Dr Dray Backs 12% Lactic Acid Over Home Glycolic for Dermal Thickness

Dermatologist Answers Your Skincare Questions | AmLactin, Fraxel, Sunscreen & KP — Dr Dray

Dr Dray

Biopsy data confirm 12% ammonium lactate lotion stimulates both epidermal and dermal thickening, whereas over-the-counter glycolic acid formulations lack histological proof of deep collagen remodeling.

AI-assisted summary of Dermatologist Answers Your Skincare Questions | AmLactin, Fraxel, Sunscreen & KP — original source. Check the original for full context.

Source published:

Key ideas

  • Human biopsy trials demonstrate that over-the-counter 12% ammonium lactate stimulates both epidermal and dermal thickening and prevents corticosteroid-induced dermal atrophy, whereas dermal remodeling from glycolic acid remains largely substantiated only in high-strength professional peels. (0:19)
  • For Fitzpatrick skin phototype IV without atrophic scarring, fractional resurfacing lasers like Fraxel carry an elevated risk of post-inflammatory hyperpigmentation, making non-ablative 1064 nm Laser Genesis a safer maintenance modality for microvasculature and subtle collagen remodeling. (6:36)
  • Sunscreen film formers cannot set properly on wet or heavily perspiring skin; surfaces must be patted dry prior to reapplication, with lightweight alcohol-based gel formulations recommended to allow sweat evaporation. (9:54)
  • A regimen pairing 10% or higher urea with 15% azelaic acid effectively treats keratosis pilaris by combining keratolytic pore-clearing hydration with anti-inflammatory reduction of erythema in KP rubra. (13:09)

Detailed notes

## Background Published on YouTube on August 29, 2026, by dermatologist Dr Dray, this video is a weekend Q&A session addressing subscriber skincare questions. According to the video description, the discussion covers lactic acid versus glycolic acid for dermal thickening, laser safety considerations between Fraxel and Laser Genesis for Fitzpatrick skin type IV, sunscreen reapplication techniques, eyebrow scarring from trichotillomania, keratosis pilaris management, and the skin aging risks of office fluorescent lighting.

## TL;DR Dr Dray reviews clinical evidence showing that 12% ammonium lactate stimulates both epidermal and dermal thickening at home, whereas the dermal remodeling attributed to glycolic acid is largely confined to high-strength, in-office chemical peels. She advises caution regarding Fraxel laser for Fitzpatrick skin type IV, warning against unnecessary cosmetic clinic upsells when gentler modalities like 1064 nm Laser Genesis pose far lower risks of post-inflammatory hyperpigmentation. In addressing routine skincare questions, she emphasizes that sunscreen must be reapplied to dry rather than sweaty skin, notes that hair follicles lost to trichotillomania scarring require transplantation rather than topicals, and endorses combining 10% urea with 15% azelaic acid to address both keratin plugs and redness in keratosis pilaris. Finally, she debunks the idea that standard indoor fluorescent bulbs cause premature wrinkles or skin sagging, highlighting that their shielded UV output is negligible compared to direct sunlight.

## Atmosphere & style The presentation carries the measured, authoritative feel of an unvarnished clinical consultation grounded in real-world patient advocacy. Dr Dray speaks with a direct, no-nonsense delivery, using clear histology findings and practical analogies to dismantle commercial skincare myths and aesthetic clinic upsells. The viewing experience feels reassuring and empowering, giving the audience practical medical literacy to navigate cosmetic procedures and daily routines without fear or confusion.

## Bulletin - [00:19](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=19s) Human biopsy trials demonstrate that over-the-counter 12% ammonium lactate stimulates both epidermal and dermal thickening and prevents corticosteroid-induced dermal atrophy, whereas dermal remodeling from glycolic acid remains largely substantiated only in high-strength professional peels. - [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) For Fitzpatrick skin phototype IV without atrophic scarring, fractional resurfacing lasers like Fraxel carry an elevated risk of post-inflammatory hyperpigmentation, making non-ablative 1064 nm Laser Genesis a safer maintenance modality for microvasculature and subtle collagen remodeling. - [09:54](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=594s) Sunscreen film formers cannot set properly on wet or heavily perspiring skin; surfaces must be patted dry prior to reapplication, with lightweight alcohol-based gel formulations recommended to allow sweat evaporation. - [13:09](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=789s) A regimen pairing 10% or higher urea with 15% azelaic acid effectively treats keratosis pilaris by combining keratolytic pore-clearing hydration with anti-inflammatory reduction of erythema in KP rubra.

## Key takeaways - [00:19](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=19s) At-home 12% ammonium lactate has biopsy-backed evidence showing significant increases in both viable epidermal and dermal thickness, whereas 5% concentrations only thicken the epidermis. - [00:19](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=19s) Buffered 12% ammonium lactate lotion co-administered with superpotent corticosteroids like clobetasol successfully offsets and prevents steroid-induced dermal atrophy. - [00:19](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=19s) While high-potency professional glycolic acid peels remain superior for clinical collagen induction, over-the-counter glycolic products are highly variable and lack reliable evidence for stimulating the dermis. - [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) Fraxel (1550 nm/1925 nm) carries an elevated risk of post-inflammatory hyperpigmentation in Fitzpatrick skin type IV, requiring conservative energy settings and topical pre-treatment with retinoids, antioxidants, or hydroquinone. - [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) Laser Genesis uses a 1064 nm Nd:YAG micropulse mode that bypasses epidermal melanin, providing a minimal-risk option for treating background redness and gentle neocollagenesis in darker skin tones. - [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) Elective resurfacing lasers should be scrutinized before purchase, as aggressive treatments like Fraxel are designed for deeper textural defects or atrophic scarring rather than mild laxity or fine lines. - [09:54](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=594s) Sunscreen cannot adhere or form an even protective barrier over sweat or water, making patting the skin dry an essential preliminary step before reapplication. - [09:54](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=594s) Alcohol-based sunscreen gels dry significantly faster and facilitate sweat evaporation during heavy perspiration compared to thick, occlusive creams. - [11:06](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=666s) Chronic mechanical trauma from trichotillomania that leads to true scarring permanently destroys the hair follicles, rendering spontaneous eyebrow regrowth impossible. - [11:06](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=666s) Eyebrow transplantation into scar tissue utilizes scalp hair, which retains scalp hair characteristics and requires continuous trimming and grooming. - [12:13](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=733s) Laser hair removal does not cause keratosis pilaris and typically improves it over time by eliminating coarse hairs that trap dead skin cells inside follicular orifices. - [12:13](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=733s) Immediate post-laser follicular prominence represents transient perifollicular edema and erythema rather than keratosis pilaris, resolving spontaneously within days. - [13:09](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=789s) Urea at 10% or greater concentrations delivers dual therapeutic action for keratosis pilaris, functioning as both a hydrating humectant and a keratolytic to break down follicular plugs. - [13:09](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=789s) Azelaic acid at 15% provides mild exfoliation and targets the background vascular inflammation and erythema seen in keratosis pilaris rubra. - [14:25](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=865s) Standard intact fluorescent office lighting emits negligible ultraviolet radiation due to internal phosphor coatings and does not contribute to wrinkles, sagging, or photoaging in healthy individuals. - [14:25](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=865s) Fluorescent fixture UV exposure is clinically relevant only when unshielded bulbs sit in extreme proximity to the face or in patients with photosensitive conditions such as systemic lupus erythematosus.

