Your Skincare Routine Might Be Aging You Faster

You're doing everything right. You bought the serums, the retinols, the vitamin C. You're spending hundreds every month because you want healthy skin.

But what if I told you that most people are making two mistakes that sabotage all of it?

Recently on the Medspa Confidential Podcast, I sat down with Dr. Angela Casey, a board-certified dermatologist and Mohs surgeon who's spent decades looking at skin under microscopes.

What she told me changed how I think about skincare forever. The products you're layering on your face right now could be punching microscopic holes in your skin barrier. And once that happens, even the most expensive routine won't save you.

When More Products Mean More Problems

"When that skin barrier gets disrupted, it gets little microscopic tears in it. Think of that piece of Saran wrap and you're punching a bunch of holes in it." — Dr. Angela Casey, Med Spa Confidential

Dr. Casey sees patients every single day whose skin has been damaged by their own bathroom cabinet. They're using all the right ingredients, but they're layering them wrong or using them too frequently.

Your skin barrier is supposed to protect you from the outside world. When you disrupt it with too many actives, you're letting in allergens, pollution, and bacteria while losing moisture from the inside out.

The result? Red, irritated, sensitive skin that feels like it reacts to everything. Most people don't have naturally sensitive skin. We create it by overloading our routines.

I asked Dr. Casey what the biggest culprits are, and her answer surprised me. It's not just retinols. It's the alpha and beta hydroxy acids, the vitamin C serums, even antioxidants when used incorrectly. These aren't bad ingredients. They just need to be dosed right and combined carefully.

The Retinol vs. Retinoid Confusion

"A lot of times I have patients come in and they say, 'I'm using the 0.5 retinol,' but that is much, much less potent than the 0.05% Tretinoin that I might be prescribing." — Dr. Angela Casey, Med Spa Confidential

Dr. Casey explained something critical that every patient needs to understand. Over-the-counter retinols and prescription retinoids look similar on the label, but they work completely differently.

Most over-the-counter products have to be broken down through several steps before they become active. Prescription retinoids go straight to work.

That means comparing percentages is pointless unless you know what you're actually using. Only a couple of companies have done real studies comparing their retinol formulations to prescription tretinoin.

For med spa owners and estheticians, your clients need this education before they walk out with products. For consumers, don't assume higher percentages mean better results. Sometimes they just mean more irritation.

Your Skin Has a Microbiome Too

"It's like a farm. You've got all sorts of organisms, and you have to have every piece of that farm working together in harmony to create the optimal environment." — Dr. Angela Casey, Med Spa Confidential

Your skin has its own ecosystem of bacteria, and when it's balanced, everything works beautifully. When it's not, bad bacteria like the acne-causing one or staph aureus start taking over.

What throws it off balance? The same things that damage your skin barrier. Harsh cleansers. Too many actives. Products that strip your skin's natural pH.

She also talked about how hydration plays a massive role in keeping that microbiome healthy. If your skin barrier is compromised and you're losing moisture, your microbiome can't thrive.

This matters whether you're treating acne, preventing aging, or recovering from procedures like lasers and chemical peels. Your at-home routine has to support your skin's natural defenses.

Dr. Casey shares her exact product recommendations for different skin types in the episode, including which ingredients protect your microbiome.

Before Your Next Appointment

If you're investing in treatments at a med spa or dermatology office, your skincare routine at home determines how much you actually get out of those procedures.

You can't laser your way to great skin if you're sabotaging it with the wrong products between appointments.

Watch or Listen to the full episode of Med Spa Confidential to hear the simple morning and evening routine that works and the one ingredient that still beats every trendy new product.

The transcripts

[00:00:00] Dr. Kate Dee: A board certified dermatologist just told me that most people are undereducated about skincare and the $500 they spend on skincare every month might be doing more harm than good. By the end of this episode, you'll know how to build an evidence-based skincare routine that , protects your skin at any age without wasting money on products that don't work.

[00:00:19] Dr. Kate Dee: This is part one of our three-part skincare series, so make sure you subscribe so you don't miss the next one.

[00:00:26] Dr. Kate Dee: Hi, I am Dr. Kate d, and today's guest is Dr. Angela [00:00:30] Casey, a board certified dermatologist, MOS surgeon and founder of Bright Girl Skincare. So she's here to talk all about skincare and what you can do at home to take care of your skin. Angela, thanks so much for talking with me today.

