just like volume loss, people desperately want a cream to wipe out skin tags—and "trust me, dermatologists want a cream to wipe those out" too.

She pushes back against the idea that skin tag removal is "some hidden secret dermatologist money maker." She guarantees that the dermatologist who charged the viewer $150 didn't personally pocket a dime of that fee, and would much rather tell patients to go to the drugstore and buy a $2 cream to melt them off. Because insurance does not reimburse for cosmetic skin tag removal, clinics have to charge out-of-pocket just to cover overhead and pay their employees—though she notes many dermatologists will actually snip off a couple of tags "on the house." Furthermore, from a medical-legal perspective, dermatologists often send at least one removed tag to a pathologist to make sure it isn't cancerous, which further stacks up the cost. Ultimately, there is nothing you can use at home to remove skin tags reliably or safely.

[12:24](https://www.youtube.com/watch?v=DprHVOUpvaM&t=744s) Debunking the Myth: Does Adapalene or Retinol Cause Facial Fat Loss?

Responding to internet rumors that retinol or tretinoin can cause facial fat loss in certain people or under certain conditions—and whether adapalene carries the same risk—Dr. Dray states unequivocally: "There's no concerns of facial fat loss with any of these things."

While people on the internet frequently ascribe volume loss to topical retinoids, what is actually happening is a classic case of "guilty by association." Facial fat loss is a very natural, common part of the normal aging process. Because the exact age when people start using anti-aging skincare is also the age when natural age-related volume loss begins to have its onset and become noticeable, users mistakenly associate the two and blame their skincare. Retinol, tretinoin, and adapalene do not cause facial fat loss.

[13:10](https://www.youtube.com/watch?v=DprHVOUpvaM&t=790s) Do Blue Light LED Masks Actually Treat Acne?

A viewer asks if blue light LED masks genuinely help with acne after their own dermatologist claimed there is "no evidence" that they are an effective treatment. Dr. Dray disagrees with that dermatologist, stating that blue light "definitely can help with acne" by targeting the acne-causing bacterium on the skin.

To back this up, she cites a systematic review evaluating treatment outcomes in 1,185 individuals with acne who received blue light therapy, where 95% of participants experienced a reduction in their acne spots. She fairly caveats what the current scientific literature lacks versus what it proves: - **What is missing:** Good head-to-head comparison studies pitting blue light directly against standard-of-care treatments like isotretinoin, tretinoin, benzoyl peroxide, or antibiotics, as well as long-term follow-up data. Blue light does not have the same towering degree of evidence as those gold-standard medications. - **What is proven:** There are numerous studies, solid review articles, and a clear biological mechanism showing that blue light—including at-home LED devices—is a viable option that works. Saying there is "no evidence" is simply inaccurate.

[14:16](https://www.youtube.com/watch?v=DprHVOUpvaM&t=856s) Epiduo vs. Adapalene: Which Makes Sense for Anti-Aging?

A viewer who uses prescription-strength Epiduo (containing 0.3% adapalene) asks why Dr. Dray mentioned in a previous Reel that Epiduo can't work for anti-aging. Dr. Dray clarifies that Epiduo *can* absolutely work for anti-aging, and apologizes if her short-form video wasn't clear enough on the nuance.

She breaks down the two active ingredients in over-the-counter Epiduo, which recently became available over the counter in the United States as a combination of 0.1% adapalene and 2.5% benzoyl peroxide: - **Adapalene (0.1%):** Effective for acne (its FDA-approved indication) and effective off-label for improving signs of skin aging. - **Benzoyl Peroxide (2.5%):** Very effective for acne (especially when combined with adapalene), but does *nothing* for anti-aging. Worse, it can be drying, irritating, and—because Epiduo is a leave-on product—it bleaches fabrics on contact.

Therefore, whether someone should switch from plain over-the-counter adapalene (0.1%) to over-the-counter Epiduo depends entirely on their goals:

```mermaid flowchart TD accTitle: Decision Flow for Switching from OTC Adapalene to OTC Epiduo accDescr: Flowchart showing when it makes sense to use plain OTC adapalene versus switching to OTC Epiduo based on anti-aging and acne goals.

Start["Using OTC Adapalene (0.1%)"] --> Goal{"What is your goal?"}

subgraph AntiAgingOnly ["Anti-Aging Only"] Goal -->|"Anti-aging only (no acne)"| Stay["Stay on plain Adapalene 0.1%"] Stay --> WhyStay["BPO 2.5% adds zero anti-aging benefit, increases irritation, & bleaches fabrics"] end

subgraph AcneAndAging ["Acne + Anti-Aging (or Acne Alone)"] Goal -->|"Acne not fully controlled"| Switch1["Switch to OTC Epiduo"] Goal -->|"Doing 'Epiduo dupe' (applying separate Adapalene + BPO)"| Switch2["Switch to OTC Epiduo"] Switch1 --> WhySwitch1["Added 2.5% BPO boosts acne control"] Switch2 --> WhySwitch2["Combines 2 steps into 1 product"] end ```

In short, if you have been buying plain adapalene for the past 10 years strictly for anti-aging, switching to Epiduo gives you the exact same 0.1% concentration of adapalene while adding unnecessary irritation and bleached pillowcases. It only makes sense to switch from an acne-control or routine-simplification perspective.

[16:56](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1016s) Makeup Expiration Dates and Why Mascara Is the Biggest Risk

Responding to a terse question—"Makeup expire?"—Dr. Dray confirms that makeup does indeed expire, and the shelf life depends heavily on the formulation: - **Powder products:** Have a much longer shelf life because they do not contain water. Dr. Dray reminisces about the height of the YouTube beauty guru era when creators hoarded massive makeup collections and palettes—when "it seemed like every 5 minutes there was some new palette"—noting that at least with powder palettes, keeping them for a longer time made a little more sense. - **Cream and liquid products:** Have a much shorter shelf life because they contain water. Over time, the preservatives "go off," the formula separates and looks weird, and microbial contamination becomes a major hazard.

Contamination is especially dangerous around the eyes. Dr. Dray emphasizes that mascara is the number one product to stay on top of: its average shelf life is only 3 months, and she personally throws hers out every 3 months without fail because old tubes harbor bacteria that can lead to styes and eye infections.

