If you regularly read skin care stories, you’ve probably come across the often-touted advice to patch test new products before trying them. (It’s certainly a suggestion SELF has made more than once!) But what exactly does patch testing a new serum or moisturizer entail? Is it something everyone really needs to do, or does it fall more into the “wash your comforter weekly” advice category—a goal that’s idealistic, but probably won’t happen every time it should? We asked a few top dermatologists for their take on this common recommendation, as well as step-by-step instructions for how to patch test skin care products at home.What is skin care product patch testing?There’s no rocket (or even dermatological) science involved here: A DIY patch test simply involves applying a small amount of a new product on an inconspicuous spot—before you slather it all over your face or body—and monitoring your skin to see how it reacts. (More on all of those specifics to come.) “It helps let you know if you’re going to experience a reaction to a new product before you’ve applied it on your face, where a reaction is much more unpleasant to deal with,” Hadley King, MD, board-certified dermatologist and clinical instructor of dermatology at the Weill Medical College of Cornell University in New York City, tells SELF. Just don’t confuse this with professional, in-office patch testing, during which a dermatologist or allergist tests specifically for reactions to potential allergens, like common skin care ingredients or environmental substances. To that point, a DIY patch test at home can help you determine if you can tolerate a particular product, but if you have a reaction, it won’t pinpoint exactly which ingredient is causing the problem, Michelle Henry, MD, board-certified dermatologist and clinical instructor of dermatology at the Weill Medical College of Cornell University in New York City, tells SELF.Who should consider patch testing skin care products?All of the dermatologists SELF spoke with agreed that, ideally, at-home patch testing is a good idea for everyone and every type of product that has prolonged contact with your skin, from moisturizer to makeup. However, it can admittedly be time-consuming and cumbersome. As such, they all also emphasized that patch testing is especially important for certain people. If you have a history of sensitive skin; have reacted poorly or experienced irritation after using new products in the past; have rosacea, eczema, psoriasis, or other chronic skin conditions; or have known skin allergies, at-home patch testing is particularly important, says Dr. King. You can also decide whether or not to patch test based on the kind of product you’re trying. “Most people can get away with not patch testing mild formulas, such as fragrance-free moisturizers that don’t contain any active ingredients,” Melanie Palm, MD, a board-certified dermatologist in San Diego and a clinical professor at Scripps Encinitas Memorial Hospital, tells SELF. On the flip side, any product with a lengthy ingredients list and/or actives such as retinoids, exfoliating acids, or vitamin C, should be patch tested before you fully incorporate it into your routine; these are more likely to elicit a reaction, Dr. Palm advises. How to patch-test a skin care productOur experts offered up some slightly differing pieces of advice, so you have options.The forearm methodDr. King suggests applying a thin layer of the new product to a nickel-sized area of clean, dry skin on the inside of the forearm. Why here? It’s a discreet spot, so if a reaction does show up, it won’t be super visible. Still, the skin is delicate enough that it’s comparable to the skin on your face, she explains. Leave it on and don’t wash it off, then reapply the product—the same amount in the same spot—as often as the instructions recommend, be that once or twice daily.
