Don’t Be Rash: The Pediatric Dermatology Podcast

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Welcome to the Don’t Be Rash Pediatric Dermatology

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Podcast, the owner’s manual for your kid’s skin.

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I’m your host, Dr. K, board -certified pediatric

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dermatologist and father of two boys. I’m here

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to chat with you to promote dermatological education

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and improve skin health in our children everywhere.

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Let’s get started. Welcome to Don’t Be Rash,

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the pediatric dermatology show, coming to you

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from historic Bethlehem, Pennsylvania. I’m your

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host and board -certified pediatric dermatologist,

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Dr. Andrew Krakowski. On today’s show, we’ll

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discuss kids and social media skin trends. As

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a father of two young boys myself, this topic

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is near and dear to my own heart. Like it or

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not, social media has pervaded most of our lives.

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Platforms like TikTok and Instagram have given

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birth to skincare obsessions among kids such

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that we have nine-year-olds using anti-aging

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serums and wrinkle prevention products. And if

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you think your kids are immune to these trends,

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well, then you never heard of “slugging” or the

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“glass skin challenge” or the extremely dangerous

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“fire challenge.” But don’t worry. Today’s show

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will help make you better aware of these trends

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and hopefully give you some tools for how to

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deal with them. Joining us today as our guest

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co-host is renowned pediatric dermatologist,

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Dr. Sheilagh Maguiness. Dr. Maguiness is double board

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certified in dermatology and pediatric dermatology.

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In addition to having a thriving practice in

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Minneapolis, Minnesota, Dr. Maguiness currently

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serves as the Immediate Past President of the

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Society for Pediatric Dermatology. Like me, she’s

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a parent to two tween boys and she’s a recognized

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expert on, among other things, the topic of kids

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and social media skin trends. Welcome, Dr. Maguiness.

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Thanks for joining me today. Thanks for having

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me. So what do you say to the parent who believes

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that their children are not being influenced

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by social media platforms like TikTok and Instagram?

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Oh, goodness. I would say I wish that were true.

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But unfortunately, we have strong data to the

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opposite of that. You know, over the last, I

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would say, two to three years, we’ve really seen

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a complete rise in interest, consumer interest,

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sales, et cetera, of teens and tweens getting

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extremely into skincare and often to their detriment.

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What’s driving the interest? Well, I think it’s

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the proliferation of social media, you know,

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with TikTok and Instagram and all of the users.

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You know, we have Gen Alpha, which is 2 billion

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people. It’s actually the largest generation

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now. So Gen Alpha, anyone born, you know, after

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2010, these are the kiddos that are digitally

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fluent, Andrew. I mean, these kids are spending,

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we know, based on research studies. three or

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over three hours a day online. And much of that

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is on social media platforms. So, you know, as

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parents, we may not want to believe that our

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kids are taking part in this, but they absolutely

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are. So one of the benefits of doing a podcast

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like this is to raise awareness so that parents

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and their tweens and teens can really have a

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good discussion about the good, the bad, and

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the ugly about social media. And in this case,

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how it relates to how kids are approaching skincare.

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What age group are we talking about mostly you

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seeing this affecting? I think tweens and teens

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for sure. And we know that based on survey data,

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different studies that have come out, but also

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market data. For example, Andrew, did you know

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that households with teens or tweens are outspending

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other households that don’t have tweens or teens

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by two to one, specifically on skincare? So the

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rise in sales at popular beauty outlets is in

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part largely being derived from sales that are

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from tweens and teens who are really into this.

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And you just have to go on social media before

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you’ll be served many different videos with very

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young so-called “skinfluencers” as young as eight

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years old showing. “Get Ready With Me” videos,

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complex, really multi -step, inappropriate skincare

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being used by this population driven by this

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phenomenon. And is there a gender breakdown?

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Is it heavier weighted to females versus males?

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Or I mean, what are you seeing? So in my practice,

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and maybe you’ll feel the same, and I do think

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this is largely female driven, especially when

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I myself have been kind of like a little spy

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on social media, going into those get ready with

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me videos. It is mostly tween and teen girls

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that I think are driving this market. And that’s

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a really interesting point, because on the one

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hand, we have this dichotomy where the tween

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girls are kind of over consuming. And we can

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talk about this a little later, being targeted

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directly by the marketing tactics of these companies.

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And then we have tween boys like you and I, we

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both are parents to tween boys who have largely

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been left out of this conversation. So it really

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is a strong dichotomy. And yes, I would say that

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from my experience in clinic with my tween and

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teen girls coming in for various skincare complaints,

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a lot of them are carrying a huge bag of different

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products that they’re using, sometimes all together

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at the same time, which is obviously not how

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products are intended to be used or tested for.

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Of course. So for the person, the uninitiated

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out there, walk us through what does a “Get Ready

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with Me” video look like? I mean, what would you

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see if you were a mom or dad logging on and watching

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the same thing that your son or daughter presumably

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would be watching? Well, I have seen “Get Ready

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With Me” videos all the way from six-year-old

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girls to, you know, 18. And there are very popular

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beauty influencers online who have millions of

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followers whose videos got tens of millions of

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views. And a “Get Ready With Me” video is simply

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this influencer, whether it’s a tween teen or

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other, showing you their skincare regimen. And

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that might be, you know, washing their face,

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putting on a variety of toners and serums and

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moisturizers. et cetera, and then doing their

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makeup, et cetera, commenting on products. But

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there is a really hidden kind of rule for these

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“Get Ready with Me” videos. And that is that a

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lot of times these influencers are being paid

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by companies to show the products. They have

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been gifted the products by companies. You know,

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there’s definitely influencers as young as six

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who are being given product by companies to show

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in videos. And of course, if you’re a six- to

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eight-year-old on a medium like TikTok or Instagram,

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of course, the parents are actively involved

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in doing that and kind of involved in this influencing

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journey that their child is on and helping edit

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the videos, participating. the video so there’s

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lots of layers to this and they’re all not necessarily

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good. I think you hit on the “layers” right There

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literally and figuratively are layers involved

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in this uh 20 30 products being used at one time

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we in your experience when you’ve seen these

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videos do most or any or all of them seem to

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have some level of thought behind the order of

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use and what each product is supposed to be doing

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is being applied in some logical fashion or are

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the people who are using these products literally

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just putting it on their skin without really

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understanding what they’re doing I think it depends

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on the age and the credentials. Of course, we

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have some healthcare professionals that do “Get

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Ready With Me” videos, and I think there’s a lot

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more thought behind and evidence-based thinking

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behind what they’re doing. But, you know, for

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example, one of the big trends right now is called

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a “skincare smoothie.” And if you’ve never heard

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of that, it just means that you actually squeeze

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out a little bit of all the products, put them

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in your hand or on the top of the container,

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and then spread them all over. your face in a

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way in which they weren’t designed or formulated

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to be applied to the skin. And this is really

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popular and trending right now, this “smoothie.”

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So I would say that from the tween and teen standpoint,

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I don’t believe there is a lot of understanding

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about some of the active ingredients that can

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be extremely harsh and inappropriate for young

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skin. And also, you know, about the order of

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application. And then I don’t know, Andrew, if

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you heard about the recent really interesting

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study that was published, in June, in Pediatrics,

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like a very reputable journal. They looked at

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TikTok skincare regimens that had over a million

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views put out by tweens and teens. And the amount

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of products, the expense of the products, and

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the repeated exposure to potential irritants

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and allergens just shows you that, you know,

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we’re really doing more harm than good by applying

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all of these things and causing irritation and

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even long, lifelong contact allergies. I mean,

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we know just in the world of acne itself. that

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they’re not meant to be put on together. They

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can inactivate one another or they can exacerbate

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or amplify the side effects of one another when

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used in sort of a concurrent fashion. And here

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you’re just describing lumping a bunch of stuff

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together and rubbing it on your face. That’s

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not going to be necessarily a good thing. No,

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it’s going to lead to a lot of irritation and

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rashes. You know, the active ingredients that

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are available over the counter are no joke. You

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can buy a 10% salicylic acid serum. You can

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buy a 10% glycolic acid serums. All of the AHAs,

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the BHAs that you’re putting on that literally

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are kind of like almost prescription strength

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exfoliants. And if you leave that on, you will

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cause an irritant or almost like a chemical burn

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for parents listening. So we really have to be

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careful and pay attention to the ingredients.

