Let’s be honest — most skin “sins” aren’t deliberate and may not even be within your control. They sneak into your routine disguised as shortcuts, viral hacks, misunderstood “good habits,” or even as requirements of the healthcare system. As a board‑certified dermatologist, these little acts of skin betrayal show up every day in clinic, quietly contributing to irritation, flare‑ups, and frustration. This year’s Derm Betrayal list is here to help you spot them — and swap them for habits that actually support your skin.

1. Prior authorizations

They betray all of us. Nothing kills treatment momentum faster than the dreaded prior authorization, especially when it delays a medication or procedure you are ready to start. Staying informed about your insurance plan and being patient as we navigate the process together can make a big difference. Being open to alternative medications, different pharmacies (including mail‑order or compounding), or cash‑pay options can sometimes speed things up and keep your plan on track.

2. Ignoring your hands and neck

Your face shouldn’t get all the attention. Hands and neck often reveal age first, yet they are frequently left out of daily sunscreen and active treatments. Extend your skincare routine below the jawline every day, including sunscreen, moisturizer, and any anti‑aging products you’re using on your face.

3. Not telling the MA why you’re really here

Honesty helps the whole team help you. If your true concern is forehead lines, a “mystery spot,” or something you’re feeling a little shy about, tell the medical assistant right away. This ensures your visit, time allocation, and documentation match your priorities so your dermatologist can focus on what matters most to you.

4. Neosporin

A well‑intentioned betrayal. While it is a common household staple, Neosporin is a frequent cause of allergic contact dermatitis. For most minor cuts and scrapes, plain petrolatum ointment (like Vaseline or Aquaphor) is a gentler option to protect healing skin. If you are worried about infection, schedule a visit for an exam and, if needed, an antibiotic ointment that does not contain neomycin.

5. Not knowing your meds or products

It is incredibly difficult to give safe, precise advice when no one is quite sure what’s in “the red and white tube.” Not knowing your prescription medications, supplements, or skincare products makes it harder to avoid duplications, interactions, and irritants. Before your visit, make a quick list, snap photos of labels, or bring your products with you so your care plan can be tailored to what you actually use.

6. Lack of med spa regulation

Not all injectors or laser providers have the same training or level of medical oversight. In some settings, the supervising physician may not be on site, readily available, or even trained in cosmetic dermatology. There have also been reports of non‑FDA‑approved products being used and emergency medications, such as hyaluronidase (to dissolve filler), not being available. Before you book, ask about credentials, supervision, products used, and safety protocols — your skin and your health deserve medically sound care.

7. Magnifying mirrors

These are enemies of both your self‑esteem and your skin barrier. A 10x mirror encourages fixating on pores and “imperfections,” which often leads to picking, scrubbing, over‑exfoliating, and over‑treating. Stepping back to a normal mirror distance helps you focus on overall skin health instead of chasing microscopic flaws.

8. Washing your face before brushing your teeth

This tiny sequencing mistake can have a surprisingly big impact. Toothpaste residue and aerosolized particles can irritate the skin around the mouth and may worsen conditions like perioral dermatitis. Make it a habit to brush your teeth first, then wash your face so your cleanser can remove any leftover toothpaste from your skin.

9. Biotin

The “hair, skin, and nails” supplement has great marketing but often underdelivers. High doses of biotin can interfere with certain lab tests and may worsen acne in some people, without meaningfully improving hair growth unless there is a true deficiency. Lower‑dose biotin can support brittle nails, but for hair concerns, it is usually better to talk with your dermatologist about evidence‑based treatments and targeted supplements.

10. Hydrogen peroxide

Hydrogen peroxide is simply too harsh for healthy, living tissue. While it does kill bacteria, it also damages the cells that are trying to repair the wound, which can slow healing. For most minor cuts and scrapes, gentle cleansing with mild soap and water, followed by a bland ointment, is a much kinder choice.

11. Loofahs

Loofahs can feel satisfying in the shower, but they are excellent at trapping bacteria and creating microtears in the skin over time. This combination can worsen irritation, body acne, and sensitivity, especially if they are kept in a warm, damp environment. Opt for a clean washcloth, your hands, or a gentle chemical exfoliant instead, and wash or replace these items regularly.

12. Too many actives

Retinol, exfoliating acids, vitamin C, niacinamide, hyaluronic acid — it is easy to end up with a crowded lineup. More is not always better; layering too many active ingredients can overwhelm the skin, leading to redness, dryness, and breakouts. A streamlined routine with thoughtfully paired or combination products is usually more effective, more sustainable, and much kinder to your skin barrier.

Ready to retire a few derm betrayals?

Healthy skin is not about perfection; it is about small, consistent choices that support your skin over time. If you see yourself in a few of these habits, you are not alone — and it is never too late to make gentle, science‑based changes. If you are unsure where to start, or you’d like a personalized routine that works with your skin instead of against it, schedule a visit with our dermatology team and let’s build a plan that feels realistic, effective, and kind to your skin.