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- I have patient who know they have a skin cancer
and they're like well, I treated it with apple cider vinegar
for two months and it didn't go away.
I'm like really? (chuckles)
Okay. (upbeat percussion music)
Hi, I'm Dr. Ellen Marmur.
I'm a Board Certified Dermatologist in New York City.
I have two practices called Marmur medical
and a skincare line called MM Skincare.
I'm here today to do a deep dive in the go to bed with me
comments section about sunscreen, eye creams, and cleansers.
First things first, let's dive into sunscreen.
(upbeat percussion music)
Catherine Coon, "Why do dermatologists
"talk about using sunscreen all the time?
"If I'm only going to be outside for a total of 30 minutes
"spread throughout the day,
"isn't that just a good healthy way
"of getting your vitamin D?
"I definitely don't burn unless I'm outside
"for more than 30 minutes at a given time."
The myth is that sunscreen blocks vitamin D.
So really you need to know
that you're gonna get your vitamin D through your diet,
so eat a great diet,
you're gonna get vitamin D through your sunscreen
so you can still wear your sunscreens.
It's not really a reason to not wear sunscreen
and think about sunscreen math.
When you wear sunscreen 20 plus sunscreen 30
you're still just getting a better sunscreen 20.
So there's no reason to not just have it in your makeup
or in your moisturizer every day
and just get that added benefit.
But talk about skin cancer math.
Skin cancer happens from an accumulation of sun exposure
so even if you're out for five minutes here,
five minutes there, five minutes there
you're getting an addition of that sun damage
throughout the day.
So use your sun protection.
I tell my patients it's like money in the bank
for good health and better skin
so there's no reason not to put on your sunscreen.
So what is SPF?
SPF is sun protection factor and really what it means
is how long can you stay out in the sun
without getting a sunburn and usually what is means
is that it's protecting you against UVB
which is a portion of the type of UV you get.
So you get ultraviolet A and ultraviolet B.
A is usually the tanning rays,
B is usually the burning rays.
Now that we have broad spectrum sunscreen
you're getting sun protection
throughout the UVA and UVB segment
but SPF still stands only for UVB protection
and it means how many times longer
can you stay out in the sun before getting red.
So an SPF 15 would mean
that you can stay out for 15 times longer in the sun.
So for example if I were to go out in the sun
and get sun burnt in a minute and I put on SPF 15
it would give me 15 minutes before I turned red.
If you're the kind of person who would go out in the sun
and you live in the tropics where the sun is really hot
and it would take you only let's say an hour
to get a sunburn and you put SPF 15 on
then you could stay out for 15 hours theoretically.
However, the problem is none of us put on SPF
as thick as it is tested in the FDA labs.
So most of us rub it off.
We think we're rubbing it in
but we're really just schmearing it thinner and thinner
so you're really never getting the number
that you have on you label.
So maybe an SPF 50 or an SPF 60
is then giving you an SPF 30.
So always opt up on the number of SPF.
I feel like a 15 doesn't even count.
So really it should be between SPF 30 and 60
for your sweet spot.
KW Jeong said, "How should I put my SPF and with what?"
I think that means how should I put on my SPF and with what?
It depends, so there's so many different kinds of FDA
sort of approved types of applications.
So gels, the balms, the creams, the sprays.
Those are all allowable by the FDA to claim an SPF,
meaning the FDA says those all work.
The old fashioned ways are lotions
and you should just schmear it on and you should put it on
about 15 minutes before you go out in the sun.
I think there's a little bit of a mythology in that
like putting it on for 15 minutes
allows it to come to like your body temperature
and therefore it's active and it works better.
I feel like if you just put it on enough and sufficiently
you can run right out the door and be protected
but put it on thoroughly, put it on with sunglasses, a hat,
UV protective clothing is a lifesaver
because then you're not using so much sunscreen on your body
and then reapply it every 30 to 60 minutes
when you're truly out in the sun being athletic
or being at the beach which I know you would never do
between 10 am and 2:00 PM
but you really wanna keep yourself covered and reapply.
"Quick question regarding sun cream.
"Would an SPF in foundation suffice
"or best to have sun cream underneath generally?"
So that means do you put on a moisturizer
and then sunscreen?
