Derm-it Trotter! Don't Swear About Skincare.
Feeling frustrated or overwhelmed with everything skin? Does the skinformation overload make you want to swear about skincare? Join Dr. Shannon C. Trotter, board certified dermatologist, as she talks with fellow dermatologists and colleagues in skincare to help separate fact from fiction and simplify the world of skin. After listening, you won’t swear about skincare anymore!
Derm-it Trotter! Don't Swear About Skincare.
Fall Skin Reset: Repair, Rehydrate, and Restore
Your skin doesn’t follow the calendar—it follows the weather. As temps cool and indoor heat kicks in, we share how to shift from summer’s light layers to a fall routine that restores hydration, strengthens the barrier, and fades post-sun pigment—without irritation.
Registered nurse and aesthetic nurse specialist Raquel Merlini joins us to break down hydration by skin type, smart retinoid use, and why SPF still matters in fall. We also cover post-summer pigment care, from vitamin C and azelaic acid to peels, IPL, and microneedling, for a smooth, balanced glow all season long.
You know, you don't go out and just run five miles the first time you've ever trained. You know, you do one mile and then you work yourself up. So oftentimes I'll tell my patients, let's gradually get your skin used to that retin A. Even going to get a manicure, right? We're putting our hands in, you know, those UV lights to cure the polish. Winter months, you know, you can put it in your evening product if you want for a little bit more correction.
SPEAKER_00:Welcome to Dermot Trotter, Don't Swear About Skin Care, where host Dr. Shannon C. Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.
SPEAKER_01:Welcome to the Dermot Trotter Don't Swear About Skin Care podcast. I'm excited today because we're entering my favorite season, fall, and we're going to talk with Raquel Merlini. She's a registered nurse and certified aesthetic nurse specialist with over 14 years in plastics industry, and she's the owner of our skin aesthetics. She's a former pro bodybuilder, pretty impressive here, a tri-athlete and personal trainer. She's going to put us all to shame. But what she really understands that's important is that connection between confidence and well-being. And I'm really happy to have her here because she's going to talk about fall skincare, what we all should be doing to take better care of our skin this fall. So welcome to the podcast, Raquel.
SPEAKER_02:Thank you so much for having me. And I agree with you, fall is like one of my favorite times of the year. I love everything pumpkin. So definitely, and I'm here in Michigan, and so our leaves are beginning to change, and we're getting that Indian summer. So fall is definitely a great time of year, and it's a great time of year to, I like to say, fall cleanup for your skin.
SPEAKER_01:Fantastic. Because I think a lot of people always think about the spring cleaning aspect of what are we going to do for skincare? What do we look at product-wise? What should we be doing or how should we adjust things? So I wanted to talk about like why do you feel like there's a need to make a change in your skincare routine just because it happens to be fall?
SPEAKER_02:Yes. So I mean the seasons change, weather changes. Um, I think it's very important dependent upon uh your location geographically. So I know here in Michigan, uh it our heat turns on, skin starts to lose that um humidity factor, and you get dry. Uh, a lot of um chapped skin, uh seasonal dryness, uh, allergies, also taking allergy medications that people oftentimes forget will also contribute to skin change. So I think it's definitely uh important that we don't want to weaken that skin barrier and we want to make sure that we're um not accelerating that moisture loss. We want to lock that moisture into the skin.
SPEAKER_01:And you mentioned even before that, like a great time to maybe do a little cleanup. So I'm sure a lot of us are bothered by the leaves that fall every year and the amount of raking we're doing and getting things sort of ready as we transition into winter, especially in the Midwest. When you talk skincare cleanup, what do you recommend people should be doing? Like expiration dates or certain things you're like, hey, just toss it, move on to the next product. What is your recommendation for fall when it comes around on how to really get just our products back in line?
