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Expert Shopper Beauty & Personal Care

Get to know our skin care expert, Alina Zufall 

Having healthy, attractive skin from head to toe requires precise care. From treating skin ailments and issues to using quality skin care products, expert guidance will help you make informed decisions that will result in glowing skin. That’s where our skin care expert comes in. 

Alina Zufall, M.D., obtained both her bachelors and medical degree at the University of Virginia. She then completed her medical internship at VCU Medical Center in Richmond, VA, and is now completing her Dermatology residency at Metropolitan Hospital in New York, NY. Dr. Zufall gained early experience in the field of dermatology prior to entering medical school through her time spent as medical assistant at Family Dermatology of Albemarle in Charlottesville, Virginia. During medical school, she performed research and authored many publications within the field of dermatology. All these experiences have led to her expertise in skin care and conditions.

Q. You're BestReviews' skin care expert. How did you get into dermatology?

AZ: I first got interested in dermatology when I struggled with acne as a teenager. I went to see a dermatologist many times — and tried several medications — before I finally went on Accutane (isotretinoin), which is the strongest medicine we have available to us for the treatment of acne.

It cleared my skin within a few months and changed my whole outlook on life. I was more confident in both myself and my ability to interact with people and the world around me. I knew I wanted to do that for other people.

Skin conditions can impact people not only physically but also emotionally, like it did for me. I love that as a dermatologist, I not only treat my patients’ medical conditions but also improve their confidence in themselves.  

Q. With so many options on the market, what's your advice for people shopping for skin care products?

AZ: Find brands that you trust and that are trusted by dermatologists. This will significantly narrow the number of products to choose from and make your life much easier.

Generally, less is more. Take a look at the ingredient list of potential cosmetic products. Is it a long list of ingredients, made up mostly of words you can’t pronounce? If yes, then maybe think twice before buying that product.

Or, more importantly, use resources like BestReviews to help guide you in this market saturated with endless options. As the skin care expert, I will teach you which ingredients are clinically effective and can make a difference in your skin health and/or specific skin condition.

Q. How has your experience shaped your expertise and approach to making purchasing decisions?

AZ: I research every ingredient in these products that companies claim to benefit the skin. If the “active” ingredient does not have any studies showing efficacy, then I usually do not buy it.

I also look at the percentage of the active ingredient, if it is even listed. I then go to the literature to see what percentage the ingredient needs to be at for it to be clinically effective. Personally, I do not trust an over-the-counter product if it does not list the percentages of its active ingredients. What that tells me is that the ingredient may be in there but not anywhere near the level to produce any measurable changes to the skin. 

Next, I review the rest of the ingredient list. Sometimes the ingredients include botanicals and other “inactive ingredients,” which companies claim add to the efficacy of the product. There is sometimes data to support these claims, though this data usually comes from small studies that are not rigorously designed. However, if the added ingredients seem nonirritating and the product is not overpriced because of these added ingredients, then I will usually give it a try.  

Again, however, the fewer the ingredients the better. Then there is less of a chance of something being irritating to your skin and causing more harm than good. Keep it simple. 

Q. How does your philosophy as an expert align with BestReviews’ mission to simplify purchasing decisions?

AZ: There is a plethora of products out there, some making claims that are misleading. It is helpful to have a place that people can go where they trust that products are being recommended to them that are actually worth the money to buy.

I like that BestReviews brings in experts to comb through the literature and come up with product recommendations that are based on scientific data so that the consumer does not have to. 

Q. What are some skin care tips that are applicable to most people, regardless of their age, skin type or skin tone?

AZ: Cleanse the skin, moisturize the skin and sunscreen, sunscreen, sunscreen.  Everyone can benefit from these tips.

Cleansing keeps the skin free of toxins and junk that builds up on the skin throughout the day, and moisturizing helps add back that essential moisture that your cleansers can strip away. Moisturizing is especially important for people prone to dry skin  or with chronic skin conditions where the skin barrier is dysfunctional, such as eczema.

Adequate hydration of the outer layer of skin (called the stratum corneum) prevents dry skin, itchy skin, rashes and infections.  

Q. Despite information about the sun's damaging effects, some people still like to tan. Please explain why this is a bad idea, and why sunscreen is so important. 

AZ: Sunscreen is important for all skin types. Not just to prevent skin cancer, but also to treat many other skin conditions.

Skin cancer is, of course, the scariest result of too much time in the sun. Melanoma is the most dangerous form of skin cancer, as it can spread throughout the body quickly and cause death. While lighter skin types and those with family history of melanoma are at much higher risk of developing this form of skin cancer, people with darker skin are not at zero risk.

There are other forms of skin cancer that are considered less dangerous but still must be surgically removed, which can result in significant scarring if you develop multiple skin cancers over the years. 

