My Evidence Based Skincare Routine: Part 2

What does your skin need? Surprisingly little. Read on for my ‘less is more’ philosophy. 

Last week I talked about my philosophy on skincare. I covered how genetics plays a huge role in how our skin behaves and ages, why prevention is the gold standard, how choosing the right skincare often feels like an art, and why less is often much more. 

This week I want to talk about the building blocks of a basic, essential skincare routine.  Note, it’s not the quantity of ingredients in a product, but what they can do for your skin. Trending active ingredients, new formulations, multiple steps – it may come as a surprise but the vast majority of products out there you really don’t need, and they can do more damage than good. 

Gentle, consistent, and effective. That’s what research supports and what patients find the most effective post surgery when taking care of their healing scars – simplicity is often what delivers the best results.

With the abundance of skincare choice out there, it can be hard to know which products are essential and which are extraneous and could ultimately lead to problems. Read on for my thoughts on gentle essentials and the ingredients that can help, not hinder. Image by Freepik.


Most Important Players 


1. Cleansers

Why is a cleanser so important? Even if you don’t wear cosmetics or other skincare products, a good, gentle cleanser will remove excess sebum (oil that your skin produces throughout the day), bacteria, fungi, yeast (important for seborrheic dermatitis sufferers) and pollutants that you come into contact with. A good cleanser can also help condition the skin, remove sunscreen (which you should be wearing on sunny days) and cosmetics. 


Though boring to some, the mighty face cleanser is a critical step in your skincare routine. It’s one step to get right! Image by wayhomestudio for Freepik.


What happens if you don’t wash your face? If you opt not to cleanse your skin, it could eventually show wear and tear in the form of inflammation (from free radicals and dermatitis), acne flare-ups – which can be aggravated by the build up from dead skin cells – and your skin can appear less luminous. 


A properly formulated cleanser can really help your skin over the long term. It's an easy, simple step that can yield huge benefits with little to no downside – provided you take the time to find a formula that works for the skin you have. 


A lot of people ask if a cleanser is really that much better than a bar of soap. YES. Traditional bars of soap are too harsh and can damage the skin barrier by stripping essential oils. That in turn can open your skin up to infection and more irritation. 

So, what makes a good formula? 

Some ingredients to look out for in a well formulated cleanser are:


Panthenol – A vitamin B5 precursor that’s a powerful and hydrating humectant (holds water in the skin). It’s also an anti-inflammatory which is important for wound healing. 


Mild Surfactants – If you’re under the impression that there’s a fine balance to be struck when cleaning your skin, you would be right. The trick of course is to get make-up, excess oil, and pollutants off your skin, without stripping it of natural oil. Stripping the skin is often where problems begin as your skin barrier is your first line of defense against outside pollutants and infections. I can understand the trend towards ‘no cleansing’ – though that can lead to a host of other problems. Avoiding sodium lauryl sulfate is a good step, as it’s one of the harsher cleansing agents. I used a combination of four milder surfactants (cocamidopropyl hydroxysultaine, sodium lauroyl methyl isethionate, cocamidopropyl betaine, sodium methyl oleoyl taurate) to create an effective but gentle cleanser. 


Speaking of protecting the skin barrier, look for cleansers that also include great anti-inflammatory, antimicrobial, and antioxidant components, which can help reinforce the skin barrier. For people who struggle with acne, a facial cleanser that contains salicylic acid can help control sebum and breakouts. 


In my Feel Confident Facial Cleanser, I included camomile and calendula extracts for their soothing, antiseptic, and calming properties. Aloe Vera gel moisturizer, antioxidant and anti-inflammatory properties. 


2. Serums

Serums can be a great, light way to deliver extra moisturizers and useful ingredients to your skin. Note, a serum isn’t essential, but many people enjoy using them and hyaluronic acid serums in particular are a low irritation risk way to add extra humectants that can further help retain water and ‘plump’ the skin, as hyaluronic acid can attract 1000x its weight in water. You may recognize the name from fillers, but it’s also a naturally occurring molecule that’s in every cell in your body. 


As we all age, the number of components like HA, elastin, and collagen in our skin cells and extracellular matrices decrease. It’s one of the reasons I developed my Feel Confident HA Serum, which also includes hyaluronic acid at a variety of molecular weights (to better penetrate the skin) and other great ‘HA assistants’. 

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3. Moisturizer

As far as moisturizers go, there are a lot of gimmicks out there, but all moisturizers do the same thing: hold in water. 


One of the first commercial moisturizers ever made available was petrolatum (Vaseline), which is still available today. Moisturizers have come a long way since then and come in more elegant formulas, but don’t let that fool you. The job is the same, to hold moisture in. 


Depending on your skin, you may not need a moisturizer. If you like the way a moisturizer makes your skin feel, find one with ingredients that can help with the job at hand. My Facial Moisturizer includes 7 different weights of hyaluronic acid to help with just that. 


As I emphasized last week, where sun damage is concerned, prevention and avoidance are key. The sun can surprise you and the damage to your skin will keep delivering for years to come. Image by Freepik.


4. Sunscreen

Whatever sunscreen you will wear consistently is the right one for you. Especially during high UV index days, protect your skin from UVA and UVB rays. Protective clothing, sunscreen, seeking shade, and avoiding midday exposure – it will all help take care of your skin’s health. Despite trending concern over blue light and UVC, you really don’t need extra protection for those. The exposure we get is fairly incidental, and your sunscreens (or iron oxides in make-up and moisturizers) may already provide plenty of protection from your digital screens. 


5. Retinoids

Whether you use prescription retinoic acid (Retin A) or an over-the-counter retinol, this can be a potent step in your skincare routine. There aren’t many other ingredients out there (beyond sunscreen) that have had as much of an impact on the health and appearance of our skin as these topical forms of vitamin A. If you are going to use one active ingredient, choose this one – and skip the trends. 


We have an entire video dedicated to retinoids if you’re interested in learning the difference between the two main available forms (retinol and retinoic acid), what they can do for your skin, and if retinoids are something you want to pursue on your own (retinol) or with the help of a doctor (retinoic acid). For applying retinoids, always start with a pea sized amount – unlike sunscreen, this is a product where a little goes a long way. I (and many dermatologists out there) also recommend starting slow, applying in the evening (sun deactivates it) every other night and seeing how your skin reacts first, and decreasing application to 2 or 1 x a week depending on how your skin behaves. Don’t give up on this one – it’s worth the trial and error. 


A final note on healthy beauty habits


One of the reasons I came up with a skincare line is that as a plastic surgeon I do have training in skin health and, more importantly, see people on their healing journey after both hair transplants and facial plastic surgery. 


Factors that impact how well someone heals are their operating surgeon’s technique, genetics, but also how well they treat their skin afterwards. My skincare line is intentionally paired down and simple because simple, well thought, gentle products with ingredients that work are a confident place to start. 


Your skin barrier is precious – treat it that way! 

Written by
Kristi Charish
Edited by
Dr. Gary Linkov
The content of this newsletter is for entertainment and educational purposes only. This content is not meant to provide any medical advice or treat any medical conditions. Patients must be evaluated by an appropriate healthcare provider on an individual basis and treatment must be tailored to meet that patient’s needs. Results and particular outcomes are not guaranteed.



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