[AMA] I'm Dr. Leslie Baumann - Let’s talk skincare, AI, and the future of personalized skincare routines!
Hi Reddit!
TL;DR Dermatologist here to answer all of your skin care questions!
I’m Dr. Leslie Baumann, MD, FAAD. I’m a board-certified dermatologist, textbook author, educator, and researcher based in Miami Beach FL, USA.
In 1997, founded the Cosmetic Dermatology division at the University of Miami, which was the first university center ever dedicated to cosmetic research in the US. My Cosmetic Dermatology textbook was the first on the subject. It's in many languages and is used by dermatologists to learn cosmetic procedures. I’ve also written a textbook on Cosmeceuticals and Cosmetic Ingredients (McGraw Hill 2015) and a New York Times bestselling book on skin care, The Skin Type Solution (Bantam Del 2006, 2007, 2010).
I have spent the last 20 years researching skin type, skin care products, and skin care routines. My research on skin care ingredients has been published in my monthly column Cosmeceutical Critique in Dermatology News. (I am getting the linked for you)
My latest paper, “AI-Guided Personalized Skin Care and Custom Routines”, was published in the Journal of Cosmetic Science. It discusses the science, testing, and research behind my clinically-validated skin type quiz, the 16 skin types, and designing a custom skin care routine for your skin type. The paper also discusses how I see AI shaping the future of skin care product recommendations and personalized skin care routines.
I’d love to chat with you all about skin care, dermatology, AI, the Baumann Skin Type System/the 16 Skin Types, and anything else to do with beauty and skin health!
You can ask me almost anything you like, with one exception: Please don’t ask me to diagnose you. My answers will be informational and educational, and are not intended as an alternative for medical care. Please also ask me one question at a time. I'm Gen X - so I get confused trying to navigate multiple questions in one comment. :)
If you’d like the best personalized skincare advice, it’ll be helpful if you know which of the 16 skin types you are. You can take the skin type quiz here.
I look forward to answering your skin care questions!
Hey all, we're super excited to have Dr. Baumann join us! This AMA has been verified by the mods. You can start asking questions now. She will begin answering on April 5th, 9:00 am EST.
Dr most skincare goals tend to be about having glass skin or clear skin which is not really my goal since I don’t mind a few red spots my concern is maintaining my facial volume I’ve heard we tend to lose facial volume as we age what products do you recommend where it seeks to keep your skin plump and full rather than clear and glassy. I’m 21F and I use SPF, ditched my retinol for retinal from beauty of Joseon using sandwich method . Cleanse my face at night with a cleansing bar and starting to use this peptide serum from medicube
Luckily- not everyone loses facial volume. It depends on your body weight. If you stay at a healthy body weight, you should not lose much facial volume which is mostly facial fat and natural substances like hyaluronic acid.
Tip to preserve facial volume: Stay away from the prostaglandin analogue lash growing products as they have been associated with facial fat loss.
As far as your skin care routine goes-
Retinol vs retinal-
I personally like retinol better than retinal because I have seen better results. If you start using a good SPF and a retinoid at your age and avoid the sun as much as possible your skin should age well.
Antiaging peptides-
I don’t think the peptide serums are very effective in most cases, but since you are worrying about facial volume- the brand Alastin has an HA Serum that has a peptide in it that helps your skin make its own HA which can help with volume. There are several studies to back up this claim.
I interviewed the scientist on youtube about the HA that plumps skin and helps increase HA. You can find it here. Look at timestamp 24:32 where he discusses this. If you prefer reading, this is one of the publications that discusses this: https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.15027
I hope this answers your question. I am so happy that you are getting started on preventative skin care so young. You will be so glad when you are my age.
Yes, there is a lot of data about Excimer lasers for treating vitiligo and trying to bring back pigmentation. I recommend you search Google Scholar for Excimer laser and vitiligo. You will see many studies.
Make sure you are vigilant about SPF over the hypopigmentated areas whether you get laser or not.
Wonderful! I will read further. While currently treating vitiligo with both therapy and topical cream, I want to work on the hyperpigmentation on my face with IPL but am fearful of developing new patches.
Oh I see. I am not a fan of using IPL for hyperpigmentation anyway because we see a lot of rebound pigmentation. I suggest only using a skin lightener and be careful to not apply in the light areas.
You should have your patients take the skin type solutions skin type quiz at least once a year. But it is also good to retake it if: hormone status changes, the seasons change and skin care routine needs to be adapted for the climate, skin care is not working, or major life stress or illness.
Skin types can change. I’m sure you have seen your patient’s skin type improve when they use the correct skin care products for their Baumann Skin Type.
