I always thought that you go on birth control to help with acne.
SPEAKER_01Birth control shouldn't be like a solution to acne. Like anything that's high in progestin is gonna be really andergenic, which is gonna cause the skin to produce a lot more oil.
SPEAKER_00Okay. I feel like we just cleared a misconception right now. Yeah, yeah, yeah.
SPEAKER_01That should be my first one.
SPEAKER_00Acne. Whether it's stubborn breakouts or lingering scars, it affects millions. But what if everything you thought you knew about treating it was wrong?
SPEAKER_01I think the m biggest misconception is that things cause acne. Nothing causes acne. It is a genetic disorder, but there are things that trigger this reaction in the skin.
SPEAKER_00So, what do you think is the most effective treatment for acne?
SPEAKER_01I would say definitely sidewind used correctly. There's just not enough education behind how to use it, which is frustrating because it is such a phenomenal ingredient, but it's not used correctly. I think it's important to understand the difference between cause and trigger when you eat something like dairy that's going to overproduce oil in the body, and that's when you'll see like the inflammation, the pus, the acne.
SPEAKER_00I was curious about microneedling. Is microneedling beneficial for acne?
SPEAKER_01This is such a hot topic in the industry right now.
SPEAKER_00Oh wow. Acne myth or fact. You should never pop a pimple. Welcome
to Face It, the podcast that cuts through the noise of the beauty industry. I'm your host, Barry, and today we are busting acne myths wide open, diving deep into the science, and getting expert advice from the man who's seen it all.
My guest today is Michael Rizzano, a licensed aesthetician and acne expert. Michael specializes in acne treatments and scar solutions, helping clients tackle everything from breakouts to lingering scars with a personalized approach. Michael, welcome to Face It.
SPEAKER_01Thank you so much for having me, Barry. I appreciate it.
SPEAKER_00We're so excited to have you and just dive into like all the truths, the myths, myths, the facts about acne.
SPEAKER_01Amazing.
SPEAKER_00All right, let's get started. So I kind of want to first start off about just like the acne journey in general. Um, you know, acne affects so many people.
What do you think is the biggest misconception about acne?
SPEAKER_01For me, I think the biggest misconception is that things cause acne. I think it's important to understand the difference between cause and trigger. Cause is the root cause. So it's essentially a genetic disorder. And then trigger is something that's gonna initiate this reaction. So things that are going to essentially initiate the process in the skin, um, whether it's dairy, which we can get into in biotin, things like that. Essentially, what's happening when someone is acne prone is we're shedding about five layers of dead skin. I'll try not to get too sciencey, but we're shedding about five layers of dead skin. And someone that doesn't have acne is shedding about one layer of dead skin. Oh, wow. So our body can keep up with the cell cycle, and that's what forms the microcomodone, which is the beginning of all acne. When you um eat something like dairy that's gonna overproduce oil in the body, oil is gonna get in with that dead skin cells, and that's gonna cause um that is when C acne bacteria will kind of thrive in that environment, and that's when you'll see like the inflammation, the pus, the acne. Um, so nothing is causing this process. It's genetic, but things are essentially triggering this uh reaction in the body and in the skin.
SPEAKER_00Gotcha. Okay, that's a good one. So essentially, people that are acne prone are shedding more skin than those that are not acne prone.
SPEAKER_01Exactly.
SPEAKER_00Oh my gosh, I never knew that. Interesting. Okay. And
what's the most surprising thing you've learned about acne in your career?
SPEAKER_01I would say just how healthy the skin barrier has to be. I feel like when I was young, I was on proactive for so many years, and it was just like active ingredient, active ingredient, active ingredient. And a lot of the time when we're trying to clear our skin, we're trying to figure out our acne, we're just throwing all these ingredients at it, but we're not necessarily thinking about the health of the barrier. And that's really, you know, that really should be the first thing is is the barrier healthy? Um, and then you can start to slowly introduce those ingredients that are a little bit more effective at treating the actual acne. Um, but definitely barrier health has been like an eye-opener for me because I never thought about treating the skin like that.
SPEAKER_00Yeah. And I feel like that's such a big topic now. Like people are actually finally discussing like skin barrier health and what's important to keep your skin barrier healthy. And I feel like it kind of all starts with the skin barrier.
SPEAKER_01Absolutely, 100%.
