Dr Andrew Markey

Dr Andrew Markey Consultant Dermatologist, Skin Scientist
MB ChB, MD, FRCP
Healthy skin is fabulous skin.

31/03/2026

Unpopular Opinion: Exosome treatments are a 3/10. 🩺🚩️

Exosomes are the "it-girl" of the aesthetic world right now, but as a dermatologist, I’m here to lower the temperature on the hype. 🧊🧼

The Science: 🔬 Exosomes are tiny "messenger bubbles" derived from stem cells. They carry proteins and growth factors to tell your cells to repair themselves. It sounds like sci-fi magic, but here is why they only get a 3 from me:

1️⃣ The "Add-On" Problem: Exosomes are almost always used as an add-on to Microneedling or Lasers. Most of the "glow" you see is actually from the primary treatment, not the expensive serum on top. 🧪🩹

2️⃣ Regulation & Consistency: Because this is such a new field, the quality and concentration of exosomes vary wildly between brands.

3️⃣ Better Alternatives: If you want regenerative results, Polynucleotides or Platelet-Rich Plasma (PRP) have much more robust clinical data behind them for a similar (or lower) price point. 💉🩸

The Verdict: They offer some anti-inflammatory benefits and can speed up healing by a day or two, but for the price? There are far more effective ways to spend your skincare budget. 💸🛡️

29/03/2026

Microneedling or CO2 Laser? 🥊

Both are 10/10 for their jobs! The only real difference is DEPTH. 🩺🔬

✨ Microneedling = The Superficial Glow-Up. ☁️
Best for: Surface imperfections, fine lines, and maintaining your glow. It’s a gentle polish.

✨ CO2 Laser = The Deep Resurfacing. 🔥
Best for: Major wrinkles, acne scars, and structural changes. It’s a total renovation.

The Final Word: For minimal fuss and gradual change, Microneedling. For maximum impact and real downtime, CO2 Laser. 🧬✨

27/03/2026

Do Collagen supplements actually reach your skin? 🧐 Let’s look at the science.
The marketing makes it look like you swallow a pill and it travels straight to your face to fill in wrinkles. The reality is a bit more complicated. 🧬

The Biological Fact: Your body treats collagen like any other protein (like chicken or lentils). Once you ingest it, your stomach acid breaks it down into amino acids. Your body then sends those building blocks wherever it needs them most—which might be your muscles, your organs, or your joints before it ever hits your skin.

The Verdict: There is no specific biological pathway that guarantees ingested collagen will turn into skin collagen.

Are they useless? Not necessarily. If your general diet is low in protein, these supplements provide the "raw materials" your body needs to eventually make collagen. Think of them as a "protein boost" for your general health rather than a "miracle wrinkle cure." 🛡️🧴

19/03/2026

Rating AHAs & BHAs: 7/10. ⭐️

Why not a 10? Because while they are powerhouses for texture and pores, they can be a cause of "accidental" barrier damage.

The Breakdown:
✨ AHAs (Glycolic, Lactic): The surface polishers. They dissolve the "glue" holding dead skin cells together to reveal a fresh glow. Best for: Pigment & fine lines.

✨ BHAs (Salicylic Acid): The pore-deep cleaners. They are oil-soluble, meaning they get inside the pore to clear out gunk. Best for: Blackheads & acne. 🧼

The Secret: It’s all about frequency.
❌ Daily use: A recipe for redness and sensitivity.
✅ 2–3x a week: The "sweet spot" for glass skin without the burn.

17/03/2026

As a dermatologist, I see a lot of "diet-cleansing" trends, but Keto has some interesting science behind it when it comes to your skin.

The Potential Wins:
✅ Reduced Inflammation: By cutting out high-glycemic sugars and refined carbs, you’re lowering your insulin levels. High insulin is a major trigger for acne and systemic inflammation. 📉
✅ The "Keto Glow": Many people report a brighter complexion. This is likely due to the increase in healthy fats (Omega-3s) which help fortify your skin barrier. 🧱✨

The Potential Fails:
❌ The "Keto Flu" Breakout: Radical dietary shifts can stress the body initially, leading to temporary flares.
❌ Hidden Triggers: If your version of Keto is heavy on dairy (specifically skimmed milk or whey), you might actually see more acne. 🥛🚫

The Verdict: Reducing refined sugar is always a win for your skin. But "Dirty Keto" (processed meats and excessive dairy) can do more harm than good. Balance is key! ⚖️🛡️

15/03/2026

I’m rating 6 of the most talked-about skin "secrets" on your feed.

The Scores:

1️⃣ Sculptra: 7/10 💉 The long-game treatment. It doesn’t just "fill"; it stimulates your own natural collagen. It’s the "Gold Standard" for restoring volume and skin quality over time however it's not easily reversible. 🏗️✨

2️⃣ Microneedling: 6.5/10 🔬 A powerhouse for texture, scarring, and pores. By creating controlled micro-injuries, we trigger a massive healing response. Professional grade is a must—don't try this at home with a roller and it doesn't suit all skin types so consult your derm 🛑

3️⃣ Slugging with Vaseline: 4/10 🐌 The cheapest way to fix a damaged skin barrier. It’s an "occlusive" powerhouse that locks in moisture overnight. Just skip it if you’re prone to milia or active acne! 🧴🛡️ Low score for the messiness!

