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Last week’s issue on botulinum toxin sparked an incredible response. Many of you shared how refreshing it felt to see Botox discussed not as a trend or moral debate, but as what it truly is: a medical tool, grounded in evidence, nuanced in its application, and deeply shaped by patient perception. Thank you for the thoughtful messages, reflections, and appreciation, it reminded us why these conversations matter.

That discussion opened a broader question worth exploring further: if even one of the most studied treatments in dermatology can be culturally misunderstood, what happens when skincare itself becomes a cultural identity?

Over the past decade, skincare has evolved from a routine into a form of self-expression…

What once lived quietly on the bathroom shelf is now a language that reveals how people think about health, beauty, control, and belonging.

Skincare trends rarely emerge from science alone. They are shaped by culture, emotion, aesthetics, and the human desire for certainty. While movements like K-beauty and Tretinoin-core appear radically different, both blend valid dermatologic principles with exaggerated narratives.

For clinicians, the challenge is not rejecting trends outright but understanding where evidence ends and aesthetics begin.

K-Beauty: Ritual Meets Barrier Science

K-beauty marked a turning point. It introduced the Western world to the idea that skincare could be gentle, preventive, and ritualistic. At its best, it aligned closely with sound dermatologic principles.

What was evidence-based

These practices helped patients understand the skin barrier long before it became a clinical buzzword.

Where aesthetics took over

Common clinical consequences

K-beauty offered comfort and control, but often at the cost of restraint.

Tretinoin-Core: Science with a Social Media Filter

Then came the counterculture: dermatologist-led minimalism.

“Tretinoin-core,” as it is now called online, celebrates prescription actives, clinical authority, and simplicity. A single tube replaced the shelf of serums. The tone shifted from pampering to purpose.

What is strongly evidence-based

Where the narrative breaks down

Common clinical consequences

Here, control comes from logic and proof, but sometimes loses empathy.

What Evidence-Based Skincare Actually Means

Evidence-based skincare does not mean fewer products at all costs, discomfort as a rite of passage, or one routine for every patient.

It does mean matching actives to diagnosis, adjusting treatment to individual skin biology, respecting tolerance and lifestyle, and using the least aggressive effective approach.

Actives with the Strongest Long-Term Evidence

The Clinical Takeaway

Trends change the language patients use, but not the biology of skin.

K-beauty and Tretinoin-core are not opposing forces. They reflect how different generations seek control in an overwhelming world, one through ritual and softness, the other through science and certainty.

For dermatologists, understanding these cultural shifts is essential. Patients do not arrive with just a skin type. They arrive with a skincare identity shaped by online narratives.

Meeting them where they are requires both rigor and empathy.

Science earns trust.
Empathy sustains it.

This guide is designed to help clinicians quickly identify how a patient relates to skincare, spot trend-driven red flags, and reframe evidence-based care in a way that patients can accept and follow. The goal is not trend compliance or trend rejection but alignment between skin biology, patient values, and realistic outcomes.

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Here is our featured course for today!

The Courage to Be Disliked unfolds as a dialogue between a philosopher and a young man, who, over the course of five enriching conversations, realizes that each of us is in control of our life’s direction, independent of past burdens and expectations of others.

In the end, skin biology remains constant, even as trends evolve.
Culture shapes how patients interpret care, but science must guide how we deliver it.

Our role is not to dismantle skincare identities, but to translate them into treatments that are effective, humane, and sustainable.

Science earns trust.
Empathy keeps patients with us long enough for it to work.

See you next Thursday, DERM Community!

— The Derm for Primary Care Team