Q&A: How Clinicians Are Healing “Overdosed” Skin Damaged by Viral Trends

In the age of viral skin care trends and influencer-driven online “advice,” dermatologists are increasingly confronted with patients whose skin health has been compromised by misinformation circulating on social media. To help clinicians navigate these challenges in patient education and treatment, Dermatology Times spoke with Nerissa Prieto, MD, founder and medical director of Privvy Modern Health and the director of clinical trials at FACTORFIVE Skincare. She shared insights on the most damaging viral skin care trends, the clinical consequences of “overdosing” the skin, and evidence-based strategies for helping patients restore and maintain barrier integrity.

Dermatology Times: What are the most common viral ingredients or incorrect advice you're currently seeing on social media that dermatologists need to be aware of?

Prieto: The most damaging trend I'm seeing is the "more actives, better results" mentality, where patients layer multiple high-strength ingredients—tretinoin, vitamin C, glycolic acid, benzoyl peroxide—all introduced simultaneously without regard for barrier integrity. Social media promotes aggressive multi-step routines with daily retinoids and chemical exfoliants as if they're universally beneficial, when in reality they're causing widespread barrier dysfunction, especially in rosacea and sensitive skin patients. The trend toward DIY high-percentage peels and the misconception that visible peeling equals effective treatment is particularly concerning. The emerging issue is patients believing they need to "push through" irritation rather than recognizing it as a sign their skin barrier is in jeopardy.

Dermatology Times: What are the most frequent long-term issues you are seeing due to "overdosing" the skin? How can these be corrected?

Prieto: The most frequent long-term issues I see are chronic barrier dysfunction presenting as persistent stinging, burning, and developing new sensitivity to previously tolerated products. I also see treatment-resistant rosacea that has been inadvertently worsened by the very actives meant to treat it. Patients develop what I call "angry" skin—constant low-grade inflammation and hypersensitivity that is a result of compromised barrier proteins, increased transepidermal water loss, and, of course, microbiome dysbiosis. To correct this, I implement a 4 to 8 week "radical simplicity" protocol:

• Eliminate all actives and harsh cleansers
• Use only cool water or gentle micellar water for cleansing
• Apply a serum (like this Nourishing Silk one from FACTORFIVE) containing highly concentrated growth factors, niacinamide, and emollients to soothe and encourage ceramide and sebum production
• Layer with a ceramide-containing moisturizer
• Use mineral sunscreen

The cornerstone is removing irritants and trusting the skin's innate capacity to heal itself. The SILK serum accelerates this natural repair process, for example, by reducing inflammation and supporting cellular communication and healing.

Dermatology Times: What tips do you give to your patients who are testing out new products and deciding if it's beneficial to their routines or not?

Prieto: I tell patients that beneficial products should make their skin feel more comfortable over time, not less. If they're experiencing persistent stinging, burning, or increased redness beyond a brief adjustment period, that's not "purging" or "skin getting used to it": that's barrier damage. I tell them to wait until their skin feels stable and "normal" before introducing anything new, then add only 1 product at a time with at least 4 weeks between additions so you can clearly identify what's helping versus harming. Skin should not require constant "management" of irritation. If a routine requires you to buffer, sandwich, or carefully time applications to minimize discomfort, it's likely too aggressive. Most importantly, I emphasize that the goal isn't to use the most products or the highest percentages, but to maintain a healthy, comfortable skin barrier that functions naturally with minimal intervention.

Dermatology Times: How can dermatologists more effectively leverage social media to provide trustworthy facts to counteract viral misinformation?

Prieto: Dermatologists and other specialists in skin health and anti-aging have a responsibility to provide science-based content. We need to intelligently counter the misguided concept of the "miracle ingredient" and the overly complex "miracle 12-step routine." The difficulty is that to respond to things that are trending, our measured and nuanced recommendations need to be packaged as catchy sound bites that grab attention, without bending the truth or oversimplifying. Rather than simply promoting aggressive treatments or responding reactively to trends, we should be teaching foundational concepts: barrier physiology, the microbiome's role in skin health, why "less is more" is physiologically sound, and how to recognize when skin needs rest rather than more actives. The most effective approach is sharing real clinical cases: showing patients who improved by removing products rather than adding them, explaining the science behind why retinoids or acids might worsen rosacea, and demonstrating that sustainable results come from working with the skin's biology rather than forcing it. We need to move beyond quick tips and create content that helps patients develop critical thinking skills about their skin, so they can evaluate new trends through the lens of "Is this supporting or disrupting my barrier?"

Dermatology Times: What communication strategies are most effective in encouraging compliance in patients and tackling difficult conversations in clinical?

Prieto: I start by validating their knowledge and effort: "I can see you've done extensive research and really care about your skin." Then I reframe the conversation from "You're doing it wrong" to "Your skin is telling us something important." I point to their symptoms as evidence: "The burning, stinging, and worsening redness aren't signs you need stronger products; they're your skin barrier asking for a break." I use the phrase "We're not treating your rosacea right now, we're creating the conditions for your skin to heal itself," which shifts the focus from active intervention to strategic restraint. The most effective strategy is explaining why less is more using their own physiology—showing them that their skin produces its own ceramides and sebum when given the chance, that the microbiome needs time to rebalance, and that inflammation actually prevents the cellular turnover they're trying to achieve. When patients understand they're working with their biology rather than fighting against it, and when they experience rapid symptom relief, compliance becomes easy because the results speak for themselves.