Hi everyone, today we're going to talk about constructing the optimal skincare routine. So many people, so often, have gotten completely disappointed and completely let down by skincare that effectively doesn't do anything for them. And instead, they have a drawer filled with unused or partially used products and then they're on to the next. This is such a common cycle. If you want to maintain your youthful skin, if you're young enough to be watching this, or restore it, if you're a little bit older and you want to get that youthful skin back.
There's going to be lots of pearls in terms of benefits of the specific ingredients, as well as pitfalls and things that you want to avoid. All right, let's get into it. Hi everyone, I'm Dr. Amir Karam, board-certified facial plastic surgeon and founder and creator of Karam MD Skin. I specialize in facial rejuvenation, which basically means I help people look as young as they feel.
And on today's episode of Skin School, we're going to really break down what components are must-haves. in a good skincare routine. And this is really, really important. And I want to get you wised up to this.
All right, guys, let's break it down. Keep a couple of things in mind. Number one, skin is an organ. So basically it's like our heart or liver.
It literally is a part of us. So as a result is a reflection of our health. So number one, you have to think skin health, right? So What does that mean? Basically, everything you do to keep your body and your organs healthy, you gotta focus that on the skin as well.
So things like diet, lifestyle, exercise, hydration, sleep, smoking, sun exposure, all these things have a role in skin aging. In addition, obviously, to the genetic things and just simply being a human being, which means, especially if you're a woman and you're seeing the estrogen curves change over time, you realize that what happens is collagen, is directly correlated with estrogen. And I've showed this curve before.
You know, collagen is up here in your 20s and it starts to diminish and then it really takes a nosedive down in the 40s and 50s. The skin changes follow that. So when you combine your things that are related to your diet and lifestyle and then you combine what's happening biologically, that is the underlying reason why skin is fundamentally aging.
At the core of it is collagen loss. That's a major, major reason why a lot of the changes are happening to the skin. In addition to that, you can also see that There's also very, very important components that you need to do to address all aspects of skin aging. What are those aspects of skin aging? So when I think about skin aging, I think, number one, skin thinning.
Skin thinning is related to collagen loss. It's related to loss of elastin. It's just the physical thinning of the actual skin because over time, the fibroblasts produce less collagen.
And as a result, the skin begins to thin and gets more wrinkled. It becomes more crepey. It just starts to look less supple and thick like it did when it was younger.
right so that's an important aspect of it skin gets more dry that's also related to estrogen and and changes that are happening at that level, as well as collagen, because collagen absorbs and maintains some water balance. So does hyaluronic acid, which also decreases as we age. So skin becomes more dry. Skin also becomes more pigmented.
It absorbs all that sunlight that is accepted all throughout the life. And then in the melanocytes, which is the cells that produce pigment, it begins to disperse them. So you get more discoloration of the skin.
Skin also becomes more dull. The layers of the top layers of the skin start to become thicker as dead layers don't get sloshed. sloughed off and cell turnover isn't quite the same.
So you start to see dull, rough looking skin. In addition, you start to see pores. So we got pores, dullness, dryness, thinness, discoloration.
These are all the things that are happening to the skin as we get older. So what that means is you have to address all of these aspects simultaneously. Otherwise you're gonna be left with a partially improved condition and not a complete. So Comprehensive is at the core of skin care routines. And this is something that I've recognized and known and advocated for.
For years, long before I developed the trifecta, long before I got into skin as a equally important part of my surgical practice, I recognized for all my surgical patients the need to be on a comprehensive skincare routine, and I literally put them on eight to 10 steps, but that is what it took to really change their skin. So what should those eight to 10 specific steps be? Let's break it down.
So number one, by far, is sunscreen. Guys, I cannot stress this enough. And as you can see examples of people who have not used sunscreen and their skin is literally fried, basically. It's all the things that we just mentioned, but on steroids, right?
So sun... is a massive accelerator of skin aging. You have to protect it if you really want to, you know, get the most out of your skincare routine. So consider that an important step when I've done loads of videos on this and really stress the importance of it.
So trust me on that. Number two is cleansing. Cleansing, I cannot stress enough the importance of it. A lot of people underestimate this you need to wash your face twice a day but you need to use a gentle non foaming cleanser because if you use a foaming cleanser your skin is going to become more dry non foaming you can use it twice a day it wipes away all the impurities the dirt all the things that are going to cause pores, as well as set your skin up to absorb the products that are coming forward by your skincare routine.
The next step, I would say exfoliation is really important because especially if you're a little bit older and your skin starts to get that dullness, well, if you don't take away away that dull layer of skin off your skin, you're not going to get the brightness to come forward and get the most out of your skincare routine. So exfoliation can come in a variety of different ways. You could use chemical peels. You could use alpha hydroxy acids, glycolic acids. You could use microdermabrasion in the office.