[00:00:43] Dr. Angela Casey: Thank you so much, Dr. Kate for inviting me on the show. I'm a big fan of your podcast, so really thrilled to be here

[00:00:50] Dr. Kate Dee: so I'm really excited to talk to you about skincare 'cause I know you are an expert, especially in teen acne, but we'll get to that. Um, what's the biggest mistake you see [00:01:00] people making with their skincare at home? Um, and even when they're spending like tons of money on it.

[00:01:04] Dr. Angela Casey: I am gonna give you two answers to that. The first is lack of consistency. So they're getting bored with a routine or seeing that it's not effective after two or three weeks when we know. The natural cycle of the skin, so it takes our skin. About a month or 28 days to completely turn over. And when we're looking at skincare regimens, we really need to give them about three months is the [00:01:30] standard rule of thumb in the dermatology space.

[00:01:32] Dr. Angela Casey: If you ask any dermatologist, they're gonna tell you three months. And I have patients all the time, they're like, I tried it for two weeks. It wasn't doing what I wanted to, so then I switched to something else. So that's one. And then the second is piling too many products onto their skin. Skincare does not need to be that complicated.

[00:01:50] Dr. Angela Casey: It just needs to be super consistent. So when you're adding all of these products together, a lot of them have effects that are layering on and just [00:02:00] creating too much irritation to the skin barrier, which is gonna work against your goals of getting that clear, healthy, glowing skin, allowing your skin to repair and rejuvenate like we want it to.

[00:02:13] Dr. Angela Casey: So I would say those are the two biggest things I see in my practice.

[00:02:16] Dr. Kate Dee: So when they have all those layers and extra ingredients and they get that irritation and their, their skin barrier is damaged. So can you explain like,what does your skin barrier do and, and like what happens when [00:02:30] you have too many actives or harsh products? What does that look like?

[00:02:33] Dr. Angela Casey: Yeah, so your skin barrier is the protective seal on your skin. So think of it as almost like a layer of seren wrap over your skin, and it's a little bit permeable, so it's letting certain ingredients in, and it is also letting ingredients. And molecules out of your skin. But it's kind of that communication between your internal environment and the external world.

[00:02:57] Dr. Angela Casey: When that skin barrier gets disrupted, [00:03:00] it gets little microscopic tears in it. So think of that piece of Saran wrap and you're punching a bunch of holes in it, so then more bad stuff, potentially bad stuff from the environment can come in, whether that's allergens, sweat, dirt, pollution, things that float around our environment.

[00:03:15] Dr. Angela Casey: Which are gonna feed into inflammation in your skin. not to mention your skin is going to lose more moisture when that skin barrier is compromised. so your skin's gonna get dry, dehydrated, brittle, uh, irritated, so. [00:03:30] The ideal situation is to have a skincare regimen that's going to really nourish, protect and strengthen that skin barrier.

[00:03:38] Dr. Angela Casey: You want that really robust seal, essentially on your skin so that your skin is functioning as we want it to. We want it to communicate. Somewhat with the external environment and kind of taking in humidity, et cetera, and as well as skincare products that we put on our skin. But we do not want that barrier [00:04:00] interrupted because that leads to a vicious cycle of inflammation, irritation, inability to repair, and that's when you get that red.

[00:04:08] Dr. Angela Casey: Irritated, super sensitive skin. I'm sure you see that in your practice that patients come in and they have been using the wrong regimen and their skin is super irritated and now, and now they have quote unquote sensitive skin.

[00:04:23] Dr. Kate Dee: Hmm.

[00:04:23] Dr. Angela Casey: the truth is most of us at baseline don't have sensitive skin, but we do drive our skin to that [00:04:30] sensitive tipping point when we're using the wrong products and the wrong skincare routine.

[00:04:35] Dr. Kate Dee: Right, right. I would say, I mean, the biggest thing is when people are on way too much. Retinol or Tretinoin, and they come in, their skin's all irritated. And some people will even say that they're allergic to retinol, when really just someone gave them a really high concentration and they just started using it every day.

[00:04:53] Dr. Kate Dee: But, are there other ingredients that you find are like the biggest, uh, problems?

[00:04:59] Dr. Angela Casey: Yeah, I, [00:05:00] I think some of the other big offenders are the alpha hydroxy acids and beta hydroxy acids. So your lactic acid, salicylic acid, um. Anything like that, um, can definitely, again, there's a role for all of these ingredients and they can be really helpful for skin rejuvenation in the right setting.

