Do You Really Need a 7-Step Skincare Routine? Dermatologist Q&A

Dr Dray

AI-assisted summary of Do You Really Need a 7-Step Skincare Routine? Dermatologist Q&A — original source. Check the original for full context.

Source published: 2026-09-13

Key ideas

Multi-step regimens of 5 to 7 skincare products carry significantly higher risks of barrier disruption, contact dermatitis, and excessive preservative layering compared to simple 2- to 3-step routines. (5:59)
Topical retinoids do not shrink meibomian glands or trigger dry eye disease, a side effect uniquely associated with oral isotretinoin, though products should stay at least 1 mm from the lash line to avoid vehicle irritation. (8:47)
Patients discontinuing oral contraceptives should initiate oral spironolactone 6 to 9 months in advance to bridge androgen suppression and avoid rebound acne flares requiring rescue antibiotics. (10:23)
A 10% urea concentration treats keratosis pilaris through dual action, chemically exfoliating follicular plugs while restoring epidermal hydration necessary for skin barrier enzymes to function. (0:00)

Detailed notes

## Background Published on YouTube by dermatologist Dr. Dray on September 13, 2026, this Q&A video addresses viewer inquiries regarding common and confusing skincare topics. The session covers whether complex multi-step routines are necessary, the science behind ingredients like urea and spironolactone, tretinoin application safety, and product comparisons for anti-aging body care.

## TL;DR Dr. Dray debunks beauty industry marketing trends by advocating for simple, streamlined routines over intricate 5-to-7-step regimens that risk barrier disruption and contact dermatitis. She addresses common clinical misconceptions, clarifying that topical retinoids do not shrink meibomian glands like oral isotretinoin does, and that cosmetic topicals cannot eliminate senescent 'zombie cells' or reverse genetic gray hair. She also offers practical medical guidance on using 10% urea for keratosis pilaris, considering low-dose Accutane for refractory perioral dermatitis, proactively starting spironolactone before stopping oral contraceptives, and comparing lactic acid against retinol for body rejuvenation.

## Atmosphere & style The session features Dr. Dray's signature no-nonsense, clinically grounded demeanor, blending candid pragmatism with sharp consumer skepticism. Her delivery is brisk, authoritative, and occasionally visibly exasperated when dismantling predatory cosmetic buzzwords and overhyped beauty industry claims. Listening feels like an unfiltered, transparent consultation with a trusted dermatologist who cuts through online panic and marketing trends to prioritize skin barrier health and scientific common sense.

## Bulletin - [05:59](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=359s) Multi-step regimens of 5 to 7 skincare products carry significantly higher risks of barrier disruption, contact dermatitis, and excessive preservative layering compared to simple 2- to 3-step routines. - [08:47](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=527s) Topical retinoids do not shrink meibomian glands or trigger dry eye disease, a side effect uniquely associated with oral isotretinoin, though products should stay at least 1 mm from the lash line to avoid vehicle irritation. - [10:23](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=623s) Patients discontinuing oral contraceptives should initiate oral spironolactone 6 to 9 months in advance to bridge androgen suppression and avoid rebound acne flares requiring rescue antibiotics. - [00:00](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=0s) A 10% urea concentration treats keratosis pilaris through dual action, chemically exfoliating follicular plugs while restoring epidermal hydration necessary for skin barrier enzymes to function.

## Key takeaways - [00:00](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=0s) Urea at a 10% concentration treats keratosis pilaris by acting as both a mild keratolytic to dissolve plugs and a humectant that restores the water levels required for barrier-maturing enzymes. - [01:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=66s) Topical skincare marketing claiming to clear senescent 'zombie cells' lacks scientific validity, as these products function merely as standard moisturizers formulated with trademarked botanicals. - [02:27](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=147s) Burning rashes from sun exposure can indicate phototoxic reactions, drug photosensitivity, lupus, or rosacea flushing, requiring medical evaluation rather than an automatic assumption of solar urticaria. - [03:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=186s) Spironolactone's systemic anti-fibrotic activity in renal and cardiac tissue does not impair cosmetic neocollagenesis triggered by biostimulators like Radiesse or Sculptra. - [03:33](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=213s) Topical cosmetic products cannot halt or reverse age-related gray hair, which is permanent unless caused by a rare, early-stage nutritional deficiency. - [04:19](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=259s) Warm water is preferable when rinsing off oil cleansers because it allows emulsifiers to dissolve and lift away oils without requiring excessive mechanical scrubbing. - [04:37](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=277s) Children can safely use adult broad-spectrum sunscreens, whereas withholding sun protection out of ungrounded ingredient fears dramatically raises lifetime risks of skin cancer and photoaging. - [05:59](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=359s) Multi-step routines of 5 to 7 products are driven primarily by commercial marketing and heighten the risk of barrier compromise, irritation, and cumulative preservative exposure compared to basic regimens. - [07:42](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=462s) Low-dose oral isotretinoin is a recognized off-label second-line alternative for perioral dermatitis when first-line therapies fail, avoiding open-ended courses of oral antibiotics. - [08:15](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=495s) Topical spironolactone lacks sufficient clinical trial evidence to serve as an equivalent 1:1 substitute for oral spironolactone in treating hormonal acne. - [08:47](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=527s) Topical tretinoin does not cause dry eye syndrome or shrink ocular oil glands, but formulations must be kept at least 1 mm from the eyelid margin to avoid direct conjunctival irritation. - [10:23](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=623s) A 6- to 9-month advance timeline is advised when initiating spironolactone before discontinuing birth control to account for administrative delays and allow therapeutic androgen control to establish. - [11:34](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=694s) Microdermabrasion can be excessively abrasive for mature, sensitive skin, and spa facials should be treated as temporary cosmetic refreshes rather than dermatologic treatments. - [12:41](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=761s) Traumatic longitudinal nail splitting is caused by permanent scar tissue in the nail matrix that topicals cannot heal, necessitating complex reconstructive surgery or cosmetic wraps. - [14:22](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=862s) Both 12% lactic acid lotion and over-the-counter retinol promote body skin collagen synthesis, with AmLactin producing a uniquely rapid, reflective overnight hydration effect.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=0s) 10% Urea for Keratosis Pilaris

Dr. Dray welcomes viewers back to her Sunday skincare Q&A, reminding everyone that past sessions are cataloged in the dedicated playlist with timestamps to let viewers jump straight to their questions of interest. The first question comes from a viewer asking whether using a 10% urea cream is appropriate for keratosis pilaris (KP). Dr. Dray affirms that, if tolerated by the skin, 10% urea is an exceptional choice. At this concentration, urea functions at a mildly keratolytic strength, allowing it to penetrate and actively break down and exfoliate the rough, dry, plugged follicular bumps characteristic of the condition.