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

Dr. Dray opens the Saturday Q&A session by welcoming viewers back and expressing gratitude for the community's questions. She reminds everyone that all weekly Q&A sessions are cataloged in an ongoing dedicated playlist for easy catch-up. Furthermore, timestamps are provided in the video notes so viewers can quickly check whether their submitted questions made the cut and jump directly to the topics that interest them if they are pressed for time.

[00:19](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=19s) Lactic Acid 12% vs. Glycolic Acid: Dermal Thickening and Anti-Aging

A viewer asks about the difference between 12% lactic acid and various percentage strengths of glycolic acid regarding dermal thickening and exfoliation, wondering if one is measurably superior for addressing signs of aging. Dr. Dray begins by drawing a sharp distinction between professional in-office chemical peels and over-the-counter products intended for home use. In a clinical dermatology setting, high-strength glycolic acid peels reign supreme for stimulating collagen and producing dramatic dermal thickening effects. If a patient visits a clinic specifically looking to soften wrinkles and improve visible photoaging via a medical peel, a dermatologist will almost invariably reach for high-potency glycolic acid over 12% lactic acid.

However, those professional glycolic formulations carry extreme potency and cannot be safely managed by consumers at home without risking severe burns, irritation, or scarring. The clinical justification for recommending at-home 12% ammonium lactate (the active ingredient in AmLactin) stems from solid, peer-reviewed human volunteer trials with biopsy-backed histological data. In one key clinical trial, human subjects applied either a 5% or a 12% lactic acid formulation twice daily to the face, deliberately avoiding the eyelids. Following application, the participants moisturized with classic Nivea cream, were permitted to apply their standard makeup, took measures to avoid excess sun exposure, and were provided with a titanium dioxide physical sunscreen. Biopsies and skin assessments evaluated at 4, 8, 12, and 16 weeks revealed that while the 5% concentration improved epidermal thickness alone, the 12% concentration successfully triggered both epidermal and dermal thickening. Dr. Dray emphasizes that epidermal thickening is itself a genuine, clinically meaningful benefit—counteracting the progressive epidermal and dermal atrophy caused by aging and ultraviolet damage—but the higher 12% concentration uniquely engages the dermis beneath.

```mermaid flowchart TD accTitle: Lactic Acid and Glycolic Acid Dermal Thickening Evidence accDescr: Visual flowchart comparing in-office versus at-home indications and histological outcomes for lactic acid and glycolic acid.

subgraph Office["In-Office Medical Peels"] A["High-Potency Glycolic Acid"] -->|"Clinical Superiority"| B["Pronounced Dermal Remodeling"] end

subgraph Home["At-Home OTC Skincare"] C["12% Ammonium Lactate (AmLactin)"] --> D["Epidermal & Dermal Thickening"] E["5% Lactic Acid Formulations"] --> F["Epidermal Thickening Only"] G["OTC Glycolic Acid Formulations"] --> H["Variable / Predominantly Epidermal"] end ```

The second compelling piece of evidence comes from research examining whether a buffered 12% ammonium lactate lotion could counteract steroid-induced skin thinning. Long-term, unmonitored use of superpotent topical corticosteroids like clobetasol frequently induces severe dermal atrophy, which manifests visibly as skin fragility and permanent striae (stretch marks). Researchers found that co-administering buffered 12% ammonium lactate alongside clobetasol effectively induced dermal thickening and prevented steroid-induced atrophy. In the introduction to that study, the authors noted: "during studies on the effects of daily topical application of buffered ammonium lactate to normal human skin, we have observed increases in viable epidermal thickness and ground substance in the dermis, unpublished observations."

Conversely, the market for over-the-counter glycolic acid products is wildly heterogeneous. Commercial formulations vary wildly in pH, free acid value, vehicle, and intent—some act strictly as humectants while others function as surface exfoliants. Because the robust dermal remodeling documented with glycolic acid is tied almost exclusively to intense in-office peel strengths, there is little reliable histological evidence showing that standard, safe-to-use home glycolic products stimulate the dermis. Dr. Dray points out that other OTC actives possessing substantiated evidence for reaching the dermis include retinoids (retinol, retinaldehyde, and adapalene) and well-formulated L-ascorbic acid. She adds a cautionary note that participants in the lactic acid clinical trials were pre-screened to ensure they could tolerate the product, as 12% ammonium lactate can cause noticeable stinging and burning in sensitive skin.

- **Human Clinical Trial Protocol:** Twice-daily facial application of 5% vs. 12% lactic acid solution, buffered with Nivea cream, paired with titanium dioxide sunscreen, and assessed at 4, 8, 12, and 16 weeks. - **Histological Findings:** 5% lactic acid stimulated epidermal thickening; 12% lactic acid produced significant increases in both viable epidermal thickness and dermal thickness/ground substance. - **Clobetasol Co-treatment:** 12% buffered ammonium lactate successfully offset and prevented steroid-induced dermal thinning and atrophy caused by potent corticosteroid exposure. - **Other Dermal-Targeting OTC Actives:** Retinol, retinaldehyde, over-the-counter adapalene gel, and well-formulated topical L-ascorbic acid (vitamin C).

---

[06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) Fraxel vs. Laser Genesis for Fitzpatrick Type IV Skin

A 64-year-old viewer with self-described "young-looking" skin presents a clinical dilemma: she exhibits mild fine lines, slight laxity, and superficial discoloration, but lacks deep wrinkles or atrophic acne scarring. She has undergone quarterly Laser Genesis (1064 nm) treatments for four years and maintains an active home routine consisting of daily sunscreen, a 20% vitamin C E Ferulic serum, prescription tretinoin, and a moisturizer with niacinamide. Her dermatologist—practicing in an office affiliated with a university hospital that nonetheless gives off a "day spa up-sell vibe"—has suggested stepping up to a Fraxel laser (either the 1550 nm or 1925 nm wavelength). Given her Fitzpatrick phototype IV, she is anxious about post-inflammatory hyperpigmentation (PIH) and scarring, and wonders if the upgrade provides genuine value.