[00:05:20] Dr. Angela Casey: But when you layer them on too heavily, when you layer them on with certain other products, or you're using them too frequently, that's when the problems occur. So that's one. secondly [00:05:30] is antioxidants as well. So like the vitamin Cs, the caffeine, lic acid, things like. That, that can also really have a benefit in, um, arming your skin to protect against environmental, uh, pollution and toxins.

[00:05:46] Dr. Angela Casey: But when used, um, too frequently or in too high of a concentration or with other products, it can tip your skin towards that irritated, sensitive, um, side as opposed to nourished and [00:06:00] protected. So it's. Not so much. I try not to think about it as there are bad ingredients out there. It's just knowing how to dose those ingredients, what to combine them with, how much time your skin needs to adapt to them when you're introducing them to your skincare regimen.

[00:06:15] Dr. Angela Casey: And it always comes back to what else are you doing to nourish your skin? So making sure that you have the right cleanser, moisturizer, sunscreen, so that you're giving your skin that nice supported environment so [00:06:30] that when you add those other actives, which are so beneficial. I mean, I've been using Tretinoin a retinoid.

[00:06:36] Dr. Angela Casey: For 25 years, I would venture to say you are too. 'cause your skin is glowing and gorgeous. You talk to most, of anyone in our, um, space and, and they will. So definitely there's a, a time and a place for those. You just have to know,

[00:06:51] Dr. Angela Casey: uh, how

[00:06:52] Dr. Kate Dee: to introduce them slowly and then not use too much. I, I, I had the mistake of somebody, uh, like [00:07:00] RU returned or there was some issue with the packaging of a 1%. Retinol and I normally use a 0.5 and I, and they're like, well, do you wanna take this home? I'm like, uh, you know, maybe I could, you know, once every week I could stick that in there.

[00:07:16] Dr. Kate Dee: And, but I did that one day and my, my face within 24 hours was kind of red and flaky and irritated. And I was like, okay, no, I cannot do this. You know, so

[00:07:29] Dr. Angela Casey: love that you shared [00:07:30] that story. It, it's such a good point that we all know our skin the best, right? So when you go see a provider who's as specialized as can be in this space and they're telling you to use something and like you get home and, and it's just not working with your skin, you've gotta listen to that.

[00:07:46] Dr. Angela Casey: You've gotta respect it. 'cause we've been living with our skin for our whole lives. So I think we know when something's working. When it's not. Um, and with retinols in particular too, I think it's very important to [00:08:00] distinguish between the retinols and retinoids. Um. Just in terms of strength. So, um, a lot of times I have patients come in and they say, oh yeah, I'm using the 0.5 retinol.

[00:08:11] Dr. Angela Casey: So they might be using a product made by, kind of a skin pharmaceutical company, but it's still considered over the counter and that is much, much less point, um, potent than the 0.05% Tretinoin that I might be prescribing. So they can get confused between that. [00:08:30] Percent 0.5% and then the prescriptions, which are more in the 0.02, five to 0.05 to 0.1%.

[00:08:37] Dr. Angela Casey: So I think, , it just. Brings back the conversation to really educating your patients so they know that those percentages don't translate across the board. And understanding that prescription retinoids are the most active form. So those are direct retinoic acid as opposed to a lot of the over the counters, formulations, which have to be broken down through a few steps to get down to that [00:09:00] active forms and thereby they're not as potent.

[00:09:02] Dr. Kate Dee: right. The only company I know of that's done those laboratory studies is SkinMedica. So comparing like their 0.5 to a Tino and 0.05, they actually showed that that was equivalent. It's actually. I think it's the only one that I know of

[00:09:19] Dr. Angela Casey: Um, yes, skin Medica and the other is, uh, skin better, skin better science. They've also done the side to side studies as well.

[00:09:27] Dr. Kate Dee: Yeah. And then so then you have to make sure you're looking at the right [00:09:30] percentages. A lot of the other companies will put, will say low or medium. On the packaging, but they don't publish a percentage and they have not done the studies. And I think it's a bunch of hooey personally, so I don't, don't use those.

[00:09:46] Dr. Kate Dee: But, um, yeah. Anyway, so what, what, how, what about the role of the microbiome of the skin? Like how does that play a role

[00:09:54] Dr. Angela Casey: Hmm.

[00:09:54] Dr. Kate Dee: you're choosing skincare?

