Adding Prescription Products To Your Skincare Routine

Airdate: 1/10/14

Your doctor wrote you a prescription for a skin care treatment. Now what? How do you use this new product with your other skin care? What goes on when? Do you have to wait after washing your face? The confusion ends here as Paula and her longtime co-writer and researcher Bryan reveal what they discovered about how to use various prescription topicals with your daily skin care—and get the best results!

Paula Begoun: Hello, I’m Paula Begoun, the Cosmetics Cop, here with my co-writer and research director, Bryan Barron. We’re the bestselling authors of “Don’t Go to the Cosmetics Counter Without Me.” We’re here to keep you beautifully informed so you can make the best decisions about everything from skincare to makeup, hair care, Botox, cosmetic surgery, everything. You name it, we’ll discuss it, tell you the truth, and take your questions on our Facebook page.
00:00:27 Today we will be talking about when to add prescription products and how to add them to your skincare routine. It’s a big deal because a lot of women are using Retin-A or Renova or topical antibiotics or even oral antibiotics for acne, Rosacea, the list goes on and on. There is psoriasis, there’s eczema, there’ s all kinds of things that get prescribed for the skin that are necessary, that actually make a huge difference.
00:00:56 And we’re going to tell you how to use those - because you still have to take care of your skin. Unfortunately the dermatologists in the world, the aestheticians in the world are clueless. They’re so busy selling their own products - not that I’m against anybody selling their products, but they’re so busy selling their own products and they don’t know what’s in the products they’re using. They actually make matters worse or they tell you to just go use soap which will absolutely make matters worse.
00:01:24 And a big secret that is now not going to be a secret anymore is that Bryan, who is really the brains behind the books and the work we do for Beautypedia,, which is the Paula’s Choice information/product review section of the company.
Bryan Barron: Yes.
Paula Begoun: You are celebrating an anniversary.
Bryan Barron: I am.
Paula Begoun: You are.
Bryan Barron: Yes. Yes. It is the one-year anniversary since I quit smoking.
Paula Begoun: And we know long this has been between us. I mean -
Bryan Barron: Yeah.
Paula Begoun: And you hid and I complained and I chastised and begged.
Bryan Barron: We used to travel together and I would sneak away for a cigarette and Paula would be like, “Were you smoking? Were you smoking?”
Paula Begoun: Actually, I want you to know, and we’ve been together for 14 year, right?
00:02:11 14 years.
Bryan Barron: Yeah.
Paula Begoun: I never, ever smelled cigarette smoke on you. How you did that is really one of the more astounding -
Bryan Barron: I don’t know how I did it, because now since, when you stop smoking your sense of smell comes back in spades. And your sense of taste, which is why a lot of people gain weight after they quit because all of a sudden it’s like going from black and white to color with fool.
00:02:33 Food tastes really good.
Paula Begoun: Oh, you actually notice that big a -
Bryan Barron: Oh yes!
Paula Begoun: Wow.
Bryan Barron: Absolutely. Yeah. Huge, huge difference.
Paula Begoun: You know, the other thing separate from that you never stunk of cigarette smoke, and I’m very sensitive as it is. I mean, I have no sense of smell and I can smell cigarette smoke on something. I can tell when my boyfriend has snuck a cigarette and he tries to rinse his mouth out which just, I said, “At least if you’re going to sneak, don’t try to cover it up, because then I just get more angry.”
00:03:02 But he, I mean, I can’t believe you never, never ever smelled of cigarette smoke. But the other thing you don’t have, which also pisses me off, because I bet you it would have made a bigger difference for you is you don’t have any lines around your mouth from sucking down a cigarette.
Bryan Barron: Ooh.
Paula Begoun: Because women and men who smoke frequently, by the time they’re in their thirties have deep lines or beginning lines around their lips and that sunken lip look, because smoking creates necrotic skin, meaning it kills skin cells, mutates skin cells, and breaks down collagen severely. You don’t have—
00:03:42 I wish you had more side effects is what I’m saying, Bryan.
Bryan Barron: I was done. I was just done.
Paula Begoun: I’m so glad.
Bryan Barron: And I think what helped, and I’m not encouraging anyone who smokes to keep smoking, but I was never a heavy smoker. I was never a pack-a-day smoker. In all the years I smoked, and more than I care to admit, I was never a really heavy smoker.
Paula Begoun: Now, you’re husband, Ben, did he stop, too?
Bryan Barron: Yes! Yeah.
Paula Begoun: Oh, so you’re having your joined one-year anniversary?
Bryan Barron: Yes.
00:04:10 Yeah, he stopped, too, because we tried quitting at various times before where one quit and the other didn’t. And it was just too hard.
Paula Begoun: That wouldn’t work.
Bryan Barron: It never worked. And then the other person felt guilty that the quitter started smoking again. And on, and on, and on. So, we made a pact to do it this time and do it for real. And we were both serious about it. And we both got to the point where we just thought, you know what? We’re done.
