Dr. Sam Jejurikar and Dr. Sal Pacella cut through a two hundred billion dollar industry to answer a simple question: what actually works?

In this episode of Beauty and the Beasts, Dr. Sam Jejurikar explains why "medical grade" skincare is not a category the FDA recognizes, why a fifteen dollar sunscreen applied every day beats a two hundred dollar one applied occasionally, and how a genuinely effective regimen can be built for around a hundred dollars a month.

The two surgeons walk through the four pillars they recommend to patients: daily broad spectrum sunscreen at SPF 30 or higher, retinoids stepped down to retinols for maintenance, an antioxidant such as vitamin C, vitamin E, or niacinamide, and a moisturizer. Dr. Pacella makes the case for physical blockers containing zinc oxide and titanium dioxide, and argues that what you put in your body matters as much as what you put on it.

They also cover why the peeling and redness from tretinoin is a sign the product is working rather than an allergic reaction, why exosomes are heavily marketed and thinly supported by evidence, and how to think about laser resurfacing for sun damaged skin. Ablative versus non-ablative. Fractionated versus full field. CO2 versus erbium. Plus a blunt rule of thumb: the effectiveness of a laser treatment tends to track with its downtime.

The episode closes on the sun protection blind spots almost everyone misses. The eyelid margins. The light reflecting off pavement, right under the brim of that hat. The sunglasses that focus ambient sun back onto the skin. The ears. As Dr. Pacella puts it, it is the only skin you have.

Dr. Sam Jejurikar is a board certified plastic surgeon in Dallas, Texas. Dr. Sal Pacella is a board certified plastic surgeon in San Diego, California.

Beauty and the Beasts is available on Apple Podcasts, Spotify, YouTube, and everywhere you get your podcasts. New episodes every other Tuesday.

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