[00:09:57] Dr. Angela Casey: So the microbiome, it's super exciting 'cause we [00:10:00] have discovered so much about the microbiome in the past decade or so, and it's coming into play with so many common skin conditions, from acne to eczema to sensitive skin, kinda understanding why our. Skin, might be dry or oily and, and the differences in the microbiome of an individual with oily skin versus dry skin.

[00:10:22] Dr. Angela Casey: But the way I like to think about the microbiome, , so I kind of like dumb it down in a way to like something that [00:10:30] like we can all understand. Um, it's like a farm, right? So like in a farm you've got all sorts of like organisms and you've got certain like, um. Animals that are helping to like fertilize the soil, and then you need like the sunshine and the water to help the plants grow.

[00:10:50] Dr. Angela Casey: Um, so the microbiome is not unlike that. You have to have like every piece of that farm working together in harmony to create the optimal [00:11:00] environment. And getting back to the water analogy, hydration is a big part of that. Um, which is kind of goes back to when that skin barrier is compromised and our skin is not hydrated, right?

[00:11:11] Dr. Angela Casey: Good hydration. then our microbiome is not gonna be flourishing as it should. When the microbiome gets out of balance, a few things can happen. Your skin's gonna get more sensitive, it's gonna be more irritable. And then bad bacteria that can sit normally in our skin, in [00:11:30] harmony with everything else and not do anything bad, then start to become a problem.

[00:11:35] Dr. Angela Casey: So that's when your acuity bacterium, acne, which is the acne causing bacteria, starts to get out of balance and the levels start to raise, and all the good bacteria on your skin can't keep. Cut bacterium acnes at bay. So that's part of the process that contributes to an acne lesion forming. staph aureus is another common, um, [00:12:00] bacteria that sits on our skin that normally doesn't cause a problem until somebody who has eczema and their skin gets dry and that skin barrier is disrupted.

[00:12:09] Dr. Angela Casey: And then the staph aureus gets into the eczema and causes, uh, superficial skin infection. So the microbiome, I mean, it's, I, I think another good analogy is just understanding it like the gut microbiome and how certain foods that we eat can really nourish and, support and allow that gut microbiome to [00:12:30] thrive.

[00:12:30] Dr. Angela Casey: The skin microbiome is the same and it has to do with the, the products that we put on it, um, how we're keeping it hydrated, as well as like our internal health and wellness. So I never discount that, like the foods we're eating. How well we're staying hydrated. Are we eating a lot of things that cause inflammation in our bodies and therefore in our skin, um, like sugars and alcohol and things like that.

[00:12:55] Dr. Angela Casey: So it all kind of comes full circle. But yeah, that, that microbiome, it's the farm [00:13:00] that's keeping our skin healthy. And if we can keep it in balance, everything works beautifully.

[00:13:06] Dr. Kate Dee: So do you have recommendations on what kinds of, um, topical support your skin microbiome as opposed to ones that disrupt it?

[00:13:15] Dr. Angela Casey: Yeah, so a big thing. Um, so let's start with cleansers. With cleansers, you want pH balanced cleansers. So our skin, microbiome and our skin naturally sits at a slightly acidic pH. So we [00:13:30] want to use cleansers and skincare products that sit a little bit more in that neutral to acidic side. When we use certain soaps, um, they are very alkaline, so like a bar soap is very alkaline.

[00:13:42] Dr. Angela Casey: Like certain, um, like detergent, like, substances can be very alkaline. So that is like really bad for our skin. Does not like that at all. So sticking with a pH balance cleanser, um, and then.

[00:13:56] Dr. Kate Dee: that you can give of the really bad ones that are just people use [00:14:00] all the time? I mean,

[00:14:01] Dr. Angela Casey: Oh yeah, like, um, like the, the biggest defender, like dial soap, Irish Spring, um, I'm not even a big fan of Ivory. I know ivory and, and Dove soap were. Kind of marketed for so long as the, like the cure all in the dermatology space. And I don't, I, I tend to shy away from those bar soaps and use more, um, like the, the Cetaphil CE Bays or Bright Girl.

[00:14:29] Dr. Angela Casey: Um, [00:14:30] our Bright Girl Cleanser is of course pH balance. It's a great facial cleanser. Um, but there's a reason why those brands have really come to the forefront and being very nourishing and supportive. So great for people with. Sensitive or eczema prone skin, or for the rest of us that maybe have normal skin.

[00:14:46] Dr. Angela Casey: So, um, pH balanced cleanser with your moisturizer. It's so important that you have that good blend of humectants that draw water into the skin, your emollient, which are going to help with repairing that skin [00:15:00] barrier that we talked about, and then your occlusive, which are the ingredients that help keep that moisture locked in.