00:04:32 It’s now or never. We’re both almost 40, you know.
Paula Begoun: It’s interesting. We talk a lot in our company and on the show and in everything we write about sun damage and the terrible impact of sun damage on skin. Cancer. Everything. Aging. Premature aging. Brown spots. The works. You know, but we don’t talk about smoking. A lot of people smoke. It’s still a major bad habit, dangerous habit.
Bryan Barron: Millions and millions.
00:05:01 Especially in other parts of the country. Like in China and India.
Paula Begoun: The world. Although given the global world that we are all part of the same global country. But, yeah, it’s incredibly dangerous for many reasons. But it is absolutely skin aging. That smoke is wafting up across your face and that smoke is deadly. There’s no way around it.
00:05:27 The research about it immediately killing skin cells, immediately breaking down collagen. I don’t care what skincare product you think you’re going to buy that’s going to undo sun damage or undo smoke damage or second hand smoke damage - it’s a fool’s game. It doesn’t work.
Bryan Barron: And there’s a lot of reputable dermatologists and plastic surgeons that will not do a procedure or operate on you until you quit, because continuing to smoke significantly affects your healing time.
Paula Begoun: God, I wish all physicians did that. Refused Botox. Refused IPLs.
Bryan Barron: That’s why I said “reputable.”
Paula Begoun: Reputable.
00:06:05 Well, and at the very least surgeons will say you can’t smoke two to three weeks before and two to three weeks after, which I guess is something. But obviously it would be better not to. So, before we - so congratulations, Bryan.
Bryan Barron: Thank you.
Paula Begoun: And before we jump into talking about when to add and how to add prescription products to your skincare routine, you know, obviously one of the things we do for a living is critique, and review, and analyze other company’s products and -
Bryan Barron: Paula is a little worked up.
00:06:45 She hasn’t been on the mic for awhile.
Paula Begoun: I can barely - I don’t even know how to do this without stuttering and stammering and I want to make the point - some companies do great products and great formulations. They might make obnoxious claims and really just so upsetting because of the claims. However, they’ll make great products. And I’m actually going to jump - I’m going to talk about a Clarins product. But I have to mention that I just edited the review we did of a line of products called Kora by a Victoria’s Secret model.
00:07:24 Remind me her name. I’m not remembering her name.
Bryan Barron: Her name is Miranda Kerr.
Paula Begoun: Miranda Kerr. I don’t want to say anything bad about beautiful women, beautiful models. They can have incredible brains.
Bryan Barron: She’s gorgeous.
Paula Begoun: They’re as smart as Harvard grads would ever -
Bryan Barron: She’s an Australian native, I think. Well, I think she’s an Australian native.
Paula Begoun: This one, I can’t speak to her brains, but I can speak to the fact she knows nothing about skincare. Some of the worst products we’ve reviewed in a long time. But I’m not going to rag on Kora, that line, but it will be up on—
00:07:56 Actually by the time people hear this show it’ll be on up
Bryan Barron: Yeah. It’ll be up on the site.
Paula Begoun: But let’s talk about Clarins Shaping Facial Lift Lipo Drain Serum. So, for the most part -
Bryan Barron: There’s like so many things wrong with that name!
Paula Begoun: So, mostly what was so disturbing was the little video they have on YouTube demonstrating how you’re supposed to take a good portion of your life and massage this stuff into your skin, sweeping up and over the face.
00:08:34 So, before I talk about how ridiculous, useless, time-wasting that is. I mean, it’s not bad for skin, it’s just such a waste of time. But more significantly is the claims they make that Clarins is the number one serum - I don’t know what they mean by that, because they’re not saying selling. I don’t know what number one serum means - in Asia.
00:08:59 First of all, Asia is a huge part of the world. It includes India. It included China. It includes Japan. I mean, I could go on and on and the number of countries, I mean, we’re talking 2, 3 billion people in whatever they mean as Asia. I don’t know what part of Asia they’re talking about. But globally, that product isn’t even available in India, at least not the last time I checked. And, that’s a billion people who aren’t using it. It isn’t the number one anything in that part of the world.
00:09:30 It isn’t sold in a number of parts of the Asian world, so that claim is just bizarre. However, one of the things about many East Asians, in terms of China, and Japan, and Korea, is they do have this thing about how you massage a product into your skin. But they also use dozens of products to take care of their skin. Talk about a culture that overdoes skincare. But the notion that this product, with the claims that it contains horse chestnut to drain puffiness.
00:10:04 It’s not true. That’s not what horse chestnut does. “Blue button flower refines by reducing trapped fat.” Not quite sure how button flower could possibly do that. It doesn’t. Because then we would all be skinny because we would apply it to where there’s fat any place on the body.
Bryan Barron: Well, but specific to the face, as we age we start losing fat.
Paula Begoun: You want -
Bryan Barron: You want your fat in the face because that’s what gives you a more youthful appearance.
