My Evidence-Based Skincare Routine

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all right so having the perfect skincare routine is actually pretty simple all you need is a few things number one use a moisturizer number two use some kind of sunscreen every day number three use some kind of retinoid every evening feel free to wash your face with a cleanser if you really want to and in fact you can do two in one and you can get this sunscreen moisturizer combination and that is all you need to know to get a really solid skincare routine going but okay let's go a little bit deeper into the details like why should we have a skincare routine in the first place and then what is the scientific evidence that these are the sorts of products

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that we should actually care about well there's two main reasons number one for healthy skin and number two for pretty skin and a question that i like to think about is what are the actions that i can take right now today that my future self would be very glad for so in theory if i can find the perfect evidence-based productive skincare routine that helps me maximize my skincare results with minimum effort then i'm winning in terms of health and also in terms of looks the problem is that there are millions of skin care products out there like avocado face masks and charcoal cleansers and led therapy and snail slime face cream slather on the slime

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now i trained as a doctor but i'm not a skin care specialist so i've enlisted the help of my friend and new york trained dermatologist dr osama sayeth to find out exactly what we should actually be doing to get good skin and apparently to get like 90 of the results all we have to do is follow three or four simple rules and we'll do absolutely fine so why should we actually use a moisturizer well the most important thing that the skin does is that it acts as a barrier to the outside world and it keeps irritants and allergens outside of our body and locks in moisture if our skin loses moisture and gets dry and

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cracked that barrier gets weakened which means inflamed red itchy skin and you might even get infections and the way the skin is built is they call it a brick and mortar system where you have the little cells which are the bricks called the keratinocytes and you have the mortar which is like the little paste in between it made up of different types of fats and proteins now what these moisturizers do especially the ones that are evidence-based is they will replenish that layer of paste to help keep that barrier intact so you don't lose moisture therefore you don't have inflammation itchy skin now anyone can get dry skin but you're especially

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likely to get it after having a hot shower because that dries out your skin and strips away your natural protective layer of oils so we want to find a good moisturizer that rehydrates that skin replaces our natural fats and proteins and helps keep the skin barrier intact so what sort of moisturizer do we actually want to get well osama's main recommendations for moisturizer are any standard product from eucerin cerave or la roche posay mainly because those are huge companies that have the budgets to do lots and lots of research and quality control on their products i firmly believe no skincare product should ever cost more than 30

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because anything beyond that point is you're paying for the fluff the active ingredient and getting something effective can always be done for less than 30 dollars so what products do i use well my main dedicated moisturizer is from cerave and i use cerave pm for moisturizing in the evening it's very nice it's very chill it's available absolutely everywhere it's reasonably priced and it feels really nice on my skin and then in the mornings i use the altruist dermatologist face fluid spf 50 moisturizer which is a moisturizer combined with sun cream and this brings us to rule number two of my productive skincare routine which is to use a

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sunscreen every single day well have a look at this case report from the new england journal of medicine which is one of the most prestigious medical journals in the world they looked at this truck driver who'd spent 28 years working with just the left side of his face being exposed to some light through the driver's side window he's 69 years old in this photo but the researcher said that the left side of his face which has a bunch of wrinkles and damage from sun exposure is apparently more like what you'd expect from an 86 year old skin that's what the sun does to your skin if you're regularly exposed to it without any protection and that happens even if

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you never actually get sunburned but you just tanned technically this is called photo aging or dermatoheliosis and it happens because the sun is constantly bombarding us with uv radiation that mutates the dna in our skin cells and then in the long term the more of this uv light that we're exposed to without protection the more we get wrinkles and dark spots from that dna mutation and that dna mutation can also lead to skin cancer which is ultimately just unrepaired dna mutations that snowball into cancer so what sunscreen does is it gives you an extra layer of that protection so that not relying on your own pigment your own melanin

