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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."

- I have patient who know they have a skin cancer

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A Dermatologist Reacts to Your Comments about Sunscreen & Eye Creams | Derm Reacts with Dr. Marmur

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    Summer 發佈於 2020 年 09 月 04 日
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