Ep 44: TikTok Skincare Hacks That Work & Those to Avoid
Dr. Teo: Hi guys and welcome to this week’s episode of Dermatologist Talks: Science of Beauty. I’m Dr. Teo Wan Lin of TWL Specialist Skin and Laser Centre and today we’re going to talk about various TikTok skincare hacks and how they might be dangerous for your skin.
Chelsea: First of all, let’s talk about microneedling. Microneedling is a cosmetic procedure popular in many aesthetic clinics that involves pricking the skin with small needles. The theory is that the small wounds cause the skin to start it’s wound healing processes, and produce more collagen and elastin to heal the skin. Well, there has been a rise of a worrying trend to do with at-home microneedling. Is microneedling safe to do at home? What are your thoughts on that?
What is microneedling?
Dr. Teo: Microneedling, in my opinion, may be considered a little archaic. The reason why I say this is, while there are in-office microneedling treatments, these are certainly not state of the art type of treatments that minimise tissue trauma while stimulating collagen production. Well, the key concept is you are trying to introduce micro-perforations in your skin to increase the absorption of certain products. However, if you’ve ever had a microneedling procedure, you’d know that it can leave bruising, marks and punctures in the skin. It can also be painful for the individual that’s undergoing the treatment.
My personal opinion as a dermatologist is that there are so many other treatments available that have a focused result. For example, for acne scarring or any other types of scarring. Physical therapy whether it is in the form of laser treatments – ablative or non ablative lasers. These have specific cellular actions. If you’re just talking about superficial skin treatment at the level of the epidermis, there are chemical peels. All of these procedures can also increase product absorption.
Skincare hacks are usually cost-effective, but can come with a price
Microneedling on its own has been recommended as a cost-effective way say in, less developed countries. It is an alternative to CO2 laser treatments for acne scarring. On its own, it is not as effective unless you are pairing it with a cosmeceutical. The other thing is that both the cosmeceutical and microneedling instrument in theory should be sterile. This is because it involves skin punctures. Also, a medical professional should be the one performing the procedure.
In that sense, I don’t think there is a lot of evidence for microneedling as an aesthetic intervention. The ways of increasing cosmeceutical absorption that are noninvasive or in a sense, doesn’t traumatise the skin would include the novel use of materials. So that’s what our company, the biomaterials arm does. We use polymers that alter the skin microenvironment as well as functional textiles.
The key concept to understand is that if anything damages your skin barrier. Firstly, there is always a chance of side effects, specifically irritation. There will be certain patient groups that we end up seeing, who perhaps you would call unfortunate, can get infections. So we’re not just talking about typical skin infections. If you’re using non-sterile, non-disposable equipment, especially at home, this can be dangerous.
Chelsea: Would washing the needle with antibacterial soap and tap water work? Why is this so dangerous?
The dangers of non-sterile needles
Dr. Teo: The reason for this is because of a certain type of tap water bacteria that can occur even on perfectly clean instruments. Beauticians, for example, often say ‘it is brand new’, but do not autoclave it using gamma rays, which is the standard in medical surgical procedures. You can certainly contract mycobacterial infections. Cutaneous mycobacteria infections I’ve seen these cases before. Microneedling in theory has a slightly lower risk, but it is still important for us to appreciate that non-sterile microneedling instruments are not exactly safe for use. I have seen patients with mycobacteria infections that arose after facial extractions by beauticians and these have to be treated with months of oral antibiotics.
Chelsea: I’m familiar with blue and red light therapy in the clinic setting. What about at-home LED light devices? Can they benefit the skin?
Are LED light devices safe to use at home?
Dr. Teo: I would love to share a little bit about these at-home LED device skincare hacks. It is actually a very established skincare trend. My main concern is the devices that are available without eye protection. The size of the device limits the efficacy of home devices. The studies so far for LED lights exist only for in-clinic treatments with the ability to generate higher energies. For smaller handheld devices, I am not sure if it is even able to generate a fraction of what is required, or whether it is effective based on the studies. Nevertheless, it is true that red light, for example, does stimulate your skin’s mitochondria which are the powerhouses to produce more collagen and also to enhance the cell processes that enable cell renewal to occur more efficiently.
The relevance of eye protection in light therapy
What is relevant is for consumers to realise is Neutrogena, which is actually one of the most established brands in the world that work with dermatologists. They were amongst the first to launch light therapy mask. They actually recalled the masks due to concerns that there could be some level of retinol damage. Now, it is definitely a decision that they took erring on the side of caution, because of certain at-risk users. For example, those with photosensitivity conditions such as lupus autoimmune diseases.