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instead we're giving a physical barrier which will stop genetic mutations being created by the sun and not only is that great for preventing skin cancer also it prevents things like photo aging all right so what sort of sun cream should you get well there's loads of different options on the market but there's mainly three things that you want to consider here well the first thing you want to look for is that you want to find a sunscreen that's a broad spectrum now back in the day people used to think that it was only uvb rays that actually damaged our skin but now we know that it's uva rays and also uvb rays and broad spectrum sunscreen has protection

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for both sorts of rays and therefore gives you the maximum protection now some sunscreen is physical and some is chemical it doesn't really matter which type of variety you go for what matters is that the spf is high enough and that is the second thing that we need to look out for now the actual spf number of the sunscreen refers to how much longer it would take for the sun to make your skin go red with the sunscreen on compared to without the sunscreen on so if it would normally take one hour of direct sunlight on your cheeks to make them a little bit red then in theory with spf 15 it would take 15 hours if you got exposed to the exact same amount of

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sunlight but it's not quite that simple and there's extra issues that we do want to consider with spf firstly we don't need to actually burn for the sun to damage our skin and cause aging we want to be protected well before our skin actually gets physically red secondly the spf is calculated based on a pretty thick amount of sun cream actually going on the skin i do say don't go below 30 typically the number you get on there you never truly get that level of protection based on how normal people wear it because it would rely upon like a pretty thick layer of sunscreen like caked on there most of us will be getting around like say 60 of that true

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spf protection factor so if you use a 50 you'll actually get a 30 if you use a 30 you'll get a 15 kind of thing and finally in reality we sweat and smudge our faces all the time which takes away a lot of our sun cream protection during the day so in an ideal world we actually want to top up our sunscreen every few hours i don't personally bother with this but what i do try and do is i use a high spf like spf 50 because chances are even with spf 50 i'm only really likely to get spf 30 or 20 or 15 levels of protection now the final thing to think about with sun cream is comfort and the issue with the max spf sunscreens is that they can be uncomfortable or make

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you look like you're wearing this sort of white pasty makeup and the thing we want to bear in mind is that some spf is way better than no spf so actually an spf 30 sun cream that you actually like and feels comfortable on your skin and they're actually gonna wear is way better than the state-of-the-art gold standard spf 100 sun cream that you buy once and then never really use because it makes you look like a clown right so what products do i actually use well in the mornings i use altruist dermatologist face fluid which has spf 5050 built into a moisturizer so that's what i use on my face this one costs about 11 here in the uk and then usually

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on my body i will also use the altruist dermatologist sun cream with spf 50 and this is what i use on my arms or my legs on my neck or my shoulders whatever especially if it's a very sunny day and i'm going out in t-shirts and shorts and this one's actually really cheap it's about four dollars or five pounds here in the uk but to be honest you can find whatever product works for you in your country it doesn't really matter right so this one is a little bit more rogue so we've all probably heard of moisturizers and sunscreen but most people have not heard of retinoids and in fact i hadn't really heard of retinoids as being good for normal

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people's skin even though i went to med school i'd only really heard of retinoids being a treatment for acne and that's exactly what they started out as it was like this vitamin a based treatment for acne in the 1970s but then researchers found that the active ingredient retinol actually had a bunch of anti-aging effects as well i think it is as close as possible to a miracle ingredient that you will get anywhere in the world of skin care when it comes to retinoids they genuinely lay a credible scientific case for helping reduce pigment unevenness helping to minimize wrinkles help to minimize acne breakouts and they do all

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of these things to a level where it's noticed in clinical trial data and on biopsy samples from the skin something that does all of those things with minimal to no downside i consider that to be something which it really is worth your time now there's been a ton of research and studies into retinoids and like osama says they've pretty consistently found that when you apply a strong enough retinoid for a long enough time then there's three main positive effects that you get firstly retinoids reduce wrinkles by promoting the growth of collagen and elastic fibers in the dermis or the thick middle layer of our skin and if we have enough collagen and

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elastic fibers deeper down in our skin then it gives our skin a healthy young looking structure aging and uv damage makes us lose these collagen fibers and that's what makes our skin sag and look old the second positive thing that you get from retinoids is that they reduce uneven pigmentation i eat like dark or discolored spots that you get on your skin particularly again from sun damage and thirdly retinoids also make our skin cells regenerate faster which means our skin consistently looks fresh and new so overall basically retinoids make most people's skin look younger and smoother and healthier so if like me you do want to start using retinoid then remember