Do you put on sunscreen and then a moisturizer
or do you put on sunscreen, moisturizer, and then makeup?
It gets very confusing.
So here's where you wanna simplify your life
and just get something that has everything in it.
So a tinted SPF 30 is a great moisturizer, sun protection,
and makeup base that you can just put on
and go out the door.
Lilianna B, "Does sunscreen worsen your acne,
"cause breakouts, or make acne scars?"
And then Jenna says, "Lilianna B chiming in here.
"Chemical sunscreens cause a chemical reaction
"on the surface of your skin,
"so it can be irritating for a lot of people.
"Try a zinc or a TD formula."
That means titanium dioxide.
"They'll be a little whiter at first
"but are much gently for skin.
"Just be sure to use a serious cleanser
"at the end of the day."
Okay, all of it's great questions.
Acne can definitely get worse with certain sunscreens.
Part of it is because some sunscreens
that are water resistant are a little bit tacky
and they actually kind of occlude or block the skin
and that can make your skin break out a little bit,
especially like she said, like Jenna said
if they have a lot of chemicals in them.
There are sunscreens that are just for acne.
For example EltaMD Clear has lactic acid in it
and the lactic acid exfoliates the skin a little bit
and prevents blockage of the skin for your acne
and is tinted so it protects your skin.
And then when you wash it off at the end of the day,
because it's mineral based,
it's actually not that hard to get off
so you don't need to use any harsh cleansers.
So do pick something for acne skin
when you're picking your sunscreen.
Okay so Apurva Tik.
"Can I use sunscreen under eyes "and on eyelids?"
Great question, yes you can use sunscreen on your eyelids
and around your whole eyelids.
I see a lot of skin cancers on the eyelids.
I think the best and easiest way
is to wear a really big sunglasses
as much as you possibly can starting at a very early age.
So if you're a mother and you have kids
buy them sunscreen, or sunglasses actually that are bigger
and cover sort of the outer part of the eye.
How much of your body do you need to apply sunscreen to
when you go out?
And the answer is everywhere that's exposed
or that might be exposed as soon as you take off
whatever you're planning on taking off.
The difference between mineral sun protection
and chemical sun protection ingredients
are easy to understand.
Chemical ingredients absorb the energy from the UV light
and that's called photons.
So if you imagine like a ping-pong of energy
coming from the sky, hitting your skin,
it gets captured by the chemical ingredient
in your sunscreen, captured and converted to heat
so it evaporates right off the top of your skin
and doesn't get a chance to go in your skin
and cause a hot mutation to your skin cells
which could lead to sun damage and skin cancer.
The mineral sun protection like zinc and titanium
sit there on top of your skin and are like little rocks
that are protecting and like bouncing the photon off
and they don't get used up in that chemical reaction.
So as long as it's there and you've put it on
and you've haven't gone swimming
or you're not sweating a lot and wiping it off
the minerals sit there better
and they can block or resist both UVA and UVB.
Skin cancer affects men on their backs more often
and it affects women on their legs more often
and when I'm saying skin cancer
I mean the bad kind called melanoma.
So men get melanoma on their backs
and it peaks at the age of 40.
So it's a young person's problem.
So definitely protect your back.
Don't forget, ask somebody to spray it on for you
or just put a shirt on.
Women like to have tan legs.
It makes us feel svelte and skinnier
and all that great stuff
but it does lead to skin cancer earlier.
And again it's on the legs in women.
So protect yourself, wear pants, wear shirts,
do sun-protective clothing but if you're gonna be out
you need sun protection, sunscreen everywhere.
All right let's talk about a heated topic, eye creams.
(upbeat percussion music)
The next comment is, "Yes, eye creams are a waste of money."
(laughs)
It's not even a question,
it's just like they're a waste of money.
Eye creams are wonderful
and I think they're a good investment
if you have sensitivity around your eyes.
Now the question is do you need to spend a lot of money
on an eye cream?
Can you trust
that an eye cream is different from a face cream?
The eyes are more sensitive and the skin is more thin
and so you don't wanna use something
that's like an anti-ager for your face.
It has all kinds of alpha hydroxy acids or scrubs
or anything in it around your eye
'cause it's just gonna be too strong
and cause worse problems.
So when in doubt go simple for around the eye.
Pick something that's in your budget
but does say pH balanced for eyes or eye cream.