Beyond its keratolytic action, urea serves as a powerful humectant that significantly boosts epidermal hydration. Dr. Dray explains the underlying pathophysiology of KP flares: the skin barrier requires adequate water content for its natural enzymes to drive proper barrier maturation. When epidermal water levels drop, enzymatic function suffers, precipitating KP flares and bump formation. By acting as a humectant and restoring water content, urea fosters optimal enzyme activity, smoothing and softening the skin while reducing the recurring formation of rough bumps at the source.

```mermaid flowchart LR accTitle: Mechanism of 10 Percent Urea on Keratosis Pilaris accDescr: Diagram illustrating how 10 percent urea acts as both a keratolytic agent and a humectant to treat keratosis pilaris bumps.

subgraph UreaAction["10% Urea Dual Action"] K["Mildly Keratolytic"] H["Potent Humectant"] end

subgraph SkinResponse["Skin Improvement"] E["Breaks up and exfoliates rough keratin plugs"] W["Restores epidermal water content"] M["Supports enzymes for barrier maturation"] end

K --> E H --> W W --> M E --> R["Smoother, bump-free skin"] M --> R ```

- Urea at a 10% concentration provides mild chemical exfoliation alongside humectant hydration. - Epidermal water depletion inhibits normal barrier enzymes, directly driving KP bump formation.

---

[01:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=66s) "Zombie Cells" in Skincare: Can Topicals Clear Senescent Cells?

A viewer asks about topical products formulated to eliminate "zombie cells," specifically referencing Peach & Lily's formulas or similar offerings. Dr. Dray explains that "zombie cells" is a colloquial industry buzzword for senescent cells—damaged, aged, and worn-out cells that no longer divide or function normally, yet are "too stubborn to give up and die and go away." Because they linger in the tissue like "rotting corpses," these senescent cells secrete pro-inflammatory signals that can exacerbate chronic inflammation and aggravate underlying skin diseases.

Despite the biological reality of senescent cells, Dr. Dray remains completely unconvinced that any topical cosmetic cream can selectively target and purge them from living tissue. While standard antioxidants such as niacinamide can theoretically mitigate non-specific inflammation, marketing claims surrounding senolytic creams rely heavily on proprietary, trademarked botanical extracts dressed up to sound rigorously evidence-based. In reality, Dr. Dray points out that "it's not y'all. It's not." These formulations are simply standard moisturizers wrapped in clever marketing narratives designed to make ordinary products appear clinically groundbreaking.

---

[02:27](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=147s) Burning Rashes from Sun Exposure and Photosensitivity

A fair-skinned viewer with a history of Mohs surgery for basal cell carcinoma on the chin describes developing a burning rash whenever they spend more than an hour in the sun, even when wearing heavy layers of sunscreen, and asks if they might have a sun allergy. Dr. Dray clarifies that she cannot diagnose an individual viewer, but explains that such reactions encompass a wide spectrum of dermatologic possibilities beyond a true solar urticaria.

The underlying cause could range from a photoallergic or phototoxic reaction to medication-induced photosensitivity, an underlying autoimmune disorder with photosensitive features (such as lupus), or cutaneous flushing and sensitivity secondary to rosacea. Individuals with rosacea frequently flush intensely and feel a burning sensation in response to UV radiation and thermal heat. Dr. Dray emphasizes that anyone experiencing recurrent burning reactions should be formally evaluated by a physician rather than guessing.

---

[03:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=186s) Spironolactone and Collagen Formation with Radiesse or Sculptra

Addressing a question lingering from the prior week's discussion, a viewer asks whether taking spironolactone could impair the de novo collagen formation induced by biostimulatory dermal treatments such as hyperdilute Radiesse (calcium hydroxylapatite) or Sculptra (poly-L-lactic acid). Dr. Dray dismisses the concern entirely, reaffirming that spironolactone does not inhibit cutaneous collagen synthesis.

She notes that while spironolactone has clinical evidence demonstrating an anti-fibrotic effect against cardiac fibrosis and renal fibrosis when prescribed as an antihypertensive medication, that systemic anti-fibrotic activity does not translate to inhibiting cosmetic neocollagenesis in facial skin. Patients undergoing biostimulator procedures do not need to worry that spironolactone will blunt their treatment outcomes.

---

[03:33](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=213s) K18 Scalp Treatments and Claims About Stopping Gray Hair

Responding to inquiries about whether K18 scalp treatments can prevent or halt graying hair, Dr. Dray gives an emphatic "No, there's not." She stresses that no topical cosmetic product on the market can halt the genetic, age-related loss of follicular melanin. Gray hair is only potentially reversible under very specific, narrow medical circumstances: when premature graying is triggered by a systemic nutritional deficiency that is identified, treated, and corrected early enough while follicular melanocytes are still capable of recovering pigment production.

Outside of resolving an acute, early-stage nutritional deficit, age-related or hereditary graying is permanent. Dr. Dray expresses visible irritation at cosmetic brands exploiting consumer insecurities by implying hair serums can prevent grays: "if you're gray, I mean you're gray... This garbage is like—I I I, it annoys me frankly, because it's all a lie."

---

[04:19](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=259s) Oil Cleansing: Does Emulsifying Require Warm Water?

A viewer asks whether warm water is strictly mandatory to emulsify and rinse off an oil cleanser properly, or if cool water suffices. Dr. Dray notes that while cold water is technically permissible, warm water makes the removal process far more efficient. Because oils break down and rinse away much more readily in warmer temperatures, warm water allows the emulsifiers to work effectively without leaving behind residual product or requiring excess mechanical scrubbing.

---

[04:37](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=277s) Sunscreens for Children and Overcoming Sunscreen Phobia

A parent inquires about the best sunscreens for children whose other parent is deeply suspicious and critical of potential product side effects. Dr. Dray responds bluntly that children can safely use the exact same broad-spectrum sunscreens that adults use. The notion that children require distinct, pediatric-only formulas is largely a marketing construct; the primary reason to purchase a child-specific product is simply child preference regarding texture, scent, or eye-stinging.

Dr. Dray emphasizes that commercial sunscreens are thoroughly evaluated and safe, reiterating that she has presented the safety data repeatedly. The worst-case adverse event from sunscreen is an allergic contact dermatitis or irritant rash to a specific ingredient, which is treatable and not life-threatening. By contrast, "sunburns in early childhood are associated with a greater risk of skin cancers later on in life," as well as severe premature photoaging. Dr. Dray stresses that withholding sun protection out of unwarranted fear causes genuine, lasting long-term harm.