Dr. Dray validates the viewer's hesitations immediately, confirming that her concerns about PIH are entirely well-founded. While fractional non-ablative resurfacing lasers like Fraxel (at both the 1550 nm erbium fiber wavelength and the 1925 nm thulium wavelength) can technically be performed safely on phototype IV skin, darker skin tones carry an inherently elevated risk of post-inflammatory pigment complications. Mitigating this risk requires strict conservative provider technique—namely selecting lower microthermal zone (MTZ) treatment densities and conservative pulse energies. Furthermore, pretreating the skin with melanogenesis inhibitors or turnover agents such as hydroquinone, tretinoin, and topical antioxidants significantly reduces PIH risk. The viewer is already well ahead of the curve on that front, as her current daily regimen of tretinoin, 20% vitamin C, and niacinamide naturally serves as a protective pre-treatment protocol.

| Laser Modality | Wavelength(s) | Mechanism & Pigment Safety | Primary Clinical Indications | |:--- |:--- |:--- |:--- | | **Laser Genesis** | 1064 nm Nd:YAG | Non-invasive micropulse energy; bypasses epidermal melanin; negligible PIH risk | Microvasculature, diffuse erythema/redness, subtle upper dermal collagen remodeling | | **Fraxel (Dual)** | 1550 nm / 1925 nm | Fractional non-ablative microscopic thermal zones; targets water; moderate-to-high PIH risk in skin phototype IV | Atrophic acne scars, textural irregularities, prominent pores, upper dermal collagen induction |

Dr. Dray contrasts this with the patient's existing Laser Genesis protocol. Utilizing a 1064 nm Nd:YAG wavelength in a non-ablative micropulse mode, Laser Genesis bypasses epidermal melanin almost completely, making its risk profile for post-inflammatory hyperpigmentation exceptionally low in phototypes IV through VI. In addition to gentle upper dermal neocollagenesis, Laser Genesis targets the microvasculature, making it an excellent maintenance modality for controlling background facial redness and microvascular erythema.

Looking critically at the patient's cosmetic goals, Dr. Dray questions whether Fraxel truly offers enough clinical upside to justify the added procedural risk and expense. Fraxel excels at leveling out surface texture, minimizing enlarged pores, and remodeling atrophic acne scars or deeper structural etched lines—none of which the viewer actually has. Dr. Dray encourages the patient to critically interview the provider before agreeing to an upsell, advising her to ask direct questions: - "Have you treated people of my skin tone before?" - "How often do you see post-inflammatory hyperpigmentation as a complication?" - "What is the overall risk in your hands, would you say?"

Because laser treatments are entirely elective aesthetic procedures, Dr. Dray emphasizes that patients must advocate for themselves and ensure that proposed treatments provide tangible clinical benefits rather than simply serving the aesthetic clinic's financial bottom line.

[09:54](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=594s) Sweating, Wet Skin, and Reapplying Sunscreen

Applying sunscreen over wet skin—whether drenched in sweat from a rigorous outdoor workout or wet from swimming in a pool, the ocean, or getting blasted by a water gun—simply will not work. Sunscreens are formulated to repel water rather than blend with it, especially water-resistant varieties designed for active outdoor use. If applied directly onto wet skin, sunscreen "is not going to set up, period."

Before reapplying, you should always pat the skin dry of any standing water or copious sweat. For individuals who anticipate heavy sweating or hot, humid climates, Dr. Dray particularly favors alcohol-based gel sunscreens over thick, occlusive creams. Gel formulations dry rapidly and allow sweat to evaporate naturally rather than trapping moisture and heat underneath a heavy layer.

- Sunscreen active ingredients and film formers cannot adhere or set evenly on wet surfaces because the water repels the formulation. - Patting the skin dry with a towel is an essential preliminary step before any reapplication. - Lightweight, alcohol-based sunscreen gels dry much faster and facilitate perspiration evaporation compared to occlusive creams.

---

[11:06](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=666s) Trichotillomania Scarring and Eyebrow Hair Regrowth

When hair follicles undergo chronic mechanical stress and damage from long-standing traction—such as compulsive eyebrow pulling in trichotillomania—the resulting scar tissue permanently destroys the follicle. Once true scarring has replaced the follicular architecture, hair cannot regenerate naturally: "If you have a scar, hair won't grow out of it, period, point blank, because there's no follicle remains there."

The only viable medical alternative for restoring hair in a scarred brow area is an eyebrow hair transplant. While hair can take root when transplanted directly into scar tissue, the procedure carries quirks that patients need to anticipate. The donor grafts are harvested from the scalp, meaning the transplanted hair retains the characteristics of scalp hair rather than natural brow hair. It has a different texture and continues to grow at a scalp hair growth rate, requiring patients to trim their eyebrows on an ongoing basis. Despite these cosmetic maintenance demands, many people are ultimately very satisfied with the outcome.

---

[12:13](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=733s) Laser Hair Removal and Keratosis Pilaris

Laser hair removal does not cause keratosis pilaris (KP). The laser mechanism specifically targets melanin pigment within the hair follicle to heat and disable hair growth; it does not trigger the abnormal retention or buildup of dry skin cells around the follicular orifice. In fact, laser hair removal frequently improves keratosis pilaris over the long term, because eliminating coarse body hair and preventing ingrown hairs removes a primary factor that traps dead skin cells inside the pores.

Confusion often arises because laser treatments can induce an acute reaction known as "follicular prominence." This consists of mild perifollicular edema, erythema, and localized swelling around the treated follicles immediately following a session. While this temporary bumpy texture resembles the characteristic "chicken skin" appearance of keratosis pilaris, it is merely short-lived inflammation that resolves on its own within a few days, completely distinct from the chronic, relapsing-remitting nature of KP.

---

[13:09](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=789s) Combining Urea and Azelaic Acid for Keratosis Pilaris

A combination of 10% urea cream and 15% azelaic acid is an effective strategy for managing keratosis pilaris. Urea is a gold standard for KP, particularly at concentrations of 10% or higher where it exerts dual-action benefits. First, it serves as a potent humectant, drawing water into the stratum corneum to normalize epidermal turnover and prevent the rough, dry accumulation of skin. Second, at these higher strengths, urea acts as a keratolytic agent, actively dissolving and breaking down the stubborn keratin plugs clogging the follicular openings.