SPEAKER_00Interesting. Okay.
How do you approach a client's acne treatment when they first come to you?
SPEAKER_01So when they first come to me, I'll definitely ask them, we'll do like a more of an in-depth consultation. Um, diet and lifestyle factors is another huge thing that's kind of surprised me with the importance because when I was in aesthetic school or before I was licensed, it was always for me just looking for the right ingredients and the right products. But diet and lifestyle is so, so important. So if I'm sitting down with an acne client, I'll ask them questions like are they on, um, if I'm working with a female client, are they on a birth control that's maybe high in progestin? Because that can cause a lot of hormonal or trigger a lot of hormonal acne. Um, or if they have an IUD that can trigger a lot of hormonal acne. Um, if they're consuming, you know, a lot of energy drinks with biotin, eating a lot of dairy, um, a lot of peanut butter, anything that's gonna essentially stimulate the body to produce more oil, it's good to know that now. So that can be like a conversation we have that that's something to be mindful of. And then we'll kind of go into what they're using at home. You know, is their barrier stripped from a bunch of actives that they may have been using on their skin to try to clear the acne? Um, make sure that barrier is healthy. And then, like I mentioned, I'll kind of solely introduce those active ingredients that are gonna target the specific acne and the acne bacteria. Um, but it's a very low and slow approach for me getting to know, like I said, their diet and lifestyle and then slowly introducing some of the ingredients that we'll get into that are really effective.
Okay, we I have a question about something you said. Yeah. So I feel like growing up, like I always thought that you go on birth control to help with acne.
SPEAKER_01Yeah.
SPEAKER_00But you said that there's some birth controls or some IUDs that could actually trigger acne. Yes. Can you explain that a little bit?
SPEAKER_01Yeah. So there's estrogen and um progestin, anything that's high in progestine is going to be really androgenic, which is gonna cause the skin to produce a lot more oil. So, like I mentioned, when that oil gets in with that, um, that overproduction of that cell cycle is called retention hyperkeratosis. So when that overproduction of oil is um mixing in with that cell cycle that we're not able to keep up with because we're acne prone, that's when that a lot of those um issues start to rise with the inflammation. So anything high in progestine is gonna cause the body to produce more oil. Wow. Um, birth control shouldn't be like a solution to acne. Like I'm not saying get on birth control if you're trying to like clear your acne. I think the holistic approach that we were talking about last night is definitely more of the solution. But anything that's high in that progestine is gonna be a little bit more um cause a little bit more issues in those that are acne prone because it's gonna cause a lot more of that oil in the skin.
SPEAKER_00Gotcha. Okay. I feel like we just cleared a misconception right now. Yeah, yeah, yeah. Right.
SPEAKER_01That should have been my first one.
SPEAKER_00Um so do you think acne is something that everyone will probably experience in their lifetime?
SPEAKER_01I think so. I was when I looked at this question, I was I was doing I was asking my chat DBT. Um, but I think it's 85 million Americans are affected with acne. So I hope I hope I remember that uh number correctly. But I don't think that um I don't think that everyone will experience it. There's definitely a difference between acne prone and then just getting like an occasional random pimp bowl. Um I think I remember in aesthetic school, I think it was one in 20 men will experience acne, like acne, acne. I think then I think it's like one in four or one of five women who experience acne. Those numbers may have changed since I was in aesthetic school, and if I remember that correctly. Um but yeah, I think I definitely don't think everyone will experience it, but I think a lot of a lot of people will will end up experience acne at some point.
SPEAKER_00Wow. Okay. So now I kind of want to move on to like what works versus what doesn't. You know, there's so many different acne treatments out there. It's
overwhelming. Right. What would you say is the most misunderstood treatment for acne?