- Commercial sunscreens are safe across all age groups; the primary pediatric risk is localized contact dermatitis from an allergen. - Severe childhood sunburns significantly elevate the lifetime risk of developing melanoma and non-melanoma skin cancers.

---

[05:59](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=359s) Simple 2-Step vs. 5- to 7-Step Skincare Routines

A viewer poses a hypothetical comparison: if two people in their twenties with normal, healthy skin and good environmental conditions compare routines—one using a minimal 2- to 3-step routine (cleanser, moisturizer, SPF) and the other practicing a 5- to 7-step regimen (cleanser, exfoliator, toner, serum, moisturizer, SPF)—will the multi-step routine yield better cosmetic results, or will it simply lead to chemical buildup and barrier damage? Dr. Dray replies candidly: "dude, nobody knows any of this stuff. And all of this is guided by marketing." The intricate 7-step routine did not exist two to three decades ago; it was engineered by the beauty industry to drive consumption.

Dr. Dray acknowledges that some individuals, including herself, can successfully layer targeted actives without developing irritation. However, dermatologically, increasing the number of layered products dramatically elevates the statistical likelihood of irritation, barrier disruption, and post-inflammatory hyperpigmentation:

She warns that each additional product also introduces more preservatives onto the stratum corneum, creating theoretical concerns about altering the cutaneous microbiome. Ultimately, Dr. Dray advocates for streamlined regimens because they save substantial time and money while achieving healthy skin with far fewer complications.

---

[07:42](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=462s) Low-Dose Accutane for Refractory Perioral Dermatitis

Asked for her opinion on using Accutane (isotretinoin) for perioral dermatitis, Dr. Dray notes that it can be a valuable, effective second-line therapeutic option. Although isotretinoin is not FDA-approved for perioral dermatitis and its use is strictly off-label, low-dose regimens are frequently employed by dermatologists when patients fail to clear with standard first-line therapies such as oral tetracyclines or topical calcineurin inhibitors.

Dr. Dray emphasizes that leaving non-responsive patients on open-ended cycles of conventional oral antibiotics is poor medical practice and violates principles of antibiotic stewardship. In stubborn, recurrent cases, pivoting to an off-label course of isotretinoin is a sensible clinical decision.

---

[08:15](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=495s) Oral vs. Topical Spironolactone

A viewer recounts suffering whole-body itching and leg weakness after one month on oral spironolactone, asking whether compounded topical spironolactone cream would serve as an equivalent alternative. Dr. Dray explains that while preliminary studies suggest topical spironolactone may exert localized anti-androgenic effects, robust evidence validating its clinical reliability is sparse.

Topical spironolactone has not demonstrated parity with oral spironolactone, which remains the gold-standard systemic anti-androgen therapy for female hormonal acne, androgenetic alopecia, and hirsutism. Patients struggling with systemic side effects must recognize that topical formulations are not a proven one-to-one replacement.

---

[08:39](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=519s) Tretinoin Application Near the Eyes

The conversation turns to retinoid safety when a viewer asks whether applying tretinoin around the eye area causes direct damage to the meibomian glands, ultimately precipitating chronic dry eye syndrome. The viewer notes that they have struggled to find conclusive scientific evidence supporting this widespread online warning, prompting Dr. Dray to address the clinical realities of periocular retinoid exposure.

[08:47](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=527s) Tretinoin and the Myth of Dry Eye Disease

Dr. Dray addresses the recurring claim that applying topical retinoids near the eyes can trigger dry eye disease. While she has encountered plenty of online anecdotes—people claiming they started a topical retinoid, developed dry eye symptoms, and saw them resolve upon stopping—she remains deeply skeptical because she has never seen reliable scientific evidence supporting a causal link. Dry eye disease is exceptionally common in the general population, especially in an era defined by constant screen time.

Much of the confusion, she explains, stems from conflating topical treatments with oral isotretinoin (Accutane). Oral Accutane systemically shrinks sebaceous oil glands—which is why it clears severe acne—and it can simultaneously shrink the meibomian oil glands in the eyelids, leading to genuine dry eye issues and contact lens intolerance (which resolves after completing the course). In contrast, topical retinoids do not shrink oil glands, whether on the facial skin or in the eyes.

However, introducing topical skincare directly into the eye itself is an entirely different issue. Retinoid formulations, along with their vehicle ingredients and preservatives, are not ophthalmic solutions; direct contact can cause substantial surface irritation and damage. Because of this, standard dermatological advice dictates keeping any topical product at least one millimeter away from the lash line. Dr. Dray acknowledges that some optometrists discuss topical retinoid-induced dry eye as though it were established medical fact, but after consulting with numerous dermatology colleagues, none have encountered it in clinical practice.

- **Oral Isotretinoin (Accutane) vs. Topical Retinoids**: - *Accutane*: Systemic mechanism; actively shrinks sebaceous and meibomian glands, causing reversible dry eye during therapy. - *Topical Retinoids*: Act locally; do not shrink oil glands on facial skin or within ocular structures. - **Application Margin**: Keep creams at least 1 mm away from the eyelid margin to prevent migration of irritating formulation ingredients and preservatives into the tear film.

---

[10:23](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=623s) Preventing Acne Rebounds When Stopping Birth Control

A viewer approaching perimenopause asks how to manage the transition off oral contraceptives, which have kept her acne well-controlled, and wonders if preemptively starting oral spironolactone six to nine months beforehand is a smart strategy. Dr. Dray enthusiastically endorses this exact proactive approach for any woman relying on hormonal birth control for clear skin. Rather than stopping the pill cold turkey and waiting for an aggressive inflammatory flare before calling a doctor, patients should establish a transition plan well ahead of time.

Dr. Dray emphasizes that navigating the modern healthcare system takes months. Between scheduling appointments with a dermatologist, securing prior authorizations, appealing insurance denials, and dealing with pharmacy supply logistics, the timeline to get a pill bottle in hand is notoriously protracted. If a patient waits until the breakout occurs, the dermatologist may be forced to prescribe oral antibiotics to bring the acute eruption under control—an outcome best avoided if possible. Introducing spironolactone months before stopping birth control gives the new medication sufficient time to reach therapeutic efficacy and maintain suppression of androgen-driven sebum production seamlessly.