Nevertheless, it is sometimes difficult for us to predict when it might happen to an individual especially if there is no light protection for the eyes. So in the clinic, we always have opaque, black goggles and the treatment is of course with a huge machine. There are brands that offer these light therapy masks with eye protection and I think that would be the gold standard for home treatment because there is evidence that these lights in particular, stimulate parts of your skin physiology that may be beneficial.
Chelsea: That makes sense because apart from the mask that you’re putting over your skin, it’s also covering your eyes – so we can’t forget about eye protection as they’re one part of the face that are so sensitive. I’ve also heard of DIY homemade scrubs such as “coffee granule” face scrubs, putting baking soda on your face or sugar lip scrubs.
What’s the science behind DIY face scrubs?
Dr. Teo: On the topic of DIY skincare hacks, I have come across is sugar lip scrubs which I think is quite cool and fun. It’s not a bad idea – firstly it is edible, sugar is edible. The problem is I’m not totally on the side of recommending scrubs in general. Sugar itself is a coarse granule, which is going to be harsh on the lips. The lips are part of your skin, but it’s a very special part known as the mucosa. It is far more sensitive than the rest of the skin on your face.
The lip scrub that we compound in the pharmacy is from a phytoceramide formula. So if you’re familiar with phytoceramides, they are ingredients from plant seeds oils or their nuts. Nuts, for example, when you extract it, you get a lot of good fats. These can repair the barrier and is also an edible formula.
The Barely There Lip Scrub contains solid state crystals that gently exfoliate. Hence effectively removing rough and dry skin without irritating your lips. The crystals then dissolve into a moisturising serum, leaving you with soft, smooth and hydrated lips.
Above all, it is important to recognise that there is a need for some sort of physical exfoliation of the lips. Because we often feel or see flaking on our lips and when we remove it, it’s easier to apply glosses and lip balms. But we should also address the reason of the flaking. It’s commonly cheilitis, a condition which is synonymous with lip eczema. What happens is there is first a defect in the barrier function of the lips, then the inflammation begins, leading to flaking. In the case of the phytoceramide lip scrub, it is using microcrystals which encapsulates the phytoceramides so that when you rub it into the lips, it essentially disappears, and it also have an additional cosmetic effect of removing the flakes, and it also works as an emollient.
Can putting various foods on facial skin be beneficial?
Chelsea: There’s definitely been skincare hacks on putting various foods on our face – such as applying apple cider vinegar or turmeric face masks on the face. On their own, as a food, we know that this can bring various health benefits. But can it really help with our skin?
Dr. Teo: Using apple cider vinegar or turmeric mask is kind of interesting. If you were to do a literature search on these active ingredients, you’d find that there is scientific evidence that suggests that these are potent antioxidants. The key thing is that these active ingredients have to be extracted and formulated in a way that it is non-irritating and retains its potent cosmeceutical effects, while functioning as a cosmeceutical.
There is an issue here I want to remind our listeners. You really should not make your own skincare – don’t boil it, cook it or mix it up in your kitchen. Simply because cosmeceutical formulations have to be firstly, stable. Secondly, it has to be compatible with your skin, it has to be non-irritating. Furthermore, the concentrations that are present in food is so high that it is more likely to cause irritation in individuals who do not have an allergy, but simply do not tolerate the pH of this ingredient. I think in terms of efficacy, when it is in the form of food and you are applying it to your skin, I’m not sure if it is able to penetrate the skin.
Will powdered foods penetrate the skin better?
Dr. Teo: I think the commonest example of a potent superfood or antioxidant that’s available in a powder form is turmeric. If you’re actually applying the turmeric powder on your facial skin, I don’t think that this is a viable method of absorption. Powdered formulations as skincare hacks, firstly, absorb extremely poorly. The only application of powders would be in the form of astringents to absorb excess moisture say in hyperhidrosis – excessive sweating.
The main side effect is dryness from the powder formulations. So, if you are going to be using these DIY masks as skincare hacks, you really have to bear in mind the concentration of the active ingredient and the actual formulation. Whether or not it is cosmetically acceptable, practical, and if your skin is going to accept it. So in the first place if it can’t be absorbed, you may never see an effect. Absorption has to take place via the stratum corneum.
The risks are also very real. There is a high risk of irritant contact dermatitis and there will be people who are allergic to turmeric powder itself. So in cosmeceutical formulations, these would be in the 0.01% or 0.1% range and the bulk of it would be in a vehicle, which enables the product to be effectively absorbed by the skin barrier (stratum corneum).
