How can you keep skin dryness, acne, and pigmentation, at bay?

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): A Further Inquiry

Publication Date (yyyy/mm/dd): 2025/09/11

Part 2 of 2

Dr. Viktoryia Kazlouskaya, MD, PhD, is a dermatologist with 20 years of skincare, cosmetic procedures, and dermatological research expertise. She specializes in evidence-based treatments, including sunscreen, retinol, and antioxidants, while addressing conditions like acne, rosacea, and aging skin. Passionate about patient education, she emphasizes the importance of lifestyle, diet, and personalized care. Dr. Kazlouskaya is also experienced in advanced therapies like exosomes, microneedling, and lasers, making her a trusted authority in modern dermatology. Kazlouskaya discussed effective skincare, focusing on essentials like sunscreen, retinol, and vitamin C while cautioning against overusing active ingredients or following unproven trends like beef tallow or period blood in skincare. Kazlouskaya highlighted the role of diet and lifestyle in skin health, including the impact of insulin resistance and treatments like Ozempic. In this 2-part interview, she explained different patient demographics, from cost-insensitive individuals seeking comprehensive treatments to those resistant to interventions like injections. They concluded by planning future discussions on hair, nails, and advanced skincare procedures.

Scott Douglas Jacobsen: Let’s discuss skin dryness, acne, pigmentation, or any skin malfunctions that develop over time, such as sunspots, moles, etc.

Dr. Viktoryia Kazlouskaya: If you have dry and sensitive skin, focusing on moisturizing is essential. Everyone is fond of hyaluronic acid, but pure hyaluronic acid isn’t effective unless it’s layered with more occlusive ingredients. Using a hyaluronic acid serum can evaporate from your skin, making it feel drier. It’s most effective when combined with other molecules in a cream, and nearly every cream on the market today contains hyaluronic acid. Alternatively, you can use it as a serum for targeted areas or your entire face. Still, you must follow it with an occlusive product to prevent evaporation.

Glycerin, petrolatum, panthenol for healing, and ceramides, which mimic our natural fats, are the best moisturizer components. These ingredients help restore the skin’s normal barrier.

For oily skin or skin with sebaceous filaments (those tiny black dots often mistaken for blackheads), we recommend using acids such as salicylic acid to dissolve oil buildup, as well as alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs). However, it’s crucial not to overuse these acids, as they can dry out the skin, worsen acne, and even trigger new breakouts.

In the anti-aging category, we now have interesting molecules studied less than retinol, vitamin C, and sunscreen, but they are still promising. One example is bakuchiol, which is less potent than retinol but safe for use during pregnancy and breastfeeding. It increases skin turnover, thickens the epidermis, and improves skin texture, offering a plumper look.

We’re also entering a new era with ingredients like growth factors, peptides, and exosomes. These are trending right now and are highly sought after. They work because they’re small molecules that participate in skin regeneration. However, choosing products from reputable brands with clinically proven formulations is important, as not all molecules penetrate the skin effectively. These products are often priced in the higher range, costing several hundred dollars for a quality formula.

Another emerging trend is addressing mature skin, particularly for women in their 50s experiencing estrogen deficiency. Products targeting estrogen-depleted skin are still limited, but some companies are developing compounded estrogen molecules or estrogen-like ingredients that mimic estrogen’s activity on the skin. This is a growing field and represents a new direction in skincare.

Jacobsen: What about products or treatments that are widely used but lack evidence or don’t work?

Kazlouskaya: Many at-home treatments don’t have sufficient evidence to support their effectiveness. I’m also cautious about oils in skincare. They’ve become trendy, but they aren’t always helpful. While some evidence supports certain oils, they can clog pores, provoke acne, and cause allergic reactions, especially for sensitive skin. Oils often contain fragrances, which can be irritating.

Another questionable trend is using beef tallow in skincare. For those unfamiliar with beef tallow, it is fat derived from animals. While it’s gaining popularity in some circles, I’m unaware of strong evidence supporting its benefits for the skin, and it may not be suitable for everyone.

Animals have fat inside, stored between their organs, and if it’s from beef, it’s called beef tallow. It’s a huge trend right now. I was interviewed about it at least three times last month, and one news magazine has already published an article about it.

But it’s everywhere—on TikTok and Instagram—so it’s a hot topic. Essentially, it involves putting animal fat on your face.

Will it work? Who knows? There’s some indication that fat might have anti-inflammatory properties, but we don’t have sufficient data to support its effectiveness.

Another trend I’ve noticed is castor oil. It’s becoming very popular here in the U.S. What trends are you seeing in Canada?

Jacobsen: Oh, I don’t even know. This is a new topic for me, so I don’t know if people in Canada follow similar trends to those in the United States but in a less extreme way.

People do things that might work to some degree but are exaggerated for appearance’s sake, such as surgical procedures like facelifts or other cosmetic surgeries. Those are trendy, but they’re also very expensive.

Kazlouskaya: In skincare, I feel that home remedies or DIY treatments, like putting unusual substances on your face, don’t work. For example, some people are now putting period blood on their faces.

Some studies suggest that period blood might contain exosomes, which can have regenerative properties. However, period blood is also full of bacteria and can become a breeding ground for harmful pathogens. Even though it’s being promoted as a trend, it’s risky and not evidence-based.

This is just one example of how much advertising is driven by untrained individuals—not specialists—looking to gain likes, shares, or income from social media. This kind of misinformation can be very dangerous. It’s not just ineffective in some cases but outright harmful.

Jacobsen: What’s being proposed now, that’s new and experimental and shows promise but isn’t sufficiently supported by evidence yet?