Next comment from Amanda.
"She doesn't even know how to properly apply 'eye cream'
"and she wipes her eye cream downward
"when it should be upward."
Oh, by the way it's "eye cream".
"She's dragging down her skin.
"I can't believe my eyes.
"She's horrible."
Okay Amanda. (laughs)
I can tell you're really passionate
about this eye cream application situation and I get it.
Even as a Board Certified Dermatologist
I get a little confused by other people saying like
you have to use your pinky finger
and you have to like dab in a certain particular pattern.
I'll be honest, when I put on my eye serum
I just go like swipe, swipe, swipe
on the upper and lower eyelids over my lashline
and I feel so happy when I do that.
So it's true, you don't wanna be like scrubbing
and rubbing and dragging and pulling on your skin
but it doesn't matter what finger you use
and it really just is, the key take home is
use it on the upper eyelids and the lower eyelids
and you should be able to put it right over your lash line
without it stinging or burning.
Hend Mohamed wrote,
"At what age should we start using eye cream
"and night cream?
"I'm really confused about this.
"Also, I read that using serums in your 20s
"is bad for your skin is that true?"
All good questions.
Eye cream, like I said,
should be used when you feel like you should start using it.
So usually I'd say in your 20s
is when you're gonna wanna start using an eye cream.
Night cream, again should be done at night.
All the same reasons
but at night is when your body is repairing
and so you wanna take advantage
of that whole like repair mechanism
that's happening in your skin.
Your skin is bionic.
It knows what to do.
It's an organ, it has so many thousands of things
that are happening at night.
So use an eye cream and a night cream
that are meant for rejuvenation and repair of your skin.
Then she says,
I'm really confused about when I should start using serums.
If you start using them in your 20s is it bad?
I love that question and I think the answer is a solid no.
You can use serums in your 20s.
Serums are just a more elegant form of a moisturizer.
They're really not supposed to be like harsh in any way.
They should be really, really nice and very elegant
and like a soft touch on your skin
so you should definitely be using serums in your 20s.
It's gonna set you up for success
in your 30s and 40s and 50s and beyond.
Helloe Shungzi, "Actually I think you use the eye cream
"in the right order, right after the toner."
Perfect, so again you don't really need a toner.
In this question or statement
I think the toner is really meant to be used
as a makeup remover.
And so here's what I love.
I do love thin makeup removers,
not the ones that are on wipes.
So get rid of all the makeup remover wipes,
that's just bad for the environment and bad for your skin.
I don't like wipes and I don't love toners
but I do love great makeup removers.
So buy like the oil-free
or the light gentle oil makeup removers
and you can use that just with your plain finger
on your eye makeup.
Gently rub it, your makeup will come off
and then you can use a clean washcloth
and then get rid of the rest of the makeup
and then put on your eye cream.
Palekid14, "I would never recommend to anyone
"to put a retinoid under your eyes.
"The skin is way too thin in that location."
I am probably the only dermatologist on Earth
who does not love retinols or retinoids at all for anything.
So if you have acne yes, if you have comedonal acne,
which means little blackheads, definitely.
But in general retinols came out as one of the first
anti-aging ingredients in cosmeceuticals in the 1980s
and it was great at the time but we all know
that retinols can cause harsh side effects like redness
and scaly skin and itchy skin and cause inflammation
and now we know inflammation
can get rid of your beautiful collagen and elastin
and make wrinkles.
So the side effect profile to retinols
for a good portion of the society
is actually a pretty important side effect.
So we have so many other great gentle powerful
anti-aging ingredients, tons of them.
You've been reading all about them.
So if you can't tolerate retinols don't worry,
you're not like disqualified from anti-aging
just find other anti-aging peptides and anti-inflammatories
and good things for the microbiome,
all kinds of great other things
that you can use on your skin to rejuvenate your skin
without those harsh side effect profiles.
Let's talk cleansers.
(upbeat percussion music)
Supriya Sharma, "Where do masks fit into your weekly regimen
"and is there such a thing as too much cleansing
"and too many products on your face?
"I mean ultimately isn't your skin just genetic?"
Every sentence in this is perfectly cool,
I love this question.
So masks, I love masks.
I developed a line of masks
because masks are 300% more hydrating and powerful
than just a cream.