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Because although the bottle may be pink and…

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pretty and very fruity scented. And of course,

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that just is a nod to the aggressive and maybe

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predatory marketing that’s going on with respect

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to our young people. But it’s important to pay

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attention to what the ingredients are because

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some of the actives can really do a lot of harm

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to a teen’s developing skin barrier. So what

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do you think the draw is? If you’re a tween and

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you’re coming home from school, long day, you’re

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sitting at home and you have a couple minutes

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to yourself. What’s the draw to even watch something

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like this? I mean, is it peer pressure? Are your

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friends doing it or are they trying to glean

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information, education? What do you think the

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draw is to do this in the first place? Oh, gosh,

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Andrew, I think there are many reasons. So first

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of all, this is the “selfie” generation, right?

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We are looking at ourselves on social media.

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We are posting selfies. There’s a lot of influencing

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culture that really. basically emphasizes and

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prioritizes appearance and beauty think of the

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filters a lot of these young people are seeing

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themselves and others curated very carefully

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by a filter and so what they actually look like

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is really not what’s being showed on the screen

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and i think that is fueling also this interest

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in beauty and maintaining a youthful appearance

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etc and i think it’s really becoming you know,

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at the point of an epidemic proportion here.

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And obviously, we know that that can impact not

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only skin health, but mental health for our young

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tweens and teens. Do the parents know what’s

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going on? For the most part, do we have any statistics

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one way or the other that parents are aware that

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this is what their children are (A) watching and

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(B) doing? Or is it, hey, whatever happens behind

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closed doors is what’s happening? I don’t know.

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Well, I think if your tweener teen asks you for

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a gift card to a popular beauty outlet and you

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go with them and you see what’s on the shelf,

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you probably have a good idea. So I would say

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moms of tween and teen girls probably do have

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a good idea. This is what people are gifting

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each other for birthday present at parties. I

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mean, there’s a whole culture of sleepover parties

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that are skincare or self-care related where

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kids are putting on these, you know, irritating

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masks that smell like watermelon and getting

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a rash afterwards. I mean, it’s a whole movement.

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So I think that some parents are aware, but they

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might not realize what they need to say no to

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and what they can enthusiastically say “yes” to.

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You know, in the study that I mentioned that

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was published by Northwestern, they looked at

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all of these skincare regimens and, you know,

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only a quarter. included a sunscreen, which you

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and I both know is arguably the most important

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step when you’re this young. Obviously, when

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you’re 12 to 14 or younger, you have the most

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collagen you are ever going to have. So protecting

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that by using a broad spectrum SPF every day

00:12:47.919 –> 00:12:52.379
is, you know, the most important part of any

00:12:52.379 –> 00:12:55.360
tween and teen skincare, yet it’s often not even

00:12:55.360 –> 00:12:57.730
discussed. I love kind of where we’re going with

00:12:57.730 –> 00:13:00.389
this. For the person out there who’s not aware

00:13:00.389 –> 00:13:02.509
of what some of these kids are talking about,

00:13:02.549 –> 00:13:04.610
can you walk us through some of the specific

00:13:04.610 –> 00:13:06.889
media trends and “challenges” that you’re seeing?

00:13:07.320 –> 00:13:09.519
Sure. Well, let’s take it with the sun care,

00:13:09.659 –> 00:13:11.860
basically. You know, just last year, there was

00:13:11.860 –> 00:13:16.399
a social media trend going on about how to contour

00:13:16.399 –> 00:13:19.419
your face and look very bronzed in certain areas

00:13:19.419 –> 00:13:22.519
while not in others by only selectively applying

00:13:22.519 –> 00:13:25.139
sunscreen to certain parts of your face and then

00:13:25.139 –> 00:13:27.960
tanning the rest. Obviously, a tan means that

00:13:27.960 –> 00:13:29.860
your skin has been damaged. It’s not good at

00:13:29.860 –> 00:13:32.539
any age, especially not when you’re young. Most

00:13:32.539 –> 00:13:35.159
significant sun exposure when you’re young is

00:13:35.159 –> 00:13:39.100
what is directly caused. related to risk for

00:13:39.100 –> 00:13:41.720
skin cancer over time, let alone photo-aging

00:13:41.720 –> 00:13:46.639
and looking visibly damaged from the sun. So

00:13:46.639 –> 00:13:48.940
we certainly don’t want to be selectively applying

00:13:48.940 –> 00:13:52.419
sunscreen. You and I both know there was like

00:13:52.419 –> 00:13:54.700
a “sunburn challenge” or writing your name with

00:13:54.700 –> 00:13:57.940
sunscreen to like make various, you know, designs

00:13:57.940 –> 00:14:01.100
on someone’s back with selective application

00:14:01.100 –> 00:14:03.440
of sunscreen. But all of those things are really

00:14:03.440 –> 00:14:05.759
dangerous. You know, they’re trending. They go.

00:14:05.929 –> 00:14:08.250
viral. Kids look at it, they think, oh, that’s

00:14:08.250 –> 00:14:11.570
cool. And of course, risk-taking behaviors is

00:14:11.570 –> 00:14:14.470
really rampant at this age group. So it’s one

00:14:14.470 –> 00:14:16.570
of those things where as, you know, as parents,

00:14:16.649 –> 00:14:19.730
we can kind of be aware of it and be educating

00:14:19.730 –> 00:14:22.269
kids about how to apply the sunscreen appropriately,

00:14:22.590 –> 00:14:26.230
how, you know, high the SPF should be, educating

00:14:26.230 –> 00:14:29.169
about the UV index and what exposure is the most

00:14:29.169 –> 00:14:32.750
risky, and then of course reapplying. So all

00:14:32.750 –> 00:14:35.370
of those things are great to talk about. with

00:14:35.370 –> 00:14:37.730
your teen about and open a healthy conversation

00:14:37.730 –> 00:14:40.370
by maybe talking about this trend. Your teen,

00:14:40.450 –> 00:14:42.389
you might catch your teen by surprise. They might

00:14:42.389 –> 00:14:44.690
be excited to chat with you about it. What is

00:14:44.690 –> 00:14:47.120
this “glass skin challenge” I’ve heard about? So

00:14:47.120 –> 00:14:50.059
glass skin is, you know, I think there’s a filter

00:14:50.059 –> 00:14:53.220
for this too, where you can look extremely dewy,

00:14:53.259 –> 00:14:56.460
like your skin is shining and glowing, like you’re

00:14:56.460 –> 00:14:59.279
looking in a mirror or glass. And there are various

00:14:59.279 –> 00:15:03.299
serums and actives that people tout as being

00:15:03.299 –> 00:15:07.120
able to give you this glass skin look. And, you

00:15:07.120 –> 00:15:09.700
know, again, the focus on beauty and appearance

00:15:09.700 –> 00:15:12.759
here, I think, is negative. But the ingredients

00:15:12.759 –> 00:15:15.399
for this trend are probably less harmful than

00:15:15.399 –> 00:15:17.899
others. we might talk about because I think people

00:15:17.899 –> 00:15:20.820
are using things like snail mucin or hyaluronic

00:15:20.820 –> 00:15:23.379
acid. Those are things that are humectants that

00:15:23.379 –> 00:15:25.659
plump the skin that I don’t think are necessarily

00:15:25.659 –> 00:15:29.980
bad for tween skin, but certainly not necessary.

00:15:30.340 –> 00:15:32.759
We did actually publish an article a couple months

00:15:32.759 –> 00:15:36.620
ago on a girl that came in and she was having

00:15:36.620 –> 00:15:38.960
an allergic reaction around her lips. Apparently,

00:15:39.179 –> 00:15:42.519
I mean, we’d have…we had heard of snail mucin,

00:15:42.539 –> 00:15:45.419
but had not really read up on it. And one of,

00:15:45.460 –> 00:15:47.539
apparently one of the specific things you’re

00:15:47.539 –> 00:15:49.720
not supposed to do is put it on mucosal surfaces.

00:15:50.039 –> 00:15:52.519
And she had been using it on her lips and she

00:15:52.519 –> 00:15:54.929
wound up getting. basically had an allergic contact

00:15:54.929 –> 00:15:58.269
dermatitis looking rash around her face in that

00:15:58.269 –> 00:16:01.870
area. And we did attribute it eventually to the

00:16:01.870 –> 00:16:03.889
snail mucin. She stopped using it and it went

00:16:03.889 –> 00:16:07.809
away and got better. So in that sense, I guess

00:16:07.809 –> 00:16:11.269
it wasn’t totally benign, but it sounds grosser

00:16:11.269 –> 00:16:13.870
than it really is. So this is one I’ve not seen

00:16:13.870 –> 00:16:17.409
or heard of myself yet in my kids’ social network.