00:10:32 Women are having fat injected.
Paula Begoun: Yes!
Bryan Barron: Because it’s gone.
Paula Begoun: Actually, it’s kind of funny that the cosmetic world…
Bryan Barron: It all goes to our middle.
Paula Begoun: …hasn’t quite gotten…yeah, leaves the face…hasn’t quite caught on to, it isn’t just collagen breakdown that does something special, hurts the skin and causes aging, but fat breakdown. So, if anything you want a product that increases whatever trapped fat means. Or, well, because fat is in a cell, so I guess you flatten the cell when the fat leaves it.
00:11:04 So, maybe that’s an accurate concept. That blue button flower isn’t going to do anything about it. It’s a joke. And, you don’t want to lose fat on your face. You definitely don’t want to lose it universally. You want more of it on your cheeks, your forehead, under - even under your eye, because the eye sinks down and gets puffy.
Bryan Barron: Absolutely. Avoid that hallowed look.
Paula Begoun: So, for $75, I don’t even know what the ounces are. They don’t tell - oh, 1.7oz.
00:11:29 So, actually it’s not wildly expensive.
Bryan Barron: Pretty standard size.
Paula Begoun: But it is wildly ridiculous.
Bryan Barron: I’m sure it’s wildly fragrant.
Paula Begoun: And the little video, it’s worth it if you’re only going to laugh at it and not do it because it’s such a waste of time. All right, that video, I just - I hate the cosmetics world sometimes. Okay, so let’s talk about when to add prescription products or how to add actually prescription products to your skincare routine.
00:12:00 This article took a lot. This was quite the group effort between…
Bryan Barron: It did.
Paula Begoun: …you and I, was it Nathan, or was it - ?
Bryan Barron: Well, Nathan read one of the drafts, the proposed final. But even before we started writing it we consulted our entire Paula’s Choice customer service team because we wanted to know what questions they’re getting from our customers who are using prescription products and calling us saying, “I’m confused. I have this 4% hydroquinone skin lightener from my doctor. Can I use that with your retinol serum?
00:12:36 Okay, I can, great. What goes on first? Does this skin lightener go on after I use the toner or before the exfoliant?”
Paula Begoun: It’s complicated.
Bryan Barron: It’s complicated and it’s hugely confusing. And what you found, because you really delved into - or attempted to delve into the research, is that there is hardly anything out there.
Paula Begoun: There’s nothing out there.
Bryan Barron: To go on.
Paula Begoun: We didn’t find a thing. Not a study.
00:13:00 Not even on dermatologist websites. Nothing. We found not a shred of information about how to incorporate any topical prescription medication with any skincare routine.
Bryan Barron: There’s lots of research on, for example, tretinoin, the active ingredient in Renova and Retin-A. What it does. How it works. Potential side effects.
Paula Begoun: Differin.
Bryan Barron: Yeah. How Differin or tazarotene, which is Tazorac, works for acne. How the different topics psoriasis - tons of research about how it works…
Paula Begoun: Azelaic.
Bryan Barron: …and how we know it works on skin.
Paula Begoun: Azelaic acid.
00:13:35 I mean, the number of different medications out there - and their benefit. I mean, we’re not - there’s no way we’re criticizing any type of topical medication.
Bryan Barron: Oh, no. They all - depending on what your concern is, what your need is, they can be incredibly helpful.
Paula Begoun: Incredibly helpful. So, if you are prescribed a topical medication, what needs to be said for almost every single one that is available, maybe not cortisone for eczema, because that by definition is an anti-inflammatory. But you would make eczema worse.
00:14:19 If the products you use contain irritants, and don’t contain anti-inflammatories. If you use products that use - cleansers that use strong detergent cleansing agents. Products that contain alcohol. Products that contain irritating plant extracts. And the list can go on and on. Everything from - every essential oil practically that’s on the market. Is vanilla an essential oil? I don’t think vanilla is an essential oil.
Bryan Barron: I don’t think it would be considered an essential oil.
Paula Begoun: It’s a flavoring.
Bryan Barron: It’s a flavoring. It can be used for some fragrance.
Paula Begoun: [Crosstalk] turned it into an oil.
Bryan Barron: It’s got some beneficial compounds in it and far fewer of what we call irritating fragrant components.
00:15:02 For example, rosemary is a tremendous antioxidant. It has some very, very powerful antioxidant capacity to it, but it also has some fragrant components that while they exhibit antioxidant activity, they’re irritating at the same time.
Paula Begoun: They’re irritating! Right.
Bryan Barron: So, our mode of thinking is given the number of antioxidants out there with research behind them showing that they work without hurting your skin.
Paula Begoun: No irritation potential.
Bryan Barron: Why settle or bother with antioxidants that while they can be good for skin it comes with a price?
Paula Begoun: It comes with a problem.
