What can a derm do for rosacea? What can an esthetician do for rosacea

[Intro] Hey, everyone. Welcome back to Facially Conscious with myself, Trina Renea, esthetician, Dr. Vicki Rapaport, dermatologist, Rebecca Gadberry, the cosmetic ingredient guru, and our fabulous, overly-educated consumer, Julie Falls. We are gathered here together with you to talk about this crazy world of esthetics. It's confusing out there in this big wide world. 

That's why we are here to help explain it to you all, subject by subject. We will be your go-to girls, and from our perspective without giving medical advice, we will keep things facially conscious.

Let's get started. 

01:00 Rebecca Gadberry: Hello, and welcome to the Facially Conscious podcast where you get the skinny on all things skin. My name is Rebecca Gadberry and I am the cosmetic scientist. 

01:12 Trina Renea: My name is Trina and I am the highly educated esthetician. I like that word.

01:19 Julie Falls: My name is Julie and I'm a highly educated shopper, consumer. 

01:23 Dr. Vicki Rapaport: And I'm Dr. Vicki Rapaport, a board-certified dermatologist. 

01:27 Rebecca Gadberry: In Beverly Hills and Culver City, too.

01:30 Dr. Vicki Rapaport: Oh, yes. 

01:31 Rebecca Gadberry: Yes. Absolutely. 

01:33 Julie Falls: I love your Culver City office. 

01:33 Dr. Vicki Rapaport: Ooh, thank you.

01:34 Trina Renea: Welcome, everybody. 

01:36 Rebecca Gadberry: Welcome, and we are continuing with our Rosacea Awareness Month podcast episodes. Today, we're going to be talking about what a derm can do for rosacea and what an esthetician can do for rosacea. 

Before we do that, though, I want to go to Dr. Vicki for our tip of the day. 

01:55 Dr. Vicki Rapaport: Hello, everybody. My tip of the day for this month of rosacea, Rosacea Awareness Month is the following. If you are a teenager with acne, and you are on the reddish side, you have a reddish face, your acne is reddish, unfortunately, that could be a predictor of rosacea later in life. 

So, if your acne is improved, your teenage acne is gone, but you sort of have a little bit of redness, what I would do every single day is moisturize and sunscreen. And if it looks like you're developing rosacea much later in life, like after 30 or so, don't feel traumatized like it's PTSD back to teenage acne. It might be rosacea and you should see either an esthetician first or a dermatologist.

02:42 Rebecca Gadberry: Thank you very much. And, by the way, we're going to be talking about sunscreens and rosacea when Trina and I do the deep dive on ingredients that can be used for rosacea skin or on rosacea skin, not to give you rosacea but to take rosacea and keep it from reoccurring. 

Going back to rosacea, what is rosacea? Well, rosacea is simply the blushing, flushing, pustular, papule skin that is not acne. Acne has blackheads. It can occur with acne, but it frequently occurs on its own. 

And Dr. Vicki, as a dermatologist, what can be done for rosacea? I know there's a lot of new treatments out there, better than what we've ever been able to do before.

03:30 Dr. Vicki Rapaport: Thank you for asking me that because I have a wealth of knowledge on rosacea. It's something that we will learn in our first year of derm residency.

What I typically tell patients, and I did do a spoiler on our earlier episode, but I tell them very briefly, it can be treated topically, it can be treated orally, it can be treated with lasers. 

There are a myriad of topical treatments and we can sometimes do like a permutation of things. We'll do something in the morning, something at night. If the choice of topicals that we choose for you isn't necessarily working for you, we will switch them around to other topicals.

Some topicals kill bacteria. Some topicals kill the mites that we think are associated with rosacea. Some topicals are just anti-inflammatory. And then there are actually even topicals that constrict blood vessels, which are actually not my favorite. I don't really like them very much because I think people get rebound redness, but they exist. 

So, typically, if a topical works for you, I explain to rosacea patients they should use them forever. If they take breaks…

04:30 Trina Renea: Everyday?

04:30 Dr. Vicki Rapaport: Everyday, yes. 

04:31 Trina Renea: So not just when they're having a flare-up. 

04:33 Dr. Vicki Rapaport: Not just when they're having a flare-up. It's really important to be preventative when you have rosacea. If the topicals don't work, we'll escalate it to oral medications. And, typically, those are antibiotics. There's low-dose doxy, there's regular dose doxy.