Chelsea: Next up, I’ve recently seen beauty blogger Sukhi Mann who posted a tutorial about skincare hacks on her how to get rid of whiteheads and blackheads. She takes two flossing sticks and scrapes them down and around the nose, then she soaks a cotton ball in mouthwash, and uses it as a toner! Is this a good DIY hack, or is it just plain dangerous?
Can the dental floss whitehead extraction really work?
Dr. Teo: Now, it’s quite interesting, so this is the dental floss whitehead extraction that we see on TikTok skincare hacks. First of all, I don’t agree with using any physical, traumatic methods to remove whiteheads. The closest effective, extraction tool that you can use at home is microdermabrasion. For vacuum microdermabrasion, it’s not correct to use the vacuum to suck out blackheads. That’s what commonly marketed as it is very gratifying. What happens is that – for whiteheads or blackheads, the debris especially for blackheads, will re-accumulate.
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I’m sure all of us who have had blackheads before understand see them come back. So the way to treat it is never about physical removal, but it’s to treat it at the microcomedonal level. This uses either retinoid with peels, or with laser treatments. Certain botanical extracts are also proven to control oil production such as chlorella, which is an algae extract. The problem with extraction of any method is that it’s going to traumatise the skin. It can cause infection and thereafter if there is inflammation, you get scars.
Chelsea: Well in the same vein of using dental products on our face. What about the age-old tip of using toothpaste on your zits? Some people swear by this hack!
How effective is using toothpaste as a pimple cream?
Dr. Teo: Yes, I have seen toothpaste being recommended by TikTok users as a pimple cream. The key thing about toothpaste is that it contains an astringent. It is also a highly alkaline substance. So, I don’t recommend that on your skin for sure. You will get skin irritation or irritant contact dermatitis. Drying out pimples is a very outdated way of treating pimples. The pathogenesis of acne is essentially in a genetically predisposed individual that leads to inflammation. This starts with microcomedones that appear on the surface of your skin after approximately 2 to 3 weeks. Then we see blackheads or whiteheads which are respectively, open and closed comedones.
The Blemish Spot Cream is a power-packed dermatologist pimple cream formulated using bioactive plant extracts to quickly reduce and inhibit spot inflammation.
Coupled by the growth of secondary skin bacteria, it can get infected and when you see a lot of pus on the face, that’s not just acne alone, it’s a secondary infection known as gramme negative folliculitis. The primary bacteria causing acne in inflammatory acne is p acnes. Increasingly, we talk about c acnes as the predominant pathogenic acne organism. When you treat acne, you want to target these all these factors for a holistic approach as well.
While we know that it’s impossible to change one’s genetics, but all acne treatments are targeted at, firstly, controlling inflammation, because that’s going to stop the comedone formation process. Secondly, we need to address scarring. So toothpaste and virtually just thinking of drying out the pimples, does none of that. There is a role an effective pimple cream plays to control seborrhea, which in medical terms referred to as excess in oil production.
Treatment for oily skin
Physical methods when applied to individuals with very oily skin, for example, zinc oxide, it can help to improve the seborrhea. Most individuals with mild or moderate acne will complain that their skin is both oily and dry. However, it’s not a paradox because most commonly they have oily skin but all the topical treatments they use such as benzoyl peroxide – which my practice has stopped using for the last five years, is not very effective. It can cause irritant contact dermatitis which is the reason why you feel that superficially, your skin is very dry. Instead, we use anti-inflammatory botanical agents.
With maskne becoming a relevant issue these days, using a benzoyl peroxide-containing acne cream or even DIY astringents like toothpaste will make the problem worse because of the occlusive effect of the face masks. So if it’s going to be drying on it’s on, when you wear a face mask in the day time, these drying effects are amplified. I’ve spoken about this in my paper on maskne, published in the Journal of the American Academy of Dermatology (JAAD) in November last year. It is also available via the COVID-19 resources on PubMed. In that paper, I have detailed recommendations for maskne and its also available in a previous podcast.
Chelsea: In this episode we’ve talked about various skincare hacks from TikTok trends such as DIY microneedling, sunscreen contouring and homemade face masks – to name a few- and how not only do not confer benefits, but may be harmful to the skin.
Well that’s it for this week’s dermatology flash briefing, you can follow me Dr. Teo on Instagram @drteowanlin for more podcast updates, and check out our website at www.scienceofbeauty.net for the full podcast transcript.