If you put 10 people in a room, chances are, one of them has some form of eczema. If that person is you, you probably know that it can be uncomfortable—and very tricky to treat. There’s a lot to unpack about this common skin condition, which isn’t as straightforward as it may seem. If you’re dealing with eczema, it may be well worth asking a dermatologist about a skin patch test, which can help determine what—if any—topical ingredients you’re allergic to that may be exacerbating your skin issues. Patch testing can also help you confirm the type of eczema you have, so you’re better positioned to treat it. Below, experts tell SELF when it’s a good idea for people with eczema symptoms to get patch-tested, plus pretty much everything else you need to know about the process. What is eczema, exactly?High-level summary: It’s not just one thing. “Eczema is an umbrella term for inflammatory skin conditions,” Kristel Polder, MD, a board-certified dermatologist and adjunct assistant professor at the University of Texas Southwestern Department of Dermatology, tells SELF. According to the American Academy of Dermatology, there are actually seven different types of eczema. While there are differences among them, common symptoms occur across the board: Many people with eczema develop scaly, itchy skin that can be red, purple, brown, or ashy gray in color, depending on your skin tone, Peter Lio, MD, clinical assistant professor of dermatology at the Feinberg School of Medicine at Northwestern University and member of the National Eczema Association’s Scientific & Medical Advisory Council, tells SELF. What most people call “eczema”—a rash-like patch of inflamed skin—is usually atopic dermatitis (AD), Dr. Lio says. (This is the most common type of eczema, so it makes sense that the two terms are often used interchangeably.) In terms of what causes AD: “A number of factors contribute to atopic dermatitis. For many people, there’s a genetic component: a deficiency in a protein known as filaggrin, which leads to a compromised, ‘leaky’ skin barrier,” he explains. Plenty of external and environmental factors can also come into play, including weather, diet, and exposure to certain substances and materials, Dr. Lio adds. Atopic dermatitis is a chronic condition with no actual cure, but there are multiple ways to manage it and keep it in check, Hayley Goldbach, MD, a board-certified dermatologist and assistant professor of dermatology at Brown University, tells SELF.Contact dermatitis is another common type of eczema. In this case, the skin reacts to a specific trigger that triggers the inflammation, Dr. Goldbach explains. There’s some additional nuance here, too, as there are two types: allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD).1 “Allergic contact dermatitis is a type of hypersensitivity to a certain allergen that triggers an immune response and causes inflammation,” says Dr. Goldbach. Irritant contact dermatitis, on the other hand, is an injury to the skin—the immune system isn’t involved. As a general rule of thumb, think of irritant contact dermatitis as a bit more universal: If anyone were to overuse retinoids (which tend to cause irritation, especially when you first start using them) or an industrial-strength soap, for example, it’s almost guaranteed that they’ll experience some degree of skin irritation, Dr. Goldbach says. Allergic contact dermatitis is much more individual, because it’s caused by allergens that are unique to each person.1 (Finding out what those are is where a patch test comes in—more on that in a moment.) So, is there a connection between skin allergies and eczema?A more accurate way of looking at it is by examining the connection between allergic contact dermatitis and atopic dermatitis (again, and please stay with us here, both conditions are types of eczema).
Lymphatic drainage face massages are trending on TikTok—yielding some curiously dramatic before and afters—and popping up on spa menus from coast to coast. Like most wellness trends, their purported benefits sound great on paper (er, screen): Decreased puffiness, glowier skin…sold! But are these fresh-faced effects legit or over-blown? (Is the sculpted jawline in that TikToker’s video really a result of massage?) And is there even a difference between a lymphatic facial massage and a regular one? We tapped three experts (all of whom, spoiler alert, had a slightly different take on the topic) to weigh in. Here’s what they had to say re: what a facial lymphatic drainage massage can and can’t do for your skin, and how to try it on yourself, if you’re so inclined.First, let’s talk about the lymphatic system.Before we can get to the “drainage massage” part of things, it’s helpful to understand what the lymphatic system is and the purpose it serves. Per the Mayo Clinic, the lymphatic system consists of a network of tissues and organs including lymph nodes and channels. Lymph—excess fluid that’s present in bodily tissue—moves through these channels and ultimately drains into the bloodstream, which helps maintain balanced fluid levels in the body, Jennifer Levine, MD, a double board-certified facial plastic surgeon in New York City, tells SELF. The lymphatic system also plays a major role in your immune system. Lymph nodes are