```mermaid flowchart TD accTitle: Topical Mechanisms for Keratosis Pilaris accDescr: Flowchart illustrating how urea and azelaic acid target rough bumps and redness in keratosis pilaris. subgraph KP["Keratosis Pilaris Presentation"] Plug["Keratin Plugs & Rough Bumps"] Red["Erythema & KP Rubra"] end subgraph Treatments["Active Ingredients"] Urea["10%+ Urea Cream"] Aza["15% Azelaic Acid"] end Urea -->|"Humectant: binds water"| Plug Urea -->|"Keratolytic: dissolves plugs"| Plug Aza -->|"Mild exfoliation"| Plug Aza -->|"Anti-inflammatory: reduces redness"| Red ```

While azelaic acid is less commonly prescribed as a standalone treatment for keratosis pilaris, it makes a beneficial adjunct. It offers mild exfoliation to smooth surface texture, but its standout benefit is its anti-inflammatory power. Many patients suffer from keratosis pilaris rubra, a clinical variant characterized by persistent background redness and vascular flushing around the bumps. Azelaic acid calms this underlying inflammation, directly addressing the erythema where traditional keratolytics fall short.

- Urea at 10% or above functions as both a hydrating humectant and a keratolytic to loosen tough keratin buildup. - Azelaic acid 15% adds mild surface exfoliation and calms the vascular redness of keratosis pilaris rubra (KP rubra).

---

[14:25](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=865s) Fluorescent Lighting, Wrinkles, and Premature Aging

Spending eight hours a day under standard fluorescent office lighting poses virtually no meaningful risk of wrinkles, skin sagging, or accelerated photoaging for healthy individuals. Although fluorescent bulbs emit trace levels of ultraviolet radiation, commercial bulbs are manufactured with internal phosphor coatings specifically designed to filter out and absorb harmful UV rays. As long as the bulb remains structurally intact and the coating has not degraded, the amount of escaping UV radiation is negligible.

Elevated exposure concerns are limited to damaged or cracked bulbs, or situations where an unshielded fluorescent bulb is positioned in close proximity to the face, such as an uncovered desk lamp. Furthermore, fluorescent bulbs can act as a trigger for individuals with photosensitive medical conditions, such as systemic lupus erythematosus. For the average, healthy person sitting beneath overhead office fixtures, the UV dose is inconsequential. Dr. Dray emphasizes the vast difference in scale between indoor light fixtures and direct sunlight: "The doses between the two are like night and day. It's like a drop of sand versus an entire beach."

- Standard intact fluorescent bulbs have internal protective coatings that block harmful UV emission. - Overhead fixtures situated several feet away do not deliver enough UV radiation to trigger photoaging or elastosis. - Photosensitive patients (such as those with lupus) may experience cutaneous flares and need extra precautions around unshielded or degraded fluorescent bulbs. - In closing, Dr. Dray reminds viewers to tune into part two of the weekend Q&A the following day, invites viewers to leave future questions in the comments, and departs with her signature reminder: "don't forget sunscreen and subscribe."

## Notable quotes > [00:19](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=19s) during studies on the effects of daily topical application of buffered ammonium lactate to normal human skin, we have observed increases in viable epidermal thickness and ground substance in the dermis, unpublished observations. — Dr. Dray

> [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) day spa up-sell vibe — Dr. Dray

> [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) Have you treated people of my skin tone before? — Dr. Dray

> [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) How often do you see post-inflammatory hyperpigmentation as a complication? — Dr. Dray

> [06:36](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=396s) What is the overall risk in your hands, would you say? — Dr. Dray

> [09:54](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=594s) is not going to set up, period. — Dr. Dray

> [11:06](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=666s) If you have a scar, hair won't grow out of it, period, point blank, because there's no follicle remains there. — Dr. Dray

> [12:13](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=733s) chicken skin — Dr. Dray

> [14:25](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=865s) The doses between the two are like night and day. It's like a drop of sand versus an entire beach. — Dr. Dray

> [14:25](https://www.youtube.com/watch?v=YIQdXvlvmgA&t=865s) don't forget sunscreen and subscribe. — Dr. Dray

## Mentioned Dr. Dray, AmLactin, AmLactin Daily Nourish 12%, Nivea, Fraxel, Laser Genesis, Clobetasol, Tretinoin, Adapalene, Hydroquinone, Azelaic acid, Urea, Fitzpatrick scale, Trichotillomania, Keratosis pilaris, Keratosis pilaris rubra, Systemic lupus erythematosus

## Video description Amlactin Daily Nourish 12% https://amzlink.to/az0r9ArzAFr9W My shirt: https://amzlink.to/az0FReeRstTL5

Dermatologist Dr. Dray answers skincare questions from followers in this Q&A, covering lactic acid vs glycolic acid, laser treatments for aging skin, sunscreen reapplication, eyebrow hair loss, keratosis pilaris, azelaic acid, urea, and fluorescent light exposure.

In this video, Dr. Dray discusses whether 12% ammonium lactate, such as AmLactin, can improve dermal thickness and collagen-related signs of aging, and how its potential benefits compare with glycolic acid. She also explains why the evidence for at-home lactic acid products differs from the evidence for high-strength glycolic acid chemical peels performed in a medical setting.

She also answers whether Fraxel laser is worth considering for Fitzpatrick skin type IV, especially for someone concerned about post-inflammatory hyperpigmentation, and compares it with the gentler 1064 nm Laser Genesis treatment.

Other questions include whether sweating makes sunscreen reapplication less effective, whether eyebrow hair can regrow after scarring from trichotillomania, whether laser hair removal can cause keratosis pilaris, and whether urea and azelaic acid can be used together for KP.

Finally, Dr. Dray explains whether spending eight hours under fluorescent office lighting can contribute to wrinkles, sagging, or premature skin aging.

Topics covered:

0:00 Intro 0:19 Lactic Acid 12% vs Glycolic Acid for Anti-Aging and Dermal Thickening 6:36 Fraxel vs Laser Genesis for Aging Skin and Fitzpatrick IV Skin 9:54 Does Sweat Make Sunscreen Reapplication Less Effective? 11:06 Can Eyebrow Hair Regrow After Scarring From Trichotillomania? 12:13 Can Laser Hair Removal Cause Keratosis Pilaris? 13:09 Azelaic Acid + Urea for Keratosis Pilaris 14:25 Can Fluorescent Lights Cause Wrinkles and Sagging? 15:46 Outro

Dr. Dray provides evidence-based dermatology information, but individual skincare and treatment recommendations can vary based on skin type, medical history, and diagnosis. For concerns about prescription medications, lasers, or persistent skin or hair conditions, consultation with a board-certified dermatologist is recommended.