00:15:32 A serious problem for skin. And that includes lavender, particularly. I mean, we point out lavender because, one, it’s gloriously beautiful to smell. It is also sensationally bad for skin. On and on. Eucalyptus, menthol, peppermint, [unintelligible], bergamot, tea tree.
Bryan Barron: Geranium. Those are the ones we see quite a bit. All the ones you just mentioned show up more often than you would think. And they are notorious for being in natural lines and they are a brilliant example of how a natural ingredient, just because it’s a plant doesn’t mean it’s great for skin.
Paula Begoun: Cinnamon shows up.
00:16:06 Synthetic fragrances. Linalool. Citronella. The citruses. On and on. Lemon. All of those things will absolutely cause you to have negative - one is that prescription medications can be irritating. Almost all of them. Topical prescription medications can be irritating.
00:16:28 If you use skincare products that make the irritation worse, you’re doomed. You won’t get the results you’re hoping for.
Bryan Barron: So, let’s stop there for a second because you bring up a good point in that you mention that all prescription topical medications are irritating or can be irritating.
Paula Begoun: Yeah.
Bryan Barron: So, one of the questions we get from women is, “Why is that type of irritation okay but I can’t use a toner with alcohol that I like because you say it’s irritating?” So, it’s like where do I draw the line.
Paula Begoun: Oh, that’s a very good question.
Bryan Barron: So how would you answer that?
Paula Begoun: Okay.
00:17:03 How would I answer that? So, after you’ve tried all kinds of skincare products, hopefully you’re using good skincare products because if they’re irritating they won’t make whatever disorder you’re dealing with worse. You do have to turn or consider turning to prescription medications. For whatever reason, the way these are formulated and what they do to skin, their activity on skin causes irritation.
00:17:30 The overwhelming benefit means that in order to get that benefit, again, for whatever reason these ingredients exert their energy on skin, there is a negative that comes with it. But the positive, again, if you can take care of your skin without these items, yes, in the long run that would be best for your skin. But, products like topical anti-acne medications, the ingredients that can fight Rosacea, psoriasis, seborrhea, many different skincare disorders, if you choose the stronger skin lightening ingredient, hydroquinone, particularly in the higher concentrations, you will absolutely get benefit and they do come with the potential for irritation.
00:18:23 Is the irritation good? No. The irritation isn’t good. But you will only if after trying over the counter products, meaning regular skincare products, and you’re not getting the benefit, then that it is your only other option. You can’t stay searching for skincare products for the rest of your life to try to deal with, hope you’re not running into the bad ones, if you haven’t checked out Beautypedia. But to really get results, particularly for disorders like severe eczema, psoriasis, seborrhea, Rosacea, some severe forms of acne, you’re just not going to find anything in the world of skincare.
Bryan Barron: That’s going to get you all the way there.
Paula Begoun: Uh-uh. Yeah -
Bryan Barron: You need help.
Paula Begoun: You need help.
00:19:07 You need the prescription medication. So, the irritation isn’t okay, but in terms of options, if you want to deal with these other disorders, there isn’t an option.
Bryan Barron: Yeah.
Paula Begoun: So, to make it easier for your skin, to counter the irritation, these helpful medications have, and also especially if they’re loaded with antioxidants, one of the things antioxidants do for skin is reduce irritation. They’re anti-inflammatories, especially the ones that don’t have irritant potential in their component the way they’re made naturally.
00:19:45 Then what you’re going to be getting is a better result for your skin. You will counter some of the, if not all of the potential irritation from these topical medications, and building collagen at the same time. You won’t break - that’s the risk, right, is that with these topical medications you could get elastin breakdown and collagen breakdown.
Bryan Barron: Yes.
Paula Begoun: But when you load the skin up with these healthy, the barrier protecting ingredients, when you load the skin up with these healthy, gentle ingredients, you’re not using irritating cleansers that breakdown the barrier. Then you will not only counter the irritation from the prescription medications, you’ll actually improve skin in tandem, in combination with what the prescription medications do.
00:20:35 Does that make sense?
Bryan Barron: Yeah!
Paula Begoun: Did I over-explain? I always over-explain. I can’t help myself.
Bryan Barron: But, I think in that case, it’s a complicated issue. And so I think the over-explanation there was needed.
Paula Begoun: Okay, all right. Thank you. But you can cut me off when I carry on too long, because lord knows I can. We’ve written thousands of pages together.
Bryan Barron: I know. Well, listeners, you can go to the Contact Us page and email me and just say, “Will you please tell Paula to stop talking so much?”
Paula Begoun: Ha! Let’s get to the next point.
00:21:05 So, the next point - was there another question you wanted to ask? I think I just interrupted you.
Bryan Barron: Oh, I was just - no, I’m just moving us along to the next section.
Paula Begoun: So, the next section is what do you use then. And the short answer is exactly - almost exactly - what you would use otherwise. You need a gentle cleanser, appropriate for your skin type.
