208SkinDoc.

"Another topical prescription I can try to help slow down oil production and get fewer of these lesions to grow is something called Winlevi. This is a topical acne medication that targets the oil glands specifically to reduce oil production so we don't feed the bacteria that cause acne. Topical Winlevi is very similar to oral spironolactone, which is commonly used in females for hormonal acne. Winlevi has to be used twice a day to be effective, and currently it's only a brand-name medication, meaning it's going to be expensive depending on your insurance plan."

"Melanotan 2 is a synthetic peptide that absolutely produces a tan, that part is real, but it is not selective, so along with the tanning receptor it also hits receptors that cause nausea, stomach cramps, flushing of the skin, fatigue, decreased appetite, and in men spontaneous erections within one to five hours of injection. Beyond that there are documented cases of rhabdomyolysis leading to kidney failure, renal infarction, and priapism serious enough that surgery was needed to save function. There are also multiple published case reports linking Melanotan use to melanoma, and because it directly stimulates your melanocytes, the exact cells that become melanoma, this is the reason I would never recommend this peptide to anyone. It is an unregulated, non-FDA-approved product usually sold as a powder online with no quality control and no standardized dosing, so people end up having to be their own chemist calculating their own dose, and the reality is this is not worth the risk."

"There's a newer ingredient called Thiamidol, one of the most potent tyrosinase inhibitors available over the counter, and it's tolerated really well even by deeper skin tones. A 24 week randomized controlled trial showed it was significantly superior to placebo for moderate to severe melasma, and I believe it's also been compared to 4% hydroquinone and found to be superior. Thiamidol is available through Eucerin in their Radiant Tone Collection, which has a moisturizer, a sunscreen, a serum, a cleanser, and I believe an eye cream also. If you want a full routine that really focuses on pigmentation, I do highly recommend the Eucerin Radiant Tone Collection."

"One of the most common over-the-counter treatments you can get is Rogaine, or minoxidil, the generic. It comes in a 2%, marketed toward women, and a 5%, marketed toward men. The 5% is absolutely going to work better, and I generally recommend that for my female patients as long as we've covered all the risks and benefits, because at those higher percentages there might be a little more risk of irritation. I generally find that they charge more for the 2%, and it definitely doesn't work as well as the 5%. So if you are a candidate for Rogaine, I would just start with the 5%."

"For toenail fungus I'll often work with a compounding pharmacy to create a 10% terbinafine solution, terbinafine's brand name is Lamisil, and you get a bigger size for a lot less money than Jublia. This 10% terbinafine solution does tend to work pretty well, but you have to be committed to use it consistently, painting it on the nail and under the edge every single night for about a year. For the oral pill I usually use terbinafine because it carries a lower risk of interactions with other medications, and clearance rates with oral terbinafine are much higher than with the topical medications. There's some risk to the liver so we check liver enzymes, but with pulse dose therapy, taking it seven days a month instead of every day, we get clearance that's almost as good with a lot less risk to the liver."

"When you're putting an adhesive on the skin every day it does overtime increase your risk for a contact allergy to the adhesive. [...] When you're buying them every day the price does add up over time and I'm not sure how much money you're saving over just doing Botox in that area. But some people don't like needles and that's okay, so you can use Frownies if you want, but it's not my choice for reducing wrinkles on my forehead."

"Do you need red light therapy in your routine? The short answer is no, but it can be a nice thing to add on. Don't look to red light to solve all your skin's problems, if you're not wearing sunscreen every day, exfoliating in some manner, and using vitamin C in the morning, you're not going to see a ton of benefit from it. This is a really popular device and it's not terribly expensive, especially compared to some LED masks that cost close to five hundred dollars. I'm not big personally on using skin care devices, I don't take the time to do that regularly in my own routine, and I prefer an LED mask so I can put it on and go about another activity rather than stand in front of the mirror with a wand like this."

