Dr. Azi Answers Your Questions
If you’re on “Skincare TikTok,” you’ve seen many aestheticians, cosmetic enthusiasts, and dermatologists delivering advice and entertainment to their viewers. Dr. Azadeh Shirazi – better known as Dr. Azi to her patients and followers – is among the most recognized faces on the “For You Page.” Dr. Azi is an internationally renowned dermatologist from La Jolla, California. She is recognized for delivering tailor-made care to meet her patients’ unique skin needs. At her clinic, La Jolla Dermatology and Laser Surgery Center, each dermatologic treatment is highly customized, because she believes “skin deserves couture care.” We had the honor of sitting down with Dr. Azi to get the inside scoop on all things skin. If you’d like answers regarding acne or aging gracefully, you’ll want to read on.
The HBM: Hello Dr. Azi! How often should a person see a dermatologist?
Dr. Azi: This really depends on your medical history. If you have skin cancer, you may need to be seen every six months. If you have acne, you may need to see a dermatologist and have regular follow-ups until the acne clears, which could be every two months.
The HBM: How do people know if they’ve found the right dermatologist for them?
Dr. Azi: It’s like anything else in life; you just know. You’ll know if you click with that person and if you find the information they’re telling you to be helpful. They’ll try to resonate with you, which is vitally important.
You have to trust them; that’s one of the most important things in terms of a doctor/patient relationship. There has to be that respect from both parties, and the trust you’ll feel will allow them to treat you effectively. So in my opinion, you’ll know and be fully aware when you find the dermatologist that’s perfect for you.
The HBM: What are the most common skin conditions patients come to see you for?
Dr. Azi: For the most part, I focus on cosmetic dermatology and skin cancer surgery, however, I do have a wide variety of patients. A large number of my patients come in with acne – I treat a lot of acne. I also see individuals for melasma, which is a skin condition characterized by brown, blue-gray, or freckle-like patches.
My practice is in Southern California, so there’s a lot of sun. When it’s nice out, people thoroughly enjoy being outdoors, so I also see a lot of sun-related concerns with the skin.
The HBM: What can cause acne flare-ups?
Dr. Azi: When it comes to acne, the flare-ups can depend on a lot of factors. Acne is very complex, and it’s truly a medical condition. However, your acne is not related to the foods you eat or you know what is commonly said – it’s all due to your gut health. While these things could be a part of your flare-ups, it’s a lot more in-depth than that.
Genetics, hormones, lifestyle, and skincare can also play a part in acne flare-ups. Sometimes even medicine can be involved. Things like Polycystic ovary syndrome (PCOS), which is a hormonal disorder common among women of reproductive age, may also contribute.
It’s best to have a thorough evaluation by a dermatologist to determine the type of acne you have. Afterwards, you’ll be able to receive treatments for your unique skin and acne type.
The HBM: What are some recommendations to avoid skin congestion and maintain clear skin?
Dr. Azi: Sometimes you’re doing all the right things, but your skin still doesn’t clear up. I see a lot of patients come in and when they tell me their skincare routine, I realize they’re using way too many products; they’re essentially trying too hard to clear their skin, leading to a damaged skin barrier and acne.
I think the best advice to avoid skin congestion and maintain clear skin is to not overdo it. Make sure you’re using products that are good for your skin type.
The HBM: Is there anything we can incorporate into our diet to help keep skin clear?
Dr. Azi: This goes back to the healthy lifestyle. You should definitely try to avoid too much sugar because if you have a high glycemic index, which is when your sugar levels are constantly elevated, then it can negatively affect your collagen and your sebaceous glands. Sugar can also contribute to the disruption of your skin’s microbiome and cause acne bacteria to overgrow.
It’s all about moderation and knowing what you put in your body. Try eating or drinking healthy amounts of grains, chocolate, alcohol, sweets, and greasy foods. You want to eat a lot of fruits and vegetables to make sure your body is getting the vitamins and nutrients it needs to function properly.
Exercising is also an important aspect when it comes to clearing your skin because, at the end of the day, your skin is a sort of manifestation of what’s going on inside your body. So when you’re healthy on the inside, your skin will show that.
The HBM: Why do you think society has such an obsession with staying young-looking?
Dr. Azi: I think that the obsession with staying young-looking has been there since the beginning of time. For example, in your mind, you may feel like a teenager; you might be a young spirit, but when you look in the mirror and see someone who is much older, then it just doesn’t resonate with you.
We are always seeking the fountain of youth because youth is commonly associated with health, beauty, and so forth. But I think it’s important to show that aging can be beautiful and that it’s not something we should try to avoid.
When people come in and ask me about aging, I usually say, “It’s better than the alternative. At least you’re healthy and thriving!” It’s easy for people to come obsessed with the idea of youth and aging skin, and it can become unhealthy really fast.
The HBM: What products should we never do without when it comes to our skin?
Dr. Azi: You should always have sun protection (SPF) because it’s key for so many aspects of the skin. SPF can have an effect on your pores, the health of your skin, and wrinkles. Sun damage is no joke, so you should always apply an SPF, even if you’re not going outdoors.
Retinols are also vitally important. Plus, they have the most science behind them. Vitamin C is wonderful for addressing signs of aging, but if you have rosacea, for example, you shouldn’t use products with vitamin C because it can be sensitizing.
The HBM: Is there a certain skincare regimen you generally recommend?
Dr. Azi: I’ll use well-aging as an example of a more generalized regime that I love to recommend. I tell my clients to use a gentle cleanser, vitamin C, and SPF day cream in the morning; I like to keep it super simple. At bedtime, using the gentle cleanser again and a tightening serum is best.
The HBM: How often should one exfoliate?
Dr. Azi: You should exfoliate once or twice a week. In my opinion, you don’t really need to do it more often than that. Some people can exfoliate every day and they're fine, but for most, one to two times a week is ideal.
The HBM: What is the best way to keep skin moisturized?
Dr. Azi: Staying hydrated is vital, so try to drink a lot of water throughout the day. In terms of skincare, I really love applying a serum right after cleansing onto damp skin because you seal in the hydration that way. Afterwards, you can use a heavier moisturizer.
Try to be aware of hyaluronic acid, and make sure not to overuse it. If you do overuse it, you can dry out your skin. When using products with hyaluronic acid, apply it to damp skin because it does need water to hold on to. Otherwise, it can dig deep into your skin, ending up in your skin cells.
The HBM: What type and level of sunscreen do you recommend to best protect our skin?
Dr. Azi: I always recommend an SPF-30, but if you’re not one to apply much SPF, then I’d say you should go to a higher number, such as SPF-50 or SPF-60.
I’m a huge fan of SPF powder brushes! I use the SunKissed Powder SPF; I think that it’s an easy way to reapply and it gives me some coverage while getting rid of any shine, oil, or sweat on my skin. I use it consistently throughout the day because if you apply it in the morning and go out in the evening, then it’s not going to be very effective.
I actually have a TikTok video on this product!
The HBM: What is the one thing that everyone should know about their skin?
Dr. Azi: You should know what type of skin you have, and if you aren't sure, then you should try seeing a dermatologist. Getting to know your skin early on in your life is so important; it’ll give you the knowledge of what products you should use and which ones you should avoid.
You may have sensitive skin and hyperpigmentation, for example, so you don’t want to use vitamin C, you’d want azelaic acid. It all comes down to the fact that knowing your skin is key, and a dermatologist can help you do just that.