Bryan Barron: So, the question we’re answering then is, okay, I have a prescription from my doctor. It doesn’t necessarily matter at this point what it is, but it’s a topical prescription for my face. Does my skincare routine need to change as a result of this?
Paula Begoun: Probably not. What skincare is always about is your - aside from great ingredients, exfoliation, sun protection…
Bryan Barron: Sun protection.
Paula Begoun: …gentle cleansing. And then special needs. The kind of moisturizer you need. If you want to add extra products like serums, if you have a recent wound and you want to use a scar reducing serum. You want some special treatment for your skin discolorations, like a vitamin C product. At Paula’s Choice, our product line, our Pure Radiance for example.
00:22:17 All of those can and should be used. There isn’t any reason to shortchange your skin. I just realized, am I answering your question, or did I just go off on a tangent?
Bryan Barron: You’re answering it.
Paula Begoun: Okay. Good. So, the basics are critical. You still have to clean your face. You still have to moisturize your face. You still have to wear sunscreen. You need to load up your skin with antioxidants, barrier repair ingredients and soothing agents. I still believe firmly that you need to exfoliate. Some skin types can’t do that, but you absolutely can and should consider it.
Bryan Barron: That is a huge question, especially when women start using a retinoid.
Paula Begoun: Okay.
Bryan Barron: Because there’s the mistaken notion that Retin-A or Renova exfoliates.
Paula Begoun: Peels skin.
Bryan Barron: So they don’t think they need the AHA or BHA anymore.
00:23:11 Or they think it’s too much.
Paula Begoun: Right. That’s a great question. So, to be clear, the skincare products you use are always based on your skin type. If you have dry, normal to dry skin, normal skin, normal to oily skin, blemish prone skin, you always use the products that are designed for your skin type. And there are some exceptions. Like, for example, if you’re using a topical antibiotic to control your acne because you tried benzoyl peroxide and it didn’t work, you wouldn’t use benzoyl peroxide and the topical antibiotic.
00:23:48 In fact, it would be counter indicated. You wouldn’t want to do that. But, other than that, other than - even if you’re using a hydroquinone-based skin lightening product, it absolutely can be beneficial to use other gentle products from, you know, regular skincare products that contain good amounts of vitamin C or good amounts of other so-called natural or derived from natural ingredients that can improve skin color.
00:24:19 Absolutely you can use those and probably should be using those in tandem with hydroquinone because it only adds to the - hydroquinone is not going to erase all of the skin discoloration, so it can be incredibly beneficial to still consider using those.
Bryan Barron: That is a very good point. When it comes to fighting brown spots, all of the latest research has shown that a multi-faceted approach is the best. Do not put our hopes into one skin lightening ingredient. Even hydroquinone, no matter how much research it has - like for example, with our hydroquinone products we added the exfoliating step.
Paula Begoun: Right.
Bryan Barron: We have the one with the AHA, the one with the BHA, and those both help increase the efficacy.
00:25:01 But then the other key component that a lot of people tend to forget about or aren’t really great about doing every day is the sun protection.
Paula Begoun: Can you believe that?
Bryan Barron: Prescription or not, no skin lightening product is going to lighten that dark spot or that patchy unevenness, the Melasma, if you’re not - really by that point you have to be neurotic about sun protection.
Paula Begoun: Neurotic.
Bryan Barron: Every day.
Paula Begoun: And sun smart.
Bryan Barron: Yes. Don’t slather SPF 50 and think you can sit on the beach all day. You need your hat. You need your umbrella. You need to avoid the sun during peak hours. It’s a big deal.
Paula Begoun: It’s a huge deal.
00:25:33 Actually, I can wax poetic now that I’ve been spending more time in Hawaii about the bad sun behavior I see and the incredible leathery skin on women over the age of 40 who obviously have been in Hawaii a long time and have just hammered their skin. But that’s another show. The point is that if you’re using topical prescription products of any kind, it has nothing to do - you absolutely can’t drop out the sunscreen step.
00:26:05 You actually shouldn’t really drop out just about any step. The only step I can think of dropping out is you wouldn’t add, if you were using a hydroquinone - so, we mentioned that if you’re using a topical antibiotic for acne like, oh god, Clindamycin -
Bryan Barron: Erythromycin.
Paula Begoun: Erythro-Dapsone, that also contains benzoyl peroxide.
Bryan Barron: If you’re using a topical, like a BenzaClin, which has Clindamycin and benzoyl peroxide.
00:26:33 Any type of antibiotic with benzoyl peroxide, you don’t need that over the counter benzoyl peroxide product, too.
Paula Begoun: I probably would suggest not using a benzoyl peroxide product with a topical antibiotic. You can always ask your physician about that, but I suspect that there could be some - well, actually I don’t know 100%. I haven’t done the research on that one.
00:26:57 I would wonder if it would be too high a percentage, because one of the things about the - what did you call it? I never remember names. Ben - ?
Bryan Barron: BenzaClin?