SPEAKER_01Um, kind of what we touched on before. I think healing that skin before you introduce the ingredients. I know like a lot of prescriptions, you hear about these harsh prescription topicals or just the benzyl peroxides and all of the acids and stuff that people just kind of put themselves on without any kind of education behind how to use it. Um I think it's really, really important in it nourishing that skin barrier before you introduce anything like that. So what I'll do is if I have a client come in and typically I'll see like acne clients while they're clearing every two weeks, but if I have a client come in and they're really dehydrated, they're really sensitized, and you can tell when the skin is sensitized because it will have like a leathery appearance, um, it gets really, really reactive. So even if I like cleanse it once with a gentle cleanser, it gets really, really inflamed and reactive. If the client's feeling a lot of activity based on like what they're feeling, even if I put something gentle on their skin, it's usually a good telltale sign that their skin's compromised. So what I'll do is for two to four weeks, I'll have them use gentle cleanser, gentle moisturizer, sunscreen. Um, and then definitely ingredients that are gonna heal the skin. Like aloe is very good. Beta glucane is one of my favorites. It's derived from wheat and it will actually help support the immune system. So it's very, very healing. Um, ceramides are great for just nourishing and repairing that skin barrier, things like that. And then in about four weeks, they'll typically have gone back, calmed down pretty well, gone back to normal. And then I'll kind of
slowly introduce those actives that I um that I like. So benzyl peroxide, I love. Um, it's it can be misused just because there's not a lot of education to the consumer about how to use benzyl peroxide. It should be like a very low and so approach. I'll have clients actually wear it full face as a mask and increase that time every three days. So 15-minute mask and then wash off, and then the next three days 30-minute mask, and then we'll slowly introduce um wearing it overnight once their barrier is ready to go.
SPEAKER_00And I feel like you're kind of saying like a lot of people will just throw strong actives on their skin, like right when they like sense a breakout, when really you need to rebuild that barrier and make sure you're using like the ingredients that are right to build versus just strong actives.
SPEAKER_01Absolutely. And these clients come in and they're like, Oh, I don't want to be on benzoyl peroxide because I had such a bad experience. But it's like, well, when you use benzyl peroxide, how did you use it? And most of my clients will be like, Well, I just wore it overnight. And it's like, we don't know what the strength of your skin barrier is in. We also want to, you know, introduce that really, really nicely and really slow. Um, and then I'll have those clients will we'll use it the correct way, and then they'll love benzyl peroxide, and then we'll it'll pretty much clear the acne. So I think definitely just the knowledge behind how to use a lot of these ingredients, and if the barrier is healthy is so so important.
SPEAKER_00Awesome.
So, what do you think is the most effective but often overlooked treatment for acne?
SPEAKER_01I think I I was like, oh, I just answered two questions in one question, but I think definitely benzyl peroxide. Okay. I think I think it overlooked in the sense that there's just not enough education behind how to use it. Consumers aren't told how to use it correctly, um, which is frustrating because it is such a phenomenal ingredient, but it's not used correctly. So I would say definitely benzyl peroxide when used correctly. Um, but that can go for any ingredient. I even even retinol can be really, really good for acne, especially the non-inflamed acne, like the blackheads and white heads, not necessarily like the super inflamed acne. Yeah. And with retinol, you want to introduce it very, very slowly, like wear it, you know, one to two times a week for two weeks, and then two to three, and then three to four, and you're slowly building, and you really shouldn't be using it every night until like you're two to three months in. Um, that's not something that every everyone is educated, even when they go to a doctor's appointment. That's not something that's like very um that's like explained to them at the end of the appointment. So people just all these ingredients that are really, really effective get a bad rap because they're just not educated on how to use it properly.
Right. Is there a difference between like because in my brain, like, okay, I think I could be completely wrong. So please correct me if I'm wrong. The three acne like fighting ingredients would be salicylic acid, benzyl peroxide, retinol.
SPEAKER_01Depending on the kind of acne, I think I think it's also it it gets very complicated because it's different for everyone. And you know, skin, skin at the end of the day can respond to different things. Um what I've had the most success with is benzyl peroxide being for inflamed acne. So, like really inflamed acne, because that ingredient is actually going after the C acneus bacteria and killing that bacteria that's that's um kind of causing that acne. Um, so it's very, very anti-inflammatory. It essentially creates an oxygen environment that this this uh bacteria cannot live in. Right. Whereas retinol and salicylic, salicylic's oil soluble and it has a very small molecule. I'll try not to get too sciencey, but very small molecule. You got me? It goes really, really deep into the skin and clears out any congestion. Um, and because it's oil soluble, it's really good for those non-inflamed comodones with that oil and sebone and dirt, it's kind of in that pour. So I like it for the non-inflamed acne. The same with retinol, too. Retinol can be good for inflamed and non-inflamed. I've just I've noticed that if I introduce retinol too early in a client's routine and they still have a lot of inflamed acne, it'll essentially cause like more of a purge, even if they've already experienced the purge or it will cause a lot more inflammation. So, good rule of thumb for me is I'll typically clear with like benzyl peroxide or mandelic acid. Mendelic acid is a great alpha hydroxy acid that's very anti-inflammatory as well. Um, and then when they haven't experienced that inflamed acne for a few months is when I'll slowly introduce like the retinol or the salicylics. Gotcha. Um, to go after some of that more non-inflamed congestion.