```mermaid flowchart LR accTitle: Acne Medication Transition Protocol accDescr: Sequence showing proactive initiation of spironolactone before discontinuing oral contraceptives.

subgraph Proactive ["Proactive Bridge (6–9 Months Prior)"] A["Patient on Birth Control"] --> B["Consult Dermatologist Early"] B --> C["Start Spironolactone"] end

subgraph Maintenance ["Discontinuation & Maintenance"] C --> D["Allow Spironolactone to Reach Efficacy"] D --> E["Discontinue Birth Control Safely"] E --> F["Maintain Clear Skin without Antibiotic Rescue"] end ```

---

[11:34](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=694s) Facials and Microdermabrasion for Mature, Sensitive Skin

When asked whether microdermabrasion is too harsh for a 65-year-old with sensitive skin, Dr. Dray gives a clear warning: yes, it can be excessively abrasive. She describes microdermabrasion as "literally sand blasting the skin." While it mechanically exfoliates surface irregularities and buffs rough texture, it can easily strip the stratum corneum, disrupt skin barrier integrity, exacerbate baseline dryness, and trigger heightened sensitivity in mature tissue.

Dr. Dray broadens the discussion to spa facials as a whole. While she enjoys an occasional facial herself and understands the pampering appeal, she stresses that consumers should view them as temporary aesthetic refreshes rather than medical therapies: - **Temporary Glow vs. Lasting Change**: Facials are great to schedule the morning of a major event or photoshoot to look radiant and dewy, but they do not treat dermatological conditions or impart long-term biological improvements. - **Mental Health Value**: The primary tangible benefit is stress relief and relaxation, which can indirectly aid skin health. - **Risk of Flare-ups**: Facials carry an inherent risk of aggravating underlying dermatoses or triggering contact dermatitis if unfamiliar botanical extracts or sensitizing cosmetic ingredients are introduced.

---

[12:41](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=761s) Post-Traumatic Split Nail and Matrix Scarring

A viewer inquires about a thumbnail that has grown split down the middle in two distinct halves ever since suffering a burn injury over ten years ago. Dr. Dray explains that a decade-old thermal injury inevitably produced deep scar tissue within the nail matrix—the specialized germinative tissue beneath the proximal nail fold responsible for generating the hard nail plate. Because the matrix cells at that site are permanently scarred, they can no longer synthesize and fuse keratinocytes into a uniform, continuous sheet.

She emphasizes that topical creams, oils, or home treatments are completely useless for repairing structural matrix scarring. The only theoretical corrective option is complex reconstructive surgery: - **Surgical Intervention**: A specialized nail dermatologic surgeon or an experienced hand surgeon can attempt to excise the scarred portion of the matrix, occasionally combining excision with a nail matrix graft. However, surgical outcomes vary significantly, and the invasive procedure may not guarantee a cosmetically normal nail. - **Cosmetic Camouflage**: Non-surgical management involves cosmetic maintenance, such as visiting a nail technician for professional acrylic overlays or applying silk wraps with adhesive to smooth the gap. Dr. Dray notes that patients choosing acrylics must stay mindful of the risks of acrylate contact allergies and localized irritation.

---

[14:22](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=862s) Amlactin 12% vs. Gold Bond Retinol for Body Anti-Aging

Dr. Dray compares two popular body treatments for photoaging and skin rejuvenation: AmLactin Daily 12% Lactic Acid Lotion and Gold Bond Age Renew Retinol Overnight Body & Face Lotion. Although no clinical head-to-head trials directly pit them against one another, both active ingredients stimulate collagen synthesis—lactic acid through deep alpha-hydroxy acid (AHA) signaling and exfoliation, and retinol through retinoid receptor activation. While both formulas can theoretically be rotated if skin tolerance permits, Dr. Dray weighs their distinct real-world characteristics:

Dr. Dray makes it clear that while she is an ardent fan of the Gold Bond Age Renew formula—stating she genuinely "stans" it—AmLactin 12% provides a dramatic visual payoff that sets it apart. When applied to areas like the legs before bed, AmLactin delivers an unmatched level of deep hydration that leaves her skin looking strikingly glossy, reflective, and plump by the following morning.

## Notable quotes > [01:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=66s) too stubborn to give up and die and go away — Dr. Dray

> [01:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=66s) rotting corpses — Dr. Dray

> [01:06](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=66s) it's not y'all. It's not. — Dr. Dray

> [03:33](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=213s) No, there's not. — Dr. Dray

> [03:33](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=213s) if you're gray, I mean you're gray... This garbage is like—I I I, it annoys me frankly, because it's all a lie. — Dr. Dray

> [04:37](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=277s) sunburns in early childhood are associated with a greater risk of skin cancers later on in life — Dr. Dray

> [05:59](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=359s) dude, nobody knows any of this stuff. And all of this is guided by marketing. — Dr. Dray

> [11:34](https://www.youtube.com/watch?v=K6KBDR1y7Wo&t=694s) literally sand blasting the skin. — Dr. Dray

## Mentioned Dr. Dray, Peach & Lily, Radiesse, Sculptra, K18, Accutane, AmLactin Daily 12% Lotion, Gold Bond Age Renew Retinol Lotion

## Video description In this skincare Q&A, dermatologist Dr. Dray answers questions from viewers about some of the most common and confusing skincare topics, including 7 step skincare routines, keratosis pilaris, urea, "zombie cells," sun sensitivity, sunscreen for children, spironolactone, tretinoin around the eyes, perioral dermatitis, anti-aging skincare routines, microdermabrasion, and more.

Dr. Dray also discusses whether a simple two-step skincare routine can be just as effective as a complicated 5 to 7 step routine, whether topical spironolactone is a reasonable alternative to oral spironolactone for acne, whether tretinoin can cause dry eye, and how to plan for acne control when coming off birth control.

The video also covers the difference between Amlactin 12% lactic acid lotion and Gold Bond Retinol Lotion for anti-aging body care, as well as whether microdermabrasion is appropriate for mature or sensitive skin.

TIMESTAMPS:

0:00 Intro

0:16 10% Urea for Keratosis Pilaris

1:06 "Zombie Cells" in Skincare: Can Products Get Rid of Senescent Cells?

2:27 Burning Rash From Sun Exposure: Is It a Sun Allergy?

3:06 Spironolactone and Collagen Formation From Radiesse or Sculptra

3:33 Can K18 Stop Gray Hair?

4:19 Does an Oil Cleanser Need Warm Water to Rinse Off?

4:37 What Sunscreen Is Best for Children?

5:59 Simple 2-Step vs. 5 to 7-Step Skincare Routine

7:42 Accutane for Perioral Dermatitis

8:15 Oral vs. Topical Spironolactone for Acne

8:39 Can Tretinoin Around the Eyes Cause Dry Eye?

10:23 Preventing Acne Rebound After Stopping Birth Control

11:34 Is Microdermabrasion Too Harsh for Mature, Sensitive Skin?

