In this episode of Dermbusters, host Nicholas Brownstone, MD, chats with Anthony Rossi, MD, about some common misperceptions they often hear from their patients. 

Dr Rossi shares some suggestions on how to counsel patients on 3 significant topics: a misconception surrounding higher-percentage medications, the proper use of facial cleansers, and the necessity of wearing sunscreen during the winter months. 

Myth 1: Higher-percentage ingredients mean a medication is more efficacious. 

Dr Rossi begins by addressing the prevalent belief that higher percentages of ingredients in medications indicate greater efficacy. Contrary to this notion, he emphasizes that the right amount, rather than the highest percentage, is the key to achieving optimal results. 

Patients are advised to focus on key or active ingredients, striking a balance between not being the first or last listed in a formulation. Striving for a middle ground ensures effectiveness without causing unnecessary irritation. 

Tips for counseling your patients: 

• Advise them to look at their product’s ingredient list. The active ingredient should neither be the first nor the last listed. Being the first suggests it's the highest percentage, while being the last indicates it's the lowest. Suggest they aim to find a product with the active ingredient listed somewhere in the middle. 

• Caution them that certain ingredients, such as vitamin C, can actually be irritating in higher concentrations. 

   

Myth 2: You must wash your face for 60 seconds for maximum effectiveness. 

Dr Rossi supports this popular notion that washing the face for at least 60 seconds maximizes impact, with one important caveat: water alone is not an effective cleanser. 

He emphasizes the importance of a good cleanser and advises patients to focus on contact time; he recommends keeping cleanser on the face for at least 60 seconds to allow the active ingredient to work. 

Tips for counseling your patients: 

• Advise patients not to wash with water alone, especially if they wear makeup or live in an urban environment and are exposed to daily pollution. 

• Suggest they apply their cleanser, let it become sudsy, then brush their teeth before washing it off. This ensures the cleanser is making contact with their skin for at least one minute. 

   

Myth 3: Sunscreen isn’t necessary in the winter. 

Next, Dr Rossi addresses a myth that dermatologists hear often: sunscreen isn’t necessary in the winter or on cloudy days. Dr Rossi underscores that significant amounts of both UVA and UVB rays can still reach the skin even in the winter months and that sun protection is still important. 

Tips for counseling your patients: 

• Show them images from the New England Journal of Medicine article “Unilateral Dermatoheliosis” by Gordon et al, which showcases photoaging on one side of a truck driver’s face and serves as an impactful visual aid that UVA can be transmitted through window glass.
• Explain that the light reflection from snow can amplify sun exposure when engaging in outdoor winter activities. 

• Advise them to look for a sunscreen that offers both an SPF of 30 or higher and UVA protection.