SPEAKER_02:Yes, so good question. I don't necessarily think that you need to toss all of your products. I mean, I think the shelf life is is um quite extensive, you know, as long as you're keeping them in that cool, dry, uh not exposed to light. And oftentimes a lot of the glass bottles now that some of the serums will come in are in amber color. So it helps to protect those products. I keep mine all in a drawer so they're not even exposed to light. But um, when I say fault cleanup, just taking those those sun screens that are a little bit more coverage, um, perhaps your lighter uh moisturizers, your uh serums that are gonna help keep pigmentation down. Let's switch them more to maybe a ceramide or you know, some type of a lightening and brightening agent. So just tuck away that summer skincare and let's get into using more products, such as those that are gonna help prevent that dryness, that flakiness that can possibly lead to um uh uh your skin not being as hydrated as it ordinarily would be.
SPEAKER_01:Yeah, it's something that I struggle with. I definitely am a gal that changes my skincare routine based on seasons. And I tell patients that because sometimes they want it to be just straightforward. I can use the same thing year-round, don't need to make adjustments. So unfortunately, it's just not, you know, the way it is. Like our skin changes with the seasons, and keeping my skin well moisturized is something that I've struggled with when the weather shifts. What do you taug or recommend or talk about, you know, with folks about what's the best way to hydrate, or is there a certain type of moisturizer that you think is better as we transition into fall and winter?
SPEAKER_02:Yeah, so I think you have to definitely take your uh skin um uh what exactly your particular skin type is into consideration, right? Like, you know, I'm over 50, so my skin, I'm dealing with some menopausal issues. You know, your skin's gonna get a little drier, um, maybe a little bit more prone to cracking, um, irritation. So again, you want to take someone who's who might be younger and still having those acneic breakouts, your skin still needs hydration, right? Not necessarily oil, because you're already producing oil yourself. An older population or someone with a thinner skin may um not be producing that oil. So they need a different type of moisturizer to replace that. Someone who is still maybe uh breaking out, but you still need hydration. So, and then that's when your treatment room going to a professional that can put together a particular skincare routine, select the products that are going to be best suited. You know, I'm a big retin A person. I think every patient should be on retin A. However, uh someone who still is having oil and acne and breakouts, maybe they need a little bit more of an aggressive or a higher strength retinol in comparison to somebody who does have a more mature skin or drier skin, finding a less uh a lesser percentage retin A. And then they have amazing products like we care the skin better line, they've got their alpha retinse, it's buffered, so that then, you know, you don't go through the peeling process either. That oftentimes frustrates patients. I mean, I'm sure you know, being um in this profession and being a physician, that your patients come in and oftentimes we'll see the most when a patient tends to be non-compliant, it's not that they don't want to do the treatment, but when your skin's going through a period where it is flaking or it's irritated because of that particular retin, uh, you know, you don't want them to get frustrated. And then also explaining to them the layering process, right? Like, you know, I'm sure you tell share with your patients, when I speak to my patient about a retin A, it's um again, like we we mentioned about doing triathlons earlier. You know, you don't go out and just run five miles the first time you've ever trained. You know, you do one mile and then you work yourself up. So oftentimes I'll tell my patients, let's gradually get your skin used to that retin A. Maybe just use it Monday, Wednesday, and Friday. You know, I will explain to a patient, you can put a little bit in the palm of your hand, put your moisturizer. It's like instead of having a straight vodka on the rocks, you put a little pineapple juice or orange juice with that vodka and dilute it a little bit. So I'll have my patients mix their retin A with their moisturizer and put it on and create their own buffered process. So I think again, that's where seeking a professional, you know, um, I think it's great to be able to go to over-the-counter uh places that retail skincare. But until you really speak with a professional and answer some certain assessment questions to figure out what the best products are for your skin, um, having someone put together a routine for you is a, in my opinion, you're gonna get your best optimal results.
