A Celebrity Dermatologist Answers Your Toughest Skincare Questions

When it comes to objective truths, the beauty industry might as well exist on another planet. In the world of hair, makeup, and skincare, facts become blurry and complicated—especially since it is, at its heart, a billion-dollar industry whose goal is to generate income, with product efficacy for its consumers coming in close second. Beauty writers and editors are constantly trying to decipher the real results from the junk. Rest assured, we at W do not suffer fools gladly—and that’s why we consider Dr. Shereene Idriss not only a skincare professional, but a real truth-teller. For the last year, I’ve been following her Instagram videos; in a world where people often skirt the truth, Dr. Idriss puts it right in your face, the way a sister might. The sardonic, witty, New York-based board-certified dermatologist analyzes inflated, hocus-pocus skincare ingredients as well as the many hyped skin treatments that end up only wearing down your credit card instead of your wrinkles and dark spots. Aside from an impressively scholarly medical career, her honesty and unmistakable plainspoken manner plays a large part in her following, which number in the hundreds of thousands. Her celebrity client list also includes Emily Ratajkowski, Paloma Elsesser, and Ashley Graham.

Just because Idriss is a medical scholar doesn’t mean she hasn’t got skin ailments of her own—the Lebanese-born mother of two also has suffered from dark spots and melasma over the years. Growing unsatisfied with the many faulty pigmentation products on the market, she developed an affordable, three-step Major Fade system from her new PillowtalkDerm line, which was named after her website but has become her moniker on TikTok. Over a cup of tea and a flattering Zoom filter, straight from her cozy New York offices, which she’s dubbed “The Apartment,” we had a chance to not only discuss her new skincare system, but compare the shortlist of ingredients and skin philosophies that do and do not matter.

Can we discuss something that has been on my mind forever: hyaluronic acid? Is it all bullshit? I like to call it the one-night stand of skincare because it’s great for a few hours and then it’s gone.

I am very proud to say that the PillowtalkDerm Skincare line is hyaluronic acid-free. I’ve formulated everything myself in my own line, and that’s also how you know I don’t work with stock formulas. Hyaluronic acid is in everything and it’s everywhere; I sometimes joke that I want to hire the publicist for hyaluronic acid because they’ve done a damn good job at marketing this ingredient for so many years. When low molecular hyaluronic acid became the holy grail, I started to do more research. I learned that low molecular hyaluronic acid is actually more inflammatory for your skin. It’s like when you cut yourself or have a wound, your body is trying to heal itself, so it secretes naturally a low molecular hyaluronic acid weight to cause blood vessel formation, and wound healing. In theory, it goes deeper—but it still doesn’t even go that deep. It can cause a very superficial inflammatory reaction.

Let’s talk about Vitamin C. Tell us what to look out for in a good product.

Vitamin C is next in line after hyaluronic acid in terms of ingredients with which you need to be careful. Vitamin C is very popular online, and everyone thinks they need to make their own vitamin C serum as the next holy grail product. Another thing that bothers me is that vitamin C is often associated with brightening and evening your skin tone, when it’s just one part of the story. It doesn’t do all of that on its own—it works best if combined with other actives. Also, you should be careful if you’re sensitive, because the active form, which is often absorbic acid, can be very irritating. It also has a short shelf life, so if you’re saving your prized vitamin C for a special occasion, you are wasting your money after opening it. Don’t try saving it.

Even when a Vitamin C product says shelf-stable?

I can’t speak for other brands, but pure vitamin C, which is ascorbic acid, is not shelf stable at all, and it does not work well with other ingredients.

You’ve also spoken out about issues associated with high amounts of Niacinamide. You recommend 3-5%. What happens when it’s more than that?