[00:15:06] Dr. Angela Casey: And the great thing about moisturizers, there's so many different formulations that you can really tailor it to your skin. If you have oily skin, you might want something lighter weight. Um, if your skin's really dry, you're gonna want something that has more of those occlusive properties. and then the other big, skincare product that's important for the supporting that microbiome and barrier is, your sunscreen.

[00:15:28] Dr. Angela Casey: sunscreens [00:15:30] are of course protecting our skin from ultraviolet damage, but also mitigating all of that inflammation, which is just that vicious cycle that's gonna tear down our collagen. It's gonna cause damage to our skin cells at the cellular level, um, and create a lot of irritation. So a mineral based.

[00:15:49] Dr. Angela Casey: Sunscreen with an SPF 30 or higher. And um, I love the bright girl sunscreen. It's what I wear every single day 'cause it is a mineral and we have a tinted and a sheer [00:16:00] version. but there are so many great sunscreen brands and the mineral formulations, as you know, have come a long way just with cosmetic elegance.

[00:16:07] Dr. Kate Dee: Okay, so let's build a skincare regimen, like a basic one, um, for, you know, for our audience. And then, and then let's talk about things that you would add in, depending on the main big problems people would have. So what would you consider to be like. The basic minimum skincare, regimen that most people should do.

[00:16:29] Dr. Angela Casey: [00:16:30] Basic minimum in the morning. Cleanser, moisturizer, sunscreen in the evening, cleanser, moisturizer. That's all you have to do. You don't have to layer on anything else. you're gonna be in good shape in staying consistent with that. So keeping it simple.

[00:16:47] Dr. Kate Dee: Okay. And so since, uh, you are, well, you're a specialist in several things, but let's talk about teen acne since that is what bright girl's all about. So can you speak to that a little bit? Like [00:17:00] what would you be particular about if you have acne prone skin?

[00:17:03] Dr. Angela Casey: so with acne prone skin, you're gonna need a little bit more support in, that microbiome. So in that case, I would be adding in a toner, which is going to help with balancing. Oil production in the skin, and also ideally one that has some anti-inflammatory ingredients that are gonna help settle inflammation in the skin.

[00:17:25] Dr. Angela Casey: So with acne, um, there are four main triggers to acne [00:17:30] that, see acne's bacteria that I talked about earlier. inflammation, in the skin, which can cause by be caused by a whole host of things. Plugging of the pores, which is addressed by retinols. and then, Inflammation. C acnes, bacteria, plugging of the PO and oil production.

[00:17:49] Dr. Angela Casey: So those are the four main triggers. So with your skincare regimen, you're needing to address that. , the sunscreen and your, um, moisturizer are gonna help [00:18:00] with combating that inflammation, and keeping that microbiome stable. Again, the toner one that's kind of tailored towards balancing oil production is key.

[00:18:09] Dr. Angela Casey: in terms of addressing plugging of the pores, that's when your retinol or retinoid comes into play because retinoids help with increasing skin cell turnover, and as such, they're going to eliminate any of those little dead skin cells that wanna get into pores and plug them, and they get kind of sticky in there.

[00:18:27] Dr. Angela Casey: And that helps drive the, the [00:18:30] inflammatory process of acne.

[00:18:31] Dr. Angela Casey: Um, we will also add in like a topical antibiotic, um, like a benzoyl peroxide or clindamycin 'cause that fights the c acnes bacteria as well.

[00:18:42] Dr. Kate Dee: And so about the pore clogging, I think the, so your, your hydroxy acids also help those cells slough out of the pore so they don't get plugged up. So that's super important. But my follow-up question about the antibiotic is. [00:19:00] How do you not kill off your good bacteria at the same time as you're targeting the bad bacteria in your skin?

[00:19:07] Dr. Angela Casey: It's impossible 'cause you are going to kill some of the, the good bacteria along with the bad. I mean that's the, the dilemma of antibiotics in general, right? When we take. An antibiotic by mouth and it wipes out our gut microbiome 'cause it kills off all those good bacteria that we've been working to grow for years with one [00:19:30] course of antibiotics.

[00:19:31] Dr. Angela Casey: Same with topical antibiotics on the skin. They are going to, they are not so specific that they're just going after the bad bacteria. They're mostly getting that, but it's. They're also killing off a lot of good stuff. It's not unlike chemotherapy, right? That kills the bad cancer cells, but also kills a lot of other good stuff.