[17:54](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1074s) "Natural" Deodorants vs. Antiperspirants for Sensitive Skin

A viewer explains that "natural" deodorant doesn't work for them, while regular products (which they assume contain aluminum) cause severe itching, and asks for alternatives.

First, Dr. Dray dismantles the marketing around "natural" deodorants, pointing out that there is no real difference between a natural deodorant and a regular deodorant other than the word "natural" on the label—"there's nothing more natural about a natural deodorant than an unnatural one, okay?" Unlike antiperspirants (which use aluminum to block sweat), deodorants are simply solid perfumes, sticks, or gels that work by masking body odor: "they're kind of like the Febreze of your armpit." She notes that some deodorants, such as Lume, also include ingredients that help absorb moisture, which can cut down on underarm maceration (skin breakdown from trapped moisture that compromises the skin barrier).

[18:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1121s) Aluminum, Crystal Deodorants, Fragrance, and Underarm Irritation

Dr. Dray breaks down the functional and biological differences between products designed for the underarms. Deodorants influence odor by altering the skin's environment, pH, and bacterial flora, whereas antiperspirants contain aluminum salts that physically plug sweat ducts to stop perspiration. When someone finds standard underarm products irritating, aluminum salts are frequently assumed to be the culprit. Some individuals report anecdotally that they tolerate potassium alum crystal deodorants without issue. However, Dr. Dray cautions that solid clinical evidence showing crystal stones reduce sweat effectively is lacking, and patients can still develop contact irritation to them, meaning they are far from a guaranteed fix.

Consumer confusion is rampant because marketing blurs these categories. Most shoppers casually announce, "I need a new stick of deodorant," rather than saying, "I need to purchase antiperspirant." Dr. Dray jokes that while she personally uses the term antiperspirant, everyday colloquial language defaults to calling everything a deodorant. In reality, the vast majority of drugstore sticks are hybrid antiperspirant-deodorants that combine aluminum salts with heavy fragrances and moisture-absorbing powders.

Beyond aluminum, a major and under-recognized culprit behind armpit rash and burning is synthetic fragrance. Deodorant sticks pack exceptionally high concentrations of fragrance to mask body odor, and the thin, folded, friction-prone skin of the axilla is especially vulnerable to irritation and contact allergy. Fragrance-free formulations in this product category are notoriously difficult to find. Dr. Dray points to Lume's fragrance-free deodorant as a solid alternative; it absorbs ambient wetness without aluminum and offers mild moisturizing properties that help protect the compromised skin barrier.

For addressing stubborn body odor without relying on heavy perfumes, Dr. Dray recommends cleansing the armpits a couple of times a week with an over-the-counter benzoyl peroxide acne wash. Benzoyl peroxide suppresses the localized burden of bacteria that metabolize perspiration into pungent odors. For those coping with genuine primary hyperhidrosis (excessive sweating) who cannot tolerate topical antiperspirants, in-office dermatologic interventions offer substantial relief. Botulinum toxin (Botox) injections directly into the axillae effectively shut down sweat production for about six months at a time—a process she acknowledges is "painful under the arms, but it's like get it out, get it over with" to buy half a year of sweat-free comfort. Another systemic option is oral glycopyrrolate, an anticholinergic medication that significantly cuts down total-body sweating, with mild dry mouth being the most common dose-dependent side effect.

- **Potassium alum crystals:** Anecdotally better tolerated by some, but lack rigorous evidence for sweat reduction and can still cause allergic or irritant contact dermatitis. - **Fragrance sensitivity:** Often the true source of underarm rash rather than aluminum salts, exacerbated by occlusive armpit skin folds. - **Benzoyl peroxide washes:** Used 2–3 times weekly in the shower to eradicate odor-causing armpit bacteria directly at the source. - **Hyperhidrosis medical management:** Axillary Botox injections (lasting approximately six months) or oral glycopyrrolate tablets (monitoring for dry mouth).

[21:24](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1284s) Outro and Submission Reminders

Dr. Dray wraps up the weekend Q&A by thanking her viewers for submitting thoughtful, detailed skincare questions. She invites viewers to drop their queries for the following week's video in the comments section below, noting that she combs through them right before sitting down to film. She frequently replies directly in the comments to direct users to past comprehensive videos when a topic has already been addressed in detail. She signs off with her trademark channel reminder: giving the video a thumbs up, sharing it with friends, subscribing to the channel, and never forgetting to wear sunscreen.

## Notable quotes > [02:55](https://www.youtube.com/watch?v=DprHVOUpvaM&t=175s) can make a cell in a dish get up and do the polka — Dr Dray

> [02:55](https://www.youtube.com/watch?v=DprHVOUpvaM&t=175s) the la-di-da-di derivatives — Dr Dray

> [08:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=521s) If you want to pay $195 for a 2% niacinamide moisturizer, go right ahead. — Dr Dray

> [09:27](https://www.youtube.com/watch?v=DprHVOUpvaM&t=567s) literally... about the same thing — Dr Dray

> [10:14](https://www.youtube.com/watch?v=DprHVOUpvaM&t=614s) 6 months and you're done. — Dr Dray

> [12:24](https://www.youtube.com/watch?v=DprHVOUpvaM&t=744s) There's no concerns of facial fat loss with any of these things. — Dr Dray

> [13:10](https://www.youtube.com/watch?v=DprHVOUpvaM&t=790s) definitely can help with acne — Dr Dray

> [16:56](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1016s) it seemed like every 5 minutes there was some new palette — Dr Dray

> [17:54](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1074s) there's nothing more natural about a natural deodorant than an unnatural one, okay? — Dr Dray

> [17:54](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1074s) they're kind of like the Febreze of your armpit. — Dr Dray

> [18:41](https://www.youtube.com/watch?v=DprHVOUpvaM&t=1121s) painful under the arms, but it's like get it out, get it over with — Dr Dray

## Mentioned Dr Dray, Paula's Choice Clinical Pro Retinaldehyde Dual-Retinoid Treatment, The Minimalist Retinal 0.1% Face Serum, Sunday Riley A+ High-Dose / A.I. Adaptive Retinoid Serum, SkinCeuticals Advanced RGN6, CeraVe, L'Oréal, The Ordinary, Carpe, Lume, Epiduo, Accutane

## Video description In this skincare Q&A, dermatologist Dr. Dray answers audience questions about retinoids, retinaldehyde, adapinoid, HPR, vitamin C derivatives, collagen production, sunscreen expiration, seborrheic dermatitis, Volufine, facial antiperspirants, skin tags, adapalene, LED masks for acne, makeup expiration, and deodorant options for sensitive skin.