04:49 Rebecca Gadberry: Doxycycline.

04:49 Dr. Vicki Rapaport: Doxycycline, yes, oral antibiotic. Kills bacteria, but it's also anti-inflammatory. So the low-dose doxy is an anti-inflammatory dose that we actually got from the dental world. The dentists use that to decrease bacterial load and decrease inflammation of the mouth. We inherited that low-dose doxy from the dental world, which, thank you to dentists. Thank you very much. 

05:12 Rebecca Gadberry: Does that affect the gut microbiome at all? 

05:13 Trina Renea: Yeah.

05:15 Dr. Vicki Rapaport: It may. I'm not a huge gut microbiome expert, although I believe in it. I think it's great. We just never really were taught about it. I don't know much about it, but it might. I know high-dose doxy, regular dose doxy can be very, very, very irritating to the gut, but it's also incredible for rosacea. 

If oral doxy doesn't work, minocycline is amazing. And rosacea patients that really have pretty impressive acneiform component, I love having a bottle around in their house. I love to tell them, "Look, take a bottle, have it around. When you have a flare, start taking the oral antibiotic, usually about a week or two later. 

05:51 Rebecca Gadberry: Minocycline or doxy.

05:54 Julie Falls: What about staying on a prebiotic, a probiotic? 

05:57 Dr. Vicki Rapaport: I think that's fine. I also don't know about that. But I would love to have an esthetician or a nutritionist talk about that. 

06:03 Julie Falls: Yeah, and we're going to hopefully talk to nutritionists. 

06:05 Trina Renea: I love probiotics. I take them every day and I feel like it helps just my rosacea and inflammation overall. 

06:12 Dr. Vicki Rapaport: I think that's great. I wish I knew more about it, really. I would love to recommend things to my patients like that. 

And then, lastly, the oral, more of an escalated treatment, oral treatment for rosacea would be Accutane. So people that have failed the antibiotics or they don't want to go on the antibiotics, Accutane in either short courses or long courses can be beautiful for rosacea. 

06:32 Rebecca Gadberry: And that's where a good skincare program comes in because Accutane can really upset the barrier of the skin, from that I understand. 

06:40 Dr. Vicki Rapaport: Absolutely. I think it's really important to have a barrier. 

For me, I love to send my patients to estheticians who have rosacea so that they can get monthly facials, certain treatments, certain products, which I know Trina is really well-versed on. I would love for you to enlighten us, Trina. 

06:59 Rebecca Gadberry: Before we go over there, I had a couple of questions for you.

07:02 Dr. Vicki Rapaport: Oh, yes. 

07:03 Rebecca Gadberry: For when the patient comes in. Is there anything that they need to bring with them? Like, we talked about the diary of your triggers that you could download from the National Rosacea Society at rosacea.org. Should they know what they've done in the past? Is there anything that can help point the derm into a more appropriate selection of treatment? 

07:32 Dr. Vicki Rapaport: You know, a food diary isn't something that I typically recommend for patients to bring in. If they want to start to keep one, I'm happy to look at it. I usually will ask these very pinpoint questions such as, “Do you flush with alcohol? Do you flush with hot spicy foods? Do you flush with hot beverages?” And it's something that they usually kind of know the answer to. 

If the answer is yes, okay. Maybe we have rosacea on our hands. If they don't, that's fine. Great. Good for them. They can continue and eat those foods and drink those drinks. 

I do like to see their products because sometimes the products can be very irritating and they don't realize. But I feel like by the time they've made it to the dermatologist, they know that their skin is sensitive. They know that they can't handle things, so they're reaching for products that’s safe for sensitive skin. 

Hopefully, they're reaching for sunscreens because they've realized that the sun is an exacerbator. But it is nice to see what they're using. 

08:24 Rebecca Gadberry: Okay. Good.

08:25 Julie Falls: Can I ask a question relating to products? 

08:26 Dr. Vicki Rapaport: Yeah.

08:28 Julie Falls: As far as products are concerned, Dr. Vicki, we were also kind of talking about drugstore things. There are a myriad of products that are supposed to help with calming and redness and rosacea, even. I'm seeing azelaic and something called Prosacea, drugstore things. I'm not familiar with any of them. Do any of them work? Do you recommend any of them? 