00:16:17.590 –> 00:16:19.629
And I guess I’m oblivious when I’m walking through

00:16:19.629 –> 00:16:22.090
the aisle at Target. I’m not seeing “charcoal”

00:16:22.090 –> 00:16:25.990
out on the aisles. So I’ve missed this one. There’s

00:16:25.990 –> 00:16:28.210
some popular brands that contain charcoal-containing

00:16:28.210 –> 00:16:31.190
cleansers, etc. And making all kinds of claims,

00:16:31.289 –> 00:16:33.370
that’s another whole topic we could have today,

00:16:33.590 –> 00:16:36.029
Andrew, that you and I both know that the health,

00:16:36.070 –> 00:16:38.850
wellness, and beauty industry is not regulated

00:16:38.850 –> 00:16:41.629
by the FDA to the same scrutiny that the pharmaceutical

00:16:41.629 –> 00:16:45.190
industry is. So a lot of times when parents are

00:16:45.190 –> 00:16:47.509
trying to find guidance by looking at a bottle

00:16:47.509 –> 00:16:50.710
and seeing all these great claims that are printed

00:16:50.710 –> 00:16:54.129
right on the label, they have to know that there’s

00:16:54.129 –> 00:16:56.940
really a… A strong lack of regulation here

00:16:56.940 –> 00:16:59.139
and companies really don’t have to answer to

00:16:59.139 –> 00:17:01.580
anyone. They can put anything on the label. So

00:17:01.580 –> 00:17:03.799
you really do have to be very careful when you’re

00:17:03.799 –> 00:17:06.480
selecting products for, you know, children. And

00:17:06.480 –> 00:17:08.720
that’s true for baby care all the way up to tweens

00:17:08.720 –> 00:17:11.339
and teens. The one I get really sort of nervous

00:17:11.339 –> 00:17:13.519
about are the retinols. Can you talk a little

00:17:13.519 –> 00:17:15.059
bit about that? What’s your experience seeing

00:17:15.059 –> 00:17:18.420
people use those? Oh, I mean, that’s part of

00:17:18.420 –> 00:17:21.319
this whole so-called “Sephora kids” trend is that

00:17:21.319 –> 00:17:26.059
young kids are using retinol products at a very

00:17:26.059 –> 00:17:29.759
young age and doing so with the idea of maintaining

00:17:29.759 –> 00:17:31.900
a youthful appearance, you know, obviously at…

00:17:32.359 –> 00:17:34.519
ages 6 to 12, that’s completely unnecessary.

00:17:35.119 –> 00:17:37.960
And of course, retinol, even over-the-counter

00:17:37.960 –> 00:17:40.220
retinols or prescription strength like we use

00:17:40.220 –> 00:17:43.700
for acne or other indications, they are very

00:17:43.700 –> 00:17:46.559
strong exfoliants and they can cause a lot of

00:17:46.559 –> 00:17:50.200
skin barrier breakdown and damage. And also,

00:17:50.319 –> 00:17:53.680
you know, that leads to an impaired skin barrier

00:17:53.680 –> 00:17:57.319
that can then be more primed when you apply other

00:17:57.319 –> 00:18:00.339
things on the skin to then develop more irritation,

00:18:00.720 –> 00:18:04.390
allergy. or even sometimes skin infections. And

00:18:04.390 –> 00:18:06.750
I have seen that in children who are using harsh

00:18:06.750 –> 00:18:10.049
exfoliating acids or retinols, yes. And then

00:18:10.049 –> 00:18:12.890
they’ve participated in dermablading. Do you

00:18:12.890 –> 00:18:15.210
know what this trend is? I have, but please share

00:18:15.210 –> 00:18:17.069
it with the audience just so everybody’s on the

00:18:17.069 –> 00:18:19.730
same page. Yeah, so dermablading is the act of

00:18:19.730 –> 00:18:21.950
kind of removing the small vellus hairs on the

00:18:21.950 –> 00:18:25.150
face. And you can blow this, you know, kind of

00:18:25.150 –> 00:18:27.970
chalky substance onto the face and see all the

00:18:27.970 –> 00:18:30.549
tiny hairs. And then with a very sharp razor,

00:18:30.650 –> 00:18:32.859
just… like you would shave with, you actually

00:18:32.859 –> 00:18:35.319
shave the face. And people do feel like that

00:18:35.319 –> 00:18:39.019
allows them to achieve what you just talked about,

00:18:39.059 –> 00:18:42.140
this glass skin dewy finish. But at the same

00:18:42.140 –> 00:18:45.119
time, with a straight razor, you’re irritating

00:18:45.119 –> 00:18:47.299
the hair follicles. You’re making some small

00:18:47.299 –> 00:18:49.400
micro tears or abrasions in the skin. Of course,

00:18:49.420 –> 00:18:52.819
you can cut yourself too. And then boom, you’ve

00:18:52.819 –> 00:18:55.079
got an irritated face with little portals of

00:18:55.079 –> 00:18:57.940
entry for bacteria. And you can then develop

00:18:57.940 –> 00:19:01.000
impetigo. Yeah, I’ve definitely taken care of

00:19:01.000 –> 00:19:02.839
a couple of kids who have burned themselves with

00:19:02.839 –> 00:19:05.480
over-the-counter strength retinols, not even

00:19:05.480 –> 00:19:07.420
the prescription strength retin-A type medicines

00:19:07.420 –> 00:19:11.000
that we’re talking about for acne. And when they

00:19:11.000 –> 00:19:12.880
ask about dermablading, I say it’s like using

00:19:12.880 –> 00:19:14.579
a cheese grater on your face. You just can’t

00:19:14.579 –> 00:19:18.099
see the damage that you’re doing and try to get

00:19:18.099 –> 00:19:20.359
them to avoid doing it. But it sounds like

00:19:20.720 –> 00:19:22.740
all bets are off when you’re on social media

00:19:22.740 –> 00:19:25.180
and talking about it behind a microphone or a

00:19:25.180 –> 00:19:27.539
camera. Oh, yeah. And they show themselves doing

00:19:27.539 –> 00:19:31.420
it. And with magnification, it’s really interesting,

00:19:31.500 –> 00:19:34.740
but also very damaging. What do you see as the

00:19:34.740 –> 00:19:36.759
role of the pediatric dermatologist in all of

00:19:36.759 –> 00:19:39.059
this? Other than the direct – obviously – “we’re

00:19:39.059 –> 00:19:40.740
there to answer your questions when you see us.”

00:19:40.779 –> 00:19:43.779
But have you taken more of an advocacy position

00:19:43.779 –> 00:19:46.180
here at all? Or do you see us maybe doing that?

00:19:46.680 –> 00:19:49.039
So I think there are two ways to do this, one

00:19:49.039 –> 00:19:51.220
of which is what’s happening right now with us

00:19:51.220 –> 00:19:53.400
discussing this and giving parents, you know,

00:19:53.400 –> 00:19:57.339
a real good education from two, you know, board

00:19:57.339 –> 00:19:59.480
certified experts who see it all the time. So

00:19:59.480 –> 00:20:02.420
this is a great way to help educate. You can

00:20:02.420 –> 00:20:04.500
do it on an individual basis in clinic. As I

00:20:04.500 –> 00:20:07.039
mentioned, I have these young girls come in with

00:20:07.039 –> 00:20:09.440
all of these products. And guess what we’re doing?

00:20:09.579 –> 00:20:13.160
Every single time we are paring it down. And

00:20:13.160 –> 00:20:15.720
so telling parents what they can say yes to.

00:20:16.079 –> 00:20:19.039
So you can say yes to a gentle cleanser. You

00:20:19.039 –> 00:20:21.720
can say yes to a moisturizer. And you definitely

00:20:21.720 –> 00:20:25.200
want to enthusiastically say yes to sunscreen,

00:20:25.480 –> 00:20:28.839
SPF. So those are the real backbones of any skincare

00:20:28.839 –> 00:20:31.779
regimen for myself, for you, and for our tweens

00:20:31.779 –> 00:20:34.539
and teens. But guess what the surveys tell us

00:20:34.539 –> 00:20:37.039
that they’re actually buying in all of these

00:20:37.039 –> 00:20:40.390
beauty outlets? It’s actually treatment and toners.