"The Shark Beauty Depuffy attachment, I think, is genuinely innovative. This device is incredibly easy to use. It only takes about 10 minutes, and the extraction results speak for themselves. This satisfies that same urge that we get while watching pimple popping videos, but it's actually good for your skin. The hydration boost from the products is real. At $399, it pays for itself after just three uses because professional facials in the dermatology office can cost $150 or more. And unlike those monthly appointments, this is available whenever your skin needs it."

"There's a newer ingredient from La Roche-Posay called Melasyl that works on pigmentation. It doesn't work directly on the tyrosinase enzyme, but instead it takes away the amino acids that would go into making pigment. It's very well tolerated, very safe, and highly effective. Studies show it's more effective than 4% hydroquinone. You can get it in the Mela B3 serum. This is one of my favorites, and I've recommended it and given samples to many of my patients."

"If you want to try copper peptides, I recommend starting with The Ordinary Multi-Peptide Plus Copper Peptides 1%. It's straightforward and it's affordable. Copper peptides are probably the most legitimate peptide in the skincare industry right now, since copper is essential for making healthy collagen and elastin, but they're not going to turn back the clock twenty years, so don't expect overnight miracles. They can also be finicky, so I wouldn't layer them with a strong chemical peel acid like an AHA or BHA, certain vitamin C's, or other aggressive exfoliants."

"You will find this peptide in the hugely popular SkinMedica TNS serum, which is kind of an expensive product, so you're paying for a premium, but it's a cult favorite and it's widely loved by the people who use it frequently. This is really for skincare enthusiasts who want to try cutting edge ingredients and don't mind paying for that, even if the science isn't quite there yet. I do think most people would be better served by more proven ingredients, and if you're just getting started with skincare, this isn't the place you need to start."

"This is the top tier, high price range option, the SkinBetter Science Alto Advanced Defense and Repair Serum. It has vitamin C, but it also has a complex of 20 different antioxidants in it, so you're getting a whole range of additional ingredients to help fight free radicals. To be frank with you, this is the one that I use every single day. It comes in an airless pump and you get about 150 days of use out of it, so even though it comes in at like 190 or 210 dollars, you do get a long time of use out of that."

"Remedy for Dark Spots has a treasure trove of ingredients all designed to help fight pigmentation in the skin, so it doesn't just have one single ingredient to interrupt the melanin synthesis pathway, it has several approaches. It's been a very well received product on social media from people posting their before and afters. I've had the chance to use this and recommend it to patients, and it is pretty well liked. It has a really nice cosmetic feel to it, and most importantly it does a good job of reducing unwanted pigmentation. It starts with an encapsulated retinol, which makes it a little more gentle on the skin, along with mandelic acid for gentle exfoliation, one percent kojic acid, glutathione, three percent tranexamic acid, silymarin, and I do like the addition of five percent niacinamide. It's pretty reasonably priced for all the ingredients you get, somewhere around thirty eight dollars."

"The Eucerin Radiant Tone collection is built around an active ingredient called thiamidol, a molecule that's newer to the US, and it inhibits the tyrosinase enzyme, which is the rate limiting step in making pigment. It was tested against hydroquinone and actually shown in a clinical trial to be as effective as four percent hydroquinone, without the risk of toxicity to the melanocytes or the risk of ochronosis. You use the serum twice a day, the sunscreen in the morning, and the moisturizer at night, and you'll see a significant reduction in pigment. There are some amazing before and afters I've seen on Reddit in the skincare addiction subreddit. Products with thiamidol shouldn't be used more than four times a day, so using the serum, sunscreen, and moisturizer together is already a complete routine and you probably don't need to combine it with the other products."

"If you're dealing with sensitive skin and rosacea, you want an excellent moisturizer, and La Roche-Posay Cicaplast Balm B5 is one of my favorites. It's a thick moisturizer that's easier to use at night than in the daytime, but you want a generous amount on the skin to really help repair the skin barrier. I use it on my patients after laser procedures to repair their skin barrier, and I've also seen it work really well on patients who have rosacea."