08:56 Dr. Vicki Rapaport: I know that Eucerin had a big push years ago, and they had this redness relief line, and I recommended it to patients. Some loved it, some hated it. I think it's fine for patients to try things. I think the price point is really low. 

I think that there are some ingredients in there, and Rebecca, you could probably speak to that a little bit more clearly, that are very harmless. They're going to have glycerins and they're going have lots of hydrating ingredients. Sometimes they have roots and natural…

09:26 Trina Renea: Calming ingredients. 

09:26 Dr. Vicki Rapaport: Calming ingredients that may or may not have enough of a percentage in to do anything, but they're also not going to irritate the skin, which is great. So if it really just turns into like a moisturizer that they use, amazing, great. Do I think it makes the redness go away? No, I really don't. And we're going to be talking about that…

09:43 Rebecca Gadberry: Trina and I are going to do a deep dive on that later on this month.

09:45 Julie Falls: Oh, good. 

09:47 Rebecca Gadberry: So, look for that because we're going to be talking about ingredients that are cosmetic ingredients. They're not drugs. So we can't say that they work on rosacea or eliminate redness or anything, but you'll see it works with signs of redness or whatever. And then we'll talk about ingredients to avoid as well.

10:09 Dr. Vicki Rapaport: I think that is the place, the first place that people go to. It makes sense. They're going to the Target shelves and they're going to the pharmacy shelves because they probably have an inclination that's what they have. 

These products are smart. They have that word, Prosacea, I've never even heard of that. 

10:24 Trina Renea: But it rhymes with rosacea. 

10:25 Julie Falls: I'm telling you, if you Google ‘rosacea’, I've never seen so much information. 

10:31 Trina Renea: I think all over the world, that's the first thing that people do is they go, "I'm red. I'm getting red." And then they go to the grocery store, the pharmacy, and they start looking for things that say for redness, for rosacea. And they start kind of dabbling into and start using things for sensitive skin. Then it may help them stay at bay for a while until they end up in a dermatologist's office, or maybe they don't. 

So they're not bad products, but they're not going to treat your rosacea if you have, I feel like, a flare-up.

11:04 Rebecca Gadberry: And rosacea skin is not a skin that you want to play around with. I know Julie…

11:08 Trina Renea: If you find that you have it.

11:10 Rebecca Gadberry: You love to play with different products. But when you have rosacea, you play with different products, you are risking having an episode or not. 

So the first place you should go, if you don't go to the dermatologist, is the esthetician. And what can the esthetician do? 

11:27 Trina Renea: Well, the esthetician can, if you decide to see an esthetician before a dermatologist and you feel like my skin is red, an esthetician can tell you, like she can try and find out if she thinks you have rosacea by asking the questions, “Do you flush and blush? How long does the blushing stay?”

We can look at their skin. Do they have the little veins on their cheeks? Are they starting to get the little papules? 

I find that rosacea, when I'm extracting and they do have the light white little dots on their cheeks, they're almost watery. It's like they just pop like a little water bubble. And you shouldn't be extracting any cysts at all.

But those little ones that are right at the surface, they look like little whiteheads, basically. But it's just like water. That's usually a sign that's rosacea. That is not acne. That's one way I can tell.

But mostly because they are red and swollen in their cheek area, usually, is a start, and the redness isn't going away. 

I make people's skin red in facials all the time. That's my job. I like to exfoliate and get their skin reactive so that I bring blood to the circulation. But, definitely, we can guide the person on ingredients and products to use that are going to be gentle for their skin, things that are anti-inflammatory, how to use AHAs, alpha-hydroxy acids, like glycolics and azelaic and salicylic and stuff like that, so that they're not irritating their rosacea. But that goes for people with red skin, dermatitis, anything like that as well. 

But what we shouldn't do as estheticians is treat someone with a rosacea flare-up.

I like to recommend estheticians when I'm training them that you'd want to have a dermatologist next to you. The best way to find a dermatologist is to ask your clients, "Who do you go to?" And if they love their dermatologist, try and get a meeting with the dermatologist and see if you can even talk to them for five, 10 minutes just to see if you're on the same page. Just let the front desk know, “I'd like to make an appointment.”

13:47 Rebecca Gadberry: As an esthetician.

13:48 Trina Renea: As an esthetician because I have clients I want to refer. And I'm interviewing dermatologists right now to see if you're the one. I did that with Dr. Vicki. 

13:59 Dr. Vicki Rapaport: I love that. 