00:20:40.390 –> 00:20:43.829
That’s the highest number of products. Yes, sunscreen

00:20:43.829 –> 00:20:46.430
doesn’t even make the list, Andrew. So this is

00:20:46.430 –> 00:20:48.529
our opportunity. I knew sunscreen wasn’t on there.

00:20:48.910 –> 00:20:52.730
I mean, you know, that’s probably not surprising.

00:20:52.769 –> 00:20:55.410
But toners and a nine-year-old, geez, like,

00:20:55.470 –> 00:21:00.609
wow, okay. Toners, yes. Exactly. Toners and treatments

00:21:00.609 –> 00:21:02.910
and serums. Those are the top categories for

00:21:02.910 –> 00:21:05.890
retail sales over the counter. And it’s driving

00:21:05.890 –> 00:21:08.190
billions of dollars of growth in the industry.

00:21:08.369 –> 00:21:11.390
And guess who’s taking notice of it? The brands,

00:21:11.609 –> 00:21:14.589
right? So then all of a sudden, these techniques

00:21:14.589 –> 00:21:17.069
of aggressive and I would even venture to say

00:21:17.069 –> 00:21:19.529
predatory marketing to tweens and teens where

00:21:19.529 –> 00:21:23.089
they know they can get you. And part of that

00:21:23.089 –> 00:21:27.930
is blurring the line between education. and marketing

00:21:27.930 –> 00:21:31.390
or entertainment and marketing. But that’s really

00:21:31.390 –> 00:21:34.470
getting very fuzzy out there. And our tweens

00:21:34.470 –> 00:21:36.190
and teens don’t know how to spot the difference,

00:21:36.410 –> 00:21:38.829
right? So that’s where we need to have a great

00:21:38.829 –> 00:21:41.210
conversation about them. And as parents, you

00:21:41.210 –> 00:21:43.390
could ask them, hey, what are you seeing? Have

00:21:43.390 –> 00:21:46.009
you seen a “Get Ready With Me” video? Let’s critically

00:21:46.009 –> 00:21:48.470
appraise this video together. Why do you think

00:21:48.470 –> 00:21:50.630
she’s using all of these pink, fruity-scented

00:21:50.630 –> 00:21:54.250
products that cost $120? Where do you think she

00:21:54.250 –> 00:21:57.119
got them from? Teach them to look down at the

00:21:57.119 –> 00:21:59.720
video and see if it’s an ad or a paid partnership

00:21:59.720 –> 00:22:02.259
or if they’re tagging the companies in their

00:22:02.259 –> 00:22:05.079
videos. And use it as an opportunity to tell

00:22:05.079 –> 00:22:08.519
the kiddos, hey, just have a degree, an index

00:22:08.519 –> 00:22:10.819
of suspicion when you’re watching these. Are

00:22:10.819 –> 00:22:12.680
they actually trying to tell you something that’s

00:22:12.680 –> 00:22:15.339
good for you? Or are they being paid to show

00:22:15.339 –> 00:22:17.900
you this content? Most of the conversations,

00:22:18.079 –> 00:22:21.240
if not all, that I’ve had around this topic in

00:22:21.240 –> 00:22:26.319
the clinic usually were prompted by dads asking

00:22:26.319 –> 00:22:30.279
me, does my daughter really need to use all this

00:22:30.279 –> 00:22:33.160
stuff? I haven’t really noticed moms asking me

00:22:33.160 –> 00:22:35.700
that, maybe because they’ve already weeded out

00:22:35.700 –> 00:22:39.980
what they feel is good or useful and aren’t bothering

00:22:39.980 –> 00:22:42.940
me with the questions. But dads will do it. I’ve

00:22:42.940 –> 00:22:47.980
found them to be very receptive for the scaling

00:22:47.980 –> 00:22:50.420
down for one good reason. It’s going to save

00:22:50.420 –> 00:22:54.599
them about 200 bucks a month, right? They are

00:22:54.599 –> 00:22:57.579
very happy to hear that they don’t need their

00:22:57.579 –> 00:23:01.819
daughters using 100 products…that maybe two or

00:23:01.819 –> 00:23:04.559
three would suffice. And ultimately, I think

00:23:04.559 –> 00:23:06.660
I’ve had some of the kids kind of smile and say,

00:23:06.779 –> 00:23:09.539
“Oh, that’s good to know as well. I can use my

00:23:09.539 –> 00:23:14.559
money better elsewhere!” How do you bring up the

00:23:14.559 –> 00:23:18.259
topic of enrolling the parents in this process

00:23:18.259 –> 00:23:20.799
of getting them educated about this and maybe

00:23:20.799 –> 00:23:24.140
peeling back a little bit? Well, I think it’s

00:23:24.140 –> 00:23:27.180
a really nice opportunity to talk about what

00:23:27.180 –> 00:23:29.500
is healthy hygiene habits. And isn’t it great

00:23:29.500 –> 00:23:31.819
that your child is interested and wants to start

00:23:31.819 –> 00:23:35.269
early, right? And we know that the girls are

00:23:35.269 –> 00:23:37.930
looking to mom because mom is modeling this for

00:23:37.930 –> 00:23:40.690
them. Mom is using her cleanser, her moisturizer,

00:23:40.930 –> 00:23:43.309
her whatever serum. So the little girls are getting

00:23:43.309 –> 00:23:46.029
that modeled for them by mom and often will even

00:23:46.029 –> 00:23:48.789
borrow from mom to use their products or, you

00:23:48.789 –> 00:23:50.549
know, kind of use that as a jumping off point.

00:23:50.710 –> 00:23:54.470
But then, you know, in clinic or, you know, with

00:23:54.470 –> 00:23:56.710
educating moms to say, you know what, your skin

00:23:56.710 –> 00:23:59.230
doesn’t need this yet. Here’s what we can do.

00:23:59.289 –> 00:24:02.569
We can go together and you can actively participate.

00:24:02.569 –> 00:24:04.970
Participate with me and we will pick out a good,

00:24:05.069 –> 00:24:08.630
safe, and really appropriate, age-appropriate

00:24:08.630 –> 00:24:10.609
skincare regimen together. That’s kind of a nice

00:24:10.609 –> 00:24:14.269
bonding experience for them to do. And then for

00:24:14.269 –> 00:24:16.470
the dads, you’re right. Of course, they don’t

00:24:16.470 –> 00:24:18.609
want, you know, to be spending all this money

00:24:18.609 –> 00:24:20.730
having their kids use all these expensive products

00:24:20.730 –> 00:24:23.309
when they’re literally making problems for their

00:24:23.309 –> 00:24:26.769
skin and not helping at all. In fact, it is detrimental.

00:24:26.849 –> 00:24:29.630
And that’s what the big study in pediatrics showed

00:24:29.630 –> 00:24:32.269
us. But this is a nice time to say, hey, you

00:24:32.269 –> 00:24:35.470
know, get the dads involved and say, hey, you

00:24:35.470 –> 00:24:38.109
know, what do you think a healthy hygiene habit?