Dr. Dray also discusses the claims surrounding so-called dual retinoid products, including retinaldehyde combined with adapinoid or hydroxypinacolone retinoate (HPR), and explains what the research actually supports about these cosmetic retinoid alternatives.

Other topics include whether THD ascorbate and ascorbyl tetraisopalmitate can build collagen like topical ascorbic acid, whether Centella asiatica enhances collagen production, how to interpret sunscreen expiration dates, whether long-term doxycycline can cause seborrheic dermatitis, and whether topical products such as Volufine can actually restore lost facial volume.

For acne, Dr. Dray explains the evidence behind blue and red LED light therapy, and discusses why Epiduo may or may not make sense for anti-aging depending on whether acne treatment is also needed.

The video also covers adapalene and facial fat loss, expired makeup, facial and scalp antiperspirants, and alternatives for people who develop irritation from aluminum-containing antiperspirants.

CHAPTERS

0:00 Intro 0:28 Retinaldehyde + Adapinoid + HPR: Are These Really Dual Retinoids? 2:55 THD Vitamin C, ATIP & Granactive Retinoids for Collagen 5:06 Can Centella + Vitamin C or Retinoids Boost Collagen 3-4x? 6:36 When Does Sunscreen Expire? 7:01 Can Doxycycline Cause Seborrheic Dermatitis? 8:41 Is SkinCeuticals RGN6 Worth $195? 9:22 Can Volufine Restore Under-Eye Volume? 10:14 Antiperspirant for the Face and Scalp 11:12 Can Skin Tags Be Removed at Home? 12:24 Does Adapalene Cause Facial Fat Loss? 13:10 Do Blue LED Masks Actually Treat Acne? 14:16 Can Epiduo Be Used for Anti-Aging? 16:56 Does Makeup Expire? 17:54 Natural Deodorant, Aluminum & Alternatives 21:22 Outro

Topics covered: skincare Q&A, dermatologist Q&A, retinoids, retinaldehyde, adapalene, adapinoid, HPR, Granactive Retinoid, vitamin C, THD ascorbate, collagen, Centella asiatica, sunscreen expiration, seborrheic dermatitis, doxycycline, Volufine, under-eye hollows, antiperspirant, skin tags, facial fat loss, LED acne treatment, blue light therapy, Epiduo, makeup expiration, deodorant, sensitive skin, acne treatment, anti-aging skincare.

#Dermatologist #Skincare #SkincareQandA #Retinoids #Retinaldehyde #Adapalene #Retinol #VitaminC #Acne #AntiAgingSkincare #SeborrheicDermatitis #SkincareTips

FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links.

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Disclaimer: This video is not intended to provide diagnosis, treatment or medical advice. Content provided on this Youtube channel is for informational purposes only. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. Information on this Youtube channel should not be considered as a substitute for advice from a healthcare professional. The statements made about specific products throughout this video are not to diagnose, treat, cure or prevent disease.

[Source](https://www.youtube.com/watch?v=DprHVOUpvaM)

中文简报

Dr Dray驳斥阿达帕林导致脂肪流失的说法：纯属衰老巧合外用维A酸类药物不会消耗面部脂肪垫，观察到的面部容量流失源于自然生理衰老，而非护肤品副作用。 Dr. Dray对当下热门的护肤说法进行了批判性分析，强调adapinoid、HPR、THD抗坏血酸酯以及Volufiline等化妆品成分缺乏严谨的人体临床试验，无法替代抗坏血酸或真正的维A酸类等经证实有效的活性成分。她打破了阿达帕林或其他外用维A酸类会导致面部脂肪流失的流言，解释称与年龄相关的容量流失只是在时间上恰好与开始抗衰护肤重合。此外，她还就利用蓝光LED治疗痤疮、权衡换用非处方Epiduo的利弊、安全丢弃过期化妆品，以及通过肉毒素或口服药物控制多汗症提供了实用的皮肤科指导。将视黄醛与adapinoid或HPR结合的化妆品“双重维A酸”配方，以及THD抗坏血酸酯等维生素C衍生物，均缺乏严格的人体临床试验证明其相比标准L-抗坏血酸、视黄醇、阿达帕林或维A酸具有真正的胶原蛋白合成效果或生物利用度有效性。 (0:28) 外用维A酸类药物（包括视黄醇、维A酸和阿达帕林）不会导致面部脂肪流失；网络上的这一谣言，主要是因为使用者开始抗衰老护肤的年龄，恰好也是自然、与衰老相关的面部容量流失变得明显的时期。 (12:24) 一项针对1185名痤疮患者的系统评价发现，95%的患者在使用蓝光疗法后皮损有所减少，尽管缺乏与金标准药物的直接对照试验，但这证实了家用LED设备仍是一个有效的选择。 (13:10) 虽然非处方Epiduo（0.1%阿达帕林/2.5%过氧化苯甲酰）可通过其阿达帕林成分发挥抗衰老作用，但从单一的0.1%阿达帕林换用该药毫无意义，除非同时需要控制痤疮；因为过氧化苯甲酰没有任何抗衰老益处，反而会增加刺激性并漂白织物。 (14:16) 常见止汗除臭剂引起的腋下刺激往往是由高浓度合成香精引起的，而非铝盐；每周使用2至3次过氧化苯甲酰洁肤产品即可在无香精的情况下控制异味，而严重出汗则可通过维持6个月的肉毒素注射或口服格隆溴铵来改善。 (18:41)

Reading summary

Dermatologist Dr. Dray evaluates common skincare trends, debunking claims that topical retinoids cause facial fat loss and highlighting the gap between unproven cosmetic derivatives and clinically established dermatologic treatments. Retinoid Realities, Fat Loss Myths, and Epiduo (12:24) Dr. Dray firmly refutes rumors that topical retinoids like adapalene, retinol, or tretinoin cause facial fat loss. She attributes this belief to a false correlation: the age when individuals typically begin anti-aging skincare coincides with the natural onset of age-related facial volume loss. Furthermore, she dismisses marketing around novel "dual-retinoid" formulas containing cosmetic novelties like adapinoid and hydroxypinacolone retinoate (HPR). Unlike bioavailable retinoids, these cosmetic esters lack rigorous human clinical trials demonstrating meaningful collagen production or anti-aging efficacy. Regarding the prescription and over-the-counter acne medication Epiduo (0.1% adapalene combined with 2.5% benzoyl peroxide), Dr. Dray clarifies that it can serve an anti-aging function strictly because of the adapalene component. Benzoyl peroxide provides no anti-aging benefits, increases barrier irritation, and bleaches fabrics. Consequently, patients using adapalene solely for photoaging have no clinical reason to switch to Epiduo, whereas the combination remains valuable for active acne. Evaluating Volufiline, Vitamin C Derivatives, and Markups (2:55) Cosmetic ingredients claiming to restore structural facial volume or dramatically accelerate collagen synthesis lack clinical validity. Dr. Dray states that topical Volufiline cannot rebuild depleted facial fat pads or anatomical under-eye hollows, dismissing underlying commercial breast studies as bogus. Similarly, while pure L-ascorbic acid remains the gold standard for collagen stimulation, lipid-soluble derivatives like tetrahexyldecyl (THD) ascorbate and sodium ascorbyl phosphate lack reliable human data proving they successfully penetrate skin and convert to active ascorbic acid. Claims that *Centella asiatica* multiplies collagen synthesis threefold to fourfold are likewise unsubstantiated, though its triterpenes do offer genuine barrier-soothing and wound-healing support. Dr. Dray also advises skepticism toward prestige product markups, such as SkinCeuticals' $195 Advanced RGN6 moisturizer. Because parent company L'Oréal shares formulation architectures and patents across luxury and drugstore lines like CeraVe, paying