I took your skintype quiz and noticed the products/brands mentioned for the most are ones I am not familiar with and in turn pricier. Have you considered adding lower price brands as an alternative for those of us who are more financially conscious? What would also be a lot more helpful is when you identify specific products you recommend that you point out the specific ingredients in that product that have led you to think they're good for the skintype. Skin care field is so vast and so many of them share ingredients that I would imagine it isn't possible for you to know all the products to recommend but at the same time it might be limiting your audience from trying out other products that are more affordable.
Hi! In my book The Skin Type Solution (2006, 2010), I included many more affordable skincare brands—I called them “$” or “one-dollar-sign” brands. The challenge I ran into with budget-friendly brands like Neutrogena, RoC, and Aveeno is that they frequently change their formulas, product names, and even packaging, often varying by country. This made it difficult to stay up-to-date, especially since I test products in multiple skincare routines and combinations across the 16 Baumann Skin Types. So I tend to stick with brands that have consistent formulas and names.
I really like your idea about focusing on ingredients! Have you had a chance to look at any of the products recommended for you onskin type solutions? I make it a point to personally write the ingredient descriptions, so all that info is there. Pick a product and scroll down to the black-and-white ingredient icons—click on the featured ingredient, and you’ll see why it was chosen and what it does.
Also, after you take the quiz, you’ll get an email with a link to a blog post all about your skin type. (Or you can just Google your skin type—like “OSPW Skin Type blog”—and it should pop right up.) In that intro blog, I explain which ingredients you should use and which to avoid, based on your skin’s specific needs.
And yes—we definitely include $ brands like CeraVe and La Roche-Posay on the site. You’ll always see options at multiple price points. My goal is for everyone to benefit from this algorithm, no matter what your budget is.
I’m 26 and I’m curious to know what things I should start implementing into my skincare to take good care of my skin as I’m now technically past my “prime” as far as skin goes. I currently have a pretty bare bones routine with micellar cleansing water, witch hazel mist, and CeraVe moisturizing cream. My main struggles currently are acne, large pores on my nose, and dry skin.
I promise you, your skin isn’t “past it’s prime”! It is a great time to start really taking care of it. I am going to guess from your comments that you are a DSNW acne type (This is Baumann Skin Type 4), but it’d be better if you take the skin type quiz to find which of the 16 skin types you really are.
If you are a Skin Type 4-your issue will be that acne and antiaging products can dry your skin. I would stop using the witch hazel because it can dry you out. Although its soothing, there are better soothing ingredients for your skin type such as Argan Oil.
Make sure you completely wash off the micellar water because it can leave drying detergent on your skin.
You need to add a good barrier repair moisturizer so that you can tolerate a retinoid. There are much better barrier repair moisturizers than CeraVe cream- and they are affordable. I prefer the ones that have a maltese cross pattern under the microscope which is an important characteristic that the best barrier repair moisturizers have. You can google it and find which ones are sold in your country. Make sure it is a noncomedogenic face cream designed to help the skin barrier.
I believe a retinoid is a great addition to your skin care routine because it will help your acne and give you antiaging benefits. Retinol is an easy way to get started. Use a low strength one (0.025%) and every time you run out buy the next strength up.
Your skin care routine (if you take the quiz and indeed are a skin type 4) should be a creamy nonfoaming cleanser or micellar water, barrier repair moisturizer, SPF every day, and the same night regimen but with a retinol instead of SPF.
This can still be a bare bones regimen. If you get a creamy barrier safe cleanser, a barrier repair moisturizer, a good SPF and a retinoid- you are set for a while.
I took the 16 skin type s quiz at my dermatologists office but how do I know if it’s correct? What if I answered the questions wrong? It says I’m oily skin but I think I’m dry.
The "Is my skin oily or dry" question is an important one and I get asked it a lot!
This is something we researched extensively over more than a decade. Our data and studies by others have shown that most people are wrong when they self-assess whether their skin is oily or dry. We did a study using a Sebumbeter to validate the quiz questions and prove they can actually diagnose oily vs dry skin. We compared a lot of questions to figure out which wording led to the most correct results.
So if the Skin Type Solutions Quiz that you took in your dermatologist’s office diagnosed you as an oily skin type, you should follow your dermatologist’s advice on how best to treat your oily skin. (Or find out what the best products for oily skin types are at skintypesolutions.com)
If you are like others who are surprised that they tested as an oily skin type you will be amazed how much better your skin care works when you are on the correct routine for oily skin.
Hi Dr B! I love the Zerafite moisturizer for my rosacea. I've been using it for a couple of years now after finding it through the skin type quiz. Are there any stronger versions of it, like a face mask or serum, that I could use for an extra soothing boost?
I have rosacea and I love the Zerafite Soothing Moisturizer too. The new Zerafite Wrinkle Defense has both soothing and anti aging ingredients so I have switched to using that for myself and my patients.