00:24:38.519 –> 00:24:42.960
starts with and getting those boys to start washing

00:24:42.960 –> 00:24:45.599
their face or taking more showers or just taking

00:24:45.599 –> 00:24:48.680
more of an interest because it is really important

00:24:48.680 –> 00:24:51.980
to start good hygiene practices early. And self

00:24:51.980 –> 00:24:55.119
-care is a really important thing for both young

00:24:55.119 –> 00:24:57.000
boys and girls. So we need to make sure that

00:24:57.000 –> 00:25:00.319
we’re getting it across in both avenues. How

00:25:00.319 –> 00:25:04.000
do you broach the topic to the patient, the tween,

00:25:04.000 –> 00:25:06.859
without pushing? too much so that you’re starting

00:25:06.859 –> 00:25:09.059
to get them to worry about their own self -esteem

00:25:09.059 –> 00:25:11.140
or, you know, there’s that balance, right? So

00:25:11.140 –> 00:25:13.940
how do you involve them more directly in the

00:25:13.940 –> 00:25:15.859
process of understanding what’s important and

00:25:15.859 –> 00:25:18.140
what’s not and kind of getting them to understand

00:25:18.140 –> 00:25:20.740
that there is a fine line maybe between going

00:25:20.740 –> 00:25:23.460
overboard and now you’ve kind of gotten yourself

00:25:23.460 –> 00:25:26.519
into some trouble psychologically. Yeah, I think

00:25:26.519 –> 00:25:29.640
when that population shows up with a big bag

00:25:29.640 –> 00:25:31.980
of products and you have that opportunity to

00:25:31.980 –> 00:25:35.160
pare down and to educate and to show them that

00:25:35.160 –> 00:25:38.779
and teach them that repeatedly exposing your

00:25:38.779 –> 00:25:41.160
skin to these potential irritants and allergens

00:25:41.160 –> 00:25:44.099
over and over again is going to make you potentially

00:25:44.099 –> 00:25:46.460
allergic to some of these ingredients for the

00:25:46.460 –> 00:25:48.200
rest of your life. That’s a really important

00:25:48.200 –> 00:25:51.339
thing to hone in on because a lot of the products

00:25:51.339 –> 00:25:55.009
have. fragrance, essential oils, harsh botanical

00:25:55.009 –> 00:25:58.390
ingredients. And so telling the kids and they

00:25:58.390 –> 00:26:00.710
will know, Andrew, they know the ingredients.

00:26:00.769 –> 00:26:03.589
So you can name it by name and it will give you

00:26:03.589 –> 00:26:06.150
amazing street cred with your tween and teen

00:26:06.150 –> 00:26:08.849
patients. If you can say, you know, here’s what

00:26:08.849 –> 00:26:11.130
you need and here’s what’s safe for you. You

00:26:11.130 –> 00:26:13.309
know, it’s okay to use a glycerin. It’s okay

00:26:13.309 –> 00:26:15.730
to use like a petrolatum for slugging. It’s okay

00:26:15.730 –> 00:26:19.309
to use, you know, certain ingredients, but it’s

00:26:19.309 –> 00:26:22.769
not okay to use harsh exfoliating acids or retinols

00:26:22.769 –> 00:26:26.200
right now. Maybe save if you want to splurge

00:26:26.200 –> 00:26:29.240
on something really fancy that you’ve seen. Maybe

00:26:29.240 –> 00:26:31.539
that’s the time to splurge on sunscreen. And

00:26:31.539 –> 00:26:34.759
that’s what parents can say yes to. Yeah, I totally

00:26:34.759 –> 00:26:36.619
agree. Since you brought it up, do you want to

00:26:36.619 –> 00:26:40.210
explain what “slugging” is? Of course. Actually,

00:26:40.250 –> 00:26:42.609
in dermatology, we’ve got to say that we are

00:26:42.609 –> 00:26:45.450
big fans of slugging. So slugging is the act

00:26:45.450 –> 00:26:47.609
of putting like a thick, thick occlusive moisturizer

00:26:47.609 –> 00:26:50.369
on your skin, most commonly a petrolatum -based,

00:26:50.430 –> 00:26:53.769
so plain Vaseline or Aquaphor, et cetera, to

00:26:53.769 –> 00:26:56.569
try to trap water in and, again, achieve what

00:26:56.569 –> 00:26:59.589
people would call that glass skin type of appearance.

00:26:59.829 –> 00:27:03.329
And it can be very, very nice to help restore

00:27:03.329 –> 00:27:05.430
the skin barrier. We use this technique actually

00:27:05.430 –> 00:27:07.990
a lot in our kids with eczema and dry skin. sensitive

00:27:07.990 –> 00:27:10.869
skin. We usually call it the “soak and smear” technique,

00:27:11.009 –> 00:27:13.569
but slugging is certainly what’s trending online.

00:27:14.650 –> 00:27:17.750
Yeah. Now, speaking of trending online, there’s

00:27:17.750 –> 00:27:20.170
a little bit of a darker side to this. And it

00:27:20.170 –> 00:27:22.750
wasn’t just a recent phenomenon. This is something

00:27:22.750 –> 00:27:25.269
that we’ve heard over the last 10, 15 years.

00:27:25.390 –> 00:27:28.430
Things have, quote unquote, gone viral. And there

00:27:28.430 –> 00:27:30.029
are these challenges that I’m talking about.

00:27:30.190 –> 00:27:32.690
Are you familiar with what I’m referring to?

00:27:33.699 –> 00:27:36.940
Yes, absolutely. Risk-taking behavior and challenges

00:27:36.940 –> 00:27:41.059
have definitely percolated and gained momentum

00:27:41.059 –> 00:27:44.420
on social media for sure. And always seems like

00:27:44.420 –> 00:27:46.519
there’s a new one. I mean, that’s the bummer.

00:27:46.539 –> 00:27:48.759
Someone can come up with something crazier or

00:27:48.759 –> 00:27:51.700
more dangerous to do. But the ones that I wanted

00:27:51.700 –> 00:27:53.500
to share with the audience and make sure that

00:27:53.500 –> 00:27:55.779
people are aware that they’re out there were

00:27:55.779 –> 00:27:58.740
ones that I’ve actually seen myself. So are you

00:27:58.740 –> 00:28:00.900
familiar with the “Salt Ice Challenge?” I sure

00:28:00.900 –> 00:28:03.599
am. Yep. Okay. Can you explain what that is?

00:28:03.700 –> 00:28:06.180
Oh, goodness. So this is where teens will…

00:28:06.180 –> 00:28:07.940
You might not be able to explain it because it

00:28:07.940 –> 00:28:12.339
makes zero sense to do it. I know. Well, I think

00:28:12.339 –> 00:28:15.240
that the challenge of pain and how long you can

00:28:15.240 –> 00:28:17.400
tolerate something is sort of a common theme

00:28:17.400 –> 00:28:19.700
to several of these. And there are some similarities.

00:28:19.880 –> 00:28:23.599
So the salt ice challenge is when the kids will

00:28:23.599 –> 00:28:26.460
put salt on the skin. And having salt on the

00:28:26.460 –> 00:28:29.599
skin lowers the freezing point of water. And

00:28:29.599 –> 00:28:32.200
if you put an ice cube on, you will rapidly

00:28:32.200 –> 00:28:34.900
achieve lower temperatures than you would with

00:28:34.900 –> 00:28:37.000
just a regular ice cube. And of course, that

00:28:37.000 –> 00:28:40.819
results in a frostbite kind of burn injury to

00:28:40.819 –> 00:28:44.480
the skin. We’ve all been in – many pediatric dermatologists

00:28:44.480 –> 00:28:46.359
have been in – the emergency room asked to look

00:28:46.359 –> 00:28:49.680
at these very geographic type burns with blistering.

00:28:49.700 –> 00:28:51.680
And then if you, you know, probe a little further,

00:28:51.819 –> 00:28:54.599
you might find that this is an “external job” from

00:28:54.599 –> 00:28:57.319
our salt ice challenge. And it’s similar to the

00:28:57.319 –> 00:28:59.299
“deodorant challenge,” if parents don’t know about

00:28:59.299 –> 00:29:02.000
that one. But that’s when you hold an aerosolized

00:29:02.000 –> 00:29:04.160
deodorant, which does have accelerators and different

00:29:04.160 –> 00:29:06.839
chemicals that are quite cold, very, very close

00:29:06.839 –> 00:29:09.319
to the skin. And again, you’re basically inducing

00:29:09.319 –> 00:29:12.119
a thermal injury that way. Those ones look circular

00:29:12.119 –> 00:29:14.799
because, of course, the diameter of the spray.

00:29:15.079 –> 00:29:17.000
But that’s another one that’s out there, too.

00:29:17.059 –> 00:29:20.380
And those two are quite similar. Another painful

00:29:20.380 –> 00:29:22.660
one that gives you a hint because it’s a geometric

00:29:22.660 –> 00:29:24.819
pattern you often are looking at sort of in a

00:29:24.819 –> 00:29:27.920
rectangle is the “eraser challenge” where, as

00:29:27.920 –> 00:29:31.220
I understand it – and we wrote this up a couple

00:29:31.220 –> 00:29:34.140
of years ago, it was back in San Diego. There

00:29:34.140 –> 00:29:37.099
were, pardon the pun, a rash of kids who were

00:29:37.099 –> 00:29:41.140
taking. school erasers and just grinding it into

00:29:41.140 –> 00:29:43.480
their skin until they basically peeled off the

00:29:43.480 –> 00:29:46.140
top layer of the epidermis, maybe even down into

00:29:46.140 –> 00:29:48.099
the dermis a little bit. They definitely could

00:29:48.099 –> 00:29:50.440
get scarring. That was one of the big risks.