Is there such a thing as too much cleansing
and too many products on your face?
Yes, there is such a diagnosis as cosmeceutical dermatitis
and that means too many skincare products on your face.
Cleansing is a huge step
in your cosmeceutical beauty routine
and often it's the step
that people make the biggest mistakes in.
So when in doubt
choose a cleanser that's very chemical free
and that doesn't leave your skin feeling squeaky clean.
Over cleansing is a problem, don't do it.
I tell people cleanse
just in the areas that feel really greasy and oily
and that tends to be on the side of their nose.
You don't need to be scrubbing your face everyday.
You don't need to like,
some guys use their shampoo on their head
and then like use the shampoo on their face
and that's like a little harsh for your skin.
So really it's all about getting rid of any excess oil
and sort of getting rid of any excess debris off your skin.
And then she asks I mean ultimately
isn't your skin just genetic?
Yes, so the answer is yes and also a bit no.
So just like your liver is genetic and your brain is genetic
and your heart is genetic your skin is an organ
and it is mainly genetic but it's also super complex
and it's also the one organ of your body
that is exposed to the environment
and exposed to you doing things to it all the time.
So you're not like scrubbing your liver
and you're not scrubbing your heart
or putting toner in your other organs.
So you have a lot of power over how your skin looks
and how it feels
and that's why you have so many questions about it
because this is something that you can look into
and make decisions yourself
about how you can take care of your things.
So Daphnia, "What is a water based-cleanser
"and an oil-based cleanser?"
Great, so water-based cleansers are water based,
oil-based cleansers are oil based.
It's really that simple.
Now why would you choose one versus another?
A water-based cleanser is probably not gonna get off makeup
as much as an oil-based cleanser.
Think about oil taking off oil.
So from a chemistry perspective water and oil separate.
Oil can get off mineral makeup better,
it can get off oil-based products better
and most makeup is oil based.
So you would want an oil-based cleanser to get things off.
If you have acne or really, really, really bad oily skin
you may prefer a water-based cleanser
or you may prefer an oil-based cleanser.
They're really very different in terms of how they feel
but from a chemical perspective
it doesn't matter too much which one you choose.
So I would pick one that you love.
Raspberry says, "Foamy cleanser aren't okay,
"even for oily skin.
"You are a dermatologist you should know that.
"You can get gentle foaming cleansers
"but most of them aren't.
"I think that's important to say."
Okay so foaming cleansers are a huge debate in this world
because they have ingredients in them called SLS,
sodium laurel sulfate.
Some people love foaming cleansers,
it's just part of their routine
and they love that feeling of a foaming cleanser.
I kind of agree.
Like I would go less is more on foaming cleansers
for your face and so as a dermatologist I should know that
and I do, I do know that but if you love a foaming cleanser
just make sure again that you pick one
from a company that's very mindful about sensitive skin.
Make sure that the cleanser
doesn't make you feel like parched afterward,
that you don't feel overly clean and too squeaky clean
because then you're just going to be getting rid of
your own beautiful lipids in your skin
that are like the treasure that you've made overnight
and you don't wanna over cleanse them
because then you're gonna be paying money
to take like a skincare product
and replenishing what you just washed away.
Emilie Jugand, "If I'm not wearing makeup
"do I still need to double cleanse?"
And Britton Droic said, "Emilie Jugand no.
"A good, single cleansing will be fine."
True, okay so double cleansing is a trend
that came out about two years ago
and double cleansing means that basically first
you take off all your makeup with one kind of cleanser
and that would be like the oil-based cleanser
or a makeup remover type of cleanser
and then the second one is about using a cleanser
that might have some added value.
So there are some medicated cleansers that we use
as dermatologists for people with acne or rosacea
that might have an ingredient in it
that's very anti-inflammatory
or something that's helping the acne
or something that has like an alpha hydroxy acid in it
that might be for exfoliation.
So double cleansing has a role for people who need it.
So I would just ask your dermatologist
if you really need a double cleanse
but otherwise I would say keep it simple
and don't double cleanse.
I love this, okay.
So Bong Wei Xim, is that how you say it?
Bong Wei Xim,
"Harper's Bazaar is it okay to use ACV on skin?"
So I had to ask like what is ACV.
So that's apple cider vinegar, of course.