12:41 Nail Damage Years After a Burn

14:22 Amlactin 12% vs. Gold Bond Retinol for Anti-Aging

15:45 Outro

中文简报

真的需要7步护肤法吗？皮肤科医生答疑 Dr. Dray打破了美容行业的营销趋势，主张采用简单精简的护肤流程，而非可能破坏屏障并引发接触性皮炎的繁琐5至7步方案。她厘清了常见的临床误区，澄清了外用维A酸类药物不会像口服异维A酸那样使睑板腺萎缩，以及外用化妆品无法清除衰老的“僵尸细胞”或逆转遗传性白发。此外，她还提供了实用的医学指导，包括使用10%尿素改善毛周角化病、针对难治性口周皮炎考虑低剂量Accutane、在停用口服避孕药前提前启动螺内酯治疗，以及对比乳酸与视黄醇在身体抗衰中的作用。与简单的2至3步护肤流程相比，包含5至7种护肤品的多步骤方案具有显著更高的屏障受损、接触性皮炎以及防腐剂过度叠加的风险。 (5:59) 外用维A酸类药物不会导致睑板腺萎缩或引发干眼症（这是口服异维A酸特有的副作用），但产品使用时应与睫毛根部保持至少1毫米的距离，以避免基质刺激。 (8:47) 停用口服避孕药的患者应提前6至9个月开始口服螺内酯，以衔接雄激素抑制期，避免出现需要抗生素补救治疗的反弹性痤疮爆发。 (10:23) 10%浓度的尿素可通过双重作用治疗毛周角化病，既能对毛囊角栓进行化学去角质，又能恢复表皮水合作用，使皮肤屏障酶正常发挥功能。 (0:00)

Reading summary

Dermatologist Dr. Dray argues that expansive multi-step skincare routines and trend-driven cosmetic claims are largely commercial constructs that heighten irritation risks rather than clinical outcomes. She advocates for streamlined, evidence-based regimens, distinguishing proven topical and systemic dermatological treatments from unverified beauty industry marketing. Evaluating Routine Complexity and Marketing Claims (5:59) Dr. Dray explains that intricate 5- to 7-step skincare routines are products of industry marketing rather than clinical necessity. While individual skin tolerances vary, layering numerous products substantially increases the statistical risk of barrier disruption, contact dermatitis, reactive post-inflammatory hyperpigmentation, and cumulative preservative exposure. For most individuals, a minimalist 2- to 3-step regimen comprising cleanser, moisturizer, and sunscreen delivers effective maintenance with minimal complication. She identifies several popular product claims as commercial hype lacking scientific support. Topicals marketed to purge 'zombie cells' (senescent cells) rely on proprietary botanicals that function merely as standard moisturizers, as no cosmetic cream has been proven to selectively eliminate senescent cells from living tissue. Similarly, she dismisses claims that hair serums can halt or reverse age-related or genetic graying, noting that repigmentation is medically possible only when treating early, acute nutritional deficiencies. Regarding sun protection, Dr. Dray notes that specialized pediatric sunscreens are largely marketing constructs; children can safely use adult broad-spectrum formulas, and preventing early childhood sunburns is critical to reducing lifetime skin cancer risks. Topical Retinoids, Accutane, and Ocular Safety (8:47) Addressing concerns that topical tretinoin causes chronic dry eye syndrome by damaging meibomian glands, Dr. Dray states there is no reliable scientific evidence demonstrating a causal link. She attributes this persistent belief to confusion between topical retinoids and oral isotretinoin (Accutane). Oral isotretinoin functions systemically to shrink sebaceous and meibomian glands, producing temporary dry eye and contact lens intolerance during therapy. In contrast, topical retinoids act locally and do not shrink oil glands. However, because topical formulations and their preservatives are not ophthalmic products, direct contact with ocular tissue can cause substantial surface irritation. Dr. Dray recommends keeping products at least one millimeter away from the lash line to avoid tear film contamination. Regarding related treatments, she highlights that low-dose oral isotretinoin serves as a valuable, off-label second-line therapy for perioral dermatitis when patients fail standard oral tetracyclines, preventing indefinite and improper antibiotic cycles. Hormonal Management and Collagen Biostimulation Realities (10:23) For women using oral contraceptives for acne management who plan to stop, Dr. Dray recommends initiating oral spironolactone six to nine months in advance. Because systemic anti-androgens require time to achieve therapeutic suppression of sebum production, and administrative delays such as appointments and insurance authorizations often take months, preemptive planning prevents aggressive acne rebounds and eliminates the need for emergency oral antibiotic rescue courses. She cautions that compounded topical spironolactone cannot be considered an equivalent substitute for oral spironolactone, as rigorous clinical evidence establishing its efficacy is sparse. Furthermore, Dr. Dray clarifies that oral spironolactone does not inhibit cosmetic neocollagenesis induced by biostimulatory dermal injectables such as Radiesse or Sculptra; its clinically documented anti-fibrotic activity is confined to cardiac and renal fibrosis and does not blunt facial collagen formation. Targeted Actives and Physical Barrier Interventions (0:00) Dr. Dray highlights 10% urea as an optimal topical for keratosis pilaris (KP). At this concentration, urea serves dual roles: a mild keratolytic that breaks down rough keratin plugs, and a potent humectant that restores epidermal water content, thereby enabling the natural enzymatic activity necessary for barrier maturation. For body photoaging, she compares 12% lactic acid lotion with over-the-counter retinol, noting that while both promote collagen synthesis, 12% lactic acid provides a distinct, highly reflective visual finish overnight despite mild potential for stinging. In contrast, physical and mechanical interventions require caution. Dr. Dray warns that microdermabrasion acts like 'sand blasting' and can strip mature or sensitive skin, advising that spa facials offer temporary aesthetic refreshes and relaxation rather than medical corrections. For structural trauma, such as split nails caused by scarred matrix tissue, topical treatments are ineffective; patients must choose between specialist surgical revision or cosmetic options like overlays. Dr. Dray emphasizes that dermatologic health is best supported by respecting the skin barrier, selecting targeted actives with verified biological mechanisms, and avoiding the trap of layering unproven cosmetic products.

Source quotes

[1:06] Dr. Dray: too stubborn to give up and die and go away [1:06] Dr. Dray: rotting corpses [1:06] Dr. Dray: it's not y'all. It's not. [3:33] Dr. Dray: No, there's not. [3:33] Dr. Dray: if you're gray, I mean you're gray... This garbage is like—I I I, it annoys me frankly, because it's all a lie. [4:37] Dr. Dray: sunburns in early childhood are associated with a greater risk of skin cancers later on in life [5:59] Dr. Dray: dude, nobody knows any of this stuff. And all of this is guided by marketing. [11:34] Dr. Dray: literally sand blasting the skin.