SPEAKER_01:Well, I love that because there are there are quite a few things I want to pull from what you just talked about. So, one, when you talked about, you know, oily skin, acne-prone skin, really important point that I think a lot of people don't realize that you mentioned is that acne skin, oily prone skin still needs moisture. As you mentioned, not necessarily oil, but still needs moisture because hydrated skin is healthy skin. And even if you're treating acne, you know, somebody may not love a heavier moisture or moisturizer, one that may have an oil component to it, but they still crave that need for moisture because dried out skin can definitely make their acne worse. So that's that's great to highlight. Because I do think that's a myth that some people are like, oh, you know, I feel oily, so I'm never going to use a moisturizer, and not necessarily true. And as we move into fall with that need for hydration, how you talked a little bit about sort of looking for moisturizers that might be a little bit more deserving of that dry skin, kind of shifting way. I will recommend, you know, kind of avoiding maybe the gel type moisturizers, really focusing on those that have somectant properties, might be a little bit heavier, you know, for patients. And then two, I love that you use mixology. Gosh, like anyone that can use mixology beyond, you know, going out to have a cocktail, but in our skincare. But honestly, that's kind of what we're doing. And you're catering, you know, to the patient, like what's the perfect cocktail for them, right? Their signature cocktail based on their skin type and individual needs. So that's fantastic. And then we talked a lot about retin A. For some of the folks out there, if you're not familiar with Retin A, that is a branded version of tretinoin, which is a form of a vitamin A or what we call a topical retinoid. And so you'll see multiple versions, whether you have over-the-counter, retinol, retinal. Um, you also have granactive. You have a lot of options out there over the counter that you can look at, and then prescription strength too, which you can do with adapling over-the-counter prescription strength, tretinoin, or even as high as tzerotine if you're really feeling uh kind of excited and daring and see what happens to your skin. But I think you know, the point of addressing your retinoid or vitamin A is really essential because I'm one of these people, and I don't know if you've ever done this, but I'll switch, I'll go to a lower potency or sometimes even over-the-counter during the you know, the fall and winter, because I just can't handle you know the higher potency ones. Uh, do you find that to be the case too for yourself or your patients?
SPEAKER_02:I yes, I agree. I tend to get a little bit more um oilier myself in the summer months, so I can use my straight um 0.1% uh retinol or I'm sorry, retin A product. And then in the wintertime, I have to use a more buffered, and then I also use a heavier moisturizer, and I'll even go the extra mile sometimes and slugging as we've heard the term. Um, I will put my aquifer as a third barrier to lock that moisture in and really um make it a little bit more occlusive so that uh uh my skin really is able to absorb those products overnight. So again, I mean, we know that our skin is our largest organ, right? And it's the one that is continuously changing.
SPEAKER_01:And I think you have to, like I said, it changes with the weather, like we've talked about. And selecting I do find for some people can be beneficial. And it's kind of a little bit of a test if you're acne prone. You know, unfortunately, some people it definitely can aggravate their acne and may not be the best option, but there are great non-comedic moisturizers out there or ones that don't clog those pores up and lead potentially to acne that you can use with your tretinoin or your topical vitamin A cream as well. So I think that's a good balance that you can offer people if they're craving that extra hydration. Because you're right, if it's too irritating, people are not going to use their topical retinoid, whatever we recommend. So changing the strength or the potency and then arming them with really good instructions on how to moisturize. And then your analogy, the marathon, that is the one I have always used. I tell people that little bit of flake or dryness is kind of like that little bit of sore muscle when you first start running, but you really want to minimize that. And a lot of people over time can tend to build up some tolerance. And I tell them that moisturizer is kind of like your stretching and your hydration just to kind of help you get through up to the next level. Or sometimes we talk about that three, two, one rule where you'll apply like every, you know, three nights for three weeks, every two nights for a couple weeks, every one. But again, sometimes we don't always get there, you know, especially with the weather shifting. And so we need to arm people with tools like that. Now, one of the things we've talked about obviously a little bit of hydration, moisturizer a little bit. What about sunscreen? Because I think there are a lot of people that feel like, oh, it's done. All right. So toss in that sunscreen when I do my fall cleanup, and then maybe they're not thinking about using sunscreen for the fall. What do you talk about with your patients about sunscreen use when the weather shifts?