high prices for basic 2% niacinamide formulas offers negligible clinical advantage. Clinical Realities for Acne, Dermatitis, and Lesions (13:10) Addressing at-home blue light LED devices, Dr. Dray disagrees with assertions that they lack evidence, citing a systematic review of 1,185 acne patients where 95% experienced lesion reduction. Although blue light lacks head-to-head clinical trials against standard prescriptions like tretinoin or oral isotretinoin, its biological mechanism targeting acne-causing bacteria is valid. For seborrheic dermatitis, she warns that taking systemic doxycycline for eight years poses risks of antimicrobial resistance and microbiome disruption without addressing the root cause; doxycycline suppresses inflammation but does not reduce sebum output, the primary driver fueling *Malassezia* yeast overgrowth. Addressing skin tags, Dr. Dray emphasizes that no safe or effective at-home creams exist. Safe removal requires in-office procedural excision to manage bleeding, control infection risks, and occasionally send tissue for pathological review to rule out malignancy. Managing Perspiration, Odor, and Product Expirations (10:14) Underarm irritation is frequently caused by heavy fragrance concentrations rather than aluminum salts, while "natural" deodorants are functionally solid perfumes that merely mask odor rather than halt perspiration. To control body odor without heavy fragrances, Dr. Dray recommends cleansing the axillae two to three times weekly with a benzoyl peroxide wash to reduce odor-generating bacteria. For severe facial, scalp, or underarm sweating, effective medical alternatives to topical aluminum salts include botulinum toxin injections—which control sweating for approximately six months—or systemic oral glycopyrrolate. Regarding product longevity, a sunscreen stamped with an expiration date of "12/26" remains functional through the month, expiring on January 1st; after this point, failing preservatives and emulsion separation increase infection and irritation risks. In cosmetics, dry powder formulations resist contamination longest, whereas water-based liquids harbor microbes rapidly, requiring mascara to be discarded every three months to prevent eye infections. Dr. Dray emphasizes that consumers should rely on well-studied gold standards—such as pure L-ascorbic acid, true retinoids, and established procedural interventions—rather than marketing-driven cosmetic derivatives or unproven at-home remedies for anatomical volume loss and skin lesions.

Source quotes

[2:55] Dr Dray: can make a cell in a dish get up and do the polka [2:55] Dr Dray: the la-di-da-di derivatives [8:41] Dr Dray: If you want to pay $195 for a 2% niacinamide moisturizer, go right ahead. [9:27] Dr Dray: literally... about the same thing [10:14] Dr Dray: 6 months and you're done. [12:24] Dr Dray: There's no concerns of facial fat loss with any of these things. [13:10] Dr Dray: definitely can help with acne [16:56] Dr Dray: it seemed like every 5 minutes there was some new palette [17:54] Dr Dray: there's nothing more natural about a natural deodorant than an unnatural one, okay? [17:54] Dr Dray: they're kind of like the Febreze of your armpit. [18:41] Dr Dray: painful under the arms, but it's like get it out, get it over with

Original transcript

[0:00] Hey guys, happy Sunday. We are back for [0:02] part two of the weekend Q&A. This video [0:06] will be saved in the skincare Q&A [0:08] playlist along with my Q&A from [0:10] yesterday and the prior weekend. So, if [0:12] you've missed one, go back and check [0:14] there. The videos are timestamped, so [0:17] you can do a quick scan of the chapters [0:18] and find out what questions were [0:20] answered and if there's a particular [0:21] question that you are very very [0:23] interested in, you don't have time to [0:24] watch the whole video, you can just jump [0:26] right to that particular timestamp. [0:28] Could you do a video on dual retinoid [0:30] formulas for anti-aging and pore [0:33] clearing like Paula's Choice Clinical [0:35] Pro Retinaldehyde Dual Retinoid [0:37] Treatment with 0.1% Retinaldehyde [0:39] alongside 0.16% [0:43] Adapalene or The Minimalist Retinal 0.1 [0:46] Face Serum with 0.1 Pure Retinaldehyde [0:49] and 0.5 Adapalene or Sunday Riley A.I. [0:53] Adaptive Retinoid Serum with Adapalene [0:56] alongside Hydroxypinacolone [0:59] Retinoate. So, I don't consider these [1:01] dual retinoid products in any way, [1:03] shape, or form. They are retinaldehyde [1:05] serums [1:07] except doesn't I I don't know I don't [1:08] see retinaldehyde in the Sunday Riley [1:10] thing. No surprise there and I'm sure [1:12] that's the most expensive. So, I [1:14] mentioned this in last weekend's Q&A, [1:16] but I'll repeat it here cuz I often get [1:18] questions about it and then this didn't [1:20] come up then, but we we need to talk [1:22] about it. So, Adapalene and HPR, these [1:25] are cosmetic ingredients that have not [1:28] been shown to do what retinol, [1:30] retinaldehyde, and your prescription [1:32] retinoids or over-the-counter Adapalene [1:34] can do. Okay, they're cosmetic [1:35] ingredients that kind of look and smell [1:37] like retinols and retinoids, but okay, [1:42] these are not actual retinoids or [1:44] retinols. So, if they're in there, cool, [1:47] maybe they do something. I don't know [1:49] what they actually do. You know, you can [1:51] go and look at the the literature on [1:53] them and there's some inkling of what [1:55] they might do, but the studies are not [1:57] super robust. So, in other words, we [1:59] don't really know to to what extent [2:01] these are really that beneficial. But, [2:03] it kind of helps the brand out cuz it [2:05] makes it seem like you're getting a lot [2:07] of good stuff in the formula cuz you got [2:09] a retinoid, and isn't that a retinoid [2:11] [clears throat] basically? No, it's not. [2:13] A retinoid is not a retinoid. [2:15] Hydroxypinacolone [2:17] pinacolone retinoid or HPR is not [2:20] retinol, it's not retinoid. So, those [2:22] are just in there to sell the product as [2:25] far as I'm concerned. They may offer [2:27] some benefit. I'm not completely [2:28] negating them, and if you happen to be [2:30] using them and finding them to be [2:31] beneficial, no reason to stop provided [2:34] you tolerate them, right? But, I would [2:35] not [2:36] you got to be careful, okay? Because [2:38] they will they will get marketed as like [2:41] gentle retinol. They're nowhere they [2:44] don't do what retinol does, okay? [2:46] Hydroxypinacolone retinoid, I believe [2:48] it's a retinol ester, which we already [2:49] know retinol esters don't do squat as [2:52] far as the anti-aging benefits that [2:54] people are seeking. She says, "Also [2:56] discuss ingredients like tetrahexyldecyl [2:58] ascorbate, ascorbyl tetra isopalmitate, [3:01] granactive retinoids, and studies [3:03] showing their building their potential [3:05] at building collagen with less [3:07] irritation." These are None of these [3:10] have good any [3:11] robust clinical like on actual people [3:14] studies. I mean, cells in a dish is one [3:16] thing, but I mean, some of these [3:18] manufacturers, they can make a cell in a [3:19] dish get up and do what the polka, I [3:21] swear. [3:23] It's like, what does that mean for me? [3:24] Nothing, okay? Go do some more research [3:27] on it and actual human human beings [3:29] before we go making these. THD and the [3:32] What was the other? The tetrahexyldecyl [3:35] ascorbate and the ascorbyl tetra [3:36] isopalmitate. Ascorbic acid is what you [3:39] want, okay? In vitamin C. They have a [3:42] lot of what I call the lotty dotty [3:43] derivatives, meaning they're things like [3:45] tetrahexyldecyl [3:47] or sodium ascorbyl phosphate. They're [3:49] modified versions of vitamin C that are [3:53] marketed as more stable, sensitive [3:55] skin-friendly, gentler, perhaps with [3:57] better dissolving ability to get [3:59] potentially into the skin. So what? We [4:02] don't have any evidence that they [4:03] actually get into the skin and do what? [4:06] Convert to ascorbic acid. Y'all are [4:08] pursuing ascorbic acid presumably for [4:10] the benefits. The benefits include [4:12] improving collagen production. You don't [4:14] get that reliably, predictably. There's [4:17] no data at least support that you get [4:19] that from any of these what I call the [4:20] lottie dottie derivatives. They're just [4:22] there to sell more product because [4:24] people know that vitamin C is good for [4:27] anti-aging, but maybe they don't [4:29] tolerate it because the good ones are [4:31] can be pretty irritating, right? A good [4:33] formula can actually end up being kind [4:35] of irritating, frankly. So you get [4:37] these. And to me, it's holding up a [4:38] plastic lemon and saying, "This is a [4:41] non-sour lemon object." Okay, Jan. Okay, [4:45] what what am I supposed to do with that? [4:47] How does that help my lemon meringue pie [4:49] recipe? It doesn't. I'm not going to be [4:51] using a plastic lemon in my recipe. I [4:53] kind of view these as well, plastic [4:55] lemons. They're just in there to occupy [4:58] space for the time being and to catch [5:00] your eye, but they don't do they don't [5:02] offer what the actual ingredients offer [5:05] in a reliable way. Does combining [5:07] centella asiatica with vitamin C or [5:09] retinoids improve collagen in the skin [5:11] by a factor of three or four times? That [5:14] is a bold claim. I've never seen any [5:16] research to back up the three to four [5:18] times claim at all. Now, centella or [5:21] specifically compounds from centella, [5:23] like I believe madecassoside, [5:24] asiaticoside, these actually have been [5:26] shown applied topically and taken in [5:29] systemically to uh show promise for [5:31] improving collagen production. They have [5:33] some uh small but you know, interesting [5:35] evidence for improving like uh healing [5:38] after burn uh and wound healing. And so [5:41] they're really of interest and it makes [5:42] some sense from an anti-aging [5:44] perspective that they would be helpful [5:45] for collagen. And I think there's even a [5:47] little bit of evidence that people get [5:49] an improvement in wrinkles with [5:51] supplements that have centella, although [5:52] I'm not a big fan of supplements. [5:54] Centella is a reasonable ingredient to [5:57] incorporate because it has a variety of [6:00] fairly well-established benefits for the [6:02] skin. Combining it with a topical [6:04] retinoid or ascorbic acid, provided the [6:07] ascorbic acid is well formulated, makes [6:09] some sense that it would play a [6:10] supporting role in improving collagen. [6:12] We just don't have good studies at all [6:14] on the [6:15] combination of these ingredients with [6:17] centella and seeing how like that [6:19] affects improvement in texture and [6:21] things like that, let alone quantifying [6:22] this three to four time claim. I've [6:24] never seen that substantiated, but it's [6:27] a good ingredient to pair with with [6:29] those things, but I wouldn't bank on it [6:31] necessarily reliably improving collagen [6:35] that much three to four. Sunscreen [6:37] expiration date says 12/26, when does it [6:40] actually expire? December 1st or January [6:43] 1st? And relatedly, what should we do [6:45] with expired sunscreens? January 1st. [6:48] January 1st. I just would get rid of [6:50] them. No reason to keep expired product. [6:52] The preservative system goes off, and [6:54] once the preservative system goes off, [6:56] the product can separate, the [6:57] ingredients can become a lot more [6:59] irritating, and it can become [7:00] contaminated. I have a question [7:02] regarding seborrheic dermatitis. Is this [7:04] the one that can be driven by or caused [7:07] by overuse of antibiotics like [7:08] doxycycline? I've consistently been [7:11] getting redness in the beard area, and [7:12] I've gone to dermatologist for many [7:15] years without any diagnosis. They're [7:17] about ready to try Accutane, and I've [7:19] been on doxycycline consistently now for [7:21] about eight years straight. Doxycycline [7:24] doesn't routinely cause seborrheic [7:25] dermatitis. If anything, it might help [7:28] because it's anti-inflammatory. That's [7:30] how it works for acne. That's a long [7:32] time to be on it. The downside of being [7:33] on doxycycline that long is antibiotic [7:36] resistance is [7:37] positive [7:39] possible antibiotic resistance is [7:41] possible. The bacteria, namely, [7:43] theoretically