The first time I went to a dermatologist was in middle school to combat a teeny bit of teenage acne. I don’t remember the exact conversation that took place, but I do remember feeling like my personal concerns and questions were one-of-a-kind and very unique to me. The reality is, though, that dermatologists face all sorts of similar questions — ranging from pimples to products to prevention and beyond, regardless of their patients’ ages, locations, and genders.
While some skin concerns may be a bit more niche, we asked two board-certified dermatologists to share the questions they get asked on a daily basis and what treatments their offices administer most. Whitney Tan, MD, of TriBeCa Park Dermatology℠ in NYC and Loretta Ciraldo, MD, who is based just north of Miami in Aventura, Florida, can attest: no query is too specific, and you’re certainly not alone. So, ask away!
Spotlyte: What are the most frequent questions you’re asked by patients?
Dr. Whitney Tan: The most common question is, “Should I be getting injectable wrinkle reducers?”
The answer is very patient-dependent. I have a lot of young patients who don't have a line on their face, so [as long as they’re at least 18 years old] I'll usually tell them that once [they have moderate to severe wrinkles], we can really start doing procedures like that. But, it varies. I have older women who have really taken care of their skin, or are darker skin tones, that don't have any [lines], so I don't think they necessarily need to be doing anything.
Injectable wrinkle reducers are used to temporarily smooth the look of moderate to severe wrinkles in certain areas of the face such as the forehead, frown lines, and crow’s feet. They should not be used more frequently than every three months. Like any medical treatment, they have potential risks and side effects. Be sure to talk to a licensed provider to see if they’re right for you.
Dr. Loretta Ciraldo: A lot of women ask about frequency of use. “Do I really need to do things twice a day?” Yeah! One way I explain it is that I've only used my own products for 26 years. I do clinical tests on my products, so if it says on the package, “Do it twice a day,” that reflects some clinical testing that we've done. To get the results that they're promising, you need to do it twice a day. If you use it once a day, it isn't going to give you the full benefit.
A lot of my patients ask, “Why do I have to wash my face in the morning?” There are a lot of indoor environmental aggressors. Indoor pollution is worse than outdoor pollution. If you don't wash your face in the morning, you're not going to really wash away debris and stuff that you're getting all night long.
Spotlyte: What kinds of concerns bring patients to you most often?
WT: It's definitely a mix. I would say I probably see 50/50 [aesthetics] and medical [patients]. I find that, frequently, patients will come to me for medical concerns — and then end up doing something [aesthetic], either to help with something like acne scars, or they will want consultations [regarding other issues].
Spotlyte: In your office, what are the most popular treatments?
LC: For sure, injectables. Frankly, it's partially because I don't have lasers in this office. I've been doing injectable wrinkle reducers now for years, so I have a big following with that. And then fillers.
Injectable filler is a temporary treatment that adds volume to areas of the face such as the lips, cheeks, and laugh lines. Like any medical treatment, it has potential risks and side effects. Be sure to talk to a licensed provider to see if they’re right for you.
I really believe there is a huge movement amongst women to want [their results] to look as [subtle] as possible. When I started in dermatology 41 years ago, it was very, very common that women in their fifties were getting facelifts — at least amongst my clientele. Nowadays, so many women in their sixties come in and say, “You know, my mom had a facelift, but I never want to do it.” I feel that way for myself, too.
Spotlyte: What’s your best advice for people who get overwhelmed with so many skincare options and regimen steps?
LC: I’m frequently asked, “How many products should I use?” The Koreans are now saying, "Oh, you know, 10 steps are good." I believe that we each have a skincare personality. If there's somebody who is motivated enough and truly believes enough in skincare to do five steps, go ahead and do it. But don't get yourself into a prescribed routine that you know is impractical for you.
Why is it so important to have a customized skincare routine?
WT: [For example, if someone has a] new onset of [adult] acne, the things they can control at home are minimizing their skincare routine and stopping anything new that might've been contributing to it. I saw somebody yesterday who had acne for 20 years and told me all of these things she had tried — and they were all over-the-counter products. She said she had never seen a dermatologist [before]. She just lived with acne on her skin. She might end up needing something like [prescription] isotretinoin, but even if she doesn't want to [try it], we can make significant differences in her skin with just a few different prescriptions, with an appropriate moisturizer — even with the appropriate use of over-the-counter products.
Retinol shouldn't be used by women who are pregnant, considering getting pregnant, or nursing. Please consult with your doctor before use.
Spotlyte: What’s one thing people everywhere should know about skincare?
WT: It's very important to see an expert, to go make an appointment with a dermatologist. Don’t take other people's medications. Something that works for somebody else is not [necessarily] going to work [for you].
LC: I feel more confident about my appearance now, in my sixties, than I did in my thirties. We should all — women especially — feel that we can age confidently. These days, something I always say to my patients is, “I feel so blessed to be aging in the time of great skincare ingredients.” You've got to find a doctor that you trust and products that you trust.