SPEAKER_00Gotcha. Okay. On topic
of this, does hypochloric acid actually kill bacteria that causes acne? Yeah. Because I feel like that's like a hot thing right now.
SPEAKER_01Yeah, yeah. I there have been studies that show it does kill the Cacinus bacteria. Okay. I have read some studies that like it can potentially be overused because it is a very gentle acid. So people just think that they can, you know, spray it whenever. Um, but I think it's a great alternative or like a substitute if maybe someone is sweating a lot and maybe can't get to the bathroom or maybe they, you know, just worked out and they have like an hour or a half hour to commute home. Yeah. It's a really great, like, um, it doesn't replace a cleanser, but it's really great to use to just kill that bacteria after like a workout. Sweat is like a huge breeding ground for bacteria. So I think it's a great option if somebody like can't do the routine, they can you kind of use that in between to hold them over or just, you know, if like I said, if they're sweating a lot, they can kill that bacteria on the go.
SPEAKER_00Okay, good to know. So hypochlorous acid approved.
SPEAKER_01Yes, love it.
SPEAKER_00Okay, amazing.
Um, so I was curious how important is consistency in acne treatment and how do you keep clients motivated when results take time?
SPEAKER_01It is so, so important. I think it's important with that question too. Is I mentioned purging. So what purging is essentially when we're introducing all these actives that are going to speed up cell turnover, which is the rate at how you know quick our skin is renewing. Someone has a lot of inflammation under the skin and they introduce these actives for the first time, it can bring up a lot of inflammation, a lot of congestion up at once. Um, so if you've heard like with acne, like sometimes it gets worse before it gets better. That's essentially what we're talking about. Um, but on average, it doesn't, you know, last more than eight weeks. So we really have to, you know, motivate our clients to stay on these active ingredients and just educate them that like once the purge is over, they can really look forward to like more consistent clear skin. Um, but once that purging is experienced, or you know, once a client has just been clearing and seeing really good results, I'll make sure I take pictures at every appointment so they can I can pull them up and say, like, well, look, because clients are looking at their face every day, they might not necessarily be noticing the changes that you notice in the treatment room. So it's important to have photos that you can say, well, look at where you started and look at where you are now. And the client's like, Oh, my skin is getting better. And that is really what keeps them motivated.
SPEAKER_00Yeah, oh, I love that.
Um, so I was curious about microneedling. Is microneedling beneficial for acne?
SPEAKER_01Ooh, this is such a hot topic in the industry right now.
SPEAKER_00Oh, wow, okay, great.
SPEAKER_01There are some brand reviews that are or there are some brand studies that show that there is success when with clearing acne with microneedling. Okay. Um, I work for a plastic surgeon and we've been like kind of back and forth with the topic. He doesn't feel there's enough studies to show that make us feel comfortable doing it because we've always been taught that it will spread the bacteria, but now there's more studies showing that like the C acne bacteria is already living on the skin, so you can't really spread it. I personally have had um, this is a way longer of an answer than you probably wanted.
SPEAKER_00But I'm just I'm learning so much. I'm so interested.
SPEAKER_01There um, I've had enough bad experiences, even microneedling over acne clients, that have been cleared for two or three or four months that like for me personally, I'm not ready to do it yet. But there are there are studies and there are aestheticians that have had good results microneedling over acne. So I don't want to knock that. It's just it's such a big topic in our industry right now, and like all of the results and the studies that are coming out have kind of gone against everything we believe in. But to answer your question, for me personally, I haven't had amazing experience with it. So just right now, I would say for me, no. Okay. Without, but not knocking like all the aestheticians that have had success with it. Cause I have seen a few providers on Instagram that have gotten really good results with it. Just for me, I'm just not ready yet. I'm just not I'm not there yet, right? I need more stuff to come out and then I'll I'll maybe think about it. Yeah. Micro channeling is similar to micro needling, but instead of like a dragging motion, it's stamping.