[00:19:52] Dr. Angela Casey: In the meantime, it's just coming blasting through everything.

[00:19:55] Dr. Kate Dee: That's why though it's so important to use the proper skincare so that when those [00:20:00] bacteria do grow back, they're growing back in balance and they're not, you know, out of proportion. Right. Towards the bad ones.

[00:20:07] Dr. Angela Casey: hundred percent. A hundred percent, yeah. You gotta nourish and feed all those good bacteria.

[00:20:12] Dr. Kate Dee: so for, uh, for acne, the things you're adding in are, you know, a, a toner, um, an antibiotic of some kind, and then, and, and a retinol. is there any, uh, so I always think of, um, so moving on to just sort of general skincare [00:20:30] and, and anti-aging. I always think of every time I watch my skin, it's an opportunity to put some kind of treatment on my skin that's gonna benefit it.

[00:20:39] Dr. Kate Dee: I always think that anything that's going to stimulate collagen is good. And I've said many times before on the podcast, like those cells inside your dermis that make collagen and elastin, those are dormant unless you're poking at them in some way or other. So we, that's a whole other conversation about.

[00:20:57] Dr. Kate Dee: Different procedures to do to stimulate [00:21:00] collagen, but from, for somebody who is doing all those things, uh, it's really important to add in some ingredients that support collagen synthesis so that you actually get more collagen out of it. So, 'cause a lot of people, you mentioned vitamin C before, and actually retinols also stimulate collagen.

[00:21:17] Dr. Kate Dee: You know, there are a lot of different collagen stimulating serums. But if, you know, if you're. If those cells are dormant, you don't get any collagen out of it. Right? But if those cells are awake, then you're gonna actually increase your yield of, you [00:21:30] know, collagen synthesis if you're feeding your skin.

[00:21:32] Dr. Kate Dee: That so, so I always feel like for anyone over 30, but you know, especially people like me over 50, like, you really need some kind of serum that's gonna, that's gonna support anti-aging. Do you have a favorite

[00:21:46] Dr. Angela Casey: percent. Yeah. I mean, most of us in our generation, we grew up in an era where we were out in the sun a lot. We got a lot of sun damage. we used a lot of skincare products in our [00:22:00] teens and twenties that were really not good at all for our skin. Like I. Throughout for myself, uh, the Sea Breeze, a stringent that just like totally stripped your skin, uh, St.

[00:22:11] Dr. Angela Casey: Ives apricot scrub that totally just like destroyed your skin barrier. So our skin's been through a lot, um, for us, like Gen Xers and probably some of the millennials as well. So we really like, we have to do a lot of catch up and a lot of repair. So [00:22:30] anything like that. I'm a huge fan of retinoids for that purpose.

[00:22:35] Dr. Angela Casey: I'm a big fan of antioxidants, like the vitamin Cs for that purpose. I'm a big fan of chemical peels to just to kind of get a little deeper into the skin and the lasers of course. Um, you know, that's not the topic of this discussion, but, as well as the biostimulatory, injections that we can do.

[00:22:51] Dr. Angela Casey: Along with a whole host of other things, microneedling, et cetera. So, um, but with getting back to skincare regimens, yeah, we've got some catching up [00:23:00] to do. So our skin is going to require a little bit more, like, harsh is not the right word, but like a little bit more aggressive care compared with somebody who's in

[00:23:10] Dr. Kate Dee: We got upper game basically.

[00:23:12] Dr. Angela Casey: We do, we do. I am, um, a big proponent and a big mission of Bright Girl, uh, is staying ahead of the damage. So just like we brush and floss our teeth every day from the time we are little bitty and we get our first teeth throughout our life. When we start [00:23:30] those good skincare habits with the right ingredients, with consistency and understanding.

[00:23:35] Dr. Angela Casey: Our generation, uh, or the current generation of Gen Z and Gen Alpha will age. Much differently. 'cause they've had, they have this knowledge on board and they will be able to protect and prevent as opposed to wait for the damage to occur and then diagnose and treat it. So, equipping them with the right tools and understanding.

[00:23:57] Dr. Angela Casey: Is key in, again, heart of the [00:24:00] mission of Bright Girl. It's everything from preventing that skin damage, the brown spots, the laxity, the fine lines, the texture changes, et cetera. And the skin cancers, frankly, that can be very prevented with, the proper use of, of sunscreen. And I can't underscore that enough.

