字幕表 動画を再生する 英語字幕をプリント - I have patient who know they have a skin cancer and they're like well, I treated it with apple cider vinegar for two months and it didn't go away. I'm like really? (chuckles) Okay. (upbeat percussion music) Hi, I'm Dr. Ellen Marmur. I'm a Board Certified Dermatologist in New York City. I have two practices called Marmur medical and a skincare line called MM Skincare. I'm here today to do a deep dive in the go to bed with me comments section about sunscreen, eye creams, and cleansers. First things first, let's dive into sunscreen. (upbeat percussion music) Catherine Coon, "Why do dermatologists "talk about using sunscreen all the time? "If I'm only going to be outside for a total of 30 minutes "spread throughout the day, "isn't that just a good healthy way "of getting your vitamin D? "I definitely don't burn unless I'm outside "for more than 30 minutes at a given time." The myth is that sunscreen blocks vitamin D. So really you need to know that you're gonna get your vitamin D through your diet, so eat a great diet, you're gonna get vitamin D through your sunscreen so you can still wear your sunscreens. It's not really a reason to not wear sunscreen and think about sunscreen math. When you wear sunscreen 20 plus sunscreen 30 you're still just getting a better sunscreen 20. So there's no reason to not just have it in your makeup or in your moisturizer every day and just get that added benefit. But talk about skin cancer math. Skin cancer happens from an accumulation of sun exposure so even if you're out for five minutes here, five minutes there, five minutes there you're getting an addition of that sun damage throughout the day. So use your sun protection. I tell my patients it's like money in the bank for good health and better skin so there's no reason not to put on your sunscreen. So what is SPF? SPF is sun protection factor and really what it means is how long can you stay out in the sun without getting a sunburn and usually what is means is that it's protecting you against UVB which is a portion of the type of UV you get. So you get ultraviolet A and ultraviolet B. A is usually the tanning rays, B is usually the burning rays. Now that we have broad spectrum sunscreen you're getting sun protection throughout the UVA and UVB segment but SPF still stands only for UVB protection and it means how many times longer can you stay out in the sun before getting red. So an SPF 15 would mean that you can stay out for 15 times longer in the sun. So for example if I were to go out in the sun and get sun burnt in a minute and I put on SPF 15 it would give me 15 minutes before I turned red. If you're the kind of person who would go out in the sun and you live in the tropics where the sun is really hot and it would take you only let's say an hour to get a sunburn and you put SPF 15 on then you could stay out for 15 hours theoretically. However, the problem is none of us put on SPF as thick as it is tested in the FDA labs. So most of us rub it off. We think we're rubbing it in but we're really just schmearing it thinner and thinner so you're really never getting the number that you have on you label. So maybe an SPF 50 or an SPF 60 is then giving you an SPF 30. So always opt up on the number of SPF. I feel like a 15 doesn't even count. So really it should be between SPF 30 and 60 for your sweet spot. KW Jeong said, "How should I put my SPF and with what?" I think that means how should I put on my SPF and with what? It depends, so there's so many different kinds of FDA sort of approved types of applications. So gels, the balms, the creams, the sprays. Those are all allowable by the FDA to claim an SPF, meaning the FDA says those all work. The old fashioned ways are lotions and you should just schmear it on and you should put it on about 15 minutes before you go out in the sun. I think there's a little bit of a mythology in that like putting it on for 15 minutes allows it to come to like your body temperature and therefore it's active and it works better. I feel like if you just put it on enough and sufficiently you can run right out the door and be protected but put it on thoroughly, put it on with sunglasses, a hat, UV protective clothing is a lifesaver because then you're not using so much sunscreen on your body and then reapply it every 30 to 60 minutes when you're truly out in the sun being athletic or being at the beach which I know you would never do between 10 am and 2:00 PM but you really wanna keep yourself covered and reapply. "Quick question regarding sun cream. "Would an SPF in foundation suffice "or best to have sun cream underneath generally?" So that means do you put on a moisturizer and then sunscreen? Do you put on sunscreen and then a moisturizer or do you put on sunscreen, moisturizer, and then makeup? It gets very confusing. So here's where you wanna simplify your life and just get something that has