could compromise the [7:45] overall microbiome of your skin being on [7:47] it that long and maybe favor more [7:50] Malassezia overgrowth, but routinely no. [7:53] That doesn't cause seborrheic [7:54] dermatitis, but medications can [7:56] aggravate seborrheic dermatitis. Lithium [7:58] and haloperidol, griseofulvin, oddly [8:01] enough, has also been associated with [8:03] flare-ups of seborrheic dermatitis. [8:05] Griseofulvin is an antifungal, which you [8:07] think would help, but yeah, it has been [8:09] associated with that. Um sebderm can get [8:11] worse when you get sick, run down, [8:13] changes in the weather. Uh you know, if [8:15] you happen to be taking testosterone [8:17] replacement therapy, that certainly can [8:19] aggravate it because it drives more [8:21] sebum production. Seborrhea is, you [8:23] know, at the root, the excess sebum [8:24] drives more Malassezia, which drives [8:26] more inflammation, which flares the [8:27] disease. It's common to have it in the [8:29] beard area. Isotretinoin Accutane [8:31] actually can help uh seborrheic [8:32] dermatitis cutting down on sebum, but [8:34] doxycycline doesn't cut down on sebum. [8:36] It just cuts down on inflammation. [8:38] Doesn't sound like it's helping. Maybe [8:39] things will improve with the [8:41] isotretinoin. What are your thoughts on [8:42] using SkinCeuticals Advanced RGN 6 as a [8:45] daily moisturizer? If you want to pay [8:47] $195 for a 2% niacinamide moisturizer, [8:50] go right ahead. I did see that in [8:52] contrast to many of their other [8:54] moisturizers, it's fragrance-free. It [8:56] also has ectoin in it, which is an [8:57] extremolyte, very hydrating, but you can [8:59] find a niacinamide cream dime a dozen, [9:02] right? You don't need to pay that much [9:03] money, in other words, for a niacinamide [9:05] moisturizer. And I've often pointed this [9:07] out, but CeraVe, SkinCeuticals are under [9:09] the L'Oreal family members. They have a [9:11] lot of overlapping products in their [9:13] portfolios. They're really very similar. [9:16] The main difference is the marketing and [9:18] the price point. I would not pay that [9:20] much personally. While you fill in for [9:21] under eye hollows, question mark. It's [9:23] not going to bring back lost volume. [9:25] Volufiline is a cosmetic ingredient that [9:27] they like to pretend it's going to [9:28] restore lost volume, but it is only [9:30] going to restore lost volume exactly [9:32] where you place it and exactly to the [9:34] degree in which you want. It's not going [9:36] to over correct. I have a couple of [9:38] videos at this point on volume filling, [9:40] including reviewing the volume filling [9:41] serum from The Ordinary. And suffice it [9:45] to say the ingredient the study that [9:47] they did was bogus on the women's [9:50] breasts showing an increase in breast [9:52] watch. So, they never actually showed [9:54] any kind of fat restoration or anything [9:56] like that. It's not going to replace [9:58] that. Topicals aren't aren't going to [9:59] correct that. You know, that people want [10:01] so desperately that for a cream to [10:03] correct that. I I get it. But, it's just [10:05] not a reality. Hoping that a cream is [10:07] going to correct I I don't know [10:09] gallbladder [clears throat] disease. [10:11] Literally, it's about as as [10:14] the same thing. Is there an [10:15] antiperspirant for the face and the [10:17] scalp? Yes, they do make those, but be [10:19] aware that aluminum salts, which are the [10:21] active ingredients in antiperspirants [10:23] that, you know, they're what work to cut [10:25] down outflow of sweat. They can be [10:26] pretty irritating at baseline, but they [10:28] tend to be pretty irritating on the [10:29] face. So, that limits the individual's [10:32] ability to tolerate it in a lot of [10:33] cases. But, you may tolerate it. A lot [10:35] of people like that brand Carpe. I mean, [10:37] I I don't have any ties to them or [10:39] anything. I've never used that product. [10:41] But, you know, the other alternative [10:43] that I think is worth looking into if [10:44] this is something that really really [10:46] bothers you because, yeah, it's an [10:48] upfront cost for sure, but it's like 6 [10:51] months and you're done. You know, 6 [10:53] months of of a reduction in sweat. And [10:56] that's neuromodulator scalp injections [10:58] Botox can definitely help cut that cut [11:01] down on that. Alternatively, there's an [11:02] oral medication called glycopyrrolate, [11:05] which can help cut down on sweat output [11:07] as well. So, that's another option, [11:09] especially if you find that the [11:10] antiperspirant's too irritating. Are [11:12] there any at-home treatments for skin [11:14] tags? I had had skin tags removed on my [11:18] neck. Cost me $150 for 5 to 10 tags [11:21] about 5 years ago. Don't want to pay [11:23] that at this time. No, unfortunately, [11:25] that's another thing. You know, people [11:27] want a cream to just wipe those out. [11:29] Trust me, dermatologists want a cream to [11:31] wipe those out. The dermatologists who, [11:33] you know, charged you $150, I guarantee [11:36] they themselves did not see a dime of [11:37] that and they would much rather much [11:39] rather be like, "Oh, yeah, just just go [11:41] to the drugstore and buy this $2 cream [11:43] or whatever and it'll melt them." Much [11:45] rather have that happen, okay? I know no [11:47] one believes me when I tell you guys [11:48] that, but it's not it's not like skin [11:50] tag removal is some hidden secret [11:53] dermatologist money maker, okay? It it [11:55] The reason they have to charge for that [11:57] is because they have to pay the [11:58] employees in their everything and [12:00] they're not getting reimbursed by [12:02] insurance for that. So, that's like, how [12:04] are they going to make up that cost kind [12:05] of a thing? And a lot of derms will take [12:07] off a couple of them on the house. Um [12:10] the other thing is, you know, a lot of [12:11] times from a medical legal perspective [12:13] at the very least they send at least one [12:15] of them to the pathologist to make sure [12:17] it's not cancerous. And so, that kind of [12:19] does start to stack the deck. But at the [12:21] end of