[00:24:18] Dr. Angela Casey: I mean, there are so many Exciting new skincare products out there. You know, you've got the peptides and the exosomes and the growth factors and all these things. But when you look at [00:24:30] efficacy and you look at just objective studies, the retinoids are still gonna be far more powerful than any of those other, like, newer, sexier ingredients.

[00:24:41] Dr. Angela Casey: And then sunscreen is still like the number one most. Important part of your skincare regimen. If you do nothing else, put on your sunscreen. It's not super exciting to talk about 'cause sunscreen has been around forever. It's not like the newest, latest, and greatest, but it's definitely the most proven. So if you're not getting your sunscreen on, [00:25:00] you can spend all the money in the world on other products, and you're just not gonna get those same results.

[00:25:05] Dr. Kate Dee: Yeah, totally agree. I mean, I think that people think of it as just to prevent sunburns, right? But, but it prevents. The two giant things that we talk about, which is skin, cancer and aging. So you can keep younger skin, just preserve your skin just by using your sunblock every day. And I always tell people, even here in Seattle where we have a lot of gray days over the [00:25:30] winter, you know those UVA rays come straight through your window, through the clouds.

[00:25:34] Dr. Kate Dee: They do all their damage and you don't see it. You're not gonna get a sunburn from them. But they are super damaging. So it's important to wear that sunblock every day, even. In cold climbs and all through the winter there, there's my little plug.

[00:25:48] Dr. Angela Casey: As you said, the UVA rays are the ones that penetrate deeper into your skin. So those are the ones that are getting down to that dermis layer, breaking down all the collagen and elastic [00:26:00] fibers there. and it's, it is tricky because it comes through everything. And, and you brought up a good point. So many of my patients say well, I, I'm not really out in the sun.

[00:26:11] Dr. Angela Casey: I just like drive to and from work. I might run into the grocery. All those day-to-day incidental exposures that add up to significant damage over time.

[00:26:21] Dr. Kate Dee: I don't, I don't know if you ever saw this image, but, um, maybe 11, 12 years ago when I was first starting all this. There is this [00:26:30] pretty famous picture of this guy who's a truck driver for his entire life. He's an older gentleman and, and you could see the left side of his face that was exposed to the sun through the driver's side window was so much more damaged and wrinkly and aging and drooping than the right side of his face.

[00:26:48] Dr. Kate Dee: Have you, you know that picture?

[00:26:49] Dr. Angela Casey: Exactly

[00:26:50] Dr. Kate Dee: I can try to drum that up somehow for the podcast. I don't know if we could find that. but uh, but yeah, I, it's just, it's very dramatic. So, so those [00:27:00] UVA rays are just everything coming in through your windows. I think it's really

[00:27:03] Dr. Angela Casey: Mm-hmm.

[00:27:04] Dr. Kate Dee: Uh, even if you're just driving,

[00:27:06] Dr. Angela Casey: yeah, as part of my job as a MO surgeon, I look at skin under the microscope every day, so it is just. So interesting to correlate what I see just in, in clinical practice as I'm looking at someone's skin and then looking at that same skin under the microscope and you see all of that collagen, it's like broken down and it's kind of like [00:27:30] mushy looking and it doesn't have any of that like firm elasticity and the epidermis is all thinned out in, in atrophic.

[00:27:37] Dr. Angela Casey: So it's really, and, and when. You get into areas that maybe were more sun protected and you see that contrast, um, again, same patient, same area, but like you're moving back towards like where the hair is versus the forehead and you see that protection of where the hair protected the skin. It's just tremendous, is, it's really fascinating.

[00:27:58] Dr. Angela Casey: But yeah, it just goes [00:28:00] back to like the day-to-day habits add up. Just like brushing and flossing your teeth every day.

[00:28:05] Dr. Kate Dee: Right, right. So we've basically covered the change of skincare routine for different decades. So in your twenties and thirties, you're in prevention mode. In your forties and fifties, we're adding anti-aging ingredients like retinoids and. Stuff. And then what about as you get older, sixties plus, are there other things you would do or add or change or [00:28:30] subtract?

[00:28:30] Dr. Angela Casey: I mean, yeah, many of my patients in their sixties, there's a whole spectrum depending on how aggressive they wanna be.

[00:28:37] Dr. Kate Dee: I guess I shouldn't, I'm like three years away from that. It's a little scary, but.