everything in it. So a tinted SPF 30 is a great moisturizer, sun protection, and makeup base that you can just put on and go out the door. Lilianna B, "Does sunscreen worsen your acne, "cause breakouts, or make acne scars?" And then Jenna says, "Lilianna B chiming in here. "Chemical sunscreens cause a chemical reaction "on the surface of your skin, "so it can be irritating for a lot of people. "Try a zinc or a TD formula." That means titanium dioxide. "They'll be a little whiter at first "but are much gently for skin. "Just be sure to use a serious cleanser "at the end of the day." Okay, all of it's great questions. Acne can definitely get worse with certain sunscreens. Part of it is because some sunscreens that are water resistant are a little bit tacky and they actually kind of occlude or block the skin and that can make your skin break out a little bit, especially like she said, like Jenna said if they have a lot of chemicals in them. There are sunscreens that are just for acne. For example EltaMD Clear has lactic acid in it and the lactic acid exfoliates the skin a little bit and prevents blockage of the skin for your acne and is tinted so it protects your skin. And then when you wash it off at the end of the day, because it's mineral based, it's actually not that hard to get off so you don't need to use any harsh cleansers. So do pick something for acne skin when you're picking your sunscreen. Okay so Apurva Tik. "Can I use sunscreen under eyes "and on eyelids?" Great question, yes you can use sunscreen on your eyelids and around your whole eyelids. I see a lot of skin cancers on the eyelids. I think the best and easiest way is to wear a really big sunglasses as much as you possibly can starting at a very early age. So if you're a mother and you have kids buy them sunscreen, or sunglasses actually that are bigger and cover sort of the outer part of the eye. How much of your body do you need to apply sunscreen to when you go out? And the answer is everywhere that's exposed or that might be exposed as soon as you take off whatever you're planning on taking off. The difference between mineral sun protection and chemical sun protection ingredients are easy to understand. Chemical ingredients absorb the energy from the UV light and that's called photons. So if you imagine like a ping-pong of energy coming from the sky, hitting your skin, it gets captured by the chemical ingredient in your sunscreen, captured and converted to heat so it evaporates right off the top of your skin and doesn't get a chance to go in your skin and cause a hot mutation to your skin cells which could lead to sun damage and skin cancer. The mineral sun protection like zinc and titanium sit there on top of your skin and are like little rocks that are protecting and like bouncing the photon off and they don't get used up in that chemical reaction. So as long as it's there and you've put it on and you've haven't gone swimming or you're not sweating a lot and wiping it off the minerals sit there better and they can block or resist both UVA and UVB. Skin cancer affects men on their backs more often and it affects women on their legs more often and when I'm saying skin cancer I mean the bad kind called melanoma. So men get melanoma on their backs and it peaks at the age of 40. So it's a young person's problem. So definitely protect your back. Don't forget, ask somebody to spray it on for you or just put a shirt on. Women like to have tan legs. It makes us feel svelte and skinnier and all that great stuff but it does lead to skin cancer earlier. And again it's on the legs in women. So protect yourself, wear pants, wear shirts, do sun-protective clothing but if you're gonna be out you need sun protection, sunscreen everywhere. All right let's talk about a heated topic, eye creams. (upbeat percussion music) The next comment is, "Yes, eye creams are a waste of money." (laughs) It's not even a question, it's just like they're a waste of money. Eye creams are wonderful and I think they're a good investment if you have sensitivity around your eyes. Now the question is do you need to spend a lot of money on an eye cream? Can you trust that an eye cream is different from a face cream? The eyes are more sensitive and the skin is more thin and so you don't wanna use something that's like an anti-ager for your face. It has all kinds of alpha hydroxy acids or scrubs or anything in it around your eye 'cause it's just gonna be too strong and cause worse problems. So when in doubt go simple for around the eye. Pick something that's in your budget but does say pH balanced for eyes or eye cream. Next comment from Amanda. "She doesn't even know how to properly apply 'eye cream' "and she wipes her eye cream downward "when it should be upward." Oh, by the way it's "eye cream". "She's dragging down her skin. "I can't believe my eyes. "She's horrible." Okay Amanda. (laughs) I can tell you're