You don't really need a mask.If you want one- choose a hydrating mask with hyaluronic acid but no exfoliants in it.
For a serum- have you tried Plated Intense? It has exosomes derived from platelets and I have seen really good results using it for antiaging my rosacea patients. You may not need antiaging yet. Depends on which of the 16 skin types you are. If there is a “W” in your skin type name- then you do need anti aging ingredients- even if you don't have wrinkles yet.
Hey Dr. Baumann. I read your article about using the skin type system to train AI to do custom skin routines. How can i get one of these personalized routines? Do I go to skintypesolutions.com? Is that the correct website? It didn’t say in the article where to get these routines and advice. Thanks!
Hi Dr. Baumann! I'm a DSPW. I know that the "perfect" skin type is essentially the opposite of mine - is the goal to eventually change your skin type to get as close to ORNT as possible? Is that even possible for skin types like mine? Thanks!
In a way, yes- that's the whole point. Your genetic skin type stays the same but with a customized skin care routine that targets your underlying dehydration, inflammation, hyperpigmentation and tendency to wrinkle, you can change how your skin acts. You can get it to look and act like a Baumann Skin Type 12:ORNW!
Although your skin will improve- it’s still important to use the correct skin care routine. So after your skin improves- retake the skin type quiz and see if you need to update your skin care routine.
Skin type changes after pregnancy- so for a good post partum skin care routine- I always recommend taking the 16 Skin Types Quiz (link in the intro comment) . It will ask you questions that I need to know the answer to before I can tell you what to use.
For example, the quiz will ask if you are breastfeeding. You may be oilier than you were before or have more acne. Post partum skin care advice depends on which of the 16 skin types you are. You can take the quiz and come back and ask me for more personalized advice- or follow the recs on my website. Once you stop breastfeeding - take the quiz again for an updated custom routine that has ingredients in it you cannot use when breastfeeding.
Hi u/whirlpool - very fair question and the short answer is yes, depending on the product and where I recommended it. Nowadays, Skin Type Solutions is, in many ways, primarily a SaaS retail platform that we license to dermatologists and med spas, and to sell products, we have to have a contractual relationship with the brand.
We choose products after testing them on various Baumann Skin Types and making sure they align. Brands have even agreed to reformulate products based on our guidance. The website also includes brands to which I own the trademark (but not formula).
Skin Type Solutions is an approved seller for major brands like Skinmedica, Alastin, La Roche Posay, EltaMD and others - so we sell products through dermatology offices to patients and directly to consumers online. This is why we have brands exclusive to dermatologists. Our skin care blog includes store links, the moderators here asked me to avoid linking to it in my answers.
Don't forget- if you want the best skin care advice- take the 16 skin types quiz and tell me which of the 16 skin types you are. If you are one of the 8 sensitive types, please tell me which type of sensitivity you have (acne, rosacea, stinging, or allergic).
I will be able to give you better personalized advice on your skin care products and skin care routine.
Each of the 16 skin types has very different needs- so if you don't tell me your skin type- then I am just guessing with my suggestions for you. If you already asked a question and did not put your Baumann Skin Type- you can edit your comment and add it in.
I will begin answering questions tomorrow am. See you then!
I am a DSNW- rosacea type. Super sensitive. Its hard because I am always trying new products and they often make me red and itchy. But- if I can use the product- than anyone with sensitive skin should be able to so I'm a good beta tester. But my rosacea has been so calm lately!
Hi Dr. Baumann! What was the thought process that led you to start developing your skin type system in the first place? Was it a conscious response to the "dry, oily, normal" skin types invented by cosmetic companies?
I created the 16 Baumann Skin Types to solve a very real problem in my dermatology practice.
In 2004, when I was a Professor of Dermatology at the University of Miami, patients from all over the world would fly in just to get personalized skin care advice. My Cosmetic Dermatology textbook (2002) was in many languages around the world and I had developed a reputation as a skin care expert. But here’s the thing: each consultation took around 45 minutes! That is how much information I needed just to diagnose their skin type and customize an effective skin care routine.
The skin typing system used back then divided skin into dry, oily, combination, and sensitive. This was not accurate enough to be useful in choosing the best skin care products to effectively treat my patient’s skin concerns. I needed a faster, more consistent way to personalize skin care recommendations—not just for me, but for my team and other dermatologists.
So - I took a step back and asked myself: What are the core skin issues I have to evaluate to build a great skincare routine? I narrowed it down to five:
Dehydration – Is the skin barrier impaired?
Oiliness – How much sebum is produced? Enough to prevent water evaporation from skin?
Sensitivity – Is there inflammation (acne, redness, stinging, or allergies)?
Pigmentation – Is the skin tone even, or are there dark spots (hyperpigmentation)?