00:29:50.559 –> 00:29:54.960
You won the challenge by going. longer and deeper

00:29:54.960 –> 00:29:58.019
and harder than the guy or gal you were competing

00:29:58.019 –> 00:30:00.619
against. So I remember we ended the article by

00:30:00.619 –> 00:30:03.359
saying there were no winners in the eraser challenge.

00:30:04.180 –> 00:30:07.180
There aren’t. And I think our tweens and teens

00:30:07.180 –> 00:30:09.519
don’t realize that what they’re doing can cause,

00:30:09.660 –> 00:30:13.059
you know, a really deep abrasion, erosion. Even

00:30:13.059 –> 00:30:14.720
if they get into the dermis, they can have a

00:30:14.720 –> 00:30:17.440
scar. And that, of course, the post-inflammatory

00:30:17.440 –> 00:30:20.480
changes to the skin, whether it’s hypo- or hyper-pigmentation,

00:30:20.680 –> 00:30:24.180
can last for years. they may carry around these

00:30:24.180 –> 00:30:26.200
wounds with them for a very, very long time.

00:30:26.420 –> 00:30:30.279
Yeah, this is a definite example of a couple

00:30:30.279 –> 00:30:33.200
of split seconds of bad decision you might be

00:30:33.200 –> 00:30:35.700
having to carry around for a lifetime. Have you

00:30:35.700 –> 00:30:37.859
heard of the “tooth filing” challenge? The tooth

00:30:37.859 –> 00:30:40.259
filing one is really upsetting because, of course,

00:30:40.299 –> 00:30:43.529
if you file down a permanent tooth, that… that’s

00:30:43.529 –> 00:30:45.990
for life that’s permanent unless you get a cap

00:30:45.990 –> 00:30:49.730
on and so yes some kind of like desire to make

00:30:49.730 –> 00:30:52.609
the teeth more pointy using a very coarse nail

00:30:52.609 –> 00:30:56.410
file and filing the teeth into a point is definitely

00:30:56.410 –> 00:30:59.490
something that has been on tiktok and going around

00:30:59.490 –> 00:31:03.730
and obviously This is one of the more detrimental

00:31:03.730 –> 00:31:06.390
challenges out there because it’s so long term.

00:31:06.650 –> 00:31:09.769
And also when you file the enamel off the teeth,

00:31:09.829 –> 00:31:11.690
you can have a whole host of dental problems

00:31:11.690 –> 00:31:13.809
down the road. So this is something that is really

00:31:13.809 –> 00:31:17.490
not a good thing to do. And we would hope that

00:31:17.490 –> 00:31:20.190
it doesn’t gain any more momentum than it already

00:31:20.190 –> 00:31:23.190
has. Yeah, that one’s crazy. I mean, you would

00:31:23.190 –> 00:31:25.650
think as a parent that you would be able to spot

00:31:25.650 –> 00:31:29.089
that. But the problem is by the time you see

00:31:29.089 –> 00:31:31.170
it, the damage has been done. You can’t reverse

00:31:31.170 –> 00:31:34.309
that. So…totally nuts! How about the “fire challenge?”

00:31:34.490 –> 00:31:37.069
Have you heard of that one? I haven’t seen it,

00:31:37.130 –> 00:31:39.890
but I guess setting fire to flammable liquids

00:31:39.890 –> 00:31:42.150
on the skin. I mean, that’s, again, like a recipe

00:31:42.150 –> 00:31:44.549
for a complete disaster. Yeah, I’ve seen videos

00:31:44.549 –> 00:31:47.430
of this on YouTube where kids do this. They’ll

00:31:47.430 –> 00:31:50.650
put something on. Actually, the one that I did,

00:31:50.940 –> 00:31:54.319
do remember seeing was DEET, the insect repellent

00:31:54.319 –> 00:31:57.099
that we do, or at least I do recommend. Was it

00:31:57.099 –> 00:31:59.440
an alcohol base maybe? Yeah, it’s, it is flammable.

00:31:59.480 –> 00:32:01.200
And there were, and there were a couple challenges

00:32:01.200 –> 00:32:03.799
around, you know, being near a campfire with

00:32:03.799 –> 00:32:05.799
your DEET on and what you could do with it. So

00:32:05.799 –> 00:32:11.490
that’s nuts. Oh my goodness. Right. The good

00:32:11.490 –> 00:32:14.490
news is conversations like this, not all social

00:32:14.490 –> 00:32:17.450
media is bad. I mean, we can actually use this

00:32:17.450 –> 00:32:20.490
as a as a foothold for educating our patients,

00:32:20.569 –> 00:32:23.089
educating our families. Right. You know, is there

00:32:23.089 –> 00:32:26.349
any sort of regulations that you would like to

00:32:26.349 –> 00:32:29.890
see put in place as an advocate? Or what can

00:32:29.890 –> 00:32:32.670
we do at a higher level to prevent kind of this

00:32:32.670 –> 00:32:36.109
some of these crazy things? Well, we did talk

00:32:36.109 –> 00:32:38.720
about. the general lack of regulation in health,

00:32:38.740 –> 00:32:41.839
wellness, and beauty. And luckily, people are

00:32:41.839 –> 00:32:44.259
starting to take notice and want to do better.

00:32:44.299 –> 00:32:47.400
For example, I think just a few months ago in

00:32:47.400 –> 00:32:50.220
California, there was a bill that was proposed

00:32:50.220 –> 00:32:53.299
that would actually ban the sales of these kind

00:32:53.299 –> 00:32:56.359
of anti-aging ingredients to teens and tweens

00:32:56.359 –> 00:32:58.799
or anyone under 18. Now, I’m not sure if that

00:32:58.799 –> 00:33:02.259
will pass or how practical it would be to obtain

00:33:02.259 –> 00:33:05.420
ID at any of these retailers, but at least we

00:33:05.420 –> 00:33:10.210
have… some health policymakers taking notice.

00:33:10.549 –> 00:33:14.190
And one of the biggest advancements we had, actually,

00:33:14.210 –> 00:33:16.789
Andrea, was the development of MOCRA. Are you

00:33:16.789 –> 00:33:18.849
familiar with that? It’s called the Modernization

00:33:18.849 –> 00:33:21.650
of Cosmetics Regulation Act, and it was signed

00:33:21.650 –> 00:33:23.950
into law by the Biden administration in 2023.

00:33:24.470 –> 00:33:28.109
And that was really a first step at getting more

00:33:28.109 –> 00:33:30.730
regulatory authority into the hands of the FDA.

00:33:30.930 –> 00:33:33.529
Because before that, before MOCRA was signed

00:33:33.529 –> 00:33:36.579
into law, you know, Companies were not mandated

00:33:36.579 –> 00:33:39.660
to remove products from the shelf, even if they

00:33:39.660 –> 00:33:43.160
were dangerous or had, you know, multiple adverse

00:33:43.160 –> 00:33:45.619
events, you know, with them. And the FDA did

00:33:45.619 –> 00:33:49.000
not have legal jurisdiction to make companies

00:33:49.000 –> 00:33:52.220
have recalls of products that were unsafe. Now

00:33:52.220 –> 00:33:55.759
that’s changed. They do. But there’s still so

00:33:55.759 –> 00:33:58.599
much of what I like to call the Wild West out

00:33:58.599 –> 00:34:01.960
there in the beauty industry where, you know,

00:34:01.980 –> 00:34:04.420
we have unregulated claim making, unethical.

00:34:04.430 –> 00:34:07.309
marketing practices. We have, you know, facilities

00:34:07.309 –> 00:34:09.829
and manufacturers who may not even be registered

00:34:09.829 –> 00:34:12.010
with the FDA. So there’s a lot of cleaning up

00:34:12.010 –> 00:34:14.550
that we need to do. And so drawing attention

00:34:14.550 –> 00:34:16.849
to it and raising awareness is really important

00:34:16.849 –> 00:34:20.010
so that if people feel so, you know, politically

00:34:20.010 –> 00:34:22.710
inclined, they might be, you know, able to bring

00:34:22.710 –> 00:34:26.909
this up with one of their representatives. So

00:34:26.909 –> 00:34:29.469
that’s definitely one way to approach, you know,

00:34:29.489 –> 00:34:32.090
the lack of regulation. Another is education.