SPEAKER_00Oh, I've seen that.
SPEAKER_01Have you seen that? Yeah. Procel is like a really popular device. There's some other ones, but um, and then like cure is like the one at home that people have been using, like the little stamper that I can get behind because you're not dragging, you're just stamping everything individually. Yeah. Um, so if I were to do something like that over inflamed acne, it would be microchanneling at this time, but that could change.
SPEAKER_00Wait, so what's the actual purpose of microneedling, if not to help with acne?
SPEAKER_01So microneedling is great because essentially when you have like an acne scar or even like a fine-liner wrinkle, um, what microneedling does is it creates a controlled wound in the skin. So we're creating these microchannels and we're attentionally wounding the skin so that when the skin heals, the body's response is to overproduce collagen in that area because the skin kind of knows like where it's lost collagen or where it's lacking collagen. So when you microneedle consistently over like a scar or a fine line and wrinkle, over time it's gonna smooth out the appearance of that of that divot because it's it's kind of lacking collagen in that area. And when we create that controlled wound, our body is gonna overproduce collagen in that area, which makes it a really great treatment for those skin concerns.
SPEAKER_00Okay. So more so for like scarring or like post acne, but when it's active, we're not so sure yet if we should do it. Exactly. Gotcha. Okay, I'm following.
All right, and how do you feel about LED masks? I love.
SPEAKER_01I love, love, love, yeah. I think it's something that has to be used consistently. I would say like four to five times a week. Um, but I my favorite is the Omnilux. I'm not sure if you're familiar with that one.
SPEAKER_00Yes, I've used that one.
SPEAKER_01You wear it, isn't it great? Yes. You wear it, you can like re-you know, clean or do whatever you want to do with it, which I think is is a really great, um, a really great idea. Because like I said, you have to use it four or five times a week if you really want to see the true benefit. So something that you can just, you know, pop on for 10 minutes, do something else, take it off, I think is is is something that's attractive in using it. But yes, I love LED.
SPEAKER_00And what is it, what's it doing for your acne?
SPEAKER_01So essentially, um, if you think about like how I always like mess this analogy up. So I'm sorry if I mess this analogy up, but essentially, like when when plants like receive sunlight and there's like that whole photosynthesis thing going on, I'm not gonna do a great job at explaining this. I don't know. I don't know why I went this route. Essentially, when when your skin's exposed to LED, the different wavelengths are penetrating different layers of the skin. So red light is great for fine lines and wrinkles because it's penetrating the hypodermis where fibroblasts live, and that's gonna they're gonna be stimulated to produce collagen and elastin. When blue light is um penetrating the skin, it will hit the epidermis while Cacneus bacteria is kind of doing its thing. Okay. So it's great at like being antibacterial, killing the Cacneus bacteria, helping to reduce that inflammation from the acne. So that's why it's good for acne from like uh what it's doing perspective.
SPEAKER_00Gotcha. So blue light's the one you want if you have active acne. Yes.
SPEAKER_01Okay. Yeah, yeah, yeah. Red light can be very inflammatory too, but it's not going to have that antibacterial effect that blue light does. Gotcha.
SPEAKER_00Okay, cool.
Now I kind of want to move on to acne scarring. I know we touched a little bit on it. Um, acne scars can be just as challenging as active breakouts. So, what do you recommend for someone that's looking to treat acne scars? Is there more beyond microneedling?
SPEAKER_01I think that's a good question. So, kind of like how I mentioned, when I like to introduce retinol in a client's routine, I kind of like I kind of like to wait until the inflammation has subsided for a few months, just so I don't, you know, introduce it too prematurely. But with home care, I would typically slowly introduce retinol once the client is clear because retinol is gonna be the gold standard for encouraging collagen elastin production in their home care routine. Um, it's not gonna be nearly as effective as something like micro needling that's gonna create that controlled wound. But retinol is gonna be great to use in between treatments. Peptides have been um shown to be really great in between treatments. Um, and exosome technology is newer. So those are cells that are they kind of like act as like communication cells and kind of give certain cells what they need. So they're really great at encouraging collagen and elastin production as well. That's a newer technology that's there's not uh enough studies yet, or I think there could be more studies in, but exosomes I've I've seen a lot of people have a lot of success in. That's great for their home care routine. In the treatment room, once they're a candidate, a series of like four microneedlings about four weeks apart would be great to, like I mentioned, create that controlled wound in the treatment room and really um produce that collagen elastin as far as treatments go. Deeper chemical peel is can be really great. TCA is an ingredient that we use. It's an amazing um exfoliating agent that we can use to encourage collagen elastin production in the skin. Um, but if someone, if someone doesn't mind like more downtime and and doesn't really have a budget, something like CO2 laser from like a plastic surgeon or a dermatologist is great. Um, but it's just kind of what makes sense with the client's budget and client's lifestyle because with CO2, they're gonna maybe have like four weeks of downtime where they're gonna have a lot of erythema, a lot of redness, um, whereas opposed to microneedling, it's only like 48 to 72 hours max for most patients. Um, so it's really just about what makes sense for the client, the client's lifestyle.