bean-shaped glands—found in the armpits, groin, abdomen, and yep, the face and neck—that act as guards, stopping foreign substances from entering the body, Dr. Levine explains. When they trap these molecular intruders they can become enlarged, hence why swollen lymph nodes are sometimes a symptom of infection. Lymph nodes also produce disease-fighting white blood cells, which are then transported throughout the body via those lymphatic channels.What is a lymphatic drainage massage?There are different techniques, but the overall goal of any lymphatic drainage massage is to help improve the flow of the lymph with a very targeted type of motion, using either a tool or the hands, Kseniya Kobests, MD, board-certified dermatologist and director of cosmetic dermatology at Montefiore Einstein Advanced Care in New York City, tells SELF. Proponents claim that the lymphatic system sometimes needs this encouragement because—unlike the circulatory system, which is driven by the heart—it doesn’t have an organ helping it pump and move fluid. However, according to Dr. Levine, your lymphatic system is remarkably good at working on its own, without any type of manual assist. “A lymphatic drainage massage isn’t going to make your lymphatic system do something it wouldn’t do otherwise. What it can do is help it work a bit faster,” she explains. To that point…What are the potential benefits of a facial lymphatic drainage massage?All of the experts we spoke to agree that the primary benefit is moving excess fluid out of the facial area, and that translates to a de-puffing effect. It’s usually instantaneous, although Dr. Levine is quick to note that any type of reduced swelling or puffiness is only temporary. “There’s anecdotal evidence that this kind of massage will move the fluid, but that doesn’t mean it’s not going to come back,” she says. These de-puffing, swelling-reduction benefits are why lymphatic drainage massages are sometimes recommended after plastic surgery, be it on the face or body. (Dr. Levine says that she doesn’t suggest it to her patients because she doesn’t think it’s necessary, but notes that it’s certainly not harmful as long as you’re careful around areas that are healing.)
Here’s a little riddle for ya: What has more than 1.7 billion (yes, with a “b”) views on TikTok, plays a role in conditions ranging from acne to eczema, and is currently all the rage when it comes to skin care products? If you guessed the skin barrier—congratulations, you are correct.Unlike some other trending skin care topics, the skin barrier is a very real thing, and one that plays an integral role in healthy skin function, according to the experts SELF spoke with. We’ll get to the specifics in a moment, but the skin barrier is well, exactly what it sounds like—a protective layer that’s responsible for keeping the good stuff in and the bad stuff out.A variety of factors can take a toll on this skin shield of sorts—it’s why #skinbarrierrepair videos are also racking up millions and millions of views on TikTok and allegedly barrier-repairing products are all over the place. Here, top dermatologists explain exactly why you should care about the skin barrier and how to tell if yours needs a little extra TLC.What is your skin barrier, anyway?“In the simplest terms, it’s the skin’s protective layer,” Mona Gohara, MD, associate clinical professor of dermatology at the Yale School of Medicine, tells SELF. “Our skin is what protects our body, and the skin barrier is what protects the skin.” Technically speaking, this protective layer is called the stratum corneum, the outermost layer of the epidermis.1To get a better sense of how the stratum corneum functions, it might be helpful to picture a brick wall: “The ‘bricks’ are cells called corneocytes, which are held together by the ‘mortar,’ a mix of lipids including fatty acids, cholesterol, and ceramides,” Robyn Gmyrek, MD, a board-certified dermatologist at Union Derm in New York City, tells SELF. This “brick wall” creates a barrier that prevents harmful bacteria, chemicals, irritants, and allergens from getting into the skin, while simultaneously locking in necessary hydration, Dr. Gmyrek explains.What kinds of things can affect the skin barrier?Really, the question should be what doesn’t affect it. A bunch of internal and external factors can damage or weaken the stratum corneum, according to the dermatologists we talked to. For example, some people are naturally deficient in filaggrin, a protein that strengthens the skin barrier, making them more predisposed to dryness and irritation, Dr. Gohara says.2 (More on other signs that your skin barrier isn’t in great shape in a sec.) Externally, many grooming and skin care routines can also change and damage it, such as using harsh soaps, over-exfoliating, taking extra-hot showers, and waxing, she adds. “Environmental factors can also weaken the skin barrier, including low humidity and dramatic temperature changes,” Naana Boakye, MD, a board-certified dermatologist and founder of Bergen Dermatology in Englewood Cliffs, New Jersey, tells SELF.3 All of the above can alter and deplete those aforementioned lipids, that “mortar” in between the cells. Essentially, that brick wall that was once solid can start to develop cracks and crevices.
