In this month’s Cosmetic Conundrums article, Zoe Diana Draelos, MD, reviews 5 popular social media dermatology trends for dermatology clinicians to be aware of.
TikTok seems to be a trusted source of skin care information for many people in the United States. Videos abound of how to put a variety of home concoctions on your face for enhanced appearance. I think it is worthwhile for dermatologists to decipher the new vernacular and have an understanding of whether the beauty ideas are safe and effective. I will present and evaluate the 5 most highly viewed beauty ideas for 2023.
Skin slugging or flooding is so named because the skin becomes hyperhydrated. The skin is first cleansed and then left wet followed by a thick application of petroleum jelly. Petroleum jelly reduces transepidermal water loss by 99% and thus occludes the skin surface. This hyperhydrates the skin, reducing fine lines of dehydration and overall plumping the skin surface to minimize texture irregularities. There is no harm from this treatment. As a matter of fact, petroleum jelly occlusion is used in dermatology frequently to enhance topical medication penetration, especially when topical corticosteroids are applied to psoriatic plaques. The main problem with this benefit from slugging is that it is short lived. Once the petroleum jelly is removed, transepidermal water loss resumes, the skin again loses water to the lower-humidity environment, and all appearance benefits are lost.
Skin cycling is a new word for an old concept used in dermatology referring to the rotation of skin care products on a 5-day cycle. For example, an exfoliant is used on Monday followed by retinol on Tuesday. This idea is that the exfoliation will enhance penetration of the retinoid, but it will also increase skin irritation. In order to minimize the skin irritation, a good bland moisturizer is used on Wednesday, Thursday, and Friday and the cycle is then repeated. The term “skin cycle” has actually been trademarked. Dermatologists commonly cycle retinoids to encourage retinization of the face and improve retinoid tolerability. A new tretinoin patient frequently applies the drug twice weekly, then every other day, and then daily on an escalating dosage routine over 4 to 6 weeks. Skin cycling is not a new concept but perhaps “consumerization” of an old concept.
Perhaps the most medically concerning trend is skin supercharging. Supercharging is the intravenous (IV) administration of vitamins and minerals in a nonmedical facility. The substances that are commonly placed in the IV bag include magnesium, B complex, vitamin C, zinc chloride, glutathione, selenium, and biotin. Several celebrities have touted how fresh and wonderful their skin looks after the IV treatment, which has tremendously increased its popularity among young girls. My concerns include facility cleanliness and the skill of the person placing the IV. I am also concerned about the sterility of the IV bag and the safety of vitamin and mineral infusions directly into the vein. There is no evidence that IV vitamins and minerals are more effective than oral vitamins and minerals, unless the patient has gastrointestinal absorption problems.
Dopamine beauty is an interesting concept based on the wearing of garish colored facial cosmetics. The face is adorned with feathers, glitter, and jewels while the eyelids are painted in bold, dramatic colors. The idea here is that the wearing of cosmetics and an adorned face increase serum dopamine levels, leading to a sense of well-being.
Retinol sandwiching is a concept that is also well known to the dermatologist. Here, a moisturizer is applied to the skin surface followed by retinoid application, and then another layer of moisturizer is applied on top. The retinoid is “sandwiched” by the moisturizer. In the social media space, this technique is touted to reduce retinol cosmeceutical irritation, and I think most dermatologists would agree that this same effective technique is used to minimize irritation from prescription retinoids, such as tretinoin and tazarotene. There are conflicting reports in the literature as to whether the effectiveness of a moisturizer-sandwiched drug is compromised. Again, this is an old concept with a new name.
Zoe Diana Draelos, MD, is a consulting professor of dermatology at Duke University School of Medicine in Durham, North Carolina, and the Editor in Chief Emeritus of Dermatology Times.