Season 3 | Episode 6
Doctor Jonette Keri: There are the dynamic wrinkles and those are the ones can frowning and smiling and laughing. And then there are static wrinkles to just come from over time from aging. When I see people who frown a lot, yes you will be more predisposed, when people smile a lot they might get the crow's feet more. I'm not going to take away the smiling, but I may help them with the frowning.
>>Joe McIntyre: Hello and welcome to the Merck Manuals Medical Myths Podcast. I'm your host, Joe McIntyre and thank you all for joining us. Today is part three of our discussion with Dr. Doctor Jonette Keri. Dr. Doctor Jonette Keri is an associate professor of dermatology and cutaneous surgery at the University of Miami Miller School of Medicine. She is also chief of dermatology service at Miami VA Hospital. Dr. Keri right thanks for joining us.
>> Doctor Jonette Keri: Thanks Joe. I'm so happy to be here this morning.
>>Joe McIntyre: On this episode, we're going to dive into some skincare beauty myths. The first of which I can bust right up front. This is not just discussion for those who wear makeup, we're going to talk to Doctor Jonette Keri about a number of skincare topics that affect all of us, especially as we age. And speaking of aging, Doctor Jonette Keri right do anti-aging creams actually work?
>> Doctor Jonette Keri: Yes they do. They do work, some better than others. We know that we have good data from our prescription anti-agers way back in the 1990s. If you look at the before and after pictures of women in their 70s. I use it as a impetus to help my patients decide to start using topical anti agers because they look at those articles from the 1990s I showed them the before and afters. And these are in medical journals. So, it is validated. They get excited and they start using anti agers. But the thing about anti agers is you can't expect them to make a seventy-year-old look like a 50-year-old. You can't make a 40-year-old look like a 20 year old, you have to be realistic in your expectations but they do work.
>>Joe McIntyre: Is there a time of your life or a an age when you should start thinking about them or is or commercially, a time where it's too soon to start using anti-aging creams?
>> Doctor Jonette Keri: So the number one anti ager is the sun, with some protection of the sunscreen, so you can start doing that, you know, over the age of six months, basically, to protect the skin. So that is one of the best things you can do, how I explained it to my patients is, you got to start with the sunscreen. You don't want to ask me for a wrinkle cream until you use the sunscreen. As far as the creams that help with quote wrinkles, some of the best are the retinoids, which are the derivative of vitamin A, but the antioxidants are also good, you may know an antioxidant as a vitamin C, or a coenzyme Q 10 So they do work, But you got to start with the sunscreen.
>>Joe McIntyre: That's great. That's great advice. Now, our anti-aging creams, only for women? I know you look at commercials on TV and that seems to be the case but I'm sure you're gonna bust that one right away.
>> Doctor Jonette Keri: Joe That's so unfair for you. Okay. And I can see you now as we're doing this podcast so I can tell you, you don't really need anything, but I will tell you that it's so untrue men needed to men are using more cosmetic procedures than ever before, they are going in for chemical peels and Botox and different types of cosmetic procedures, why not have a man started home with something simple like a cream at bedtime. That's how I would take it, and of course that sunscreen.
>>Joe McIntyre: Now, is it possible once wrinkles appear in your face, to get rid of them with creams or ointments?
>> Doctor Jonette Keri: You can with the topical retinoids and with some of the other topical anti agers and there's a whole huge industry based on different products that are not just retinoids, which are the vitamin A's, so yes you can. You can get rid of wrinkles or as the product insert will say, often for over the counter treatments, they'll say, reduce the appearance of wrinkles, so you can make yourself look better and some of them actually help a fair amount.
>>Joe McIntyre: Doctor Jonette Keri, are chemical peels and these more severe skin, or more serious I guess rather skincare treatments bad for you or are they okay?
>> Doctor Jonette Keri: They're okay, we use chemical peelings, not only for aesthetics, which means making us feel better about how we look. But we also use them in the treatment of pre cancers, something called an actinic keratosis so I do not feel skin pills aren't safe, but they have to be done by people who know what they're doing.
>>Joe McIntyre: Now how about sleeping in makeup does this cause breakouts acne or worse is this unsafe for you to sleep in your makeup if you put that on during the day?
>> Doctor Jonette Keri: You should wash your makeup off before you go to bed, it can aggravate acne because if the skin is occluded for too long the makeups meant to be worn during the day maybe into the night. It's not meant to be worn for through the next day with your face rubbing against a pillow. We had talked about acne mechanica in the past and that's where the skin is robbed by something such as the COVID mask, same thing can happen if you leave the makeup on with the pillow and everything's rubbing so we want patients to wash their face before they go to bed.
>>Joe McIntyre: Whether you're a parent or a seasoned professional, a medical student or a caregiver, the Merck manuals has the right medical information in the best format, and it's always free, easy to access and readily available for you.
>>Joe McIntyre: Now, and you moisturize your skin too much and how often should someone apply a moisturizer to their skin especially their face.
