Dermatologist & 'Skinfluencer' Dr. Muneeb Shah Talks TikTok Skin Care Trends & Products – Exclusive Interview

What sparked your interest in dermatology and what do you love most about the practice?

It's a very visual field whereas in a lot of specialties, if someone has high blood pressure or diabetes, you work to get those under control through various medications, but they're hard to see. And when you treat them, the patients often don't know the difference right away, because these are long-term conditions, whereas with a dermatologist it's very visual.

You walk in, oftentimes [you know] what the diagnosis is when you see it because you've seen it before. If you don't, you can get a piece of the skin very easily with a biopsy without having to do something invasive. You can just take a piece of the skin right in front of you, and then you can treat it. And you can see the patient do better. And sometimes we take pictures. Even for something as simple as acne.

When we see someone coming in with acne and it really is affecting their life, we have photos. Then three or four months down the line, they have clear, perfect skin. It's amazing to see that transition. And it gives me a lot of job satisfaction, but also I think the patients are very happy with the outcomes a lot of times. And so really [it's] a patient-focused field where we actually can see results. I really just love that visual aspect.

That's great. And where did your passion for educating people come from?

That was actually primarily my thing. Pre-TikTok, pre-YouTube, pre-Instagram, I loved to be an educator, and my audience before was the medical community. I used to write a lot, I used to mentor a lot, I used to tutor a lot. And I used to also create medical curriculums for medical students. And I loved teaching medical students, loved mentoring pre-med students. And that was sort of my outlet.

I always thought I would just do that. I would end up in the medical education space, specifically talking to professionals, and then the pandemic hit. Our medical students weren't visiting the office anymore. And I got on TikTok and I realized that there was a need for someone to communicate simple information to people to improve their skin health. And there was a lot of misinformation out there. I didn't realize that there was such a white space that existed.

I started to create content that really resonated with my core audience. And I realized I could educate millions of people the same way I would do with the medical community, but just on a larger scale. And so I kind of took that and ran with it.

How has that platform of social media really changed the way that you're educating people?

Well, I think that you have to kind of know your audience now. On TikTok, it shows up right on their page. It's not a search. It's not people you follow a lot of times. It's people that are just scrolling for content that resonates for them. It's just the way that algorithm is. And so to capture those people, you have to really draw them in pretty quickly, and you have to get them to buy into whatever you're going to say next, early on. People aren't searching for things, you're being presented the things. And I think I create content in a way that it's short snippets. I get just enough information in there for people to act on it, not too much to overwhelm them, but enough to grab their attention and then maybe have them seek out more information elsewhere. And so that's what I do on TikTok.

On Instagram, there's a little bit of an audience, that's a little bit very curious [about a] particular topic. They follow you and see, you can give them a little bit more than that. A lot of times [in] the description, you're giving them more information about something they're already passionate about instead of presenting them with a new idea. You're just really filling in ideas of things that they already know and want to [build] upon it. And then on YouTube, it's totally different too. We do YouTube, soon to be the largest dermatology channel on YouTube probably within the next month or so–

Congratulations!

Thank you. Thank you. Thank you. It's fun. On YouTube, we now search. So people, lots of times, have a question. "How do I treat acne?" And so you're creating content to really answer questions for people just [like] any how-to video would be. That's how I make content, really — I make it for the audience, right? I know the science but I need to make it for the audience. And so I really cater to the people that watch the videos.

What kind of misconceptions about skin care do you see circulating pretty regularly [on social media]?

I find that they come in phases. I think that one thing that always comes up is there's always some type of fear-mongering around an ingredient or saying certain ingredients are "dirty" and others are "clean." ... At one point DMDM hydantoin was a very common ingredient that people were fearful of and [some were] claiming that it caused hair loss. And there's no data that it actually causes hair loss, but they catch a lot of virality and then people avoid those ingredients. And then other companies come in and they say, "Well, our product doesn't have that so you should buy our product." So it becomes this thing, and I try to balance those out as they come in. That's just one example. So it's this fear-mongering that's usually overblown that I'm always trying to debunk.

I think another thing is this idea that medical-grade or very expensive skin care is somehow better or that you have to really spend a lot of money to have better skin. I think that's something that is very common on social media. That's just not true.

Right now, around this time of year, one of the things that's just very common is tanning. People in tanning booths, people thinking that base tans are good for you, that it's safe to get that. Of course ... the sun is responsible for vitamin D production. But [saying] that it's safe that you should be getting vitamin D from the sun when, in fact, it's just going to age you and give you skin cancer. And you can get vitamin D in safer ways. You're actually probably going to get enough vitamin D even if you wear sunscreen, just because it doesn't block out all of the rays that would help with that. And tons of people that get tons of sun are still vitamin D deficient. It's, I think, complicated. That's something that around this time of the year people are always pushing through: base tans or thinking that maybe their self-tanners are going to protect them from the sun or that they just simply just don't need to wear sunscreen.

Another thing right now is that sunscreen actually gives you cancer. I've seen this one going viral [claiming], "Oh, the more people wear sunscreen, actually that [why] skin cancer's on the rise." It turns out that sunscreen use is also on the rise. And so people think that somehow these things are correlated when they're not. There are many reasons why skin cancer's on the rise, but in fact, we know that sun causes cancer and we do not know that sunscreen causes cancer. We do not think that sunscreen causes cancer. 

What is the most basic daily skin care routine that you recommend to people?

I think skin care routines are built on a foundation, and I think everyone's goal is to have better skin. So they go for the active ingredients ... they'll say "I want a retinol, I want an exfoliant, I want XYZ thing to get better." But I think if you're new to skin care, first you have to build the house before you can put the paintings up.

