These may have clinical significance, but are not close to Retin-A at night + sun protection:
B3, Vit C, CoQ10, retinol (for around eyes with thinner skin), ALA, AHAs, salicylic acid, catechins, gingko, ginseng, grape seed, soy isoflavones, chemical peels (depending on the severity of skin photoaging), daylight photodynamic therapy. There are also cosmetics like botox, filler, and laser resurfacing (primarily ablative fractional photothermolysis, but all uncontrolled studies afaik).
Note a transient effect cannot be ruled out for a lot of laser stuff afaik for recent evidence - the people using and selling lasers tend to have the most positive praise for it. But I never hear them say it could be a transient effect which is suspected bias. Trustworthy scientists tend to speak up about the limitations of any intervention. Not to mention, PRP is a general term - there are no actual standards of administration afaik - this makes it nearly impossible to evaluate objectively and they tend to use scientific-sounding names without sufficient evidence. I would avoid it for now until the industry matures enough to make precise claims and standards, instead of positive hearsay claims of some random industry-sponsored and/or small uncontrolled study that is almost bound to have publication bias. I also tend to (not always!) avoid expensive skincare services sold by biased people with possible adverse effects (ie laser is not risk-free!).
I don’t have any skincare affiliates and I either get the cheapest one with the ingredients I like or make it myself with professional equipment. Just my own research on suggestive evidence. I’m not a dermatologist, so do not rely - ask your derm. You also have to get the dosing and application right.
I also go down lower evidence custom products not available in the market, such as topical prebiotics/probiotics. Also, I take oral organic (this specific brand does not have heavy metals) collagen peptides, but all the studies are industry sponsored. Every single dermatologist I talked to so far has not heard about these custom products and oral collagen peptides yet - it’s more of very specific PhDs at this point.
The basic skincare routine is a cleanser, moisturizer, then sunscreen (zinc oxide) in the morning. Not really much to it beyond avoiding specific ingredients. This is where having a deep biochem background helps a lot to avoid cancer - I find a lot of skincare folks don’t care enough about cancer or just pay lip service to the simple stuff that is relatively obvious.
When it comes to the more complex biochemistry - it starts becoming more obvious a lot of people don’t know much but purport to be experts. As the simplest example, they push benzene-containing chemical sunscreens blindly following recommendations because they lack chemistry knowledge. I long suspected these sunscreens will end up in recalls.
Another simple one is they don’t think of heavy metals when I mention oral collagen peptides. You can ask these two yourself to test different derm clinics.
There are very low levels of regulation in personal care products, very low safety standards, and very high-profit margins with classic human insecurities. The perfect storm for BS.
I’ve even seen dermatologists getting into skincare multilevel marketing schemes selling questionable products, so I only trust specific research-heavy dermatologists (usually academic) with no company affiliation or upsold products in the clinic to save time, instead of interviewing a bunch of possibly subpar and sales folks one-by-one.
You don’t need to spend a lot to get the effect - most skincare products alone are actually pretty cheap for me, but you need to get unbiased experts if you want reliable information - I can’t believe how many times a medical assistant at the front desk upselling me was spewing skincare BS when I was in different derm offices. Not going to name any offices, but that’s my experience. Unfortunately, the industry is heavily female-focused so you need to adjust for that too when it comes to male-specific skin stuff (ie post-shave moisturizers).
Also, every single subpar derm clinic in my experience will skimp on the penis, testicles, and anal mucosa in a standard preventative full body skin exam (to detect skin cancer early), especially if they farmed it out to female PA. I find those in my experience are the most hesitant to deliver excellent healthcare (feel free to test this theory if you are skeptical - I’ve been to more than 10 derm clinics) unless you specifically request and insist on the completeness of a full body skin exam. Yet, anal cancer is an extremely deadly killer in men. The fact is most derm clinics are saying they are the best, yet don’t deliver the best thorough care when you have someone without a big knowledge gap testing it out. Beware most derm places aren’t thorough enough and I find men tend to get screwed over more so in healthcare. I have been repeatedly disappointed by objective findings of substandard care, but most people don’t take men’s health seriously. I can’t even easily find an andrologist and everyone never does a testicle exam during a preventative visit unless I ask, yet my SO can easily find many gynecologists who will routinely do a pelvic exam and check the ovaries without prompting.