You can use an enzymatic scrub, which is what we use with Polish, one of our products, basically to digest the dead cells off the skin. You can even have a laser peel to remove all the dead stuff off the skin. So basically you you want to get that off and you want to keep it off.
So at-home exfoliation is probably the best way, even if you do an in-office treatment, to maintain that exfoliation. For example, like polish, you can use that two to three times a week. Same thing with some of the other alpha hydroxy acid type products, but you want something that's going to exfoliate.
That's very, very important. As I said, collagen is at the core of a lot of the things that are happening, right? So you want to do something that's going to increase the production of collagen.
And sitting at the helm of that is retinol. Retinol, as I mentioned in the- many different videos, is really one of the most powerful, magical products you can use on your skin. To me, an anti-aging skincare routine that doesn't include retinol is not a anti-aging skincare routine. I just flat out mean that because it's going to stimulate collagen.
It's going to decrease pigmentation. It's going to improve cell turnover. It just does so many things.
And if you do a PubMed search on it, you'll literally see thousands and thousands of articles written from like 40 years ago up until now. So it is by far undisputed the king of anti-aging and you need it in your skin. skincare routine.
Typically, it's one of the hardest things to get acclimated to your skin. So I would suggest using it slowly in the beginning, two to three times a week, and then going up further to once a day if you can get acclimated. But it's really, really important.
Next magic ingredient is vitamin C. Another one of those multitasking type products improves the production of collagen. It decreases pigmentation.
It brightens the skin. It's an antioxidant. It does a lot of really important things. So I also consider that a must.
have in your skincare routine. Next up is niacinamide. Niacinamide is a vitamin B derivative. It is an important part of overall skin barrier function, oil balance. It also stimulates collagen.
It also has a role in pigmentation. It's just an all-around multitasking product that really helps in a synergistic way do all the things that we want for the skin. On that same note are peptides.
And I particularly like acetyltetrapeptide 2, which is basically... a product that is going to stimulate collagen production. It's going to basically improve all those things related to anti-aging.
It is a novel and very powerful component of a lot of anti-aging routines. And I consider that also not necessarily a must-have, but really a strong enhancement to a skincare. routine.
So let's talk about oil balance. Oil balance is very important because if your skin is a little on the dry side or a little bit on the oily side, you're going to want to basically bring oil to the skin to improve the skin's ability to essentially not need to make as much of its own oil. So oily skin becomes less... oily, dry skin becomes more balanced.
And therefore, at the end of the day, adding oil, like it sounds paradoxical that adding oil for oily skin is going to make it less oily, but it does. And it also improves the situation related to pores because pores are basically clogged oil ducts. So if you can decrease the production of oil, exfoliate the surface of the skin by adding oil to it, what you're also going to do is basically decrease the burden on the oil ducts. And therefore, you...
you end up having less blocked ducts, therefore less pore size. So what are those oils? They're squalene, they're lipid complexes.
They're things that are basically going to give the skin what it naturally uses, but in some cases it actually decreases, like I said, with aging. So squalene and lipids are a very important part of the overall story. Next up is hyaluronic acid. Hyaluronic acid is like a moisturizer on steroids.
What it's doing basically is it's a molecule that absorbs water. It actually... holds up to a thousand parts water per molecule so it really really functions like a sponge bringing in water to the skin and creating the skin to expand and that expansion gives it that supple beautiful look that you see in young skin so that's something that works immediately unlike a lot of the things that i just was mentioning above that works slowly over time hyaluronic acid one of those things that you put it on and literally within an hour or two, you see your skin plump up. So that's also a key, key piece to cosmetically enhancing the skin and looking great immediately after use.
Some other really important products that I think are key are things like glycerin and aloe vera. These are basically, again, they hydrate the skin, they nurture the skin, there's antioxidant components in some of this, but it also just makes the skin look better. And those are things that I think a lot of times are missed in skincare routines. But those are the subtle things that can make your skin look better in the short run so that the long-term players, the ones that I just mentioned above, can continue working and doing their thing.
And so that you can feel better about how your skin is looking while you're getting fundamental genetic changes happening month over month, year over year. And here's a key, key piece that I think is very, very important to a skincare routine. That's pigment reduction.
So think about this. So... If you're somebody who's lived in an environment, if you're around my age, around 50, you grew up tanning, etc. All that pigment is going to start to surface.
All that sun that you absorb is going to start to surface and pigments are going to be produced. So things that are going to decrease pigmentation are really important. So what are those things?
Well, retinol, vitamin C, even niacinamide help with reducing pigmentation. So those are powerful. But there are specific things like azelaic acid, certain botanical ingredients like daisy, flower. licorice root.