13:59 Rebecca Gadberry: That's how you found each other. 

14:01 Dr. Vicki Rapaport: I'm interviewing dermatologists right now. That's brilliant.

14:05 Trina Renea: I'm getting red. So that way, you have a dermatologist to refer your rosacea patients to. If I see that a client is getting a flare-up and they're not being treated for rosacea and I'm like, “You definitely look like this is rosacea. You should go and see a dermatologist because you need to have some kind of medicine or something that they're treating you for.” 

Along with getting your facials because I can calm the skin. I can recommend products to use that go along with the medications that are being used. And I can just really keep the skin very calm and help them through the process so they don't get rosacea flare-ups. So 

I see patients monthly for rosacea, and I keep them from getting rosacea flare-ups, and I make sure they're still taking their medication, and we just keep it…

14:56 Rebecca Gadberry: So you monitor them. 

14:57 Trina Renea: We monitor them, yes. 

14:59 Dr. Vicki Rapaport: I love that, Trina. And, you know, you refer to the dermatologist and I certainly see patients all the time, but one little tip of the day that I could give patients who see the dermatologist is if they're only recommending lasers, then I would probably find another dermatologist, because that isn't necessarily for everybody and it's also very expensive. 

And if they're recommending products that are very, very expensive, I would probably also find another dermatologist, because you don't have to spend a fortune, especially if that's not in your budget. There are medicated creams that are covered. There are a lot that, unfortunately, are not covered. If they're not covered, your dermatologist has to work with you because there are so many topicals that we love that come in generic and should be covered. So just keep…

15:42 Rebecca Gadberry: Like, what kind of products are you talking about? 

15:45 Dr. Vicki Rapaport: Soolantra, for instance, it's only brand name. That's the topical ivermectin. S-O-O-L-A-N-T-R-A, Soolantra. 

And dermatologists aren't benefiting from it, but I'm just saying they need to work with your budget and your medications that are approved. Every insurance company is different. But because that only comes in brand and there's no generic substitute, it's not covered. 

Now what? The patient doesn't let you know that they're not on anything. So make sure that you're constantly having conversations with them about what is working, what isn't working, what is covered, what isn't covered, because they can come up with a whole different plan for a different patient who has a different insurance. 

16:21 Rebecca Gadberry: And that's what I wanted to ask you is, how much of this would be covered by insurance? 

16:25 Dr. Vicki Rapaport: It's medical. It's 100% medical. Well, you know, every…

16:30 Trina Renea: But lasers aren't covered by insurance. Are they? 

16:32 Dr. Vicki Rapaport: Sorry. No, they're not. Sorry. So you're saying what is covered, sorry. All the topicals, all the orals, all the medications, all the prescriptions should be covered. Everybody has a different plan. Some people's plan covers 20%, 80%, 90%, they're a huge deductible. 

So when I say it's covered, it's billable. Your medical office is billable. I don't know what their co-pay would be or what their portion of the visit would be, but it is something that a dermatologist would bill for. 

16:58 Trina Renea: We also have an episode coming up. We're going to speak to our laser specialist, Dr. James Wang. 

17:03 Rebecca Gadberry: That’s by Dr. Wang. 

17:05 Trina Renea: Who has lasers at work on rosacea. He's going to be coming on in a future episode. So, people can get a little familiar because they are out there and people are using them for rosacea. 

17:14 Dr. Vicki Rapaport: And don't get me wrong. They do work, they're just expensive. They're not in everybody's budget. I wish everybody with red rosacea could get lasers. Unfortunately, not everybody can afford it. 

I'm not saying they're bad. I think they're really wonderful. But I do also feel like doctors have become so monetized and it's sad. 

17:31 Rebecca Gadberry: And I do want to say one other thing about an esthetician. An esthetician, by recommending products, helps to save you money because you're not going out and grabbing everything off the shelf and trying it. That doesn't work. It actually caused it. You throw that away, you're wasting that money. 

A good esthetician will tell you what cleanser to use, what moisturizer, if there's any serums. 

17:55 Trina Renea: Which I agree with, and I feel like people should always get recommendations from their estheticians on products rather than going to the shelf.

18:04 Rebecca Gadberry: Absolutely.

18:06 Trina Renea: And also going to stores where salespeople are selling to you. 

18:10 Dr. Vicki Rapaport: Yeah, and like the derms, we stay up on all the new research and all the new products. The estheticians need to do that too. And ingredients. 