When it comes to cosmetic procedures, arguably none have gotten more attention—both good and bad—than the Brazilian butt lift, a.k.a. the BBL. Attribute it to social media or a general culture shift, but the booty continues to have a major moment. According to The Aesthetic Society, buttock augmentation increased by 37% between 2020 and 2021 alone.And while no butt augmentation procedure is without risk (and illegal-market butt injections, in particular, can be quite problematic), the BBL is more notorious than the rest, with lots of buzz about its associated dangers. So is this bad reputation warranted or just overblown hype? And what, exactly, can make a BBL potentially dangerous? Ahead, top plastic surgeons answer those questions and explain how to avoid the major risks of Brazilian butt lift surgery.What is a BBL? | What can make a BBL dangerous? | Side effects of BBL surgery | BBL vs. other butt-enhancement procedures | How to minimize the risks of a BBLWhat is a BBL, exactly?A Brazilian butt lift is a cosmetic surgical procedure that changes the size and shape of a person’s butt using their own fat from other areas of the body. “Fat cells are removed via liposuction from the abdomen, hips, thighs, or lower back,” George Bitar, MD, a board-certified plastic surgeon in Washington, DC, tells SELF. “The extracted fat is then purified and strategically injected into specific parts of the derriere to help patients achieve their desired size and shape.”“Contouring the body in this way makes a BBL a very impactful procedure that can transform someone’s shape in ways that simply aren’t possible with butt exercises alone,” Alex Earle, MD, a board-certified plastic surgeon in Miami and president of the World Association of Gluteal Surgeons, tells SELF.Back to topWhy is a BBL potentially dangerous?To be clear, no cosmetic procedure—even something considered minimally invasive, like injectable eye fillers—is risk-free. But there seems to be a never-ending stream of news stories and reports detailing Brazilian-butt-lift-related complications and even deaths. (Google “BBL gone wrong” and you’ll see what we mean.) A 2017 paper in the Aesthetic Surgery Journal found the death rate associated with BBL surgery to be as high as 1 in 2,351—higher than any other cosmetic surgery, including tummy tucks, which were previously the riskiest, Steven Williams, MD, a board-certified plastic surgeon in Oakland, California and founder of Tri Valley Plastic Surgery, tells SELF.1 (But note that the death rate has declined significantly since that study was published—more on that point in a minute.)So what’s behind such an alarming number? The 2017 research shows that the cause of death in the majority of these cases was a pulmonary fat embolism. During a BBL, fat is placed into the butt with a long cannula (a thin, straw-like tube) that’s inserted under the skin, Dr. Earle says. “If the surgeon is inexperienced or doesn’t have a good sense of anatomy and goes too deep into the muscle, the fat can end up injuring the superior and inferior gluteal arteries,” he explains. “These blood vessels have a direct route to the heart, so if they’re injured and fat gets into them, that fat can go into the heart and lungs and the patient can die immediately.”It’s scary stuff for sure, which is why several plastic surgery societies, including the American Society of Plastic Surgeons (ASPS), formed the Task Force for Safety in Gluteal Fat Grafting in 2018. Their goal: Create new guidelines to make Brazilian butt lifts safer. These included recommendations such as injecting the fat only in the subcutaneous space above the muscle (directly under the skin) and using larger cannulas that don’t bend, which make it easier to see where the tip is, says Dr. Bitar.Implementing this protocol appears to have had the intended effect so far. By 2020, deaths associated with Brazilian butt lifts had dropped to approximately 1 in 15,000, according to a study published in the Aesthetic Surgery Journal.2 “This rate is on par with that of very commonly accepted procedures, such as tummy tucks,” says Dr. Earle. (In fact, another 2020 study in Plastic and Reconstructive Surgery puts the BBL death rate at 1 in 20,000, compared to 1 in 13,000 for a tummy tuck.)3And experts continue to put additional BBL guidelines in place. This past June, The Aesthetic Society released new recommendations, stating that all surgeons should use ultrasound technology before and during the fat injection portion of BBL surgery.4 “This transforms the procedure from one that you are essentially doing blindly to one in which you can see exactly where the cannula is, ensuring you stay in the safe space between the muscle and the skin, greatly minimizing the chance of a fat embolism,” Dr. Earle explains. These most recent guidelines also recommend that surgeons perform no more than three BBLs per day, citing surgeon fatigue as another potential reason for complications and problems.