really passionate about this eye cream application situation and I get it. Even as a Board Certified Dermatologist I get a little confused by other people saying like you have to use your pinky finger and you have to like dab in a certain particular pattern. I'll be honest, when I put on my eye serum I just go like swipe, swipe, swipe on the upper and lower eyelids over my lashline and I feel so happy when I do that. So it's true, you don't wanna be like scrubbing and rubbing and dragging and pulling on your skin but it doesn't matter what finger you use and it really just is, the key take home is use it on the upper eyelids and the lower eyelids and you should be able to put it right over your lash line without it stinging or burning. Hend Mohamed wrote, "At what age should we start using eye cream "and night cream? "I'm really confused about this. "Also, I read that using serums in your 20s "is bad for your skin is that true?" All good questions. Eye cream, like I said, should be used when you feel like you should start using it. So usually I'd say in your 20s is when you're gonna wanna start using an eye cream. Night cream, again should be done at night. All the same reasons but at night is when your body is repairing and so you wanna take advantage of that whole like repair mechanism that's happening in your skin. Your skin is bionic. It knows what to do. It's an organ, it has so many thousands of things that are happening at night. So use an eye cream and a night cream that are meant for rejuvenation and repair of your skin. Then she says, I'm really confused about when I should start using serums. If you start using them in your 20s is it bad? I love that question and I think the answer is a solid no. You can use serums in your 20s. Serums are just a more elegant form of a moisturizer. They're really not supposed to be like harsh in any way. They should be really, really nice and very elegant and like a soft touch on your skin so you should definitely be using serums in your 20s. It's gonna set you up for success in your 30s and 40s and 50s and beyond. Helloe Shungzi, "Actually I think you use the eye cream "in the right order, right after the toner." Perfect, so again you don't really need a toner. In this question or statement I think the toner is really meant to be used as a makeup remover. And so here's what I love. I do love thin makeup removers, not the ones that are on wipes. So get rid of all the makeup remover wipes, that's just bad for the environment and bad for your skin. I don't like wipes and I don't love toners but I do love great makeup removers. So buy like the oil-free or the light gentle oil makeup removers and you can use that just with your plain finger on your eye makeup. Gently rub it, your makeup will come off and then you can use a clean washcloth and then get rid of the rest of the makeup and then put on your eye cream. Palekid14, "I would never recommend to anyone "to put a retinoid under your eyes. "The skin is way too thin in that location." I am probably the only dermatologist on Earth who does not love retinols or retinoids at all for anything. So if you have acne yes, if you have comedonal acne, which means little blackheads, definitely. But in general retinols came out as one of the first anti-aging ingredients in cosmeceuticals in the 1980s and it was great at the time but we all know that retinols can cause harsh side effects like redness and scaly skin and itchy skin and cause inflammation and now we know inflammation can get rid of your beautiful collagen and elastin and make wrinkles. So the side effect profile to retinols for a good portion of the society is actually a pretty important side effect. So we have so many other great gentle powerful anti-aging ingredients, tons of them. You've been reading all about them. So if you can't tolerate retinols don't worry, you're not like disqualified from anti-aging just find other anti-aging peptides and anti-inflammatories and good things for the microbiome, all kinds of great other things that you can use on your skin to rejuvenate your skin without those harsh side effect profiles. Let's talk cleansers. (upbeat percussion music) Supriya Sharma, "Where do masks fit into your weekly regimen "and is there such a thing as too much cleansing "and too many products on your face? "I mean ultimately isn't your skin just genetic?" Every sentence in this is perfectly cool, I love this question. So masks, I love masks. I developed a line of masks because masks are 300% more hydrating and powerful than just a cream. Is there such a thing as too much cleansing and too many products on your face? Yes, there is such a diagnosis as cosmeceutical dermatitis and that means too many skincare products on your face. Cleansing is a huge step in your cosmeceutical beauty routine and often it's the step that people make the biggest mistakes in. So when in doubt choose