00:34:32.449 –> 00:34:35.969
So you and I both know that pediatric dermatology

00:34:35.969 –> 00:34:39.010
is a very tiny subspecialty of medicine, right?

00:34:39.150 –> 00:34:42.429
So there’s only 400 of us board-certified pediatric

00:34:42.429 –> 00:34:45.389
dermatologists in the whole country practicing.

00:34:45.789 –> 00:34:49.889
And we can do a lot of good in clinic, but we

00:34:49.889 –> 00:34:53.369
also need to kind of battle misinformation and

00:34:53.369 –> 00:34:57.329
provide educational assets to patients and families

00:34:57.329 –> 00:34:59.880
in a variety of settings. And that’s one of the

00:34:59.880 –> 00:35:02.219
reasons why I myself actually started a social

00:35:02.219 –> 00:35:05.199
media presence. So I am on TikTok. I am on Instagram.

00:35:05.659 –> 00:35:08.780
But in my work with the Society for Pediatric

00:35:08.780 –> 00:35:12.219
Dermatology, we’ve created a wonderful page filled

00:35:12.219 –> 00:35:15.159
with helpful resources for patients, families,

00:35:15.300 –> 00:35:17.940
and even primary care providers who may not have

00:35:17.940 –> 00:35:20.480
as much experience. So giving that education,

00:35:20.820 –> 00:35:23.639
getting it out there, making it free and accessible

00:35:23.639 –> 00:35:26.400
and easy to digest, that’s a really important

00:35:26.400 –> 00:35:28.340
way that we can start. to make a difference.

00:35:28.639 –> 00:35:31.000
I totally agree. And it’s not just having the

00:35:31.000 –> 00:35:34.280
resources to educate, it’s having the time. And

00:35:34.280 –> 00:35:36.539
I mean, let’s be honest, you have to have the

00:35:36.539 –> 00:35:40.340
conversation 20, 30 times before you can get

00:35:40.340 –> 00:35:43.079
it into a… a package that’s just efficient

00:35:43.079 –> 00:35:45.800
enough to reach either the patient or the parent

00:35:45.800 –> 00:35:48.699
of that patient in the 10 or 15 minutes that

00:35:48.699 –> 00:35:51.800
we get for a skin visit, let alone the pediatrician

00:35:51.800 –> 00:35:53.980
who’s trying to do, you know, head to toe care

00:35:53.980 –> 00:35:58.659
on a kid – vaccines, development, etc.. They don’t have

00:35:58.659 –> 00:36:01.260
the time for that. So I love it that the patient

00:36:01.260 –> 00:36:04.119
handouts and all the resources that the Society

00:36:04.119 –> 00:36:07.639
for Pediatric Dermatology has out there are invaluable,

00:36:07.920 –> 00:36:12.510
I think, for. that mission um you’d like to think

00:36:12.510 –> 00:36:15.389
or at least i would like to think that geez the

00:36:15.389 –> 00:36:18.789
answer here is just educating the kids but i

00:36:18.789 –> 00:36:21.920
i mean just thinking of my own boys right I get

00:36:21.920 –> 00:36:24.340
them alone and I can see that there’s a message

00:36:24.340 –> 00:36:26.500
that’s received, right? But then they get in

00:36:26.500 –> 00:36:28.300
with their three or four other friends and it’s

00:36:28.300 –> 00:36:31.059
like all of the social mores and norms that we’ve

00:36:31.059 –> 00:36:33.940
tried to impress on them can go right out the

00:36:33.940 –> 00:36:37.119
window pretty quickly in the group. So I don’t

00:36:37.119 –> 00:36:39.440
– I hear that. You get what I’m saying? So I’m

00:36:39.440 –> 00:36:42.739
not sure if it’s gonna come down to just, is

00:36:42.739 –> 00:36:48.179
it simple as teaching confidence and self -perception?

00:36:48.760 –> 00:36:50.760
Yes, I’m sure that’s part of it. But for me,

00:36:50.920 –> 00:36:54.179
the real answer is, and you’ve sort of alluded

00:36:54.179 –> 00:36:58.530
to it, is trying to become. partners with maybe

00:36:58.530 –> 00:37:01.809
the platforms that are kind of the most guilty,

00:37:01.949 –> 00:37:05.849
Facebook, Instagram, TikTok. To me, that’s where

00:37:05.849 –> 00:37:08.769
we’re going to have to have some discussion,

00:37:09.090 –> 00:37:11.489
some partnership. And I’m using that word very

00:37:11.489 –> 00:37:13.769
specifically because there’ll be a quid pro quo

00:37:13.769 –> 00:37:17.050
there. But there has to be some level of trying

00:37:17.050 –> 00:37:19.590
to do better for these kids in terms of what

00:37:19.590 –> 00:37:22.530
messages they get. I’m involved in a project

00:37:22.530 –> 00:37:27.219
slightly related to this. It’s regarding… Minors,

00:37:27.219 –> 00:37:30.840
so under the age of 18 years of age for the most

00:37:30.840 –> 00:37:34.639
part, who are seeking elective cosmetic procedures.

00:37:34.880 –> 00:37:37.000
And there’s some guidelines that we’re putting

00:37:37.000 –> 00:37:41.239
together. Murad Alam and Kristen Kelly were working

00:37:41.239 –> 00:37:43.199
on this. Yeah, it’s an important project. I’m

00:37:43.199 –> 00:37:44.940
aware of it. Thank you for the work you’re doing.

00:37:45.079 –> 00:37:48.300
Society for Peds Derm has supported it. And I

00:37:48.300 –> 00:37:51.519
was surprised. This was not something I knew

00:37:51.519 –> 00:37:54.940
going into the project, but someone did a…

00:37:56.240 –> 00:37:58.320
research literally like i guess a little secret

00:37:58.320 –> 00:38:01.159
investigative they went undercover as an underage

00:38:01.159 –> 00:38:04.420
under 18 years of age woman on Facebook open

00:38:04.420 –> 00:38:08.460
an account put a few blogs in about how she, as

00:38:08.460 –> 00:38:11.039
the undercover agent, was concerned about how

00:38:11.039 –> 00:38:13.539
her nose looked and i think – i want to quote this –

00:38:13.539 –> 00:38:17.619
in, in less than four hours she had an ad come

00:38:17.619 –> 00:38:20.800
to her from a plastic surgeon willing to do the

00:38:20.800 –> 00:38:23.699
nose surgery…the nose job… the rhinoplasty

00:38:24.590 –> 00:38:27.110
Wow. You know, that’s scary. That’s pretty scary.

00:38:27.369 –> 00:38:29.809
And geez, could we do better than that? Right.

00:38:29.849 –> 00:38:32.170
I mean, that seems to me such an easy technological

00:38:32.170 –> 00:38:35.309
fix. You can’t get these ads if you’re under

00:38:35.309 –> 00:38:38.309
this age. And it’s just not happening because

00:38:38.309 –> 00:38:40.010
I think you hit the nail on the head. There’s

00:38:40.010 –> 00:38:43.199
too much money involved in it. There’s huge money

00:38:43.199 –> 00:38:46.800
involved. Yeah. And the techniques are very,

00:38:46.880 –> 00:38:50.280
very sophisticated for how they know who the

00:38:50.280 –> 00:38:53.139
person is, the content that that user is creating,

00:38:53.219 –> 00:38:57.500
and then have the exact ads targeted to that

00:38:57.500 –> 00:39:00.300
exact population. So they know that the yield

00:39:00.300 –> 00:39:02.579
is going to be really high for the next click

00:39:02.579 –> 00:39:06.530
or the next purchase. Yeah, and it’s a constantly

00:39:06.530 –> 00:39:09.829
moving target. I mean, as these platforms change,

00:39:10.130 –> 00:39:12.630
we went from Facebook to Instagram to TikTok

00:39:12.630 –> 00:39:15.710
as sort of being the source of information that

00:39:15.710 –> 00:39:17.449
the population we’re talking about, at least,

00:39:17.449 –> 00:39:19.969
is getting their messaging from. That’s going

00:39:19.969 –> 00:39:21.349
to change, right? Who knows what it’s going to

00:39:21.349 –> 00:39:23.630
be next? What role does artificial intelligence

00:39:23.630 –> 00:39:27.489
play? I mean, right now, I don’t know if you

00:39:27.489 –> 00:39:30.809
use AI at all in your life, but I still am kind

00:39:30.809 –> 00:39:33.670
of in the realm of where I’ll use it more as

00:39:33.670 –> 00:39:38.300
a more evolved Google search, right? If I want

00:39:38.300 –> 00:39:41.239
to dive deep into a topic I’ll use, I could see

00:39:41.239 –> 00:39:43.500
that being very helpful in certain ways, right?