Aging risk – Based on lifestyle habits, how much prevention or repair is needed?
I needed a system that considered all of these factors together.
One day I saw the Myers-Briggs Personality Types book on my bookshelf (controversial, I know), and it hit me: Why not do the same for skin? Combine these parameters into 16 distinct skin types. That was the turning point. I started using the 16 Skin Types in my medical practice- and it really worked!
But there was still a problem- I needed to make sure the skin type was diagnosed accurately for other doctors to use my skin care recommendation algorithms.
From there, I developed and scientifically validated a skin type questionnaire - now known as the Baumann Skin Type Indicator—the same quiz dermatologists use today to diagnose skin type with precision. It took over a decade to test it around the world on various ethnicities, genders and geographic locations.
Once the skin type test was proven to be accurate, I worked with dermatologists around the world to test skincare products and routines from over 70 brands on the 16 skin types. You can find these studies by searching “Baumann Skin Type” on Google Scholar.
Now the 16 Skin Types Skin Care Recommendation Algorithm powers the personalized skin routines. You can take the scientific skin type quiz, find out what skin care products are right for you, build an effective skin care routine, get educational material, and leave reviews for others with your same skin type.
I achieved my goal! Now hundreds of thousands of people around the world have benefitted from correct customized skin care advice. The more people that hear about the skin type solutions system- the more people I can help. So please help me spread the word.
Thanks for asking such an insightful question and giving me the opportunity to explain how the 16 Skin Typing System was developed.
You should not use any retinoids while pregnant or breast feeding in your post partum skin care routine. It can lead to increased Vitamin A levels and safety studies have not been done on use during breastfeeding. Wait till you stop breastfeeding to use any skin lighteners. In the meantime- moisturize your elbows and knees with a good barrier repair body cream.
i’ve been using CVS products but would like to upgrade. I did my skin type quiz and I’m a 3 DSPW. What anti-aging serum is best for me if I only want one?
I’m so glad you told me your skin type. We need to focus on inflammation, pigmentation and aging.
A Vitamin C serum is a good idea for you if you are already using a retinoid. For your skin type look at the ISDIN Melatonik ($160) if you have very dark spots you want to lighten.
If your dark spots are pretty light- choose Derma Made Antioxidant Serum ($54), Skinceuticals CE Ferulic ($182) Alastin C-Radical Defense Antioxidant Serum $199),The Rationale #1 The Hydragel ($135) or the La Roche-Posay Vitamin C Serum ($45)
If you are exposed to lots of sun, choose the Photozyme Vitamin C+E Ferulic Acid Serum.
If you are over 50 and your skin is thinning, I also love Plated Intense Serum ($258 but you get a $50 gift card so it's a great price.)
I gave you prices to help narrow it down because some of these are pricey. If you are not using a retinol/ retinoid- then that is your first serum you should add. Get used to it before you add one of these other serums. Getting on a retinoid and a SPF and a good barrier repair moisturizer should be your highest priority.
What is the best way to help heal new tattoos and/or revive the brilliance, color, etc of older tattoos? I have mostly sensitive skin on my face but not as much of a concern on other parts of body where I have tattoos. Nothing seems to really work.
Great question! How you clean and protect your tattoo can make a big difference in how long it lasts. I’m going to split this into 2 answers:
What to use on a new tattoo to speed healing? Many cleansers are too harsh for new tattoos but you need to keep them clean to prevent infection. I recommend to my patients to use an enzyme cleanser made specifically for new tattoos. I like the protease enzymatic cleansers. Here is an article that discusses proteases and why they are good for healing skin.
How to protect or bring back the brightness and intense color of older tattoos? How to keep tattoos vibrant? The same company that makes the protease cleanser (Proteya) has a NiaZyme lotion that contains ingredients like proteases, niacinamide and hyaluronic acid. This tattoo enzyme lotion can be used along with their tattoo enzyme cleanser. This company specializes in wound healing and tattoo care.
Also- wear SPF on your tattoo every day!! A high SPF mineral sunscreen is best. The brand Sonrei has a sunscreen for tattoos called Sea Clearly SPF50 Clear Gel.
It’s nice that your sister is looking out for you! Asking me why you should care about your skin type is a little like asking your primary care physician why you should care about your health.
You are at the right age (32) to get serious about protecting your skin. Finding out which of the 16 skin types you are will help you find the right products to protect your skin and keep you from buying or using something that is not effective. There is no reason to waste time and money.
I call the 3 most important skin care products “ CPR products”-because they are critical and skin saving.
At a minimum you need to:
Cleanse
Protect
Repair
But I can’t tell you exactly what to use without knowing which of the 16 skin types you are- you sister is right- take the quiz! It will also assess how susceptible your skin is to skin aging which may motivate you to start wearing SPF every day. (You can thank your sister in 20 years when your skin looks healthier than others your age).
