How To Treat Combination Skin - Tips for Routines, Regimens & Products

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Tonia:
Welcome to the Smazy Academy Show with Tonia Ryan and-

Doc Vegas:
Christopher Khorsandi MD.

Tonia:
This show is dedicated to giving you the best tips and tricks when it comes to skincare. Combined, the doctor and I have over 30 years of experience in the medical and skincare industries and we're here to share all of our tips with you. We've seen thousands of our customers' skin transformed and we can't wait to help you out as well. So, whether you're a skincare newbie or a skincare connoisseur, this show's for you.

Doc Vegas:
Yeah, we're here to demystify and make this fun. Skincare, the way I look at it, if you're not educated in this, it's overwhelming. I mean, you look at these stores that have thousands of products.

Tonia:
Oh, and what do you do?

Doc Vegas:
Yeah, and even when patients walk into my office I carry a couple of skincare lines here, it's very confusing. What do you need? What do you buy? What's good? What's not? What's going to work for you?

Tonia:
Well, it takes a lot of time and a lot of education to even know yourself, "Okay, so what skin type am I? What should I use?" It's a lot of work.

Doc Vegas:
No, it is. I think, first of all, you have to know yourself. And I think that if you're going to begin a journey of education and skincare, first, you have to be good at taking care of your own skin. Don't you think?

Tonia:
Yes. So, today we're going to be talking about what skin type are you?

Doc Vegas:
Right, so we're basically getting down to the fundamentals here. What are you? I mean, because what your skin type is is going to dictate what you do with it, right?

Tonia:
Yeah. So, at Smazy Academy we break down every single skin type that there is. Unfortunately we can't do all of that in one video because there's a lot of information, so-

Doc Vegas:
Yeah, you don't want it in one video anyway. I mean, because if you're not a combo skin type and you're not oily or dry, you don't really care about the dry skin type if you're oily, you do if you're treating people and you become a skincare expert.

Tonia:
Yes, right.

Doc Vegas:
Which is fine, but begin with understanding what you are, and begin with treating your skin so that you have glowing radiant skin that makes you the envy of your friends.

Tonia:
Those are such good tips, yes.

Doc Vegas:
We want to empower you to feel good every day when you wake up to have that clear, beautiful skin that makes people say, "Wow, you look beautiful."

Tonia:
Yeah, "What did you do different? What are you doing?" So, we're going to talk today about one of the most prevalent skin types, and that is combination skin.

Doc Vegas:
Right.

Tonia:
And there's five different things that you can look at within yourself to see if you're a combo skin type.

Doc Vegas:
Right. And so, let's talk about it from the top, right? How do you identify... Well, combo's like this, it's not dry, it's not oily, it's all over the place, it's all over the place, right? So, what are the signs that you look for? What happens after washing your face?

Tonia:
Okay. So, the first time about 20 minutes after you've washed your face, if you see oiliness in certain parts of your face you know you're probably combo because you could be a little dry certain places and oily other places.

Doc Vegas:
Yeah, and the reason for that is that skin is not all one homogenous sheet of tissue, right? It's not one thing. Different areas of our face, different areas of our body react differently to stress, different areas of our body have different concentrations of pores and sebum glands. And so, it's just, some patients will come in and their T-zone, in this area here, is completely oily, but they're dry everywhere else, right?

Tonia:
Mm-hmm (affirmative).

Doc Vegas:
And so, that's one of the things you have to take into consideration. You can't treat combo skin with one big roller and paintbrush.

Tonia:
No, and some people, they have other issues, so they think they're other skin types. It's a little tricky sometimes to pinpoint exactly what it is. So, well, we go to number two, when you use a moisturizer for normal skin it makes your cheeks feel good, but it makes your T-zone still feel oily.

Doc Vegas:
Yeah, you look like you're radiating, I mean, and not in a good way, right? And so, I think that having the skin shine is good, but when it's oily, there's something about it. And it's a certain... I think when skin is bright and it's reflective, it's healthy looking, it's moisturized, it looks great, but oily skin definitely has a certain look to it that makes people look sweaty, glossy, maybe they have a fever, there's something you're kind of like, "Well, why is this person... Are they sweating? Are they not feeling good?"

Tonia:
And there's a fine line too, because a lot of girls want to look dewy.

Doc Vegas:
Dewy, right. And so, that's what I'm saying, there's this fine line. So, when you have this oily forehead, nose area and your skin everywhere else-

Tonia:
You can feel it.