Original transcript

[0:00] Hey guys, happy Sunday. Welcome back to [0:02] the skincare Q&A. If you missed the last [0:05] Q&A, I have it saved in the skincare Q&A [0:08] playlist along with all of them. And of [0:10] course, they are timestamped so you can [0:12] skip around to the question that you're [0:13] most interested in if you don't have [0:15] time to watch the whole video. I have [0:17] keratossis pilaris and I'm planning to [0:18] use 10 ura. Is that okay? You know, if [0:21] tolerated it can be great. 10% ura is a [0:23] kerat mildly keratolytic strength [0:25] meaning it'll get in there and break up [0:27] and exfoliate away the dry rough bumps [0:30] of keratossis polyaris. It can soften [0:32] smooth the skin and also hydrates. URA [0:36] is is also a hctant and so it can help [0:38] moisturize the skin and ultimately you [0:40] know acting as a hctin improving [0:42] moisture content that ultimately cuts [0:44] down on the formation of dry rough bumps [0:47] through better barrier maturation [0:49] because the enzymes that do that they [0:52] require good water content and the drop [0:54] in water content in the epidermis is a [0:56] big underlying you know precipitating [0:57] factor for a flare of KP and the [1:00] formation of those bumps. So yeah, [1:01] definitely it can be a great great KP uh [1:04] targeter for sure. I'm wondering about [1:06] zombie cells and if any topical product [1:09] can actually help get rid of them like [1:11] the advanced rebound Bigalow zombie [1:13] cream from Peach Lily. Is that what that [1:16] says? Peach and Lily or any others. So [1:18] zombie cells is um basically uh [1:21] referring to what is called scinsesscent [1:22] cells. These are cells that are damaged, [1:25] old, worn out, and they're not really [1:28] offering anything anymore. They're not [1:29] dividing. They're not working, but [1:31] they're like too stubborn to give up and [1:32] die and go away. And they hang out and [1:35] because they're just kind of, you know, [1:37] rotting corpses, if you will, like, you [1:40] know, hence the name zombie, they [1:41] generate a lot of inflammation, which [1:43] can aggravate underlying inflammatory [1:44] diseases and things of that sort. But [1:46] I'm not convinced that any of these [1:47] creams that market themselves around [1:49] zombie cells are doing anything specific [1:51] to get in and clear them out. um you [1:54] know an antioxidant in theory can help [1:56] offset the inflammation because that you [1:59] know antioxidants have that [2:01] anti-inflammatory effect like [2:02] nioinamide. [clears throat] [2:03] I'm not convinced that you know a lot of [2:05] times you'll you'll find these creams [2:06] and they'll have some trademark [2:08] ingredient and then you figure out the [2:10] trademark ingredient is like some [2:11] extract from a plant somewhere and [2:14] they're trying to make it seem like [2:15] that's like super evidence b like that's [2:17] reliably going to get in there and and [2:19] get and it's not y'all. It's not. These [2:22] are just moisturizers with a new way to [2:24] market them to make them seem special. [2:27] Frankly, I get a burning rash anytime [2:29] I'm in the sun for more than an hour, [2:31] even with tons of sunscreen. Am I [2:33] allergic to the sun? My doctor didn't [2:34] think so. I'm very fair and have had one [2:37] basil cell removed from my chin by mo. I [2:40] do avoid the sun, but sometimes it's [2:42] hard like when I was in Hawaii. Can't [2:44] diagnose or tell you what exactly are [2:46] going on. What exactly is going on? It [2:48] could be any number of things. Photogic [2:50] reaction. um a medication induced [2:52] photosensitivity, an underlying [2:54] autoimmune disease with [2:55] photosensitivity, uh rosacea, it really [2:58] could be any number of things. Uh people [3:00] with rosacea do commonly flush that, you [3:03] know, definitely could be what's going [3:05] on. You know, some type of hives as [3:06] well. Would the spironolactone affect [3:08] collagen formation if it's collagen [3:10] trying to form from a hyperdilute radi [3:13] or sculpture session? No. Again, um this [3:16] is like from last weekend. [3:18] Spironolactone does not inhibit collagen [3:21] production. Okay. It's been shown to [3:22] help with preventing cardiac fibrosis [3:25] and kidney fibrosis when used as an [3:27] anti-hypertensive. That doesn't mean [3:29] anything for facial skin at all. Okay. [3:33] Is there any validity to K18 scalp [3:35] treatment in terms of stopping gray [3:37] hair? No, there's not. Stopping gray [3:38] hair is not something that you're going [3:40] to get from any kind of product. The [3:42] only time that gray hair has any [3:44] potential to be reversible is if in the [3:46] if it's due to like an underlying [3:48] nutritional deficiency that's caught [3:50] early, treated intervened on. There is [3:52] like potentially it seems this window [3:54] where the cells can get back on track [3:56] and get back to to producing pigment if [3:59] caught early enough. Like for example, [4:00] there are cases of premature graying and [4:03] people with underlying nutritional [4:04] deficiencies that are corrected and then [4:06] their hair repigments. But um if you're [4:08] gray, I mean you're gray. Okay, people [4:09] go gray when they go gray. be related to [4:12] genetics and stuff like that. This this [4:14] garbage is like I I I it annoys me [4:16] frankly because it's all a lie. Do you [4:19] have to use warm water to emulsify and [4:21] wash off an oil cleanser in order for it [4:24] to be washed off correctly or is it okay [4:26] to use cool water? No, but it likely [4:28] makes it easier to rinse stuff off. I [4:30] mean, oil is going to come off of your [4:31] face a lot more likely and a lot more [4:33] readily and efficiently in a warmer [4:36] water than cold. What type of sunscreens [4:38] are best for children whose parents are [4:40] super critical and suspicious of [4:42] products that may have harmful side [4:43] effects? I know it's sun I know it's [4:46] sunscreens, but the dad has some [4:47] unshakable ideas. Same ones you and and [4:50] dad use. Okay, this idea that children [4:52] need their own special sunscreen. The [4:54] only reason they need their own special [4:55] sunscreen is if they're like really [4:57] picky and they have the one they like. [4:58] Give them whatever they want to use. [5:00] Sunscreens are safe. All of them are [5:02] safe. I can I can say that. I I [5:03] presented the data behind that numerous [5:06] times on here. Some people are not going [5:08] to hear it. Okay? You just kind of have [5:10] to accept that in your case, it's a lot [5:12] more challenging because you're talking [5:13] about your children here. And you know, [5:15] I do have to say that children are not [5:17] harmed by using sunscreen unless they're [5:20] allergic to an ingredient. They'll get a [5:21] a rash from the the sunscreen. The worst [5:25] case thing that'll happen is if they [5:27] have an allergy to an ingredient, then [5:28] they get a contact dermatitis