"If you're dealing with sensitive skin and rosacea, you want an excellent moisturizer, and Vanicream is one of my favorites. It's a thick moisturizer that's easier to use at night than in the daytime, but you want a generous amount on the skin to really help repair the skin barrier. I use it on my patients after laser procedures to repair their skin barrier, and I've also seen it work really well on patients who have rosacea."

"The moisturizer option is the First Aid Beauty Ultra Repair Cream. It has a nice rich texture to it, and it's great for helping to repair the skin barrier. It is a little bit more expensive than the Neutrogena Hydro Boost we talked about, but it has a really elegant feel to it, a little bit more premium, a little bit elevated experience, and I think that you'll really like it, still without really breaking the bank."

"If you're going to add one proven active on top of your basics, I'd recommend a retinoid, and your late twenties or early thirties is a great time to start thinking about it. AlphaRet from SkinBetter Science gives you prescription retinoid level results in my opinion, with a gentler experience, and that's where I'd put my money. I'd be using something like that before I'd put anything on my skin with longevity on the label."

"We've talked about the Neutrogena Collagen Bank line before. It's a line of facial products, they have a vitamin C, a sunscreen, and a moisturizer. These products help to preserve the collagen in your skin using micropeptides or nanopeptides that signal your body to make more collagen, and they make a collagen bank SPF, so you're getting the minimum requirement of SPF 30 on the skin, which helps protect you from basal cell, squamous cell, and even some melanomas."

"This is a completely mineral based sunscreen made with 12.9% zinc oxide, so it's the only sun filter in it, giving you broad spectrum coverage over both UVA and UVB at SPF 50. It was originally developed for the post procedure or sensitive skin patient, so if you have very sensitive skin and chemical sunscreens burn or sting you, a complete zinc oxide sunscreen like this is going to be much more gentle. The key ingredients, a 2% amino acid complex, a blend of ceramides, and centella asiatica, are all designed to help repair and restore the skin barrier, which is why it's great for sensitive skin and can also be used after nonablative laser procedures like IPL or BBL that induce redness. Even though it's a pure zinc oxide sunscreen it's really not leaving any white cast on my skin, though if you have darker skin types this is something you'll want to test first. It has a very lightweight feel, it's not sticky, and it doesn't smell like an overwhelming chemical sunscreen. Their clinical studies showed it reduced visible redness after just one use, reduced overall skin redness by 52% in about 12 weeks with continued use, and reduced dryness by 72%, so you probably don't need a separate moisturizer while using it. It feels great on the skin and I love the way it looks and feels. If you're looking for a new sunscreen I do highly recommend the EltaMD UV Skin Recovery. It's been one I've been recommending frequently to my rosacea patients, and I've been using it myself after lasering my face a couple months ago and loved the results even for myself."

"They sent me the Beauty of Joseon Relief Sun a while back and I have loved using it. It's a very lightweight Korean sunscreen that does not sit heavy on the skin, and I use it all the time, even all the way up over my head. It provides SPF 50 level protection without leaving a heavy feeling on the skin. This is a great option for those with acne prone skin who tend to produce a lot of oil, because it's not going to add another layer on top that feels really heavy."

"The Isntree Hyaluronic Acid Watery Sun Gel is another Korean sunscreen, and I find that Korean sunscreens are a lot better than a lot of the ones we have available in the US. They have better filters and better UVA protection. This is a really great option for your skin. It's the one I took to Hawaii last year because it was really hot and humid and I wanted a lightweight sunscreen that would protect my skin, and this one did an excellent job."

"I love the Unseen Sunscreen from Supergoop. It feels good on my face, it's not heavy, I'm not overpowered by fragrance, it doesn't leave me shiny, and it provides 40 minutes of water resistance. But at 38 dollars for 50 milliliters it's the most expensive sunscreen by the ounce of all four I tested, and because of that I think the Trader Joe's dupe beats it out. I do love Supergoop, but it's probably my third favorite of the four."