00:39:43.599 –> 00:39:47.519
Where you could maybe load your proposed regimen

00:39:47.519 –> 00:39:51.039
into an artificial intelligence platform and

00:39:51.039 –> 00:39:53.099
have it spit back out, hey, you shouldn’t use

00:39:53.099 –> 00:39:56.079
product C and D together because it could cause

00:39:56.079 –> 00:39:58.920
a very well-known problem. Or what you’re missing

00:39:58.920 –> 00:40:01.960
from your regimen is, in fact, a sunscreen. Wouldn’t

00:40:01.960 –> 00:40:04.300
that be kind of cool, right? That’d be great,

00:40:04.360 –> 00:40:07.079
right? But I don’t know. Have you seen anything

00:40:07.079 –> 00:40:10.579
like that? Or do you have any hope? Not yet,

00:40:10.599 –> 00:40:12.960
because I think consensus is really hard to get

00:40:12.960 –> 00:40:15.679
online. I mean, there’s just a lot of different…

00:40:16.699 –> 00:40:19.480
I would say stakeholders, right? Because we have

00:40:19.480 –> 00:40:22.699
the doctors and the dermatologists, the pediatricians

00:40:22.699 –> 00:40:25.260
who would give a certain set of recommendations.

00:40:25.300 –> 00:40:27.260
And then we have a whole host of other people

00:40:27.260 –> 00:40:29.780
who are recommending something completely different.

00:40:30.079 –> 00:40:32.260
So because there are so many different stakeholders,

00:40:32.559 –> 00:40:35.940
what AI might generate may or may not be science

00:40:35.940 –> 00:40:38.340
or evidence -based. So it’s really, I think we’re

00:40:38.340 –> 00:40:41.579
still in the infancy of all of this and it is

00:40:41.579 –> 00:40:44.360
really tricky. And unfortunately, I do think

00:40:44.360 –> 00:40:48.710
that more regulation is going to be at least

00:40:48.710 –> 00:40:52.050
part of the answer. How can we limit targeted

00:40:52.050 –> 00:40:55.750
ads to kids under 18 or at least under 12? You

00:40:55.750 –> 00:40:57.510
know, I mean, we have to draw the line somewhere.

00:40:58.289 –> 00:41:00.570
12 years of age is kind of also on the parents,

00:41:00.670 –> 00:41:03.369
I feel, right? So where’s the money coming from?

00:41:03.530 –> 00:41:05.949
You gotta have a discussion with your kids. Like,

00:41:05.949 –> 00:41:09.250
I’m giving you $50 a month, where’s it going?

00:41:09.489 –> 00:41:11.429
Well, if you’re purchasing online, it shouldn’t

00:41:11.429 –> 00:41:13.550
be that hard to find that, right? And then it’s,

00:41:13.550 –> 00:41:15.250
well, what’s in this bundle that you brought

00:41:15.250 –> 00:41:17.909
home? Oh my goodness, I don’t even understand

00:41:17.909 –> 00:41:20.130
what half of these things are. Great, bring them

00:41:20.130 –> 00:41:22.550
into the dermatologist or your pediatric dermatologist

00:41:22.550 –> 00:41:24.630
if you’re lucky enough to have one. And then,

00:41:24.650 –> 00:41:27.519
but maybe you as a parent could. Put some of

00:41:27.519 –> 00:41:30.000
these things into a search engine and find out

00:41:30.000 –> 00:41:32.300
what they’re being used for and what the dangers

00:41:32.300 –> 00:41:34.360
around them are. Right. I mean, that to me seems.

00:41:34.480 –> 00:41:37.760
Yeah, I love that. I mean, using this as an opportunity

00:41:37.760 –> 00:41:41.460
to connect with, educate and, you know, grow

00:41:41.460 –> 00:41:44.000
with with your child, because I think it’s really

00:41:44.000 –> 00:41:45.860
important. You want to know what they’re doing,

00:41:46.019 –> 00:41:47.360
what they’re applying, what they’re spending

00:41:47.360 –> 00:41:51.550
their money on and use it as a chance to. I don’t

00:41:51.550 –> 00:41:53.889
know, advocate, but also have fun with it, right?

00:41:53.989 –> 00:41:56.409
Because at the end of the day, that’s what skincare

00:41:56.409 –> 00:41:59.730
should be. It should be easy, accessible, age

00:41:59.730 –> 00:42:02.349
-appropriate, safe, and fun. I love it. Yeah,

00:42:02.409 –> 00:42:06.710
that really is the trick. And I think we’re going

00:42:06.710 –> 00:42:08.590
in the right direction here. I mean, the fact

00:42:08.590 –> 00:42:11.969
that you’re an expert in this topic and are drawing

00:42:11.969 –> 00:42:14.610
so much attention around it, the idea that there

00:42:14.610 –> 00:42:18.300
was this wonderful… an important article to

00:42:18.300 –> 00:42:20.960
come out in what I think many people would consider

00:42:20.960 –> 00:42:24.639
at least one of the top two pediatrics journals,

00:42:24.699 –> 00:42:27.590
if not the top one in the country. Great. the

00:42:27.590 –> 00:42:29.989
American Academy of Pediatrics hopefully will

00:42:29.989 –> 00:42:33.030
be spotlighting this issue more and more as we

00:42:33.030 –> 00:42:35.469
go along. So I think this is just the start of

00:42:35.469 –> 00:42:38.489
it. I think we’re right at the point where we

00:42:38.489 –> 00:42:40.929
can get involved as much or as little as we want

00:42:40.929 –> 00:42:44.150
around this topic and make some big strides in

00:42:44.150 –> 00:42:46.449
the right direction. Me too. So thank you so

00:42:46.449 –> 00:42:49.190
much for highlighting this topic. It’s one that

00:42:49.190 –> 00:42:51.429
is both, you know, a little bit fun and a little

00:42:51.429 –> 00:42:53.989
bit scary to talk about with families. Well,

00:42:54.030 –> 00:42:56.070
with that, I’d like to thank Dr. Sheilagh Maguiness

00:42:56.070 –> 00:42:59.250
for joining me today. She’s coming from Minneapolis,

00:42:59.570 –> 00:43:01.650
Minnesota, where she is a practicing pediatric

00:43:01.650 –> 00:43:03.929
dermatologist. So you can try to book an appointment

00:43:03.929 –> 00:43:06.610
with her to discuss your very complex skin regimen

00:43:06.610 –> 00:43:09.070
for you or your tween. And I also want to thank

00:43:09.070 –> 00:43:12.170
her both in her role as a colleague of mine,

00:43:12.230 –> 00:43:14.110
but also as the Immediate Past President of the

00:43:14.110 –> 00:43:16.889
Society for Pediatric Dermatology for bringing

00:43:16.889 –> 00:43:19.030
this issue to light. Have a wonderful day. Thanks

00:43:19.030 –> 00:43:23.539
for joining us. Thanks for tuning in to this

00:43:23.539 –> 00:43:26.039
episode of the Don’t Be Rash Pediatric Dermatology

00:43:26.039 –> 00:43:28.619
Podcast. I’m your host, Dr. Andrew Krakowski.

00:43:28.760 –> 00:43:30.900
Don’t forget to subscribe to our show on your

00:43:30.900 –> 00:43:34.000
favorite podcast platform and check out dontberash

00:43:34.000 –> 00:43:37.119
.org for more information. A special thank you

00:43:37.119 –> 00:43:39.719
to our nonprofit sponsor, the St. Luke’s University

00:43:39.719 –> 00:43:42.280
Health Network, for making this episode possible.

00:43:42.460 –> 00:43:45.619
Until next time, remember, keep calm and don’t

00:43:45.619 –> 00:43:46.099
be rash.