the day, there's nothing you can [12:22] do at home to take them off reliably or [12:24] safely. You know how we hear that under [12:26] certain conditions or on certain people [12:29] retinol or maybe even tretinoin can [12:31] cause facial fat loss. What about [12:33] adapalene? Does it have similar [12:35] potential concerns? There's no concerns [12:37] of facial fat loss with any of these [12:38] things. I know people on the internet [12:40] have ascribed volume loss to the use of [12:43] these, but there's that doesn't happen. [12:45] Facial fat loss is very common with the [12:47] aging process and a lot of people [12:49] misidentify the use of their anti-aging [12:52] skin care as being contributory or [12:54] causative when in reality it's guilty by [12:56] association because people using these [12:58] products they're of the age where it [13:00] starts to become noticeable and has its [13:02] onset. So, they associate the two and [13:05] think that one causes it. They don't. [13:07] Retinol, adapalene, none of these cause [13:10] facial fat loss. Do blue light LED masks [13:12] actually help with acne? My [13:13] dermatologist said there's no evidence [13:16] that they are effective treatment. Oh, [13:17] blue light definitely can help with [13:19] acne. Blue light targets the [13:20] acne-causing bacterium. A systematic [13:23] review evaluating treatment outcomes in [13:25] 1,185 [13:27] individuals with acne um who received [13:29] blue light, 95% of them got um reduction [13:32] in their acne spots. So, it definitely [13:34] can work. Uh admittedly, we don't have [13:36] good like head-to-head comparison [13:38] studies with this versus isotretinoin [13:41] versus you know, more standard of care [13:43] treatments or like long-term follow-up, [13:45] but it definitely can work. There's you [13:48] know, good evidence that the at-home [13:49] stuff is a great option. You'll find [13:51] really good review articles saying, [13:53] "Yeah, you know, this this is definitely [13:55] an option. You'll There are a lot of [13:57] studies on it. It definitely can work." [13:59] The same degree of evidence that [14:01] isotretinoin or tretinoin or uh benzoyl [14:04] peroxide or antibiotics have for the [14:07] management of acne? No, but to say that [14:10] there's no evidence is uh inaccurate. [14:12] There's There's quite a bit of evidence [14:14] that it it does in fact work and a [14:16] mechanism there. Why can't Epiduo work [14:18] for anti-aging? I noticed you said that [14:20] in one of your reels. Mine has 0.3% [14:23] adapalene. It can absolutely work for uh [14:26] anti-aging. What I um pointed out in [14:28] that video and maybe I I was wasn't [14:31] clear. Basically, adapalene is effective [14:34] for anti-aging and adapalene, of course, [14:36] is effective for acne. Benzoyl peroxide, [14:38] on the other hand, very effective for [14:40] acne, very effective for acne when [14:42] combined with adapalene. It doesn't do [14:44] anything for anti-aging. So, the point I [14:46] was trying to make in that reel is that [14:48] if you're someone who is using adapalene [14:51] that you buy over the counter and you've [14:53] been using it not for acne, which is [14:55] what the FDA indication is, but you've [14:56] been using it off-label improving the [14:58] signs of of skin aging. And now we have [15:01] in the United States over-the-counter [15:03] all of a sudden we have Epiduo, which at [15:06] um which is adapalene 0.1% plus 2.5% [15:09] benzoyl peroxide. There's no point in [15:12] switching from adapalene 0.1% to Epiduo, [15:16] which is adapalene 0.1% plus benzoyl [15:19] peroxide 2.5% because the adapalene is [15:22] the same. However, Epiduo has benzoyl [15:25] peroxide, which does nothing for [15:26] anti-aging. It can be drying and [15:28] irritating. So, you're switching from [15:30] one thing to another that is just more [15:32] likely to be irritating. Plus, the [15:34] annoying thing about benzoyl peroxide is [15:36] it's in that it's a leave-on product. [15:38] When it touches fabrics, it bleaches [15:40] them. And so, now you have to deal with [15:42] that, and it's not doing anything for [15:43] the anti-aging. Now, if you're someone [15:45] who has been treating acne and you're [15:48] motivated to continue uh because of the [15:51] anti-aging benefits over-the-counter [15:53] adapalene, but you're not quite um [15:56] getting maximum control or whatever, [15:59] then it might be worth switching to [16:00] Epiduo because the addition of the 2.5% [16:04] benzoyl peroxide in the Epiduo can [16:06] provide additional acne control [16:08] alongside the 0.1% adapalene. Or, if [16:12] you're someone who has been doing the [16:13] Epiduo dupe, meaning you have been [16:15] buying adapalene over-the-counter for [16:17] these past 10 years that it's been [16:19] over-the-counter, and you've also been [16:21] buying a benzoyl peroxide and you use [16:23] them together. You apply one, you apply [16:25] the other. Well, I [16:27] see about switching to the new [16:29] over-the-counter Epiduo because now you [16:31] just have to buy one thing and apply one [16:32] thing on cuz it has both ingredients in [16:35] in the one thing. So, that makes your [16:36] life a heck of a lot easier. In other [16:38] words, if you only use adapalene for [16:40] anti-aging benefits, it makes no sense [16:42] to switch to Epiduo, but if you use it [16:44] for acne and anti-aging or for acne [16:47] alone, then it might make sense [16:49] depending on how good the acne control [16:51] is. But, it only makes sense to switch [16:53] from an acne control perspective, not [16:55] from an anti-aging perspective. Makeup [16:57] expire? Question mark. Um I assume [17:00] you're asking, "Does makeup expire?" [17:01] Yes, it does. The expiration dates vary [17:04] depending on the type of product. [17:05] Powders and things last a lot longer. [17:07] They don't have the water uh versus [17:09] creams have a shorter shelf life. You [17:11] don't want to use expired makeup cuz the [17:13] preservatives go off, the product [17:15] separates, looks weird sometimes, And uh [17:18] contamination is a big issue, [17:20] especially, especially around the eyes. [17:22] In fact, mascara is one you definitely [17:24] want to stay on top