[00:28:42] Dr. Angela Casey: it great though that like we are at this stage in our lives? I don't know about you, but this is how I feel like. At my age now, like I used to think that, that was so old when I was younger. Like, and, and now I'm like, gosh, I feel pretty good. Like, I feel like I could be in my early thirties for [00:29:00] like, and I am a long way from that.

[00:29:02] Dr. Kate Dee: I'm

[00:29:02] Dr. Angela Casey: Um,

[00:29:03] Dr. Kate Dee: I'm working on it, you know, every day.

[00:29:05] Dr. Angela Casey: that's like the coolest thing about like our patients that are in their sixties and seventies, eighties, I mean, I have. Patients in their early nineties that are living very full lives. They're active and they're engaged with their communities, and they're still wanting to look on the outside, how they're feeling on the inside.

[00:29:25] Dr. Angela Casey: So. Yes, I think it's important to keep up with some of those corrective [00:29:30] and, um, just simple regimens of the retinoids and the sunscreens and the, um, antioxidants and then getting them in periodically. I mean, this is where I really see a role for like the lasers and chemical peels that you're doing those on a more.

[00:29:45] Dr. Angela Casey: Regular basis for those patients. Um, microneedling the same thing. I mean, you've said it well, you almost have to injure that skin to kind of keep it awake and keep it active. Keep that collagen stimulation going. And then there's a big [00:30:00] difference, and I'm sure you see this in your individuals who live healthy lifestyles.

[00:30:04] Dr. Angela Casey: So they're getting enough sleep, they're exercising, they're eating well, they don't drink a lot of alcohol, obviously they don't smoke. Versus somebody who's maybe not practicing those same, um, good habits on a consistent basis.

[00:30:18] Dr. Kate Dee: Absolutely, and, and a reminder also everything that we've been talking about with skincare. It's so important to have that really good regimen at home if you are doing [00:30:30] procedures at a dermatology office or at a med spa where you are poking at your fibroblasts and, and doing resurfacing and other things like that.

[00:30:38] Dr. Kate Dee: Um, if you have a really great regimen at home, you are gonna get a much higher yield out of those procedures, and so you might as well get a much bigger bang for your buck. I mean, it costs money and effort and downtime. To do those procedures is really important to support that with a really good regimen at home.

[00:30:56] Dr. Kate Dee: As we, as we kind of wrap up this topic, [00:31:00] um, what's, if you were gonna tell our audience, like, what's the one thing you wish every patient knew before they walked into your office?

[00:31:07] Dr. Angela Casey: I wish they really grasped and understood like how, um, much they can be in charge of their skin health. Um, like how, and like. And it's easy for them to get excited about that when they're in the office and even immediately after they leave. And then so often they kind of fall off the wagon.

[00:31:27] Dr. Angela Casey: I see it every day in my [00:31:30] practice. I have at least a couple patients that are like, yeah, I used my Tretinoin for like a few weeks. My tube ran out and I didn't get it refilled, or Oh yeah, I ran out of my sunscreen. and I didn't get it refilled or I didn't go back to get it. Or that it takes them six months to get through their two ounce tube of sunscreen.

[00:31:52] Dr. Angela Casey: I'm like, you're not using enough.

[00:31:54] Dr. Kate Dee: right, right.

[00:31:55] Dr. Angela Casey: Uh, so I think that's like the biggest thing is like we're each [00:32:00] patient, every individual, we are in the driver's seat with our skin health, and we make that decision just like so many other things in our lives, like how we're going to navigate that and how much of a priority.

[00:32:11] Dr. Angela Casey: It's just choices. You're just making choices every day.

[00:32:14] Dr. Kate Dee: Yeah, absolutely. If, if anything that we do in our practice and then hopefully on this podcast is, is to educate and support people's, you know, uh, ability to like, take care of their own skin and know enough so that they feel really energized [00:32:30] and, and able to have a great skin without doing too much, without spending that much money, So thank you so much, Angela, for being on the podcast today. I just, I so appreciate all your input and we'll be back soon with another discussion about your expertise, uh, skin cancer.

[00:32:50] Dr. Angela Casey: Oh, a hundred percent. I'm super excited about that discussion, and it's been so wonderful to connect with you and your community, Dr. Kate.

[00:32:58] Dr. Kate Dee: Thanks for listening. If you found this [00:33:00] helpful, do me a favor and share it with a friend who's considering any aesthetic treatments. Subscribe so you don't miss the next one and drop a comment telling me your biggest takeaway. I actually read them all. Let's keep each other safe and elevate the standards in the MedSpa industry.