Your Instagram feed isn’t always distorting reality: A ton of people, with and without blue checkmarks, are getting facial fillers. According to The Aesthetic Society—an educational and patient advocacy group comprised of 2,000-plus board-certified plastic surgeons—there were nearly 2 million dermal filler procedures performed last year alone, making them the second most popular non-surgical cosmetic treatment (neurotoxins, like Botox, took the number one spot with around 3.5 million procedures).What makes fillers such a crowd-pleasing enhancement among patients and doctors alike? According to the experts we talked to, it likely has something to do with their versatility. There are multiple types of dermal fillers out there, with the ability to do everything from filling in fine lines to bulking up cheekbones that have thinned with age, as SELF previously reported. But arguably one of their best-known purposes is for non-surgical lip augmentation—yep, to create plump lips. (Insert Kylie Jenner visual here.)At the end of the day, these lip injections offer a quick, minimally-invasive way to score a fuller pout with minimal downtime and side effects. However, as is the case with all of the other injectable fillers you can get in your face, the results aren’t permanent. So, how long do lip fillers last? We asked doctors to weigh in on that and answer some other commonly asked questions about this popular cosmetic procedure.What are lip fillers? | What happens during the procedure? | How long do lip fillers last? | Can lip fillers be reversed?First, what are lip fillers?Injectable dermal fillers are typically made using one of three substances: hyaluronic acid (HA), calcium hydroxylapatite, and poly-l-lactic acid. “Most doctors use hyaluronic acid-based fillers, like Restylane and Juvederm, for the lips,” Melissa Doft, MD, a board-certified plastic surgeon in New York City, tells SELF. “Hyaluronic acid is a sugar that’s naturally occurring in the body and attracts and holds onto water, creating the appearance of fuller lips.”1Most people think about injectable lip fillers as a way of adding volume, but they can do more than just increase the size of the lips. Depending on which particular HA filler your doctor uses, lip injections can be more subtle, simply making lip skin look smoother and more hydrated, Jennifer Levine, MD, a double board-certified facial plastic surgeon in New York City, tells SELF.To that point, there are several different types of HA fillers that can be injected into the lips. “Different hyaluronic acid products have varying physical characteristics including molecular sizes, formulations, and water absorption,” Samuel Lin, MD, a board-certified plastic surgeon and associate professor of surgery at Harvard Medical School, tells SELF.2 “These variations have different implications in terms of appearance and longevity.” In other words, while it’s still the same ingredient, there are nuances that change the effect the filler has—and how long it lasts.Back to topWhat’s it like to get lip fillers?Filler treatments don’t take very long, about 30 minutes, according to Dr. Lin. Since the lips tend to be a sensitive area, your doctor may first apply a topical anesthetic; Dr. Doft says she applies a lidocaine-based cream on her patients’ lips 10 to 15 minutes prior to injecting. And be prepared for more than one needle poke: In order to evenly distribute the product, lip fillers are typically injected via a series of small injections, on average 10 to 12, says Dr. Doft. Most fillers have lidocaine mixed in to help with immediate discomfort, she adds.The effects of filler injections are pretty much instantaneous but it’s important to note that what your lips look like immediately post-procedure is not—we repeat is *not—*a good indication of what the final result will be. “You’re going to look a little swollen right away, a little more swollen over the next few hours, and quite a bit more swollen by the next day,” says Dr. Levine. “It can actually be a little terrifying for a lot of patients, who are worried that they overdid it when they see how big their lips look.”If you decide to have the procedure, try not to stress as you go through the lip filler swelling stages. The lips are a very vascular area (meaning they contain a lot of blood vessels) so a good amount of swelling (and potentially bruising) is totally normal and to be expected, Dr. Levine says. She recommends giving it a full two weeks for everything to subside, at which point you’ll get an accurate sense of the final result.