Sunscreen can also help prevent dark spots and melasma, which is more commonly seen in people with darker skin types and a significant cosmetic concern for people. Sunscreen can help prevent new dark spots from forming and protects against further pigmentation of the already dark spots. 

And if those two aren’t good enough reasons to convince you to wear sunscreen, then use the fact that sunscreen is arguably the best anti-aging product we have. Sun induces damage to the skin that accelerates skin aging, leading to wrinkles and sagging skin, and no one wants that. 

Q. Please explain how diet, stress and environmental factors can affect skin health and appearance. 

AZ: In terms of diet, I think that this definitely plays a role in many skin conditions due to the gut-skin axis and role of the microbiome of the gut influencing that of the skin. Studies have shown that acne is worsened by eating high glycemic foods. I think in general, eating a well-balanced diet not high in processed foods would help in many skin conditions by reducing inflammation throughout the body. 

Stress has been seen to flare many skin conditions, such as acne, rosacea, psoriasis, eczema and many more. Stress increases cortisol in the body, which can increase inflammation and exacerbate disease. 

Environmental factors, such as smoking, pollution and, of course, UV radiation, also play a role in many skin diseases and aging especially. This happens through increasing the inflammatory response and producing reactive oxygen species, causing direct and indirect damage to the skin. 

Q. Skin types are classified as oily, dry, sensitive or combination. Do you have a few skin care tips for each type?

AZ: For dry skin, I recommend using creams rather than lotions, as lotions do not provide as much hydration power as creams. Dry skin also tends to be sensitive skin. Try to use products without harsh added chemicals as well as “fragrance-free” products. Even if a product says it is free of synthetic fragrance, I would generally avoid products if they have a lot of essential oils for “natural fragrance,” as this can still be irritating for sensitive, dry skin.  

For oily skin, you can be more aggressive with the use of topicals that can be more drying, like salicylic acid, glycolic acid, retinoids, etc., whereas someone with dry skin might have to start more slowly using these products. This is not to say that if you have dry skin, you cannot benefit from some of these products, but you might have to use more gentle versions or use them less frequently than someone with oily skin.  

For combination skin, I’d say you should be careful about overly drying ingredients, but you can likely tolerate them better than someone with dry skin. I’d also recommend creams rather than lotions for these people. 

In general, for any new product, start slow and don’t push it. See how your skin tolerates it first. 

Q. What are some signs of unhealthy skin that mean someone should seek the advice of a health care professional?

AZ: Any person with anything abnormal with their skin, hair or nails can come see a dermatologist, even if it’s to reassure you that something is normal. The scariest thing that we see is skin cancer, the most dangerous being melanoma. Check your skin regularly for anything out of the ordinary for you.

For melanoma, we use what’s called the “ugly duckling sign,” meaning that the concerning spot looks very different than any other spot on your body. If you develop something that is growing, bleeding, painful or just plain weird looking, please bring it in to be seen by a health care provider. 

Q. Many products don't require a prescription but improve the skin's appearance and ease minor issues. Tell us about some of your favorite products.

AZ: Because I could spend hours on this topic, I’ll just go through some of my favorite active ingredients to look out for.

Benzoyl peroxide is a go-to ingredient for me. It helps treats many conditions, such as acne, folliculitis and hidradenitis suppurativa. If you have red pimplelike bumps, chances are, it’ll be improved with benzoyl peroxide. 

Adapalene is another go-to product. It used to be a prescription-level retinoid but now is available over the counter. Retinoids are good for so many conditions, including acne, dark spots and even wrinkles. Use it at nighttime and skip a day or two in between if you are prone to dryness or irritation. Don’t forget to wear your sunscreen, though because it can make you sun sensitive. 

Minoxidil is a tried-and-true ingredient for male-patterned or female-patterned hair loss. Many companies sell minoxidil products now. Apply it one to two times a day, and be consistent. As soon as you stop using it, you lose all the benefit and go right back to where you started. If you have itching, burning or pain of the scalp, excessive or patchy hair loss or scarring, then please seek professional care from a dermatologist, as this could be a sign of a more serious form of hair loss. 

Azelaic acid is an excellent ingredient with anti-inflammatory, keratolytic and lightening properties. This can be found over the counter as high as 10%. I recommend it for people with acne, rosacea and dark spots. 

Lastly, coal tar is another age-old ingredient with keratolytic, anti-microbial, anti- inflammatory and anti-itch properties. If you have an itchy, scaly scalp, this is my go-to first recommendation.  

 

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Jennifer Manfrin writes for BestReviews. BestReviews has helped millions of consumers simplify their purchasing decisions, saving them time and money.

BestReviews spends thousands of hours researching, analyzing, and testing products to recommend the best picks for most consumers.

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