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

💜Shop my Amazon store https://o.bttn.io/0BwiPWFIZLG 💜Follow me on liketoknowit https://www.liketoknow.it/drdrayzday 💜Social media Instagram @drdrayzday Pinterest https://www.pinterest.com/drdrayzday/ Facebook @DrDrayzDay Twitter: @drdrayzday Tiktok: @drdrayzday

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=YIQdXvlvmgA)

中文简报

Dr Dray：增加真皮厚度，12%乳酸优于家用甘醇酸 活检数据证实12%乳酸铵乳液能刺激表皮和真皮增厚，而非处方甘醇酸制剂则缺乏深层胶原重塑的组织学证据。 Dr Dray回顾临床证据指出，12%乳酸铵在家使用即可刺激表皮与真皮增厚，而甘醇酸所具备的真皮重塑作用基本仅限于诊所内的高浓度化学剥脱。她建议Fitzpatrick皮肤分型IV型的人群对Fraxel飞梭激光保持谨慎，警惕医美诊所不必要的推销加码，因为像1064 nm Laser Genesis这类更温和的手段引发炎症后色素沉着的风险要低得多。在回答日常护肤问题时，她强调防晒霜必须补涂在干燥而非出汗的皮肤上；指出因拔毛癖瘢痕化而丧失的毛囊需要植发而非外用药；并认可将10%尿素与15%壬二酸联合使用，以同时改善毛周角化的角质栓和红斑。最后，她澄清了标准室内荧光灯会导致皮肤过早出现皱纹或松弛的说法，指出其受屏蔽的紫外线输出与直射阳光相比微不足道。 人体活检试验表明，非处方12%乳酸铵能刺激表皮与真皮增厚，并预防皮质类固醇引起的真皮萎缩；相比之下，甘醇酸带来的真皮重塑在很大程度上仅在专业高浓度剥脱治疗中得到证实。 (0:19) 对于没有萎缩性瘢痕的Fitzpatrick皮肤光反应IV型人群，Fraxel等点阵焕肤激光存在较高的炎症后色素沉着风险，这使得非剥脱性1064 nm Laser Genesis成为改善微血管和实现轻微胶原重塑更安全的日常维护方式。 (6:36) 防晒霜成膜剂在潮湿或大量出汗的皮肤上无法正常成膜；补涂前必须将皮肤表面拍干，并建议选用质地轻薄的含酒精凝胶配方以利于汗液蒸发。 (9:54) 将10%或更高浓度的尿素与15%壬二酸联合使用的方案能有效治疗毛周角化，它兼具疏通毛孔的角质剥脱与保湿作用，同时具有针对红斑型毛周角化的抗炎退红效果。 (13:09)

Reading summary

Dermatologist Dr. Dray evaluates common aesthetic and dermatological interventions, arguing that evidence-based skincare requires distinguishing robust clinical data from cosmetic marketing and aligning procedural risks with individual physiological profiles. Emphasizing histological backing and anatomical reality, she highlights targeted interventions for dermal remodeling, follicular disorders, and photoprotection while advising caution against unnecessary elective procedures. Histological Dermal Remodeling with Alpha Hydroxy Acids (0:19) Dr. Dray distinguishes professional in-office chemical peels from over-the-counter formulations, noting that while high-potency glycolic acid peels remain standard in clinical settings for collagen stimulation and dermal remodeling, safe at-home glycolic options lack comparable histological proof. By contrast, at-home 12% ammonium lactate (AmLactin) is supported by human clinical trials demonstrating structural change. In a 16-week biopsy-evaluated trial using twice-daily facial application alongside physical sunscreen and moisturizer, a 5% lactic acid concentration increased only epidermal thickness, whereas a 12% formulation stimulated both viable epidermal and dermal thickening. Furthermore, buffered 12% ammonium lactate was demonstrated to induce dermal thickening and offset dermal atrophy induced by superpotent corticosteroids like clobetasol. Dr. Dray explains that while retinoids and well-formulated L-ascorbic acid also reach the dermis over the counter, commercial glycolic acids vary widely in free acid value and pH, acting primarily as superficial exfoliants or humectants rather than dermal stimulants. She cautions, however, that 12% ammonium lactate can cause stinging and burning in sensitive individuals. Procedural Risks and Modality Selection for Phototype IV (6:36) Addressing laser rejuvenation in Fitzpatrick phototype IV skin, Dr. Dray validates patient concerns regarding post-inflammatory hyperpigmentation (PIH) and procedural upselling. Non-ablative fractional resurfacing via Fraxel (1550 nm or 1925 nm) can treat textural irregularities, enlarged pores, and atrophic scars, but it carries an inherently elevated PIH risk in darker complexions. Mitigating this risk demands conservative pulse energies, reduced microthermal zone treatment density, and pretreatments such as tretinoin, topical antioxidants, or hydroquinone. Conversely, 1064 nm Nd:YAG Laser Genesis utilizes non-ablative micropulses that bypass epidermal melanin, presenting a negligible PIH risk while addressing microvascular erythema and providing subtle upper dermal neocollagenesis. Because elective aesthetic procedures should target specific structural concerns rather than clinic revenue, Dr. Dray questions stepping up to Fraxel when a patient lacks deep scarring or textural defects, advising patients to directly ask providers about their complication rates in darker skin tones. Managing Keratosis Pilaris and Follicular Trauma (12:13) Dr. Dray clarifies that laser hair removal does not cause keratosis pilaris (KP). While post-treatment "follicular prominence"—transient perifollicular edema and erythema resolving within days—mimics KP, eliminating coarse body hair actually benefits KP over time by removing a primary factor that traps dead skin cells inside the pores. For topical maintenance, she endorses combining 10% or higher urea cream with 15% azelaic acid. Urea acts as both a hydrating humectant and a keratolytic agent to dissolve keratin plugs, while azelaic acid provides mild exfoliation and crucial anti-inflammatory relief for the persistent vascular redness seen in keratosis pilaris rubra. In cases of severe mechanical trauma, such as compulsive eyebrow pulling in trichotillomania, Dr. Dray emphasizes that true scar tissue irreversibly destroys follicular architecture. Because hair cannot regenerate through scar tissue, surgical eyebrow transplantation using scalp donor grafts is the sole restorative option. Patients must anticipate that transplanted scalp hair retains its intrinsic growth rate and texture, requiring continuous cosmetic trimming. Sunscreen Adhesion Dynamics and Ambient Lighting Safety (9:54) Sunscreen active ingredients and film formers are formulated to repel water and cannot set evenly on wet or heavily sweating skin. Dr. Dray stresses that individuals must pat their skin dry before reapplying sunscreen, noting that alcohol-based gel formulations dry rapidly and facilitate sweat evaporation more effectively than occlusive creams in hot or humid environments. Addressing indoor environmental concerns, Dr. Dray dismisses claims that routine eight-hour exposure to overhead fluorescent office lighting causes wrinkles or accelerated photoaging. Commercial fluorescent bulbs utilize internal phosphor coatings that absorb ultraviolet radiation, rendering escaped UV negligible compared to direct sunlight. Meaningful UV risk is restricted to damaged or cracked bulbs, unshielded fixtures positioned in close proximity to the face, or patients with photosensitive disorders such as systemic lupus erythematosus. Dr. Dray underscores that effective skin management depends on matching proven pharmacological mechanisms to distinct physiological conditions, warning against procedural overtreatment and exaggerated environmental anxieties. Nevertheless, clinical outcomes for potent topicals like 12% ammonium lactate remain constrained by individual barrier tolerance, and procedural laser safety in darker phototypes remains heavily reliant on provider expertise.