Doc Vegas:
Yeah, you'll know it.

Tonia:
You know when you have it.

Doc Vegas:
But that's combo skin. And the reason why these areas are really packed with sebaceous glands is that again, the nose sticks out of the face, right?

Tonia:
Okay.

Doc Vegas:
So, whereas the face is pretty vertical like this, the nose hangs out at basically a 45 degree angle, some people it's a little bit more, and what it is is that the sun is coming down and hitting the nose, right? And it's hitting it almost directly rather than hitting it in the face and on an angle and reflecting off. So, we have more sebaceous glands in the area that have more exposure to sunlight. Why on top of the brows? Well, in evolutionary terms, Cro-Magnon man had what we call frontal bossing, meaning the eyebrows came out and made almost like a shell.

Tonia:
Frontal bossing?

Doc Vegas:
Bossing. It means, you know like to emboss?

Tonia:
Like boss?

Doc Vegas:
To emboss.

Tonia:
Oh, emboss.

Doc Vegas:
But it's called bossing, frontal bossing.

Tonia:
Okay, got it.

Doc Vegas:
And so what it is is that the forehead of just above the eye sockets would stick out. You see these Neanderthal looking things at the Natural History Museum or drawings of them. They had these foreheads that came and stuck out.

Tonia:
They were sticking out.

Doc Vegas:
Right. So again, just like the nose, these things were getting hit by sun directly. And so, in some people, they have a high degree of oily pore skin there. They have very highly concentrated sebaceous gland milia in the skin there. And this is, fast-forward a million years, it's not really advantageous anymore, right?

Tonia:
Right.

Doc Vegas:
We're not walking around all day hunting and gathering, and so that really protective oily skin is not really protecting us anymore, it's just making us look oily.

Tonia:
And then, of course, the whole evolution of everything with skincare, there're so many ways to make sure that you aren't oily and you aren't showing it.

Doc Vegas:
Sure, I mean, you can dry up oil in many different ways, but this is the thing, if you're going to use a moisturizer on an oily area it's just going to make it look worse.

Tonia:
Yeah, we have a great oil-free moisturizer that we have with Smazy, with our skincare, which is really nice too.

Doc Vegas:
Right. And that's the thing I should say, a lot of moisturizers are oil based.

Tonia:
Yeah, they're too heavy.

Doc Vegas:
And so, you add oil to oil and it's just done, you look like you're the fender of an old '57 Chevy, it's all Chrome and polished and you just look too much, right?

Tonia:
Right. So, number three.

Doc Vegas:
Right. So, this is kind of what we're talking about, is about the pores on your nose.

Tonia:
They're visibly larger on your nose than they are on your cheeks and jawline.

Doc Vegas:
Yeah, that's always a problem. That's a problem for me when I do rhinoplasty patients who have really thick skin in the nose, they got massive pores.

Tonia:
Does the skin get thick in the nose or just some people?

Doc Vegas:
Yeah.

Tonia:
Okay.

Doc Vegas:
And so, when you have really oily, large poor skin, the annoying thing is that in those areas it tends to grow as you age.

Tonia:
Oh.

Doc Vegas:
And there's a disease called rhinophyma, which is a diseased process of the oil glands of the nose that makes these noses look like these big red tumors.

Tonia:
I've seen that.

Doc Vegas:
Yeah, and people think it's because they drink alcohol. It's not from that.

Tonia:
It's not from that.

Doc Vegas:
It's a disease of the skin that causes chronic inflammation of the glandular tissue which then grows and multiplies and divides and just becomes bigger and bigger and bigger. People with very oily skin on the nose, the pores get clogged, you get a lot of blackheads, right?

Tonia:
Okay.

Doc Vegas:
And because of that you can actually see that they have blackheads pushing that gland out a little bit and it makes the nose bigger and bigger. And then over time, if you're not controlling that, that hyperplastic mechanism, meaning that it's overly productive, makes the cell grow bigger, it makes the cells multiply and all of a sudden the skin gets thicker and thicker. So, you really want to try to control that.

Tonia:
Yeah, because that's no fun.

Doc Vegas:
No, I think that it's interesting when I see some patients that I've taken care of for over a decade or more and you look at the pictures from when they were in their late teens, like 18, 19, and then you see them in their twenties, you actually can take a look at the noses and you see that if they have really oily skin the nose gets wider.

Tonia:
Oh, wow.