Hi! I am wondering what the correct order is to use my skincare products. Different doctors have told me different things. Should I apply my lightening cream first after washing my face, and then my SPF, and finally my moisturizer? When do I apply my toner? Or is it Face Wash, then Toner, then Lightening cream, then SPF, and finally the moisturizer? Please help. Thank you!
The new Eucerin "epigenetic" serum contains dihydromyricetin and claims to activate genes important to skin aging in the epidermis.
Do you think this ingredient can PREVENT skin aging by protecting collagen and elastin and REPAIR it by increasing the number of fibroblasts in the dermis or does it just make the epidermis temporarily look better while using the product? Thanks!
I am assuming you mean the Eucerin Hyaluron-Filler Epigenetic Serum. I am fascinated with epigenetics and they (Biersdorf) have done interesting work. DHM exhibits potential in preventing skin aging by protecting and possibly restoring collagen by enhancing fibroblast function. So I think it could prevent aging. Further research is needed. For example- does it absorb? We need some long term data to assess prevention- but yes- I think its very promising.
would not use it instead of retinoids but in addition to them- just in case.
Oh, due to the low pH? I wait 10 minutes after the C-serum if that could help.
Beiersdorf speculated in their 2024 paper below that combining DHM with ascorbic acid could potentiate DHM via promotion of the activity of TET enzymes. They also speculate that topical B12 could possibly be synergistic with DHM.
But perhaps the combination must be carefully thought through and separated by morning and evening use?
Skin Rejuvenation by Modulation of DNA Methylation (2024)
"For example, it seems reasonable to increase the potency of DHM through combinations with other epigenetically active compounds.
Candidates include vitamin C, which promotes the activity of TET enzymes [51] and could thus potentiate the effects of DHM.
Another vitamin, B12, has been shown to improve the in vivo efficacy of epigenetic reprogramming [52]. Vitamin B12 plays a key role in the one-carbon metabolism, which is required for methylation reactions."
Ok. Can I use the ascorbic acid serum (pH 3-3.4) at night under the tazarotene cream or will the vitamin C destabilize the tazarotene? I can wait between the layers if that helps.
Vit C is usually a low pH so it can affect other ingredients. So I’m really just being cautious. But your right- that might not bother a flavonoid
I don’t know what mechanism they use to get it in the skin. You can go look at the Beiersdorf patent. But we want to make sure it does not interfere with absorption
I love how you think about these things.
For now- don’t use them together till we figure it out.
Thank you Dr Baumann. I´ll use them separately until we know more.
I´m a registered dietitian and I do think there´s similarities in the way we think about absorption and bioavailability via the dietary and topical route.
So many factors to take into account when looking at nutrients, like the inhibition of nonheme iron absorption by polyphenols and chelation due to flavonoids for example.
My iron deficient patients have no idea that tea and coffee with meals may decrease the bioavailabilty of iron by 50-70%! And conversely that with accumulation over time, too much free iron can lead to oxidative stress via the Fenton reaction.
Hi Dr. Baumann! I’m skin type DSNW. I feel like I have a great routine suited for my skin and its needs, but would like to reintroduce retinoid again but minimize irritation. I have Tretinoin 0.025%. Should I start with that or go to something even weaker OTC?
You can start with it but use it 3 nights a week. And dilute it with 1/2 moisturizer to lower the strength. Then after 2 weeks slowly increase. It takes 4 days to see side effects so start slowly. Also- how old is your tretinoin? If opened it can go bad quickly- so if over 6 months old and open and not in fridge- throw it out.
My skintype is DRNW. I currently use Oil of olay face moisturizer during winter months and Peter thomas roth water drench moisturizer (+ elta md sunscreen) in the summers. This regimen seems to be working pretty well for me. I've noticed I can't do the oil of olay in the summer since it is a thicker product and it makes me have some redness/minor acne to it but in the winter it is the right amount of thickness to give my then much drier skin the right amount of support. Wondering if you have thoughts on alternate products I could try that would meet these criteria?
In winter- try the La Roche Posay Toleriane Double Face repair moisturizer. For light summer moisturizers with SPF, I like Elta MD UV Restore or UV Clear and a lot of the La Roche Posay Anthelios moisturizers.
You can find good options at any price point.
Since you are a DRNW- consider starting a retinol at night. Let me know if you need recommendations.
Hi Dr. Baumann. I'm getting a new tattoo and have sensitive skin, I always get red itchy skin as my tattoo heals. Is there anything I can do to prepare my skin before and after I get it to help heal? I prefer lotions, in the past i've used Aquaphor and do not like it, really can't stand applying it, too think and greasy! Any ideas?