Source quotes

[0:19] Dr. Dray: during studies on the effects of daily topical application of buffered ammonium lactate to normal human skin, we have observed increases in viable epidermal thickness and ground substance in the dermis, unpublished observations. [6:36] Dr. Dray: day spa up-sell vibe [6:36] Dr. Dray: Have you treated people of my skin tone before? [6:36] Dr. Dray: How often do you see post-inflammatory hyperpigmentation as a complication? [6:36] Dr. Dray: What is the overall risk in your hands, would you say? [9:54] Dr. Dray: is not going to set up, period. [11:06] Dr. Dray: If you have a scar, hair won't grow out of it, period, point blank, because there's no follicle remains there. [12:13] Dr. Dray: chicken skin [14:25] Dr. Dray: The doses between the two are like night and day. It's like a drop of sand versus an entire beach. [14:25] Dr. Dray: don't forget sunscreen and subscribe.

Original transcript

[0:00] Hey guys, happy Saturday. Welcome back [0:02] to the weekend Q&A. We are going to get [0:04] into it. Thank you so much for all of [0:06] the questions. These are of course saved [0:08] in the Q&A playlist if you missed prior [0:10] videos and there are timestamps. So, if [0:12] you want, you can find the question that [0:14] you asked and see if it was answered and [0:17] skip right to that if you don't have [0:18] time to watch the whole video. What's [0:19] the difference between lactic acid 12% [0:22] and any percentage strength glycolic [0:24] acid in terms of dermal thickening? Is [0:26] one any better than the other in terms [0:28] of both dermal thickening and [0:30] exfoliation? Something that's really [0:31] important to note here. When we're [0:33] talking strictly speaking in-office [0:35] chemical peels, glycolic acid is [0:38] actually going to be superior for dermal [0:40] thickening effects. It's used in-office [0:43] at very, very potent strengths. If you [0:45] were to go to a dermatologist, they're [0:47] going to offer you an in-office chemical [0:49] peel for the purposes of improving [0:51] wrinkles and the visible signs of aging, [0:53] it would make a lot more sense for them [0:55] to gravitate towards something with [0:57] glycolic acid than 12% lactic acid. [1:00] However, what we're talking about here [1:02] is stuff that you can buy over the [1:04] counter and safely use at home. You [1:05] can't safely use that potency of [1:08] glycolic acid at home. It's very, very [1:10] risky. And so, wherein is the basis of [1:13] this 12% lactic acid recommendation and [1:16] how does it compare to glycolic acid? [1:18] The basis of the ammonium lactate 12%, [1:22] the 12% ammonium lactate lotion comes [1:24] from two clinical studies on actual [1:26] human volunteers. In one study, the [1:28] subjects applied either a 12% or a 5% [1:32] lactic acid test solution twice a day to [1:34] the face, sparing the eyelids. After [1:37] they did this, they were told to put [1:38] Nivea cream on and then they could use [1:40] regular cosmetics throughout the day. [1:43] They were also encouraged to avoid [1:44] excessive sun exposure and they were all [1:46] given a titanium dioxide sunscreen to [1:48] wear. And they looked at the subjects at [1:50] 4, 8, 12, and 16 weeks of having used [1:54] these solutions twice a day. The 12% [1:57] group had an improvement in epidermal [1:59] and dermal thickening, whereas the 5% [2:01] group only had an improvement in [2:03] epidermal thickening, which is good, [2:04] okay? It's good to have an improvement [2:06] in epidermal thickening. That's not [2:07] anything to dismiss. That's a genuinely [2:10] beneficial outcome, a reversible change [2:14] as far as skin aging goes, because you [2:16] do get epidermal and dermal atrophy with [2:19] skin aging and sun damage. So, it's [2:21] genuinely having a clinical and [2:24] histological meaning on biopsy [2:25] improvement of the epidermis. But, the [2:28] higher strength not only does the [2:29] epidermis, but it does the dermis as [2:32] well. This is the basis of me [2:33] recommending AmLactin 12% strength and [2:36] higher as opposed to their lower [2:38] percentage strength to people who are [2:40] interested in getting those dermal [2:41] effects. The second study that makes for [2:44] a compelling case for ammonium lactate [2:47] for dermal thickening comes from a paper [2:49] that was interested in if topical [2:51] application of 12% ammonium lactate in a [2:55] buffered lotion, which is what AmLactin [2:57] is, used in conjunction with a super [2:59] potent topical corticosteroid [3:01] clobetasol, if the dermal thickening [3:04] property of the 12% ammonium lactate [3:06] could help to protect against [3:08] clobetasol-induced skin atrophy. If [3:11] you're not aware, long-term [3:12] inappropriate, especially use of topical [3:15] very potent steroids like clobetasol, [3:17] can come with the unwanted side effect [3:19] of dermal atrophy, and that's what leads [3:21] to the appearance of stretch marks as [3:23] well as skin thinning. And what they [3:25] showed is that the concomitant [3:27] application of 12% ammonium lactate in a [3:30] buffered lotion with clobetasol was able [3:33] to induce dermal thickening and offset [3:36] and prevent that dermal atrophy. One of [3:39] the things that led the researchers to [3:40] become interested in this in the first [3:42] place, I will quote what they pointed [3:44] out in their introduction, is that [3:45] during studies on the effects of daily [3:47] topical application of buffered ammonium [3:49] lactate to normal human skin, we have [3:52] observed increases in viable epidermal [3:54] thickness and ground substance in the [3:56] dermis, unpublished observations. So, [3:59] it's something that has been [4:01] [clears throat] [4:01] observed clinically, it's something [4:03] that's been published clinically, and [4:05] it's something that has histologic [4:07] confirmation that it's actually making a [4:09] meaningful difference in dermal [4:10] thickness. And this is a type of a [4:12] product that you can readily get over [4:14] the counter. Now, how does that compare [4:15] to all of the hundreds of thousands of [4:18] glycolic acid things on the market? The [4:20] glycolic acid stuff that you can buy and [4:22] use safely at home is all over the [4:25] place. It is very heterogeneous. And so, [4:27] it's a lot less clear what types of [4:30] formulas out there yield what types of [4:32] benefits. And by and large, it's likely [4:34] that the stuff that you get over the [4:35] counter that you can safely use at home, [4:37] as far as glycolic acid, likely works [4:40] primarily at the epidermis because those [4:42] potent dermal thickening effects are [4:45] only known to happen, I should say, [4:47] using the super strong