"Black Girl Sunscreen is SPF 45, fragrance free, and rated water resistant for 80 minutes, so it's a step up in protection from the other clear sunscreens I tested. I like the formulation, that it's a little higher SPF, and that it's better rated for water resistance. But it feels a little more oily and thicker, it doesn't rub in quite as well, and I just didn't enjoy the texture of it as much as the others, though that's an individual personal preference. I wouldn't make this my primary sunscreen if I were jumping in a pool, since I feel like it can rub off and I don't know that you get the same longevity out of it."

"First up is Nizoral shampoo, which contains ketoconazole, a common antifungal agent. This is my go-to recommendation over-the-counter. It's a true antifungal and directly targets the malassezia. You can get the one percent version over the counter at pretty much any pharmacy or off Amazon, and if your case is more stubborn there's a two percent ketoconazole version available by prescription."

"The recommendation for Selsun Blue or ketoconazole shampoo is accurate. These will help reduce the number of yeast on the skin. In order to use them effectively you want to wash the area and let it sit for about five to ten minutes before you rinse it off, giving the active ingredient time to kill some of that yeast. If that is not helping, that is the time to go see a dermatologist."

"I use T/Gel personally. I know it does not smell good, it smells like tar, it's a tar based shampoo and it stinks the whole bathroom, your wife's going to yell at you. But it does help me, it helps my itch, especially any inflammation going on in the scalp. That tar based shampoo is very anti-inflammatory on the skin and really does a great job of breaking up scale. It's becoming harder to find unfortunately, but it's a good option."

"Vichy just released an anti-dandruff shampoo and they have clinical studies showing it's comparable to a 2% ketoconazole shampoo. The main ingredient is called Dercos, and selenium sulfide as the active ingredient is very effective. They have a shampoo, a conditioner, and a leave-in scalp spray with salicylic acid in it. I had a patient in who we'd been treating for seborrheic dermatitis who wasn't getting better the way we wanted, so I gave her the Dercos shampoo, conditioner, and salicylic acid spray, and it was a remarkable transformation. Selenium sulfide is a great ingredient, and if you get dandruff on the face you can wash your face with these products too, just let it sit for a few minutes."

"My first experience with physical exfoliation was the St. Ives Apricot Scrub. It has little shards of walnut shells in it that are just tearing your skin. We just didn't know better, we were rubbing that stuff all over our face thinking it was doing something, but what it's doing is causing little micro tears all over your face and compromising your skin barrier. I typically don't recommend physical exfoliants very often because it is harsh on the skin and it can tear it."

"This is the Water Sleeping Mask from Laneige. This one has mineral water in it, which can help to balance the skin's microbiome, and it's going to have a little bit of fragrance as well, so be careful if you're sensitive to fragrance, this may not be a great option for you. But this is kind of a boost of hydration on top of your regular moisturizer, you put it on and go right to sleep, so it's not the kind of thing you'd use as a morning moisturizer, but it's great for nighttime."

"I have here the Cure Micro Infusion System, and this is the one product that I think is superior to any other at-home product. You get the bottle, and when you take it off you've got tiny little needles that only go 0.25 millimeters into the skin, but it delivers a solution as it does that can help with fine lines, wrinkles, and pigmentation. You use a new bottle of solution every time and a new tip every time, so you're not having to clean it, and these come in sterile packaging. When you wash your face at home, you dry it, you don't put any other product on, you stamp this onto the skin, and it takes maybe ten minutes to do your whole face. I think it's a twice a week at-home treatment, and if you are going to be doing micro infusion or micro stamping at home, this is the product that we recommend."