rash. You [5:30] know, no one's going to die from that. [5:33] The more worrisome thing is that uh [5:35] sunburns in early childhood are [5:37] associated with uh greater risk of skin [5:40] cancers later on in life. [5:41] [clears throat] So essentially, you [5:42] know, by not wearing sunscreen or being [5:43] sunscreen phobic can get a lot of sun [5:46] damage, sun exposure, unprotected sun [5:48] exposure, sunburns that not only set [5:50] them up potentially for skin cancers [5:52] later on in life, but also like [5:54] premature skin aging and things of that [5:56] sort. So sunscreen in early childhood [5:58] can make the biggest difference. [5:59] Honestly, if you compare two people with [6:02] normal, healthy skin, living in good [6:03] climates, who are in their 20s, what's [6:05] the difference of someone using a [6:06] two-step routine, cleanser, moisturizer, [6:08] sunscreen, versus the other doing the [6:10] five to seven step, cleanser, [6:11] exfoliator, toner, serum, moisturizer, [6:14] SPF every day? Will the person doing [6:15] more steps just have better cosmetic [6:17] appeal? Is there more potential for [6:19] barrier damage and stripping from all [6:20] the chemical buildup and mixture? Is [6:22] their skin healthy? If their skin is [6:24] healthy, if the baseline to dude, nobody [6:26] knows any of this stuff. And all of this [6:28] is guided by marketing. The whole [6:30] sevenst step skincare routine that you [6:32] just laid out here didn't exist 20, 30 [6:35] years ago, okay? Like, so it's just [6:38] stuff that the industry has come up with [6:40] to get us to buy more things. Now, can [6:42] it help? Yeah. I mean, I I certainly [6:44] benefit in many cases from layering a [6:46] couple of different products with [6:47] different unique ingredients. They don't [6:48] cause me irritation in those situations. [6:50] I do quite well with that. But in [6:52] general, the theme is the more products [6:54] you use, the greater the likelihood of [6:55] irritation. Irritation is not great for [6:57] your skin. It can cause unwanted [6:59] pigmentation, flare underlying skin [7:01] conditions. Keeping the routine to a [7:03] minimum number of products helps you to [7:06] reduce the likelihood that that happens. [7:08] Yes. Also, more products, more [7:10] likelihood for barrier compromise [7:12] because you're stacking more things that [7:13] can potentially compromise the barrier. [7:16] Also, you're stacking more things with [7:17] preservatives in them that potentially [7:19] could ultimately influence your [7:20] microbiome. It's another thing to think [7:22] about in the back of your head and keep [7:24] you awake at night. Like [gasps] I know [7:26] some of you guys get a little nervous [7:27] about things like this, so I don't mean [7:29] to scare you guys. I don't really worry [7:31] about it myself, but yeah. And versus [7:33] the the other reason to stick to simple [7:35] is like it's cheaper. It's it's easier [7:38] to stick with and saves you time and [7:40] energy and all those things, which don't [7:41] underestimate that. Do you have [7:43] thoughts, opinions on Accutane being [7:44] used for peroral oral dermatitis? Uh, [7:47] you know, it can help uh peral [7:49] dermatitis. It might even be considered [7:51] as a second line treatment to be off [7:52] label of course because it's not FDA [7:54] approved for perioral dermatitis. But it [7:56] certainly does seem to be helpful [7:58] especially for cases that don't respond [8:00] to the conventional antibiotic treatment [8:02] of course and and so yeah it's [8:04] definitely worth considering in those [8:06] cases cuz putting people on antibiotics [8:08] they don't respond and and just keeping [8:10] them on that is not a good idea for them [8:12] or for antibiotic stewardship or [8:15] anything of that sort. I've tried [8:16] spironolactone for one month and I got [8:18] extremely itchy all over my body and [8:19] felt weakness in my legs. Would the [8:21] cream form be better for me instead of [8:23] the pill? You know, there's not a lot of [8:26] um evidence on the reliability of [8:27] topical spironolactone. I mean, we've [8:29] got some evidence showing that it can be [8:31] helpful for sure. But as far as how it [8:33] compares to the oral stuff, no. Oral [8:35] oral therapy is still the go-to for like [8:37] acne and androgenetic alpia and [8:39] heretism. Um, will applying tininoan [8:41] around my eyes really damage the glands [8:43] and eventually give me dry eyes? I've [8:45] never seen any evidence that this [8:47] happens. I've heard anecdotes of it, but [8:49] I've never seen any evidence. Keep in [8:50] mind, dry eye disease is very, very [8:52] common. So, when people say they started [8:53] using a topical retinoid and got dry eye [8:55] disease and then they stopped and it [8:57] went away, I I I'm still very skeptical [8:59] because um you know, what else were you [9:01] doing? It's it's very common to have dry [9:03] eye disease, especially now that we look [9:05] at these screens all the time and things [9:06] of that sort. You know, I think a lot of [9:08] people think about Accutane causing dry [9:11] eyes and they assume that a topical [9:13] retinoid is going to do that as well. In [9:14] contrast to Accutane, which does cause [9:17] dry eyes because Accutane shrinks uh oil [9:20] glands, namely abnormally large oil [9:23] glands of acne, but it can shrink the [9:25] oil glands in the eyes, cause dry eyes. [9:27] Um, and it can make it difficult to like [9:29] put contacts in and stuff. Once you stop [9:31] the Accutane though, that goes away. [9:33] Topical retinoids, however, don't shrink [9:34] the oil glands. They don't shrink the [9:36] oil glands on your face or if they got [9:38] in your eye, they're not going to shrink [9:39] the oil gland in there. Now, if they get [9:40] in your eye, they can be super [9:42] irritating. Could contribute to damage [9:44] for sure if they got in your eye. But [9:46] that's going to be any skin care [9:47] product, you know, like the [9:48] preservatives and preservatives and [9:50] things of that sort in the cream, you [9:53] know, all that. It's not good for being [9:54] in the eye. That's why in general, the [9:56] recommendation is to avoid getting any [9:58] topical within a millimeter of the lash [9:59] line to reduce the likelihood that it [10:01] gets in your eye. But yeah, I've never [10:03] seen reliable evidence that topical [10:05] retinoids cause dry eye disease at all. [10:07] I have videos on this. Um, but it always [10:09] comes up. You know, some there's some um [10:12] op optometrists that talk about this as [10:14] if it's like an established thing. I [10:16] guess it's something maybe they observe, [10:17] but I've never seen it. I talked to many [10:19] many derms and they're like, "Yeah, it's [10:21] never never been anything we've come [10:23] across. I'm on birth control for acne. [10:25] Works quite well, but due to pmenopause, [10:28] I'm going to be getting off of it in the [10:29] next 2 to 3 years. How can I prevent [10:31] from a