Skin Care Strategies from Peter Attia

Skin Care Strategies from Peter Attia

01/03/2026 | Kristen Sparrow, MD |
You can try to access some of this lengthy podcast here.  Attia was speaking with two prominent dermatologists.  I did a recent podcast here, on my recommended skin routine.

They covered a vast array of topics, from how the body aging affects the skin, to consent for minors, to the role of fat implants and fillers, not to mention the all too vicious, “beauty pressure” exerted by social media that caues people of all ages to do exaggerated interventions, which unscrupulous dermatologista and surgeouns are more than happy to provice.

Prevention.

The main strategy for prevention is sunscreen.  Obagi feels strongly that you should use mineral sunscreen since there is not evidence on the safety for chemical ones.  I wouls assume that in San Francisco, where we don’t have blazing sun and usually have long sleeves, a chemical/or mineral one on the face is enough.

So UVA is bad for aging/cancer. UVB is bad for burns and cancer.  High intensity visible light, and visible light lead to hyperpigmentation.  Infra red may go deeper, so might lead to fat atrophy in the subdermal layer.  We want thick, full dermis and subcutaneous layers for a youthful appearance, so getting rid of fat is NOT optimal. But the takeaway is that sunexposure is damaging to outer and deeper skin layers.  Melanin is a sort of parasol over the skin nuclei, which is why the more pigmentation you have genetically, the more resistant to aging your skin is.  “Black don’t crack” is a pithy saying concerning African American skin and wrinkles.

Retinol.  So you HAVE to do sunscreen, but the other most highly recommended strategy from dermatologists is retinol, or retin A.   Over the counter retinol is find for people in their 20’s.  Retinaldehyle is ok for people in their 30’s.  But after 40 or 50, you need to use prescription strength retin A, or tretinoin and other alternatives.  This keeps your skin making collagen and is your best bet for younger looking skin.  Collagen production peaks at age 18 in women.

I’ve had trouble getting used to tretinoin, even .05% and can only use it once or twice a week.  Obagi says to just gut it out and use it every day and within 6 weeks your skin will be used to it.  That’s hard to imagine! Tanuj Nakra says to mix it with hydrocortisone for the first few weeks.  That doesn’t sound healthy to me!  But, maybe a bit of judicious hydrocortisone would help.

Vitamin C.  The other strong recommendation was using Vitamin C serum.  It has many benefits.  I’ve never tried it, so not sure.  See the link below for vitamin C serums.

Moisturizer.

Nakra says if you get the cheapest moisturizer at the drug store and wear is religiously for 60 days your skin will look better, fuller.  It’s a key composnent for skin health.  But they also both have their own formalations, naturally.  See the links below.

As in keeping with my philosophy I will share a few things I learned about skin care itself, preventative and otherwise..  I did a YouTube on skincare here.

So what these two experts recommended as a minimum was

In the morning

  1. Cleanser.  Use a glycerine based cleanser, mild that doesn’t strip your skin of oil or disrupt the microbiome.
  2. Use a mineral based sunscreen

 

 

 

 

Cleansers

SPF Moisturizers