SPEAKER_00Gotcha. So when you're deciding which scar treatment to recommend to to clients, it really just depends on lifestyle and budget.
SPEAKER_01Yeah, absolutely.
SPEAKER_00Is there anything that you just mentioned that's like, no, this is the winner, like this is what you should be doing, in your opinion?
SPEAKER_01Yeah, yeah, yeah. I I love microdeedling. I think it it just makes sense for most. But like I mentioned, if if people don't have a budget and they kind of want it gone quicker, I've seen a lot of success with CO2 laser.
SPEAKER_00Gotcha.
SPEAKER_01Yeah.
SPEAKER_00Good to know. And then is there an ideal time to start treating scars after your acne has cleared up?
SPEAKER_01Yes. I would wait the like three to six months once the inflammation has subsided.
SPEAKER_00Gotcha.
SPEAKER_01Um that's definitely it's a it's a good question because people will probably have a different uh A couple different answers, but just from what I've experienced in the treatment room, I would say three to six months.
SPEAKER_00Yeah. Okay. Cool.
So I want to move on to holistic acne care.
SPEAKER_01Yeah.
SPEAKER_00Um, so how big of a role does lifestyle and diet play in acne? Are there any foods or habits that you recommend avoiding?
SPEAKER_01Yeah, I think it definitely does play a role. We kind of went over like the hormonal stuff. Um, with foods, you just want to avoid anything that's gonna cause the body to produce more oil. So dairy is a big one. Um, iodine salt can be very irritating. That's why like a lot of sushi products like soy and seaweed and shellfish can be a little bit triggering, is because they're loaded with iodine. Um, peanut butter stimulates androgenic activity in the body, which can cause the body to produce more oil. Um, and then biotin is a big one because what biotin is doing is essentially causing the body to create more skin cells. And I mentioned that acne bone clients can't keep up with that cell cycle because they're already producing enough skin cells. So that kind of just adds more fuel to the fire. But when I'm going over like this diet and food list with my clients, I really like them to have a healthy relationship with that list. So I always make sure to mention like, don't cut out any of this entirely because that's just gonna stress the client out even more. But just be mindful of, you know, if you can substitute, you know, milk with almond milk or just like cut back a little bit, um, you'll notice changes in your skin. Gotcha.
SPEAKER_00And then can stress and sleep deprivation trigger acne?
SPEAKER_01Yeah. And I'm always like, this is always such a fun one to go over with my client because I am the king of getting not enough sleep every night, which is why like I told you last night, I was like, I got 10 hours of sleep because I was like, here, just chilling. Yeah. But um it can because when when when the body is produced, when when you're stressed, you're essentially um it's increasing your cortisone levels, um, which is gonna spike your oil production as well. So you want to try to keep your stress at bay, but that one is like easier said than done, you know. Right. If we're stressed at work or we're stressed in life, like it's hard to manage stress. Yeah. Um, so I just encourage my calls, my clients to do, you know, exercise if that's like a really great um thing for you to do to manage your stress or make sure that you're like, you know, partaking in your hobbies, whatever that might be. Just like really try to do everything you can to keep your stress at bay.
SPEAKER_00Yeah. And then so how do you approach treating acne when these lifestyle factors are at play? And like, let's say this said client like doesn't want to really change their lifestyle, but yeah, they do want to get rid of the acne. Like, what could you do for them?