Paula Begoun: BenzaClin. Is that it only contains 0.5% benzoyl peroxide. In that amount it’s actually not working as an antibacterial agent to fight the acne causing bacteria, but it’s actually working to reduce inflammation. Don’t ask me why. It’s a very complicated - you don’t want me going off, waxing about how that works in a low concentration.
00:27:29 But that is absolutely what the research shows. So, I think it might be negative returns to also use benzoyl peroxide along with any topical antibiotic, whether it contains benzoyl peroxide or not. And then hydroquinone. If you’re using a 4% hydroquinone from a physician, because that is what only can be dispensed by a physician, you wouldn’t then want to use a product like ours that also contains 2% hydroquinone.
00:27:58 You wouldn’t want to put that much. I mean, it’s tempting.
Bryan Barron: It is tempting. But hydroquinone is one of those ingredients, it’s regulated for a reason.
Paula Begoun: Yes.
Bryan Barron: And a lot of the bad press it’s gotten over the years comes from formulations that have not followed regulations. The product ends up getting adulterated with other compounds that makes the hydroquinone even potent. That’s some of the scary stories you hear about using hydroquinone. When it’s formulated in the recommended amounts and formulated by a reputable company, not something you buy from a brand you’ve never heard of that’s selling on eBay.
Paula Begoun: Ha!
00:28:32 Isn’t that the truth.
Bryan Barron: And you’re thinking you’re getting a deal because the prescription product from your doctor would cost this much and then the doctor visit, but don’t take your chances and do that. Please don’t take your chances and do that.
Paula Begoun: It could be such a negative for the skin.
Bryan Barron: Yeah.
Paula Begoun: So, you wouldn’t want to double up on a hydroquinone product.
Bryan Barron: But you can use an alternative skin lightening product.
Paula Begoun: Right.
Bryan Barron: As you mentioned earlier, the vitamin C or the plant-based lighting extracts.
Paula Begoun: Like Arbutin.
Bryan Barron: Yes.
Paula Begoun: Like Arbutin. I mean, there are so many. The niacinamide with Ascorbyl. Glucosamine. I mean, there are many options that don’t up the ante in terms of a problem with hydroquinone.
00:29:15 If anything, they add synergistically to the effect hydroquinone has. So, only use gentle water soluble cleansers. Do not use scrubs. Actually, you know, I don’t like scrubs in general. I know I say that all the time, but let me just add that here. Ripping at the skin. Puts tiny little tears into it. Unless you’re doing it really gently -
Bryan Barron: And maybe just for extra cleansing.
Paula Begoun: And only if it’s a gentle scrub. The round beads that don’t tear into skin.
Bryan Barron: Yes.
Paula Begoun: Just such a problem. So, no scrubs.
00:29:51 If you want to use the gentle head Clarisonic or a very soft wash cloth, that’s plenty. That’s fine. Don’t tear into skin. Do use a great toner. That means a toner that contains no irritants. Very hard to find. I often feel like I’m just plugging blatantly Paula’s Choice because we are one of the few cosmetic companies out there that actually have a well formulated toner that is loaded with antioxidants and…
Bryan Barron: Several of them.
Paula Begoun: …skin repairing. Yeah, actually probably many. But, yes, because I never discontinue a product. And then I do generally for almost every skin type still recommend using either an AHA or BHA exfoliant, which one feels best or works best for your skin.
Bryan Barron: And we’re kind of going down the steps here in the order that you would apply the product.
Paula Begoun: Yes.
Bryan Barron: So, if you’re listening and thinking, okay, okay, I get it, but when does my prescription product go on?
00:30:46 We’re getting to that.
Paula Begoun: We will get to that. So, the AHA and BHA exfoliant, especially in regards to when you use a retinoid like the over the counter retinoid which is the whole vitamin A molecule.
Bryan Barron: Retinol.
Paula Begoun: Retinol. Or you’re using the prescription version, which can be anything from the active ingredient in Retin-A and Renova, which is Tretinoin. The active ingredient in Differin, which is Adapalene. The active ingredient in Tazorac which is…
Bryan Barron: Tazarotene.
Paula Begoun: Tazarotene. All of those versions of vitamin A don’t exfoliate skin. What they do is they improve cell formation. That is phenomenally helpful for skin.
00:31:34 Whether it’s retinol in a regular skin care product, or a prescription medication, the different retinoids we just mentioned, different forms of vitamin A, help skin make better skin cells. They don’t exfoliate skin. The top layers of skin are dead. And because of sun damage, they get abnormally thick. And for many skin types, they are just naturally thicker, like oily skin when you have clogged pores.
00:32:09 For some genetic reason, some people just have naturally thicker skin. When you exfoliate off that gently, that top layer of skin, other ingredients, the healthy ingredients penetrate better, particularly the antioxidants and the skin repairing ingredients. And what that also does is make skin smoother, make wrinkles look less.