I mean, there's not that much new under the sun with rosacea. It's been pretty consistent for many, many years. But it is important that your esthetician switches it up on you. It can't be the same stuff all the time.

18:27 Trina Renea: Right. I also wanted to say, Dr. Vicki, if a patient did have to go to Accutane with their rosacea, is that something that fixes it? What does that do? 

18:41 Dr. Vicki Rapaport: It can “cure it” for many months, maybe even many years. But some people, as soon as they go off of the Accutane, their rosacea comes back. 

18:51 Trina Renea: Is it like low-dose Accutane that you do for consistent long time period? 

18:55 Dr. Vicki Rapaport: Either low dose, long time, weight-based dose for five to six months, and everything in between. But low dose, long time is probably the way to go because it is such— if they're needing Accutane, it means their rosacea is pretty severe. It's not just going to shut it down and cure it. They're probably going to need it for a long time. 

And if it works really, really well and it's so easy to use, it is something really nice you can use long term. 

19:17 Trina Renea: And that's something very important that you just said that triggered something in my head. There is no cure for rosacea, right?

19:27 Julie Falls: No, it's not curable. It's treatable. 

19:28 Trina Renea: It's not curable.

19:29 Julie Falls: It can be treatable. 

19:30 Rebecca Gadberry: Right. It's controllable. 

19:32 Trina Renea: It's treatable, right, but there is no cure. So if anybody out there is saying, "I have the cure for rosacea," there is no cure. 

19:39 Dr. Vicki Rapaport: Yeah, and there's a spectrum of disease with rosacea. Some people have one little patch when they got pregnant or when they went through menopause, and then it's over. Whatever their trigger, might have been hormonal and then some people start in their thirties, it goes throughout the rest of their lives and they have it for 50 years. 

And then there's everything in between. Some people get flares when they have their period. Some people get flares when they're stressed. Some people, it comes and goes. One year it's here, the next year it's gone. It's kind of a little unpredictable, and that's part of the reason why you do need to seek esthetician advice and dermatology advice, because if it's changing or the medication is changing, we can help them. 

20:15 Trina Renea: Yep. 

20:14 Rebecca Gadberry: I think one of the takeaways here is that you don't want to treat your rosacea on your own. You need expert advice. 

20:23 Julie Falls: I'll use that as my takeaway for the day.

20:24 Rebecca Gadberry: Okay. 

20:26 Trina Renea: Are we ready for the takeaway? 

20:29 Julie Falls: If you have an illness, you go to the doctor, and so you think of it as illness in your face. 

20:31 Rebecca Gadberry: Yeah, it's a disease or disorder. 

20:36 Trina Renea: Illness in your face. 

20:37 Dr. Vicki Rapaport: Illness. 

20:38 Rebecca Gadberry: That's a takeaway right there, Julie.

20:44 Trina Renea: So this is a nice, easy, short little episode here. It was basically just seeing what an esthetician and a derm can do. But I'll give a takeaway for the day. 

20:55 Rebecca Gadberry: Thank you. Which will be on our Instagram as well. If you haven't tuned into our Instagram account, it's under Facially Conscious. You can also find us at faciallyconscious.com to read our blog and to download any episodes. Of course, if you're on Spotify or Apple iTunes, we're there. You could find us anywhere. 

And if you like our podcast, please weigh in. Give us a review, give us your star ratings. You guys have been awesome, by the way, in the star ratings. We're averaging five stars per episode. 

21:28 Trina Renea: Yes.

21:29 Rebecca Gadberry: It's really great. If you have questions, you can just send it into info@faciallyconscious.com. 

And now, I think, you are ready for the takeaway. 

21:41 Trina Renea: I am ready for the takeaway. 

Hello, everyone. My takeaway for today is that if you feel like you have rosacea or you are blushing and it's lasting a long time, please go see an esthetician or a dermatologist so that they can treat it and get it fixed before it gets too bad. 

22:01 Rebecca Gadberry: Yes. 

22:02 Trina Renea: Thank you. 

22:02 Rebecca Gadberry: And don't we have a question from a listener? 

22:04 Trina Renea: We do. So, Cathy, I caught her name, she said, "If you look at the ingredients on some famous brands versus over-the-counter, or some brands only sell to estheticians…”

22:24 Rebecca Gadberry: Those are called professional brands. 