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that you are playing a really long game because it does take a long time to see results and to be honest when you're young and you don't really have that many wrinkles i think it's mostly preventative rather than kind of curative as it were and the thing with retinoids is that they can also make some people's skin feel a little bit more sensitive it can make your skin peel and it can sometimes make your skin feel a little bit painful and that's why a lot of people don't actually stick with it long enough to see the benefits so what sort of retinoids should you get now this is where it kind of gets complicated because retinoids actually

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come in different types of strength levels now the first big one is retinols now retinols are part of the retinoid family but they are the weaker version now if you see any kind of skincare product labelled anti-aging and you can get it over the counter it usually has some kind of retinol in it i.e the weaker version of a retinoid then we have retinoids which are stronger and they're generally prescribed by a doctor and tretinoin is one of the most common ones and the one that i use you'll see a bigger change with retinoids than retinols because they're stronger but the side effects can potentially be stronger as well like peeling and dry

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skin and like a little bit more sensitivity so if you are going for a retinoid then it is worth it to be a little bit more careful with these and maybe even consult a doctor before actually starting to use one what i was telling people was when you're using a retinoid at the beginning it should make you feel a little bit dry at least if it doesn't even tear on the edge of making you feel a bit dry you wonder whether you need a higher strength because maybe your skin is more tolerant and maybe you need to apply more because it should be especially the beginning it should be like oh i feel a little bit dry today like i need to put on more moisturizer

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since i started my retinoid this first week and if you don't feel that it's probably not strong enough for you the over-the-counter retinoid-based product that osama recommends for beginners is differing gel which costs about 20 and has a slightly newer type of retinoid in it called adapalene which causes less irritation than a lot of other retinoids but because that one's kind of hard to get in the uk the one that i get is actually from a place called domatica which is like this online consultation type thing they do an online consultation with you you send them some pictures of your skin it's a bit it's a bit of a faff initially because

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technically a doctor has to review those images and prescribe it for you at least here in the uk but then once you've been prescribed it they just send you it every month i've been getting the deliveries for about seven months now so i initially started on a zero point zero two five percent tretinoin and then over the last seven or eight months it's been up to zero point one percent try to know in which is like a decent level of strength for a retinoid and remember the general recommendation for retinoids is to start with a tiny pea-sized amount every other night and then work your way up to once a night using lots of moisturizer at the same time and this

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helps keep your skin from drying out so when it comes to cleanses it's basically water is good at you know removing debris but a cleanser is supposed to kind of help to remove some of the oils that might stay on your skin that are hard to remove with just water some dermatologists say that if you're using lots of heavy cosmetics or if you have visible dirt or like loads of sweat on your face then yeah you can use a cleanser but actually for most people you could just clean your face using water without needing to worry about these kind of products anecdotally for me i find that on days where i'm consistently using my cleanser morning

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and evening those weeks i tend to get a lot less breakouts of like random on my face like i tend to get kind of troubled areas around the nose and stuff and generally i find that if i've forgotten to cleanse then i'm more prone to those kind of things so n equals one but yeah this is raw number four and it's a little bit optional it will have some benefit incrementally and you should focus on a hydrating cleanser that doesn't end up stripping your skin of all the oils and leaving you feeling tight it should end up being very gentle and in the end your skin should actually feel more moisturized even after having cleansed it so a hydrating cleanser like

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this one is going to remove the oily stuff without theoretically stripping away all of your skin's natural oils and it'll also usually contain special ingredients like hyaluronic acid which apparently keeps your skin hydrated and ceramides which is what all that cerave products include which are basically fats that replace some of your skin's natural oils so you can lock in moisture and keep that skin barrier intact while also having a cleanser so the one that i use is the cerave hydrating cleanser it's pretty reasonably priced and you can get it from most places and what i like about the cerave products is that they're very like chill they're not like