00:32:32 The texture of skin -
Bryan Barron: The color.
Paula Begoun: More even color. Unclogging pores. Getting rid of blackheads. On, and on, and on. Blackheads. It makes an incredible difference. Now, is it possible that you’ll use an AHA or BHA along with your prescription medication and find it too irritating? Absolutely. However, it is worth a test, you know, with a BHA you can use a 1%, you can use the lesser amount.
00:32:58 With AHA, instead of using an 8% or 10%, you can use a 5%. So, there are many options in terms of finding the right AHA or BHA that, one, works for your skin type, and two, works with the topical prescription medications you’re using. But it wouldn’t be in our very strong opinion - and there is no research showing otherwise - that it would be a problem to use an AHA or BHA.
Bryan Barron: For sure it’s not going to make any prescription topical less effective. If anything -
Paula Begoun: It would make it more effective.
Bryan Barron: More effective.
Paula Begoun: Right. Because it would have a better chance of absorbing into skin.
00:33:32 You do want to consider applying - well, you don’t want to consider - you absolutely want to apply…
Bryan Barron: Should do.
Paula Begoun: …a sunscreen. But, now, here’s where during the day if you’re applying your topical medication twice a day, during the day, it goes on just before you apply your serum or you apply your sunscreen.
00:34:00 If you’re not using a serum, then it’s your topical medication. And then it’s your sunscreen. If you are using a serum, it’s your topical medication, your serum, and your sunscreen.
Bryan Barron: So, we’ll have to edit that article then.
Paula Begoun: What did we say wrong?
Bryan Barron: We have the serum before the prescription product.
Paula Begoun: Oh, that was a... - Well, okay, let me stop for a second.
Bryan Barron: Which I don’t necessarily see the harm in that. But I guess it depends on the texture of -
Paula Begoun: If it’s the silicone only…?
Bryan Barron: Most serums have some amount of silicone in them.
Paula Begoun: Yeah.
Bryan Barron: Whether they’re silicone based or water based, so…
Paula Begoun: Hmm. Hmm.
00:34:38 I’m going to top for - you know what it is? Oh, I got it. You know what it is? I would experiment with that one personally. Again, there’s no research on this, so we’re -
Bryan Barron: Yeah, what we recommend in the article on our site about prescription products is we recommend the prescription product being applied at step five.
Paula Begoun: But I think that that would depend on how -
Bryan Barron: If it had a different lotion texture.
Paula Begoun: Well, that too.
00:35:07 But also if it’s a strong medication, like you react strongly to Metrogel, or you react strongly to the Retin-A, or Renova, or Adapalene, if you react strongly to those medications, the serum could buffer the irritation. So, I would experiment with when you apply it.
Bryan Barron: So, I can hear the question right of, “Okay, I hear what you’re saying, Paula. But, how will the active ingredient get through?”
00:35:37 Women are always concerned with how ingredients are going to get through silicones or an oil. They think it’s an impenetrable shield.
Paula Begoun: “It’s an impenetrable shield.” Not so impenetrable. If anything, think about it - oh, we just had this discussion. Many, think about that many - well, actually, all prescription medications come in a cream form. They come in with some ingredients and the ingredient still gets through skin. In fact, many products for eczema actually come with Vaseline, come with Petrolatum. And those ingredients still disperse through the Petrolatum.
00:36:18 So, these ingredients that are in skincare products - they’re not a Band-Aid. They’re not a blanket. They’re not getting through something. They’re not being obstructed. The very ingredients we’re talking about absorb through the base that they come in. So the skincare products you are putting on, silicone is not impenetrable. In fact, if anything, one of the things that’s so phenomenal about silicone, it is very penetrable. And it also reduces - it has unique quality of maintaining hydration, keeping water in the skin and still allowing things to get through it.
00:37:05 Still allowing air to get through it. It isn’t a Band-Aid. If anything, it is a brilliant ingredient that allows skin to do many things, particularly keep things in that need to be kept in skin - antioxidants, barrier repair ingredients, and also allow things in like those ingredients to get into skin when they’re formulated in those products and also prescription medications.
00:37:29 I think that when you put the serum, I think what we need to do to change step five, versus step four - the serum, do you put that on first or do you put the medication on - I would say you need to experiment to see what works best. So, they’re relatively interchangeable depending on how your skin feels and how it reacts. But what is for absolute certain is you have to put the sunscreen on last during the day.
00:38:01 At night, then you would put your moisturizer, you would put the serum on, you would put the medication on either before or after the serum, and then you would put your moisturizer on. And that would work just fine. You will be taking very good care of your skin. We talked about whether or not to be using skin lightening products and how to do that. Scar reducing treatments, same thing. It could go on before or after your moisturizer. Before or after your serum. Those are kind of interchangeable.