strengths that [4:50] you get in office, in other words. [4:52] Hence, the basis of my recommendation [4:54] for the ammonium lactate 12% and higher, [4:57] AmLactin as the brand is called, for the [4:59] potential of improving dermal thickness. [5:01] Now, other cosmetic ingredients that [5:03] have evidence to support doing that [5:05] would be retinol, retinaldehyde, as well [5:08] as a well-formulated ascorbic acid. That [5:11] and, of course, the over-the-counter [5:12] medication adapalene. So, that's why [5:15] that's the basis for the recommendation [5:17] that if you want an evidence-based [5:20] pairing of topicals that has some [5:22] [clears throat] clinical histological [5:24] data behind it as far as yielding dermal [5:27] effects, which most skin care products [5:30] only work at the epidermis, well, there [5:33] you have it. That's one to tap into if [5:35] you tolerate it. Which, as a side note, [5:37] in these clinical studies, they did do [5:40] tests before the study began to make [5:42] sure the participants could hack the [5:44] topical 12% ammonium lactate because [5:46] some people are very sensitive to it and [5:48] it burns and stings. But to answer your [5:50] question, what you can reliably and [5:53] confidently say has the potential to [5:55] improve dermal thickne- thickness in an [5:58] at-home routine is going to be that 12% [6:00] ammonium lactate. We don't have really [6:03] good data or an indication that the [6:05] at-home safe strengths of glycolic acid [6:08] reliably do that. And there is a lot of [6:10] heterogeneity out there as far as [6:12] glycolic acid formulations. Some are [6:15] largely humectant, others are more the [6:18] exfoliating strengths to work at the [6:20] epidermis, but it's not clear if any of [6:22] them are potent enough to yield the [6:24] dermal effects that you get with an [6:26] in-office peel, in which case the [6:28] ammonium lactate is inferior to glycolic [6:31] acid when we're talking strictly [6:32] speaking the in-office stuff. I hope [6:34] that clarifies that for you. I am a [6:37] young-looking 64-year-old with some [6:39] light wrinkles, sagging, and [6:41] discoloration. I've been getting Laser [6:43] Genesis 1064 quarterly for 4 years. [6:46] Maybe it's prevented some aging signs, [6:48] who knows, but my derm is now suggesting [6:50] Fraxel either 1550 or 1925 nanometer. My [6:54] Fitzpatrick phototype is four. I use [6:57] sunscreen, 20% CE Ferulic, Tretinoin, [7:00] and moisturizer with niacinamide each [7:02] day. I'm afraid of hyperpigmentation and [7:04] scarring. This practice is part of our [7:06] university hospital system, but the [7:09] office gives a day spa up-sell vibe. So, [7:11] although money isn't necessarily a [7:14] problem, value is still important. Do [7:16] you have thoughts about the Laser [7:17] Genesis versus Fraxel benefits [7:19] considering I don't have deep wrinkles [7:21] or acne scars? So, Fraxel at either [7:25] wavelength can safely be done in a [7:28] Fitzpatrick phototype four and higher. [7:30] However, there is an overall much [7:33] greater likelihood of post-inflammatory [7:36] hyperpigmentation. Yes, your worries, [7:38] your concerns are valid here for sure. [7:41] Now, it's all in the technique. However, [7:44] when conservative settings are used, [7:46] lower densities, and often times a [7:48] pre-treatment regimen of like [7:50] hydroquinone, tretinoin, even vitamin C, [7:54] which it sounds like you're already kind [7:55] of using those things. If those are used [7:57] in advance to pretreat the skin, it does [8:00] reduce the risk even further. Um what [8:02] exactly can those offer above and beyond [8:05] what you might be getting from above and [8:07] beyond what you might be getting from [8:08] the Laser Genesis? They can help to [8:10] improve surface texture, pores. They do [8:13] offer some collagen boosting effect in [8:16] the upper dermis, and they're also very [8:19] good for um acne scars, atrophic scars, [8:22] which it sounds like you don't have [8:24] based on your question. Laser Genesis, [8:26] on the other hand, delivers a [8:28] non-invasive um micropulse of the [8:31] energy. In contrast to Fraxel, that one [8:34] is very, very, very low risk of [8:37] post-inflammatory hyperpigmentation cuz [8:39] the 1064 wavelength bypasses the melanin [8:42] part piece of things. So, it's not [8:44] something that is worrisome there, and [8:46] it actually can um be very helpful for [8:49] stimulating collagen a bit, as well as [8:53] targeting uh the microvasculature. So, [8:55] it can be helpful in some cases for [8:57] unwanted persistent redness, and the [8:59] risk of PIH is much lower there. So, I [9:02] would say this, it it all depends on the [9:05] skill of the provider. Have them give [9:07] you some idea of what exactly this is [9:09] going to accomplish for you cuz it [9:10] doesn't really sound like you have that [9:13] much that would benefit from this over [9:15] the treatments that you're already [9:16] getting without putting you at risk for [9:18] post-inflammatory hyperpigmentation, but [9:21] I don't want to say I haven't evaluated [9:23] you or anything like that. I would ask, [9:25] you know, have you treated people of my [9:27] skin tone before? How many do you How [9:30] often do you see post-inflammatory [9:32] hyperpigmentation as a complication? [9:34] What is the overall risk in your hands, [9:36] would you say? I would really I would [9:38] really push for more because at the end [9:40] of the day these are cosmetic [9:42] procedures, and so it's not like it's [9:44] medically necessary, and you want to you [9:47] want to have as much information going [9:49] in, but it doesn't really sound like [9:51] it's going to offer that much, but I [9:54] can't say. Speaking of not mixing [9:55] anything into the sunscreen, does that [9:57] mean that if you are somewhere hot or [9:59] doing physical activity, maybe sweating [10:02] a bit or even a lot, would that make [10:04] sunscreen reapplication useless or not [10:06] as effective? So, if the skin is wet [10:08] with sweat or if it's wet with water, [10:11] like you just got out of the pool or the [10:13] ocean, somebody just squirted you with a [10:15] water gun, and you try and put sunscreen [10:17] on that wet skin, well, it's not going [10:20] to set up, period, because most [10:23] sunscreens, even those that aren't water [10:25] resistant, they they don't mix with [10:26] water particularly well, they kind of [10:28] repel, but especially the water [10:30] resistant ones, which I would recommend [10:31] using if you're outdoors sweating a lot, [10:33] so it stays on a little bit better. So, [10:35] it's recommended, um, when you're going [10:37] to reapply, which you should, to pat dry [10:40] the skin of water or sweat, copious [10:43] sweat, so that it'll go on better. In [10:45] this scenario in particular, I'm a big [10:47] fan for sweat and sweaty conditions of [10:50] the alcohol-based gel sunscreens because [10:53] they do a lot better with, uh, quick dry [10:57] and allowing for really good evaporation [10:59] of sweat versus like very occlusive, [11:01] heavy creams. But yeah, you want to make [11:03] sure the skin is not wet when you put [11:06] sunscreen on. I have trichotillomania [11:08] and I've been pulling my eyebrows for [11:09] years. I suspect I scarred the follicles [11:12] where I used to pull and haven't grown [11:14] hairs in those bald spots for years. Is [11:16] there anything I can do to get hair to [11:17] grow there again? Uh, no, once, uh, [11:20] there's a scar, if there is a scar, once [11:22] the follicle is scarred, hair never [11:24] grows out of there. If you have a scar, [11:26] hair won't grow out of it, period, point [11:28] blank, because there's no follicle [11:31] remains there. It just, you know, it [11:33] destroys the follicles period. And the [11:35] only [11:37] alternative if there is true scarring [11:39] there, which can happen with [11:40] long-standing traction, a a brow [11:42] transplant. I have a video actually on [11:44] eyebrow transplants. They are something [11:47] that a lot of people do end up being [11:49] happy with the results, but they can be [11:50] kind of tricky because you're harvesting [11:53] hair from like your scalp and it's not [11:55] quite the same texture. So it can be a [11:57] little odd and it grows a lot faster. So [12:00] people find they have to cut their [12:01] brows. But a lot of people end up being [12:03] really happy with it. So that would be [12:05] basically the option is is a brow [12:08] transplant cuz you can transplant hair [12:10] into a scar, but you can't get that hair [12:12] to ever grow back. I was wondering if [12:14] laser hair removal could potentially [12:16] cause keratosis pilaris. No, laser hair [12:19] removal works by targeting the melanin [12:21] pigment in the hair follicle and that's [12:23] what disables growth. It doesn't disrupt [12:26] like the build-up or lead to I should [12:28] say the build-up of dry skin around the [12:31] follicle, which is what keratosis [12:32] pilaris is. And in a lot of cases it [12:35] actually can end up helping the [12:36] keratosis pilaris because some people [12:38] find that the trapping of dry skin is [12:40] worsened by like ingrown hairs and and [12:43] and body hair as well. One thing that [12:45] can happen after laser hair removal is [12:48] that you can get some what's called [12:50] follicular prominence, just like a [12:51] little swelling around the hair [12:53] follicles, redness, irritation and it [12:56] can kind of look bumpy and look like [12:58] chicken skin, aka keratosis pilaris. But [13:00] it's not the same thing and it should [13:03] calm down and and resolve after after a [13:06] bit, but it's short-lived. It's not the [13:08] relapsing remitting thing of keratosis [13:11] pilaris. Then the same person asked, [13:13] "Would you recommend using 15% azelaic [13:15] acid in conjunction with a 10% urea [13:18] cream to deal with keratosis pilaris?" [13:20] So urea is very effective at improving [13:23] keratosis pilaris, especially at [13:26] or higher strengths, those are [13:28] keratolytic, meaning not only urea does [13:31] two things mainly. It acts as a [13:32] humectant, which ultimately does help in [13:34] the long run with cutting down on [13:36] keratosis pilaris because you have [13:37] better water content. So, you have a [13:39] decrease in the build-up of that dry [13:42] rough skin. You also, though, at these [13:44] keratolytic strengths, you get an [13:46] ingredient that can now get in there [13:48] because it's at a stronger strength, a [13:50] higher strength, can get in there and [13:52] and dissolve some of that keratin [13:54] build-up to help exfoliate and loosen. [13:56] So, that 100% can be helpful. Azelaic [13:59] acid is not as commonly used and [14:02] recommended for keratosis pilaris, but [14:04] it certainly can be a helpful addition. [14:06] It's very mildly exfoliating, so it may [14:09] somewhat modestly smooth the skin, but [14:11] it's also really good for the redness [14:13] piece of things. A lot of people have a [14:14] variant of keratosis pilaris known as KP [14:17] or rubra. Rubra's just Rubra's just red. [14:19] And the azelaic acid could be helpful [14:22] for that redness by calming down the [14:24] inflammation [14:25] as well. How about will that affect [14:27] wrinkles and sagging? It shouldn't pose [14:30] much of [14:34] any of a risk. It's very low risk to [14:36] otherwise healthy people. People who [14:38] have photosensitive conditions, it's [14:40] thought to potentially be a trigger like [14:42] patients with lupus, for example, [14:44] sometimes have a problem with the [14:45] fluorescent bulbs. But the thing about [14:47] fluorescent bulbs is yes, they can emit [14:50] trace amounts of UV enough to have some [14:52] impact especially on people who have [14:54] like I said, photosensitivity. But [14:57] they [14:59] are [clears throat] coated. So, provided [15:00] the bulb is intact and the coating has [15:02] not worn down, it should not really be [15:05] putting out harmful amounts of UV. But [15:08] damaged or cracked bulbs can definitely [15:10] leak. And so, I would say, you know, as [15:13] long as you are at a distance from them, [15:16] you know, you're not It's not like a [15:17] lamp, right? If you have a lamp with a [15:18] fluorescent bulb, then that becomes more [15:21] concerning because the bulb coating [15:24] might especially the bulb coating has [15:25] worn down. But like your overhead [15:27] lights, it's nothing really to to worry [15:30] about. It can be a problem for people [15:32] with like lupus, but if you're if you [15:34] don't have that, then then it's not [15:36] something that you have to worry about [15:37] aging your skin. You need to worry way [15:39] more about about the sun. The doses [15:41] between the two are like like night and [15:43] day. It's like a drop of sand versus an [15:45] entire beach. You know what I mean? All [15:47] right, guys. Thank you so much for [15:49] making it through the end of the video. [15:51] I hope you're having a lovely Saturday. [15:52] Come back tomorrow for part two of the [15:55] weekend Q&A. And leave your questions [15:57] for future videos down below. And if you [16:00] like today's video, give it a thumbs up, [16:02] share it with your friends, and as [16:03] always, don't forget sunscreen and [16:04] subscribe. I'll talk to you guys [16:06] tomorrow. Bye. [16:08] >> [music] [16:21] [music]