22:26 Trina Renea: Professional brands. So, she said, "They are very similar inactive ingredients and yet some brands produce amazing results, and some don't. How are they able to change your skin so cheaply? There is one formulator lady who said that she's,” I'm pausing only because she's saying a brand name that I don't want to mention. 

22:50 Rebecca Gadberry: Okay. Bleep. 

22:50 Trina Renea: She said this brand sources cheap ingredients. “That is why they're able to sell such cheap prices. Is there any truth in that statement?”

I'm just going to, first of all, just let all of you know, when a brand is created, you have a choice to do multi-level marketing, only sell to doctors, only sell to estheticians, only sell to retail, or a combo of those. 

23:18 Rebecca Gadberry: Or sell direct.

23:20 Trina Renea: Or direct to online marketing. 

23:21 Rebecca Gadberry: Or on TV.

23:22 Trina Renea: Yes. So you have a choice of what route you want to go, and that's basically the only thing. 

23:30 Rebecca Gadberry: Type of distribution. 

23:32 Trina Renea: Type of distribution. If a brand is only selling to a dermatologist, it's not because it's better than that they decided they were only going to sell to a dermatologist for the prestige of the brand that is ‘dermatology only’. Or if they're only going to sell to estheticians, that's because they're telling the estheticians, like you can be sure that they can't find this in stores out there. 

So you choose that route. Whether the product line is good or not depends on the product line. 

24:07 Rebecca Gadberry: Right. It has nothing to do with where it's distributed. 

24:11 Dr. Vicki Rapaport: And if it's cheap.

24:13 Rebecca Gadberry: And if it's cheap then they could be sourcing more inexpensive ingredients. They could have a lot more distribution, though, than a smaller brand. So they're buying in bulk, so to speak, so they're saving. Just like you go to Costco. You buy something. You buy enough to last you six months as opposed to going to the grocery store and having enough for one meal. You're going to save money. 

Well, the same is true for how much a company buys. So a company that's a very large company can offer, a lot of times, a better price than a very tiny company. Then a tiny company may go for a higher price because they want to impress their exclusivity. 

We also have what we talk about as the price window, is the more expensive something is, the more likely we are to think it works. The less expensive, the less likely we are to think it works. 

Then there are companies that are out there, like the brand that's mentioned here, that are offering single or maybe a couple of performance ingredients. Those are what a lot of people call active ingredients, but that's a drug claim. Active means drugs, so we don't say that. We say ‘performance ingredients’ in the industry. And they may pick one or two performance ingredients. 

25:34 Trina Renea: Which is less expensive to make. When you're only putting one or two ingredients in there then it's less expensive to make. But guess what? You then have to use multiple, multiple products to get the benefits of everything you need.

25:45 Rebecca Gadberry: That’s right.

25:46 Trina Renea: So it's better to get a lot of ingredients in one product that do multiple things than buying 10 products that you have to use because this one does that, this one does that, that one does that. So they're able to sell it cheaper because they're also buying in massive amounts because they're a large name brand. They can get it cheaper that way, but also they're doing less ingredients in the product, less performance ingredients.

26:11 Rebecca Gadberry: And when I'm coming up with a formula, we might buy a really interesting, very highly clinically tested ingredient that goes on the label as, we've been talking about the retinol product I've been working on, as retinol. It goes on the label as retinol, but there's other elements of that molecule that help to deliver the retinol to reduce its irritation to prolong its delivery to the skin over a time-release basis. 

26:40 Trina Renea: Which costs a little more money. 

26:42 Rebecca Gadberry: Costs a lot more money. The ingredient by itself on a kilo price, which is what we usually price these ingredients out at, could be $16. Whereas the one that's got the larger molecule that's been more developed, that's more exclusive, that has all the clinical testing behind it, that could be $500 a kilo. But it goes on the label as the same thing.

And also remember that the base, or the vehicle of the ingredient, has to do with how you have the initial feel, the initial relationship and experience with that product. So, as a chemist, I'm going to use emollients and emulsifiers and different ingredients that make the skin immediately, instantly softer. Has nothing to do with the performance ingredients. It's just there…

27:36 Trina Renea: But those ingredients also cost money.

27:39 Rebecca Gadberry: They cost money too, but they're also not as many of them, a lot of times. So it's very inexpensive to make a very simple product that has a good feel. That helps you keep going on using the product so the performance ingredient can actually kick in. 