SPEAKER_01Yeah, I definitely would would continue, you know, treating other areas, like I said, we'll we'll low and slow approach with their treatments and their products and and and see how the ingredients and the treatments are doing. And then if they're still experiencing inflammation three months down the road, then it might be a good idea to circle back and have that conversation again with them. Yeah. Um, but it is it is important to educate our clients on just the effects that diet and lifestyle have on the skin. And like if this is really important to you, like I mentioned with the food, like you don't have to cut out these foods entirely, but I think it's just important to be mindful of. And and if you can cut back, one day, like cut back if you can.
SPEAKER_00Yeah.
So, what does an ideal skincare routine look like for someone who is prone to acne? Are there any products or ingredients that you absolutely swear by? I know you mentioned a lot of hydrating things, but yeah, what's the ideal routine look like?
SPEAKER_01Yeah, I would say um, I don't think everyone needs a toner. So I would say like a good gentle cleanser, um, uh something very gentle and exfoliating in the morning or the evening. I like mandelic acid. I think it's the most universal because it's anti-inflammatory and antibacterial, which a lot of these acids are, but mandelic is antifungal. So if you have ever heard like people washing their face with head and shoulders, it's because they have the fungal acne. Um and so mandelic acid is a little bit more formulated for the face, which I like, but it's also going to be antifungal and kind of go over that fungal acne as well. So it's more universal in treating multiple kinds of acne. Um, gentle moisturizer, obviously a sunscreen. I like zinc for anyone that's dealing with a lot of inflammation because it's very calming and soothing. Um, something hydrating that has like the ingredient I mentioned, the beta glucan or something ceramides, hyaluronic acid is great too. And then a benzyl peroxide. Um, or if they're have non-inflamed acne, maybe a salicylic or a retinol in the evening time, I think is perfect.
SPEAKER_00Gotcha.
That brings up another question. So I've heard that sometimes you're not supposed to wash your face in the morning. What do you say about this?
SPEAKER_01I don't hate it. I don't hate it. I think like a gentle creamy cleanser in the morning is great, but I I I don't think if someone if someone's skin is thriving and they're not cleansing in the morning and they're and they are also more prone to sensitivity, um, I don't think they need to cleanse. I know that's another hot topic. I do think it's good to just prep your skin in the morning for the following products that you're gonna use on a clean canvas. And like there is back, especially if you have pets, like there's bacteria on your pillowcase that you're sleeping on overnight. But I definitely um I know a lot of like germs and a lot of doctors swear by not cleansing in the morning. And I think for the right candidate, I think it's not there's no harm in not doing it.
SPEAKER_00Yeah. How do you feel about like a little micellar water moisturizer SPF?
SPEAKER_01Yeah, that's perfect. Yeah, that's my morning.
unknownYes.
SPEAKER_00It's making sure I'm doing it right.
SPEAKER_01No, you're good. I think that's perfect.
SPEAKER_00Awesome. Okay, so I want to do a lightning round.
SPEAKER_01Okay. So is lightning gonna strike from upon us?
SPEAKER_00Maybe. I'm gonna just throw some quick skincare related questions at you, and you can just answer with the first thing that comes to mind.
SPEAKER_01Okay.
SPEAKER_00Okay.
Acne myth or fact. You should never pop a pimple.
SPEAKER_01Myth.
SPEAKER_00If you could only recommend one ingredient for an acne treatment, what would it be?
SPEAKER_01Benzyl proxide. When this can be healthy a benzyl proxide. I was gonna try to say that this whole time.
SPEAKER_00But you were thinking too hard. I was like, come on. I've been I've been talking to you for the past 30 years.
SPEAKER_01First thing that comes to mind, I'm like, I have five words in my head right now. I'm like, which one do I say?
SPEAKER_00Um, okay. What's one thing most people with acne forget to do in their routine?
SPEAKER_01Heal their skin barrier.
SPEAKER_00Best advice for someone dealing with hormonal acne.
SPEAKER_01Specifically if you're a female client, look at your birth control and see if it's high progression or high estrogen.
SPEAKER_00That's a good one. Is it better to use a harsh scrub or gentle exfoliator for acne-prone skin?
SPEAKER_01Gentle exfoliator.
SPEAKER_00Is it ever better to use a harsh scrub?
SPEAKER_01When there's only non-inflamed acne present. Okay. If there's any kind of inflammation, you could essentially, you know, irritate that lesion and spread bacteria. So I think it's a good rule of thumb to use a chemical exfoliator, a chemical exfoliant when you're dealing with inflamed acne.