Aquaphor can speed tattoo healing, but you will get better results using a product with proteases, niacinamide and other soothing ingredients to help speed healing.
Check out Proteya Tattoo Recovery and Enhancement Daily lotion. We sell it at skintypesolutions.com. It is a good tattoo enzyme lotion that I prescribe to my patients.
We also use it to speed healing after laser tattoo removal. I even use this lotion to speed healing of acne scabs.
Hi Dr. Baumann, I'm reading your Cosmetic Dermatology 3rd edition, which is so informative. I read the section on Preservatives but there is one paragraph that I cannot get the math to work out (Chapter 44, p. 613): It is estimated that parabens are found in 10% of personal care products. In most cases, these products contain 1% or less of parabens. If the average patient uses 50g of personal care products a day, then the average daily exposure to parabens topically is 0.05g. Parabens are also found in food and drugs, so the total paraben exposure per day is assumed to be about 1mg/day. When food, personal care product, and drug exposure rates are added, the average person is exposed to 1.29 mg/kg/day or 77.5 mg/day for a 60 kg individual. Clearly, personal care products account for a fraction of exposure as most paraben exposure comes from food.
The reference for the 1mg/day is behind a paywall. If exposure from personal care products is 0.05g/day (50mg/day) and from food and drugs is 1mg/day, then personal care is the majority not the fraction of exposure. Is there a typo somewhere?
Hi! Great question—and thank you for reading Cosmetic Dermatology. You're right to be puzzled; the paragraph in question is confusing, and I appreciate you bringing it up. I did make an incorrect statement. Great catch!
Let me clarify:
When I wrote that parabens are found in 10% of personal care products, I meant that 10% of SKUs (product listings) contain parabens—not that each product is made up of 10% parabens. Most products that use parabens contain them at concentrations of ≤1% (often much less), which is the maximum allowed concentration for safety reasons.
So if an average person uses 50g of skincare products per day, and only 10% of those contain parabens, that’s about 5g of paraben-containing product per day. At 1% paraben concentration, that works out to 0.05g or 50mg of parabens per day from skincare.
Now, regarding the total exposure number of 1.29 mg/kg/day (which equals 77.4 mg/day for a 60 kg person)—that comes from a 2001 study cited in the book. But here's where the contradiction comes in: the sentence that says food and drugs contribute "about 1 mg/day" is misleading or based on older, lower-end estimates. That figure may have referred to one specific paraben or one exposure route, rather than total dietary and pharmaceutical intake. It doesn’t line up with the total daily exposure cited just a few lines later.
You're right—if skincare contributes 50 mg/day, and total exposure is 77.4 mg/day, then skincare is the majority source, not a "fraction." That’s a great catch, and I’ll make sure to clarify this in future editions.
As for the broader paraben debate, it’s a fascinating (and often misunderstood) topic. I actually wrote a blog post on this that you might find helpful: Are Parabens Toxic in Skincare?
A few key points:
Some parabens (like isobutylparaben) may pose more concerns than others.
Ironically, many of the preservatives used to replace parabens (like methylisothiazolinone or phenoxyethanol) have higher allergy rates or worse safety profiles.
I personally worry more about preservatives in foods, which may negatively affect the gut microbiome, potentially influencing skin conditions like rosacea—and even metabolism and weight gain.
My final thoughts: preservatives (including parabens) serve an essential function in preventing microbial growth in products. We just need to use the safest ones possible and tailor skincare to the individual—especially if there’s a known allergy.
Do you have any recommendations for building vitamin c into your routine when your skin is sensitive? I suffer from melasma and would love to incorporate it into my routine alongside SPF
Do you know which of the 16 Baumann Skin Types you are? You look like a DSPW—but take the quiz to be sure. When you say “sensitive skin” I am assuming you mean redness and stinging and no acne. The skin type test will tell you which type of sensitive skin you have and help you shop.
Many forms of vitamin C, like L-ascorbic acid, need to be at a low pH to penetrate the skin, and that acidity can trigger irritation in sensitive or rosacea-prone skin.
Instead, look for a gentler, rosacea-friendly vitamin C serum that uses one of these less irritating forms:
Tetrahexyldecyl ascorbate (THD ascorbate)
Magnesium ascorbyl phosphate (MAP)
Sodium ascorbyl phosphate (SAP)
Look at the Vitamin C serums by Alastin and Revision. They should work for your sensitive skin. I do not know of a less expensive Vitamin C that is good for rosacea prone skin.
I use La Roche Posay Toleraine Cleanser and Byoma Brightening serum. I use a spf 50 in the morning and the ordinary moisturising factors at night.
I did try using skin and me with tretinoin once a week but started to get irritation around cheeks.