a cleanser that's very chemical free and that doesn't leave your skin feeling squeaky clean. Over cleansing is a problem, don't do it. I tell people cleanse just in the areas that feel really greasy and oily and that tends to be on the side of their nose. You don't need to be scrubbing your face everyday. You don't need to like, some guys use their shampoo on their head and then like use the shampoo on their face and that's like a little harsh for your skin. So really it's all about getting rid of any excess oil and sort of getting rid of any excess debris off your skin. And then she asks I mean ultimately isn't your skin just genetic? Yes, so the answer is yes and also a bit no. So just like your liver is genetic and your brain is genetic and your heart is genetic your skin is an organ and it is mainly genetic but it's also super complex and it's also the one organ of your body that is exposed to the environment and exposed to you doing things to it all the time. So you're not like scrubbing your liver and you're not scrubbing your heart or putting toner in your other organs. So you have a lot of power over how your skin looks and how it feels and that's why you have so many questions about it because this is something that you can look into and make decisions yourself about how you can take care of your things. So Daphnia, "What is a water based-cleanser "and an oil-based cleanser?" Great, so water-based cleansers are water based, oil-based cleansers are oil based. It's really that simple. Now why would you choose one versus another? A water-based cleanser is probably not gonna get off makeup as much as an oil-based cleanser. Think about oil taking off oil. So from a chemistry perspective water and oil separate. Oil can get off mineral makeup better, it can get off oil-based products better and most makeup is oil based. So you would want an oil-based cleanser to get things off. If you have acne or really, really, really bad oily skin you may prefer a water-based cleanser or you may prefer an oil-based cleanser. They're really very different in terms of how they feel but from a chemical perspective it doesn't matter too much which one you choose. So I would pick one that you love. Raspberry says, "Foamy cleanser aren't okay, "even for oily skin. "You are a dermatologist you should know that. "You can get gentle foaming cleansers "but most of them aren't. "I think that's important to say." Okay so foaming cleansers are a huge debate in this world because they have ingredients in them called SLS, sodium laurel sulfate. Some people love foaming cleansers, it's just part of their routine and they love that feeling of a foaming cleanser. I kind of agree. Like I would go less is more on foaming cleansers for your face and so as a dermatologist I should know that and I do, I do know that but if you love a foaming cleanser just make sure again that you pick one from a company that's very mindful about sensitive skin. Make sure that the cleanser doesn't make you feel like parched afterward, that you don't feel overly clean and too squeaky clean because then you're just going to be getting rid of your own beautiful lipids in your skin that are like the treasure that you've made overnight and you don't wanna over cleanse them because then you're gonna be paying money to take like a skincare product and replenishing what you just washed away. Emilie Jugand, "If I'm not wearing makeup "do I still need to double cleanse?" And Britton Droic said, "Emilie Jugand no. "A good, single cleansing will be fine." True, okay so double cleansing is a trend that came out about two years ago and double cleansing means that basically first you take off all your makeup with one kind of cleanser and that would be like the oil-based cleanser or a makeup remover type of cleanser and then the second one is about using a cleanser that might have some added value. So there are some medicated cleansers that we use as dermatologists for people with acne or rosacea that might have an ingredient in it that's very anti-inflammatory or something that's helping the acne or something that has like an alpha hydroxy acid in it that might be for exfoliation. So double cleansing has a role for people who need it. So I would just ask your dermatologist if you really need a double cleanse but otherwise I would say keep it simple and don't double cleanse. I love this, okay. So Bong Wei Xim, is that how you say it? Bong Wei Xim, "Harper's Bazaar is it okay to use ACV on skin?" So I had to ask like what is ACV. So that's apple cider vinegar, of course. I say that's the LOL of cosmeceuticals. So ACV is apple cider vinegar. I have patients come in who've done like the weirdest things with apple cider vinegar. Like I have patients who know they have a skin cancer and they're like well, I treated it with apple cider vinegar for two months and it didn't go away. Like really? (chuckles) Okay, or