These are things that are going to basically work at the melanocyte level to suppress the production of melanin and start to wipe away that brown spot that decreases intensity. And even if you go get a laser and wipe away the pigments, well more pigments going to be produced. But if you suppress pigment production, then when you get a laser, pigments are reduced and then you're suppressing. So more or less you're keeping the pigments from developing.
Subsequently, so that's a really really important hack. So either you use it in conjunction with lasers or you just simply use it period But it can really even the tones of the skin and make the skin look like it did when it was younger and using a comprehensive Skincare routine like that. I'm just describing here is how you can address all these aspects simultaneously Let's talk about How you're going to implement this into a skincare routine. So let's start off with a morning routine. So basically you're going to start off with a cleanser.
You're going to wash your face. You're going to apply vitamin C. You're going to apply hyaluronic acid.
You're going to apply niacinamide. You're going to apply hopefully a pigment reducer if you specifically if you need it. Squalene.
Then top it off with a moisturizer. Then sunscreen. Now in the evening you're going to cleanse again.
You're going to use a retinol this time instead of a vitamin C. Then you're going to use your hyaluronic acid, niacinamide. Then you use your peptide, squalene, and moisturizer.
The main difference is you're breaking up your retinol and vitamin C in most skincare routines. All the other ones you can use twice a day. And the specific amounts, etc., those are all, you know, according to the brands that you're going to use.
So you have to look at that and follow the directions really carefully. If you're omitting some of these components, that's not a great thing. However... you can combine some of them. There's some products that have certain things that are combined together, so you can knock off a few of these steps by combining them.
The trifecta, which is what I developed, was basically born through the reality that if I put people on these complicated programs, that very few could stick with it. So I basically took all of that and stuck it into one three-step routine, a cleanser of vitamin C, and then an all-in-one Illuminate. So that way, you take three steps twice a day and you forget about it.
That's just the way that I felt. was helpful for people to basically simplify their routines. Because all of this is for naught if you don't do it consistently and continuously over time.
So we always talk about the three C's, which is commitment, consistency, and continuity. Fundamentally, you've got to commit to it, get consistent with it, and continuous with it with a routine that works. But all I'm saying here is that if you're missing certain aspects from this routine, you're not getting the synergy and the impact that you otherwise would, and you might not be as impressed.
with the changes that are happening with your skin. That's important. So a couple points about packaging.
So vitamin C, retinol, they don't like sun and they don't like air. So I always see these certain anti-aging creams in a jar. So you open it, you wipe it, you put it on it, and you're doing this for however long the thing lasts.
Well, every time that's opening and sitting on your counter and it's in a light container or a glass container, it's basically breaking down the actives. It's losing. It's potency.
So these products are not stable with with sunlight and air and that's why you'll see a lot of vitamin C's in these dark containers basically amber containers. For me personally, I can't keep it all straight. My wife used to be able to but I couldn't so I didn't do Skincare.
I literally didn't do skincare until I formulated my own skincare that was fitting for my own simple-minded needs. So when you're taking a brand and mixing and matching with different brands, the chemistry and the pHs have to work well together in the order of steps that you put them on. Because if you pile on two, three things at once, well, those things might not necessarily be meant to coexist together.
So that's a detail and it's a challenging detail because most of us aren't chemists and most of us aren't going to go through the detail of understanding these things, but they are as, I mean, they're important. So ultimately it's the litmus test. You put this on your skin and in a month or two, if your skin's not getting better, then you're probably not getting anywhere with it.
If your skin shows signs of improvement, that's a wonderful thing, then you know you're on the right track. Also, clinical testing is really important. Folks, I can't stress this enough. I don't put a product out until I get it clinically tested.
I have to prove to myself and prove to the customer at the end of the day that the thing actually works. So what clinically tested means is you send it off to a third party lab, they get a bunch of volunteers, not volunteers, they pay them to basically go through a trial, they subject them to them, do a bunch of measurements. and then they come back and give you a report that yes, the thing worked or didn't work. And if it doesn't work, well, guess what?
It's not a useful product. It shouldn't be used. So make sure you look at the clinical studies of any test to make sure that it actually is an effective thing.
Because the last thing you want to do is waste your time, which is as important as your money that you're losing, but time you can't get back. I mean, this is an opportunity cost that every year that goes by, your skin is getting older. And if you get things right from the beginning, you're actually getting younger year after year, which is is an incredibly beautiful thing. So please, please, please take all these things into consideration as you go forward. But if you do, you will be rewarded.
All right, folks, I hope you enjoyed that. I hope that helped share with some friends. If you haven't already subscribed to the channel, like it. If you enjoyed the video, comment, if you have any questions or just want to let me know anything, and I will do my best to answer as many of the comments as I possibly can. All right, folks, until next time, Dr. Amir Karam.