SPEAKER_02:Yeah, so I think that that's still very important because your UVA or I'm sorry, your UV rays persist in fall. Still 80% um penetrate clouds, even. So, you know, again, being Midwestern girls, we're gonna not possibly see the sun as much, but you're still gonna have that sun exposure. And then I'm sure, like yourself, I'll tell my patients too, it's not just being outdoors that's a factor. It's still indoors. It's those UVA rays above us that are aging rays that are still gonna cause damage to the skin, right? So um I'm always a big proponent of still having some type of uh sunblock on. Um you could do a broad spectrum if you want, or you can do uh the mineral filters with your zinc or your titanium. Uh, the amazing thing now is the day and age that we're in, you know, you've got your tinted moisturizers, your makeup still has your SPF built in. So you may not need the strength uh required that you would being outside in the summer months or on a beach vacation. But I do believe it's still imperative that you have that sunblock on uh even in the winter months.
SPEAKER_01:Yeah, I think for a sunscreen, it just established, you know, healthy habits too. You know, if you're doing it every day, regardless of season, I do think it puts it into your routine. And you're right, it really depends upon where you're at geographically, essentially in the world, but we still get a fair amount of sun exposure even during those fall and winter months, and the likelihood of burning might be a little less, except for maybe you're on those ski slopes or you get that reflection if you're in a really cold environment. But there's that cumulative factor of sun exposure adding up over our lifetimes that makes a big difference too. And then I also think you mentioned the indoor piece. Do you talk with your patients about high energy visible lights? Gotten a lot of attention now, you know, the screens we're looking at right now or our phones for people with pigmentation issues or premature aging. Is that something you talk about with them as well?
SPEAKER_02:I do. I mean, even I'm sure you've seen, you know, some of the uh studies and discussions about even going to get a manicure, right? We're putting our hands in, you know, those UV lights to cure the polish. And so you are still getting exposure, like you said, from you know, screen time as well as those uh external factors.
SPEAKER_01:Yes, I think it's important too. And I hopefully most of the salons I know have made that shift to LED, but there are still some I understand that are using UV. So it is one of those things that you do have to take into consideration. And especially I like to recommend if people are prone to pigmentation changes, that they're using sunscreens that have iron oxides in them or tinted to really help with that high-energy visible light for protection as we're finding out more and more how it contributes to pigmentation changes as well as premature aging. And speaking of pigmentation changes, I think this is what happens a lot too at the end of summer. People have been out all season and like, wait a minute, look at this brown that's now kind of coming to the surface. Um, maybe some sparkles that faded previously have become a little bit more prominent, or they've developed some litigenies, or maybe their melasma has flared. So, how do you talk with them about sort of pigmentation changes that occur and maybe what should they be integrating into their skincare routine?
SPEAKER_02:Yeah, so I'm a big proponent. Um, I've suffered from hyperpigmentation myself. I I remember I lived in Charlotte, North Carolina for a couple of years, and I was down there no longer than 30 days, and I remember rubbing my upper lip. I looked in the mirror and I was like, as I was driving out, I'm like, what is this? And I ended up getting that chocolate milk mustache. And I was like, oh my goodness, I wear sunblock. So I'm sure is what you explained to your patients also is um heat can also trigger the pigmentation too, because your body wants to start producing those melanocytes to protect itself. So um, you know, I tell my patients all year round they should have some type of product, um, whether you want to do a hydroquinone or a vitamin C to suppress those melanocytes. And as we're getting into fall, like you mentioned, um, again, fall cleanup, I always say we need to correct either the sins of the summer or like you earlier mentioned, that cumulative sun, because we know sun damage can show up from what you did seven years ago, and you've never had that freckle or brown spot um on your face prior. And now all of a sudden you're like, oh my goodness, I wore my sun black all summer long. Why do I have this, you know, uh litigeny or um freckling going on? So that's again where I think that correction. So I like products that have vitamin C. I'll couple them with hydroquinone. Maybe uh summer months, I like them to do it in the AM. Winter months, you know, you can put it in your evening product if you want for a little bit more correction. But I think something that is gonna have those antioxidants in uh for correction is definitely important. Um, and then I'm sure we'll discuss, but then that's when you get into your chemical peels, your IPLs, your fraxals, you know, all of those that are gonna be a little bit more stronger in the correction department.