of. I get rid of my [17:26] mascara every 3 months. That's the [17:27] average shelf life of a mascara, [17:29] because, you know, it'll start harboring [17:31] bacteria, and you get styes and things [17:34] like that, and problems. So, you [17:35] definitely want to keep on top of that, [17:38] not hoard makeup for a long time. That [17:40] used to be a thing on YouTube. People [17:42] would have these massive, massive makeup [17:44] collections. I think they still do. [17:45] Powder-based things, they do have a long [17:47] shelf life, so there it makes a little [17:49] sense. Like a lot of those palettes that [17:50] people were into hoarding for the [17:52] longest time, when it seemed like every [17:54] 5 minutes there was some new palette. [17:55] And natural deodorant doesn't work for [17:57] me, but other deodorant, assuming the [17:59] aluminum is what it is, causes really [18:02] bad itching. What are my options? Okay, [18:04] first of all, there's no difference [18:06] between natural deodorant and just [18:07] regular deodorant. Just the word [18:09] natural, okay? Even the the ingredients, [18:12] there's nothing more natural about a [18:15] natural deodorant than an [18:17] unnatural one, okay? Deodorants are [18:19] solid perfumes, perfume solids, sticks, [18:23] gels, and they mostly work by masking [18:26] body odor. They, you know, putting [18:28] they're kind of like the Febreze of your [18:30] armpit. Some of them, such as Lume, also [18:33] have ingredients that absorb some [18:35] moisture, which can be helpful for [18:38] cutting down on maceration, like under [18:39] the arms, which compromises barrier [18:41] integrity, and to a certain extent can [18:43] influence pH of the skin, and influence [18:45] the bacterial constitution, and [18:47] contribute to odor. Antiperspirants are [18:49] what have aluminum salts in them, and [18:52] presumably that is what you find [18:53] irritating. Aluminum salts work to cut [18:56] down on sweat, because they plug up the [18:58] sweat glands. Some people anecdotally [19:00] report that the potassium alloy crystal [19:03] deodorant they can tolerate just fine, [19:06] as opposed to the aluminum salts. So, [19:08] you might try that. There's not really [19:10] good evidence that that works as well [19:12] for cutting down on sweat and there are [19:14] reports of irritation developing to [19:16] that. So it's not a guarantee that the [19:18] that all be a better alternative for the [19:20] purposes of sweat reduction. Where it [19:22] gets confusing for consumers is that [19:24] most things are marketed as deodorants, [19:26] but a lot of things are quote unquote [19:28] antiperspirant deodorant meaning they [19:30] have aluminum, but they're scented and [19:33] they may be absorb a little moisture. So [19:35] they go ahead and slap deodorant on [19:36] there. Antiperspirant deodorant. And [19:38] most people just call them deodorants. [19:40] Using the word antiperspirant is just [19:42] not as widely commonly used, you know, [19:44] when you're shopping and stuff you're [19:45] like I need a new stick of deodorant. [19:47] That's what most people say. I mean [19:49] people are like I need to purchase [19:50] antiperspirant. I say that, but [19:53] it's it's just a more common language to [19:56] just say deodorant and but but there is [19:58] a you know, nitpicky differences in in [20:00] the products in other words is what I'm [20:02] getting at. So another option here, I [20:04] mentioned trying the reason I'm also [20:07] mentioned Lume is cuz it definitely can [20:09] cut down on the moisture, but they [20:10] actually have an un- a fragrance-free [20:12] deodorant. And so fragrance can be a [20:14] culprit in underarm irritation from [20:16] these products because they put a a very [20:19] high concentration of fragrance in these [20:21] sticks and the nature of the skin it's [20:23] more inclined irritation under the arm. [20:25] So that's can be another culprit and [20:27] that's going to be a culprit in both [20:28] deodorants and antiperspirants and it's [20:30] actually really hard to find a [20:31] fragrance-free deodorant or [20:33] fragrance-free antiperspirant. So Lume [20:35] makes one and it works by cutting down [20:38] on, you know, absorbing some excess [20:39] moisture. And it's also kind of a little [20:41] bit moisturizing in of itself which is [20:43] good for the barrier. The other option [20:44] is to wash your underarms with a benzoyl [20:46] peroxide acne wash a couple of times a [20:49] week. This cuts down on the burden of [20:50] bacteria under there that would [20:51] otherwise break down the sweat and give [20:53] you odor. So that's another option. Then [20:55] of course you could see a dermatologist [20:57] if you have excessive sweating [20:58] hyperhidrosis they could do Botox [21:00] painful under the arms, but it's like [21:02] get it out get it over with and then you [21:04] got, you know, 6 months before you got [21:06] to go back and get it done again most [21:07] cases and it you know it buys you [21:10] relief for a while. There's also oral [21:12] glycopyrrolate which I mentioned for the [21:16] person who asked me about the sweaty [21:17] head. It makes your mouth a little dry [21:19] depending on the dose of course but [21:21] pretty good option in general. All right [21:24] guys, that about wraps up the weekend [21:26] Q&A. Thank you so much for all of your [21:28] great questions. If you want me to [21:30] answer your question next week go ahead [21:32] and drop it in the comment section of [21:34] this video and I will be checking when I [21:37] sit down to film these and sometimes I [21:39] even reply back to you if I know that I [21:42] have answered it recently or I give you [21:44] a link to a video where I answer it in [21:46] depth recently. So sometimes I might do [21:48] that but I try and answer as many of [21:50] them as I can. I hope these videos are [21:53] informative for you guys and again thank [21:55] you so much for leaving your questions. [21:57] If you enjoyed today's video, give it a [21:59] thumbs up, share it with your friends [22:00] and as always don't forget sunscreen and [22:02] subscribe. I'll talk to you guys [22:03] tomorrow. Bye. [22:06] >> [music] [22:18] [music] [22:25] [music]