Don't be an ingredient list reader and rely on that alone. I keep saying that during this podcast, I'm going to continue to say it. You do not know what you think you know when you read an ingredient list. It does not tell you. 

28:12 Trina Renea: So how does a consumer figure it out then on their own? 

28:16 Rebecca Gadberry: Well, what I suggest is making sure that you have a bottom of the jar guarantee, that you can bring the product back if it doesn't work, or you have samples, or you have an esthetician who stands behind their product. But go someplace where you can try the product out. 

Look at the reviews online. The ingredient list will only tell you the ingredients that are in there. It doesn't even tell you what components or what the total molecule of an ingredient is. It doesn't give you a clue, unless you're a cosmetic chemist and you're looking at it and you know how to read the list. But that takes years of training. 

28:57 Trina Renea: So, as an esthetician, I'm just going to say because it poked out at me when you said it, I don't give a bottom of the bottom guarantee.

29:03 Rebecca Gadberry: I know you don't. 

29:05 Trina Renea: And I don't also sample, but I do stand behind all of my products. I have tried and they are tried and true. I've had them in my line for years. I know they work on people and I always tell people, “Use the whole bottle. Don't stop. Don't switch it with other things because you're never going to know if it works unless you use it for a whole bottle.”

29:25 Rebecca Gadberry: And use it as directed. And use it if it's morning and night, you use it morning and night. And remember, these are dose dependent. Based upon how much you use is how much result you're going to get. 

29:36 Trina Renea: Right. So when I tell people to use it twice a day and tell them how to use it, or once a day.

29:40 Rebecca Gadberry: And how much to use.

29:43 Trina Renea: And then I have no problem. Everybody loves the products because I teach them how to use them. But it's because of that. I say you have to use the whole bottle. And at the end of the bottle, if you're not into it, totally fine. But they always are, It's directing how to use the products properly. And I do trust and stand behind them.

30:02 Rebecca Gadberry: And that's the reason why you go to a professional. 

But I'm talking about bottom of the bottle with a drugstore or an online or an on-air, on television line, where you don't have that communication with a professional to help guide you through the use process. 

30:20 Trina Renea: Right, because I also recommend products to my clients that I know are right for their skin. Where if you buy online or off of those TV things or whatever, you think that might be good for your skin, but you don't know because nobody's looking at your skin to tell you that that's the right product for you. 

30:35 Rebecca Gadberry: That’s right. 

30:36 Trina Renea: So that should have a guarantee if it irritates or something happens. 

30:41 Rebecca Gadberry: Absolutely. For sure. So make sure that you understand how to use the product. You use the product according to what you understand, and you use enough of the product to get the result. If you skimp on the product, let's say it's a month use in this jar and it extends to three months, you're not using it properly.

31:05 Trina Renea: So basically, back to her question is, if they're cheap, are they still great? Really, you don't know. 

31:11 Rebecca Gadberry: Who knows?

31:13 Trina Renea: Just use it all the way through the bottle and then you decide. Did it work on your skin? Did it make you feel good? Were you like, “I can't live without this product?”

31:22 Rebecca Gadberry: Are you getting compliments on your skin? 

And that goes back to what we've been talking about with rosacea. Skin is unique to the individual. What works on your girlfriend may not, probably won't work on you. So if you want to go by what your girlfriends say or what an influencer says, then you're taking a risk with maybe your skin, but definitely with the money that you're investing. 

31:47 Trina Renea: All right, everybody. Well, it was lovely chatting with you all on our episode on rosacea this week, and we'll see you next week with another episode on rosacea. 

32:02 Rebecca Gadberry: We'll see them. 

32:03 Trina Renea: We'll see you.

32:05 Rebecca Gadberry: They'll hear us.

32:06 Trina Renea: You'll hear us. 

32:08 Dr. Vicki Rapaport: We'll speak with you soon.

32:08 Rebecca Gadberry: We won’t see them. 

32:09 Trina Renea: We'll speak with you soon.

32:11 Rebecca Gadberry: We're going to be in your car with you, as you drive around. 

32:15 Trina Renea: We'll see you on your next drive.

32:16 Dr. Vicki Rapaport: See you on your hot girl walk.

32:20 Rebecca Gadberry: I'm a hot girl.

32:22 Trina Renea: All right, you guys, have a good one. Bye.

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