Q&A: Muneeb Shah, DO, Discusses What it Means to Have Healthy Skin

The American Academy of Dermatology (AAD) Association launched the first-ever National Healthy Skin Month in 1997. Their intention was to emphasize the importance of good skin care; share tips that can lead to healthier skin, hair, and nails; and ask individuals to take time to pay attention to their skin and adopt healthy habits to care for their skin. As AAD says, National Healthy Skin Month is “everyone’s awareness month.”¹

In an interview with Dermatology Times®, Muneeb Shah, DO, board-certified dermatologist and partner at PC Dermatology in Mooresville, North Carolina, and known on TikTok as @DermDoctor, discussed what healthy skin means to him as a practicing dermatologist. He talked about how he fights misinformation about healthy skin on social media, and basic healthy skin routines for acne-prone, aging, and sensitive skin.

Q: As a practicing dermatologist, what does healthy skin mean to you?

A: When you look at the definition of healthy skin in the dictionary, it’s basically “free of disease.” I think healthy skin depends on the patient that we’re treating and what their main concerns are. For somebody that has acne, healthy skin to them would mean getting rid of their acne. For someone with melasma, it’s about getting rid of that discoloration and the pigmentation that they have on their skin. Once you get through those phases, where you’re solving their initial problem, it’s still important to focus on healthy skin. And that’s the maintenance phase, which is important. That means wearing sunscreen and using retinol to prevent fine lines and wrinkles going into the future. I think healthy skin is patient dependent and then evolves with time as we saw their initial concerns.

Q: Is there any information about dermatology or skin care in general that you like to debunk?

A: Yes, there’s so much misinformation on the skin in general. One of the big things that has been happening recently is that we have had a big uptick in sunscreen use. I think a lot of that is from what dermatologists are creating on social media and other beauty influencers that have put this big focus on SPF [sun protection factor], which is amazing. But then anytime there is a swing like this, there’s this equal and opposite reaction to it. You have people saying SPF is what’s causing cancer and not to use it, and that these are dangerous, harmful chemicals. …There’s a ton of misinformation that [SPF] is dangerous. But what we do on social media, which has been amazing over the last 2 years, is that we directly combat misinformation as it’s happening from the source.

Initially, in the past, you’d have this crazy thing happening on social media, and then the Wall Street Journal or the New York Times would put out an article saying, “This isn’t true, you shouldn’t do this.” But the people that are consuming the misinformation on social media are not going to the New York Times to vet their information, right? They’re continuing to consume information on social media. So we combat this misinformation when it’s happening on social media by debunking those videos in real time, which has been awesome. One example, [as I mentioned,] is SPF causing cancer, which is absurd. Other examples that we see are that you shouldn’t use harmful chemicals like parabens, which are one of the safest types of preservatives that you can find in skin care. There’s this big movement on clean beauty, where they are saying, “These…chemicals that dermatologists prescribe or that are in your common over-the-counter drugstore products are harmful,” and that “These other products that are ‘clean’ are better for you.” But they just have less safe, less tested products in them. They are just trying to sell you their product over the other product. There’s a lot of misinformation, but a lot of it is because people are trying to have this secondary gain of selling a product.

Q: With a large social media presence, how do you personally take on the responsibility of fighting misinformation online?

A: We built this amazing community over the last 2 to 3 years where people feel comfortable tagging me on social media and reaching out to me to ask for my opinion, as the misinformation occurs. If a video has gone viral and contains misinformation, I think a lot of the public, because of the education that I have [provided] on YouTube and TikTok, knows that it’s misinformation. Then they’ll tag me in those videos and ask, “What do you think?” I’ll come home from seeing patients and I have 100 tags on a video that is obviously not correct information. Then I can make a video and say, “Hey, this is not true,” using the duet feature and the stitch feature on TikTok, which allows you to take other people’s videos and react to them in real time.

I think [for] a lot of people that may spread misinformation, it’s based on erroneous articles that they found themselves. I don’t think it’s intentional from a lot of these creators that spread misinformation, but it’s nice to have checks and balances where you can debunk misinformation in real time. At the same time, it’s nice on our end because we as dermatologists can also be debunked if we present misinformation. So it’s checks and balances from us as the professionals, and then also the average person who is making content can check us if we are not up-to-date with information as it comes out. Social media has this beautiful system of checks and balances, but I’m part of that circle too because people trust the information I have put out over the last few years.

Q: Can you review basic healthy skin routines for acne-prone, aging, and sensitive skin?

A: For acne-prone skin, that really depends on what phase in this process you are in. If you are looking at products that are just available over the counter, there are 3 ingredients that…treat your acne. First would be adapalene (Differin Gel; Galderma), which is a type of retinoid. Second would be benzoyl peroxide, which has antibacterial properties as an oxidizing agent. Third, you would be looking for salicylic acid at 2%. Those are the ingredients that appear in the US Food and Drug Administration monograph for the treatment of acne. Those are available over the counter and they are great ingredients. What I would say is start simple depending on your type of acne. Have a cleanser, have a treatment, and then have a moisturizer at night. A lot of patients with acne won’t use a moisturizer. So cleanse, use adapalene gel, moisturize in the morning, and wear sunscreen, and that’s a very simple acne routine. Then you can add other ingredients such as salicylic acid and benzoyl peroxide as your skin gets acclimated to that first ingredient. Some patients with acne will seek out home remedies for a long time before they see a dermatologist. These treatments aren’t strong enough for some patients and they do need medications that are prescription only. Scarring acne is very difficult to treat and it’s permanent. If you are developing scarring with your acne, you want to see a dermatologist right away rather than trying these remedies at home first.

I’m a big proponent of the 3-step skin care routine; so for aging skin, it should be a cleanser at night and retinol, which has 50 years of data showing that it helps to build collagen, hyaluronic acid, and elastic tissue. Retinol also helps to even the skin tone texture and is one of the best ingredients that we have available over the counter for the treatment of aging skin. Then follow retinol with moisturizer. Again, it’s like getting insurance for your skin; you need to wear sunscreen in the morning because 90% of aging is caused by the sun. For aging skin, you are going to be focusing on retinol.

For sensitive skin, this is where less is more. Patients with sensitive skin or who are hyperactive to ingredients tend to have more inflammation or develop hyperpigmentation after treatment. For these types of patients, you want to do less for them and slowly ease into things. That means introducing 1 product at a time, having your skin get acclimated, and then going from there. For sensitive skin, gentle cleansers, gentle moisturizers, fragrance-free products, and barrier-repairing ingredients like ceramides and other lipids will be beneficial. For those patients, it’s more of a 2-step skin care routine: gentle cleanser to remove your pollutants and makeup for the day, and then follow that with a gentle moisturizer that’s fragrance free. That would be a simple routine at night and then again in the morning. Patients with sensitive skin benefit more from mineral sunscreens because the chemical sunscreens are more likely to cause allergies, so zinc oxide or titanium oxide is going to be the ingredient that you are looking for in those sunscreens.

Reference

1. November is National Healthy Skin Month. American Academy of Dermatology Association. Updated November 1, 2022. Accessed November 8, 2022. https://www.aad.org/public/public-health/awareness-campaigns/national-healthy-skin-month