4️⃣ Face Taping & Frownies: 7/10 🩹 It’s "mechanical Botox." It works by physically immobilizing the muscle while you sleep. Useful for training your facial expressions, but it’s a daily commitment and won’t replace the "Tox." 💉

5️⃣ Gua Sha: 6/10 💎 I love it for the cooling effect and lymphatic drainage (bye-bye morning puffiness!), and my patients love the ritual. But it won't permanently "sculpt" your face or remove wrinkles. It's self-care, not surgery. 🧘‍♂️❄️

6️⃣ Silk Pillowcases: 5/10 🛏️ 10/10 for your hair, but only a 5 for your skin. It prevents "sleep creases" and doesn't steal your moisturizer like cotton does, but it won't fix acne or stop aging. A nice-to-have, not a need-to-have. ☁️✨

Which of these are you currently obsessed with? Let’s debate in the comments! 👇

12/03/2026

Tanning to clear your acne? Please stop. ✋☀️

It feels like it’s working, but it’s actually a Rebound Breakout waiting to happen. 💣

The Cycle:

Sun dries out the oil. 🌵

Skin looks "clearer" for 3 days. ✨

Skin panics and produces 2x the oil. 🌊

Pores get clogged by sun-damaged dead skin. 🧱

MASSIVE BREAKOUT. 💥

Plus, tanning makes those acne scars stay darker for way longer.

The Fix: Use a non-comedogenic SPF 50 and treat the acne with actual science, not a sunburn. 🛡️

10/03/2026

Is "Hypoallergenic" helping your sensitive skin? 🧐 Probably not.

Most of you don’t have sensitive skin; you have sensitised skin. 📉🩹

The Truth About Your Sensitive Skin:

1️⃣ It’s probably Sensitised: Over-exfoliating and too many actives have left your barrier raw. 🩹
2️⃣ Can You Trust The Marketing?: "Hypoallergenic" isn't a regulated medical term, it is often just buying a product with fewer known irritants, but it's not an "allergy-proof" shield.
3️⃣ Allergies Don't Care: If you’re allergic to a chemical, you’re allergic to it—no matter how "gentle" the bottle says it is. 🧬

The Fix: Stop the 10-step routine. Focus on ceramides and bland moisturisers to heal your sensitised barrier first. 🛡️🧴

08/03/2026

I’m rating 6 of the most common treatments and "hacks" I see in the clinic. Some are gold standard... others are a big NO!

The Scores:

1️⃣ Botox: 9.5/10 💉 The undisputed heavyweight champion for prevention and smoothing. It works at the source. The only reason it’s not a 10? You still need your SPF!

2️⃣ Tranexamic Acid: 5/10 💡A secret weapon for melasma and stubborn post-acne marks. It’s gentle but incredibly effective at blocking pigment production.

3️⃣ AHAs & BHAs: 7/10 🧪 Essential for texture and pores. Just don’t overdo it—twice a week is usually the "Goldilocks" zone for that healthy glow.

4️⃣ Hyaluronic Acid Injections: 8/10 💦

5️⃣ Dermaplaning at Home: 6/10 🪒 High risk, medium reward. Unless you have an incredibly steady hand and a sterile blade, you're risking nicks and barrier damage. Leave it to the pros!

6️⃣ Toothpaste on Pimples: 1/10 🚫🪥 Please. Just. No. It’s 2026—we have Pimple Patches and Benzoyl Peroxide. Toothpaste will only give you a chemical burn and a darker scar.

06/03/2026

Niacinamide - Is it drying your skin?
The Myth: "Niacinamide dried my skin out!"
The Fact: Niacinamide is actually a humectant (it loves water!). 💧

So why the dryness? 🧐
❌ You’re using a 10% or 20% serum (too much!).
❌ You’re layering it with too many other actives. 🧪
❌ You have dry skin and your serum is designed for oily skin (Zinc overload!). 🌵

The Fix: Stick to 5% or less. It’s the "Goldilocks" zone for a perfect, hydrated glow without the irritation. 🛡️✨

Derm Tip: Look for Niacinamide inside your moisturizer rather than as a standalone high-strength serum. Your barrier will thank you!

04/03/2026

Is dairy-free the secret to clear skin? Maybe... but here's the catch, skimmed milk is the real culprit!

The Science: 🧪 While the link between full-fat dairy and acne is actually quite weak, multiple studies have shown a strong correlation between skimmed (0% fat) milk and breakouts.

Why Skimmed?
1️⃣ Processing: When fat is removed, the molecular structure of the milk changes.
2️⃣ Hormonal Response: Skimmed milk contains higher levels of IGF-1 (Insulin-like Growth Factor), which sends your oil glands into overdrive. 🌊
3️⃣ Bioavailability: Removing the fat makes the hormones in milk more readily absorbed by your system. 🧬

The Verdict: If you’re prone to breakouts, you don’t necessarily need to go "Dairy Free." Try switching to a milk alternative (like Almond or Oat) or even going back to whole milk first. 🥑🥛

02/03/2026

Why Botox gets a 9.5/10 from a Dermatologist. 🩺👇
Why not a perfect 10? Because nothing in medicine is 100%, and you still need your ABCs (Vitamin A, B, and C) and SPF for skin quality. But for everything else? It’s the undisputed king. 👑

Why it’s so effective:

The Root Cause: Unlike creams that sit on the surface, Botox goes to the source. It temporarily relaxes the muscles that cause "dynamic wrinkles," giving your skin a chance to smooth out and recover. 🧬

Is it safe? 🩺 Botox is one of the most studied medical treatments in the world. It’s been used for decades—not just in aesthetics, but for migraines, muscle spasms, and more. When performed by a qualified medical professional, the safety profile is incredibly high.

The Verdict: It’s the most effective "tweakment" we have. The results are predictable, the downtime is zero, and the satisfaction rate is through the roof. 📈✨

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