What I recommend for people that are new is just get a simple cleanser, a gentle cleanser, something like the CeraVe Hydrating Cream-to-Foam Cleanser, get a moisturizer ... if you have dry skin, you may want something like a thicker cream. If you have oily skin, you may want more of a gel-like moisturizer. I really like the SkinFix products for moisturizing. And then a sunscreen. A simple sunscreen a big fan of the EltaMD sunscreen line. It's a dermatologist's favorite.

And that's the simple cleanse, moisturize, sunscreen [routine] that everyone should have as their foundation. Now in between those steps, I say, "cleanse, treat, protect." You have your "cleanse "and your "protect" when you have your cleanser, moisturizer, and sunscreen, but you don't have the "treat." Once you build that foundation, you add the treatments in there, and those are the treatments that are going to have you see your results. ... Those treatments need to be specific to you. So if you're somebody who's trying to go after wrinkles or you want to go after pigmentation or you're going after acne, you're going to choose that treatment for that particular issue that you have

To go off of that, do people really need a ton of products to keep their skin healthy and looking good?

No! I mean, I usually use anywhere from three to four products a night in my routine. Pretty simple. You can get by on a three-step, skin care routine pretty well, and if you want to get fancy, you can get up to five. Anything more than that, you're going to end up in trouble.

What makes a skin care product really top of the line — like you said, not necessarily price-wise but quality-wise? What should people be looking for in these really good quality skin care products?

Quite honestly, you don't know. Now we are so limited by what the manufacturer is going to tell us. ... It was very popular to look at ingredient lists probably about two years ago. And now there's almost been a backlash against ingredient lists from a lot of the skin care community. It's very subtle, it's very small –and I'm involved in the skin care community, which is a small group of people, [so] I know. what the discourse is right now about these things — so there was a big push [saying] "you've got to know your ingredients. You've got to choose the ingredients that are safe and effective." And then there's a backlash against that.

Looking at the ingredient list, you don't really know how this comes together. ... It's [like] cooking. Just because you see the ingredients doesn't mean [you know] how it's going to taste. So there was this pushback against just focusing on ingredient lists: "Oh you shouldn't do that. You should just focus on how it feels and what it does."

I think, as consumers, you really do need to focus on the ingredient list because we don't know. I mean a company can say anything they want, but the only thing that we have to go on is the ingredient list to decide. Is this going to have anything in here that I'm allergic to? Does this have the ingredient I'm looking for that is going to treat the condition I'm looking to treat?

I would say look at the ingredient list. Make sure that they have safe and effective ingredients, which takes a little bit of research to figure out what you're looking for there. Look for trusted sources. I think a lot of dermatologists and skin care influencers are great on social media. They're going to give you very good and honest opinions and breakdowns.

And then the third thing, which not a lot of brands do, but some do, is research. They actually will publish clinical studies on their products. And then you can read the study and look at the inclusion criteria and the way that they ran the study and the results and decide whether or not you think it's a clinically effective product.

But they're all inherently flawed. There's no perfect way to really get it right. And so I would say rely on the ingredient list. Rely on recommendations from friends and family and your trusted skin care influencers. And then if you can find clinical studies, it's good, but not perfect.

How does diet impact your skin?

Diet plays a role — a big role — in everything. What you put in your body is going to affect your face. It's going to affect your heart, affect your liver, your kidneys. The body is not isolated organs. They all are interconnected. ... If you have a poor diet, it'll reflect in the skin.

The problem, though, is that there are not a lot of studies on how diet affects the skin because they're really hard to do because there are so many variables. You're not going to eat the same thing every day. There are other factors — sun exposure, smoking — that interfere with the results. And so isolating data, I mean on exactly what thing you eat is actually causing the problem is very, very difficult to do. We just don't have a lot of studies.

I suspect that a low-inflammatory diet would be beneficial for the skin, even though there's not a tremendous amount of data that says that it is. But I think the Mediterranean diet, which is known to be helpful for the heart, would be very helpful for the skin as well, just because it does have anti-inflammatory properties.

Right now it's Ramadan for Muslims that are fasting. There was a study that showed Ramadan, which is basically intermittent fasting to some extent, was able to decrease psoriasis. So, I think that there are probably some anti-inflammatory components to that as well.

Then you have sugar, which we know can cause acne. High-glycemic diets can also damage collagen and can cause aging. So, probably the one consistent thing that can affect your skin negatively is high-glycemic or high-sugar diets.

And again, you said that there's not a lot of data to go on this, but are there certain foods that we do know we can eat to keep our skin looking great?

I think foods that have high omega-3 content are pretty helpful. That can be various nuts and different meats and fish and things like that. That can be helpful. I'm not a diet expert, but ... turmeric has anti-inflammatory properties. There's nothing I would say, "Okay, everyone should take [this].} There's nothing I would say everyone should use to make their skin better. Other than maybe taking Niacinamide, Nicotinamide supplement, [because] high B3 levels have been shown to be beneficial to prevent cancer, but also have other benefits on the skin.

What is one thing you think everyone needs to know about skin care?

That protection and prevention are always going to be more effective and save more money in your wallet than trying to always treat after you've ruined your skin. I think focusing on sunscreen and moisturizing really, really go a long way, and focusing so much on treatments is not really the way to go. So I would say protection and prevention is the one thing I think everyone should really, really hone in on.

Dr. Muneeb Shah is a Dermatology Chief Resident at Campbell University in North Carolina. You can follow him on TikTok, Instagram, and YouTube for all things skin care.