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trying to overly wow you with the avocado extract or the hero ingredient it's just literally it looks like medication and that's what skincare really needs to look like it doesn't need to be as fancy as a lot of these other really expensive products that we get sold by random influencers so here is my overall productive skincare routine adding up all of this evidence-based stuff in the morning i wake up and i shower and i cleanse my face in the shower with the cerave hydrating cleanser and then when i'm out of the shower i dry my face with a face towel and i put on the altruist spf 50 face fluid which is the sunscreen and

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moisturizer rolled into one so just two products in the morning and it's super nice and easy and then in the evening after brushing my teeth i generally wash my face with warm water and again i use the cerave hydrating cleanser in the sink and then again i dry my face with a face towel and then i put on my dormatica retinoid cream and then after giving it a few minutes to settle in i moisturize with the cerave pm moisturizing lotion and that feels pretty good and that's it like honestly before having this extensive conversation with osama and a few other dermatologists to be like what should i actually be using for my skincare

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routine i thought skincare was going to be this complicated thing and i didn't i didn't want to bother with it but now like once i saw the before and after photos and once i spoke to dermatologists and they were like yeah these are the only three or four products that actually matter it simplified the whole thing and now i've been using this kind of productive skincare routine for the past eight months i think now you can also find my full interview with osama about skin care on my vlog channel he goes in depth on more products and treatments that he'd recommend so check it out if you like and if you're interested in more

Key Themes, Chapters & Summary

Key Themes

  • Essentials of Skincare Routine

  • Importance of Moisturizing

  • Sun Protection and SPF

  • Benefits of Retinoids

  • Role of Cleansers in Skincare

  • Evidence-Based Product Selection

  • Personal Skincare Experience

Chapters

  • Introduction to Skincare Fundamentals

  • The Science of Moisturizing

  • Sunscreen as a Skincare Staple

  • Integrating Retinoids into Routine

  • The Use of Cleansers

  • Choosing Evidence-Based Products

  • Summary of the Host's Skincare Routine


Summary

In the podcast transcript "My Evidence-Based Skincare Routine," the host, a doctor with a keen interest in skincare, provides a detailed and practical guide to an effective skincare routine, emphasizing evidence-based products and simplicity. The host begins by highlighting the fundamental components of a good skincare routine: moisturizing, using sunscreen, and applying a retinoid. He emphasizes that a solid routine doesn't need to be complex or expensive.


The discussion first delves into the importance of moisturizers. The host explains how moisturizers work to maintain the skin's barrier function, preventing dryness and irritation. He recommends reputable brands like Eucerin, CeraVe, and La Roche Posay for their research-backed products. Personal experience with CeraVe PM for nighttime moisturizing and Altruist Dermatologist Face Fluid SPF 50 for morning use is shared, underlining their effectiveness and accessibility.


Sunscreen is identified as the second crucial element of the skincare routine. The host cites a case study to illustrate the damaging effects of sun exposure and explains the science of photoaging. He advises choosing a broad-spectrum sunscreen, emphasizing high SPF and comfort in use. The host personally uses Altruist Dermatologist Face Fluid SPF 50, combining moisturizer and sun protection.


The third component of the routine is the use of retinoids. The host explains their origins as acne treatments and their evolution into products with anti-aging properties. He notes the importance of retinoids in reducing wrinkles, uneven pigmentation, and promoting skin regeneration. For his routine, he uses a prescribed retinoid from Dermatica, starting with a low concentration and gradually increasing.


Finally, the host touches on the optional but beneficial use of cleansers, especially for those with heavy makeup or visible dirt on their skin. He personally finds that regular use of CeraVe Hydrating Cleanser helps prevent breakouts.


The podcast concludes with the host summarizing his routine: CeraVe Hydrating Cleanser in the morning, followed by Altruist Face Fluid SPF 50. In the evening, he cleanses again, applies Dermatica retinoid cream, and finishes with CeraVe PM moisturizer. This routine, honed with the advice of dermatologists, is presented as a simple, efficient, and scientifically backed approach to skincare.