SPEAKER_01:Do you counsel patients about hydroquinone sort of overuse? Because, you know, in some areas of the world it's kind of been, you know, taboo to go there. I think a lot of people will come in, and you may have patients like this too. They're they're even afraid to potentially use it. They're looking for cogic acid, transamic acid, some of these other options. Do you use a combination of those or educate them on sort of the right way to use hydroquinone if you think it's appropriate?
SPEAKER_02:Yes. So I do love, you know, I I'm a little old school. I like the six-week cycle of it. Um, and then yes, I do love the um transemic uh uh product as well as azalic acid for those that want to go a little bit more natural. We use the cogic berry um our cogic acid uh every microneedling treatment. It's one of the add-ons that we just complimentary throw on because I love the way that it does lighten and brighten the skin. So I think that there are other avenues to be able to use uh as well. So I think again, it just depends what's the level of pigmentation. You know, when I'm getting into my IPL season, I do like my patients to be on a little bit more of an aggressive product to really lighten that skin. Because I think that people are under the misconception, oh, I haven't been in the sun for a month. Okay, that's fine. Maybe you haven't been directly exposed by the sun, but you still possibly could have some color or pigmentation left to your skin, right? And I don't want to get caught where we have a burn situation or anything else like that. So I like to aggressively lighten up the skin a little prior, um, possibly even with a Jezzner or um uh a chemical peel uh to help uh get that skin in line before we go ahead and use a different modality.
SPEAKER_01:And that kind of is a good segue into talking about chemical peels or more in-office procedures for kind of lightening and brightening. Is that something you jump to right away, or you wait to see what top goals do? Are you looking at kind of the severity of pigmentation to talk more with patients about that as an option?
SPEAKER_02:Yes, I think again, it's going through that assessment, um, understanding what the patient's goal is, uh length of time, you know, too, I think is really important. Uh, meaning, you know, do they have a couple of months to be able to get their skin conditioned, or is it something that, okay, we have an event at Christmas time and I need to be able to get in these treatments before I'm gonna be a snowbird and go out of town. So, you know, I think every patient is individual. You know, each circumstance should be geared towards patient specific and understanding what it is that those patients' needs are. Uh, and again, like you mentioned, I love combining different modalities and and different treatments. And, you know, what we might have done the year prior or past with my patient, it may change for this particular season as well.
SPEAKER_01:Wow. I so what we talked about, I think, has really probably got people excited that fall skincare can still be a good thing. Doesn't have to be boring, maybe not as fun as summer because the weather is shifting. But between hydration, adjusting the routines, really catering it to the individual, what other tips or tricks do you have to offer, you know, as the weather changes? Do you have any of your like favorite tips you'd love to share with patients as well?
