- Hey everyone, how's it going?
- Hi.
- Hey, thanks for coming.
We got Phuong here and David from Curology
and Phuong is a licensed physician assistant
I'm a board-certified dermatologist
and we got a ton of questions from you guys
over the past week,
so we're here to answer them.
And we chose only the best four to answer today so...
- Outside.
- Yeah,
why the hell not, Phuong?
Let's do it. - Great.
Okay, so the first question
is from Jaya, Miss Jaya.
She asked, "Hi Doctor,
are there any foods that tend to cause acne
which you recommend avoiding or moderating?"
Um, and that's a great question.
- Yeah, thanks Jaya.
- Yes.
If you are acne prone,
then there are certain foods that can cause an acne flair.
For example, the two major food groups
we're referring to here is dairy,
which includes skim milk, ice cream, oh God...
Eggs are good, cheese are bad.
- Anything made with milk is bad.
- Especially skim milk.
- Yeah. - Which you wouldn't think.
- Yeah, and ice cream is really bad
for your skin unfortunately.
- Right. Ice cream is worse.
- So Jaya, you gotta avoid these dairy products.
- Yes, avoid these.
Along with one thing a lot of patient's didn't know
is whey-containing proteins or products.
So whey protein shakes,
protein bars,
those can also cause acne as well.
- Yeah, and these are actually most protein shakes.
You have to look for something that's specifically
dairy-free, you find like a rice protein or something else
other than whey.
- Yeah, and the other food group is really simple carbs.
So what you can do is try to cut these out.
Just do a trial.
Cut 'em out for two to four weeks,
the longer the better,
and see if this helps your oil production,
reduces your oil production,
and helps your acne.
So that's one great thing.
- And Suze does not like the news you gave her.
She says she loves ice cream. - I know.
- And no wonder she's in a breakout right now.
But it's good you told her,
at least you're being honest with her.
You know, Phuong is like your strict parent, Suze.
Phuong is just telling you what's up.
- Yeah, yup.
- She can't eat that ice cream.
- No, I truly can't eat it either because I'm
lactose intolerant. - Neither can I, oh boy.
[Laughing]
- That's a different story.
- That's a very different video, right.
- Okay so, why don't you go?
- Okay, I'd love to.
- Answer the next question.
- So next question is from Samantha.
And Samantha said this to us
I think on Instagram,
"How do you adress and treat hormone-related acne?
Do you find oral medications such as tretacycline
are necessary additions to topical treatment?"
That's a great question.
People ask us a lot about hormonal acne.
Phuong and I both,
we see a ton of people
with hormonal acne.
And what that typically means is a special pattern
of breakouts that adult women get.
The quintessential presentation is breakouts
along the jawline,
and they look a certain way because
it doesn't tend to be blackheads or small dots on the nose
like maybe a 12-year-old male would get.
These are different types of breakouts,
you know, they're deeper red lesions
that are sort of under the jawline area.
And so the interesting thing about hormonal acne
is that a good dermatologist can recognize it
but just because we know it's hormonal acne,
doesn't mean we need to treat it with a pill.
- Right.
- You know, and in my experience,
I think Phuong, you probably notice the same thing,
I think most people with hormonal acne,
maybe 90%, we can get clear with
just a really good regiment without any pills.
- Right.
- And so, to answer your question you don't.
For hormonal acne, I would say if you do just a good
sort of three-part regiment,
part one being making sure you're not using any skincare
products that are clogging your pores.
Part two, using a good active topical treatment.
And part three, watching your diet like Fong said.
No ice cream, no high glycemic index foods.
You can really get rid of your hormonal acne
without any pills.
So give that a try and I'm confident that you can have
clear beautiful skin without taking any hormonal pills.
- Great.
- So what's next?
- I think I'm going to go. - Sounds good.
- Okay, so I have a question from...
- From Brandon? - Mister Brandon.
- Nice.
- "What is the best way to treat acne cysts
without injections?"
And that's also a great and very common question.
I think the best thing to do is really just to leave
it alone and let it take it's course,
let your body do what it's supposed to do.
It's probably the best way.
And if you do have pain, or swelling,
any of those symptoms,
then it's probably best to treat just the symptoms itself.
So the first thing is,
I'm just gonna mention two things,
'cause there are quite a few,
that you can do.
The first thing is really just try not to touch it.
That's the main thing.
Try not to manipulate it,
try not to squeeze it because this can definitely
worsen the pain, increase the inflammation,
and worst of all, cause scarring.
And you don't want that.
- And that's where most acne scarring comes from.
People have a cyst and you go at it.
And it leaves you with a scar that's there your whole life.
So it's really important.
- So instead what you should do or look into
is those hydrocolloid bandages.