I say that's the LOL of cosmeceuticals.
So ACV is apple cider vinegar.
I have patients come in who've done like the weirdest things
with apple cider vinegar.
Like I have patients who know they have a skin cancer
and they're like well, I treated it with apple cider vinegar
for two months and it didn't go away.
Like really? (chuckles)
Okay, or they have like fungus,
ya know toenail fungus or something.
Well, I used apple cider vinegar on my fungus
and it didn't go away.
Okay, or it did go away, great.
So apple cider vinegar is basically something acidic
that will blow things up and help kill them
and so if you really wanna use it on your skin
for something that you think is infected
or if you think you have scaly skin
and it want it to sort of dissolve all that extra dead skin
you can totally use it.
Again, it's the kinda thing,
it's like I wouldn't suggest it too much
because it can just cause rashes.
So it's a great home brew if you know what you're doing
but it's an acid so be really careful.
So homemade skincare products I think are pretty much great.
So if you use like sweet potato mash
and you put in some yogurt or if you use cucumber
or if you use ingredients that are like coconut oil,
those usually are pretty good
because they're not really gonna do any harm
and they're basically very good moisturizers.
Some of them
will like take out your oils a little bit better
and make your skin feel really soft
and like almost like you put a clay mask on,
add some minerals to your skin.
So most of them are really nice
and I love the idea of the do-it-yourself DIY home care
because I think it's part of self care
and we know self care is healthcare.
So all the beauty routines
that you're taking care of yourself, they're not vanity.
They have a really important value
which is taking care of yourself.
So do-it-at-home skincare is great.
Lollsazz says, "Micellar water super gentle?
"I don't agree with that."
Okay, so micellar water
is actually a really genius invention
that came out in the cleansing world a couple years ago
and micellation is a chemical term
which means to take a large substance
like a big droplet of oil and break it up
into very small droplets
and then that allows it to wash away.
Typically micellar waters are very gentle on skin
and I think that's why I love them as cleansers for people
because some cleansers are too harsh.
Originally cleansers were actually like,
they were made out of lye which is,
lye was used in like farm equipment.
So Dove soap actually started like one of the first soaps
that actually were made out of liquid, with cream
that weren't pH balanced that was called basic.
It was more acidic and the skin is acidic.
So we like things
that are little bit more neutral to the skin.
So something that's a little bit more acid
than the good old fashioned soaps
which were basic and were just breaking up the skin.
So micellar water
takes that new like be nice to your skin philosophy
and makes it even more gentle to the skin.
So typically I've never ever had a patient
have a problem with micellar waters.
Okay so Lakes.
"As a guy, "I wonder if physical exfoliants
"work better than chemical ones.
"We have thicker skin so have yet to decide
"what I'm gonna buy
"since I work in a warehouse-like environment
"with dust and dirt being thrown everywhere LOL."
I love the LOL, like I don't really, that's like okay.
Guys, do they have thicker skin?
Yes they kinda do
and part of that is because they have more facial hair
and then the skin is like anchored
with these like thicker hairs on the skin.
Do they need physical versus chemical exfoliants?
Not really, there's not that much of a difference
in terms of which one a general guy would need better
but it's sort of like which you like better
and which one you wanna use and why you're using it.
So this could be a good question for your dermatologist.
Working in a dusty, dirty warehouse
doesn't mean that your pores are getting clogged
with dust and dirt it just means
that your skin is getting coated with dust and dirt
and this goes back to the idea
that your skin is actually like super sophisticated.
And so your skin has a barrier on it
called the stratum corneum.
It does have little hair follicles
and it does have glands and then your skin
has like a thick thing called the epidermis
and below that it has this structure
called the basement membrane
and below that it has all your blood vessels.
So it's actually kind of impossible
for anything to get down through the top of the skin
into your body
without you having just open skin to begin with.
So if you have pretty healthy skin
I actually would not over scrub and over exfoliate
'cause then you're actually breaking through
some of that penetration barrier
and making yourself a little bit more prone
to things getting in.
But what I would say
is that since you work in a really dry environment
like a warehouse you need to put on a great serum
and that'll protect your skin while you're at work.
Itzajana Ortega, "Is it important to cleanse your skin
"in the morning when you wake up
"even though you did your skin."