Summary
Overview
Dr. Chris and Dr. Xand Van Tulleken sit down with Dr. Tess McPherson, a consultant dermatologist specializing in pediatric and adolescent skin conditions, for an in-depth discussion about eczema management. The conversation covers the science behind eczema flares, the proper use of topical steroids, the problematic trend of complex skincare routines in young children, and practical advice for managing atopic dermatitis. Dr. McPherson emphasizes that the most common cause of eczema flares is simply the condition itself, not external triggers, and advocates for confident, evidence-based treatment approaches.
The Rise of Skincare Culture in Young Children
Dr. McPherson discusses the concerning trend of increasingly younger children—some as young as seven—engaging in elaborate skincare routines with adult products marketed toward them. These 'get ready with me' routines often involve 10 or more products containing ingredients that can damage young skin, driving insecurities rather than confidence. The phenomenon raises questions about why children are using anti-aging products and spending significant time on skincare regimens that are neither necessary nor beneficial for their developmental stage.
- Younger children are developing problematic concerns about their skin and entering complex skincare regimes
- Children are using 10+ products in 'get ready with me' routines, many containing harmful ingredients
- These products can cause both short-term and long-term skin damage
- The trend drives vulnerabilities and insecurities rather than confidence
- Seven-year-olds are using products labeled as anti-aging
" If we have to see aging as a problem rather than as something that we all do, then that does seem as a society kind of concerning. "
" A lot of skin problems are not because you not trying hard enough or not using the right products most skin conditions are because of your genetics and your hormones and things that you can change "
Understanding Acne and Effective Over-the-Counter Treatments
The discussion turns to acne-prone skin and evidence-based treatments that actually work. Dr. McPherson explains that while genetics and hormones are the primary drivers of acne, topical retinoids and benzoyl peroxide are effective over-the-counter options. She emphasizes the importance of patience, noting that maximum results typically appear around 20 weeks of consistent use, and addresses the predictable irritation that occurs when starting these treatments.
- Non-comedogenic products that don't clog pores can be helpful for acne-prone skin
- Topical retinoids available over-the-counter are effective at reducing skin grease and preventing spots
- Initial dryness and irritation from retinoids is predictable, not an allergic reaction
- Start retinoids slowly (1-2 nights per week) to allow skin to adjust
- Maximum effect is seen at about 20 weeks of use—patience is essential
- Benzoyl peroxide is another key active ingredient for preventing spots
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