- Hi, I'm Dr. Dendy Engelman.

I'm a board-certified dermatologist in Manhattan

and I work for Manhattan Dermatology and Cosmetic Surgery.

I'm here to take a deep dive into

the Go to Bed With Me comments section

in order to get to the bottom of some of

your burning questions.

In this episode, we're gonna talk specifically about

process, tools, and injectibles.

First step, we're gonna talk about process.

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The first comment is from Mona Sabbar.

"Dear Doctor, I'm really concerned about dairy products

"and their relation to acne.

"Can you explain it briefly, thank you," heart.

Okay Mona, you are exactly right.

Dairy does play into acne and there are two things

in diet that can play into increased breakouts

and we used to think that it was chocolate

or greasy food and that's all kinda been debunked

and the two things that really have been shown

and proven in the dermatologic literature

for making increased breakouts are dairy

and high glycemic index foods, so those are foods

that spike our blood sugar really quickly.

So what I tell patients every day is pay attention

to your diet and how it affects your skin.

If you feel like you had an indulgent weekend of pizza

and ice cream and you're breaking out on Monday,

then maybe we have some interplay with dairy

being a culprit in our breakouts.

So let's try to eliminate that as much as possible.

The good news about skin is that if it's good

for your body, it's probably good for your skin as well,

so we have to think about healthy living,

clean eating, drinking a lot of water.

Probiotics to take are not only good for gut health

but they also are great for skin health

and so that can be an easy way to implement

some tiny changes that not only make you look better,

but make you feel better as well.

So Vee V said "celebrity skin is 70% procedures

"and 30% skincare."

I would put a pretty significant percentage

also on great genetics.

I mean we all are kind of dealing with the hand

we're dealt and certainly celebrities are born

with some pretty good hands in their appearance

and stature and figures.

That said, not all celebrities have great skin.

I treat a lot of celebrities and I help them

with a lot of skin issues, whether it's acne,

rosacea, sensitivities, and procedures are also

a big part of looking great.

I always have patients who come to me

and they just think that celebrities flawlessly

and effortlessly look amazing and that is not the case.

There's a huge commitment to both skincare

and procedures, almost weekly, in order

to maintain their looks.

One thing that I think patients can do at home

that is very much like celebrities is really just

stick to a good routine.

I mean there's not a ton of magic in the fact

that all these great products that we have at home

will not work if they just sit in the medicine cabinet,

and the people who I treat who are celebrities

are certainly dedicated to having good skin,

and they know that if they kinda slack off

on their products that really work for them,

then their skin doesn't look as great.

Maddie said "I watched a video where a dermatologist

"said that if you mix skincare products

"from different brands, you're mixing different chemistries,

"his words, and can cause irritation.

"Is there any truth to this?"

Maddie, I would say that there's probably

a little bit of truth in the testing.

I mean obviously if you're a formulator for skincare,

you want everybody to buy every product in your offering.

The reality is if you use an over the counter cleanser

and somebody else's vitamin C, and someone else's retinol,

it's probably gonna live compatibly together,

but we don't know because they haven't

been formulated together, and so there probably is

some truth to mixing chemistries, but I don't think

that it's gonna counteract the efficacy

of each individual product if you wanna mix and match.

That being said, you certainly want to make sure

that you're using the right products at the right time,

and there are certain chemicals just categorically

that you may not want to mix.

For example, you might not want to do a very strong

glycolic acid and then follow that with a retinol,

that's gonna be too irritating for the skin.

So it's not necessarily a formulator per se,

but just the active ingredient.

Lady S says "can we stop with the microtear BS and lies?

"There's literally no such thing."

Well Lady S, there is literally such thing,

and I see it all the time and the good news is

that we've gotten away from a lot of the harsh exfoliants

that are in a lot of formulas.

I mean when I think back to when I was an adolescent,

the St. Ives Apricot Scrub was one that had

like harsh particles in it, and that can cause

microirritation and tears over time.

Certainly under the eye, where that skin's very delicate,

around the nose if you ever look at people

and they have like these dilated vessels

that are there, those are areas where the skin

is very sensitive and prone to injury.

So we want to love our skin at home

and we don't want to do anything too harsh

in order to irritate it, but the reality is,

you can cause some injury in your skin

based on certain skincare products or even devices.