"I've been using this for the past several weeks and my skin is genuinely improved. As someone who spent years telling patients to skip the gadgets, that kind of surprised me. [...] I can't overstate the comfort of this mask. [...] The eye pads on this mask actually lift the mask off your skin for a way more comfortable fit. The reflective technology on the inside means as much of the light as possible reaches your skin. The battery pack that it comes with means that I'm not tethered to a wall. [...] LED therapy is one of those things where consistency is everything [...] and for me, this one fits easily into my routine. [...] The Ulike ReGlow mask is FDA cleared and has 272 LEDs, which is [...] double what most other competing masks have. More LEDs mean more coverage, more intensity, and faster results. [...] It has four different treatment modes: [...] glow mode with red, infrared, and yellow light for pigmentation and [...] skin tone; firm mode with red and infrared for collagen stimulation; rejuvenate mode with yellow and infrared to boost skin barrier; and clear mode with blue, red, and infrared for acne-fighting. In a 28-day study there was a 20% reduction in fine lines and wrinkles around the eyes, a 20% improvement in skin texture, and a 61% improvement in acne. In the first 1 to 2 weeks you'll notice your skin feels a little smoother. By weeks 3 and 4, texture improvements become more obvious and tone starts to even out. After 6 to 8 weeks there's firmer skin, reduced fine lines, and noticeably better overall skin quality. I recommend using it three to six times a week for 10 minutes. At-home LED therapy lives in the middle between basic skincare and professional treatments. It is a genuinely effective way to maintain and improve your skin and it's something you can do consistently at home without booking an appointment. For at-home skin maintenance, the Ulike ReGlow, in my opinion, is that thing. It is cheaper than professional treatments over time and is a one-time purchase with no subscription, no refills, and no ongoing payments. However, you have to use it consistently, results take weeks not days, and if you're not the kind of person who's going to use it consistently, you shouldn't buy it. It's not for use during pregnancy or if you're on certain photosensitive medications. This is not technically a medical device, it's an FDA cleared over-the-counter device. Individual results will vary."

"The Ulike Air10 IPL is absolutely one of the better at home IPL devices that I've tested, primarily because of the safety features and the ice cooling technology. The price point of $399 puts it in the premium category for at home devices, but when you compare it to the cost of professional treatments, it's reasonable if you're committed to using it. [...] It's not going to replace professional treatments, but it is a solid option for hair reduction if you are the right candidate. You will need to use it consistently for 8 to 12 weeks to really start to see the best results because of the hair growth cycles you're going to need to treat over time."

"The CeraVe Healing Ointment is the favorite in my family, my wife and kids use it all the time on every cut, scrape, or dry skin area. It's primarily petroleum jelly, but it comes in a tube so you can squeeze out just what you need instead of dipping your fingers into a jar. It also contains ceramides, which are important lipids and proteins for your skin barrier to function properly."

"Dermatologists hate Neosporin. It wasn't developed or recommended by dermatology. Neomycin, one of its main ingredients, was named the contact allergen of the year, so a certain percentage of people who use it become allergic to it. I've seen this so many times in the clinic where somebody just had surgery, put Neosporin on against our advice, and became allergic to it. The wound gets more red and irritated and starts weeping, they think they're infected, so they put more Neosporin on and it gets worse. Those kinds of ointments can be used when there's a verified infection, but generally they're not needed in a preventative role."

"The Eucerin Advanced Repair Lotion is a great body moisturizer. It has five percent urea in it, which is more than double what your own urine produces, and it's not going to make you smell bad. In addition to the urea, it has other beneficial ingredients like ceramide three and other natural moisturizing factors that actually help hydrate your skin and contain the lipids your skin barrier needs. If you just have dry skin and need a good moisturizer, the Eucerin is going to be a great option."

"This has a 15% L-ascorbic acid, the same percentage as CE Ferulic, plus micropeptides designed to penetrate deeper and signal the fibroblasts, and 2% PHA, which is a gentle exfoliant that also helps bind water into the skin. The formula is fragrance-free and non-comedogenic. It feels really nice on the skin, it's not heavy, not greasy, not too watery but not too oily either, it's not sticky, and it did not sting at all when I put it on. It layered well under my sunscreen and I think it would work well under makeup too. It's a small bottle so you'll run out faster if you use it on your arms and legs, but it's twenty dollars on Amazon and Walmart, compared to a similar stack of ingredients in CE Ferulic that retails at a hundred eighty five dollars, so I think this is a very worthy contender. I'm impressed with the ingredients and I think this is a very compelling product for the skincare routine of anybody who's interested in preventing the signs of aging and preventing collagen loss."