Am I not going to be able to use any retinol/tret based products at all?
You should be able to tolerate a low strength Retinoid every thirds night over moisturizer. But first- let’s try and figure out your triggers. Which spf 50 do you use? The other products don’t seem bad for your skin. I read ingredients lists. But let’s make sure nothing in dog bothering you. And which cleanser do you use.
Not a lot is known yet. Studies are conflicting But avoid processed foods and preservatives. You want diversity in your microbiome. Eating fruits and veggies is the best way to achieve this.
If you want to take something - I like VSL-4 Gut Health.
Thank you so much! This is definitely something I'm eager to learn more about; I am most grateful that you happened to mention it when answering the question about parabens. (really, I cannot thank you enough!)
There seem to be two big companies doing synthetic pseudoceramides along with fatty acids and cholesterol/phytosterol: Neopharm (Zeroid, Atopalm, Zerafite) and Amore Pacific (Aestura for example).
How would you say they differ in barrier repair efficacy? Does Aestura have the same Maltese cross pattern under electron microscope as the Neopharm brands?
No Aestura uses different tech. I have not looked at their moisturizer under the microscope. And I have not seen any scientific publications by them. Have you?
Hi there! I think you should book an appointment with your doctor. Dr. Baumann will not be providing medical advice in the AMA, and what you're dealing with crosses from regular skincare to medical.
Hello Dr. Baumann! Out of all the actives/ingredients like Salicylic Acid and stuff what would you recommend for mild papules and whiteheads on cheeks and forehead? Thank you!!!
Retinoids!! If you are one of the 8 skin types that are OR( oily résistent) then BP is good.
You can do an SA cleanser once a day but not until you get used to the retinol.
Hi! I was wondering if you know anything about Winlevi and what has been your experience prescribing patients with it? Ive seen a lot of mixed reviews online. Many people have shared that they experienced withdrawal like symptoms from it (rashes, worsened acne, itchiness)
I love it but works best combined with a Retinoid. Acne always comes back when you stop any acne treatment (except accurate) so you can’t just go cold turkey.
But used in a comprehensive acne skin care routine with a Retinoid- winlevy is great for hormonal acne. I’ve seen it clog pores when used without a Retinoid.
Have you heard of it causing withdrawal for people who stop using it for a short period? I am currently on it (3 weeks) and skipped it for a night. The next day I developed a rash on the lower half of my face.
No I have not used any perfume or added anything new into my usual routine. This is the first time this has happened to me. I’ve been applying it twice daily, only skipped it for a single night. For more context:
I applied Winlevi and Cabtreo Wednesday night
I skipped Winlevi and and applied Arazlo Thursday night
I applied Winlevi Friday morning, and started developing the rash.
I think it’s the Cabtreo. Pretty strong. Hold off on it and the arazlo till rash clears. Then restart with every other night no Retinoid ( no Cabtreo or arazlo) but use winlevy. Then report back to me at r/skintypesolutions
And please take the quiz so I know your skin type.
Sorry to jump back into this thread but I was wondering if you’d be able to provide an estimate for when the rash will clear? I have an important event to attend at the end of the week and am hoping this rash will be mostly cleared by then! I also took your quiz and I have OPSW
Thoughts on layering a mineral sunscreen over a chemical sunscreen after the chemical sunscreen has dried? I like the tint of my mineral sunscreen, which I want to use for my hyperpigmentation. But I also want to take advantage of the UVA filters of my chemical sunscreen.
Hi Dr. Baumann! I had gotten one treatment of Morpheus done last year February but it was a bad experience! I was left with a lot of inflammation and texture on my face, which I still mostly have. (Please beware for anyone thinking about doing Morpheus. I have to say that!) What helps best for the inflammation and the texture? Is azelaic acid and/or niacinamide ok? Or what are the best things to use for this situation? please and thank you!
Hi. Which of the 16 skin types are you?
Niacinamide is a better option than azaleic. Stay away from acids. There are many good soothing ingredients. Even pure Argan oil is a good idea. Only use gentle things: Argan oil, aloe, cucumber, green tea, niacinamide.
Ok thank you. I am type 8 ! Should I stop using Nolio Salicylic cleanser and Medi Wash Sulfur/Salicylic cleanser? I was using Medi Wash but then did a couple days with Nolio Salicylic to see what solely Salicylic was like but my skin became really tight feeling right after but was ok once I applied Alastin Skin Nectar. But I stopped Nolio anyway and went back to Medi Wash. Sorry for all that explanation but otherwise for cleansers I am using Medature Plantract cleanser but I do feel like it’s a bit drying- I notice it more around my eyes the dryness from it. Any other cleansers I could use instead? I’m using Medature in place of STS gentle antioxidant cleaner (or is it still possible to buy the STS cleaner on skintypesolutions.com ?)