Doc Vegas:
So, I think you can mitigate that with different strategies. Keeping those pores open and breathing is a really important strategy because that cuts down the inflammation. Getting those whiteheads and blackheads off and exfoliating and opening up and allowing those pores to exude and cleaning up that oil.

Tonia:
Yeah.

Doc Vegas:
Don't let it build up because oil and sebum are waxy and they plug things, and then you get a lot more acne. Oily skin is always more prone to acne than dry skin.

Tonia:
Right. So, we'll go to number four. And this is a good one that will definitely tell you if you're combination skin, and that is you get breakouts and dry patches at the same time. So, you have breakouts on your skin, dry right here.

Doc Vegas:
Yeah. Well, that's a good segue because that's exactly what I'm talking about. Right, exactly. So, the areas that you're oily, it's very acne prone and the other areas of your face are just kind of dry and irritated looking.

Tonia:
Yeah.

Doc Vegas:
So, I mean, there are things that can help. I think niacinamide is a great topical that can help with oily skin that's a very natural product. It's been shown to decrease oil production. It decreases inflammation in the skin and it actually increases the production of ceramides, which are skin protective.

Tonia:
Right.

Doc Vegas:
And also interleukins, it cuts down on the inflammatory mediators in the skin. So, these types of things, I mean, they're science-based products that actually work and they're healthy because they're hormone-free, they don't have any sulfates and phthalates and all these weird things that the chemical industry came up with over the years. We've avoided all that stuff to create products that are healthy for the skin.

Tonia:
Yeah, that's everything we took out of our skincare line.

Doc Vegas:
Correct. So, if you're combination, niacinamide is a great topical because it doesn't really dry you out if you're dry in some areas, and if you're oily, it's a great thing to apply.

Tonia:
Yeah, and I'm going to put a list of all of the different products that are for combination skin and other skin types as well, to help you choose the best products for yourself so it's not just a guessing game out there in the world of se-commerce when there's no one even helping guide you what you should get.

Doc Vegas:
Yeah, we're here to kind of figure out ways of teaching you to understand your skin better. And that way you can select the best products for you to help you have a healthy look to yourself and make sure that your skin glows and makes you feel beautiful.

Tonia:
Yeah. So, let's go to number five. This is the last one.

Doc Vegas:
Okay.

Tonia:
And this is if your flaky areas are within your T-zone.

Doc Vegas:
Okay.

Tonia:
Now, when that happens, it could be maybe an overuse of certain products that you're trying to get rid of.

Doc Vegas:
Yeah.

Tonia:
Yeah. So, let's say benzoyl peroxide.

Doc Vegas:
Yeah, that can be very drying and irritating.

Tonia:
Yeah.

Doc Vegas:
So, if you're really oily and you're overdoing it with kind of the benzoyl peroxides and different things that are very harsh on the skin, that benzoyl peroxide is good in moderation.

Tonia:
It's great in moderation and you're doing the proper regimen the right way.

Doc Vegas:
Correct. You're moisturizing, you're protecting, you're using your different products to kind of augment that fact that benzoyl peroxide is very, very irritating to some patients.

Tonia:
Yeah, it can be.

Doc Vegas:
Yeah.

Tonia:
And that's all trial and error too.

Doc Vegas:
Sure.

Tonia:
So, you can try different products and then sometimes maybe instead of using it every day, you're using it every other day, or even sometimes once a week if you're just getting a little bit of acne.

Doc Vegas:
Right. And I think that acne, again, it's such a spectrum of different causes, but there's a way to treat it for every patient, we just need to kind of get the regimen that works best for each patient.

Doc Vegas:
So, basically that's combination skin in a nutshell. You have oily areas, dry areas, and it's really a matter of just the genetics of your skin.

Tonia:
Yeah. So, if you want to know more, you can go to smazyacademy.com. We break down all the different skincare types so that you know exactly which skin type that you are.

Doc Vegas:
I appreciate you guys tuning in today and listening to us. Maybe you're driving to work or you're working out, download us on Apple Podcasts, rate us, give us a rating and send us a copy of that rating to [email protected], we'll enter you into a monthly drawing for $200 in free skincare products. Like, share and subscribe, we love to see you guys comment and let us know what you think.

Tonia:
Yeah, share it with your friends.

Doc Vegas:
Yeah.

Tonia:
Absolutely.

Doc Vegas:
Thanks for joining us.

Tonia:
Thank you.

Doc Vegas:
We'll see you guys next time.

Tonia:
See you next time.

Doc Vegas:
Take care.

Tonia:
Bye-bye.