they have like fungus, ya know toenail fungus or something. Well, I used apple cider vinegar on my fungus and it didn't go away. Okay, or it did go away, great. So apple cider vinegar is basically something acidic that will blow things up and help kill them and so if you really wanna use it on your skin for something that you think is infected or if you think you have scaly skin and it want it to sort of dissolve all that extra dead skin you can totally use it. Again, it's the kinda thing, it's like I wouldn't suggest it too much because it can just cause rashes. So it's a great home brew if you know what you're doing but it's an acid so be really careful. So homemade skincare products I think are pretty much great. So if you use like sweet potato mash and you put in some yogurt or if you use cucumber or if you use ingredients that are like coconut oil, those usually are pretty good because they're not really gonna do any harm and they're basically very good moisturizers. Some of them will like take out your oils a little bit better and make your skin feel really soft and like almost like you put a clay mask on, add some minerals to your skin. So most of them are really nice and I love the idea of the do-it-yourself DIY home care because I think it's part of self care and we know self care is healthcare. So all the beauty routines that you're taking care of yourself, they're not vanity. They have a really important value which is taking care of yourself. So do-it-at-home skincare is great. Lollsazz says, "Micellar water super gentle? "I don't agree with that." Okay, so micellar water is actually a really genius invention that came out in the cleansing world a couple years ago and micellation is a chemical term which means to take a large substance like a big droplet of oil and break it up into very small droplets and then that allows it to wash away. Typically micellar waters are very gentle on skin and I think that's why I love them as cleansers for people because some cleansers are too harsh. Originally cleansers were actually like, they were made out of lye which is, lye was used in like farm equipment. So Dove soap actually started like one of the first soaps that actually were made out of liquid, with cream that weren't pH balanced that was called basic. It was more acidic and the skin is acidic. So we like things that are little bit more neutral to the skin. So something that's a little bit more acid than the good old fashioned soaps which were basic and were just breaking up the skin. So micellar water takes that new like be nice to your skin philosophy and makes it even more gentle to the skin. So typically I've never ever had a patient have a problem with micellar waters. Okay so Lakes. "As a guy, "I wonder if physical exfoliants "work better than chemical ones. "We have thicker skin so have yet to decide "what I'm gonna buy "since I work in a warehouse-like environment "with dust and dirt being thrown everywhere LOL." I love the LOL, like I don't really, that's like okay. Guys, do they have thicker skin? Yes they kinda do and part of that is because they have more facial hair and then the skin is like anchored with these like thicker hairs on the skin. Do they need physical versus chemical exfoliants? Not really, there's not that much of a difference in terms of which one a general guy would need better but it's sort of like which you like better and which one you wanna use and why you're using it. So this could be a good question for your dermatologist. Working in a dusty, dirty warehouse doesn't mean that your pores are getting clogged with dust and dirt it just means that your skin is getting coated with dust and dirt and this goes back to the idea that your skin is actually like super sophisticated. And so your skin has a barrier on it called the stratum corneum. It does have little hair follicles and it does have glands and then your skin has like a thick thing called the epidermis and below that it has this structure called the basement membrane and below that it has all your blood vessels. So it's actually kind of impossible for anything to get down through the top of the skin into your body without you having just open skin to begin with. So if you have pretty healthy skin I actually would not over scrub and over exfoliate 'cause then you're actually breaking through some of that penetration barrier and making yourself a little bit more prone to things getting in. But what I would say is that since you work in a really dry environment like a warehouse you need to put on a great serum and that'll protect your skin while you're at work. Itzajana Ortega, "Is it important to cleanse your skin "in the morning when you wake up "even though you did your skin."
B1 中級 A Dermatologist Reacts to Your Comments about Sunscreen & Eye Creams | Derm Reacts with Dr. Marmur 19 1 Summer に公開 2020 年 09 月 04 日 シェア シェア 保存 報告 動画の中の単語