>> Doctor Jonette Keri: When you think about moisturizer, think about the skin is wanting to be at a happy place, and the happy place, is when it's not too moist, and when it's not too dry. So,if you over moisturize you may clog some cores. There are people who don't need a lot of moisturizer, they have enough sebum or oil in their skin. So again, we want that happy place, not too dry, not too moisturize right in a perfect balance.
>>Joe McIntyre: Now, I assume on that same kind of vein there, you can actually over exfoliate your skin to by causing it to be more dry than it should be.
>> Doctor Jonette Keri: Yes, I've had many patients think that if they scrub harder, that they will get rid of their acne so you don't want to over explain, I am always a proponent of very minimal exfoliation or exfoliation just with the product. And nothing aggressive
>>Joe McIntyre: Is more expensive or costly or makeup and other skincare products better for your skin than cheaper alternatives? And additionally, is it more effective when it comes to skincare products and anti-aging creams?
>> Doctor Jonette Keri: I'm going to say no to this and I'm a big proponent of drugstore brands, the drugstore brands can be very good, so can what we call prestige cosmetics and that's where you go into your department store and get some higher end products. What I find is that you have to search, and you can find a product in the drugstore, that is as good as a product that you might pay a lot more for at a high end department store. So, these companies, they want their products to work, they want people to like them. They don't want them to clog pores or cause allergic reactions. So, they put a lot of effort into them so I don't think things have to be expensive.
>>Joe McIntyre: Now when it comes to the body soaps we use, is there a way you recommend someone choose one? I personally use a sensitive skin body soap, but other products do you would recommend How should someone choose, the way they wash themselves every day?
>> Doctor Jonette Keri: So how I tell people to shower is to take short showers, so the water can be the dryer, not as much the soap but the soap can also contribute. I pick mild soaps, sometimes the word is a syndet soap which is a soap that is has a less irritating component to it. But in general, the shorter time and the shower will protect those with sensitive skin. They should look for things generally that don't have strong fragrances, or say, unscented. And then as far as which one they use, it's going to be their personal preference whether they like a liquid or a bar so a lot of my colleagues like the liquid soaps, but cost consciously, I recommend bar soaps, often.
>>Joe McIntyre: Now, we do see this myth quite often asked on the Merck manuals and online. Does our skin, adapt to some skincare products? Meaning we should switch the products and brands we use often?
>> Doctor Jonette Keri: You know, Joe, I love this question because I thought about this long and hard, and there have been studies to disprove that our skin gets sensitive for example that shampoo starts working, there's some good studies out there and say the shampoo doesn't stop working, probably keeps working. What it is, I believe is that our bodies change so that the soap I used when I was 35 is not going to be the, the same so by using 55, but that is not as striking as maybe the soap you use at 12 versus the soap you use at 30. So as our bodies change or environment changes maybe I lived in Pennsylvania and now I live in Florida, so you're going to need to adjust your products, somewhat based on where you live in your environment what you're doing, so I think it's more we change than we get used to things.
>>Joe McIntyre: Got it. That's good to know. Now if we make a lot of facial expressions, let's say we're frowning smiling, laughing a lot, are you more likely to get wrinkles on our face faster?
>> Doctor Jonette Keri: So there are two types of wrinkles on the face, there are the dynamic wrinkles and those are the ones can frowning and smiling and laughing. And then there are static wrinkles to just come from over time from aging. Will you get more. I think that when I see people who frown a lot, yes you will be more predisposed when people smile a lot they might get the crow's feet more. I'm not going to take away the smiling but I may help them with the frowning.
>>Joe McIntyre: That's good, that's good. Now we mentioned this a little bit in our podcast discussion about acne, but satin pillows have become very popular recently for skincare for protecting your hair. Do these satin pillows actually help your skin do they prevent wrinkles.
>> Doctor Jonette Keri: So, I thought about this question a lot too, if you think about it. Have you ever woken up and you have a crease on your face, because you've slept a certain way. So before the crease and before the pillow. The thing you can do that's the best for sleeping asleep on your back. It takes about three months to change your how your sleeping habit if you sleep on your side regularly, and you want to switch to your back it'll take about three months, if that's good for you medically for everything else. So in my mind, the satin and silk pillows probably helps some, because if you do sleep on the side, you're going to push that skin a little bit more harshly into a more firm pillow case. But the best thing you can do is not a pillow case, it is to sleep on your back for the anti aging for the acne and not have the skin against any type of material at night.
>>Joe McIntyre: Before I let you go, where should our listeners head to for information about skincare beauty how to properly care for their skin. Are there any places you recommend they, they check out first?
>> Doctor Jonette Keri: Sure, I would send them to their dermatologist, the Merck manual has some information, but also the American Academy of Dermatology, has a lot of information on such questions.
>>Joe McIntyre: Well Dr Jonette Keri we covered, not just a ton of information on this episode but on our previous two episodes about acne and protecting ourselves from the sun's harmful rays, for any listeners who haven't checked those out yet, I strongly recommend you do. They're loaded with great information, a lot of myth busting as well. And to our listeners, I want to thank you for joining us and for Dr Q Ray, I'll let her leave you with the message we always leave our listeners.
>> Doctor Jonette Keri: Thanks everybody. Remember medical knowledge is power, Pass it on.