SPEAKER_00Gotcha. Okay. What's one thing you wish everyone knew about acne?
SPEAKER_01Nothing causes acne. It is a genetic disorder, but there are things that trigger this reaction in the skin in the body that per that triggers the acne. I love that.
Okay. I have a couple closing questions for you.
SPEAKER_01Okay.
SPEAKER_00For anyone struggling with acne, especially people who feel like they've tried everything, what advice would you give them?
SPEAKER_01I think it's definitely time to seek help, whether it is an aesthetician or a dermatologist. I think seeking help is something that a lot of people just like are afraid of doing. But when you tried everything and you're still not getting the results you want, I think it's time to reach out.
SPEAKER_00Yeah. And what are some common mistakes people make when trying to treat their acne on their own?
SPEAKER_01Throwing every acid and every active on your face. That was what I did for so many years in high school with proactive and just with, you know, everything I was trying to do is overdoing the routine, over-exfoliating that skin, a lot of irritation, a lot of inflammation. You really want to heal that barrier before you do anything like that, and then slowly introduce those ingredients.
SPEAKER_00Yeah. I feel like that was a universal experience in high school because everyone just it was like those pads that we would use that were like really strong.
SPEAKER_01Like the Aztec clay mask. Did you ever use that one?
SPEAKER_00Yes. Or um the um the scrub. The scrub. Oh. The scrub.
SPEAKER_01The the not the pad, right? The ox was that oxy scrub? That was a pad.
SPEAKER_00Not that one, but I know what you're talking about.
SPEAKER_01The Oh, that's gonna kill me all day.
SPEAKER_00I know. This the scrub. Like oh, oh my god, oh my god. Yeah, see it nice, yeah, yeah, yeah. Yeah, yeah. Yeah.
SPEAKER_01Oh, so pretty cool.
SPEAKER_00Um, okay, and last question. How can someone tell if they need to seek professional help for their acne and what's the first step in that process?
SPEAKER_01Um, I definitely think this could honestly go for anyone that's not getting the results they want. If you're not getting the results they want, it's definitely great to seek seek guidance. But um specifically if you have like really inflamed, really painful acne, um that is definitely something. Like we we in the industry, we kind of uh when we're looking at treating the acne, we put it in a different grade. So grade one and two is gonna be more mild, like more non-inflamed lesions, and then grades three to grade four is gonna be that more inflamed acne. Yeah. If you're like a grade four, it's painful, you're covered in cystic acne. I definitely think that's something that you shouldn't ever try to treat on your own. You should go and try to seek professional guidance for that.
SPEAKER_00Yeah. Quick another question. What is cystic acne? Like, and how does that form?
SPEAKER_01Yeah, so cystic acne is gonna be it, it can be your papular, your papules and your pustulars. Am I in this industry? Your papillars and then your pustules. So pustules are gonna be your inflamed lesions with like pus on the inside. Papules gonna be like your inflamed lesions that don't have like a head or a core. Um, but there's also like nodules. Um, I feel like all of that can be considered cystic acne. Yeah. But cysts specifically are gonna be like the really, really deep, really painful, really lesions. But to me, like anything inflamed in my head, I just I would I would say cystic.
SPEAKER_00Yeah. Okay.
Um, so it's been really great, you know, chatting with you. I feel like I learned so much just about acne, different myths we debunked, we just learned different types of acne. And it's been really great just chatting with you. Um, I would love for you to just let listeners know where they can find you on social media.
SPEAKER_01Yeah.
SPEAKER_00Go ahead.
SPEAKER_01Um, on Instagram, I'm Michael Rosano Skin. Um, I'm also Michael Rosano Skin on TikTok, but I'm not very good at TikTok. So I definitely think Instagram is the best to find me if you're ever in the Philadelphia area. I work at Philadelphia Facial Plastic Surgery at Med Spa. That's a really long title that I wish my boss would have simplified. Um, but we're uh in uh on Fifth in Spring Garden in Philadelphia if you're familiar with the area.
SPEAKER_00And definitely, guys, you should follow him on Instagram. He is hilarious and he makes skin facts just so simplified and easy to digest and entertaining. Well, thank you so much for being here. Thank you so much for having me. This has been Face It where we get real about what works and what doesn't