rebound? Um, was thinking about [10:33] starting spironolactone 6 to9 months [10:35] prior to getting off." Yeah, this is my [10:37] recommendation for any woman who is on [10:39] birth control for acne and then wants to [10:42] stop. See the derm before you stop. Uh [10:44] so they can start something like [10:45] spironolactone for example um if that's [10:48] right for you and allow it to have time [10:50] to start working before you come off. [10:53] Don't wait until you come off and then [10:55] the acne gets flared up again to see the [10:57] dermatologist because the life cycle of [11:00] prescribing a drug and starting it is so [11:03] protracted these days. in particular [11:05] with getting in to see the dermatologist [11:07] takes forever. Getting your prescription [11:09] approved and all that stuff, you know, [11:10] especially switch from your insurance, [11:12] begging the insurance, chasing down, you [11:15] know, all the things that the farm I [11:16] mean, it's a nightmare to get a [11:18] prescription to in your hands and so get [11:22] on it is what I'm saying because if you [11:24] wait for the acne to flare, well then [11:26] the derm is going to be more likely to [11:27] need to prescribe antibiotics to to get [11:30] that under control. You don't want to do [11:31] that if you don't have to. So yeah, I [11:33] definitely see them sooner than later. [11:35] I'm considering a facial. At 65, my skin [11:37] is in pretty good shape, but can be a [11:39] bit sensitive. Would [11:40] microdermmaabbrasion be too harsh? Yeah, [11:42] microdermabbrasion can be pretty harsh, [11:44] especially for mature skin that might be [11:46] more inclined to dryness. It's [11:48] essentially like sand. It's literally [11:50] sand blasting the skin. So, you know, it [11:52] can be helpful for texture and um you [11:55] know um surface irregularities, but it [11:57] definitely can leave the skin more dry. [12:00] Compromise the barrier and aggravate [12:02] sensitivity for sure. Facials, I'll tell [12:04] you, you know, they're popular. I've [12:06] enjoyed a facial here and there in my [12:07] life. I totally get the hype. They're [12:09] pleasant. You do look good after you, [12:10] but it doesn't like treat anything or [12:13] impart any kind of longlasting change. [12:15] Okay. nice to do like the morning before [12:17] a photo shoot or a big event or [12:19] something so you look fresh and glowy, [12:22] but they're not like a treatment for [12:23] anything. They're not going to radically [12:25] change your skin at all. I mean, mental [12:26] health-wise, they might be good for you [12:28] and that could help you with stress [12:29] management. So, um, you know, I I love [12:31] getting them done from time to time, but [12:33] do be aware they can exacerbate [12:36] underlying skin conditions, especially [12:38] if ingredients you're allergic to or [12:40] sensitive to are used. I burned my [12:42] thumbnail over a decade ago and it's [12:44] never grown back normal. It grows in two [12:46] pieces, split right down the middle. Is [12:48] there anything I can do? So, a burn from [12:50] a decade ago likely caused a permanent [12:52] scar in the nail matrix, which is the [12:55] growing center of your cuticle. And so, [12:58] that's going to stop the cells from [12:59] properly fusing together to make the [13:01] nail plate one continuous thing. And [13:03] that's why you're getting that split. [13:05] There's nothing you can do that's going [13:07] to fix that. Now, a dermatologist who [13:10] specializes in nail surgery, especially [13:12] they have a lot of expertise in in nail [13:14] surgery. Um, or even a a hand surgeon, I [13:17] think, could possibly get in in there, [13:19] too. They might be able to get in there [13:22] um surgically and excise the scar and do [13:25] do maybe even a little um matrix graft. [13:29] That can be attempted. success outcomes [13:32] vary, but that's something that that [13:34] might potentially be be like your your [13:37] greatest hope right there. And that's [13:40] kind of a lot to go through, you know, [13:41] as far as just the the bothersome [13:43] nature. You could put an acrylic nail [13:45] on, although, you know, you got to worry [13:47] about acryate allergies and and [13:49] irritation, but, you know, you could [13:50] have a nail technician put an acrylic [13:53] nail on. They also make the silk wraps [13:55] that can just help make it smooth, you [13:58] know, just like a temporary adhesive [13:59] thing on there. That's an option. But [14:01] yeah, I mean, it's it's it's a scar [14:03] basically. You know, I I mentioned this [14:06] in in previous questions about treating [14:08] scars. There's not really anything you [14:10] can do yourself to to undo a scar. Scars [14:14] are very difficult because um you know, [14:16] it's kind of like um you sort of have to [14:18] try and rebuild from scratch and you're [14:20] not going to do that with any kind of [14:21] topical or thing you can do at home. [14:23] lactin 12% versus golden bond retinol [14:26] which is better for anti-aging. There's [14:27] no head-to-head comparison between the [14:29] two. Um retinol can improve collagen [14:32] production and so can 12% amlactin. Um [14:35] so you could use both of them if [14:36] tolerated. Uh we don't know if if using [14:39] both together leads to you know even [14:41] more jazzed up effects compared to [14:43] either alone. Um so uh you know if you [14:46] find that that combination works well [14:48] for you go for it. I personally find [14:50] that the 12% amlactin leads to a little [14:53] bit more u of a cosmetic benefit at [14:56] least to the the eye visual visually [14:58] speaking than gold bond retinol. And [15:00] keep in mind I I stand gold bond age [15:02] renew retinol. I love that product. But [15:04] yeah, amin 12% I personally like a [15:07] little bit better but it does sting [15:08] more. You know it's more likely to [15:09] sting. Some people don't like the smell [15:11] of it. Um so maybe a personal preference [15:13] thing to it. Gold Bond is, you know, [15:15] more of a thicker cream, so it it feels [15:18] maybe a little nicer on dry skin, but I [15:20] find that the Amlactin lotion really [15:22] imparts this um deep hydration that I [15:25] haven't ever gotten from other products [15:28] as far as like the following morning, my [15:29] my skin almost looks like like glass [15:32] where I've applied it. Like on my legs, [15:34] it's like reflective. Um it's just so [15:36] hydrated and much happier. So yeah, I I [15:39] personally get a lot more out of the [15:41] Emlactin 12% than I I do from Gold Bond. [15:44] But I love Gold Bond Age Renew Retinol. [15:46] All right, guys. That about wraps up the [15:48] weekend Q&A. Thank you so much for all [15:50] of your excellent questions, your [15:52] engagement on these videos. But if you [15:54] enjoyed this one, give it a thumbs up, [15:56] share with your friends, and as always, [15:57] don't forget sunscreen and subscribe. [15:59] I'll talk to you guys tomorrow. Bye. [16:18] Heat. Heat. [music]