When telogen effluvium occurs, the hair loss is rapid. “We all lose about 100 hairs per day on average, but in the case of telogen effluvium, you’re suddenly losing way more than that,” says Dr. Bhanusali. He adds that people tend to notice it when they see large clumps in their hands after washing their hair, see lots of hair in the shower drain, or notice that their brush or comb is filling up much faster than normal. This isn’t a gradual type of hair loss or subtle hair thinning—it’s an acute, intense, sudden shedding that can leave your hair feeling less full overall and often manifests as noticeable thinness and sparseness along the sides of the temples.⁵It’s unclear if hair loss after COVID-19 correlates with any other specific symptoms of the virus, or how sick you get. “The American Academy of Dermatology has a COVID-19 registry and we hope over time we will be able to extrapolate some data to find associations, but so far there are no clear relationships,” says Dr. Kuhn. “I have seen severe shedding following a mild case of COVID, and mild shedding following severe illness.”Back to topHow long does hair loss after COVID-19 last?Telogen effluvium, whether it’s caused by COVID-19 or another trigger, usually isn’t permanent. “Shedding can occur, however, for three to six months before it stops,” says Dr. Kuhn. With telogen effluvium, the hair growth cycle eventually normalizes and, because there is no damage to the scalp or hair follicles, all of the hair should grow back.According to the American Academy of Dermatology, your hair will likely regain normal fullness after telogen effluvium within six to nine months. Although Dr. Kuhn says, in her experience, it often takes even longer—anywhere from one to two years—for someone’s hair to reach its pre-shed status.Back to topHave any of the COVID-19 vaccines been linked to hair loss?“There’s no research to indicate that the COVID vaccines trigger hair shedding,” says Dr. Kuhn, who adds that, in her experience, she hasn’t seen any people dealing with hair loss post-vaccine. Dr. Bhanusali underscores the fact that there’s currently no direct data to connect the two.Back to topHow to stop hair loss after COVID-19Most importantly, be patient. “Though losing hair can be scary, I always reassure patients that they won’t go bald from COVID-related shedding,” says Dr. Kuhn. “Typically, the best thing to do is simply wait it out.” In the meantime, practicing healthy hair habits is paramount.You want to make sure that you’re doing everything you can to minimize the risk of losing any more hair, notes Dr. Bhanusali. That means avoiding heat styling and/or using the lowest temperature whenever you do, minimizing intense chemical processes such as highlighting and straightening, and avoiding tight hairstyles that put tension on the hair.You can also consider getting tested for nutrient deficiencies to ensure that’s not exacerbating the situation. If you are, in fact, lacking in a certain vitamin or mineral that’s associated with hair health—Dr. Bhanusali notes that vitamin D and iron deficiencies are common—talk to your doctor about how to incorporate more of it into your diet and/or if you’ll need to try a supplement (and if so, what the dosage should be).And while it’s always easier said than done, lowering your stress levels may also help. “Practicing self-care and engaging in things such as meditation and breathing exercises can be helpful as you deal with COVID-related hair loss,” suggests Dr. Ziering. “Breaking long-term stress can be helpful in helping normal hair function resume more consistently.” That said, lowering stress levels may feel nearly impossible given what’s going on in the world or in your personal life, so if self-care isn’t cutting it, consider talking to a therapist, if you’re able.