Kazlouskaya: Exosomes are a big development right now. These small vesicles facilitate cell communication, carrying growth factors and molecules that promote healing, reduce inflammation, and support various cellular processes. Essentially, they act as signalling agents between cells.

Exosomes are very trendy because of their potential benefits. They are even being studied as intravenous treatments for neurodegenerative conditions, but this research is still in its early stages. In skincare, a few companies produce exosome-based products derived from human fibroblasts.

However, it’s crucial to ensure that the source of these fibroblasts is safe. They must come from clean donors—individuals free of diseases or cancers. These fibroblasts can come from sources like skin cells or umbilical cords. Properly sourced and purified exosomes have the potential to be very helpful.

A few companies produce high-quality exosome products that work well, but this area is still developing. These products are not FDA-approved, and while some people attempt to inject them as treatments, this is 100% unregulated and not FDA-approved.

On the other hand, using exosome products topically in the form of creams or serums is not prohibited. This makes it a bit of a “Wild West” situation, as some people take risks by using or promoting them beyond their intended purposes.

We also use exosomes after procedures like microneedling, but more regulation and research are needed. Many products come from outside the United States, and we don’t fully understand their potential long-term effects or risks.

Jacobsen: Who are the main demographics that are more likely to come to your office?

Kazlouskaya: There are two primary demographics. One group is young, working professionals with medium to high incomes who want everything done to maintain a polished look. The other group comprises women in their 40s and 50s seeking skin maintenance and rejuvenation treatments.

Jacobsen: So, it’s about professionalizing their appearance and maintaining skin health.

Kazlouskaya: Interestingly, younger populations are increasingly seeking these treatments. They are very knowledgeable about cosmetic procedures. For example, I got my first Botox treatment in my 30s, and at that time, it didn’t feel very safe. But now, people in their early 20s are already getting procedures like microneedling, fillers, and Botox.

Today, these treatments are so normalized that they’re almost like ordering coffee at Starbucks—just a casual part of life.

Jacobsen: One related area I’d like to touch on is diet. An old North American phrase is, “You are what you eat.” What about the relationship between diet and skin health?

Kazlouskaya: Diet is worth discussing, as it plays a significant role in skin health. Let’s explore that further.

Diet is a significant factor, and I see its effects often. Insulin resistance and prediabetes can lead to noticeable changes in the skin, such as increased pigmentation, roughness, and other issues. These conditions are often challenging to address with just creams and procedures. Lifestyle changes, including diet, play a crucial role.

A healthy diet rich in fruits, vegetables, and proteins is essential because our skin and hair predominantly comprise protein. If you’re protein-deficient, your skin won’t look its best. For example, one in seven women in the United States has polycystic ovary syndrome (PCOS), which is now a leading cause of infertility. PCOS has specific skin-related symptoms like hair thinning, acne (especially in the lower face and later stages of life), darkened skin patches, stretch marks, and other signs.

PCOS is often linked to insulin resistance. Lifestyle changes like exercising more, eating healthier, and getting better sleep can significantly improve skin health. Even reducing salt intake can help minimize facial swelling.

I’ve had clients who underwent multiple cosmetic procedures but only saw temporary results. However, after adopting a healthier lifestyle—going to the gym and eating well—their skin transformed within six months. These changes occurred even though I knew they weren’t consistent with their skincare routines. Simply changing their lifestyle made a noticeable difference.

Another emerging factor is the rise of obesity treatments like Ozempic. This is creating a new wave of challenges in the skin industry. Fat is a tissue that stores and produces hormones and other compounds. When people lose fat rapidly, as they often do with Ozempic, it can disturb hormones on a micro-level. This can lead to changes in skin quality, including hair loss, which is particularly difficult to address.

Many of these individuals seek help for skin care and treatments, and I expect this trend to grow as more people use Ozempic. In places like New York, it’s almost as common as taking vitamins—everyone seems to be on it.

Jacobsen: When consulting with people—how do motivations factor into the conversation? Can you differentiate between good and bad motivations for seeking advice or help? How does the medical code of ethics come into play?

Kazlouskaya: As a business owner and physician, balancing the business side with the ethical duty to benefit patients can sometimes be challenging. Of course, you want patients to pursue treatments. Still, at the same time, you must recognize that some treatments may not be beneficial for everyone.

I maintain this balance by prioritizing the patient’s best interests. I never recommend or perform treatments that won’t benefit me.

There are different types of people who come in for treatments. Some want everything done. They’ll say, “I don’t care about the cost; I want to address this wrinkle or pigmentation issue. What treatments do you have?” The cost is not a concern for these individuals, so we can provide the most advanced treatments and develop a comprehensive plan to address their concerns.

Then, some people are entirely against injections. Even when you know that injections are necessary for significant improvement—like when aging is already advanced—you still need to respect their wishes. You have to explain that injections or surgery might provide the best results. Still, if they are unwilling, you can offer alternatives with the caveat that the results may be less effective.

Another group includes people who have done nothing for their skin throughout their lives and come in their sixties saying, “I just have a little bit of laxity.” These patients often have never even used a cream. When you examine them, you see sagging skin that requires significant intervention. It’s difficult to make them understand that, at this stage, achieving significant results is challenging, and even surgery might not fully resolve their concerns.

Everyone is unique, and you must navigate their beliefs and expectations. In the past, dermatologists were very assertive in their recommendations, but now, it’s more about working with the patient’s preferences.

The younger population is very different. They want to participate actively in their treatment plans. They rarely jump into any suggestions without researching, reading reviews, and seeking feedback. It’s a very collaborative process with them.

Jacobsen: Thank you for the opportunity and your time, Viktoryia.

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