Should a moisturizer be applied over Altreno (when using at night)? I’ve read that doing so will actually increase irritation by driving the Altreno further down into the skin and sealing it in. Asking about Altreno specifically, not other forms of tretinoin. Thank you!!
You put moisturizer first if you want to slow absorption and after if you want to slow it down
But HA speeds absorption either way.
Which moisturizer you use really matters. Read my blog called Penetration and absorption. I’m not allowed to link here.
Trying to determine what IPL machine is best for addressing broken capillaries, PIE (post-inflammatory erythema), crepey texture, pore size/tightening? Or, are Halo & BBL lasers better for these issues?
I’ve consulted with 2 derms, one uses the Lumeca by InMode, and the other uses StarLux 500. Each claims their machine is the “Cadillac” of IPL devices. Each claims theirs is excellent for all of these issues.
I’ve heard from 2 med estheticians that I should be treated with Halo and BBL lasers instead.
IPL is much less complicated tech than a laser so many devices are really good. It’s more important how experienced the user is because they can burn you even with the best one. Go to someone doing it at least 3 years.
Hi Dr. Baumann! I’ve been struggling with my skincare products for a while now because of all the issues I’ve had with them, and I couldn’t find any answers until I took your quiz! This was such an eye opener, it said I was DSNW and all the things it said about that skin type were spot on! I’ve been trying many products but every single one seems to cause little red bumps, dry patches and a hot/burning sensation on my face. I thought I was allergic to all skincare products because nothing worked. Do you have any recommendations on dealing with this skin type and recommend me some k beauty products that I can actually use?
I was recently prescribed metronidazole gel 7.5% twice daily for suspected rosacea. At the same time, I’m trying to repair my compromised skin barrier (caused by years of bar soap use and a recent bad reaction to retinol and exfoliants). I'm using fragrance-free, occlusive creams and a gentle, baby-formulated cleanser. Are there any ingredients or types of skincare products I should avoid during this phase, even if they're generally considered barrier-friendly? Also, since UV breaks down metronidazole, I’m using a fragrance-free sunscreen for children with filters like Tinosorb S and added jojoba oil — are there any UV filters or textures that are better or worse for rosacea-prone, damaged skin? Finally, once my skin is more stable, I’d like to wear foundation again. Are there specific makeup ingredients or product types you’d recommend — or warn against — for someone with sensitive, reactive skin recovering from rosacea?
Just so you know- the inflammation from rosacea and a defective barrier are 2 separate issues. Do you know which of the 16 skin types you are? My advice depends on that
Which baby cleanser? Some are harsh
For rosacea it’s better to use mineral zinc oxide sunscreens.
I can't see much in this picture except some redness around your hair follicles. Can you tell me about your symptoms and tomorrow I will try to answer?
Here are some more pictures. No real symptoms just all cosmetic I've had this for many years. It feels like small divits in my skin and it is bilateral on my other cheek as well. Thank you Dr.
Has micro needling and laser been proven to work in clinical studies with a significant p value and adequate sample size? I don't have medical insurance but i know there are plenty of these clinics who do this type of stuff in Asia and it's very well priced, I'm just hesitant on their actual effectiveness. Lots of psudo science out there.
It can work but will not erase them. Depends on shape and depth. You need to see someone in person to assess the depth. But I think those are “boxcar” scars that may do well. Fillers may help too. Where in Asia are you? Which city?
I'm in America right now with no insurance. I pop up around Thailand and or Vietnam from time to time. In Thailand they had these types of clinics in every mall. I don't even think insurance would cover a cosmetic procedure like that in America.
I think I see some redness around your hair follicles but it is not a great picture. Try a salicylic acid or sulfur based cleanser like Derma Made Medi Wash or Neutrogena Acne Wash (the orange one). The way you are shaving may be an issue. I wrote some shaving tip blogs that you can find by searching "skintypesolutions shaving advice"
Thank you, everyone! I really appreciate all of your thoughtful questions. I’m such a fan of Reddit and its skincare community in particular. I’m a semi-regular Reddit user, so you always tag me, DM me, or post on the r/skintypesolutions subreddit. I’ll get back to you as soon as I can. I’m juggling kids and patients and art classes so it may take me a day or two to get back to you - but I promise it is me answering your Reddit questions
For those of you who want to learn more-
The best places to learn about skin care science are:
Don’t forget- every skin care product in your routine affects how the other products work- so let me help you get the best results from your skin care routine. It all starts by finding your real skin type!
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u/mayamys Mod/Tret+BP=love 10d ago
Hey all, we're super excited to have Dr. Baumann join us! This AMA has been verified by the mods. You can start asking questions now. She will begin answering on April 5th, 9:00 am EST.