“A good skincare routine is a lot like a good wardrobe,” as Dr. Mariwalla likes to say. Some fundamentals work year-long, while certain accessories cycle into the mix seasonally. The challenge for many patients is understanding which products are fundamental and how and when to rotate their seasonal selections. Patients who experience seasonal flares of conditions like skin dryness, hyperpigmentation, and acne may face additional confusion. Misleading generalizations about ingredients and formulations only complicate matters further.
Core aesthetic physicians and their staff are key educators of proper skincare and play a crucial role in helping patients build the right regimen for their skin type, concerns, season, and schedule. It is essential that the experts in skin wellness and aesthetics provide patients the most up-to-date information and help them establish a routine that meets their needs.
At SkinCeuticals, we recognize the critical role that aesthetic practices play in cutting through the confusion and keeping patients’ skin healthy, and this is why we so value our partnerships with practices. Our innovations in skincare are focused on potency and tolerability to ensure the best patient experience from topical skincare regimens. We focus on developing vehicle bases that are well-tolerated and we offer a variety of products to suit every patients’ skincare needs. Healthcare providers can tailor product use to the specifics of the season and provide individualized care.
From simple morning routines to comprehensive schedules of morning and evening regimens, SkinCeuticals offers products that will fit the needs of every patient and keep their skin looking healthy—all year long.
Are you seeing an uptick in patients asking for skincare advice over the years? How do you start a conversation about skincare if the patient doesn’t?
Kavita Mariwalla, MD: In general, I think Americans have expectations now for instantaneous answers and services. Social media and online sources give patients access to information more easily and quickly than they ever had it in the past. But that information isn’t always reliable. So we need to be prepared to offer straight-forward education.
With more information accessibility and more social sharing, dialogue with my patients in the clinic has become more open and free. People have less hesitation to ask about not only skincare but also procedures, because it’s become much more mainstream.
The idea behind healthy skin is not to do something that’s equivalent to a crash diet. You want to change your habits and get into good routines. There are three pillars: prevention, protection, and correction. Within each of those pillars, you have to think about age, underlying skin tone, and skin type.
When I have to initiate the conversation, the easiest way is during the skin check. That can be embarrassing for patients, so I like to explain to them how the check will proceed, starting from their fingertips to their full body. As I continue the exam, I’ll ask patients to tell me what skincare products they use. I ask, “Are you using a moisturizer in the morning? What sunscreen are you using?” I can listen to them as I’m doing the skin check.
How often should patients revisit their skincare routine?
Dr. Mariwalla: I think at a minimum, it should be every year. A good routine has some fundamentals along with some modifiable components based on the season.
I practice in the Northeast, where patients want to spend time outdoors in the warm months. I typically have patients do a certain routine, basically September through May, and they do a different routine May through the end of August.
I keep regimens as simple as possible. In the summer, for prevention, I ask patients to choose a sunscreen that they will legitimately use every day. It’s more humid, so they may forego a moisturizer. I recommend a daily sunscreen that’s got a good feel to it that can replace a moisturizer so patients do fewer steps, but the skin still feels light and airy.
In the winter, when skin get drier and patients are advised to use retinol nightly, I recommend a thicker emollient in addition to sunscreen each morning.
It’s important to address misconceptions about seasonal skincare. One of the big misconceptions is that people think you can’t use retinols in the summertime. It depends on the formulation, because some of them are so elegant now that they don’t cause much sun sensitivity. Alternatives to retinoids in the summertime, especially for patients at risk for dyspigmentation, include tranexamic acid and kojic acid to reverse any visible signs of damage.
How do you recommend specific skin concerns, such as adult acne, be handled as seasons change?
Dr. Mariwalla: We talk about formulation. We talk about cleansers that have a little extra oomph in them, like exfoliating cleansers, which can be helpful. Cleansers that have beta-hydroxy acids, like LHA, are great. A toner that I love, in particular, is called LHA Toner. It has a few key exfoliating ingredients in it. I also commonly recommend SkinCeuticals Blemish and Age.
What are your favorite ingredients for reducing the signs of photo aging and hyperpigmentation?
Dr. Mariwalla: Photo aging is a significant concern that I think has now become more mainstream. While this is crucial all year long, it is especially vital during the spring and summer months. One of my favorites in the category of antioxidants is C E Ferulic. All vitamin Cs are not created equal, and the synergy provided by the addition of vitamin E and ferulic acid is really important for the most effective antioxidant protection.
Something like tranexamic acid for the morning and evening is very helpful in the treatment of visible signs of hyperpigmentation.
Men are often hesitant to use serums or creams, so for them I like to recommend Phloretin CF gel as an easy-to-use, oil-free vitamin C gel after they shave in the morning.
Prejuvenation has been a popular term lately. What skincare do you recommend for younger patients, especially millennials?
Dr. Mariwalla: I like B5 a lot, such as Skinceuticals Hydrating B5 Gel. I also recommend stepping into a retinol routine when you’re younger. One of my favorites right now is Glycolic 10 Overnight Renew. I think glycolic cream at night is beneficial in your 20s and 30s, because it supports cell renewal.
People often ask me about eye creams. I recommend these—as long as the eye cream is truly formulated for the eye area—especially for patients with a concern like puffiness or crepiness, some of which is genetic and can be evident in one’s 20s and 30s.
You were one of the first dermatologists to offer SkinCeuticals Custom D.O.S.E. technology. How has it fit your practice?
Dr. Mariwalla: As a doctor, I don’t want to come across as telling the patient she or he must purchase certain things. Custom D.O.S.E. allows me to identify and specifically target a patient’s skincare goal by focusing on ingredients that best meet their individualized needs. I have these patients return at the beginning of each season and we re-evaluate their formula’s ingredients based on their seasonal needs.
Do you think physicians have a responsibility to make skincare recommendations to patients?
Dr. Mariwalla: I think that as a board-certified dermatologist, you cannot hold onto your stake as a skin expert without actually being an expert in skincare.