So this is an example of how, in the past few years, you’ve seen a shift in the skincare world—the market has become so focused on single-ingredient stories. I love these brands because they have raised awareness about those ingredients, but I also dislike those brands because, in order to make their products stand out, they’re pushing percentage stories. And it’s not about percentage stories. Niacinamide’s sweet spot been proven to be between 3-5%. Then yet, you have brands that have their Niacinamide at 10% and claim you need to use that 10% twice a day on top of that other products. Any higher than 3-5% can cause inflammation, especially if you’re trying to reduce pigmentation. Remember, if your skin becomes inflamed it’s only going to perpetuate that hyperpigmentation.

I ask every dermatologist about skin brushing. Does skin brushing every day rob the skin of its natural oils?

That’s a very good question. I think it’s a little more nuanced and complicated; it depends. The skin on your face is very different than the skin on your body, neck, and chest, and you make more oil on your face than you do on your body. I would never recommend dry brushing or loofah scrubbing on your face—you get microtears, and the skin there is more delicate. On the body, I think you are fine to do more than your face (dry or wet), but in moderation. You’re not a piece of wood to buff!

What makes your Major Fade System for dark sports and melasma so effective?

I intentionally left out certain ingredients. When you are thinking about dark spots and uneven tones, especially post-inflammatory hyperpigmentation, the goal is to keep the pigment away and suppressed over time. If you are going to be irritating your skin, inflaming it, and triggering it—you’re reversing the whole process.

I made three products to tackle hyperpigmentation effectively. The first is the Major Fade Flash Mask, an exfoliating mask I recommend using only at night, 2-4 times a week at most, and do a patch test first. It’s made up of glycolic acid, lactic acid, and an exfoliating acid, but it also has panthenol ,which helps to ease the skin and moisturize. This guy is the first step of the routine and it’s a powerhouse on its own.

The second product is the Hyperserum. This specifically works on how the melanin is produced. It contains kojic acid, licorice root, and you have 5% niacinamide. It keeps inflammation down and helps suppress how the melanin is produced. You use this up to twice a day. I use it every day and even underneath my eyes. Third is the Active Seal, basically if a gel moisturizer and a cream moisturizer had a baby. All three products diminish the look of the pigmentation, but also how it’s transported. The Active Seal locks in all the three steps—you can use it to prevent further damage under sunscreen. Because these three products have different active cocktails, they all complement one another.

A few dermatologists in the past recommended a prescription for Tranexamic pills for melasma. Is it safe?

I put this acid topically in the mask for the first step, and orally it can work wonders for people with very stubborn melasma. It’s a medication that has been around for years for people that used to hemorrhage or had bleeding disorders. It is still used, and it was prescribed by OBGYNs during childbirth. It’s been prescribed a lot more in the last two years. Let me be clear: you must be careful if you’re prone to blood clotting or if you have that in your family history—you need to be careful and consult with your doctor and get tested for deficiencies. If you’re on birth control, you need to let your OBGYN or gyno know. Otherwise, I have seen it work miracles on patients with melasma who have tried everything.

Which skincare lasers do you like?

It depends on your problem. If you have redness, the V-Beam. If your problem is texture, I like a non-invasive Fraxel. If you have pigmentation, I would say an IPL or a Fraxel. But if you have melasma, I would be very careful using lasers.

Aside from dermal topicals, you are known for administering great Botox. Can we talk about Daxxify? Is it just the new version of Botox?

No, it’s been in the works for a long time and the cosmetic, dermatology, and plastic surgery field is very excited. I am excited about it as well. I just have one caveat about it: be careful who you go to, because if you hate the results, you are stuck with it longer. That’s something no one is bringing up and I find that fascinating: I would rather know my Botox is going to fade in three months vs. being stuck with it for eight months.

What about your health and skincare? Do you detox with green juices or take supplements?

I literally ate an éclair for lunch, so I’m not that healthy. I don’t have time to choose often, and I don’t have any sort of magic. The secret with all things, I find, is moderation, consistency, and listening to your skin. If I was breaking out, I wouldn’t be eating an éclair, necessarily—but if you are in harmony and your skin is doing well, and you want an éclair, have the damn éclair.