SPEAKER_02:Oh my goodness. I I get so excited about skincare. I mean, I know I'm behind the chair injecting the majority of the days. And and I I was a licensed esthetician before I became a nurse. So I had many years in skincare. Uh, and I oftentimes feel that if you're doing good skincare both in a treatment room as well as um at home, it just makes anything else we do with injectables look better, even when you segue into if you're looking for a more surgical route. Uh, to answer your question on what my favorite treatment, I'm always still a big fan of microneedling, which is seasonless, but I just don't think that you can go wrong with microneedling. Um, I think another nice treatment is you can stack on, you can do an IPL, maybe target some of those certain brown spots if you don't have all over browns. And then you can still layer a microneedling treatment over top. Uh, I've been doing a CO2 laser for patients for for many, many years. I just had one myself last February. Um, I'm a big, that's probably a really exciting uh part for me in aesthetics because I that laser can be so life-changing with those riddles around the mouth, the ones underneath your eyes, um neck, you know, a lot of people want to, you know, forget about the neck. And um, you know, I think it's really important to consider face, neck, and chest. And the older two, you know, a lot of people are taking care of their, there's so much knowledge that's available, and they are taking care of this up, but then they even forget to do their hands. So um I don't know, uh, Dr. Trotter, uh Shannon, I don't know if I could really give you one specific point. I just get so excited.
SPEAKER_01:I don't know. You pointed out that I want our listeners to understand is your point that you need to see a professional, somebody that deals with skincare, can help make the assessment, has that experience. And there are a wide variety of options to do that, as you mentioned. Like sometimes people have gone to an aesthetician, sometimes they've gone to their nurse, sometimes they've gone obviously to their physician. So, and then we have obviously nurse practitioners and physician assistants in the space too, but making sure they're professionally addressed so that they make good choices about their skin care to avoid complications like you know, contact dermatitis, allergy, you know, making things worse before we actually make them better. So I think that's probably one of the best things too to pull from kind of your story and your experience today is to really let listeners out there know that you don't have to do it on your own, although we are a D, you know, do it yourself kind of a you know country on all kinds of things. That's okay maybe for the house, but we tell people for your skin, you know, let a professional kind of help you through that process as well. So I think that that's really important because there's a lot of us in that skincare sandbox, as we like to call it for sure. Yes.
SPEAKER_02:Yeah, I'm sure you have some thoughts on that. I know that there was some crazy stuff during COVID because unfortunately we didn't have, you know, um access to some of the when everything was closed down, right? And the the DIY, um, you know, like the rollers and you know, I just tell my patients some of those things are great. I love gua shoo. I think you're stimulating um, you know, blood supply, blood flow to the skin. You know, you're gonna help relax some of that fascia. Um, you know, a derma roller is great too as long as you're not pulling and tugging on the skin too much. But, you know, the the microneedling do-it-yourself rollers and stuff, you know, you're just causing more trauma to the skin. So again, seek a professional. I I think some things, you know, you can get off of the internet. And if you want to go the TikTok route or social media, you know, I'm not gonna um I'm not gonna bash on that because, you know, I do think there is some good information, but there's also some very frightening information as well. So seek a professional.
SPEAKER_01:Exactly. Well, speaking of that, if our listeners want to try to find you, can you let them know where they can locate you online or your social media handles?
SPEAKER_02:Yeah, so we are located in uh Birmingham, Michigan. Uh my uh website is RSkin. So the letter R, skin, S-K-I-N dot net. And then my personal Instagram is RSkinAdmission, and then our office and business one is Rskin Aesthetics.
SPEAKER_01:Thank you for sharing. So if you want to check out Raquel, you know where to find her. And I want to thank you for coming on the podcast and giving everyone some tips for that fall skin care because we're all gonna need them as the weather here starts to shift. Yes. We're gonna enjoy those pumpkin spice lattes. So somebody can share along with it is perfect. But thanks again for coming on the podcast.
SPEAKER_02:Thank you so much for having me. It's an honor, and I love following you and all of your information.
SPEAKER_01:Thank you, thank you. And if you like what you heard here today, please click like and subscribe. And thank you so much for listening to Dermitrotter Don't Swear About Skin Care. And I look forward to joining you on the next episode.
SPEAKER_00:Thanks for listening to Dermotrotter. For more about skincare, visit dermittrotter.com. Don't forget to subscribe, leave a review, and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.