00:38:33 The retinol base moisturizers, we talked about that. We do feel strongly that while there isn’t a compelling reason or research to suggest you don’t need a retinol base product, meaning a strong - in other words, when a product says it contains retinol but it doesn’t contain very much retinol, there isn’t a negative to using it with a prescription Retin-A, Renova, Adapalene. There’s not a negative.
00:39:01 However, the stronger strengths retinol products, particularly those that contain 0.5% and greater, that is probably not wise to use with a topical medication that contains it.
Bryan Barron: Yeah. I’d be careful.
Paula Begoun: Yeah. I would think that that’s overkill. You would start, I imagine, again, no research on this, but just from what we know about the potential irritation from vitamin A based medications and vitamin A based skincare products, the higher—
00:39:31 You know, when it’s a small amount, 0.1%, 0.33%, it’s probably not an issue. You would want to pay attention to what your skin is doing, but absolutely it would be overkill and unnecessary to use the higher strengths retinol. More does not always mean better in the world of skincare.
Bryan Barron: No.
Paula Begoun: Except when it comes to antioxidants and skin repairing ingredients. Or sunscreen.
Bryan Barron: It is selective in that sense. You’re absolutely right. And, again, it’s another piece of information about skincare that makes the concept confusing for so many people.
Paula Begoun: It is. Because some things you want to use not less of, but the right amount.
Bryan Barron: That’s why I love the food analogy that we use quite a bit.
00:40:10 Because in the same way that we’re saying you can’t get enough antioxidants, you can’t get enough skin repairing ingredients, as it applies to food you can’t get enough fruits and vegetables.
Paula Begoun: Oh yes you can! Actually, yes you can.
Bryan Barron: Well…
Paula Begoun: Because, think of it this way. You can’t get enough antioxidants from food, but it has to be a mix. Right?
Bryan Barron: There has to be, like, yeah, for example, you wouldn’t want to overdose on mangoes and get too much vitamin A.
Paula Begoun: Right.
00:40:34 And you wouldn’t - or carrots, to start turning orange.
Bryan Barron: Sure.
Paula Begoun: Literally orange. So, you want a mix. That’s the same thing. That we talk about all the time. You want a mix of antioxidants. You can’t get enough antioxidants, but you need a cocktail approach. Using a product that just contains one antioxidant is probably not going to do it for you and is probably actually short - not probably - is shortchanging your skin, because skin is so complicated.
00:41:04 But, there are things that can be too much. Too much hydroquinone. Too much benzoyl peroxide. So, there are some ingredients you want to titrate. You want to control how much you’re putting on your skin. Other ingredients you can’t get enough of, like antioxidants from a diverse diet, for a diverse number of different antioxidants and skin repairing ingredients for skin. Then you want to load it up because the environment is constantly taking those out of skin.
00:41:31 Age is taking them out of skin. So, that’s why our fundamental philosophy here at Paula’s Choice is we load almost all of our products, except our cleansers, we load them with antioxidants and skin repairing ingredients. And the reason we don’t do that with cleansers is what a waste of time. They’re just rinsed down the drain. What a waste of ingredients for no reason. So, did we get to everything.
Bryan Barron: I think we covered everything. And all of the information that we’ve been talking about is in one of our expert advice articles at
00:42:05 This particular piece on how to use prescription skincare - how to use prescription products with your skincare routine, it’s filed under basic skincare tips. You can find it under our anti-aging section and under our acne section. Because this is such a huge topic for so many people, we didn’t want to just put it one area. We wanted to make sure that this article got found.
Paula Begoun: Everybody could find it.
Bryan Barron: Because the other thing is that I had a hard time finding another site that presented this information in one concise way the way that we do.
Paula Begoun: We are it.
Bryan Barron: And that’s shocking to me. the number of beauty blogs and content out there.
Paula Begoun: Well, they’re going to start copying us now, I’m pretty certain.
00:42:43 We’ll start seeing it around.
Bryan Barron: We see that more often than you think.
Paula Begoun: I read something and I go, “Wait, didn’t I write that?” And I go, “Oh, yeah, I did,” and another site has it. But the information is most important.
Bryan Barron: Yes.
Paula Begoun: This information is very important. And we love that you’re listening to us because hopefully that’s why we’re sitting here talking -
Bryan Barron: Somebody out there is getting something out of this!
Paula Begoun: They do tell us they’re listening, right Bryan?
Bryan Barron: Yeah!
Paula Begoun: Okay.
00:43:09 Good. I just wanted to make sure.
Bryan Barron: They’re glad that we’re still doing this, because we stopped for awhile and then they said, “Why did you stop? We kind of liked that.”
Paula Begoun: We’re back. We’re back. So, I’m Paula Begoun, Bryan Barron with me. We are the co-authors of “Don’t Go to the Cosmetics Counter Without Me.” Bryan is Research Director at Paula’s Choice.
00:43:32 We’re working on another book, but don’t tell anybody. And come back to and listen to all our archived shows, and find our articles. Stay beautifully informed. You will make far better decisions for your skin and save money. Thank you for listening.
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