Munira Jamali says "you do know that clinical trials

"have proven there is no benefit

"to consuming collagen in your diet?

"Collagen is produced endogenously by your body."

Munira, you're half right.

Collagen is produced by the body but you can

increase your body's stores by oral ingestion of collagen.

And this is where it gets really tricky

'cause not all ingestible collagens are created equally.

There are studies that have been documented

in our dermatologic literature that show

that they've not only traced it from ingestion

but it's been incorporated into the dermis

in meaningful amounts enough to decrease

the depth of crows' feet by 20% in just eight weeks.

Now it's not the only thing that we can do

to create collagen, you can also use retinoids

and you can use vitamin C, these are all

different ways topically to also do that,

because the problem with ingestible collagen

is there's no vegan form, and so it needs come

from an animal source and a lot of people

want to shy away from that and I understand

that's certainly a personal choice.

If that's something that you follow in the lifestyle,

then you can go at it in a topical application

in order to increase more collagen production.

The one that I recommend to patients

is called Verisol Collagen, V-E-R-I-S-O-L,

and that's the one that's really been proven

in the literature to support the skin,

increase total body stores of collagen,

it's not just helpful for your skin

but also for your joints because collagen

is one of the main building blocks and substances

of connective tissue.

Now let's get into the fun stuff, tools.

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"Are cleansing brushes, washcloths really necessary,

"and can you wash your face in the shower?"

Yeah, you can totally wash your face in the shower

and you don't have to have a cleansing brush or tool.

A lot of people, especially dermatologists

and those who are treating a lot of rosacea

or people with sensitive skin actually

are a little bit hesitant to recommend cleansing tools

because it can irritate the underlying skin condition.

So if you're happy about washing your face in the shower

and that's working for you and you don't have acne

or breakouts or any skin problems,

then by all means, continue to do that.

So if I were gonna rank things from most gentle

to strongest I would certainly say that hands

are probably the most gentle, we can obviously

regulate and feel how our pressure that we're using.

Then I would do like muslin cloth or something

very soft that is helping to remove

but not with any texture.

Then I would go to textured washcloth.

Then I would go to cleansing brushes.

The problem that I find with cleansing brushes

is that people sometimes get into trouble

by giving a lot of pressure.

You just want the brush to do the work,

so just hold it where it's barely contacting the skin

and it's gonna exfoliate for you, but people

who have acne kind of want to beat it up

and they're really angry with it

and they press into the skin, and then over time

that can exacerbate the acne that's underlying.

So we want to be really gentle in our cleansing,

we want it to be effective but you don't have

to spend a lot of money in order to get a clean face.

So So Zen asks "question, what is your opinion

"on at-home dermarollers?

"Who should use them, how and how often

"should they be used?

"Also, jade rollers.

"Do they have a scientific basis

"or are they just a gimmick?"

I like home dermarollers for certain indications

like those who have acne scarring,

but not on active acne.

I think that that can worsen existing acne,

so if it's old acne scarring where people

have textural irregularities, I do find

that you can get some improvement

with persistent at-home rolling.

We do in office procedures where we do

much more aggressive microneedling,

but some people can't afford that or they don't

have access to those who offer it,

so it's certainly better than nothing

and it can help with textural changes.

That said, we wanna be really careful with the products

that we're using when we're undergoing

these at-home dermarollers, because some things

can make it more irritating 'cause you've opened

up channels into the skin and so it's kind of

being absorbed deeper into the skin

and can be really irritating.

For jade rollers, I really like them.

I don't know if they're a gimmick or not

but I think that there's a lot to be said

about facial massage.

It's not as hot in the U.S. as it is in Asia,

but those who do this frequently really,

I find benefit for them.

Their skin looks better, it's less congested,

especially under the eyes and areas that tend to be

a little bit more puffy.

It helps to improve the lymphatic drainage

and so I'm a big fan of facial massage.

I think that it's great and if this is a way

that helps you to remember to do it,

even for five minutes a day,

it's not gonna hurt and it may help.

One of my favorite tools is one called Conture,

which is C-O-N-T-U-R-E, and it's basically like

a gym for your face, it uses pneumatic compression

to pull the skin up into the device

and then puts it right back down

and that increases blood supply, oxygenation,

and over time helps stimulate collagen.

So it's kind of a fix-all for whatever issue you're having,

whether it's pore size, fine lines, wrinkles,