You stick 'em on, you can get these at any drugstore
or even at Target, on Amazon,
or anywhere.
You stick these little bandages on for 24-48 hours,
even overnight,
the longer the better.
And this works from beneath,
just kinda drawing up all,
bringing it to a head.
And also just keep the area clean
and prevent you from touching it.
So that's number one.
Number two is,
and I think a lot of my patients actually
benefit from this,
is either cold compresses or hot compresses.
Cold compresses really do help with the pain,
and also helps decrease inflammation.
By doing this you can take a simple ice cube,
wrap it around a very soft cloth,
put it in a Ziploc bag,
or you can use a chilled tea bag that you just drank.
Do you drink tea? - I do. I love tea.
- Yes, I do too.
So just get it chilled and you just apply gentle pressure
to that area for about 20 minutes or so.
Or until your skin feels a little bit numb,
And you can repeat this.
Hot compresses,
it's known to
heat itself,
it's known to increase blood circulation in the area,
and that can help bring that cyst to a head.
Same rules apply,
you can do this two to four times a day
as needed.
This can really help just let the cyst take it's course
and you're just treating the pain and the inflammation.
- That makes a lot of sense.
Alright, we got one more question.
This one is from Dan.
And asking about what is the difference between
physical exfoliation and chemical exfoliation?
So let's talk about what exfoliation is,
just in general.
So I'm gonna bring this little model that we just got
on sale. - It's beautiful.
- Isn't it a nice model, Phuong?
Okay, so can you guys see this?
It looks like that's a yes, right?
- Yup. - So what we have up here,
this is the top of the skin we can see.
We have these tiny little hairs all over our body
that normally aren't this big, right?
This is the epidermis, the top layer of skin.
All the from here down to the purple.
This is all the dermis,
it's sort of like this fleshy layer of skin
and below the skin we have fat.
And this is all over our body, right?
So what exfoliation means is doing something to get rid
of the small layer of dead cells on the very top
of your skin.
This layer of skin at the top is actually called
"the foliaceous layer".
It's sort of named after foliage
because it's like the tree-tops,
it's like the leaves at the top of the skin.
So "exfoliation" means removing some of the skin cells
from that.
So what physical exfoliation is,
is you use a scrub with like, apricot kernels,
or a brush, or a loofah,
or something that's gonna physically scrape off
some of the dead skin cells.
Chemical exfoliation is a little different,
because you use an acid like cholic acid or salicylic acid
and what that does is sort of helps dissolve off
some of the top layers of skin.
However we're only talking like the very, very top.
This purple layer,
none of this stuff even reaches these layers,
these are all living cells.
What typically happens is,
I mean what happens in normal skin is at the bottom here,
at the bottom of our epidermis,
all new cells are produced every day.
And it takes 30 days for them to journey up to the top,
and they get flattened and they die,
and they form this protective layer.
And most of that is good to have,
but what exfoliation does is that it sort of brightens
the top layer just by scraping off some of the old ones.
The good thing about chemical exfoliation
compared to physical is that the acid actually can
get down to the follicle,
and these hair follicles, this is where acne happens.
So you see these hair follicles,
these have epidermal cells as well.
When something like salicylic acid gets down in there,
it helps unclog those too,
and sort of exfoliates in here so you're actually
preventing acne.
So chemical exfoliation has the advantage
over physical exfoliation,
'cause physical just gets the top of your skin,
it doesn't really have any effect on the hair follicles
or the pores.
And there's one extra type of exfoliation,
which I kind of think of as "exfoliation plus".
What that means is using tretinoin or Retin A.
And the reason it's called "exfoliation plus" is because
it doesn't just affect the surface,
what it does is that it changes the rate of which cells
turn over,
it increases the turn over,
it increases how fast they regenerate
and makes them less sticky.
So instead of just doing anything to the top
it affects the whole layer of skin cells
and it makes them turn over faster than 30 days,
and it makes them less sticky so it can smoothen
and brighten your skin sort of from the inside.
And just like chemical exfoliation,
tretinoin works deep,
and so it gets also into the pores and it can make
those less sticky too,
and so it's also really good for treating acne.
The other thing that tretinoin does
is it gets into the dermis,
this is another reason why I sort of think of it
as "exfoliation plus".
It makes these cells create collagen.
So that gives the plump skin like Phuong has,
it gets rid of wrinkles,
so that's just another type of exfoliation.
We have physical,
we have chemical,
and we have tretinoin,
and they all work in different ways,
they all have pluses and minuses.
So hopefully that answers your question,
and I think that was the last one for today.
- Yes.
- Yes, thanks guys for tuning in.
Thanks Phuong. - Thank you.
- Thank you for having me. Great.
Alright, we'll see you next week.
Have a good one.
- Bye-bye. - Bye.
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